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Has the 'Bone Ban' been enforced?
French cows slaughtered after madcow disease found
British doctors warn against eating raw meat
Europe proposes to ease ban on N.Ireland beef
Dispute over meaning of World Trade Organization beef ruling
Beef farmers to march on army barracks in food war
Agency 'will not tell people what to eat'
New agency: 90% old MAFF staffers
British scientists are working on low-fat meat substitute
Outbreak of swine fever in Germany

The hidden incidence of CJD
History of CJD Voice family support group

Agency 'will not tell people what to eat'

January 15 1998 Times by Nicholas Watt, Michael Hornsby and Robin Young
Every food shop and caterer in Britain faces a 100 levy to finance the new food safety watchdog announced by Dr Jack Cunningham yesterday. The flat charge would apply to anyone dealing in food - from manufacturers to hotels and from village corner shops to hypermarkets - to raise more than half the 100 million cost of setting up a food standards agency.

The agency will be independent of the Government and have powers to set standards, monitor safety and offer advice on diet and nutrition - although Dr Cunningham, the Minister of Agriculture, promised: "It will not tell people what they must eat." But while the plans, outlined in a White Paper entitled The Food Standards Agency, A Force for Change, were welcomed by producers and consumers alike, there was some consternation about the licensing system to raise 60 million towards setting up the agency. The White Paper says:

"The Government considers that the most appropriate mechanism for shifting the burden of cost away from the taxpayer towards the industry would be to introduce a comprehensive system of registration or licensing with fees. Such a scheme would both extend and consolidate the existing registration and meet the costs associated with the new agency."
But Michael Mackenzie of the Food and Drink Federation described it as the equivalent of a "food poll tax" that would inevitably be passed on to customers and push up prices. Dr Cunningham later said that the fee was only a proposal, which was open for consultation, and he suggested that small businesses might be exempted - although he also pointed out that many food scares had originated from small butchers. The worst example was the E.coli outbreak traced to a Scottish butcher's shop, which left 20 people dead and 400 ill.

The Government's proposals are designed to restore public confidence after such incidents and reduce the number of food poisoning cases. Dr Cunningham told MPs: "Our proposals represent a radical approach in which the clear priority is to protect public health. The agency will be a powerful new body, able to publish its advice to ministers, free of vested interests and able to act clearly and decisively at all stages of the food chain."

The agency will be run by a chief executive and 12 commissioners who will monitor the food safety; commission research; monitor standards of food law enforcement; prepare draft legislation and public information and negotiate with the European Union. Although it will not tell people what they should and should not eat, the agency will improve food labels to help consumers to make up their minds.

The commissioners will report to the Health Department rather than to Dr Cunningham's ministry, removing the perceived conflict of interest resulting from the Agriculture Ministry's dual responsibility for food safety and promoting producers' interests. They will even have the power to censure the Agriculture Ministry if it fails to provide sufficient safeguards.

Dr Cunningham's announcement was almost universally welcomed. The Consumers' Association said it was the "best news" after a decade of food scares and the National Farmers' Union said the agency should assure the whole food chain and consumers of a consistent approach to food safety.

The food industry had wanted nutrition to be outside the agency's remit, but the Association for Public Health said that with seven out of ten cases of cancer and three out of ten cases of coronary heart disease being food related, its inclusion was vital. In the Commons, Dr Cunningham had said: "The agency will aim to help people who want to be healthier to choose a suitable diet. It will not tell people what they must eat."

Professor Philip James of Aberdeen University, whose report formed the backbone of the White Paper, was surprised and delighted by the extent to which his proposals had been adopted. The agency could not improve safety overnight, "but I would hope that in three to five years, the incidence of food poisoning will have levelled off or be diminishing."

New agency that will monitor all we eat: Nutritionist's winning recipe

January 15 1998 Times Michael Hornsby 
THE proposed new food standards agency unveiled yesterday by Jack Cunningham, the Minister of Agriculture, will be an independent body with the power to monitor the safety of what we eat from plough to plate.

Dr Cunningham said that most of the costs of running the new body would have to be borne by the food industry and admitted that this was likely to mean higher shop prices. "If we want better and safer food standards, then we will have to pay for it," Dr Cunningham said.

