Rise in cases of CJD:Food industry must give experts information they need

Rise in cases of CJD:
Food industry must give experts information they need

September 7, 2001 The Herald (Glasgow)
BSE, the fatal neurological disease that afflicts cattle, might be eradicated in Britain in five years. The government's (pounds) 4000m-plus programme of slaughtering all cattle over 30 months, allied to the temporary ban on the sale of beef on the bone, greatly minimised public exposure to BSE-infected meat, the cause of variant CJD among humans. While the news about BSE might be better, the projections for variant CJD are not. Professor James Ironside, the senior pathologist at the CJD surveillance unit in Edinburgh, yesterday reported a 20% rise in new cases and revealed that the incidence is twice as high in Scotland and the north of England than in the rest of Britain. The 20% increase led Professor Ironside to predict that up to 140,000 people could develop CJD. It is certainly a worrying figure, but it is not new.

Oxford University scientists reported in the journal Nature last year that any infected animal that entered the food chain was likely to infect no more than two people, while only 40% of the population was genetically susceptible. That left incubation as the other key factor in developing variant CJD. But there is only limited knowledge about the incubation period. The scientists said that, if it were fewer than 20 years, there could be as few as 63 cases. But there have already been 106 probable and specific cases, which suggests a longer - and much more alarming - incubation period. The experts predicted that, if it stretched to virtually a lifetime (60 years), there were likely to be 136,000 cases. If the period over which the infection could become full-blown stretched from childhood to old age there would obviously be greater numbers of variant CJD victims.

Professor Ironside's predictions for the total number of cases are in line with the Oxford extrapolations for a much longer incubation period. He maintained yesterday that the 20% increase was not a "blip" but a sustained pattern. Although the potential number of deaths is much lower than the earlier predictions of many millions of fatalities, that would be of no consolation to the families involved who have to nurse victims through a horribly degenerative illness. A scenario of 140,000 cases would also put great strain on the already over-burdened NHS.

Although BSE might be on the way out, it is imperative that we know as much as possible about variant CJD, particularly if there are to be many thousands of cases. Scientists do not know why the incidence should be so much higher in the north. Professor Ironside said it could be for genetic reasons or because of diet. Pies and other cheaper meat products made from mechanically-recovered carcasses (believed to carry the greatest risk of CJD infection) are more common in northern diets. Researchers need to know what exactly went into these products to determine the part they played in CJD infection (and in the process helping to identify the influence of genetic make-up in developing the disease). Obtaining such information would give scientists a better idea of incubation periods and the likely number of cases.

The food industry obviously has an important part to play, but it has deliberately obstructed efforts to gain information. A picture is emerging of the ghastly remnants mechanically stripped from carcasses to make cheap meat products. The meat industry, still trying to recover from the BSE crisis, would not like the additional bad publicity that would arise from further disclosures of the practices that went on in factories and slaughterhouses if it was fully to co-operate with scientists. But it risks even greater opprobrium if it continues to stonewall because the public will rightly conclude that it has even more to hide. The only answer to is to give the experts the information they need so that we can increase our understanding, and treatment, of a dreadful illness whose full impact might still lie in the future.

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