"I've been going through some newspaper articles trying to collate information about the vCJD cases that were the basis for the government's statement on March 20. (I assume everyone recalls that date.) The reports I've seen show some inconsistencies and don't add up to 10 names. They include:Vicky Rimmer, 18, North Wales Stephen Churchill, 19, Wiltshire an anonymous 16-year-old girl of Turkish-Cypriot extraction Michelle Bowen, 29, Manchester Jean Wake, 38 Fonnie Van Es, 44, Banbury Christine Hay, 46, Australia Maurice Callaghan, 30, Belfast, Ireland Anna Pearson, 29, Kent Ann Richardson, 41 Ken Sharpe, 42, Liverpool David Tipping, Wiltshire Ann Harness, Suffolk Gwendoline Lawrence, 64, Clwyd Kevin Morrison, 25, Aberdeenshire Peter Hall, 20This adds up to 16 names. They were all mentioned in newspaper reports about vCJD in the days after March 20. However, other newspaper reports indicate that David Tipping actually contracted his case of CJD from treatments of human growth hormone, and Fonnie Van Es is apparently considered a normal "spontaneous CJD" case rather than a case of vCJD. After eliminating them, that still leaves 14 names.
Can anyone comment to me on this list? Which of the names listed don't belong among "the 10"? Which ones have been confirmed as vCJD by the government? Also, what's the current status of Vicky Rimmer? The last report I've seen indicated that she was still alive. Is this still the case? Finally, are there other confirmed or suspected vCJD cases not on this list, or not among "the 10"?"
|(* = variant - CJD)||(? = CJD unconfirmed)||(# = occupation)||(i=iatrogenic)|
|Year||Referrals *||Deaths of definite and probable cases|
|1996 (end of May)||46||12||0||0||1||6***||19|
** The CJD Surveillance Unit was set up by the Department of Health and the Scottish Home and Health Department in May 1990.
*** Plus 2 definite cases of V-CJD still alive; total number of confirmed cases of V-CJD: 11.
I think that the most interesting point in the latest Nature was a throwaway line in David Skegg's article: saying that the mouse bioassay is not sensitive enough. This is self-evident, he says, because it can't determine which tissue is the cause of maternal infection. But maternal infection happens. Therefore the mouse is not a sufficient indicator of tissues' infectivity.
People generally look to science to offer an unequivocal answer to questions. How inconvenient, then, to have to say that in the matter of the culling of cattle aged over 30 months, science can offer powerful arguments both for and against halting the scheme right now.
The arguments in favour appear in the careful calculations of the team of Oxford scientists, who yesterday reported that the BSE epidemic will die out in 2001 if there is no cull; and at virtually the same time if there is. For every case of BSE averted by the cull, they reckon, 45 cows will die needlessly. The government estimates that the cost of the scheme will be £600 million in the first year, and £500 million in each subsequent year.
But some disturbing data has also emerged in the past month. BSE can be transmitted from cow to calf. How? We don't know. This, says David Skegg, of the University of Otago in New Zealand, pushes us towards some uncomfortable facts. None of the tissues that might carry the disease from the mother cause BSE when injected into mice. But some must carry it; otherwise the calf could not catch it.
Therefore, injecting cow tissues into mice is not a sensitive enough way of finding out whether the BSE agent is present. However, all the government's assurances about the safety of beef and other tissues such as liver and lungs - yesterday's latest putative BSE-carrying villain - are based around the assumption that mice are just like humans in their sensitivity to BSE. Other experiments with monkeys imply they are not. The scientists advising the government have tried to make this point repeatedly, but the politicians don't want to hear them. "It's true," says Jeff Almond, of the Spongiform Encepalopathy Advisory Committee. "If al the tissues are genuinely BSE-negative, then you couldn't have maternal transmission." But you do: up to 10 per cent of calves born to BSE-infected mothers develop the disease.
We can hear the wind of logic blowing through this house of cards. Beef might not be "safe" after all - though the rapid drop in the incidence of the disease means that at least fewer cows harbouring the disease are reaching our dinner plates. And if there is one measurement in all this which is even harder to fathom than the risk posed by BSE to humans, it is the extent to which British consumers - ostensibly the object of all these policies - are really worried.
