Document Directory

13 Oct 98 - Calman admits 'safe' beef could have had BSE
13 Oct 98 - The BSE blackout
13 Oct 98 - Ministry 'blocked BSE disclosure'
13 Oct 98 - 'Bubbly' daughter is 28th victim
13 Oct 98 - Farmers 'didn't take BSE fight seriously'
11Oct 98 - BSE vet: I'm not guilty
10Oct 98 - Ministry accused of 'playing down' BSE
06 Oct 98 - Bones will light homes
04 Oct 98 - Cow from 'safe' herd had BSE
02 Oct 98 - BSE food test plea 'ignored'
02 Oct 98 - Same strain of CJD kills man and his pet cat
01 Oct 98 - Safe beef pledge was given despite fears of BSE link
01 Oct 98 - Man and his cat in CJD mystery
30 Sep 98 - Feed banned in Britain 'used for Sainsbury pork'
30 Sep 98 - Ministry 'team of BSE clowns'
28 Sep 98 - Cow gets barcode in bid to beat beef ban
23 Sep 98 - Abattoirs 'ignored BSE safety rules'
23 Sep 98 - Meat firms 'flouted rules on BSE'
17 Sep 98 - Advisers divided over BSE screening
11 Sep 98 - Experts back new tests for hidden BSE
08 Sep 98 - BSE in lamb clue '10 years old'
28 Aug 98 - Test may reveal how many will die of CJD
28 Aug 98 - Disease could be spread by surgical tools
28 Aug 98 - Trail that led to a deadly discovery
27 Aug 98 - New CJD shock
27 Aug 98 - Moral Dilemma As Government Launches CJD Tests
17 Jul 98 - Dobson acts on CJD blood threat
17 Jul 98 - CJD risk threatens ban on British blood



13 Oct 98 - Calman admits 'safe' beef could have had BSE

Michael Hornsby reports

Times ... Tuesday 13 October 1998


Former Chief Medical Officer says his all-clear was not meant to be taken literally .

Sir Kenneth Calman told the BSE inquiry yesterday that when he said British beef was safe to eat, he meant that the risk from BSE was negligible and not that it was "zero" .

"If you look at 'safe' in ordinary speech, we do not mean that a driver we describe as safe will never have an accident," the former Chief Medical Officer said. The word "safe" in that sense, he said, meant "free from unacceptable risk or harm".

During his time in office Sir Kenneth signed public statements vouching for the safety of British beef , endorsing reassuring newspaper advertisements taken out by the Meat and Livestock Commission as late as December 1995. Yet by this time, according to his own account, he had serious doubts about the efficacy of measures taken by the Ministry of Agriculture to stop BSE-infected material getting into food for human consumption.

Three months later, the Government admitted that a new form of Creutzfeldt-Jakob disease (CJD), a fatal human brain condition, was probably caused by exposure to BSE. Yesterday Dorothy Churchill, whose son, Stephen, 19, became the first person to die of the new CJD in May 1995, said that she was amazed by Sir Kenneth's remarks.

"I think most British people thought that 'safe' meant 'safe to eat'," she said. "Now Sir Kenneth is saying beef might have been safe, was fairly safe or possibly safe. He is rewriting the English language ."

Sir Kenneth served as Chief Medical Officer of Scotland from 1989 to 1991 and of England from 1991 until last month, when he retired to take up the post of Vice-Chancellor of Durham University. Sir Kenneth, who appeared at the London hearing alongside Sir Graham Hart, Permanent Secretary at the Department of Health from 1992 to 1997, said he had never ruled out the possibility that BSE could pass to human beings, though he had initially regarded the risk as remote.

The discovery in May 1990 that BSE had apparently passed to a cat through contaminated petfood had "strengthened my view" that the potential for BSE to move from cows to human beings was there. Sir Kenneth told the inquiry that health advice given to the public had been based on the assumption that the ban on brain, spinal cord and certain other cattle offals entering the food chain was being properly enforced. The ban was introduced in 1989.

In October 1995 he had been shocked to learn from Keith Meldrum, then the Chief Veterinary Officer, that on four occasions inspectors had found spinal cord still attached to cattle carcasses leaving abattoirs. Sir Kenneth described how he had clashed with Ministry of Agriculture officials at a meeting in early November of that year over the advice which they should give to ministers on the wording of a press statement on the abattoir lapses.

He had wanted to emphasise the seriousness of the failures by pointing out that they could have caused prohibited material to enter the human food chain. But that had been "a step too far " for the Ministry of Agriculture officials, who insisted on leaving that reference out.

Sir Kenneth said that during 1995 the appearance in two teenagers of CJD, normally a disease of the elderly, had been "exceptional but not without precedent" elsewhere in the world.

In earlier written evidence, Sir Kenneth accused Mr Meldrum of "understating" the seriousness of the abattoir findings. But yesterday he said he had not intended any personal criticism. Mr Meldrum is expected to appear before the inquiry next week


13 Oct 98 - The BSE blackout

Leader

Guardian ... Tuesday October 13, 1998


It is not just ministers who instinctively resist open government. Civil servants, too, have been even more ferocious opponents. It was one of the earliest programmes the "Yes Minister" team put together to illustrate how initial political enthusiasm for an idea can be turned by skilful mandarins. A Freedom of Information Act has been included in six successive Labour Party manifestos. In the 1992 version, Labour pledged itself to instruct counsel to begin drafting on day one with enactment promised within the first year. Eighteen months after last year's general election success, we have a government white paper but no draft bill and no indication it will be included in the next session of Parliament. Yet consider how open government would have helped health officials in their Whitehall war with Agriculture over the BSE scandal .

The battle between officials has been exposed by the current inquiry. Yesterday the chief medical officer (CMO) appeared before the panel. In his already submitted written evidence - as we reported on Saturday - he revealed his dismay over his belated discovery that safeguards in slaughter houses were being flouted , seriously increasing the risk of contaminated offal getting into the food chain. The degree to which MAFF officials delayed informing health advisers of crucial information has been documented in detail by the inquiry. It was not until March, 1988, the CMO was told about BSE - nine months after agriculture ministers had been informed. Similarly, health officials first heard about the ban on cattle offal entering the food chain from a newspaper, not a MAFF official. And when BSE finally jumped to a cat - signalling its capacity to jump species - pet food manufacturers were told of the cat's death before health department officials .

Open government would have allowed a much more open public debate. Prof Anderson, the Oxford epidemiologist, asked for data which MAFF held on its central laboratory computer to analyse the spread of the disease. He was denied it for several years delaying his study which demonstrated that cattle feed safeguards were not being properly implemented. Civil servants instinctively shy away from the rough and tumble of public debate. But BSE is just the latest example of how closed government reduces the quality of decision-taking . Ironically, even MAFF officials must by now have concluded that closed government is no guarantee of cosy government. Rarely have officials been so publicly excoriated.


13 Oct 98 - Ministry 'blocked BSE disclosure'

By Stuart Millar

Guardian ... Tuesday October 13, 1998


Former chief medical officer tells inquiry that officials drew the line at taking action that might undermine confidence in British beef

"The meaning of 'safe' is central... If you look at 'safe' in ordinary speech, we don't mean that a driver we describe as safe will never have an accident. In ordinary usage safe doesn't necessarily mean 'no risk'."

Ministry of Agriculture officials opposed telling ministers and the public that BSE-contaminated offal may have been processed into the human food chain , even after government health chiefs discovered that safeguards in slaughterhouses were being flouted .

Sir Kenneth Calman, who retired as chief medical officer last month, told the BSE inquiry yesterday that MAFF officials had refused to see its failure to police its own rules as a potential public health crisis rather than a development which could undermine confidence in British beef.

While he had felt it important that the public was given as much information on the new risks as possible, he told the inquiry that "MAFF clearly found that a step too far ".

For six years, Sir Kenneth and his predecessor, Sir Donald Acheson, had issued assurances that beef could be eaten safely - based on MAFF's repeated insistence that its ban on potentially infective materials was working. The advice had not been intended to mean that there was no possible risk, but merely that the scientific evidence suggested no significant danger.

