Variant Creutzfeldt-Jakob Disease 18 Mar 2010 : Column 1075 UK PARLIAMENT
Variant Creutzfeldt-Jakob Disease Motion made, and Question proposed, That this House do now adjourn. -(Lyn Brown.)
5.52 pm Sir Paul Beresford (Mole Valley) (Con): Thank you for giving me the opportunity to have this debate, Madam Deputy Speaker, which I have been chasing for a wee while, as I suspect the Minister is aware. I apologise to the Minister that she will be the last man standing this evening-that is not a gender mistake but an old saying. I must declare an interest: I am a very part-time dentist, and this matter faintly touches on that. In fact, dentists have been affected to some degree by the recent rules introduced by the chief dental officer.
I should like to do a little scene-setting, to which I expect the Minister to add. Variant Creutzfeldt-Jakob disease is rare at the moment, but it is an incurable, fatal human disease that is caused by protein particles called prions. It causes a spongy degeneration of the brain and ultimately death. As I said, there is no cure. In contrast to the traditional forms of Creutzfeldt-Jakob disease, vCJD seems today to have affected younger patients. Normally, older patients are affected. That at least appears to be the fact with the original causal link with bovine spongiform encephalopathy in cattle. However, that cause seems to have been eradicated, so transmission now is predominantly from individual to individual, through blood transfusions, organs or surgical equipment. It is known that the transmission from human to human through, for example, blood transfusion, is 100 times more efficient than from species to species.
Carriers of vCJD frequently spend their whole lives as carriers without developing the disease or even knowing that they are carrying it. Unfortunately, it is currently not possible to detect carriers, many of whom are almost certainly present in the population of regular blood donors and patients who undergo different forms of surgery. Logically, that means that unless extensive preventive measures are combined with detection, the population of carriers must increase, which potentially creates a devastating hidden time bomb of vCJD in the decades ahead.
The estimate of the prevalence of individuals incubating vCJD today varies from one in 4,000 to one in 20,000. That comes from the Hilton study, which is based on tests on tonsils and appendix samples. Perhaps it is more disturbing that the UK and Ireland almost certainly have the largest per head of population reservoir of that prion in the world. That explains why UK citizens and even tourists who have visited the UK are not acceptable as blood donors in many countries. It is thought that the incubation period of vCJD is decades. Indeed, if it is like kuru, a similar disease found in Papua New Guinea, it could have an incubation period of up to 40 years from the time of exposure to onset of symptoms. Regardless of the prevalence, it is almost certain that this country will have a considerable number of cases in years to come.
To make matters worse, because vCJD is so difficult to detect, it is fairly certain that the Hilton study was not 100 per cent. accurate or effective in detecting incubating cases. Having very briefly and in simplistic terms set the scene, it is important now to turn to what the Government can and should be doing to combat this potential disaster which will hit our children and 18 Mar 2010 : Column 1076 grandchildren. Obviously, it would be absolutely fantastic if a cure could be developed tomorrow and an early step made towards a detection method. I hope that Government funding is being made available for that. However, I suspect that we are a long way off from either a cure or a detection method, and prevention of transmission is the utmost priority. Indeed, it is the only thing that we can do at the moment.
With the removal of mad cow disease, transmission now is from individual to individual via blood. The Government have a blood safety advisory body called the Advisory Committee on Safety of Blood, Tissues and Organs, or SaBTO for short. In 1998, leucodepletion was introduced by the UK blood service as a first step in reducing variant CJD infectivity. That process filters blood destined for blood transfusion and removes white blood cells. It was a very useful first step, but at best it only provided a 40 to 70 per cent. reduction in infectivity of donated blood.
In July 2009, SaBTO recommended that UK-sourced blood plasma should not be used for transfusion and should be replaced with plasma sourced from other countries with a much lower risk of variant CJD. However, in October the committee recommended the use of a recently developed prion filtration system. That has been produced by Macro-Pharma, a medical device technology company. The filter is called a P-Capt filter and has been designed specifically to work directly with the existing technologies used by the UK blood service. It has been CE marked since 2006, some four years ago. This means that it has passed EU safety and efficacy testing, as required for it to be legally used in the United Kingdom.
The filter has been under review by the predecessor committee to SaBTO since 2004 and also by SaBTO since its formation in January 2008. In October 2009, SaBTO recommended several changes. First, it accepted that there was a recognition that further measures to protect the UK blood supply and prevent the spread of variant CJD through blood transfusions should be introduced. Secondly, it said that there was "now sufficient evidence" that the P-Capt prion reduction filter "reduces infectivity" and successfully cleans blood to remove the infective prions that carry variant CJD.
Next and most significantly, the committee recommended that the P-Capt filter should be introduced for filtering the red cells that will be given as blood transfusions to those born since 1 January 1996, with the rider that that should be subject to the completion of the PRISM-platelet receptor inhibition for ischemic syndrome management-trials. The fourth recommendation was that the requirement for prion filtration should be reviewed in the event that further data on variant CJD prevalence or filter efficacy became available. Although I recognise that the logistics and finance need to be fully assessed, to my mind this is an absolute must and requires considerable urgency. Personally, I see it as a first step towards filtering all blood from all donors. There is absolutely no reason why these initial steps should not be implemented immediately and the PRISM trial continued alongside. Hand in hand with this approach, the Department of Health has introduced other measures in other areas, and I give it credit for doing so.