The 81-page document estimates that annual expenditure on the agency, which is not expected to be in operation before the middle of next year, will be in excess of 100 million.

Up to 35 million of this could come from existing levies on the food industry, the paper says, but suggests that a further 60 million could be raised by a flat-rate licensing fee of 100 charged on all the 600,000 registered food premises in Britain.

Dr Cunningham said this was one of various possible financing mechanisms that would be examined during the two months of consultation on the White Paper with all interested parties. The paper says that the Government is considering "passing on the greater part of the costs of food safety work directly to the food industry, recognising that over time the bulk of these costs are likely to be passed on to the consumer".

The agency will be a single body covering the whole of the United Kingdom, with an independent chairman heading a commission of at least 12 members, representing "a reasonable balance of skills and experience", with a majority drawn "from a wider public-interest background without specific affiliation". The members will include consumer representatives.

The commission will also have members representing the special interests of Scotland, Wales and Northern Ireland. There will be separate executives, answering to a British chief executive.

When established, the agency will be accountable principally to the Health Secretary, Frank Dobson, and will take over virtually all the food safety responsibilities now exercised by the Ministry of Agriculture, Fisheries and Food.

Dr Cunningham said he believed the existence of the agency would make it possible to establish a better balance than in the past between the interests of food producers and food consumers.

However, many of the staff of the agency will come from the Ministry of Agriculture. Dr Cunningham said the agency would have a total staff of "several hundred". They would be civil servants, with 90 per cent being drawn from the existing personnel of the Ministry of Agriculture, and the remainder coming from the Department of Health.

The agency will provide policy advice to ministers, will help in the preparation of legislation and will also supply technical advisers to assist ministers during European Union and other international negotiations.

Two important bodies, the Veterinary Medicines Directorate and the Pesticides Safety Directorate, will remain attached to the Ministry of Agriculture.

The agency will be able to commission its own research, and will have a research budget of around 25 million a year. It will assume responsibility for assessing the safety of new foods, including those that have been genetically modified, and will share supervision of the work of Seac, the committee that advises the Government on "Mad Cow" disease, with the Department of Health and the Ministry of Agriculture.

The food standards agency will: 

    Be independent and be headed by a commission of up to 12 members
  from a range of interests. 

    Have a back-up staff of several hundred, drawn from the Ministry of
  Agriculture and Department of Health. 

    Be responsible for the whole of the UK, with separate executives for
  Scotland, Wales and Northern Ireland. 

    Cost in excess of 100 million a year, most of which will be borne by
  a charge on the food industry. 

    Have a research budget of about 25 million a year. 

    Have the power to supervise enforcement of food safety from plough to

    Have the final say on advice given to ministers about safety of
  pesticides and veterinary medicines. 

    Be responsible for licensing all abattoirs. 

    Draft legislation on the labelling of food. 

    Share with the Department of Health the task of advising the public on
  a healthy diet. 

Nutritionist's winning recipe

THE blueprint for the food standards agency is a triumph for Philip James, who drafted the original plan and has seen off objections from the food industry, scientists and at least one Cabinet minister.

It is also a red-letter day for the National Food Alliance, an umbrella body of health and consumer advocates chaired by Professor James since 1990. The NFA campaigns for changes in the way food is produced and distributed, in order, as it says, "to improve the health of the general public".

Though little known to the public, Professor James is a powerful figure in the world of human nutrition, where egos clash as regularly as rival theories on healthy eating. Yet for the past 15 years his job has been to run the Rowett Research Institute, an animal research centre in Aberdeen.

James: powerful figure

Rivals say he was frustrated not to be put in charge of a leading human nutrition centre and has been patiently building a powerbase ever since. When Tony Blair, as Leader of the Opposition, asked him to prepare the outline of Labour's food safety agency, Professor James required no second bidding.

With skill and speed he produced his outline, which put nutrition high on the agenda. Other scientists and the Royal Society advised that food safety, not nutritional advice, was the most urgent need. Peter Mandelson, Minister without Portfolio, agreed.