Central to the inquiry, therefore, was the definition of 'safe', he said. "If we talk about a safe driver, we do not mean that the driver will never have an accident. If you talk about a safe pair of hands, you do not mean that the person will never have a problem. In ordinary usage, safe does not mean no risk."

Yet even after that qualified advice was cast into serious doubt in October 1995 by the revelation that the controls were being flouted , MAFF argued against advising ministers on a Cabinet sub-committee that certain meat products could pose a risk to human health.

His evidence will add weight to critcism of MAFF for its handling of the BSE affair. At least 29 people are believed to have died from the human form of the disease after eating meat contaminated before controls were introduced in 1989.

Outside the inquiry, Dot Churchill of Devizes, Wiltshire, whose 19-year-old son Stephen died of CJD in 1995, condemned officials for their "lack of forward planning" in dealing with the crisis. "Two strong things that came across today are that safe does not necessarily mean safe, and also that there was very little communication made to the public. There has been very little attempt to look after victims of CJD."

In his written statement to the inquiry, published last Friday, Sir Kenneth accused the Chief Veterinary Officer, Keith Meldrum, of underestimating the extent of the problem after veterinary inspections of abattoirs revealed four instances of banned spinal cords being left in carcasses - despite assurances to the contrary.

Sir Kenneth said yesterday that his comments had not been meant as a personal criticism of Mr Meldrum.

But he added that until 1995 "the impression I had during that time was that the ban was in place and being properly policed. If I had had any concerns, I would have acted in the way I did in 1995 and drawn it to the attention of ministers."

The identification by scientists of a new human form of the disease in a cluster of patients under the age of 42 on March 11, 1996 - nine days before the Government's official announcement - had added to the pressure.

In contrast to the pharmaceutical industry, which had acted swiftly to remove British bovine material from its products, the attitude of farmers and abbatoir operators had been a crucial factor in the failure of controls, Sir Kenneth said.

"The farming industry, and perhaps the slaughterhouse industry, didn't quite realise just how serious this might be."


13 Oct 98 - 'Bubbly' daughter is 28th victim

By Maurice Weaver

Telegraph ... Tuesday 13 October 1998


A woman of 24 became Britain's 28th victim of new variant CJD yesterday when she died in hospital.

Pamela Beyless, described by her parents as "fun-loving, bubbly and ambitious" before the disease struck 18 months ago, had progressively lost her powers of speech and co-ordination .

Her father, Arthur, a milkman in Leicester, said in the end she was a "prisoner in her own body". He and his wife June were at their daughter's bedside in the city's Glenfield Hospital when she died. Mr Beyless, 51, said: "We don't know how she contracted the disease. We can only assume that it was linked to eating infected meat ."

Miss Beyless was working as an office administrator for Barclays Mercantile Credit in Basingstoke, Hants, when the first symptoms appeared.

Mrs Beyless said: "She began to suffer problems with her co-ordination and she came home to get better. But her condition deteriorated and she became bed-bound. We find relief in knowing Pamela would not have wanted to carry on as she was. She didn't suffer in the end. It was as though she had gone to sleep."


13 Oct 98 - Farmers 'didn't take BSE fight seriously'

By Aisling Irwin, Science Correspondent

Telegraph ... Tuesday 13 October 1998


The Government's former chief medical officer said yesterday that he had been astonished by the careless attitude of farmers and slaughterhouse owners in the battle against mad cow disease.

He accused Ministry of Agriculture officials of trying to play down fears over the potential threat posed by the disease . He said that he had clashed with them over what to tell the public after it emerged that contaminated offal might have entered the human food chain because slaughterhouse safeguards were being flouted .

Sir Kenneth Calman, who held the post of CMO for England from September 1991 until last month, was giving evidence to the BSE inquiry, headed by Lord Justice Phillips, at a Government office in south London. He told the inquiry, which has been hearing witnesses since March, that he had to prevent officials from continuing to put out reassuring publicity about BSE after research pointed to a new, human form of the disease .

The crucial period was the autumn of 1995, before which Sir Kenneth claims he was confident that bans on offal in the meat industry were being implemented. It was not until October 23, 1995, when he received a letter from the chief veterinary officer Keith Meldrum, that he became alerted to the fact that certain offals were still getting into the cattle feed, and thus into the human food chain. In his written evidence to the inquiry, released last Friday, he said the letter told him that on four occasions inspectors at abattoirs had found spinal cord still attached to cattle carcasses, in contravention of the ban .

Referring to Mr Meldrum he wrote: "These findings were referred to by him as 'disappointing' and in my opinion in so doing he understated the importance of this information."

As a result of what he had been told by Mr Meldrum, Sir Kenneth said he had felt unable to give assurances that banned material had not entered the human food chain. In the run-up to a meeting with Douglas Hogg, agriculture minister, on Nov 7, 1995, he had clashed with officials from the Ministry of Agriculture, Fisheries and Food (Maff) , disagreeing with them over the advice that should be given to ministers on how any press statement should be worded.

Sir Kenneth said: "For me it was important the public were given all the information. This included the important new information that offal could have entered the human food chain. Maff clearly found that a step too far for them and wanted to change that."

Until the end of December 1995, the Department of Health and the Spongiform Encephalopathy Advisory Committee (Seac), a scientific advice body, continued to make statements that were based on the assumption that bans were effective - and at that stage there was no scientific evidence linking meat-eating and CJD. He said he had regarded enforcement of the ban as the responsibility of Maff. Both Sir Kenneth and Sir Graham Hart, permanent secretary at the Department of Health from 1992 to 1997, who also appeared before the inquiry yesterday, agreed they had not raised the issue with Maff officials before October 1995.

They said they were unaware that Maff was discussing internally the problem that the offal ban was being flouted . Sir Kenneth said: "If I had had any concerns I would have acted in the way I did in 1995 and drawn it to the attention of ministers. I informed the minister (Conservative Douglas Hogg) of my view that I found the attitude of those with primary responsibility for implementation (of BSE rules) - namely the farming industry and slaughterhouse owners and operators - astonishing ."

Their attitude, he told the inquiry yesterday, was in marked contrast to the speedy way the pharmaceutical industry had acted to remove bovine material from its products .

He said: "The farming industry, and perhaps the slaughterhouse industry, didn't quite realise just how serious this might be for them, let alone public health." But Sir Kenneth insisted his comments were not meant as a personal criticism of Mr Meldrum.

Yesterday, Sir Kenneth also justified his repeated advice that beef was safe to eat by saying that "safe" did not necessarily mean "zero risk" . He said: "The meaning of 'safe' is central to this inquiry. If you look at 'safe' in ordinary speech, we don't mean that a driver we describe as safe will never have an accident. In ordinary usage safe doesn't necessarily mean 'no risk'."

Sir Kenneth, who is now vice-chancellor and warden at the University of Durham, and Sir Graham, both told the inquiry that they had not altered their diets as a result of what is now known about CJD. After the hearing, Dot Churchill of Devizes, Wiltshire, whose son Stephen, 19, died of the human form of BSE in 1995, criticised health officials for their "lack of forward planning" in dealing with the crisis. She said: "Two strong things that came across today are that safe does not necessarily mean safe and also that there was very little communication made to the public."


11Oct 98 - BSE vet: I'm not guilty

By Catherine Elsworth and Macer Hall

Telegraph ... Sunday 11 October 1998


The former chief veterinary officer at the centre of BSE cover-up allegations last night defended himself against claims that he "understated" evidence that the disease might be entering the food chain.

The accusations by Sir Kenneth Calman , the Government's former chief medical officer, have been submitted in writing to the public inquiry on BSE and will be reinforced tomorrow when he gives evidence. Keith Meldrum, former chief veterinary officer at the Ministry of Agriculture, Fisheries and Food, has been accused of failing to emphasise the dangers of spinal cords not being removed from carcasses in abattoirs.

Last night, he said: "I should be judged by my actions and not by my words." He added that he was convinced that his role in the affair would be vindicated when the "totality of the picture" emerged during the BSE inquiry.