The other logical means of transmitting the prion is surgery, especially with re-used stainless steel equipment, even if it is sterilised. This concern arises from the fact 18 Mar 2010 : Column 1077 that the prion is extremely difficult to remove from stainless steel and can often survive standard autoclave sterilisation. Even so, when I discussed this with Professor Pennington, who is an expert on the subject, in October 2007, he pointed out that there was no evidence at that time of iatrogenic transmission. That, I suspect, is down to the fact that it is extremely difficult to find the prion and to get any evidence, certainly in the short term.
6 pm Motion lapsed (Standing Order No. 9(3)).
Motion made, and Question proposed, That this House do now adjourn.- (Lyn Brown.)
Sir Paul Beresford: I suspect that the reason for the professor's opinion is that it is extremely difficult to detect the prion. However, there is a feeling-correctly-that the precautionary principle should be applied, although hopefully in a sensible manner.
With that in mind, I draw the Minister's attention to the decision in April 2007 by the chief dental officer that dentists should not reuse endodontic reamers and files-by that, I mean single-patient use. This, I understand-I may be corrected-was derived from research on mice that were particularly susceptible to variant CJD. The basis of this thinking is that the removal of the prion from stainless steel reamers is difficult, as I think we all accept. Stainless steel reamers are cheap and so not a particular economic problem, even for dentists claiming that their fees are not large enough.
Nowadays, however, most endodontists, or those doing serious amounts of endodontics, are using nickel titanium reamers. A number of specific designs are used in different techniques. Reputable nickel titanium reamers are expensive. I also understand that cleaning the prion off nickel titanium is much easier than taking it off stainless steel. Treatment for a tooth that needs endodontic treatment is therefore made very much more expensive. It is time-consuming if done properly, especially if molar root canal is involved. The unit of dental activity award for molar root canal is small, especially when compared with the alternative treatment, which is extraction using-surprise, surprise-stainless steel forceps, where the same prion difficulty would apply. That might explain the apparent increase in NHS extractions and reduction in NHS endodontics-I expect a letter from the British Dental Association telling me I am wrong.
A number of questions arise. Many stainless steel instruments and burs are used in dentistry, including forceps. If the research on these susceptible mice was so conclusive, one questions why the chief dental officer chose those reamers and whether he thought about extending his ban further. Of course, if he did, he would have to face the problem of probability versus application of the ban versus cost. Should the ban apply only to stainless steel reamers? Should it not be applied to nickel titanium? In 2007 D-Gen and DuPont produced a new prion disinfectant called RelyOn prion inactivator to remove or de-activate the prion on instruments. I would be interested if the Minister could tell me-if not tonight, certainly in a letter-whether that product has been tested, because if so, it would be sensible to introduce its use into the new onerous disinfection and 18 Mar 2010 : Column 1078 sterilization regulations that dentists are now facing, before the regulations are finalised. That would be better than landing it on a beleaguered dental practitioner after he has installed the equipment for major changes that are coming through.
In 2001, the Department of Health allocated £200 million to modernise NHS surgical decontamination, along similar lines to that descending on dentists now. Attempts have been made to produce single-use instruments for some surgery, and I understand that plastic instruments were developed for tonsil surgery but proved a failure. New rules have also been brought in on contact lenses, and it would be interesting to see whether those would be applicable or useful.
However, the way forward has to be blood transfusion filtering. Some 1.8 million blood units are donated in the UK annually, and SaBTO has recommended the immediate P-Capt filtering of all blood for children. In the Prime Minister's letter to me, on 11 February, following my question on this subject, he said that the introduction of the filter should be subject to the satisfactory completion of a clinical trial. I assume that he was referring to the ongoing-long ongoing-PRISM study. I understand that the study is way behind schedule. There are previous studies-I can draw the Minister's attention to them, if they are not in her notes-and, as I have said, the filter has a CE mark.
I ask the Minister to move now on blood filtering, initially for children and then for all. If it is good enough for the Department of Health to use the precautionary principle for endodontic files after questionable thought, the same principle should be applied to blood transfusion filtering. Action on endodontic files is essentially fiddling around the edges. Blood transfusion filtering is central to reducing or stopping blood transfusion transference of prions, to the benefit of future generations. I am sure Health Ministers would not like to be named in what I will call an "If only we had" report in 20 to 40 years, when people are dying from variant CJD.
6.5 pm The Minister of State, Department of Health (Gillian Merron): I congratulate the hon. Member for Mole Valley (Sir Paul Beresford) on securing this debate, and on his thoughtful and well-informed comments. I am glad to have this opportunity to update the House on the latest developments.
We can be thankful that the number of variant CJD cases in this country has so far been relatively low. Every case is serious, however, and devastating for the individuals and families involved. I want to express my deepest sympathy for all those whose lives have been affected by this traumatic and tragic illness. There remains much to learn about the disease. We do not know how many people are potentially infected, and we do not know the maximum incubation period, or how the disease progresses through the body.
