Subject: BSE and CJD

From: [email-masked] (J Ralph Blanchfield)
Date: Thu, 21 Mar 1996 11:21:10 GMT

Hello All, 

There is still no direct scientific evidence linking BSE and CJD, or
that BSE can be transmitted to humans..

However,  ten cases of CJD have emerged over the past two years, and
have been found by the CJD Surveillance Unit to exhibit unusual
features, as follows

1. No shared risk factors suggesting a common risk factor.

2. The individuals were much younger than normal CJD cases, with an
average age of 27.5 (cf usually over 63).

3. Duration of illness average 13 months (normally 6 months).

4. EEG electrical activity in the brain is not typical.

5. Although brain pathology is recognisable as CJD, the pattern was
different from normal CJD, with large aggregates of prion protein
plaques (the brain pathology pattern was, however, totally different
>from  that in the brains of BSE-affected cows).

The Spongiform Encephalopathy Advisory Committee (SEAC) concludes "On
current data and in the absence of any credible alternative the most
likely explanation at present is that these cases are linked to
exposure to BSE before the introduction of the SBO ban in 1989".
Professor John Pattison, Chairman of  SEAC has said "It is still just
possible that we have found this because we looked for it more
intensively than anyone else". 

(Personal comments 
Note that SBO is Specified Bovine Offals.
If the SEAC "likely explanation" is correct, I would have expected the
numbers emerging by now the very greatly in excess of 10).

The SEAC is meeting again this weekend, and I expect the Institute of
Food Science & Technology's (IFST) Position Statement on BSE to be
updated next week to take account of newest developments.

I append:

the actual statement on 20 March by Stephen Dorrell, Secretary of
State for Health;
the statement on 20 March by the Chief Medical Officer;
the statement on 20 March of SEAC.

Regards

Ralph

20 March 1996

DEPARTMENT OF HEALTH

CJD AND PUBLIC HEALTH -- STEPHEN DORRELL STATEMENT

Stephen Dorrell, Secretary of State for Health today made the
following statement to the House of Commons;

"With permission, Madam Speaker, I would like to make a Statement
about the latest advice which the <Government has received from the
Spongiform Encephalopathy Advisory Committed The House will be awake
that this Committee which is chaired by Professor John Pattison was
established in 1990 to bring together leading experts in neurology,
epidemiology and microbiology to provide scientifically based advice
on the implications for anima] and human health of different forms of
spongiform encephaJopathy.

"The Committee provides independent advice to government   Its members
are not Government scientists; they are leading practitioners in their
field and the purpose of the ( Committee is to provide advice not
simply to Government, but to the whole community on the scientific
questions which arise in its field. The Government has always made it
clear that is our policy to base our decisions on the scientific
advice provided by the advisory committee The Committee has today
agreed new advice about the implications for animal and human health
of the latest scientific evidence. Copies of the Committee's advice,
together with a statement front the Chief Medical Officer which is
based on that advice, have been placed in the Vote Office,

"The Committee has considered the work being done by the Government
Surveillance Unit in Edinburgh which specialises in Creutzfeldt-Jakob
disease. This work, which relates to the 10 cases of C}D which have
been identified in people aged under 42, has led the Committee to
conclude that the unit has identified a previously unrecognised and
consistent disease pattern. A review of patients' medical histories,
genetic analysis, ant consideration of other possible causes have
failed to explain these cases adequately. There remains no scientific
proof that BSE can be transmitted to man by beef, but the Committee
have concluded that the most likely explanation at present is that
these cases are linked to exposure to BSE before the introduction of
the specified bovine offal ban in 1989. Against the background of this
new finding the Committee has today agreed the series of
recommendations which the Government is making public this afternoon.

"The Committee's recommendations fall into two parts.

"Firstly, they recommend a series of measures to further reduce the
risk to human and animal health associated with BSE. My Rt Hon Friend
the Minister of Agriculture, Fisheries and Food will be making a
statement about those measures which fall within his Department's
responsibilities immediately after questions on this Statement have
been concluded.

"In addition the Committee recommended that there should be urgent
consideration of what further research is needed in this area and that
the Health and Safety Executive and the Advisory Committee on
Dangerous Pathogens should urgently review their advice. The
Government intends to accept all the recommendations of the Advisory
Committee in full; they will be put into effect as soon as possible,

"The second group of recommendations from the Committee offers advice
about food safety on the assumption that the further measures
recommended by the Committee are implemented.. On that basis the
Committee has concluded that the risk from eating beef . now likely to
be extremely small and there is no need for it to revise its advice on
the safety of milk.

"The Chief Medical Officer will be writing today to all doctors to
ensure that the latest scientific evidence is drawn to their
attention. In the statement by the Chief Medical Officer which we have
placed in the Vote Office, Sir Kenneth Calman poses to himself the
question whether he will continue to eat beef. I quote his answer. "I
will do so as part of a varied and balanced diet. The new measures and
effective enforcement of existing measures will continue to ensure
that the likely risk of developing CID is extremely small."

"A particular question has arisen about the possibility that children
are more at risk of contracting CJD. There is at present no evidence
for age sensitivity and the scientific evidence for the risks of
developing CJD in those eating meat in childhood has not changed as a
result of these new findings. However, parents will be concerned about
implications for their children and I have asked the Advisory
Committee to provide specific advice on this issue following its next
meeting.