Sir Kenneth, who stepped down from his post last month, claims the public continued to be reassured by officials that beef was safe although safety measures to stop contaminated meat entering the food chain were being ignored. Mr Meldrum first alerted Sir Kenneth that offal bans were being flouted when he told of four instances where spinal cords were left in carcasses. Sir Kenneth accuses him of understating the significance by terming the situation "disappointing".

Mr Meldrum said: "Sir Kenneth Calman gives evidence on Monday this week and I give evidence a week later and then those that are interested in the facts of what actually happened will be able to see all the evidence as it's actually presented."

He added: "It is unfortunate that those who are following the inquiry are not able to see the totality of the picture and therefore the comments from Sir Kenneth Calman are not being seen against the comments from my old department." Mr Meldrum said it was unhelpful to concentrate on the wording of one letter he had written rather than considering all the action taken by the ministry.

A spokesman for MAFF refused to comment. He said: "We are not going to give a running commentary on the bits of evidence as they are given. "


10Oct 98 - Ministry accused of 'playing down' BSE

by Michael Hornsby, Agriculture Correspondent

Independent ... Saturday 10 October 1998


Sir Kenneth Calman, the former Chief Medical Officer, has accused Ministry of Agriculture officials of playing down evidence about the risk of "mad cow" disease .

In a written statement to the BSE inquiry, Sir Kenneth speaks of "differences of opinion " between the Department of Health and the ministry, which he suggests was too concerned with avoiding expense to the farming industry and putting out reassuring messages to the public.

Sir Kenneth, who is to appear before the inquiry in London on Monday, criticises Keith Meldrum, the former Chief Veterinary Officer, over his response to the discovery, in October 1995, of four cases of failing to remove spinal cord properly from cattle carcases. "These findings were referred to by him as 'disappointing'," Sir Kenneth says. "In my opinion he understated the importance of this information. "

The emergence of more evidence that banned offal might have got into animal feed because of lax controls at slaughterhouses had caused him to be "extremely concerned ".


06 Oct 98 - Bones will light homes

By Charles Arthur, Technology Editor

Independent ... Tueasday 6 October 1998


A company that generates power by burning chicken manure is taking on the mountainous task of whittling down the accumulated stores of powdered meat and bone meal (MBM), made from cows slaughtered under the plan to eradicate BSE.

Fibrogen, based in London, runs three power stations that produce electricity by burning chicken manure. The firm has won a contract to burn 85,000 tonnes of MBM annually at its plant near Scunthorpe, north Lincolnshire, for the next three years.

That will start to ease the Government's problem of how to dispose of the 340,000 tonnes of MBM in storage .

The MBM cannot be used in any way that might pass it back to the human or animal food chain, state EU rules, because it is the rendered remains of animals slaughtered under the "Over 30-Month Scheme", introduced in mid-1996 to get rid of BSE or "mad cow disease".

But while animals areslaughtered at a regular rate, there has been no way of disposing of the MBM. Thus the mountain of powder has been growing at an average of roughly 1,400 tonnes each week, or 70,000 tonnes a year.

The obvious solution was incineration, but power companies such as PowerGen and National Power were reluctant to alter their power stations to handle the fuel. Rupert Fraser, managing director of Fibrogen, said the incineration of MBM would "pose no risk to health - but even so the ash will go to landfill".


04 Oct 98 - Cow from 'safe' herd had BSE

By Victoria Macdonald

Telegraph ... Sunday 4 October 1998


BSE has been detected in an apparently healthy cow, from a herd that was meant to be free of the disease, as it was about to enter the food chain, a report will disclose this week .

Although scientists and officials in Britain last night played down the findings, they will raise new concerns about the degree to which herds contain cows that have BSE but show no symptoms of the disease.

The discovery, which threatens a new crisis for beef farmers , was made last week when scientists carried out tests on the carcass of a four-year-old cow from a Swiss herd. The BSE-infected carcass was discarded.

Researchers from the Swiss biotechnology firm Prionics, who developed the test, believe that their results suggest that more herds than had been thought are infected with the prion protein which causes BSE. They say there is no certain way of telling how long the cow had been infected.

A spokesman for the Ministry of Agriculture said that all cattle in Britain were slaughtered before 30 months, so no four-year-old cow would enter the food chain here. Its scientists had been in close contact with the Zurich team.

Professor Jeffrey Almond, a microbiologist at Reading University and a member of the Scientific Encephalopathy Advisory Committee, said that the findings did not have any relevance in Britain because of the 30-month slaughter policy. But there might be a case for compulsory testing because the Swiss team had picked up BSE before any symptoms manifested themselves.


02 Oct 98 - BSE food test plea 'ignored'

By David Brown, Agriculture Editor

Telegraph ... Friday 2 October 1998


A key experiment to prove the official theory that BSE was passed to cattle that ate contaminated meat and bone meal has never been carried out by the Ministry of Agriculture, nearly 10 years after independent Government advisers called for it.

The ministry felt that the test would take too long and cost too much, senior members of the United Kingdom Renderers' Association told the BSE inquiry in London yesterday.

Brian Rogers, chairman of the association said: "A link [between BSE and meat and bone meal] has never been established, although we are aware this is the main hypothesis. In fact, the experiment which would prove or disprove it has never been carried out even though it was recommended by the Southwood Committee."

This independent working party, set up in 1988 under the chairmanship of Prof Sir Richard Southwood, Pro Vice-Chancellor of Oxford University, was the Government's first advisory committee on BSE. Its role is now carried out by the current Spongiform Encephalopathies Advisory Committee (SEAC), under Prof Sir John Pattison.

Paul Foxcroft, sales director of Prosper De Mulder, Britain's largest renderer of animal waste, said in his statement that his company had also called for the experiment to be carried out in April, 1988, only a month after the ministry disclosed the arrival of the disease. The inquiry continues.


02 Oct 98 - Same strain of CJD kills man and his pet cat

by Mark Henderson

Times ... Friday 2 October 1998


A man and his cat died within weeks of each other after developing similar forms of Creutzfeldt-Jakob disease at the same time, according to a report in The Lancet.

The 60-year-old Italian and his pet, which slept on his bed, both contracted the same form of CJD in November 1993. Neurologists at the University of Verona said the twin cases could have come from a common source, infection from one to the other or have been the result of an extraordinary coincidence.

The man exhibited symptoms which included poor eyesight and co-ordination and muscle spasms. His condition deteriorated rapidly and he died in January 1994. His cat, a seven-year-old neutered female, showed symptoms of frenzy, twitching poor co-ordination and muscle spasms. She was put down in mid-January, outliving her owner by a week.

Post-mortem examinations showed physical changes in both cat and owner that were typical of spongiform encephalopathy diseases , which leave the brain riddled with holes. Further investigations showed that the same kind of prion protein that is thought to cause the diseases was present in both brains, suggesting a possible link.

The prion strain was that which causes sporadic, or spontaneous CJD in humans, rather than the iatrogenic form associated with human growth hormone treatment, or the new variant strain linked to BSE in cattle. The features of the cat's illness were different from previously reported cases of FSE (feline spongiform encephalopathy).

CJD, FSE and BSE all come from the same family of transmissible spongiform encephalopathy (TSE) diseases, along with scrapie in sheep. But the Italian team could not explain how they might be linked in this case. The researchers are reasonably certain, however, that the man and his cat did not contract their illnesses by eating the same infected beef, as the prion strains found in their brain were not those associated with BSE.


01 Oct 98 - Safe beef pledge was given despite fears of BSE link

By David Brown, Agriculture Editor

Telegraph ... Thursday 1 October 1998


Government advisers were issuing reassurances about the safety of beef to the Meat and Livestock Commission, the statutory body that encourages people to eat meat, only a few weeks before ministers announced a possible link between BSE and a new form of Creutzfeldt-Jakob brain disease in young people.

Only 13 days before the Government announcement on March 20, 1996, which provoked the beef crisis, Richard Packer , permanent secretary at the Ministry of Agriculture, refused to confirm the commission's suspicions that scientists had established some connection, the BSE inquiry was told in London yesterday.