The House will recall that the consensus on the origins of this terrible disease, which is fatal, is that people unknowingly ate meat that was contaminated with bovine spongiform encephalopathy. The BSE controls that were introduced from 1989 minimised the risks of infection from cattle. Our focus now is on reducing the risk of person-to-person transmission, and on caring 18 Mar 2010 : Column 1079 for those who are already infected. I can give the hon. Gentleman the assurance that the Government are currently spending more than £7.5 million on variant CJD surveillance and research every year. It is true, however, that with so many unknowns still surrounding the disease, we must remain both cautious and vigilant. We must follow the evidence, and we must also ensure that any new measures that we introduce are safe and proportionate. These principles underpin everything that we have done on variant CJD.
The hon. Gentleman made a number of important comments about dentistry and about variant CJD. I appreciate that he speaks from a position of rather more personal and professional expertise than I do on this matter. There are no known cases of variant CJD being transmitted through dentistry, but, as the spongiform encephalopathy advisory committee has noted, studies using BSE in mice suggest that there is a potential risk of infection from oral tissue, as the hon. Gentleman suggested. The risk is difficult to quantify, but, given the seriousness of the disease, it is only right that we take precautions, especially when those precautions bring wider, additional benefits.
As the health technical memorandum and the British Dental Association's recent advice sheet on infection control make clear, the risks posed by variant CJD and other infections demand the most rigorous measures to prevent cross-infection. That is why we have issued guidance that encourages the use of automated washer disinfectors, which remove the worst contamination from dental instruments and ensure greater consistency and containment in cleaning. Although the guidance is part of our precautionary approach to variant CJD, it serves a dual purpose by improving overall standards of dental decontamination.
It is important to recognise that the guidance is the result of consultation with the dental profession, and that the British Dental Association was fully involved in its development. It is also important to note that that is just one of the actions that we have taken to manage risks in dentistry. In April 2007, the chief dental officer wrote to all dentists advising them that certain instruments that are difficult to clean should be made single-use. As I mentioned earlier, when it comes to managing risk in dentistry, we must always follow the evidence.
Sir Paul Beresford: At almost the moment when that instruction was conveyed to all dentists, the British Dental Journal-the journal of the British Dental Association-published a report which pointed out that forceps posed just as big a danger as files. That is extraordinary. I should be grateful if the Minister would look at some of the comments that I have made about it, and then write to me.
Gillian Merron: I shall be happy to look at all the comments that the hon. Gentleman has made this evening. I hope that my response will satisfy him, but I shall give further consideration to any issues that require it.
It is because of the importance of following evidence-this may be relevant to what the hon. Gentleman has just said-that we keep all precautionary measures under review, and have commissioned further research on the effectiveness of automated washer disinfectors and the disinfectant agents used in them. We expect the performance of AWDs to improve significantly in the coming years.
18 Mar 2010 : Column 1080
The hon. Gentleman raised important issues relating to potential transmission of variant CJD transmission via blood. The safety of blood and blood products used in the NHS is of the highest importance, and we take every reasonable known precaution to cut the risk of transmission. In 1997, we recalled all blood and tissue donated by people who later developed variant CJD. In 1998, we arranged for plasma to be procured from non-UK sources. In 1999, we introduced leucodepletion for all donations, ensuring that white blood cells are removed from donated blood. There have been no reported transmissions from blood treated in that way.
In 2002, we announced that fresh frozen plasma for treating infants and young children would be obtained from the United States and purchased a US-based plasma collection company. In 2004, we announced that people who had received whole blood transfusions since 1980 would no longer be allowed to donate blood, and we introduced new measures to protect patients who had received some plasma products. In 2005, we extended the use of American-sourced plasma to all children up to the age of 16, and started a notification scheme to track people who had donated blood to three individuals who later developed variant CJD. We have also made synthetic clotting agents available for haemophiliacs. I hope that that record demonstrates the Government's commitment to ensuring that at all stages-from procurement and donation to supply and distribution-we have taken every possible action to minimise the risk of variant CJD transmission.
The hon. Gentleman asked about the Government's position on prion filtration. The independent Advisory Committee on the Safety of Blood, Tissues and Organs recently expressed the view that there is now sufficient evidence that a particular filter can reduce potential infectivity in a unit of red blood cells, and has recommended the introduction of filtered blood to treat those born since 1 January 1996. Subject to satisfactory completion of a clinical trial to assess safety, the Government are undertaking an evaluation of the costs, benefits and impacts in order to inform a decision on whether to implement the recommendation. The rationale for the introduction of filtered blood to treat those born before 1 January 1996 is that members of that age group will not have been exposed to BSE by their diet.
We are conducting additional clinical safety trials because, as I have said, we want to ensure-as the House would expect us to-that issues of quality and safety are fully assessed before consideration is given to whether effective prion filtration technologies should be introduced. The clinical studies that have been undertaken so far involve the transfusion of filtered blood into healthy volunteers. Because those studies do not provide enough assurance about the safety of transfusing filtered blood into patients with medical conditions, studies of cardiac surgery and transfusion-dependent patients have been commissioned. I hope that the ongoing trials will be completed by the end of the year. The impact assessment will inform Ministers, who will be interested to look at the evidence.