That advice was swept aside. The new agency will have responsibility for the safety of food and its nutritional value. The danger, the food industry says, is that the tail will wag the dog and the agency will devote itself to well-meant advice to the public while food poisoning cases continue to rise.

Much will depend upon whether a microbiologist or a nutritionist ultimately takes the agency's helm. Professor James is approaching 60, retirement age for government service, so may he see the ultimate prize slip from his grasp. But it would be unwise to count him out.

Recently he stopped a government report as the printers were preparing to run it off. The report, by the committee on medical aspects of food policy, did not take a strong enough line on the alleged risks of eating red meat to satisfy Professor James.

Europe proposes to ease ban on beef

THE European Union yesterday took its first step towards easing its 21-month worldwide ban on the sale of British beef when the European Commission proposed allowing the export of meat from some herds in Northern Ireland.

The move, to permit the sale of meat from younger cattle from herds that are certified free of BSE, was hailed in Strasbourg by Robin Cook, the Foreign Secretary, as "a first step down the road, but a very big one".

But opposition to any easing of the ban from Germany and several other EU states raises doubts over whether the proposal will win the necessary approval from a majority of member states. Only Ireland and The Netherlands have publicly backed the proposal, which must go first to veterinary officials from the member states.

Jack Cunningham, the Agriculture Minister, said the Government "will be doing all we can to persuade the member states, as we have just persuaded the Commission".

 Mon, 12 Jan 1998 Edward Apling University of Reading
"Since the English (and Scots and Welsh) are generally exceedingly law-abiding the genrality is that beef on-the-bone has disappeared - and certainly from supermarket shelves. The supplies they had at the time of the ban sold out quickly as people rushed to fill their freezers with their favourite cuts.

However, a common advertisement on butchers' shop-windows is: "WANTED - BEEF ON THE BONE" and a considerable number of butchers are refusing to comply with what they see as a completely unwarranted ban on their major sales items - and some ARE still selling beef on-the-bone. The control authorities do not seem, so far, to have taken any action.

At the next race meeting at Fakenham race-course (a compatively small course near me) there will be a Beef-on-the-Bone Handicap with the prize donated by a local butcher..... [But then the Norfolk county slogan is "Du diffrn't" (do different)],... and letters to the local daily paper have contrasted the beef ban with the refusal of governments to take action to control a variety of health hazards.

It does seem that the British public are becoming surfeited with food scares and determined to follow their tastes rather than what they are instructed.... The TV started another hare this morning by headlining the British Medical Associations submission (correctly) that all raw meat products should be regarded as potentially dangerous - i.e. always be well cooked and precautions taken to avoid cross-contamination with cooked or raw foods. The TV announcement ended at the word dangerous above!"

French cows slaughtered after madcow disease found

 Reuters World Report Mon, Jan 12, 1998
RENNES, France - A 135-strong herd of cows was slaughtered in France at the weekend after one of the animals was discovered to have mad cow disease, the Agriculture Ministry said on Monday.

It was the 32nd case of BSE (Bovine Spongiform Encephalopathy) recorded in France since 1990 and the first this year. The four-year-old infected cow came from a dairy herd in the northwestern region of Normandy. The other animals were destroyed as a safety precaution, the ministry said.

British doctors warn against eating raw meat

January 12, 1998  Agence France-Presse 
LONDON ) - The British Medical Association on Monday warned in a report to members of parliament that all raw meat should be considered infected and a possible source of food poisoning.
"The current state of food safety in Britain is such that all raw meat should be assumed to be contaminated with pathogenic organisms," the report said.
It said that the number of cases of food poisoning was at its highest ever in 1997, with 1 million people infected by salmonella or E. Coli 0157 bacteria and 200 people dying as a result.
"The only safe approach for the food industry and general public is to treat all raw meat as infected and adopt universal precautions in handling and cooking raw meat," the report said.

Europe ready to accept some beef from Northern Ireland

January 12, 1998 Agence France-Presse 
BRUSSELS - A proposal to lift the ban on British beef for certain categories of meat from Northern Ireland is to be adopted by the European Commission on Wednesday, European sources said Monday. The proposal, which has to be approved by EU governments before being implemented, represents the first significant step towards a relaxation of the worldwide embargo on British beef. The ban was imposed by Brussels in 1996 after the British government revealed a possible link between BSE, or 'mad cow' disease, and a fatal human brain condition.