Colin Maclean, director general of the commission, said that in February 1996 he was surprised when the ministry asked it to undertake a confidential study of the use of specified bovine offals, which were banned from the human and animal food chain in 1989 because of the risk that they might carry the BSE agent. The commission was also asked about de-boning operations in abattoirs.

The commission had been concerned for years that some abattoirs were breaching controls . In his statement, Mr Maclean said: "I had concerns that the scientific assessment of the risk to humans had changed." He began to call his scientific contacts to seek information.

He said: "By March 7, 1996 I had guessed that a link between some CJD cases and BSE was being hypothesised by the scientists." He went to see Mr Packer to clarify the situation. "The permanent secretary was unwilling to provide clarification , so I pressed him on the importance of the Government taking professional communications advice in advance of any announcement which might have an impact on consumers," he said.

Earlier, on Jan 12, 1996, Dr Eileen Rubery, head of the Department of Health's division responsible for health aspects of food, had cleared a commission briefing paper on the safety of beef with the words: "There is currently no scientific evidence that BSE can be transmitted to humans."

A month earlier, the ministry gave permission for the commission to issue television advertisements carrying "short reassuring statements " about beef by Prof Sir John Pattison, chairman of the Government's independent Spongiform Encephalopathies Advisory Committee. But, at the last moment, the ministry withdrew its permission because the statements "might compromise his independence".

Mr Maclean, a vet and an expert on animal feed as well as meat for human consumption, told how he warned the ministry in 1994 that controls on the specified offals were not working properly . He said: "I raised concerns that the specified bovine offals ban was not being properly complied with or enforced with ministry officials."

Then, "key scientific evidence " in the spring of 1995 indicated that the oral dose of BSE agent needed to infect a cow was far less than scientists had believed . Calves could be infected with a dose of less than one milligram . This produced a "substantial change" in his attitude to the risks involved if the controls and the ban on feeding rations containing meat and bone meal to cattle were not completely enforced.


01 Oct 98 - Man and his cat in CJD mystery

By Charles Arthur, Technology Editor

Independent ... Thursday 1 October 1998


Doctors are perplexed by the case of a 60-year-old Italian man and his seven-year-old cat , who both mysteriously developed similar forms of Creutzfeldt-Jakob disease (CJD) at the same time.

While the case is not thought to have immediate implications for human health, it could provide a clue to the mechanism or transmission of the disease.

In neither victim was the illness caused by "mad cow disease", or BSE, said the doctors who report the incident today in the medical journal The Lancet. Yet the "strain" of CJD was the same in both.

CJD is a fatal human brain disease, part of a family of illnesses called transmissible spongiform encephalopathies (TSEs) which includes BSE in cows and scrapie in sheep. It is thought to be caused by a "rogue" protein whose accumulation leaves spongy holes in the brain before death.

So far, 27 Britons have died from a form of CJD caused by BSE-infected food, and since 1989 about 80 cats have died of "FSE", the feline version caused by infected cat food.

But humans also get "sporadic" CJD, which has no known cause, and affects about one person in a million each year. Typically this happens in people aged over 60.

In the Italian case, the man was admitted to hospital in November 1993, and died in January the following year. His cat started showing symptoms at about the same time and was put down. Tests showed that it had a "sporadic" form of the disease similar to the man's.

Dr Salvatore Monaco, who led the team of scientific investigators at the University of Verona, said the man had "no unusual dietary habits".

"It is unknown whether these TSEs occurred as a result of horizontal transmission [cross-infection] in either direction, infection from an unknown common source, or the chance occurrence of two sporadic forms," Dr Monaco said.


30 Sep 98 - Feed banned in Britain 'used for Sainsbury pork'

By Michael Fleet and David Brown, Agriculture Editor

Telegraph ... Wednesday 30 September 1998


Organic pork imported into Britain can come from pigs legally fed on meat and bonemeal which is banned in Britain because of BSE, it emerged yesterday.

Pigs reared in Sweden are able to feed on animal derivatives and still be described as organic under that country's own rules, which flout standards set for British meat.

Sainsbury's admitted yesterday that its Swedish pork could come from pigs given feed banned in Britain, but denied that any of its "organic" meat was fed the diet.

An investigation into Swedish pork was launched by Sainsbury's after a pig farmer's wife from near Reading, Berks, asked her local supermarket for a report on what the animals ate. A letter from Sainsbury's confirmed that it was not prohibited for Swedish farmers to feed meat and bonemeal, even to pigs described as organic. It added that the company had now asked that none of the meat supplied to it in future should come from pigs fed in that way.

The pig farmer whose wife raised the issue said: "This is a classic case of the consumer being denied the full facts by the supermarkets ."

Sainsbury's said suppliers in Sweden had agreed to a voluntary ban on giving meat and bonemeal to pigs bought by the company, with the restriction coming into force "within a few weeks"

Figures from the Meat and Livestock Commission show that in 1995 supermarket prices were 255 per cent of what farmers were being paid per pound for their pigs. Last month, the supermarket price was 408 per cent of the market price.

Timothy Lobstein, co-director of the Food Commission, an independent watchdog, said it was wrong that meat described as organic could come from pigs fed on bonemeal and meat .

"I am very surprised that a country like Sweden can license organic pork when pigs have that diet. The whole business of importing pork when there is so much here is of great concern."

A farmer who made only 18p on a calf he sent to market said yesterday that he and others like him are now "working for nothing" in the current agricultural slump.

Roger Heal, from Stoke St Michael, Somerset, sold the 10-day-old heifer for 5 - 20 times less than it would have fetched three years ago - and, after deductions, received a cheque for 18p.

Mr Heal, 37, said he would not cash the cheque because that would cost him 55p. "It is absolutely ridiculous. We left the calf at market and didn't wait to see it sold." Mr Heal paid administration costs of 4.10 and VAT of 72p.

He had paid 12 to inseminate the cow to produce the calf, 1.20 for its ear tag, 8 for the special milk ration the calf drank during its short life and 5 to transport it to Frome market.

Orkney Islands Council has offered to spend 250,000 towards feeding tens of thousands of sheep for which farmers cannot find buyers.

Farmers have said that up to 20,000 older ewes, which would normally be sold for mutton on the Continent, would have to be shot and buried because there is not enough winter grass.

Malcolm Morrison, livestock convener of the National Farmers' Union of Scotland, said: "The council has recognised the full extent of the crisis in farming and the effect that the season's poor weather has had on the quantity of winter feed available on Orkney. This will boost Orkney farmers at a time when their confidence is at a very low ebb."


30 Sep 98 - Ministry 'team of BSE clowns'

By James Meikle

Guardian ... Wednesday 30 September 1998


A meat industry consultant yesterday criticised the Government's former chief veterinary officer, Keith Meldrum, and the "clowns " who had brought the beef industry to its knees.

Peter Carrigan alleged that meetings to discuss bovine spongiform encephalopathy (BSE) had given Mr Meldrum "the opportunity to pontificate ", but that he had not been "a good listener".

"My general impression was that the meetings [were for] going through the motions , rather than purposely doing anything," Mr Carrigan said in a statement to the BSE inquiry in London.

Mr Meldrum was chief vet at the Ministry of Agriculture (Maff) from 1988 to 1997. Mr Carrigan said: "In my experience I was more likely to meet a Martian than a Maff vet within an abattoir ."

Mr Carrigan, whose company disposes of animal by-products from abattoirs, raised concerns with Mr Meldrum in 1995 about the opportunities for unscrupulous abattoirs to cheat on rules designed to keep BSE-infected meat out of the food chain.

"There weren't proper audits , and Maff and the meat inspectors were barely interested in appropriate controls being applied to the abattoirs," he said.

Maff "did not really come alive" until Stephen Dorrell, then health secretary, admitted a possible link between BSE and a new variant of Creutzfeldt-Jakob disease, or CJD, which might have been caused by eating infected beef.

"When BSE became hot news, they went completely over the top ," Mr Carrigan said. Suddenly waste cattle material for disposal "began to be treated in a similar manner to nuclear waste".

He said the economic impact of BSE was devastating. "I am not clever enough to be able to assess the impact in financial terms, but I am cleverer than some of the clowns whose total inaptitude brought this once prosperous industry to its knees ."