In all of this, my sympathies lie with the farmers. They have often been depicted as the creators of the BSE epidemic, who somehow "fed cows to cows" - as if they hung the carcasses up in their farmyards to be consumed by the herd, like a fox before hounds. Quite untrue; many are people vainly trying to make a living from this 10,000-year-old profession, who are beset by the pressures of the modern world with its insistence on economy, efficiency and productivity. Nobody could blame the farmers for taking the cheap option of using the protein cakes from the meat and bone meal manufacturers. Those are the companies to blame, if blame has to be laid. They too will feel the pinch if the cull goes ahead.
The number of infected cows consumed, by the way, averages out to about 1 in every 50 over the past ten years in Britain. Before the SBO ban, it was slightly higher - about 3 per cent.
Dealler's figure, from p.295 of his book, for the years 1985-1995 of "cattle eaten that were incubating BSE at the time of slaughter", totals to 1.71 million. In the average year, a total of 3.2 million cows are slaughtered, so multiply by 10 to get your decade total of slaughtered cows.
|Country||29 April||25 March|
A HERD of French cows, flanked by police motorcycle outriders, plodded along the slow lane of a busy highway towards Paris yesterday in the latest, and maddest, protest at the dire effects of mad cow disease on the French beef industry. The cattle and their owners set off from the south of Poitiers on August 11 to draw attention to plunging beef prices and, as they approach the end of their 220-mile odyssey, they have caught the imagination of the public and brought new pressure to bear on the French Government.
"We want to see President Chirac, and we will," declared Jacques Tourenne as he rounded up his cows on a football field near Rambouillet, 30 miles south of Paris, for the morning cattle-drive. The herd and herdsmen, originating in one of the poorest agricultural regions of France, will arrive in the capital on Saturday when the animals will be assembled on the Champ de Mars, which has not seen grazing cattle since the siege of Paris in 1870.
What began as a quixotic protest by a handful of farmers from the Vienne region has gradually swollen to 36 cows and more than 80 people. Teams of six cows at a time take it in turn to amble along the tarmac, behind a tractor with a placard reading: "We are marching to avoid annihilation", while the rest of the herd follows in trailers.
Passing through small towns and villages along the way, they are greeted by the ringing of church bells and spontaneous offers of food and money from sympathetic locals. Beef consumption in France has dropped by a third since the start of the mad cow crisis in March, and the protesters say they face financial ruin unless the Government and the European Union steps in with massively increased compensation and a fixed price for beef.
The protest now occupies a regular slot on the evening news and the progress of the "Mad Cow March" is relayed daily by national newspapers. Politically and otherwise, a prolonged occupation of the Champ de Mars, in the shadow of the Eiffel Tower, could prove extremely messy. Jacques Chirac has often emphasised his roots in the cattle-producing region of the Corrèze and one senior Elysée official said President Chirac would probably agree to meet a delegation of the marchers at the weekend.
The troop headed north along the four-lane N10 highway yesterday at a steady 2mph, causing huge tailbacks but prompting honks of support from lorries passing in the opposite direction.
Roland Fontaneau said he did not regret giving up his summer holiday to walk to Paris. "This was the best way we could think of to show how serious things have got," he said. Like many French farmers, he holds Britain to blame for the health scare that has undermined his livelihood, but he also suspects a more sinister conspiracy. "I think the United States put pressure on Britain to destabilise the European beef market so that American suppliers could monopolise the market," he said.
At night the walkers sleep on straw in the cattle trailers or accept whatever local hospitality is offered. "It's amazing how much help we've had," M Fontaneau remarked, as he whacked the ample rump of Marguerite, a Limousin heifer and the self-appointed herd-leader. The walkers say that Marguerite has become wholly committed to the protest, often refusing to get back into the trailer at the end of her stint on the road. Herding cows on a dual carriageway is technically illegal, yet the police have not only allowed the march to continue but have provided a motorcycle escort. They have warned the herdsmen, however, that as traffic becomes heavier on the approach to the capital, the cows will have to travel on the trailers for some stretches and avoid rushhours.
After their strenuous efforts, the cows will not end up at the Rungis foodmarket outside Paris, but will be returned to the Vienne, leaner and a good deal fitter. "Sometimes we bathe their feet because the road makes them hot," said Jean Grolleau, owner of Marguerite, but otherwise the cows appeared to be enjoying their forced march.
