NY Times - Britain Details the Start of Its 'Mad Cow' Outbreak

[Guest guest]

NY Times

January 26, 1999

Britain Details the Start of Its 'Mad Cow' Outbreak

By EMILY GREEN

Despite years of increasing worry and worldwide headlines, the British

government has only now gathered the information it needs to figure out how

" mad cow disease " spread through the nation's dairy herds and apparently cost

35 people their lives.

Late last year, a public inquiry by the government concluded the yearlong

fact-finding phase of a nationwide investigation into the handling of mad cow

disease, more properly known as bovine spongiform encephalopathy, or BSE.

Past Coverage From The Times • Britain's Cow Illness Is Issue in Donating of

Blood (Jan. 19)

• Europe Votes To Let British Resume Sale Of Their Beef (Nov. 24, 1998)

• Britain's Daunting Prospect: Killing 15,000 Cows a Week (April 3, 1996)

• Britain Ties Deadly Brain Disease to Cow Ailment (March 21, 1996)

• Viruses or Prions: An Old Medical Debate Still Rages (Oct. 4, 1994)

• Heretical Theory On Brain Diseases Gains New Ground (Oct. 8, 1991)

• Disease Killing British Cattle (Jan. 24, 1990)

On the same day, an advisory committee of the U.S. Food and Drug

Administration recommended that the agency consider banning blood donations

from people who have visited Britain since 1980, just in case the disease

could be spread through the donations.

Both the recommendation and the British inquiry have the same aim:

prevention. " The primary object of this inquiry is not to attribute blame for

what occurred, " Lord Justice said as his inquiry began, " but

to identify what went wrong and why, and to see what lessons can be learnt. "

Colin Blakemore, a professor of physiology at Oxford, called for the

investigation in 1997, when he assumed the presidency of the British

Association for the Advancement of Science. The year before, Blakemore said:

" We must reform the way in which scientific advice is given to and interpreted

by government ministers. Time and time again, inappropriate assurances to do

with human health were made by people with no qualification to make them. "

The British panel will sort through the information it has gathered and issue

conclusions and recommendations in June. In the process, it is producing a

medical detective story of unusual proportions. Testimony by scientists,

veterinarians and doctors who dealt with the disease has painted a detailed

picture of what happened in the field and in the laboratory as the outbreak

took its course.

/ " Nova " A cow with bovine spongiform encephalopathy being

monitored. The illness has hurt Britain's beef industry and apparently killed

35 people.

------------------------------------------------------------------------

The inquiry has established that the epidemic began 14 years ago.

On Dec. 22, 1984, a veterinarian named Bee was called to a farm in West

Sussex, in southern England, where a dairy cow known simply as No. 133 was

displaying what he described as " a variety of unusual clinical

manifestations. " By Feb. 11, 1985, No. 133 was dead, and more cows on the farm

were showing symptoms, including aggression, panic and lack of coordination.

Bee ruled out several possible causes: lead and mercury poisoning, fungal

contamination of the feed container, kidney parasites. After six more cows on

the farm died, the farm owners agreed to allow another sick animal, No. 142,

to be killed so that an autopsy could be performed by the government. The

report came in on Sept. 19, 1985. The cow's brain was riddled with spongelike

holes, a pathologist at the government's Central Veterinary Laboratory in

Weybridge, Surrey, said. Cow 142 had a " spongiform encephalopathy. "

But it took pathologists more than a year to realize that the spongy-brain

disorder was a disease in itself, and not the result of something else, such

as poisoning. By November 1986, the condition had a name: bovine spongiform

encephalopathy, one of a school of diseases known as transmissible spongiform

encephalopathies, including scrapie, a disorder of sheep, and kuru, a human

disease linked to cannibalism.

By March 1988, the source of bovine spongiform encephalopathy had been

tracked by a Central Veterinary Laboratory epidemiologist to what

Carleton Gajdusek, a kuru researcher and Nobel laureate, now calls " high-tech

cannibalism " -- the use of performance-enhancing dairy feeds whose protein

came from meat and bone meal from slaughtered sheep and cows. (The practice

of including these ingredients in animal feed is no longer allowed in the

United States.)