The move to ease the ban comes after a panel of scientists that advises the commission last month gave conditional approval to Britain's proposals to resume exports of meat from cattle aged between six and 30 months from herds that have been certified as BSE-free. Agriculture Commissioner Franz Fischler's decision to seek an easing of the ban first for Northern Ireland reflects the fact that the province has had a much lower incidence of BSE than mainland Britain. Northern Ireland also has the advantage of having had a computerised cattle tracing system in place since 1988, making it much easier to establish the history and movements of individuals animals. The rest of Britain has only compulsory cattle passports since July 1996.

Although Fischler's proposal is expected to be adopted without any problems by the 20-member commission on Wednesday, it is likely to be March or April at the earliest before a formal decision is made to ease the ban. The commission's proposal will be discussed for the first time by chief vets from the 15 EU countries at a meeting of the bloc's Standing Veterinary Committee (SVC) on January 21.

The SVC has the power to sanction legislation easing the ban if this is backed by a qualified majority of them under the EU's system of weighted voting. But this outcome is seen as unlikely given the depth of reservations in some capitals about the impact of any resumption of British beef exports on still-fragile consumer confidence in the rest of Europe. If the SVC cannot make a decision, the proposals will be referred to agriculture ministers at talks on February 16-17. If there is still no qualified majority for the proposal, and provided a simple majority of EU governments (at least eight) do not vote against it, the commission can then decide itself to implement its proposal.

British scientists are working on low-fat meat substitute

January 13, 1998 By MARIE WOOLF Scripps Howard 
LONDON (01:25 a.m. EST -- A meat substitute made from a 2,000-year-old Indonesian mold and a grain eaten by the Incas is being developed by the European Union. The high-protein rival to tofu, a soybean curd, is being produced by British scientists and should be on supermarket shelves by the end of the year. The European Commission, conscious of the demand for meat substitutes following the "mad cow disease" crisis, is funding research by a group of small organic food companies and European farmers.

The new food, yet to be named, has a squashy consistency and strong mushroom taste. It's low in fat and can be fried, baked or used in processed foods. It relies on the 2,000-year-old technique for manufacturing "tempeh" (still a staple of the Indonesian diet), which involves bonding a mold to soybeans, but the new product will use quinoa, a hardy grain grown in the Andes. Quinoa is used because the plant can be grown in the most arid climates, where it will boost the income of small farmers in remote areas. The first crop is to be grown this year in the Greek hills and sent to Britain for processing with the mold.

Trial batches have been produced by food scientists from the University of Westminster in London and Leatherhead Food Research Laboratory in Surrey, south of London.

"The final result has a very strong mushroomy taste," said David Williams of Plas Farm Ltd., part of the consortium and a producer of vegetarian foods. "The EU is funding it partly because it's the ideal crop for mountainous areas in Italy and Greece."
Demand for meat substitutes has grown following health scares over beef, but many rely on soy beans for their base, and the use of genetically modified soy from the United States is causing concern in the Britain. The European Commission has provided a $585,000 grant, and development of the food will be paid for by farmers and organic food companies.

CJD Voice update

15 Jan 98 Liz Armstrong, CJD Voice moderator
"I am the moderator and one of three "founders". We formed this group in May of 1997 in an effort to share information with others, lobby for increased research funding, to have CJD made a reportable disease nationally, as well as to support families, as what one member named, "the walk through hell".

The three of us began posting messages on medical boards all over the internet after we lost a loved one to CJD. Our professional backgrounds vary, however, none of us are medical professionals directly related to CJD research. In less than 8 months our group has grown from 3 members to almost 100, and continues to grow each day. We also have a mailing list which is used as both a discussion forum and a support forum.

Our success with CJD Voice has been tremendous, as has the member participation. Many members have written to elected officials and the CDC and continue to follow up on a daily basis. Our group wants increased funding to prevent the closing of the CJD research facility at NIH and we want to see CJD made reportable nationally. Another major concern among the members is the lack of knowledge and/or understanding of CJD within the medical community.