Mr Carrigan, who questioned the link between the cow disease and new variant CJD, praised some officials at the ministry. "The government of the day... was more interested in creating committees of professors and other aggrandised persons, whom they believed would restore public confidence.

"It was, and is, a source of constant amazement to me that decisions with regard to the functioning of abattoirs... could be written by people who, in the main, had never set foot inside an abattoir."


28 Sep 98 - Cow gets barcode in bid to beat beef ban

Staff Reporter

Telegraph ... Monday 28 September 1998


British cows will enter the digital age today when the first animal will be barcoded in a multi-million pound computerised venture to track cattle from birth to death.

The cow will be fitted with an electronic ear-tag, and log-on to the British Cattle Tracing System in Workington, Cumbria. Under the database scheme, every farmer in the country registers the movements, births, deaths and diseases of his herd, creating a full life history and medical record of the beasts.

Alternatively, farmers can input the information themselves on a central computer if they have access to the Internet. A spokeswoman for the Ministry of Agriculture said the Government is paying for start-up costs and first year running costs of 35m.

The venture, aimed at convincing both European and UK consumers that beef is safe to eat, is a legal requirement under EC regulation.


23 Sep 98 - Abattoirs 'ignored BSE safety rules'

By David Brown, Agriculture Editor

Telegraph ... Wednesday 23 September 1998


Emergency BSE controls designed to prevent people and animals eating infected beef and offal were flouted for years by the meat industry, according to a former senior Government vet who investigated working practices in abattoirs.

A statutory ban on Specified Bovine Offals - the term for the highest risk materials including brain, spleen and spinal cord - from the human and animal food chain was treated "as a joke" by some in the meat industry, Andrew Fleetwood, a former Ministry of Agriculture expert in animal diseases, claims in a statement to the BSE inquiry.

Yet these controls, which were introduced in 1989, together with a ban on using rendered ruminant animal protein in animal food, were regarded by the Government as its "first line of defence" against the spread of BSE, which has since been linked to the deaths of 27 people from a new variant of Creutzfeldt-Jakob disease.

The former vet says that instead of removing and staining SBOs for destructionto prevent them being eaten by mistake, some abattoirs allowed them to leave the premiseseither attached to carcasses or in unmarked batches of waste destined to be processed into meat and bone meal. The importance of these controls was reinforced in the light of experiments in 1996-97 indicating that rendering processes for animal waste were not potent enough to kill the BSE agent .

Mr Fleetwood, who will be questioned at the inquiry in London today, tells how one meat industry consultant warned Maff in June 1995, nine months before the beef crisis broke, that "unscrupulous abattoirs had cheated and would continue to cheat the SBO legislation and that it was little better than a joke in certain quarters of the industry."

While he thought this was "perhaps overstating the position", he felt, on the basis of his own inquiries and knowledge, that "there was likely to be deliberate evasion of the SBO controls in the industry" .

He also tells how, by late 1995, ministers and senior Maff staff, including Keith Meldrum, the chief veterinary officer, were becoming "greatly concerned" that the SBO restrictions were not working properly despite efforts to tighten them. They were also worried about lack of enforcement by the Meat Hygiene Service .

He said he was "puzzled" why "widespread and serious breaches" of the SBO controls had not been picked up earlier in spot checks by Government vets. Mr Fleetwood said: "My suspicion was that staff from the State Veterinary Service inspecting slaughterhouses were often quite junior and easily browbeaten by the slaughterhouse managers. I also had doubts about the extent to which these visits were truly unannounced , as they were supposed to be."

He was concerned about incidents where offals were not stained properly - sometimes because the wrong kind of dye was used. An older type of black dye could perish and disappear after 48 hours, making it impossible to identify which offals had been marked. But when the ministry, at his instigation, prescribed a more efficient blue dye - known as Patent Blue V - some abattoirs did not use it .

Despite tighter surveillance further breaches of the regulations continued to come to light, which he set out in a report to the Government in October 1995. The report said: "This showed a continuing high failure rate at slaughterhouses which I found very disappointing. Although I was largely satisfied with the way in which the SVS staff were carrying out surveillance, I was concerned about the attitude of the industry and also the effectiveness of enforcement by the Meat Hygiene Service."

Mr Fleetwood left MAFF in 1996 to take up a post in research and development in the pharmaceutical industry.


23 Sep 98 - Meat firms 'flouted rules on BSE'

By Charles Arthur, Technology Editor

Independent ... Wednesday 23 September 1998


Offals with a high risk of carrying BSE could have passed into human food as recently as 1995 because slaughterhouses routinely ignored government regulations , according to a former senior government vet.

Andrew Fleetwood concluded that there was "widespread and flagrant infringement" by abattoirs of rules intended to prevent the use in food of "Specified Bovine Offals" (SBOs). The SBOs are cattle parts, such as the spine and various internal organs, that are most likely to carry the BSE prions that have been shown to lead to the fatal "new variant" Creutzfeldt-Jakob disease (v-CJD).

New laws banning the use of SBOs for food came into force in November 1989, three years after the first official recognition of BSE. But in written evidence to the BSE Inquiry, where he is testifying today, Dr Fleetwood said he had seen a letter from a consultant to the meat industry in June 1995, which said that "unscrupulous abattoirs had cheated and would continue to cheat the SBO legislation and that SBO was little better than a joke in certain quarters of the industry" . SBOs were meant to be removed from carcasses and stained blue to prevent them being used in food. But he became suspicious in July 1994 when he compared actual and expected amounts of SBO recorded by rendering companies. The difference implied that SBOs were being put unstained into food. Scientific analysis has shown that thousands of BSE-infected cows would have been slaughtered after 1989, and used for food.

Dr Fleetwood also said government veterinary inspectors failed to clamp down on the problem.


17 Sep 98 - Advisers divided over BSE screening

Staff Reporter

Telegraph ... Thursday 17 September 1998


The Government is to introduce checks at abattoirs to show how many cattle may be infected with BSE without showing signs of the disease.

The survey for these "sub-clinical" and other strains of BSE could help in predicting the scale and shape of the epidemic of the human form of the disease - human BSE or new variant CJD.

However, it emerged at a public meeting of the British Association in Cardiff University last week that Government advisers were divided over the need for a more general survey.

Prof John Collinge, a member of the Spongiform Encephalopathy Advisory Committee, revealed that a study was about to be commissioned by the Ministry of Agriculture, Fisheries and Food to check whether there were several strains of BSE. But, Prof Collinge added, he had been calling for larger-scale screening .

Sir John Pattison, the committee chairman, argued that as the BSE epidemic was in rapid decline it would take a large sample of the two million animals slaughtered each year "to pick up one or two bits of under-reporting".

It is currently believed there is only one strain of BSE , based on samples of tissue from nine infected cattle. But Prof Collinge said: "You can't conclude from that that all million cases have exactly the same strain. There are multiple strains in every other animal situation."

He has developed a simple test to study the overall incidence of the disease agent. "It may be possible to do very large-scale studies very rapidly and very cheaply," he said. "It would cost a few pounds to screen a couple of dozen animals."

Prof Roy Anderson, an epidemiologist of Oxford University - who did not believe that such checks were necessary - said it would take five years before the shape of the epidemic of human BSE could be predicted.

Despite the fact that there have been only 27 cases of human BSE, he added that the data did not preclude a "very large epidemic" .


11 Sep 98 - Experts back new tests for hidden BSE

Nigel Hawkes and Nick Nuttall

Times ... Friday 11 September 1998


The Government's advisory committee on Creutzfeldt-Jakob disease has recommended a new series of tests on cows that appear healthy but may be carrying the agents that cause "mad cow" disease.

The tests are the suggestion of John Collinge, of St Mary's Hospital, Paddington, in West London, who has developed a technique that can be used to test samples from cows quickly and cheaply .

The specimens would come from healthy cows slaughtered in abattoirs without any hint that they may be incubating BSE.

The idea is to investigate whether there are some cows that carry the infective agent for long periods, but never suffer symptoms. If such sub-clinical cases exist, it is possible that many cows could remain infectious even when the BSE epidemic is over .

