Friday, April 13, 2018

Twenty-year-old African American woman with prion disease associated with the G114V PRNP variant or iatrogenic from porcine pulmonary valve replacement?

April 01, 2018; 4 (2) CLINICAL/SCIENTIFIC NOTES OPEN ACCESS 

Twenty-year-old African American woman with prion disease associated with the G114V PRNP variant 

Jason Margolesky and Mario Saporta 

First published March 22, 2018, DOI: https://doi.org/10.1212/NXG.0000000000000229 PDF CITATION PERMISSIONS COMMENT 

The c.341G>T (p.G114V) variant of the prion protein gene (PRNP) has been reported in a Uruguayan and a Chinese family to cause an inheritable prion disease, albeit with incomplete penetrance. The condition is characterized by early-onset, relatively prolonged course, early neuropsychiatric symptoms, followed by pyramidal and extrapyramidal symptoms. We present a 20-year-old African American woman, with no family history of neurodegenerative disease, who presented with rapidly progressive cognitive decline and subsequent movement disorders who was found to have the PRNP variant.

Case report A 20-year-old African American woman presented with a history of truncus arteriosus (surgically corrected early in life), and years later, she required a porcine pulmonary valve replacement. Her mother and father, ages 51 and 49, respectively, are alive and well. Her brother is 23 years old and has no medical issues. Her maternal and paternal grandparents reached their ninth decades of life without neurodegenerative disease. She presented to the clinic with involuntary movements. In the months prior, she had developed cognitive decline leading to her failing classes in college. On examination, she was found to have a paucity of spontaneous speech output and bradyphrenia and had an incongruent smiling facial expression. Facial myoclonic jerks were noted as was asymmetric action and postural tremor (affecting her left more than her right arm). Her gait was slow, and she had decreased arm swing bilaterally. She was admitted to the hospital for evaluation of reversible causes of rapidly progressive dementia and prion disease.

Electroencephalography revealed diffuse delta frequency slowing without epileptiform activity. Lumbar puncture and CSF analysis showed no inflammatory cells, normal glucose, and elevated protein levels. Autoimmune and paraneoplastic encephalopathy workup was unremarkable. An empiric course of pulse IV methylprednisolone was tried with no notable improvement. Brain MRI (figure, A and B) demonstrated findings typical of prion disease. CSF and blood samples were sent to the Case Western Prion Lab for analysis where the c.341G>T (p.G114V) variant of the PRNP gene was detected.

Figure Download figure Open in new tab Download powerpoint Figure MRI of the brain with findings typical of prion disease Diffusion weighted imaging (A) and apparent diffusion coefficient (B) MRI brain sequences showing abnormal signal in the cortex diffusely and striatum bilaterally.

One month later, in the clinic, the patient was noted to have more diffuse myoclonic jerks, now involving the extremities as well as her face. Another month passed, and the patient began falling and developed a more cautious gait. She developed emotional lability and would spontaneously cry alternating with irritability. It is interesting to note that such lability (including the inappropriate euphoria described early in her disease course) had been noted in Kuru, leading to the euphemisms “laughing disease” or “laughing death.1” Clonazepam was started to help with myoclonus, anxiety, and irritability.

Discussion The inherited prion diseases, including familial Creutzfeldt-Jakob Disease (CJD), Gerstmann-Sträussler-Scheinker syndrome, and fatal familial insomnia, are autosomal dominant in inheritance and are attributable to mutations in the PRNP gene. The c.341G>T (p.G114V) PRNP variant was initially reported in members of a Uruguayan family in 2005.2 In 2008, the same variant was reported in a Chinese family.3,4

In the Uruguayan cohort, 4 family members carried the variant and manifested the disease, and 2 family members carried the variant without neurologic signs. Age at onset ranged from 18 to 27 years, and the disease duration ranged from 1 to 4 years. The disease presented with neuropsychiatric disturbances, followed by dementia, parkinsonism, pyramidal signs, myoclonus, and cerebellar signs. In the Chinese cohort, 15 family members were found to carry a heterozygous G114V mutation with 4 affected individuals. The age at onset ranged from 32 to 47 years, with a disease duration of 2–3 years. The clinical presentation was similar to that of the Uruguayan cohort.

Our patient is an African American woman with inherited CJD found to have the rarely reported c.341G>T (p.G114V) PRNP variant. This finding strengthens the evidence that this variant is pathogenic in causing CJD and expands the possible ethnic backgrounds where this variant may be found. Without genetic information from the patient's parents, we cannot determine whether this represents a sporadic mutation or whether this provides further evidence for the incomplete penetrance of the variant. A high index of suspicion should be held for a diagnosis of CJD in a patient with rapidly progressive dementia, even in a young adult patient.

Author contributions Jason Margolesky: conceptualized and wrote the initial draft of the manuscript. Mario Saporta: conceptualized the manuscript and provided critical review of the manuscript.

Study funding No targeted funding reported.

Disclosure Jason Margolesky reports no disclosures. Mario Saporta has served on the scientific advisory boards of and received research support from the Charcot-Marie-Tooth Association and Acceleron; has served on the editorial board of Journal of the Peripheral Nervous System; and has served as a consultant for Alnylam, Strongbridge, and Biogen. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/NG.

Footnotes Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/NG.

The Article Processing Charge was funded by the authors.

Received November 29, 2017. Accepted in final form February 21, 2018. Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

References

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***> Without genetic information from the patient's parents, we cannot determine whether this represents a sporadic mutation or whether this provides further evidence for the incomplete penetrance of the variant.

***> Case report A 20-year-old African American woman presented with a history of truncus arteriosus (surgically corrected early in life), and years later, she required a porcine pulmonary valve replacement.

Our records show that while some use is made of porcine materials in medicinal products, the only products which would appear to be in a hypothetically ''higher risk'' area are the adrenocorticotrophic hormone for which the source material comes from outside the United Kingdom, namely America China Sweden France and Germany. The products are manufactured by Ferring and Armour. A further product, ''Zenoderm Corium implant'' manufactured by Ethicon, makes use of porcine skin - which is not considered to be a ''high risk'' tissue, but one of its uses is described in the data sheet as ''in dural replacement''. This product is sourced from the United Kingdom.....