The hon. Gentleman, a number of other Members and also campaign groups have raised the issue of the calling for routine vCJD testing of blood donors and/or donated blood. Although some blood tests are in development, none of them are currently suitable for use. However, if there were an effective and accurate test, we would, of course, consider it.
18 Mar 2010 : Column 1081
On care for vCJD sufferers, although there is no known treatment, the Department of Health has set up services and a care package fund to help patients and their families. The care fund is administered by the national CJD surveillance unit, and it is used to support patients in the community and to pay for those elements of their care that cannot be readily supplied by local health and social services, such as housing adaptation, additional nursing care, and access to an adapted motor vehicle. The fund is available for people with all types of CJD in any part of the UK, and it is not subject to cash limits.
I thank the hon. Gentleman for securing this debate on such an important issue. I hope he will be reassured that we continue to do everything we can to reduce the risk of transmission of vCJD between people and are pursuing a policy that is grounded in practicality and 18 Mar 2010 : Column 1082 based on evidence. We continue to invest in research that is focused on improvements in decontamination, testing and treatment. We have taken progressive action to reduce the risk from vCJD in the procurement, supply and delivery of blood products. We have developed guidance on surgical and dental instruments, which ensures that cleaning is of the highest technical standard, and which is to be continually audited. We are closely monitoring new clinical developments, whether on filtration or a blood test for vCJD. We also, of course, intend to keep all precautionary measures under review as and when new evidence emerges.
I hope my remarks serve to reassure the hon. Gentleman that this is an open book and that our work is continuing.
Question put and agreed to.
6.17 pm House adjourned.
SKROLL DOWN TO ;
18 Mar 2010 : Column 1075
Variant Creutzfeldt-Jakob Disease
WHAT ABOUT BLOOD HERE FROM THE USA, AND ANY RISK THERE FROM I.E. PRION TSE ???
regarding Bovine Spongiform Encephalopathy and the atypical's i.e. the L-BSE, and the H-BSE (not including the IBNC BSE OR THE TYPICAL UK? C-BSE), the L-BSE is more virulent than the typical UK? c-BSE, and the H-BSE has now shown it can kill humans via laboratory studies i.e. (Kong et al 2009).
for anyone wanting to know the truth and the sound science, and not just industry junk science, please see below ;
Wednesday, February 11, 2009
Atypical BSE North America Update February 2009
Both of the BSE cases ascertained in the US native-born cattle were atypical cases (H-type), which contributed to the initial ambiguity of the diagnosis. 174, 185 In Canada, there have been 2 atypical BSE cases in addition to the 14 cases of the classic UK strain of BSE2: one was the H-type, and the other was of the L-type.198
Enhanced Abstract Journal of the American Veterinary Medical Association January 1, 2009, Vol. 234, No. 1, Pages 59-72
Bovine spongiform encephalopathy
Jane L. Harman, DVM, PhD; Christopher J. Silva, PhD
Atypical BSE North America Update February 2009
Sent: Friday, January 29, 2010 3:23 PM
Subject: 14th International Congress on Infectious Diseases H-type and L-type Atypical BSE January 2010 (special pre-congress edition)
18.173 page 189
Experimental Challenge of Cattle with H-type and L-type Atypical BSE
A. Buschmann1, U. Ziegler1, M. Keller1, R. Rogers2, B. Hills3, M.H. Groschup1. 1Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany, 2Health Canada, Bureau of Microbial Hazards, Health Products & Food Branch, Ottawa, Canada, 3Health Canada, Transmissible Spongiform Encephalopathy Secretariat, Ottawa, Canada
Background: After the detection of two novel BSE forms designated H-type and L-type atypical BSE the question of the pathogenesis and the agent distribution of these two types in cattle was fully open. From initial studies of the brain pathology, it was already known that the anatomical distribution of L-type BSE differs from that of the classical type where the obex region in the brainstem always displays the highest PrPSc concentrations. In contrast in L-type BSE cases, the thalamus and frontal cortex regions showed the highest levels of the pathological prion protein, while the obex region was only weakly involved.
Methods:We performed intracranial inoculations of cattle (five and six per group) using 10%brainstemhomogenates of the two German H- and L-type atypical BSE isolates. The animals were inoculated under narcosis and then kept in a free-ranging stable under appropriate biosafety conditions. At least one animal per group was killed and sectioned in the preclinical stage and the remaining animals were kept until they developed clinical symptoms. The animals were examined for behavioural changes every four weeks throughout the experiment following a protocol that had been established during earlier BSE pathogenesis studies with classical BSE.