A HERD of more than 30 cows grazed nonchalantly alongside the Eiffel Tower yesterday as President Chirac met their owners and promised to support cattle farmers after the BSE crisis. The protesters, bovine and human, left Charroux in central France on August 11 to walk 220 miles to Paris, and were cheered by Parisians as they plodded on to the grassy Champ de Mars yesterday.
The day after farm unions mounted a huge operation to intercept lorries suspected of importing beef from Britain and outside the European Union, M Chirac welcomed a delegation of demonstrators, who entered the Elysée Palace clad in farming clothes and carrying staffs. "The farmers must know that we support cattle breeding and that we will not let them down," the President said after the meeting. M Chirac's power base is in the cattle-producing Corrèze region and the former Agriculture Minister spent an hour and a half listening to the grievances of the farmers, who have seen beef consumption drop by up to a third since March. "He talks like a farmer," Pierre Grolleau said, adding: "The President told us he would not let us down, but he had no magic wand."
NEWBORN French calves are being shipped to Britain in their hundreds to be slaughtered under a subsidy scheme intended to compensate British dairy farmers for income losses caused by "mad cow" disease.
The Labour Party and animal welfare groups said they were appalled by the trade and called on the Government to stop it. The Ministry of Agriculture is raising this matter with the European Commission. But a spokesman said there was nothing illegal about the imports under the free-trade rules of the single market.
Several hundred French calves have arrived through Dover over the past few weeks in a reversal of the trade in British veal calves to the Continent which last year brought thousands of protesters on to the streets. But the French calves are not for rearing or eating. They are taken straight to an abattoir to be slaughtered.
The carcasses are rendered and incinerated. Provided the animals are less than 20 days old, they qualify for an EU subsidy of £103 a head. The subsidy was introduced in April after British beef exports were banned in response to the Government's disclosure of a possible link between Creutzfeldt-Jakob disease in humans and eating beef contaminated by BSE. Before the ban, dairy farmers had been exporting up to 450,000 calves a year to the Continent for veal production, a trade worth about £45 million.
The animals were mainly surplus male calves for which there is no market here. British farmers, with the export market closed, have sent some 151,000 calves to slaughter under the Calf Processing Scheme to claim the subsidy, which is shared with the abattoir operator.
The man behind the import of French calves is David Muir, a leading livestock dealer based near Oxford. He says he is merely trying to save a business virtually destroyed overnight by the beef ban. "Some people are trying to portray me as an unscrupulous cattle dealer, but I have to make living," he said. "Since the ban I have had to lay off the 18 people I had working for me and get rid of seven of my ten lorries. I desperately need the work."
Mr Muir said that he got £5 of the £103 subsidy per animal as commission. About £80 went to the French farmer and the rest to the abattoir. He began shipping calves several weeks ago and his latest consignment of 200 arrived at Dover from Dunkirk yesterday. "The French have just as much need of this subsidy as the British," he said. "French cattle prices have been driven down by the BSE scare and £80 is a better price than they can get on their local markets."
Elliot Morley, Labour's spokesman on rural affairs and animal welfare, said the Goverment must act to stop the trade. Philip Lymbery of Compassion in World Farming, which led last year's protests against the veal trade, said he was "appalled at this slaughter of the innocents".
Mr Morley said: "The subsidy was put in place to help British farmers. It is being funded very largely by British taxpayers and it is not designed to line the pockets of people dragging calves over here from mainland Europe."
The Ministry of Agriculture said the subsidy came out of the EU budget and would be mostly paid for by taxpayers in other states.
THOUSANDS of angry French farmers erected barricades and intercepted lorries suspected of carrying beef from Britain or countries outside the European Union in an all-night protest over the dire effects of "mad cow" disease. The display of muscle by farm unions, organised in strictest secrecy and carried out with military-style precision, helped to push the franc yesterday to its lowest level for five months.
Using portable telephones and faxes, union leaders mobilised more than 15,000 demonstrators to block main roads, frontier posts and toll gates from late Wednesday night, while squads of farmers carried out spot-checks on lorries carrying meat into France. Simultaneous protests were held in several French towns and cities. Unions said the "nocturnal operation" was intended to reassure French consumers that no British beef was being smuggled into France in defiance of the import ban, and to ensure that all imported meat conformed to health safety standards. But the protest was also aimed at cheap meat from East Europe, which French farmers say has helped to force down prices after the BSE crisis. Beef consumption in France has dropped by a third since March.
