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Humans can live with BSE as long as they do not eat brains

Humans can live with BSE as long as they do not eat brains

June 23, 2001 British Medical Journal 322:1544 by Helen Grant

EDITOR--Brown not only understands bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease but gives a coherent account of them in plain English not embellished by jargon.1 Even he, however, falls into the trap of writing that "epidemiological evidence indicates that scrapie does not affect humans."

Epidemiological evidence indicates that we do not know whether scrapie affects humansa very different matter. If Brown had interrogated abattoir workers in 1989 (as I did) about their routine in dealing with sheep and cattle brains he would have been told that, whereas cattle brains were always removed to be added to "meat products," sheep's brains were routinely left inside the skulls (it wasn't worth the bother to remove them) to be cooked up with the rest of the carcase and fed to cattle in the form of "meat and bonemeal."

The reason that humans have had little trouble with scrapie over the centuries (but not nonehow else could sporadic Creutzfeldt-Jakob disease have arisen?) is that we were never forced to swallow sheep's brains, some of them infected with scrapie. But we were forced to swallow cattle brains, which after 1981 contained the proliferating scrapie agent.

The rendering process changed in 1981: fat solvents, previously added to collect fat for tallow, were withdrawn, and from then on the (lipid) sheep's brains, complete with the organisms, went into cattle feed instead of into candles. It was not "inactivation," or the lack of it, that enabled scrapie to get into cattle rations after 1981 but stopping its diversion into tallow. These vital facts about fat solvents, given in the Southwood report in 1989, were overlooked by the BSE inquiry, which is why the chairman of the inquiry, Lord Phillips, postulated that bovine spongiform encephalopathy must have some other origin.2

The apparent preference of variant Creutzfeldt-Jakob disease for young people, which Brown finds puzzling, is surely because the victims were children between 1981 and 1989 (cattle brains were finally banned from human foods in November 1989) and therefore shedding teeth. The resultant raw areas in their gums provided the organism with direct access to the bloodstream, thus shortening the incubation period. Nobody knows how many humans are incubating variant Creutzfeldt-Jakob disease, but we can live with bovine spongiform encephalopathy, just as we have lived with scrapie for three centuries, as long as we are not forced to eat the brains.

Helen Grant, neuropathologist (retired). 10 Antrim Grove, London NW3 4XR

1. Brown P. Regular review: Bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease. BMJ 2001; 322: 841-844[Full Text]. (7 April.)

2. BSE Inquiry. Report, evidence and supporting papers of the inquiry into the emergence and identification of bovine spongiform encephalopathy and variant Creutzfeldt-Jakob disease (vCJD) and the action taken in response to it up to 20 March 1996. London: Stationery Office, 2000.

� BMJ 2001


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