Prion
 
Volume 9, Issue 4, 2015
 
Porcine prion protein amyloid
 
DOI:10.1080/19336896.2015.1065373Per Hammarströma & Sofie Nyströma*
 
pages 266-277
 
Received: 1 Jun 2015 Accepted: 17 Jun 2015 Accepted author version posted online: 28 Jul 2015
 
© 2015 The Author(s). Published with license by Taylor & Francis Group, LLC Additional license information
 
ABSTRACT
 
Mammalian prions are composed of misfolded aggregated prion protein (PrP) with amyloid-like features. Prions are zoonotic disease agents that infect a wide variety of mammalian species including humans. Mammals and by-products thereof which are frequently encountered in daily life are most important for human health. It is established that bovine prions (BSE) can infect humans while there is no such evidence for any other prion susceptible species in the human food chain (sheep, goat, elk, deer) and largely prion resistant species (pig) or susceptible and resistant pets (cat and dogs, respectively). PrPs from these species have been characterized using biochemistry, biophysics and neurobiology. Recently we studied PrPs from several mammals in vitro and found evidence for generic amyloidogenicity as well as cross-seeding fibril formation activity of all PrPs on the human PrP sequence regardless if the original species was resistant or susceptible to prion disease. Porcine PrP amyloidogenicity was among the studied. Experimentally inoculated pigs as well as transgenic mouse lines overexpressing porcine PrP have, in the past, been used to investigate the possibility of prion transmission in pigs. The pig is a species with extraordinarily wide use within human daily life with over a billion pigs harvested for human consumption each year. Here we discuss the possibility that the largely prion disease resistant pig can be a clinically silent carrier of replicating prions.
 
SNIP...
 
CONCLUDING REMARKS 

Should the topic of porcine PrP amyloid be more of a worry than of mere academic interest? Well perhaps. Prions are particularly insidious pathogens. A recent outbreak of peripheral neuropathy in human, suggests that exposure to aerosolized porcine brain is deleterious for human health.43,44 Aerosolization is a known vector for prions at least under experimental conditions.45-47 where a mere single exposure was enough for transmission in transgenic mice. HuPrP is seedable with BoPrP seeds and even more so with PoPrP seed (Fig. 1), indicating that humans could be infected by porcine APrP prions while neurotoxicity associated with spongiform encephalopathy if such a disease existed is even less clear. Importantly transgenic mice over-expressing PoPrP are susceptible to BSE and BSE passaged through domestic pigs implicating that efficient downstream neurotoxicity pathways in the mouse, a susceptible host for prion disease neurotoxicity is augmenting the TSE phenotype.25,26 Prions in silent carrier hosts can be infectious to a third species. Data from Collinge and coworkers.21 propose that species considered to be prion free may be carriers of replicating prions. Especially this may be of concern for promiscuous prion strains such as BSE.19,48 It is rather established that prions can exist in both replicating and neurotoxic conformations.49,50 and this can alter the way in which new host organisms can react upon cross-species transmission.51 The na€ıve host can either be totally resistant to prion infection as well as remain non-infectious, become a silent non-symptomatic but infectious carrier of disease or be afflicted by disease with short or long incubation time. The host can harbor and/or propagate the donor strain or convert the strain conformation to adapt it to the na€ıve host species. The latter would facilitate infection and shorten the incubation time in a consecutive event of intra-species transmission. It may be advisable to avoid procedures and exposure without proper biosafety precautions as the knowledge of silence carrier species is poor. One case of iatrogenic CJD in recipient of porcine dura mater graft has been reported in the literature.52 The significance of this finding is still unknown. The low public awareness in this matter is exemplified by the practice of using proteolytic peptide mixtures prepared from porcine brains (Cerebrolysin) as a nootropic drug. While Cerebrolysin may be beneficial for treatment of severe diseases such as vascular dementia,53 a long term follow-up of such a product for recreational use is recommended.
 

SATURDAY, JANUARY 9, 2016

Transmission of sheep-bovine spongiform encephalopathy to pigs
Research article
 
Transmission of sheep-bovine spongiform encephalopathy to pigs
 
Carlos Hedman1, Rosa Bolea1*, Belén Marín1, Fabien Cobrière4, Hicham Filali1, Francisco Vazquez2, José Luis Pitarch1, Antonia Vargas1, Cristina Acín1, Bernardino Moreno1, Martí Pumarola3, Olivier Andreoletti4 and Juan José Badiola1
 
* Corresponding author: Rosa Bolea rbolea@unizar.es
 
Author Affiliations
 
1 Veterinary Faculty, Centro de Investigación en Encefalopatías y Enfermedades Transmisibles Emergentes (CIEETE), Universidad de Zaragoza, Zaragoza, 50013, Spain
 
2 Veterinary Hospital, Universidad de Zaragoza, Zaragoza, 50013, Spain
 
3 Veterinary Faculty, Department of Animal Medicine and Surgery, Universitat Autònoma de Barcelona, Barcelona, 08193, Spain
 
4 UMR INRA ENVT 1225, Interactions Hôtes Agents Pathogènes, Ecole Nationale Vétérinaire de Toulouse, Toulouse, 31076, France
 
For all author emails, please log on.
 
Veterinary Research 2016, 47:14 doi:10.1186/s13567-015-0295-8
 
The electronic version of this article is the complete one and can be found online at: http://www.veterinaryresearch.org/content/47/1/14
 
Received: 15 May 2015 Accepted: 21 September 2015 Published: 7 January 2016
 
© 2016 Hedman et al.
 
Open Access
 
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
 
Abstract
 
Experimental transmission of the bovine spongiform encephalopathy (BSE) agent has been successfully reported in pigs inoculated via three simultaneous distinct routes (intracerebral, intraperitoneal and intravenous). Sheep derived BSE (Sh-BSE) is transmitted more efficiently than the original cattle-BSE isolate in a transgenic mouse model expressing porcine prion protein. However, the neuropathology and distribution of Sh-BSE in pigs as natural hosts, and susceptibility to this agent, is unknown. In the present study, seven pigs were intracerebrally inoculated with Sh-BSE prions. One pig was euthanized for analysis in the preclinical disease stage. The remaining six pigs developed neurological signs and histopathology revealed severe spongiform changes accompanied by astrogliosis and microgliosis throughout the central nervous system. Intracellular and neuropil-associated pathological prion protein (PrP Sc ) deposition was consistently observed in different brain sections and corroborated by Western blot. PrP Sc was detected by immunohistochemistry and enzyme immunoassay in the following tissues in at least one animal: lymphoid tissues, peripheral nerves, gastrointestinal tract, skeletal muscle, adrenal gland and pancreas. PrP Sc deposition was revealed by immunohistochemistry alone in the retina, optic nerve and kidney. These results demonstrate the efficient transmission of Sh-BSE in pigs and show for the first time that in this species propagation of bovine PrP Sc in a wide range of peripheral tissues is possible. These results provide important insight into the distribution and detection of prions in non-ruminant animals.

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PrP Sc accumulation in the gastrointestinal tract of Sh-BSE infected pigs has not been described in similar experiments using this species. We observed PrP Sc deposition in the myenteric plexi without apparent morphological alterations of the enteric neurons, as seen in cattle experimentally infected with BSE [65]. This finding is indicative of a potential centrifugal spread of the Sh-BSE agent from the CNS via the vagus nerve to the peripheral nervous system, and may account for the large deposits of PrP Sc observed in the dorsal motor nucleus of the vagus nerve in the medulla oblongata.
 
We observed PrP Sc deposition in nerve fibers of the oculomotor muscle in two pigs. In cattle naturally infected with BSE [66], PrP Sc has been detected in intramuscular nerve fibers and muscle spindles. Although we found no PrP Sc in the oculomotor muscle of any other clinically affected pigs, positive labeling was observed in the oculomotor nuclei in the mesencephalon of all clinically affected pigs.
 