More than 2,000 lorries were intercepted illegally before the barricades were dismantled yesterday morning. The unions said at least 15 lorries were found to be carrying "suspect" cargo.
More than 40 British lorries were stopped on arrival at the Channel ports of Dieppe and Le Havre between 10pm and 4am. Four of these, carrying British poultry and lamb, were searched thoroughly and then allowed to continue. "We know it's illegal, we have no right to intercept vehicles, but we felt it was important for the sake of French consumers," Arnold Puech-Dalissac, an official of the National Centre of Young Farmers in Normandy, said. "The British lorry drivers always look frightened when they see a hundred French farmers waiting for them on the dock, but we treated them correctly." The police made no attempt to restrain the farmers. But union officials said police had diverted some lorries away from the roadblocks.
The demonstration, on the eve of an EU meeting to discuss the BSE crisis, was jointly organised by France's two largest agricultural unions, the FNSEA and the young farmers' union, which have long threatened an "explosive" end to the summer. Farmers are demanding increased compensation to counter the collapse of the beef market. "There will be more union operations in the next few days if our calls for help are not heard," a statement said. Luc Guyau, head of the FNSEA, said: "We will be inflexible." He added that the aim of the protest was not to close borders, but to ensure that "both producers and consumers benefit from complete openness on the origin of meat". The operation was carried out in secrecy in order to intercept "rogue importers from outside the EU". In other protests, farmers dumped veal on the streets of Laval, invaded local government offices in the Creuse region and occupied an abattoir near Grenoble. A Dutch lorry driver on the Belgian border who refused to allow an inspection had his tyres slashed and his cargo handed over to customs officials.
Philippe Vasseur, the Agriculture Minister, insisted last night that he had not been warned in advance of the unions' demonstration, but avoided criticising the farmers. "We will do what we have to do to ensure the farmers are compensated for their losses and to safeguard their future." President Chirac has agreed to meet a delegation of farmers from the Vienne region today. The group, driving a herd of more than 30 cows ahead of them, are due to arrive on the Champ de Mars in central Paris this morning, a day ahead of schedule. "We have some simple truths to tell him, particularly about the effects of BSE disease," a spokesman for the group said.
The German ban on imports of Swiss beef and beef products must remain in place until the BSE problem is cleared, Agriculture Minister Jochum Bochert has stressed. To date Switzerland has had 211 cases of BSE. Speaking at a meeting of the German central agricultural marketing board (CMA) last month, the minister sought to reassure consumers by stressing that German beef comes only from animals slaughtered in Germany and veterinarian checked. However, compared with its European neighbours, the German reaction to BSE has been out of proportion to its incidence.
To date there have been 4 cases of BSE reported in Germany. All were imported breeding stock from the UK and held to have been "infected" prior to entering Germany. There is no definite proof however of when and how that "infection" took place, notes Arzte Zeitung. Moreover, all four were of breeds usually grassfed and reared extensively. Perhaps as few as 200 of the 160000 British BSE cases have stemmed from cattle reared in this manner, believes Dr Gotz Anhalt, a veterinarian with the Agriculture Ministry of Lower Saxony.
The 4 cattle were sold at about 2 years old to German cattle traders. It is assumed that they were fed up before export to enhance weight gain and make them more attractive to dealers. Their ages, 3 were born in 1988 and 1 in 1986, would indicate that that any such feeding with meat and bone meal would have occurred after the UK's July 1988 ban on mammalian feed, thus illegally. Arzte Zeitung has thus speculated on the possibility that they became infected within Germany. The animals were sold through cattle traders in Lower Saxony and elsewhere. There is a dispute for at least one as to the herd of origin. A veterinarian claimed that for the index case in February 1992, UK documentation showed clearly that the animal came from a herd that until then had been BSE-free. Another veterinarian also involved in the diagnosis claims that the precise origin was far from clear and possibly through "dubious channels".
The issue of BSE and its effects in Germany have incensed the national farmers' union (DBV) whose president has lambasted the UK for its "scandalous negligence" in past BSE control efforts. He asserts that German farmers are innocent victims and have suffered a very severe backlash - surveys show that German beef consumption is lagging at under half pre-crisis levels. The DBV is adamant that mammalian feed has never been fed to German cattle and that "Germany is BSE free".