Results and Discussion: All animals of both groups developed clinical symptoms and had to be euthanized within 16 months. The clinical picture differed from that of classical BSE, as the earliest signs of illness were loss of body weight and depression. However, the animals later developed hind limb ataxia and hyperesthesia predominantly and the head. Analysis of brain samples from these animals confirmed the BSE infection and the atypical Western blot profile was maintained in all animals. Samples from these animals are now being examined in order to be able to describe the pathogenesis and agent distribution for these novel BSE types. Conclusions: A pilot study using a commercially avaialble BSE rapid test ELISA revealed an essential restriction of PrPSc to the central nervous system for both atypical BSE forms. A much more detailed analysis for PrPSc and infectivity is still ongoing.
14th ICID International Scientific Exchange Brochure -
Final Abstract Number: ISE.114
Session: International Scientific Exchange
Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America
update October 2009
Bacliff, TX, USA
An update on atypical BSE and other TSE in North America. Please remember, the typical U.K. c-BSE, the atypical l-BSE (BASE), and h-BSE have all been documented in North America, along with the typical scrapie's, and atypical Nor-98 Scrapie, and to date, 2 different strains of CWD, and also TME. All these TSE in different species have been rendered and fed to food producing animals for humans and animals in North America (TSE in cats and dogs ?), and that the trading of these TSEs via animals and products via the USA and Canada has been immense over the years, decades.
12 years independent research of available data
I propose that the current diagnostic criteria for human TSEs only enhances and helps the spreading of human TSE from the continued belief of the UKBSEnvCJD only theory in 2009. With all the science to date refuting it, to continue to validate this old myth, will only spread this TSE agent through a multitude of potential routes and sources i.e. consumption, medical i.e., surgical, blood, dental, endoscopy, optical, nutritional supplements, cosmetics etc.
I would like to submit a review of past CJD surveillance in the USA, and the urgent need to make all human TSE in the USA a reportable disease, in every state, of every age group, and to make this mandatory immediately without further delay. The ramifications of not doing so will only allow this agent to spread further in the medical, dental, surgical arena's. Restricting the reporting of CJD and or any human TSE is NOT scientific. Iatrogenic CJD knows NO age group, TSE knows no boundaries. I propose as with Aguzzi, Asante, Collinge, Caughey, Deslys, Dormont, Gibbs, Gajdusek, Ironside, Manuelidis, Marsh, et al and many more, that the world of TSE Transmissible Spongiform Encephalopathy is far from an exact science, but there is enough proven science to date that this myth should be put to rest once and for all, and that we move forward with a new classification for human and animal TSE that would properly identify the infected species, the source species, and then the route.
International Society for Infectious Diseases Web: http://www.isid.org
Saturday, January 2, 2010
Human Prion Diseases in the United States January 1, 2010 ***FINAL***
my comments to PLosone here ;
Friday, February 05, 2010
New Variant Creutzfelt Jakob Disease case reports United States 2010 A Review
Sunday, February 14, 2010
[Docket No. FSIS-2006-0011] FSIS Harvard Risk Assessment of Bovine Spongiform Encephalopathy (BSE)
Wednesday, February 24, 2010
Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America 14th
ICID International Scientific Exchange Brochure -
P26 TRANSMISSION OF ATYPICAL BOVINE SPONGIFORM ENCEPHALOPATHY (BSE) IN HUMANIZED MOUSE MODELS
Liuting Qing1, Fusong Chen1, Michael Payne1, Wenquan Zou1, Cristina Casalone2, Martin Groschup3, Miroslaw Polak4, Maria Caramelli2, Pierluigi Gambetti1, Juergen Richt5*, and Qingzhong Kong1 1Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA; 2CEA, Istituto Zooprofilattico Sperimentale, Italy; 3Friedrich-Loeffler-Institut, Germany; 4National Veterinary Research Institute, Poland; 5Kansas State University, Diagnostic Medicine/Pathobiology Department, Manhattan, KS 66506, USA. *Previous address: USDA National Animal Disease Center, Ames, IA 50010, USA
Classical BSE is a world-wide prion disease in cattle, and the classical BSE strain (BSE-C) has led to over 200 cases of clinical human infection (variant CJD). Two atypical BSE strains, BSE-L (also named BASE) and BSE-H, have been discovered in three continents since 2004. The first case of naturally occurring BSE with mutated bovine PrP gene (termed BSE-M) was also found in 2006 in the USA. The transmissibility and phenotypes of these atypical BSE strains/isolates in humans were unknown. We have inoculated humanized transgenic mice with classical and atypical BSE strains (BSE-C, BSE-L, BSE-H) and the BSE-M isolate. We have found that the atypical BSE-L strain is much more virulent than the classical BSE-C. The atypical BSE-H strain is also transmissible in the humanized transgenic mice with distinct phenotype, but no transmission has been observed for the BSE-M isolate so far.
III International Symposium on THE NEW PRION BIOLOGY: BASIC SCIENCE, DIAGNOSIS AND THERAPY 2 - 4 APRIL 2009, VENEZIA (ITALY)
Monday, October 19, 2009
Atypical BSE, BSE, and other human and animal TSE in North America Update October 19, 2009
I ask Professor Kong ;
Thursday, December 04, 2008 3:37 PM Subject: RE: re--Chronic Wating Disease (CWD) and Bovine Spongiform Encephalopathies (BSE): Public Health Risk Assessment
''IS the h-BSE more virulent than typical BSE as well, or the same as cBSE, or less virulent than cBSE? just curious.....''