Pancreatic PrP Sc staining was observed in 5 pigs. Analysis of pancreatic nervous tissue has revealed PrP Sc deposition in the islets of Langerhans in natural scrapie [34]. In natural BSE [56], PrP Sc deposition has been documented in the nerve fibers of the adrenal gland. In agreement with previous findings in natural scrapie [34], one pig showed PrP Sc immunolabeling in the medullary region of the adrenal gland, associated with chromaffin cells, which are considered modified sympathetic postganglionic neurons. Similarly, the presence of PrP Sc within the epithelial tubular cells of the convoluted tubules and the collecting ducts in the kidney in one pig has been described in FSE [67], suggesting possible prionuria.
 
In addition to the large amount of PrP Sc observed in the CNS of Sh-BSE-infected pigs, PrP Sc was widely distributed in the peripheral tissues, although the extent of this distribution varied between animals. This variation may be related to the distribution of PrP Sc within individual organs, the exact anatomical location points at which samples were collected, and the detection limits of the techniques used. More sensitive studies, such as in vitro protein misfolding cyclic amplification (PMCA) and mouse bioassays will be needed to clarify the distribution and infectivity of PrP Sc in peripheral tissues of Sh-BSE infected pigs. These assays will most likely indicate a higher number of PrP Sc -positive peripheral organs.
 
Comparison with previous studies of cattle-BSE in pigs revealed that the incubation period of Sh-BSE in our pigs was generally shorter [20], [21] and that PrP Sc was present in more peripheral tissue types [19]. We believe that these differences may be due to a modification in the pathogenicity of the cattle-BSE agent caused by its prior passage in sheep, as previously described in TgPo mice [15]. However, studies of natural routes of transmission (e.g., oral) will be required to determine the real susceptibility of pigs to the Sh-BSE agent.
 

2017***> Conclusions: This study demonstrates that PrPSc accumulates in lymphoid tissues from pigs challenged intracranially or orally with the CWD agent, and can be detected as early as 4 months after challenge. CWD-infected pigs rarely develop clinical disease and if they do, they do so after a long incubation period. This raises the possibility that CWD-infected pigs could shed prions into their environment long before they develop clinical disease. Furthermore, lymphoid tissues from CWD-infected pigs could present a potential source of CWD infectivity in the animal and human food chains.

***> CWD TO PIGS <***

Research Project: TRANSMISSION, DIFFERENTIATION, AND PATHOBIOLOGY OF TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES

Location: Virus and Prion Research

Title: Disease-associated prion protein detected in lymphoid tissues from pigs challenged with the agent of chronic wasting disease

Author item Moore, Sarah item Kunkle, Robert item Kondru, Naveen item Manne, Sireesha item Smith, Jodi item Kanthasamy, Anumantha item West Greenlee, M item Greenlee, Justin

Submitted to: Prion Publication Type: Abstract Only Publication Acceptance Date: 3/15/2017 Publication Date: N/A Citation: N/A Interpretive Summary:

Technical Abstract: Aims: Chronic wasting disease (CWD) is a naturally-occurring, fatal neurodegenerative disease of cervids. We previously demonstrated that disease-associated prion protein (PrPSc) can be detected in the brain and retina from pigs challenged intracranially or orally with the CWD agent. In that study, neurological signs consistent with prion disease were observed only in one pig: an intracranially challenged pig that was euthanized at 64 months post-challenge. The purpose of this study was to use an antigen-capture immunoassay (EIA) and real-time quaking-induced conversion (QuIC) to determine whether PrPSc is present in lymphoid tissues from pigs challenged with the CWD agent.

Methods: At two months of age, crossbred pigs were challenged by the intracranial route (n=20), oral route (n=19), or were left unchallenged (n=9). At approximately 6 months of age, the time at which commercial pigs reach market weight, half of the pigs in each group were culled (<6 challenge="" groups="" month="" pigs="" remaining="" the="">6 month challenge groups) were allowed to incubate for up to 73 months post challenge (mpc). The retropharyngeal lymph node (RPLN) was screened for the presence of PrPSc by EIA and immunohistochemistry (IHC). The RPLN, palatine tonsil, and mesenteric lymph node (MLN) from 6-7 pigs per challenge group were also tested using EIA and QuIC.

Results: PrPSc was not detected by EIA and IHC in any RPLNs. All tonsils and MLNs were negative by IHC, though the MLN from one pig in the oral <6 5="" 6="" at="" by="" detected="" eia.="" examined="" group="" in="" intracranial="" least="" lymphoid="" month="" months="" of="" one="" pigs="" positive="" prpsc="" quic="" the="" tissues="" was="">6 months group, 5/6 pigs in the oral <6 4="" and="" group="" months="" oral="">6 months group. Overall, the MLN was positive in 14/19 (74%) of samples examined, the RPLN in 8/18 (44%), and the tonsil in 10/25 (40%). Conclusions:

This study demonstrates that PrPSc accumulates in lymphoid tissues from pigs challenged intracranially or orally with the CWD agent, and can be detected as early as 4 months after challenge.

CWD-infected pigs rarely develop clinical disease and if they do, they do so after a long incubation period. This raises the possibility that CWD-infected pigs could shed prions into their environment long before they develop clinical disease.

Furthermore, lymphoid tissues from CWD-infected pigs could present a potential source of CWD infectivity in the animal and human food chains.


CONFIDENTIAL

EXPERIMENTAL PORCINE SPONGIFORM ENCEPHALOPATHY

While this clearly is a cause for concern we should not jump to the conclusion that this means that pigs will necessarily be infected by bone and meat meal fed by the oral route as is the case with cattle. ...


we cannot rule out the possibility that unrecognised subclinical spongiform encephalopathy could be present in British pigs though there is no evidence for this: only with parenteral/implantable pharmaceuticals/devices is the theoretical risk to humans of sufficient concern to consider any action.

 
Our records show that while some use is made of porcine materials in medicinal products, the only products which would appear to be in a hypothetically ''higher risk'' area are the adrenocorticotrophic hormone for which the source material comes from outside the United Kingdom, namely America China Sweden France and Germany. The products are manufactured by Ferring and Armour. A further product, ''Zenoderm Corium implant'' manufactured by Ethicon, makes use of porcine skin - which is not considered to be a ''high risk'' tissue, but one of its uses is described in the data sheet as ''in dural replacement''. This product is sourced from the United Kingdom.....


snip...see much more here ;

WEDNESDAY, APRIL 05, 2017

Disease-associated prion protein detected in lymphoid tissues from pigs challenged with the agent of chronic wasting disease


WEDNESDAY, APRIL 05, 2017

*** Disease-associated prion protein detected in lymphoid tissues from pigs challenged with the agent of chronic wasting disease ***


IN CONFIDENCE
 
EXPERIMENTAL PORCINE SPONGIFORM ENCEPHALOPATHY 1. CMO should be aware that a pig inoculated experimentally (ic, iv, and ip) with BSE brain suspension has after 15 months developed an illness, now confirmed as a spongiform encephalopathy. This is the first ever description of such a disease in a pig, although it seems there ar no previous attempts at experimental inoculation with animal material. The Southwood group had thought igs would not be susceptible. Most pigs are slaughtered when a few weeks old but there have been no reports of relevant neurological illness in breeding sows or other elderly pigs.
 