"Any further measures that the Committee recommend will be give the
most urgent considerations As the Government has repeatedly made
clear, new scientific evidence will be communicated to the public as
soon as it becomes available."

Notes  to Editors

1. The Spongiform Encephalopathy Advisory Committee (SEAC) reviews the
evidence, including the science and details of individual CJD cases

2. The National CJD Surveillance Unit was established at Western
General Hospital in Edinburgh in May 1990 under the direction of Dr R
Will. It is funded jointly by the Department of Health and Scottish
Office.

DEPARTMENT OF HEALTH

20 March 1996

CJD AND PUBLIC HEALTH -- STATEMENT BY THE CHIEF MEDICAL OFFICER

Sir Kenneth Calman, Chief Medical Officer said today

"The statement by Spongiform Encephalopathy Advisory Committee (SEAC)
of the description of a new variant of CJD which has a distinct
clinical and pathological appearance, is a cause for serious concern.
While there is no direct evidence of a link between BSE and this new
variant, pending further research I agree with SEAC that the most
likely explanation is that these cases may be linked to exposure to
BSE before the SBO ban in 1989.

"I have always sought and followed the advice from the experts in this
field, notably SEAC, and  Ministers have always followed this advice.

"While the theoretical risk has always been acknowledged, and the
measures which have been introduced to control the spread in cattle,
have had as their basis the reduction of any possible risk, these new
findings are important.
 "They have a number of implications:

-- these new findings suggest that there may have been an association
between eating bovine products, which may have been contaminated by
infected brain and spinal cord, and a risk of developing CJD before
the introduction of measures in 1989.

-- there remains, however, no scientific: evidence that BSE can be
transmitted to man by beef. However, risk analysis suggests that even
the likelihood of the extremely small risk of transmission increases
when non-muscle parts from older cattle are eaten. It is essential
therefore that the source and quality of beef is clear and that the
public can he assured of these measures .

-- current measures must be rigorously enforced. This is at the heart
of the issue. SEAC will recommend that effective training measures
should be introduced and consider this further. 

-- further research is urgently required and this will be funded.

"For this reason it is considered that an additional measure, the
de-boning of beef in specified plants with full supervision by the
Meal Hygiene Service in cattle over 30 months of age should be
introduced. This will significantly reduce the likelihood of extremely
small risk of transmission from non-muscle parts of the carcass. These
will be prevented from entering the food chain. This will be discussed
further by SEAC

"Meat or meat products on the shelf or in carcass form do not now to
be removed or destroyed .

"There is nothing to lead the Committee to change its advice on the
safety of milk. It is considered to be safe.

"The implications for the public who may be worried about contracting
the disease have also been considered. At present the overall numbers
are very small, but there is as yet no indication as to the likely
numbers of patients who may contract the disease in the future. There
is currently no clinical test for the disease and today all doctors
will be contacted and  given further background on the new
information.

"The question that will be asked is whether or not I will continue to
eat beef. I will do as part of a varied arid balanced diet. The new
measures and effective enforcement of existing measures will continue
to ensure that the likely risk of developing CJD is extremely small..

"There is at present no evidence for age sensitivity and the
scientific evidence for the risks of developing CJD in those eating
meat in childhood has not changed as a result of these new findings.
However, parents will be concerned about implications for their
chiIdren.  SEAC has been asked to provide specific advice on this
issue.

"Further discussion will take place over the next few days and
additional measures may be considered in the future. As has been said
before, should any new scientific evidence become available it will be
communicated to the public as soon as possible."
20 March 1996

STATEMENT BY SPONGIFORM ENCEPHALOPATHY ADVISORY COMMITTEE

The Spongiform Encephalopathy Advisory Committee have considered to
cases of CJD which have occurred in people aged under 42 as recently
identified by the CJD Surveillance Unit, Edinburgh. The Committee have
concluded that the Unit has identified a previously unrecognised and
consistent disease pattern, A review of patients' medical   histories,
genetic analysis to date and consideration of other possible causes,
such as increased ascertainment, have failed to explain these cases
adequately. This is cause for great concern. On current data and in
the absence of any credible alternative the most likely explanation at
present is that these cases are linked to exposure to BSE before the
introduction of the SBO ban in 1989.

CJD remains a rare disease and it is too early to predict how many
further cases, if any, there will be of this new form. Continued
surveillance is of the utmost importance and the Committee are
actively seeking further data from both the UK and abroad to help
assess the full significance of the Unit's findings.

The Committee emphasised it is imperative that current measures to
protect the public health are properly enforced and recommend constant
supervision to ensure the complete removal of spinal cord.

The Committee also recommend:

a.    that carcasses from cattle aged over 30 months must be deboned
in licensed plants supervised by the Meat Hygiene Service and the
trimmings must be classified as SBOs.,

b.    a prohibition on the use of mammalian meat and bonemeal in feed
for all farm animals,

c.    that HSE and ACPP, in consultation with SEAC should urgently
review their advice
in the light of these findings,

d.    that the Committee urgently consider what further research is
necessary.

   The Committee does not consider that these findings lead it to
revise its advice on the safety of milk.

[f the recommendations set out above are carried out the Committee
concluded that the risk from eating beef is now likely to be extremely
small.

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J Ralph Blanchfield
Food Science, Food Technology & Food Law Consultant
Chair, IFST Member Relations & Services Committee
Web Editor, Institute of Food Science & Technology
IFST Web address: http://www.easynet.co.uk/ifst/ 
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