Dr Collinge's test, using a technique called Western Blot , detects the aberrant prion proteins that are responsible for BSE or new-variant CJD, the brain disease that is the human equivalent of BSE. It is much quicker than the classical methods for testing infectivity, which have involved injecting mice with brain material from cows and waiting for them to become ill.

John Pattison, chairman of the Spongiform Encephalopathy Advisory Committee (Seac), told the British Association for the Advancement of Science's festival in Cardiff yesterday that the research had the approval of his committee and that a recommendation backing it had gone to the Ministry of Agriculture. It seems highly unlikely to be turned down.

Richard Lacey, a long-term critic of the ministry's approach to BSE, believes that the number of cases is being underestimated . He has urged an even larger series of tests, on material taken at random from abattoirs, to check this. "For years I have been asking for systematic surveys in abattoirs, but they have never been done," he said yesterday. "I cannot understand why."

Other members of Seac are more sceptical about that approach. Roy Anderson, of Oxford University, said that he still believed the BSE epidemic was close to its end, and would be at an extremely low level by 2001. He added that Dr Collinge's test needed further validation before it could be relied upon.


08 Sep 98 - BSE in lamb clue '10 years old'

By David Brown, Agriculture Editor

Telegraph ... Tuesday 8 September 1998


Sheep may also be infected with BSE

Scientists knew 10 years ago that BSE could have spread from cattle to sheep but research on suspect cases was not pursued, a senior veterinary researcher claimed yesterday.

Dr Anthony Andrews, a former senior lecturer at the Royal Veterinary College in London, said he saw an unusual pattern of brain damage in four sheep from a farm in Essex around 1988 . He concluded that mad cow disease could have passed into sheep - possibly through contaminated animal food.

Dr Andrews was speaking after the Government tried to play down a warning from one of its BSE advisers that the disease in sheep could pose a new "national emergency". The researcher said he felt that he was not encouraged to follow up his theory. He said: "I am not trying to blame anyone. It may be I was right at the time and we were seeing BSE in sheep. Or it could have been a novel strain of scrapie. I have since left the college and have no knowledge of what happened to the laboratory slides and the reports."

Dr Andrews left the college in January 1997 to become an independent consultant. His claim came after Prof Geoffrey Almond raised new fears over mutton and lamb yesterday. Prof Almond is chairman of the sheep sub-committee of the Government body SEAC - the Spongiform Encephalopathies Advisory Committee. He said: "There is a distinct possibility that BSE is out there in the sheep population .

"But there are several ways of viewing that. One is to say it's been out there all the time and it could be that BSE has been in sheep for hundreds of years and does not cause a problem because it doesn't transmit from sheep to humans. If, on the other hand, it's sort of gone back into sheep from cows and then is behaving somehow differently from sheep scrapie then that could pose a risk to humans." He told BBC Radio 4's Farming Today: "If we found BSE in sheep it would be a national emergency ."

As farmers responded angrily to the new BSE scare, Sir Kenneth Calman, Chief Medical Officer, issued a statement saying the SEAC had discussed the "theoretical possibility" of BSE in sheep at its July 30 meeting. As a precaution, the SEAC had previously recommended that certain tissues from the lamb carcass should be removed from the food chain. It concluded that "no further action to protect the public or animal health was necessary".

So far 27 people have died from a new form of Creutzfeldt-Jakob disease which has been linked to BSE. Until now, it has been assumed that cattle were to blame if indeed the victims did contract the fatal disease from eating meat. Now there is a question mark over the safety of mutton and lamb .

BSE, first recognised as a fatal, new brain disease in 1986, is believed by many scientists to have been caused when cattle were fed rations containing the remains of sheep infected with a similar disease called scrapie. But sheep were also fed rations containing meat and bone meal - a practice now banned in the UK.

Dr Andrews said: "The case on the Essex farm about 1988-89 was unusual. We were not looking for BSE or for scrapie. We were trying to find out what was making these sheep ill. Post-mortem tests showed they had scrapie-like lesions in the brain. But the pattern of these lesions was not what you would expect from scrapie.

"In addition, the sheep did not display normal scrapie symptoms when they were alive. They were not rubbing themselves against something in the way scrapie-affected sheep often do. They stood, trembling. I now believe that we are talking about yesterday's problem.

"I wish more notice had been taken of these findings at the time but subsequent control measures on cattle and sheep taken by the Government in the wake of BSE have ensured that the risk to humans from eating UK sheepmeat is infinitesimal. We are now five generation of sheep on since we made these findings. I would have expected any major health problem to have surfaced by now."

He has submitted written details of his work to the public inquiry into the BSE epidemic which resumes in London tomorrow.

But Prof Lance Lanyon, principal and dean of the Royal Veterinary College, said neither he nor colleagues at the time could remember any research by Dr Andrews">

28 Aug 98 - Dilemma over telling CJD victims

By Charles Arthur, Technology Editor

Independent ... Friday 28 August 1998


The Government faces an ethical dilemma after deciding to fund anonymous tests of tonsils and appendixes removed from thousands of patients, to see whether they are incubating the deadly "new variant" Creutzfeldt-Jakob disease (v-CJD).

The results could leave it in a position where it is obliged to tell healthy people they are harbouring an incurable illness that will destroy their brain. Professor John Collinge, a member of the Government's advisory committee on bovine spongiform encephalopathy and CJD, warned last night that the results "can only be bad news".

He explained: "If you don't find any that are positive, it doesn't mean you are in the clear, and if you find just one in a thousand tests positive, it implies that 50,000 people in Britain are incubating the disease."

Even specialists in CJD and BSE are unsure how they would interpret results. Professor Collinge said that a huge positive result - such as 50 per cent showing infection - could either mean that many people are simply "carriers" who do not develop the disease, or that they will take much longer to show symptoms.

The new tests will be carried out on more than 1,000 stored appendixes and tonsils taken from British patients over decades of surgery. Each year about 44,000 appendectomies and hundreds of thousands of tonsillectomies are carried out.

The move follows the discovery of v-CJD infectivity in appendix tissue by doctors at Derriford Hospital, Plymouth. They were testing a sample from a patient who had his appendix removed in September 1995 and developed v-CJD in May 1996.

Normally, brain tissue is tested for the "prion" protein that is the disease's signature. But when Dr David Hilton of the hospital's pathology department tested the appendix, it confirmed the diagnosis - although the patient had not shown any signs of v-CJD when it was removed. Ten appendixes from other people tested negative. Their discovery is reported in The Lancet medical journal, published tomorrow.

Since 1994, 27 people have died of v-CJD in Britain. It is a fatal illness for which there is no treatment. It leads to gradual loss of physical and mental abilities, until the victim is left unable to move, speak or swallow.

The incubation period between the time of infection and the first appearance of symptoms is at least 10 years, and may be up to 40 years. The maximum exposure to BSE through food occurred during the 1980s, said James Ironside of the National CJD Surveillance Unit yesterday.

Officials at the Department of Health, which is funding the latest tests, are thus wrestling with the problem of whether they should in future tell people if a biopsy test on removed tissues shows they are incubating a form of CJD.

Sir Kenneth Calman, the Chief Medical Officer, avoided the question yesterday. "The biggest question that we have at the moment with v-CJD is its prevalence. This [anonymous test] is one way of getting into that. If samples are identified as [v-CJD] positive, then we will need to change the nature of the study. In future testing we might tell their GP."

Scientists are still looking for a reliable test for prion protein in blood, and for individual tests.

- A mother described yesterday how she looked on helplessly as her daughter died of v-CJD. Pat Mellowship, 58, nursed Donna for three years after she was reduced to a "five foot baby".

In a statement to Hornsey coroners' court, north London, Mrs Mellowship said: "My daughter had always been a keen consumer of meat. She always bought brand name products which were cheapest at the time." Donna, 34, from north London, died last December.


28 Aug 98 - Test may reveal how many will die of CJD

Nigel Hawkes

Times ... Friday 28 August 1998


New clue that means thousands will have their tissues examined

An early warning of how many people will die from the brain disease new-variant CJD could be revealed by tests on thousands of appendixes and tonsils removed over the past two decades. The tissues stored by hospitals are to be examined after a discovery that the agent responsible for the disease, linked to eating infected beef, can be identified in the appendix before brain symptoms appear.