...see full text ;
 
 
IN CONFIDENCE
 
So it is plausible pigs could be preclinically affected with BSE but since so few are allowed to reach adulthood this has not been recognised through clinical disease. ...
 
 
snip...
 
CONFIDENTIAL EXPERIMENTAL PORCINE SPONGIFORM ENCEPHALOPATHY
 
PLEASE NOTE, these old BSE Inquiry links take a while to open with the wayback machine, so be patient. ...tss Title: Experimental Intracerebral and Oral Inoculation of Scrapie to Swine: Preliminary Report In the United States, feeding of ruminant by-products to ruminants is prohibited, but feeding of ruminant materials to swine and poultry still occurs. The potential for swine to have access to scrapie-contaminated feedstuffs exists, but the potential for swine to serve as a host for replication/accumulation of the agent of scrapie is unknown. The purpose of this study was to perform oral and intracerebral inoculation of the U.S. scrapie agent to determine the potential of swine as a host for the scrapie agent and their clinical susceptibility. snip... IN CONFIDENCE EXPERIMENTAL PORCINE SPONGIFORM ENCEPHALOPATHY 1. CMO should be aware that a pig inoculated experimentally (ic, iv, and ip) with BSE brain suspension has after 15 months developed an illness, now confirmed as a spongiform encephalopathy. This is the first ever description of such a disease in a pig, although it seems there ar no previous attempts at experimental inoculation with animal material. The Southwood group had thought igs would not be susceptible. Most pigs are slaughtered when a few weeks old but there have been no reports of relevant neurological illness in breeding sows or other elderly pigs. ...see full text ;
 
 
we cannot rule out the possibility that unrecognised subclinical spongiform encephalopathy could be present in British pigs though there is no evidence for this: only with parenteral/implantable pharmaceuticals/devices is the theoretical risk to humans of sufficient concern to consider any action.
 
 
May I, at the outset, reiterate that we should avoid dissemination of papers relating to this experimental finding to prevent premature release of the information. ...
 
 
3. It is particularly important that this information is not passed outside the Department, until Ministers have decided how they wish it to be handled. ...
 
 
But it would be easier for us if pharmaceuticals/devices are not directly mentioned at all. ...
 
 
Our records show that while some use is made of porcine materials in medicinal products, the only products which would appear to be in a hypothetically ''higher risk'' area are the adrenocorticotrophic hormone for which the source material comes from outside the United Kingdom, namely America China Sweden France and Germany. The products are manufactured by Ferring and Armour. A further product, ''Zenoderm Corium implant'' manufactured by Ethicon, makes use of porcine skin - which is not considered to be a ''high risk'' tissue, but one of its uses is described in the data sheet as ''in dural replacement''. This product is sourced from the United Kingdom.....
 
 
snip...
 
It was not until . . . August 1990, that the result from the pig persuaded both SEAC and us to change our view and to take out of pig rations any residual infectivity that might have arisen from the SBOs.
 
 
4.303 The minutes of the meeting record that: It was very difficult to draw conclusions from one experimental result for what may happen in the field. However it would be prudent to exclude specified bovine offals from the pig diet. Although any relationship between BSE and the finding of a spongiform encephalopathy in cats had yet to be demonstrated, the fact that this had occurred suggested that a cautious view should be taken of those species which might be susceptible. The 'specified offals' of bovines should therefore be excluded from the feed of all species. 17
 
 
7 OF 10 LITTLE PIGGIES WENT ON TO DEVELOP BSE;
 
1: J Comp Pathol. 2000 Feb-Apr; 122(2-3): 131-43. Related Articles, Links Click here to read
 
The neuropathology of experimental bovine spongiform encephalopathy in the pig.
 
Ryder SJ, Hawkins SA, Dawson M, Wells GA. Veterinary Laboratories Agency Weybridge, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK.
 
In an experimental study of the transmissibility of BSE to the pig, seven of 10 pigs, infected at 1-2 weeks of age by multiple-route parenteral inoculation with a homogenate of bovine brain from natural BSE cases developed lesions typical of spongiform encephalopathy. The lesions consisted principally of severe neuropil vacuolation affecting most areas of the brain, but mainly the forebrain. In addition, some vacuolar change was identified in the rostral colliculi and hypothalamic areas of normal control pigs. PrP accumulations were detected immunocytochemically in the brains of BSE-infected animals. PrP accumulation was sparse in many areas and its density was not obviously related to the degree of vacuolation. The patterns of PrP immunolabelling in control pigs differed strikingly from those in the infected animals. PMID: 10684682 [PubMed - indexed for MEDLINE]
 
 
Transgenic mice expressing porcine prion protein resistant to classical scrapie but susceptible to sheep bovine spongiform encephalopathy and atypical scrapie.
 
Emerg Infect Dis. 2009 Aug; [Epub ahead of print]
 
 
Wednesday, July 06, 2011
 
Swine Are Susceptible to Chronic Wasting Disease by Intracerebral Inoculation 

snip... 

In the US, feeding of ruminant by-products to ruminants is prohibited, but feeding of ruminant materials to swine, mink and poultry still occurs. Although unlikely, the potential for swine to have access to TSE-contaminated feedstuffs exists.
 
snip...
 
 
Wednesday, July 06, 2011
 
Swine Are Susceptible to Chronic Wasting Disease by Intracerebral Inoculation (see tonnage of mad cow feed in commerce USA...tss)
 
 
In an experimental study of the transmissibility of BSE to the pig, seven of 10 pigs, infected at 1-2 weeks of age by multiple-route parenteral inoculation with a homogenate of bovine brain from natural BSE cases developed lesions typical of spongiform encephalopathy.
 

Title: Experimental Intracerebral and Oral Inoculation of Scrapie to Swine: Preliminary Report
 
In the United States, feeding of ruminant by-products to ruminants is prohibited, but feeding of ruminant materials to swine and poultry still occurs. The potential for swine to have access to scrapie-contaminated feedstuffs exists, but the potential for swine to serve as a host for replication/accumulation of the agent of scrapie is unknown. The purpose of this study was to perform oral and intracerebral inoculation of the U.S. scrapie agent to determine the potential of swine as a host for the scrapie agent and their clinical susceptibility. snip... snip... In the United States, feeding of ruminant by-products to ruminants is prohibited, but feeding of ruminant materials to swine and poultry still occurs. The potential for swine to have access to scrapie-contaminated feedstuffs exists, but the potential for swine to serve as a host for replication/accumulation of the agent of scrapie is unknown. The purpose of this study was to perform oral and intracerebral inoculation of the U.S. scrapie agent to determine the potential of swine as a host for the scrapie agent and their clinical susceptibility.
 
see full text and more transmission studies here ;
 
 
snip... see full text ;
 
Thursday, November 10, 2011
 
National Meat Association v. Harris Docket No., 10-224 DEADSTOCK DOWNER PIGS AND PORCINE SPONGIFORM ENCEPHALOPATHY PSE Court Likely to Overturn Calif. Law on Livestock
 
 
Friday, April 20, 2012
 
Ultrastructural findings in pigs experimentally infected with bovine spongiform encephalopathy agent
 
 
Wednesday, July 29, 2015
 
Porcine Prion Protein Amyloid or mad pig disease PSE
 

Sun, 3 Sep 2000. 