Professor Kong reply ;
''As to the H-BSE, we do not have sufficient data to say one way or another, but we have found that H-BSE can infect humans. I hope we could publish these data once the study is complete.
Thanks for your interest.''
Qingzhong Kong, PhD Associate Professor Department of Pathology Case Western Reserve University Cleveland, OH 44106 USA
I look forward to further transmission studies, and a true ENHANCED BSE/atypical BSE surveillance program put forth testing all cattle for human and animal consumption for 5 years. a surveillance program that uses the most sensitive TSE testing, and has the personnel that knows how to use them, and can be trusted. I look forward to a stringent mad cow feed ban being put forth, and then strictly enforced. we need a forced, not voluntary feed ban, an enhanced feed ban at that, especially excluding blood. we need some sort of animal traceability. no more excuses about privacy. if somebody is putting out a product that is killing folks and or has the potential to kill you, then everybody needs to know who they are, and where that product came from. same with hospitals, i think medical incidents in all states should be recorded, and made public, when it comes to something like a potential accidental transmission exposure event. so if someone is out there looking at a place to go have surgery done, if you have several hospitals having these type 'accidental exposure events', than you can go some place else. it only makes sense. somewhere along the road, the consumer lost control, and just had to take whatever they were given, and then charged these astronomical prices. some where along the line the consumer just lost interest, especially on a long incubating disease such as mad cow disease i.e. Transmissible Spongiform Encephalopathy. like i said before, there is much more to the mad cow story than bovines and eating a hamburger, we must start focusing on all TSE in all species. ...TSS
Sunday, September 6, 2009
MAD COW USA 1997 SECRET VIDEO
U.S.A. HIDING MAD COW DISEASE VICTIMS AS SPORADIC CJD ? see video at bottom
DAMNING TESTIMONY FROM STANLEY PRUSINER THE NOBEL PEACE PRIZE WINNER ON PRIONS SPEAKING ABOUT ANN VENEMAN see video
The most recent assessments (and reassessments) were published in June 2005 (Table I; 18), and included the categorisation of Canada, the USA, and Mexico as GBR III. Although only Canada and the USA have reported cases, the historically open system of trade in North America suggests that it is likely that BSE is present also in Mexico.
Thursday, January 14, 2010
SAMPLE COLLECTION FROM CATTLE UNDER THE BOVINE SPONGIFORM ENCEPHALOPATHY (BSE) ONGOING SURVEILLANCE PROGRAM FSIS NOTICE 05-10 1/12/10
2009 UPDATE ON ALABAMA AND TEXAS MAD COWS 2005 and 2006
Monday, October 19, 2009
Atypical BSE, BSE, and other human and animal TSE in North America Update October 19, 2009
Monday, November 23, 2009
BSE GBR RISK ASSESSMENTS UPDATE NOVEMBER 23, 2009 COMMISSION OF THE EUROPEAN COMMUNITIES AND O.I.E.
Tuesday, July 14, 2009
U.S. Emergency Bovine Spongiform Encephalopathy Response Plan Summary and BSE Red Book Date: February 14, 2000 at 8:56 am PST
WHERE did we go wrong $$$
THANKS to the USDA, the OIE, and apparently the WTO, the BSE GBR risk assessments were trashed, and a more industry friendly trading of prions were brought forth with the BSE MRR region, which simply made legal the trading of all strains of TSE in all animals from all Countries legal. THUS they chose to expose us all to the Transmissible Spongiform Encephalopathy, and especially the atypical TSE, which they have exempted from any regulation what so ever. even with evidence to show that these atypical TSEs are transmissible, they still chose to expose humans, rather than interrupt their trading there of $ and the pass if forward and or friendly fire there from, this blunder of global exposure to the Transmissible Spongiform Encephalopathy from the OIE, the USDA, and apparently the WTO will live on in infamy. ...TSS
COMMONWEALTH OF AUSTRALIA
Proof Committee Hansard
SENATE RURAL AND REGIONAL AFFAIRS AND TRANSPORT REFERENCES COMMITTEE Reference: Import restrictions on beef
FRIDAY, 5 FEBRUARY 2010 CANBERRA CONDITIONS OF DISTRIBUTION
This is an uncorrected proof of evidence taken before the committee. It is made available under the condition that it is recognised as such. BY AUTHORITY OF THE SENATE [PROOF COPY] TO EXPEDITE DELIVERY, THIS TRANSCRIPT HAS NOT BEEN SUBEDITED
Friday, 5 February 2010 Senate RRA&T 1
RURAL AND REGIONAL AFFAIRS AND TRANSPORT
Committee met at 9.01 am
CHAIR (Senator Nash)—I declare open this public hearing of the Rural and Regional Affairs and Transport References Committee. The committee is hearing evidence on the committee’s inquiry into the impact and consequences of the government’s decision to relax import restrictions on beef. Before the committee starts taking evidence I remind all witnesses that, in giving evidence to the committee, they are protected by parliamentary privilege. It is unlawful for anyone to threaten or disadvantage a witness on account of evidence given to a committee and such action may be treated by the Senate as a contempt. It is also a contempt to give false or misleading evidence to a committee. The committee prefers all evidence to be given in public but, under the Senate’s resolutions, witnesses have the right to request to be heard in private session. It is important that witnesses give the committee notice if they intend to ask to give evidence in camera. If a witness objects to answering a question, the witness should state the ground upon which the objection is taken and the committee will determine whether it will insist on an answer, having regard to the ground which is claimed. If the committee determines to insist on an answer, a witness may request that the answer be given in camera. Such a request may, of course, also been made at any other time. On behalf of the committee, I thank all those who have made submissions and sent representatives here today for their cooperation in this inquiry.