A survey of 50 physicians was conducted in Leeds, England, to evaluate their awareness of the national surveillance system for Creutzfeldt-Jakob disease. Of the 38 physicians who responded 4 neurologists were aware of the system (3 of whom had seen cases), no neurologist responded who was unaware of the system; 3 psychiatrists were aware but 7 were not aware of the system; 5 specialists in geriatrics were aware and 2 were not; 8 other medical specialists were aware but 9 were not. Cases of variant-Creutzfeldt-Jakob disease, who may not initially present with obvious neurological symptoms, may at first be referred to psychiatrists, a group that appears to be less aware of the surveillance system. The researchers call for the existence of the CJD Surveillance Unit in Edinburgh to be made more widely known and for working case definitions for provisional, possible and confirmed cases to be available.
Goodbrand IA; Ironside JW; Nicolson D; Bell JE National Creutzfeldt-Jakob Disease Surveillance Unit, Western General Hospital, Edinburgh, UK Neurosci Lett, 183: 1-2, 1995 Jan 2, 127-30An immunohistological study of the spinal cord in 20 cases of sporadic and 4 iatrogenic (growth hormone) cases of Creutzfeldt-Jakob (CJD) diseasepatients was performed to detect the presence of disease specific prion protein using a number of different antisera. Prion protein was present in all thegrowth hormone recipients and in 11 of the 20 sporadic CJD cases. Plaque-like deposits of prion protein were found in all the growth hormone cases andthree of the sporadic cases. This is the first demonstration of the topographic immunolocalisation of prion protein in the spinal cord of CJD patients, afeature which could help elucidate some important aspects of the pathogenesis of CJD.
Budka H; Aguzzi A; Brown P; Brucher JM; Bugiani O; Collinge J; Diringer H; Gullotta F; Haltia M; Hauw JJ; et al Institute of Neurology, University of Vienna, Austria Brain Pathol, 5: 3, 1995 Jul, 319-22Despite many sensational and intimidating reports in the mass media, transmissible spongiform encephalopathies (prion disease) are not contagious in theusual sense. Successful transmission requires both specific material (an affected individual's tissue, from or adjacent to CNS) and specific modes (mainlypenetrating contact with the recipient). Nevertheless, specific safety precautions are mandatory to avoid accidental transmission and to decontaminate anyinfectivity. Autopsy is essential for definite diagnosis of these disorders. Recommendations are given here for performance of the autopsy, forneuropathology service and appropriate decontamination; they are based on the current literature and on precautions taken in most laboratories withexperience in handling tissue from transmissible spongiform encephalopathies. In particular, special care must be taken to avoid penetrating wounds,possible contamination should be kept to a minimum, and potential infectious material must be adequately decontaminated by specific means.
Hogan RN; Cavanagh HD Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas 75235-9057, USA. Cornea, 14: 6, 1995 Nov, 547-53A great deal of controversy and concern exists over potential transmission of central nervous system diseases by corneal transplant. The purpose of this study was to evaluate the available data relative to this question, pertaining especially to transmission of infectious dementia. From these data, determination of conveyance risks are possible, and rational policies for donor inclusion criteria can be constructed. Retrospective analysis of available published data regarding transmission of infectious dementias was performed. Risk of disease transmission was calculated from population data. Of the various forms of dementia, only rabies, hepatitis B, and Creutzfeldt-Jakob disease (CJD) have been transmitted by corneal transplantation. Transmission of the first two viruses is preventable by serologic testing. Prevention of CJD transmission relies on clinical history. Despite the possibility of transmission and the lack of available testing, slow virus disease (CJD) has been transmitted only once. That this case represents an extremely rare event is supported by a lack of successful transmission via corneal transplant in monkeys; lower levels of infectious agent in cornea than in brain; lack of successful transmission of similar human dementias, including Alzheimer's disease to primates; the apparent requirement for homozygosity at codon 129 of chromosome 20 for transmission; lack of transmission in 5-10% of CJD cases even after brain inoculation; and low numerical risk of transmission based on population data. Only 0.5-4 CJD infected donors per year would be expected. Current Eye Bank Association of America criteria for donor exclusion based on suspicious history are adequate to protect against accidental conveyance of transmissible dementia.