The horror stories are endless, patients misdiagnosed and confined to psyciatric wards and strapped down; family members actually having to force neurologists to perform a spinal tap in order to obtain the 14-3-3 test; facilities refusing to allow a CJD victim to remain after a positive diagnosis; pathologists refusing to perform autopsies (the only 100% accurate diagnosis); funeral homes refusing to accept CJD victims, the list is endless!

It is only with our combined efforts that we can ever hope to change the way CJD is handled. I hope I have answered your questions. If I can be of any further assistance, please feel free to contact me. You can also visit our homepage at: CJD Voice"

The hidden incidence of CJD

18 Jan 98 Listserve and correspondence
Dr. Birgitte Bendixen, assistant professor in the University of Iowa College of Medicine's Department of Neurology has been quoted as stating in 1996
'When we do autopsies, we find that five of every 100 people who have been diagnosed with Alzheimer's had CJD,''
This is reportedly just background information she provided in a talk on new variant-CJD. The data comes from autopsy or biopsy series of patients with a preliminary diagnosis of dementia for biopsy. The two abstracts below support this though one cannot extrapolate as patient groups may not have been statistically representative: the data does not mean that 5-28% of all demented patients have CJD as doctors rarely choose to brain biopsy on someone with dementia unless the person has a treatable illness or one that may present a risk for caretakers. To get more accurate knowledge about the incidence of CJD,more biopsies and autopsies are needed.

Diagnosis of dementia: clinicopathologic correlations.

Neurology 1989 Jan;39(1):76-79 
Boller F, Lopez OL, Moossy J
Based on 54 demented patients consecutively autopsied at the University of Pittsburgh, we studied the accuracy of clinicians in predicting the pathologic diagnosis. Thirty-nine patients (72.2%) had Alzheimer's disease, while 15 (27.7%) had other CNS diseases (four multi-infarct dementia; three Creutzfeldt-Jakob disease; two thalamic and subcortical gliosis; three Parkinson's disease; one progressive supranuclear palsy; one Huntington's disease; and one unclassified). Two neurologists independently reviewed the clinical records of each patient without knowledge of the patient's identity or clinical or pathologic diagnoses; each clinician reached a clinical diagnosis based on criteria derived from those of the NINCDS/ADRDA. In 34 (63%) cases both clinicians were correct, in nine (17%) one was correct, and in 11 (20%) neither was correct. These results show that in patients with a clinical diagnosis of dementia, the etiology cannot be accurately predicted during life.

Evaluation of cerebral biopsies for the diagnosis of dementia.

Arch Neurol 1992 Jan;49(1):28-31 
Hulette CM, Earl NL, Crain BJ
To identify those patients most likely to benefit from a cerebral biopsy to diagnose dementia, we reviewed a series of 14 unselected biopsies performed during a 9-year period (1980 through 1989) at Duke University Medical Center, Durham, NC. Pathognomonic features allowed a definitive diagnosis in seven specimens. Nondiagnostic abnormalities but not diagnostic neuropathologic changes were seen in five additional specimens, and two specimens were normal. Creutzfeldt-Jakob disease was the most frequent diagnosis. One patient each was diagnosed as having Alzheimer's disease, diffuse Lewy body disease, adult-onset Niemann-Pick disease, and anaplastic astrocytoma. We conclude that a substantial proportion of patients presenting clinically with atypical dementia are likely to receive a definitive diagnosis from a cerebral biopsy. However, in those with coexisting hemiparesis, chorea, athetosis, or lower motor neuron signs, cerebral biopsies are less likely to be diagnostic.

Other interesting papers from Hulette:

Rapid brain autopsy. The Bryan Alzheimer's Disease Research Center experience.