The British government quickly announced the formation of a scientific

consultative committee to be led by a professor of zoology at the University

of Oxford, Sir Southwood. This group recommended that ruminant

protein be banned from cattle feed, and a crucial issue being examined by the

inquiry is the efficiency with which that ban was put into effect.

By fall 1988, people were beginning to wonder if the condition could spread

to people who ate meat from sick animals. As Southwood recalled for the

inquiry, " From work on scrapie we considered that the central nervous system

and, to a lesser extent, the lymphatic system were the tissues that would

harbor the agent. " As a result, a total ban on the use of certain bovine

offals, including brain, thymus and spleen, was announced in June 1989.

British pet food manufacturers had removed these substances from their dog

and cat food a year earlier, but in May 1990, a house cat came down with a

BSE-like disease, followed by a several zoo animals.

This ominous " species jump " prompted another government action. The

Southwood committee had predicted that, should bovine spongiform

encephalopathy erupt in humans, it would " closely resemble Creutzfeldt-Jakob

disease, " a fatal neurodegenerative disease that usually strikes the elderly

and, like kuru, scrapie and BSE, is a transmissible spongiform encephalopathy.

Shortly after the first cat died, a unit was set up at Western General

Hospital in Edinburgh to monitor humans for signs of Creutzfeldt-Jakob

disease.

Four years later, in summer 1994, in Wiltshire, the disease first appeared in

a human, when the parents of a Royal Air Force cadet, Churchill,

noticed that he had slipped behind in school. Soon he had succumbed to

hallucinations. By March 1995, he was undergoing comprehensive tests at the

National Hospital for Neurology and Neurosurgery in London. There, his mother

for the first time saw a possible diagnosis in a note on his chart: " CJD? "

Churchill died on May 23, 1995, and by that fall more young people

were found to be stricken with the same illness. Could the disease be

spreading from cows to people? The British government maintained that beef

products were safe. But some scientists began to contradict this position

publicly.

In December 1995, Sir Bernard Tomlinson, a neuropathologist from Gateshead in

northeast England, announced on BBC Radio 4 that he would not eat beef organs,

including calf's liver. The health secretary at the time, Dorrell,

responded on BBC, saying, " We have removed from the human food chain the

organs that could conceivably be linked to that, " and " There is no conceivable

risk from what is now in the food chain. "

Nevertheless, only four months later, on March 20, 1996, Dorrell read a

fateful statement before the House of Commons that 10 young people had died,

and " the most likely explanation " was " exposure to BSE. " That day the world

learned the name of a new disease: new variant CJD, or human BSE.

The European Union banned the sale of British beef for three years, until

November 1998. In the meantime, according to Britain's Ministry of

Agriculture, Fisheries and Food, more than 4,347,380 cattle were destroyed,

most merely because they were deemed old enough to conceivably harbor the

disease agent. The Ministry of Agriculture has estimated that the total cost

will reach $7.13 billion by 2002.

To date the human death toll stands at 35, with 34 cases in the United

Kingdom and one in France. Scientists who tested tissue samples at the

Neuropathogenesis Unit in Edinburgh and at Imperial College School of Medicine

at St. 's Hospital in London said BSE and human BSE are caused by the same

disease agent, possibly a novel form of protein called prions. Whether humans

were infected by bovine products, or from an independent source entirely,

remains unknown.

News last year that two of the British victims had been blood donors has led

to the establishment of a $77.5 million program to strip donated blood of the

white blood cells that might carry the BSE agent. Meanwhile, Britain is

importing most of its blood for plasma, mainly from the United States.

Some scientists regard the small number of cases among humans as a reason for

optimism. But estimates of how many cases may follow vary wildly, from tens

to hundreds to hundreds of thousands.

More than 173,000 cows from all over Britain have been confirmed to be

infected. Hundreds of thousands more might have entered the food supply

undetected.

Though the inquiry has yet to draw conclusions, its work has brought some

comfort to the families of people affected by the disease. " What we want is

the truth, " said Churchill's mother, Dot Churchill. " We believe

that's what we'll be told by the inquiry. "