So far, there have been 27 confirmed cases of nvCJD, but some experts have warned that ultimately tens or even hundreds of thousands could die.

By testing the tissue samples, a firmer estimate may be possible. Announcing the programme, Sir Kenneth Calman, Chief Medical Officer, said that the discovery made it possible to explore how the disease develops, and measure its likely impact.

The discovery was made after a Devon coastguard, Tony Barrett, 45, died of CJD in July. His appendix was removed at Torbay in September 1995, eight months before he displayed symptoms of CJD. The appendix was recovered, examined, and found to contain prion protein, an indication of infection by nvCJD. This is the first time that the disease has been identified in any tissue before the symptoms, said James Ironside of the CJD Surveillance Unit at Western General Hospital in Edinburgh.

The plan is to examine a large number of specimens dating from the mid-1980s to the mid-1990s, the period when risk of infection from beef was at its greatest.

They will be compared with specimens from the 1970s, before "mad cow disease" appeared. Dr Ironside said it was not clear how many specimens would be tested, but it would be thousands. Each test takes about two days, and the samples will be anonymous.

If any is found to contain prion protein, Sir Kenneth said, there would be careful consideration of what to do next. Although anonymous testing is a good way of assessing the prevalence of an infection, previously used for HIV, difficult ethical questions arise if positive samples are found. The Health Department will have to decide whether to tell individuals that they are incubating a fatal disease.

Interpreting the tests will be difficult. Dr Ironside believes that anybody showing evidence of prion protein in the lymphoid tissues of the appendix or tonsils is likely to develop the disease, but this is only an assumption. It is conceivable that many people could carry the infection without it reaching the brain. It is also likely that the genetic make-up of the individual could determine vulnerability.

Yesterday Torbay Hospital, where Mr Barrett's appendix was removed, sought to reassure patients who have had operations there. The prion protein which causes nvCJD is so hard to destroy that it may have evaded normal sterilisation procedures, but a spokesman for South and West Devon Health Authority said: "Any risk is minimal and what that means is less than one-in-a-million chance of any risk of infection from a surgical instrument that may have been used."

Sir Kenneth echoed the reassurance, saying that the Government's experts had also advised that the risk was minimal. Had the hospital been aware of Mr Barrett's infection, all the instruments used would have been destroyed.

Samples of tissue taken from patients are routinely stored, both as a vaulable research tool and to enable hospitals to defend claims that symptoms were missed or operations bungled.

With 45,000 appendix operations and several hundred thousand tonsillectomies performed every year, there will be no shortage of raw material. Some hospitals have appendix specimens dating back to the 1920s, Sir Kenneth said yesterday.


28 Aug 98 - Disease could be spread by surgical tools

By Roger Highfield, Science Editor

Telegraph ... Friday 28 August 1998


Trail that led to deadly discovery

Concern that surgical instruments could spread new variant Creutzfeldt- Jakob disease, the human form of BSE, was raised yesterday.

It was prompted by the discovery of the disease agent in the appendix of a man who showed the first signs of the brain illness eight months later.

Sir Kenneth Calman, the Government's Chief Medical Officer, said the case of Tony Barrett in Torbay, who died from the disease, "raises issues" about the possible transmission of the infectious protein via medical instruments used on people incubating the disease.

The case is also significant because the Government now plans a programme of anonymous testing of thousands of the 800,000 samples of tonsil and 45,000 samples of appendix tissue removed annually. Comparison of tissue removed before and at the height of the BSE epidemic in the late Eighties will provide the first measure of the extent to which the population has been exposed to human BSE - something Sir Kenneth described as "the biggest question".

Screening will also provide, in theory at least, the first opportunity to attempt to stop the disease early in infection by suppressing the patient's immune system which is thought to carry the protein from the gut to the brain.

The protein thought to cause the disease has been seen in the tonsils, spleen and lymph nodes and there is a fear that surgical instruments used on such tissue in a person who is infected but remains free of symptoms could pass it on. A helpline has been set up to address concerns of patients at Torbay Hospital, where Mr Barrett had his operation.

Prof John Collinge, a Government adviser, of St Mary's Hospital, said yesterday: "This is something that the Department of Health should be concerned about. We don't know what the risk of transmission by that route would be. My guess is that it would be pretty small. What we don't know is how many people out there are incubating the disease. If there are a lot, it might be a significant problem. If we do see an emerging epidemic, this is something to worry about and we may need new ways to sterilise instruments."

In the classical form of CJD, it has been long recognised that the infectious agent can be passed this way. In one case, brain electrodes that had been sterilised passed the infection from one patient to a second. They were sterilised again yet remained infectious enough to pass the disease on again. After a third sterilisation, the electrodes were tested on a chimpanzee which later died of spongiform disease.

The episode underlines the persistence of the protein even after sterilisation, though it is a worst-case scenario because the agent was being introduced into the brain, the most efficient means of transmission.

The Spongiform Encephalopathy Advisory Committee and the Advisory Committee on Dangerous Pathogens say that spread by surgical instruments is an "unlikely mode of transmission" after an operation on an appendix, particularly as the scalpel blade is thrown away.

Sir Kenneth said: "I want anyone in the Torbay area who has had an operation in the last few years to be aware of this advice in case they are worried that they may have been exposed to a risk." But he announced that he has set up an expert group to carry out a further assessment of procedures used to decontaminate instruments. "This work will start shortly," he said.

Prof Collinge said there were no agreed procedures to decontaminate instruments used on a patient with CJD: instead, they were incinerated. For some operations, such as the removal of tonsils, it would be relatively easy to develop a disposable kit, he said. But for an abdominal operation, where a range of instruments were used, "that would get very expensive".

Since it first appeared in 1995, human BSE has killed 27 people. But because it has such a long incubation time, a matter of decades, no one knows how many people might be infected.

Prof Collinge has pioneered studies on the presence of the disease in the tonsils of patients as a means of diagnosis which avoids a brain biopsy. He said that the discovery of the agent in the appendix was not surprising.

Earlier studies on the sheep equivalent of the disease revealed that lymphoid tissue, such as the tonsils, spleen, and in the gut, were infected with abnormal protein a third of the way through the incubation period of the disease, long before symptoms developed From the lymphoid tissue, the agent is thought to pass into the nervous system and then the brain.


28 Aug 98 - Trail that led to a deadly discovery

Staff Reporter

Telegraph ... Friday 28 August 1998


Disease could be spread by surgical tools

Tony Barrett provided the evidence that "human BSE" can be detected in the body before symptoms of the disease appear.

Sir Kenneth Calman, the Chief Medical Officer, said the death in June of Mr Barrett from the brain disease was a tragedy and his sympathies went to family and relatives. He said the new finding "provides us with an opportunity which it is only sensible to explore".

Today's issue of the Lancet describes how Mr Barrett, 45, a coastguard from Brixham, had his appendix removed at Torbay Hospital, Devon, in September 1995, eight months before displaying any signs of human BSE and three years before he died. He developed numbness of his face and right hand in May 1996. In April 1997, he was treated for depression. Early this year, his symptoms led to an assessment in a psychiatric unit.

A sample of brain tissue was removed in April and it was confirmed that he had human BSE. Dr David Hilton, a neuropathologist at Plymouth's Derriford Hospital, said: "I saw that Mr Barrett had an appendectomy in September 1995, and we felt that some of the lymph nodes contained in the organ could reflect traces of the disease. Tests revealed that we were correct, and these were corroborated at the National CJD Surveillance Unit in Edinburgh."

The discovery that the disease can be detected before symptoms appear marks a first, said Dr James Ironside, co-author of the Lancet paper. However, there remain uncertainties, for instance at what stage during the incubation period that lyphoid tissue such as that found in the appendix becomes involved.

Mr Barrett's widow, Sandra, said at the end, her husband could not recognise her or his two children. She said: "He was just so frightened. I don't want anyone else - any other family - to go through the same torture."