40,000 human heart valves a year from BSE herds 

Unpublished Inquiry documents obtained by CJD activist Terry S. Singeltary Sr. of Bacliff, Texas

Opinion (webmaster): Below are some shocking documents. Here is a British company preparing 40,000 heart valves a year from bovine pericardium, primarily for export, and they are not required to source this material from BSE-free herds even in peak epidemic years. It is amazing to watch health "authorities" grovelling on their bellies to wring petty concessions from middle management at obscure little companies. The main worry is not the practise of using 800 potentially infected cows a week for human heart transplant material but that the press or recipients will get wind of it, hurting business. BSE wasn't the problem, it was awkward queries from importing countries like the US. The cows are stunned using brain penetration -- can't do anything about the chunks of bovine brain blasted into the circulatory system, it's the norm. Can't use younger lower-risk animals either, patch would not be big enough. It is fascinating to see the British government worrying about, but doing nothing, with pigs with BSE 10 years ago.

While scrapie was long used as an excuse for continuing with human use of BSE-tainted material, little sheep material was used medically. Bovine transplants, vaccines, insulin doeses, etc. are far more dangerous than dietary material as injections, and are done on a very wide scale. So scrapie was never a valid analogy to BSE, as MAFF knew full well.

The British government deferred to the manufacturer's rep for an opinion on how contaminated pericardium might be, just as this appeared showing that this tissue is extremely dangerous:

CJD in a patient who received homograft [was it really?] tissue for tympanic membrane closure. Eur Arch Otorhinolaryngol 1990;247(4):199-201 Tange RA, Troost D, Limburg M We report the case history of a 54-year-old man who developed a fatal neurological disorder 4 years after a successful tympanoplasty with homograft pericardium... COMMERCIAL IN CONFIDENCE

Miss M Duncan From: Dr E Hoxey Date: 29 January 1990 cc: Mr R Burton Dr N Richardson Ms K Turner Ms J Dhell Mr N Weatherhead 

BOVINE SPONGIFORM ENCEPHALOPATHY

1. In your absence on sick leave, I chaired the STD BSE group meeting on 26th January 1990.

2. The minutes of the meeting will be circulated shortly but I was asked to bring to your attention the concerns of the group regarding the BMS heart valve.

3. This concern arose from a number of points on the agenda:-

i) the______________decision to source all raw material for sutures from Australasia from January 1990.

ii) the major cleandown and decontamination proposed for the factory and the possibility of press interest that this may generate.

iii) the indication in the Tyrell Report on Research that the infective agent may be induced to cross the species barrier by intracerebral, intraperitoneal or intravenous injection.

4. As you are aware, the____________situation has been a model which we have observed closely.

5. Reviewing the BMS situatien, we considered the incidence of BSE in the herds used for materials, the processing received by the material and the age of the cattle used. Given the number of uncertainties and lack of definitive information on BSE, the_______________model was still considered as a good one. The group were uncomfortable with the position of BMS as the only company using UK sourced material.

6. The group considered that it may be worthwhile arranging a further meeting with___________to confidentially make them aware that they would now be the only company using UK sourced bovine material for products of this type.

7. Clearly, __________and__________ are now in an exposed position in this area and all the implications need te be considered. Could we have your news on this proposal please?

Dr E V Hoxey PD STD PG1A 716 RSQ Ext 3356

90/01.29/19.1 

==============


B.S.E. GUIDELINES ON BOVINE IMPLANTS & BLOOD CONTACT DEVICES - MEETING WITH MANUFACTURERS

DATE: 8 DECEMBER 1989

DH REPRESENTATIVES Nigel Richardson Will Burton Eammon Hoxey Jeremy Tinkler Helen Campbell

 Carol Bleakley

 Bill Waine 

The main purpose of the meeeting is to discuss the companies current manufacturing procedures, future plans and their compliance with the BSE guidelines. Their views were also sought as to the practical feasibility of the guidelines with respect to the manufacturing process, and any improvements that could be suggested.

The meetings were held separately with each company. Neither had received any queries concerning BSE from countries to which their products are exported.

CURRENT POSITION

1.__________ have brought in a microbiologist as a technical scientific adviser, initially to inform them of the current understanding of BSE. He is still available to them and keeps them up to date with new developments.

2. At present they produce bovine pericardial heart valves, & (a sister company) produces heparin coated products (from a porcine source). In the future it is possible that they will introduce a bovine patch produced from bovine pericardium from the same source. They will keep the Department informed of any progress in this area.

SOURCE MATERIAL

3. The source material for the manufacture of heart valves is bovine pericardial sacs. The cows used are 18-24 months old when slaughtered, the majority around 18 months. BMS have no knowledge of the actual age.

4. The cows are killed using brain penetration. Dr Bleakley made the point that as far as she was aware this was the only method used in this country. Meat inspectors are paid to obtain the bovine pericardium. They are paid a set rate but bonuses are given for increased yields. Mr Burton expressed concern as to the conflict of interests that may arise as a result of this. Dr Bleakley did not believe that this was the case because of the relationship BMS had developed with the inspectors.

89/12.12/8.1


============ 

COMMENTS ON THE GUIDELINES

14. Dr. Bleakley believed that the pericardium would not allow the replication of the causative agent, and does not present a risk.

15. She suggested that the guidelines were impossible to implement from the point of view of the manufacturing process for the following reasons:-

-It is not possible to use closed herds simply because of the numbers of cattle involved. This is up to 800 each week.

-Calves under 6 months old cannot be used as the pericardium is too thin to be incorporated into a valve.

-For cows this in the age group used brain penetration is the only method of slaughtering used in this country.

PROPOSALS PUT FORWARD BY DR BLEAKLEY

16. The goverment should fund research in this area. For example, investigating the presence or absence of the infectious agent in other parts of the body, such as the pericardium. Also to look at how the slaughtering process affects the spread of the disease.

17. Ideally the answer would be to take random tissue samples in order to detect contaminated material. This is not currently feasible with the length of time required to conduct titre testing.

COMMENTS ON THE REVIEW ON METHODS OF STERILIZATION FOR BSE

18. Everything present reflected the published material, but the validity of some of this is questionable. It was pointed out that:-

-it was stated that different strains display different heat sensitivity, but this does not appear to be chemically related

-the claim to be "effective' would depend on the type of material that was being used and the time involved.