Arch Pathol Lab Med 1997 Jun;121(6):615-618 
Hulette CM, Welsh-Bohmer KA, Crain B, Szymanski MH, Sinclaire NO, Roses AD
To develop a system for retrieving brain tissue within 1 hour after death in an effective and useful manner. Nurse clinicians were employed as study co-ordinators and were available to families 24 hours each day. Autopsies were performed at Duke University Medical Center, Durham, NC, from 1985 through 1995. Neuropathology faculty, fellows, and residents, autopsy technicians; and brain bank staff. Fifty-one rapid autopsies with a postmortem interval of less than 1 hour have been performed. Four of these were normal controls, has been distributed to 93 research teams, 30 of these located at Duke University Medical Center. Many researchers have received multiple shipments of tissue. The Rapid Autopsy Program at Duke University Medical Center has been successful in retrieving tissue from individuals with dementia and also from controls within 1 hour of death.

Creutzfeldt-Jakob disease in a pregnant woman with an implanted dura mater graft.

Neurosurgery 1994 Apr;34(4):737-739 
Lane KL, Brown P, Howell DN, Crain BJ, Hulette CM, Burger PC, DeArmond SJ
A 28-year-old woman with prior neurosurgery involving the placement of a cadaveric dural graft developed a rapidly progressive neurodegenerative disorder with prominent cerebellar dysfunction that was proven at autopsy to be Creutzfeldt-Jakob disease. She represents the second American to develop Creutzfeldt-Jakob disease in association with a dural graft. The unusual features of the case include the patient's initial clinical presentation with cerebellar ataxia in the absence of dementia, the widespread presence of kuru-type amyloid plaques on a histological examination of the brain, the development of clinical symptoms during pregnancy, and the subsequent delivery of a child who remains healthy at the age of 3 years.

Experiences of CJD Voice members with incidence data

15 Jan 98  Mary Nupensmith
There are several feature of TSE's and CJD in particular which could explain the static, "supposed" 1-2 cases per million.

1) The incubation period before CJD becomes symptomatic is up to 40 or 50 years. Until the second half of this century, the average life span of human beings has been well below 65 years. Age 65 is the generally ascribed median age of CJD victims. Until recently, large numbers of people didn't live long enough to become symptomatic for CJD, even if infected.

2) The blatantly symptomatic duration of illness in typical CJD (sporadic-85%) is generally under one year and often only two or three months. The rapid progression of the disease and, in particular the dementia, overwhelms the victim and, unless there are caregivers on site who are in a position to very actively advocate for the victim, they will be dead long before a disgnosis is achieved.

3) The most common initial diagnoses of CJD are stroke and Alzheimers. (Of 24 individual cases reported to CJDVOICE by family caregivers, 7 listed stroke as the initial diagnosis and 3 listed Alzheimers.) Almost all of the initial diagnoses are typically diseases of the elderly. Of these, in addition to stroke and Alzheimers, CJDVOICE families listed: Parkinson's, dementia, and just plain "unknown" with the underlying and unstated "old age."

4) Because of the age of the victim, neither stroke nor Alzheimer's victims are routinely autopsied. If CJD has not been diagnosed or even suspected antimortem, it is unlikely that any further investigation will be made postmortem. Old people have strokes. Old people get Alzheimers and other dementias. Old people die. Case closed.

5) In the United States at least, medical clinicians (the front line diagnosticians and caregivers) are woefully uninformed about CJD.

6) Statistics for the number of cases of CJD are being amassed, in the United States at least, by death certificate data in five "pilot" areas (4 states and the area around Atlanta, Georgia). If CJD is not listed on the death certificate, it is not reported.

7) At least two of the reporting members of CJDVOICE (to date, our statistics on this issue are very incomplete) whose family members died of confirmed CJD, reported that CJD did not appear on the death certificate. These are 1996 and 1997 cases. It is unknown how many diagnoses were never made and, therefore, unreported.

8) CJDVOICE was established in June 1997. There are some 80 members to date. Of those 38 have reported individual statistics on year of death. Of those 38, 20 victims died in 1997. Based on the US population, the CDC tells us there should be approximately 260 cases of CJD in the US per year. Is it possible that in 7 months a grass roots start-up group has located 7-8% of those cases through a medium (the internet) not available to a majority of the populace?