RRA&T 2 Senate Friday, 5 February 2010
RURAL AND REGIONAL AFFAIRS AND TRANSPORT
BELLINGER, Mr Brad, Chairman, Australian Beef Association
CARTER, Mr John Edward, Director, Australian Beef Association
CHAIR—Welcome. Would you like to make an opening statement?
Mr Bellinger—Thank you. The ABA stands by its submission, which we made on 14 December last year, that the decision made by the government to allow the importation of beef from BSE affected countries is politically based, not science based. During this hearing we will bring forward compelling new evidence to back up this statement. When I returned to my property after the December hearing I received a note from an American citizen. I will read a small excerpt from the mail he sent me in order to reinforce the dangers of allowing the importation of beef from BSE affected countries. I have done a number of press releases on this topic, and this fellow has obviously picked my details up from the internet. His name is Terry Singeltary and he is from Bacliff, Texas. He states, and rightfully so:
You should be worried. Please let me explain. I’ve kept up with the mad cow saga for 12 years today, on December 14th 1997, some four months post voluntary and partial mad cow feed ban in the USA, I lost my mother to the Heinemann variant Creutzfeldt-Jakob disease (CJD). I know this is just another phenotype of the infamous sporadic CJDs. Here in the USA, when USA sheep scrapie was transmitted to USA bovine, the agent was not UK BSE—it was a different strain. So why then would human TSE from USA cattle look like UK CJD from UK BSE? It would not. So this accentuates that the science is inconclusive still on this devastating disease. He goes on to state:
The OIE— the International Organisation of Epizootics, the arm of the WTO— is a failed global agent that in my opinion is bought off via bogus regulations for global trade and industry reps. I have done this all these years for nothing but the truth. I am a consumer, I eat meat, but I do not have to sit idly by and see the ignorance and greed of it all while countless numbers of humans and animals are being exposed to the TSE agents. All the USA is interested in is trade, nothing else matters.
Even Dr Stanley Prusiner, who incidentally won the Nobel Health Prize in 1997 for his work on the prion—he invented the word ‘prion’, or it came from him—states:
The BSC policy was set up for one purpose only, trade—the illegal trading of all strains of TSE globally throughout North America, which is home to CBSC, IBSC and HBSC, many scrapie strains and two strains of CJD to date. (please note typo error, those should have read cBSE, lBSE, and hBSE...tss)
I would also like, while I have the opportunity, to explain the beef-off-the-shelves myth. At the first Senate hearing on 14 December, it was explained that the reason why they allowed BSC beef into Australia was the beef-off-the-shelves policy, whereby if we found a case of BSC in Australia they would have to recall all—
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RURAL AND REGIONAL AFFAIRS AND TRANSPORT
Senator HEFFERNAN—Which of course is total BS.
Mr Bellinger—Correct. This is written in the FSANZ document—Food Standards Australia New Zealand. Why isn’t this same policy in New Zealand? It is not—it is only in Australia. We are the only country in the world to have this idiotic policy. So we again call for the tabling of the WTO obligations paperwork. We do not believe that exists.
Mr Carter—We have an additional concern about human health. We are not scientists, but on 18 December, four days after the last hearing here, the BBC reported a new wave of deaths due to variant CJD linked to eating BSE infected beef could be underway. This is based on the work of Professor John Collinge of the National Prion Clinic, who reported that a 2009 death in Scotland was from a different genetic pool to that of the 166 deaths already reported in the UK. Those are all thought to share one gene, but Professor Collinge and his colleagues estimate that up to 350 people in this new group, represented by the person who died in Scotland, could get CJD. He thinks that CJD has moved into a new phase, and the incubation period is a long one. We tender the Australian Red Cross donor policy sheet, which bears out what Senator Back brought up last time, questioning the Chief Medical Officer, and we say that blood from people who were in the UK between 1980 and 1996 is not acceptable. That is the current ruling. We believe this now should be extended to anyone who has visited the UK, and this new evidence should ensure that Australia revisits the science of CJD.
CHAIR—Thank you, Mr Carter. Before we kick off, can I just remind colleagues that we are short of time today, so I ask that we do not traverse ground the we have previously covered and make sure that we stick to new information that is required. Mr Bellinger, when you started you referred to your view that this decision to allow the importation was politically based. I know you are going to go into this in the course of the next 20 minutes or so, but could you just give us a quick outline of what your definition of politically based is and why you think the decision was politically based?