CURRENT POSITION

19.____________ manufacture porcine valves and bovine pericardial patches. The possibility of producing porcine conduits is currently being investigated. This has not yet progressed.

20. The material is obtained from 2 abattoires in this country:-

-Dorchester, where veal calves under 18 weeks are slaughtered for sourcing pericardium for ________________. These are used to produce small patches of less than 90mm diameter, this may be divided into 4 quadrants. This represents 80-90% of sales.

-Fairham where cows between 5 and 10 years old are slaughtered to produce larger patches and strips of 100mm by 45mm.

89/12.12/8.2


=============

32. As a result of the concern voiced of direct inoculation of BSE via sectioning instruments it was stated that it would be feasible to use new blades with each carcass.

COMMENTS ON THE GUIDELINES

33. Dr Waine was not convinced of the need for sterile sectioning equipment and separate packaging from the abattoire. He felt that this would merely have a cosmetic effect.

34. He suggested that the possibility of bovine-human cross-infection was very remote.

35. He did not believe that it was possible for manufacturers to follow the guidelines as they stand.

PROPOSALS

36. Dr Waine felt that the steps taken by the Government had been realistic to control the outbreak.

REVIEW

37. Dr Waine did not believe that any sterilization treatment proposed would retain the surgical usage of the pericardium.

VALVES

38. The response has been that this problem is restricted to the U.K. Thier material is obtained from the same Italian source as the patches. There is no age specification on the cows but the preference is for the larger valves which would therefore come from the older animals.

PORCINE VALVES

39. There was a small discussion as to whether these products do fall under the issued guidelines. The assumption had been made by the company that they are not included as pigs are not known to be susceptible to infection by a Scrapie-like agent. This was confirmed by Dr Hoxey.

40. The pigs are electrocuted and the heart and pericardium obtained prior to inspection.

41. One abattoire supplies them with most of their porcine requirments.

H Campbell PG2C Room 312 RSQ Ext. 3212 12 December 1989

89/12.12/8.3


============

TIP740203/3 0241

Bovine Spongiform Meeting Held On Friday 26th January 1990

Present Dr E Hoxey {chairman) Mr W Burton Dr N Richardson Mrs J Dhell Ms K Turner MS H Cambell Mr N Weatherhead (secretary)

 copies: Miss Duncan

1.Apologies

Apologies were received from Miss Duncan

2.Minutes of the last meeting.

The previous minutes were accepted.

3.Matters arising not on the agenda.

As agreed at the previous meeting the paper on "Inactivation of Scrapie-like Agents" was sent with a Covering letter drafted by Dr Hoxey to all companies that use Bovine or Porcine materiais.

4.Report on the STD meeting with ___________________

The minutes of the meeting were discussed by the committee it was noted that:-

a} _____________ now meet DH Guidelines as the devices produced from the calf material comply as that they are obtained from animals less than 6 months old.The company had written to confirm that they now source older animals from overseas.

b) _____________ are unable to meet the DH Guidelines. and will not be doing so in the foreseeable future. The panel showed concern over the stance that BMS are taking. The committee felt that it was important to arrange a further meeting to inform them that they are now the only company using UK sourced material. [see minutes of the meeting dated 8/12/89 attached). Dr Hoxey agreed to write separatey to Miss Duncan on this issue.

action: Dr Hoxey

5. Report on the CSM/MCA BSE working party meeting 10/1/90

Mr Burton had produced a note of the above meeting as the minutes had as yet not been distributed. The committee noted that:-

90/01.26/20.1


=============

TIP740203/3 0242

1) _______________ has exceeded all expectations tn complying with DH Guidelines. They will be sourcing all raw material from Australasia from January 1990.

2) _______________ are using an international expert _______________ to advise them on factory decontamination at the change over of source.

3) The use of Dr Taylor and the factory decontamination may qenerate press interest.

4) The offal ban has not yet been expanded to include Scotland.

5) The CSM/MCA BSE working group agrees with the approach that STD are taking to Tissue Harvesting and wished to be kept updated.

The note of the meeting is attached for reference.

6. STD Database updating

Mr Burton drafted a minute for signature by Mr Worroll.The object of the minute was to enable STD to keep a check on companies that use animal material in their products.

The control manual committee amended the minute and agreed that the audit report procedure should include (if it does not already) a statement to the effect that the company information section should include details of raw materials used.

The CMC suggested a sentence to the effect "Team leaders visiting Blue Guide companies should additionally take account of Mr Worroll's minute of Jan 1990." The committee agreed with this sentence and passed it back for inclusion in the Base-line Documents.

action N Weatherhead

7. Review of the 'Interim Report of the Consultative Committee on Research into BSE" (Tyrell committee report.)

Mrs Dhell presented a summarized Version of the above document to the committee. It was noted that only the research studies catorqorised high/medium priority would all somehow receive funding. The committee expressed a wish to find out:-

1) Areas which have not been prioritised which have relevance to STDS area of interest.

2) Has any party taken up the study "Investigation into the fate of bovine and ovine tissues and product that could lead to infection by as yet unrecognised routes."

90/01.26/20.2


==============

TIP740203/3 0243

3. The protocol of work being carried out by the Clinical Research Laboratory in Harrow add proposed by the Neuropathogenesis unit in Edinburgh:

a) Have they any plans to include pericardium. If not could PD suggest that they miqht include it.

b) What controls are they using.

c) Will it be possible to arrange a visit.

4) It was suggested that Dr Pickles be contacted as the DH representitive on the Tyrell committee, to enquire if comments on this document were being sought by the committee, as PD has a number of points it wishes to raise.

8. Incorporation of Guidance into Chemical Methods for the sterilization of animal tissue Used in medical Devices.

The draft paper on methods of validation in chemical sterilization was shown to the BGRP for comments, these were later received. A copy was also forwarded to MCA and despite numerous reminders no reply had as yet been received.

The committee recommended that the paper on "Chemical Methods for the Sterilization of Animal Tissue Used in Medical Devices" should be amended include Tissue Harvesting. The BGRP will be informed of this and a copy of tbe document will be presented to the next CMS/MCA BSE working group which is to be held on 4th July l99O.

Mrs Dhell to arrange a meeting to draft this ammendment.

Mrs Turner action:Hr Tinkler Mrs Dhell Dr Hoxey

9. Possibility of sending STD paper 'Inactivation of Scrapie-like Agents" to Dr Taylor and Dr Kimberlin for their comments.

The committee felt that the paper should be sent to Dr Taylor and Dr Klmberlin and that they should be invited to comment. If they subsequently required payment for this work the committee felt that the Department should finance it if necessary.

Mrs Dhell will draft a letter to accompany the report for Miss Duncan to sign.

action: Mrs Dhell

90/01.26/20.3 


==============

TIP740203/3 0244

10. - presentation on current situation

Miss Duncan's report was passed over until the next meeting.