27 Aug 98 - New CJD shock

By James Meikle

Guardian ... Thursday 27 August 1998


Mass screening may follow discovery in appendix

The Government may be forced to carry out mass screening for the human form of BSE following the chance discovery of evidence of the disease in a patient who had his appendix removed in routine surgery.

The man showed no outward signs of the disease at the time but died three years later displaying the appalling symptoms of new-variant Creutzfeldt-Jakob disease - dementia, aggression and loss of bodily control.

So far it has been impossible to confirm diagnosis of the disease until after death, when the brain is examined.

The Government now has the chance to track the exposure of the population to bovine spongiform encephalopathy (BSE) in the late 1980s and the risk they were at before potentially infective beef began to be removed from the human food chain.

Ministers have approved a review of thousands of laboratory specimens of appendices and tonsils which are routinely kept in hospital laboratories after removal.

If they find signs of nv-CJD - which has killed 27 people since May 1995 - in just one more sample then mass screening of patients about to have their appendix or tonsils removed will take place.

Researchers are preparing procedures and ethical rules for the initial studies, which will be funded by the Medical Research Council.

If tests on patients are authorised, it is probable they - or parents in the case of children - would be asked for permission. Guidance on whether to tell them the results has still to be considered because the disease is incurable.

The case behind the latest twist in the saga involved Tony Barrett, a coastguard. He had his appendix removed at Torbay hospital, in Devon, in September 1995, eight months before displaying any signs of nv-CJD and nearly three years before he died.

Mr Barrett complained of numbness in his face and right hand in May 1996. In April 1997, he was treated for depression and later he became hyperactive and aggressive. This was followed by intermittent deafness, blurred speech and unsteadiness. He died in Derriford hospital, Plymouth, last June. A research letter about his case, although he will not be named, and the suggested screening of specimens is expected to be published in The Lancet medical journal.

After his death, doctors examined his appendix and found a rogue protein associated with nv-CJD . Samples from 44,000 appendectomies and 800,000 tonsillectomies carried out each year are routinely kept by hospital laboratories.

Last night the Government's chief medical officer, Sir Kenneth Calman, said there would be no immediate change of health or BSE controls. But officials are anxious for repeat tests on other appendices "to see what it means. Its significance is not clear. We cannot overstate that. "If we do a test on appendices and do not find anything, it is only partly reassuring. All this will do is give us a preliminary view of what is going on in the population as a whole."

The testing of previous samples would be done anonymously but if another positive case was discovered, the Government would switch to "pro-active mode" and ask permission to test people's appendices and tonsils before surgery.

However, initial checks may not uncover further examples because of the small number of nv-CJD victims in a population of 50 million.

At present there is no treatment to "modulate" the disease as there is with HIV and AIDS, for instance, although work on simple, reliable and effective tests for the disease and drugs to block its progress is under way.

Sir Kenneth said: "Ministers are fully aware of the background to this and all the consequences. They (support) the wish to pick up the opportunity to look at the prevalence in the population." Health chiefs in the south-west are also concerned that surgical equipment used to remove Mr Barrett's appendix was used in subsequent operations after cleaning and sterilisation. Surgical instruments used on known or suspected nv-CJD patients are meant to be destroyed.

Sir Kenneth said yesterday the risk of contamination was minimal, but a helpline will be opened today for patients seeking reassurance. "It is a very unlikely mode of transmission... Advisers consider the risk is minimal," he said. A further review of decontamination and disposal procedures was under way but "no action is anticipated at this stage".

South and West Devon Health Authority said: "Our advice is that there is no evidence that other patients are at risk."


27 Aug 98 - Moral Dilemma As Government Launches CJD Tests

Late breaking news

Evening Standard ... Thursday 27 August 1998


A key question remained unanswered as an investigation to check thousands of appendix and tonsil specimens for signs of new variant CJD was launched by the Government.

No decision has yet been taken over whether living patients found to be infected should be told of their condition.

Questioned about the subject the Chief Medical Officer Sir Kenneth Calman said future policy would depend on the initial findings.


17 Jul 98 - Dobson acts on CJD blood threat

by Jo Revill

Evening Standard ... Friday 17 July 1998


The Government today took urgent action to minimise the risk of CJD being passed on to patients through donated blood.

Health Secretary Frank Dobson has instructed the National Blood Authority to start removing white blood cells from the blood supply, a process known as leucodepletion.

The move came as the Government's advisers warned that it is impossible to be sure that blood transfusions are safe. One report which was put to the Spongiform Encephalopathy Advisory Committee suggests that up to 80,000 donors could be carrying CJD , the human equivalent of mad cow disease. Leucodepletion is known to be effective at minimising the risk of passing on the infection.

So far Britain has had 27 cases of new variant CJD, the form which is believed to arise from eating contaminated beef. Earlier this year, the Government decided to start buying in blood plasma from non-British sources as a precautionary measure.

Mr Dobson said today: "We will do whatever we are advised to reduce the theoretical risk to the blood supply of the transmission of new variant CJD. Although the risks are still theoretical, it is better to be safe than sorry."

Jeremy Metters, the Deputy Chief Medical Officer, said: "Leucodepletion will be rolled out in a systematic way, so that blood supplies are not interrupted and patients will continue to get blood when they need it." He added that it was more important than ever that blood donors continued to come forward to give blood, as an increasing number of patients were needing it.

Claire Rayner, of the Patients' Association, called for greater use of autologous blood transfusions , in which patients donate blood before an operation and receive it back during surgery.


17 Jul 98 - CJD risk threatens ban on British blood

by Ian Murray, Medical Correspondent

Times ... Friday 17 July 1998


Ministers are considering banning blood transfusions from British donors because of the remote risk that they might spread Creutzfeldt-Jakob disease, the human form of "mad cow" disease.

Such a ban would cost the health service millions of pounds, since British blood is free, while foreign supplies would have to be paid for.

But first the Health Department must decide which poses the greater danger: the 40 million-to-one chance of a donor having CJD, or imported blood which may be contaminated with other infections, such as HIV. A decision is expected next week .

The dilemma arises because the Government's advisers on "mad cow" disease and CJD have concluded after studying a series of reports that it is impossible to be sure that blood transfusions are safe. Three of the 25 known victims of CJD - all of whom died - were blood donors , although it is not known if they were carrying the disease when they gave blood.

One report considered by the Spongiform Encephalopathy Advisory Committee (Seac) suggests that up to 80,000 donors could be carrying CJD , in which case one in every 125 patients given a transfusion could receive blood contaminated with new variant CJD . And some patients who receive several different blood products would be at greater risk.

Seac said that one report showed that a blood purification system known as leukodepletion - which removes white cells - could not be guaranteed to clear the infection from blood, as had been hoped. The report, based on studies in America, found that the system was effective but not perfect.

Seac has now sent the reports to the Government, coupled with the advice that it must decide whether the CJD risk is greater than that of unknown infections in foreign blood . Blood donors in Britain are carefully screened, but other countries - especially those where donors are paid - are not always so scrupulous.

Previous Seac recommendations have been accepted by the Government, including one in February that blood from British donors should not be used in the manufacture of plasma products because of the possibility of infection. From September, all plasma will be bought from the United States, where new variant CJD is unknown.

Because plasma products can be kept for long periods and individual donations are mixed together, it cannot be guaranteed that some of the contaminated blood is not present in some of the products, so they are being phased out. However, blood used in transfusions can be kept only for a month, and since there is no known test for CJD until it is in an advanced state , it is impossible to know if a donor is suffering from it until after the blood has been used.

Stephen Dealler, a microbiologist who was one of the first to raise fears about new variant CJD, last night called on the Government to take urgent action. "This is the news that a lot of people feared," he said. "The official line has always been to play down the risk, but now we have firm evidence that a significant number of people could develop new variant CJD from blood. There may be thousands of people who have become infected while the experts have been aware of the seriousness of the situation."

A Health Department spokesman confirmed that the Seac advice was being considered and that a decision would be taken shortly. "If there is a risk, it is minute and people who need blood would be in infinitely greater danger of dying without a transfusion than from catching CJD from it," he said.