9) Most of the members of CJDVOICE report that it was only the insistance of the family and their dogged pursuit of a diagnosis that resulted in finding CJD. The doctors were content with stroke or "fast" Alzheimers and, once dementia set in and cure or even amelioration seemed virtually unattainable, the clinicians did not, on their own initiative, actively pursue "far out" diagnoses (if they even knew of CJD). It is only recently that the 14-3-3 protein test has become available for antimortem diagnosis. Routine tests, even CTscans and MRI's are normal. EEG's may be normal or MAY show a brain wave anomally, but are not confirmatory. Brain biospies are not normally performed on elderly patients. It is not unlikely that managed care, cost constraints, Medicare bureaucracy, etc. play a significant part in this.

10) A paper by Dr. Manuelidis at Yale indicated that a retrospective analysis of the brains of Alzheimer's victims showed that between 1 and 13% had actually died of CJD. There are some 4 million Americans with Alzheimers in the United States annually. Incidence of Alzheimers is increasing. Do the math.

[The reference is "Manuelidis,E.E.; Manuelidis,L. - Suggested links between different types of dementias: Creutzfeldt-Jakob disease, Alzheimer disease, and retroviral CNS infections. - Alzheimer Disease and Associated Disorders 1989 Spring-Summer; 3(1-2): 100-9" They found 6 patients with CJD among 46 with an Alzheimer diagnosis. This is important and interesting, but the number 13% is not the last word.]

Therefore, in answer to Paolo's question, "why are we seeing such a big AIDS epidemic while CJD incidence is still at 1-2 cases per million? Shouldn't it have increased dramatically through the decades?" the answer may well be, IT HAS.

English experience with dementia disease surveys

Ralph Blanchfield Listserve 12 Jan 98
This does indeed suggest a large hidden incidence of CJD.

However, also of relevance here is the paper by Bruton, CJ et al (1995) "Diagnosis and incidence of Prion (Creutzfeldt-Jakob) disease: a retrospective archival survey with implications for future research", Neurodegeneration, Vol 4, 357-368.

They carried out retrospective brain histopathology on the neuropathological archive (Corsellis Collection) of brains at Runwell Hospital, a large institution for "the mentally ill". This is a collection of (at the time) 6559 brains collected between 1964 and 1990, not only from the hospital but from a wide variety of psychiatric and general hospitals in SE England (area population in 1989 was 19.4 million).

They examined the 1000+ brains of patients who in life had been considered to suffer from dementia. They found 19 cases that were actually CJD, of which 11 had been diagnosed as such before death. This suggests that only about 60 percent of CJD cases had been identified as such during life in the 25 year period up to 1990. This in turn would suggest a real incidence in SE England in the period averaging around 2 per million rather than 1 per million -- hardly the vast hidden incidence that would answer Paolo's query.

For understandable reasons, with the formation of the UK CJD Surveillance Unit in 1990, there was a very substantial increase in surveillance (Cases are notified to the Unit from a variety of sources including neurologists, neuropathologists, neurophysiologists, general physicians, psychiatrists, electroencephalogram (EEG) departments etc. As a safety net, death certificates coded under the specific rubrics 046.1 and 331.9 in the 9th ICD Revision are obtained from the Office for National Statistics in England and Wales, the General Register Office for Scotland and the General Register Office for Northern Ireland).

The effect of the post 1990 surveillance was reflected in annual totals from 1992 fluctuating around 50 rather than pre-1990 totals fluctuatiing around 30 (a noteworthy comparison consistent with the Bruton et al findings). Surveillance was further intensified from the watershed date of 20 March 1996, and Robert Will's letter to all neuropathologists. The totals in recent years, in a population of 58 million were 59 in 1994, 46 in 1995, 60 in 1996 (all figures including the nvCJD cases). The total to end of November 97 was 46 which suggests that the 1997 total will be down from 1996.

Independent 16.1.98

Beef farmers to march on army barracks in food war

S. Dealler Web site  19 Jan 98
The UK army was not buying enough UK beef and so the farmers are to stop the army using their land for practice.