1l. Oral discussion on relevant media interest and media reports.

The discussion mainly revolved around _____________ and the exposed position PD would be in if the media became involved. The possible press coverage expected in relation to events at ___________ could also raise the profile of BSE in "medical" products.

Mr Burton to obtain copies of any defensive briefings drafted by MCA in responce to the ______________ situation.

N Weatherhead

90/01.26/20.4


***> The possible press coverage expected in relation to events at ___________ could also raise the profile of BSE in "medical" products.


***> The possible press coverage expected in relation to events at ___________ could also raise the profile of BSE in "medical" products.

O.05: Transmission of prions to primates after extended silent incubation periods: Implications for BSE and scrapie risk assessment in human populations Emmanuel Comoy, Jacqueline Mikol, Valerie Durand, Sophie Luccantoni, Evelyne Correia, Nathalie Lescoutra, Capucine Dehen, and Jean-Philippe Deslys Atomic Energy Commission; Fontenay-aux-Roses, France Prion diseases (PD) are the unique neurodegenerative proteinopathies reputed to be transmissible under field conditions since decades. The transmission of Bovine Spongiform Encephalopathy (BSE) to humans evidenced that an animal PD might be zoonotic under appropriate conditions. Contrarily, in the absence of obvious (epidemiological or experimental) elements supporting a transmission or genetic predispositions, PD, like the other proteinopathies, are reputed to occur spontaneously (atpical animal prion strains, sporadic CJD summing 80% of human prion cases). Non-human primate models provided the first evidences supporting the transmissibiity of human prion strains and the zoonotic potential of BSE. Among them, cynomolgus macaques brought major information for BSE risk assessment for human health (Chen, 2014), according to their phylogenetic proximity to humans and extended lifetime. We used this model to assess the zoonotic potential of other animal PD from bovine, ovine and cervid origins even after very long silent incubation periods. 

*** We recently observed the direct transmission of a natural classical scrapie isolate to macaque after a 10-year silent incubation period, 

***with features similar to some reported for human cases of sporadic CJD, albeit requiring fourfold long incubation than BSE. Scrapie, as recently evoked in humanized mice (Cassard, 2014), 

***is the third potentially zoonotic PD (with BSE and L-type BSE), 

***thus questioning the origin of human sporadic cases. 

We will present an updated panorama of our different transmission studies and discuss the implications of such extended incubation periods on risk assessment of animal PD for human health. 

=============== 

***thus questioning the origin of human sporadic cases*** 

=============== 

***our findings suggest that possible transmission risk of H-type BSE to sheep and human. Bioassay will be required to determine whether the PMCA products are infectious to these animals. 

============== 


***Transmission data also revealed that several scrapie prions propagate in HuPrP-Tg mice with efficiency comparable to that of cattle BSE. While the efficiency of transmission at primary passage was low, subsequent passages resulted in a highly virulent prion disease in both Met129 and Val129 mice. 

***Transmission of the different scrapie isolates in these mice leads to the emergence of prion strain phenotypes that showed similar characteristics to those displayed by MM1 or VV2 sCJD prion. 

***These results demonstrate that scrapie prions have a zoonotic potential and raise new questions about the possible link between animal and human prions. 


PRION 2016 TOKYO

Saturday, April 23, 2016

SCRAPIE WS-01: Prion diseases in animals and zoonotic potential 2016

Prion. 10:S15-S21. 2016 ISSN: 1933-6896 printl 1933-690X online

Taylor & Francis

Prion 2016 Animal Prion Disease Workshop Abstracts

WS-01: Prion diseases in animals and zoonotic potential

Juan Maria Torres a, Olivier Andreoletti b, J uan-Carlos Espinosa a. Vincent Beringue c. Patricia Aguilar a,

Natalia Fernandez-Borges a. and Alba Marin-Moreno a

"Centro de Investigacion en Sanidad Animal ( CISA-INIA ). Valdeolmos, Madrid. Spain; b UMR INRA -ENVT 1225 Interactions Holes Agents Pathogenes. ENVT. Toulouse. France: "UR892. Virologie lmmunologie MolécuIaires, Jouy-en-Josas. France

Dietary exposure to bovine spongiform encephalopathy (BSE) contaminated bovine tissues is considered as the origin of variant Creutzfeldt Jakob (vCJD) disease in human. To date, BSE agent is the only recognized zoonotic prion. Despite the variety of Transmissible Spongiform Encephalopathy (TSE) agents that have been circulating for centuries in farmed ruminants there is no apparent epidemiological link between exposure to ruminant products and the occurrence of other form of TSE in human like sporadic Creutzfeldt Jakob Disease (sCJD). However, the zoonotic potential of the diversity of circulating TSE agents has never been systematically assessed. The major issue in experimental assessment of TSEs zoonotic potential lies in the modeling of the ‘species barrier‘, the biological phenomenon that limits TSE agents’ propagation from a species to another. In the last decade, mice genetically engineered to express normal forms of the human prion protein has proved essential in studying human prions pathogenesis and modeling the capacity of TSEs to cross the human species barrier.

To assess the zoonotic potential of prions circulating in farmed ruminants, we study their transmission ability in transgenic mice expressing human PrPC (HuPrP-Tg). Two lines of mice expressing different forms of the human PrPC (129Met or 129Val) are used to determine the role of the Met129Val dimorphism in susceptibility/resistance to the different agents.

These transmission experiments confirm the ability of BSE prions to propagate in 129M- HuPrP-Tg mice and demonstrate that Met129 homozygotes may be susceptible to BSE in sheep or goat to a greater degree than the BSE agent in cattle and that these agents can convey molecular properties and neuropathological indistinguishable from vCJD. However homozygous 129V mice are resistant to all tested BSE derived prions independently of the originating species suggesting a higher transmission barrier for 129V-PrP variant.

Transmission data also revealed that several scrapie prions propagate in HuPrP-Tg mice with efficiency comparable to that of cattle BSE. While the efficiency of transmission at primary passage was low, subsequent passages resulted in a highly virulent prion disease in both Met129 and Val129 mice. 

Transmission of the different scrapie isolates in these mice leads to the emergence of prion strain phenotypes that showed similar characteristics to those displayed by MM1 or VV2 sCJD prion. 

These results demonstrate that scrapie prions have a zoonotic potential and raise new questions about the possible link between animal and human prions. 


why do we not want to do TSE transmission studies on chimpanzees $

5. A positive result from a chimpanzee challenged severly would likely create alarm in some circles even if the result could not be interpreted for man. I have a view that all these agents could be transmitted provided a large enough dose by appropriate routes was given and the animals kept long enough. Until the mechanisms of the species barrier are more clearly understood it might be best to retain that hypothesis.

snip...

R. BRADLEY


Title: Transmission of scrapie prions to primate after an extended silent incubation period) 

*** In complement to the recent demonstration that humanized mice are susceptible to scrapie, we report here the first observation of direct transmission of a natural classical scrapie isolate to a macaque after a 10-year incubation period. Neuropathologic examination revealed all of the features of a prion disease: spongiform change, neuronal loss, and accumulation of PrPres throughout the CNS. 