Mr Bellinger—On the lowering of BSE standards: if you go back to 2006, for example, there were five categories for describing countries that had BSE and Australia was in the category for BSE free. Suddenly, by the time the United States got their third instance of BSE, through the influence of Robert Zoellick—who was the trade minister that signed the BSE corresponding side letter in 2004 and was George Bush’s appointment to the WTO—they suddenly changed the five categories to three categories and, instead of being BSE free, Australia became BSE negligible risk. At the time I put out a press release alerting the media to the dangers of this happening, and we are coming to the stage here when suddenly our government is saying, ‘Now let’s allow the importation of beef from BSE affected countries.’ I believe that the WTO has been influenced by large multinational meat processors and retailers to change and allow the trading of BSE beef throughout the world.
CHAIR—Thanks, Mr Bellinger.
Mr Carter—Of course, the side letter that Minister Vaile signed was at the request of Mr Zoellick, who is now in the position that Mr Bellinger has explained.
Senator HEFFERNAN—I just want to put the committee on notice that, if we do not get through what we have got to get through today, I suggest we have another hearing, because this
RRA&T 4 Senate Friday, 5 February 2010
RURAL AND REGIONAL AFFAIRS AND TRANSPORT
is the greatest ambush of Australia’s farmers of all time by a government. The evidence given at the last meeting was deadset lies. The proposition that this whole change of government policy was led by the industry is a deadset lie. While Simon Crean might want to change his mind because of the WTO and his lack of knowledge, the Australian beef industry, as you know, is under great challenge, not only from the currency but also from the undermining of our markets. This is a disgrace.
SNIP...PLEASE SEE FULL TEXT ;
Tuesday, March 16, 2010
COMMONWEALTH OF AUSTRALIA Hansard Import restrictions on beef FRIDAY, 5 FEBRUARY 2010 AUSTRALIA
COMMONWEALTH OF AUSTRALIA
Proof Committee Hansard
snip...see full text 110 pages ;
for those interested, please see much more here ;
PRODUCT Fresh Frozen Plasma. Recall # B-0526-10 CODE Unit: 5391172 RECALLING FIRM/MANUFACTURER Florida's Blood Centers, Inc., Orlando, FL, by email on April 2, 2008. Firm initiated recall is complete. REASON Blood product, collected from a donor considered to be at increased risk for variant Creutzfeldt-Jakob Disease (vCJD), was distributed. VOLUME OF PRODUCT IN COMMERCE 1 unit DISTRIBUTION Austria ___________________________________
PRODUCT Recovered Plasma. Recall # B-0656-10 CODE Units: W087908654400; W087909651903; W087909652963; W087909654017; W087909650769 RECALLING FIRM/MANUFACTURER Recalling Firm: Community Blood Bank of Lancaster County Medical Society, Lincoln, NB, by fax on October 8, 2009. Manufacturer: Community Blood Bank of Lancaster County, Lincoln, NB. Firm initiated recall is complete. REASON Blood products, collected from a donor considered to be at increased risk for variant Creutzfeldt-Jakob Disease (vCJD), were distributed. VOLUME OF PRODUCT IN COMMERCE 5 units DISTRIBUTION Austria ___________________________________
PRODUCT 1) Recovered Plasma. Recall # B-0735-10; 2) Red Blood Cells Leukocytes Reduced. Recall # B-0736-10 CODE 1) and 2) Unit: 2326023 RECALLING FIRM/MANUFACTURER Central California Blood Center, Fresno, CA, by e-mail on September 3, 2009. Firm initiated recall is complete. REASON Blood products, collected from a donor considered to be at increased risk for variant Creutzfeldt-Jakob Disease (vCJD), were distributed. VOLUME OF PRODUCT IN COMMERCE 2 units DISTRIBUTION Austria, CA ___________________________________
PRODUCT Source Plasma. Recall # B-0756-10 CODE Units: 08BINA6632, 08BINA6272, 08BINA5693, 08BINA5363, 08BINA2801, 08BINA2194, 08BINA1611, 08BINA1231, 08BINA0740, 08BINA0371, 07BINE2632, 07BINE2000, 07BINE1705, 07BINE1128, 07BINE0364, 07BIND9904, 07BIND9112, 07BIND8528, 07BIND8381, 07BIND7827, 07BIND7469, 07BIND6735, 07BIND6397, 07BIND5813, 07BIND5492 and 07BIND4515 RECALLING FIRM/MANUFACTURER BioLife Plasma Services, L.P, Bloomington, IN, by facsimile on February 13, 2009. Firm initiated recall is complete. REASON Blood products, which was collected from an unsuitable donor based on risk factors for variant Creutzfeldt-Jakob Disease (vCJD), were distributed. VOLUME OF PRODUCT IN COMMERCE 26 units DISTRIBUTION IL ___________________________________
END OF ENFORCEMENT REPORT FOR MARCH 17, 2010
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New Variant Creutzfelt Jakob Disease case reports United States 2010 A Review
Terry S. Singeltary Sr.
P.O. Box 42
Bacliff, Texas USA 77518