Independent 15.1.98

Europe offers export hope to Ulster beef farmers. The first UK red beef could be back on sale in Europe by Easter after a partial lifting of the ban as the EC asked member countries (on 21 Jan) to allow beef exports from Northern Ireland. Exports would be allowed only for deboned meat from cattle aged between 6 months and 30 months which comes from herds free of BSE for at least 8 years and slaughter and processed on approved premises. Emma Bonino ruled out any exports from Northern Ireland which pass through British meat factories. A majority of the Governments at the meeting are unlikely to agree so the EC is to then submit it to the council of EU agricultural ministers. At this Germany is expected to do all it can to prevent the ban being lifted.

Farmers Guardian 9.1.98

Bone-in beef ban could cost 140 million pounds. Meat and Livestock Commission data showing sales of foreribs as 97 million, T bones as 30 million and oxtails as 11.25 million.

Nycomed Amersham agent linked with mad cow disease

Several weeks ago Nycomed Amersham withdrew a contrast agent for lung examination after it was discovered that a blood donor from whom albumin was taken for use in the agent had died of new variant Creutzfeld-Jakob disease. The blood had been purchased from The National Blood Authority Laboratory, an authorized supplier in the UK, and was certified as suitable for this application. It is theoretically possible that the company could be sued for damages but Nycomed Amersham thinks that there will be no serious financial consequences.

Dispute over meaning of World Trade Organization beef ruling

January 16, 1998 Reuters
GENEVA (12:13 p.m. EST - The European Union and the United States clashed Friday over the meaning of a World Trade Organization ruling that found the EU's ban on hormone-treated beef ran against a global food safety pact.

Senior U.S. officials in Washington and Geneva insisted the finding by a WTO appeals board issued earlier in the day was a "clear win" for them that gave the EU no justification for keeping the 9-year-old ban in force. "They (the EU) have no wiggle-room on this," U.S. ambassador to the WTO Rita Hayes told reporters. "There is no leeway one way or the other" and the veto, which U.S. farmers say has cost them hundreds of millions of dollars, had to go.

But in Ottawa, EU Trade Commissioner Sir Leon Brittan, on a visit to Canada, which lined up with the United States to challenge the ban in the WTO, said the ruling "does not require ... the cessation of the ban immediately." In Brussels, Brittan's spokesman Nigel Gardner said the "well-informed judgment" meant the ban could stay in place while the EU carried out an assessment of the risk to human health from eating beef from cattle fed with growth hormones.

There was no formal interpretation from the WTO of the 104-page ruling by the three-man board, chosen from the organization's fiercely independent seven-member Appellate Body of leading experts on trade and trade law. But the wording of their report reviewing the ruling of an earlier WTO dispute panel, which went clearly against the EU, left no doubt that they upheld a key finding that the ban broke trade rules because it was not based on a "risk assessment."

They said a prime aspect of the EU action, imposed in 1989, was "inconsistent" with terms of the WTO's SPS Sanitary and Phyto-Sanitary agreement on food safety. And they recommended that the WTO's Dispute Settlement Body request the EU to bring its operation of the ban "into conformity" with the 15-nation bloc's own obligations under the accord. But their report, in detailed technical and legal terms, confirmed they had overturned or modified several conclusions of the earlier panel -- an aspect hailed in Brussels. It also left open to interpretation exactly what the EU had to do to come into line.

Outbreak of swine fever in Germany

January 16, 1998 Reuters 
BERLIN - The slaughter of tens of thousands of pigs began Friday after an outbreak of swine fever was detected at one of Germany's biggest piggeries. Farm authorities in northeastern Germany said all the estimated 62,000 animals at the farm near the town of Bad Kleinen in the state of Mecklenberg-Vorpommern would have to be killed at a cost of around $5.5 million. As many as 15,000 pigs in Lower Saxony, 7,600 in North Rhine-Westphalia and up to 3,500 in Schleswig-Holstein might also have to be slaughtered even though there was no sign yet that the disease had broken out there, state authorities said.

The chief veterinary surgeon in Mecklenberg-Vorpommern, Klaus Wilke, said the current slaughter represented about 10 percent of Germany's reared pig herds. Half the losses to the breeding farm where the disease first broke out would be compensated for by state authorities and the rest by a German fund that covers losses due to animal disease, Wilke said. European Union Farm Commissioner Franz Fischler, speaking at an agricultural trade fair in Berlin, urged swift action Friday to eradicate the disease from German herds.

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