BSE Testing in Humans/UK

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RE: BSE testing in humans/UK

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Subject: BSE testing in humans/UK

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Howdy, all--

Thought this might interest you prion-watchers. Again, note the

moderator's comment at the end regarding farmers and the food

system.

peace

misha

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

BSE TESTING, HUMANS - UK

************************

A ProMED-mail post

Date: Wed, 20 Jan 1999 10:32:22 -0600

From: Tam Garland

Source: Various News agencies (edited)

[For clarity, BSE = Bovine Spongiform Encephalopathy, CJD =

Cruetzfeldt- Disease, nvCJD = new variant Cruetzfeldt-

Disease, PrPsc = infectious prion. - Mod.TG]

The Lancet has the full text of *Investigation of Variant

Creutzfeldt- Disease and Other Human Prion Diseases with Tonsil

Biopsy Samples* available to registered non-subscribers. It is too

long and complex to relay directly. It can be found at

http://www.thelancet.com/newlancet/reg/issues/vol353no9148/article183

..html>.

The article may be summarized essentially as: Infectivity was present

throughout the body tissues in nvCJD patients. Infectivity was absent

in the body tissues in all other forms of CJD and neurological

disorders in patients. Infectivity throughout the body has serious

consequences for iatrogenic cases.

This suggests: new variant CJD is uniquely different from all other

forms of CJD, strengthening the supposition is has a different cause

(viz., BSE). The presence of infectivity in non-nervous tissue for

nvCJD suggests a similar effect for BSE and amplifies the likelihood

of foodborne passage. The presence in non-nervous tissue can be used

as a differential diagnosis of nvCJD vs. other CJD.

Animals studies have shown that spongiform encephalopathy diseases,

which include different forms of CJD, BSE in cattle and scrapie in

sheep, tend to reside in the lymph system before attacking the brain.

Tonsils are part of the lymph system. These findings suggest that

human tonsil biopsy samples may allow presymptomatic diagnosis of

nvCJD. Assuming sufficiently sensitive tests were available, then

PrPSc will be detectable in human tonsil within months of exposure to

BSE.

Professor Collinge, of St 's Hospital, London, published in

The Lancet the results of a test on 20 patients suspected to have

human BSE, known as new variant Creutzfeldt- disease. The test

failed to detect the prion protein in 11 patients, whom do not have

the disease. The protein was in the tonsils of the remaining 9. Of

these, 3 have died and been confirmed by autopsy; 1 has died but no

autopsy was performed and 5 are still alive. The Medical Research

Council and the Wellcome Trust funded the research that shows the

tonsil test could detect the infectious prion protein in nvCJD cases,

but not the " classical " CJD. Professor Collinge said this shows how

the rogue prion protein behaves quite differently to CJD. Possibly

the oral route of exposure, presumed to be the route of BSE infection

of patients with nvCJD, results in a more pronounced lymphoreticular

phase. Therefore, lymphoreticular tissues from patients with kuru

would be interesting to study.

Prof Collinge, said that scientists plan to screen thousands of people

using the new tonsil test. A significant positive result would provide

early warning of a major epidemic to come and allow time for action

aimed at averting the disaster. An anonymous mass screening program,

planned for later this year, will rely on anonymous tissue donors,

tissue removed during routine tonsillectomies and appendectomies.

There are now 35 confirmed cases of nvCJD, which may have developed as

a result of people consuming BSE contaminated beef, but there are

fears that this might be the first signs of an epidemic . Attempts to

estimate the future course of the disease have been hampered by a lack

of knowledge and a suitable test for early diagnosis.

Prof Collinge admitted his concern about the possibility of nvCJD

being transmitted via infected surgical instruments. This had always

been a theoretical risk, but the conclusive evidence of tonsil

infection meant it was now a real possibility. Cost prevents

discarding expensive surgical instruments, said Professor Collinge. He

added: " There is no means of sterilising surgical instruments

adequately for prions. My own view of this is that we may need to

consider using more disposable instruments for certain procedures. "

Professor Liam son, the Chief Medical Officer said, " Current

policy based on advice from the Advisory Committee on Dangerous

Pathogens published in April 1998 is when any patient with symptoms of

nvCJD, or suspected of having nvCJD, undergoes surgical operation, the

instruments must be removed so that they cannot be used again. "

Experts from the Joint Advisory Committee on Dangerous Pathogens and

the Spongiform Encephalopathy Advisory Committee are considering the

surgical implications. They will be advising the Government on setting

up new guidelines on the use of disposable surgical instruments to

limit the risks to patients.

Acting on expert advice the Government has already introduced

leucodepletion - removal of white blood cells - for donated blood and

banned the use of British-produced plasma in blood products. There is

no cure for nvCJD at this time, but research has shown that a drug

used in America to treat cystitis may block its spread.

Following this new development with BSE in humans, Nick Brown,

Minister of Agriculture, announced his decision to make the beef

industry pay u21.5 million a year in meat hygiene charges for BSE

controls. The result was a clash with leaders of the farming groups.

They said the move made a mockery of the Government's u120 million aid

to farmers two months ago. The Ministry of Agriculture said it did not

know how much the charges would be in individual cases but they would

be based " on the current national hourly rate for employment of meat

technicians, meat inspectors and official veterinary surgeons " .

Charges, to be imposed from March 29, will cover the cost of the Meat

and Hygiene Service's enforcement of controls in abattoirs and meat

plants to ensure that " high risk " cattle and sheep offals are kept out

of the human food chain. [if an animal does not show clinical signs,

is not from an infected herd, what makes them *high risk*? - Mod. TG]

Until now, costs of checks on specified risk materials, including

brain, spinal cord, tonsils and spleen, have been met by the taxpayer.

Ben Gill, president of the National Farmers' Union of England and

Wales, said: " Specified risk material removal is a public health issue

and the industry should not be expected to bear the costs associated

with it. "

The Government has allowed the industry until Feb 12 to comment on the

charges - but the consultation process only covers the details. The

decision to pass on the charges has already been taken. [Then what's

the point in comments? - Mod. TG]

- --

ProMED-mail

[Although this is a tremendous advancement in testing and hopefully

someday treatment of nvCJD, it is unfortunate the government considers

it necessary to make the farmers responsible. Yoking the farmer with

the responsibility of this and imposing higher cost on an already

suffering industry could have grave consequences on the food supply. -

Mod.TG] ...............................tg/es

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Michele Gale-Sinex, communications manager

Center for Integrated Ag Systems

UW-Madison College of Ag and Life Sciences

Voice: FAX:

http://www.wisc.edu/cias/

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

If you knew what life was worth, you

would look for yours on earth. --Bob Marley