*** This observation strengthens the questioning of the harmlessness of scrapie to humans, at a time when protective measures for human and animal health are being dismantled and reduced as c-BSE is considered controlled and being eradicated. 

*** Our results underscore the importance of precautionary and protective measures and the necessity for long-term experimental transmission studies to assess the zoonotic potential of other animal prion strains. 


SUNDAY, FEBRUARY 11, 2018 

Experimental sheep BSE prions generate the vCJD phenotype when serially passaged in transgenic mice expressing human prion protein



FRIDAY, DECEMBER 22, 2017 

Detection of PrPBSE and prion infectivity in the ileal Peyer’s patch of young calves as early as 2 months after oral challenge with classical bovine spongiform encephalopathy



Friday, December 14, 2012

DEFRA U.K. What is the risk of Chronic Wasting Disease CWD being introduced into Great Britain? A Qualitative Risk Assessment October 2012

snip...

In the USA, under the Food and Drug Administration's BSE Feed Regulation (21 CFR 589.2000) most material (exceptions include milk, tallow, and gelatin) from deer and elk is prohibited for use in feed for ruminant animals. With regards to feed for non-ruminant animals, under FDA law, CWD positive deer may not be used for any animal feed or feed ingredients. For elk and deer considered at high risk for CWD, the FDA recommends that these animals do not enter the animal feed system. However, this recommendation is guidance and not a requirement by law.

Animals considered at high risk for CWD include:

1) animals from areas declared to be endemic for CWD and/or to be CWD eradication zones and

2) deer and elk that at some time during the 60-month period prior to slaughter were in a captive herd that contained a CWD-positive animal.

Therefore, in the USA, materials from cervids other than CWD positive animals may be used in animal feed and feed ingredients for non-ruminants.

The amount of animal PAP that is of deer and/or elk origin imported from the USA to GB can not be determined, however, as it is not specified in TRACES. It may constitute a small percentage of the 8412 kilos of non-fish origin processed animal proteins that were imported from US into GB in 2011.

Overall, therefore, it is considered there is a __greater than negligible risk___ that (nonruminant) animal feed and pet food containing deer and/or elk protein is imported into GB.

There is uncertainty associated with this estimate given the lack of data on the amount of deer and/or elk protein possibly being imported in these products.

snip...

36% in 2007 (Almberg et al., 2011). In such areas, population declines of deer of up to 30 to 50% have been observed (Almberg et al., 2011). In areas of Colorado, the prevalence can be as high as 30% (EFSA, 2011).

The clinical signs of CWD in affected adults are weight loss and behavioural changes that can span weeks or months (Williams, 2005). In addition, signs might include excessive salivation, behavioural alterations including a fixed stare and changes in interaction with other animals in the herd, and an altered stance (Williams, 2005). These signs are indistinguishable from cervids experimentally infected with bovine spongiform encephalopathy (BSE).

Given this, if CWD was to be introduced into countries with BSE such as GB, for example, infected deer populations would need to be tested to differentiate if they were infected with CWD or BSE to minimise the risk of BSE entering the human food-chain via affected venison.

snip...

The rate of transmission of CWD has been reported to be as high as 30% and can approach 100% among captive animals in endemic areas (Safar et al., 2008).

snip...

In summary, in endemic areas, there is a medium probability that the soil and surrounding environment is contaminated with CWD prions and in a bioavailable form. In rural areas where CWD has not been reported and deer are present, there is a greater than negligible risk the soil is contaminated with CWD prion.

snip...

In summary, given the volume of tourists, hunters and servicemen moving between GB and North America, the probability of at least one person travelling to/from a CWD affected area and, in doing so, contaminating their clothing, footwear and/or equipment prior to arriving in GB is greater than negligible. For deer hunters, specifically, the risk is likely to be greater given the increased contact with deer and their environment. However, there is significant uncertainty associated with these estimates.

snip...

Therefore, it is considered that farmed and park deer may have a higher probability of exposure to CWD transferred to the environment than wild deer given the restricted habitat range and higher frequency of contact with tourists and returning GB residents.

snip...


SATURDAY, NOVEMBER 4, 2017 

FDA 589.2000, Section 21 C.F.R. Animal Proteins Prohibited in Ruminant Feed WARNING Letters and FEED MILL VIOLATIONS OBSERVATIONS 2017 to 2006


FRIDAY, NOVEMBER 3, 2017

BSE MAD COW TSE PRION DISEASE PET FOOD FEED IN COMMERCE INDUSTRY VS TERRY S. SINGELTARY Sr. A REVIEW

''I have a neighbor who is a dairy farmer. He tells me that he knows of several farmers who feed their cattle expired dog food. These farmers are unaware of any dangers posed to their cattle from the pet food contents. For these farmers, the pet food is just another source of protein.''

IN CONFIDENCE


TUESDAY, JULY 18, 2017 

USDA announces Alabama case of Bovine Spongiform Encephalopathy Alabama


***> THURSDAY, JULY 20, 2017 

***> USDA OIE Alabama Atypical L-type BASE Bovine Spongiform Encephalopathy BSE animal feeds for ruminants rule, 21 CFR 589.200


SUNDAY, JANUARY 11, 2015 

Docket No. APHIS-2014-0107 Bovine Spongiform Encephalopathy; Importation of Animals and Animal Products Singeltary Submission


[Docket No. FSIS-2006-0011] FSIS Harvard Risk Assessment of Bovine Spongiform Encephalopathy (BSE)


 *** APHIS USDA CFIA CWD TSE Prion Herd Certifications Update ***

FRIDAY, MARCH 30, 2018 

Docket No. APHIS-2018-0011 Chronic Wasting Disease Herd Certification Program Standards Singeltary Submission March 30, 2018

Terry S. Singeltary Sr., Bacliff, Texas USA 77518 flounder9@verizon.net Attachments (1) Docket No. APHIS-2018-0011 Chronic Wasting Disease Herd Certification Program Standards Singeltary View Attachment:View as format pdf 





WEDNESDAY, APRIL 04, 2018 

Canada Chronic Wasting Disease Voluntary Herd Certification Program Updated


THURSDAY, APRIL 05, 2018 

Boone and Crocket Club B&C News Release CHRONIC WASTING DISEASE TSE Prion


SUNDAY, APRIL 8, 2018 

Transmissible Spongiform Encephalopathy TSE Prion Disease Global Pandemic Urgent Update April 9, 2018


TUESDAY, APRIL 10, 2018 

Animal TSEs and public health: What remains of past lessons?


*USA USDA CWD BSE SCRAPIE TSE PRION?
3. Prof. A. Robertson gave a brief account of BSE. The US approach was to accord it a very low profile indeed. Dr. A Thiermann showed the picture in the ''Independent'' with cattle being incinerated and thought this was a fanatical incident to be avoided in the US at all costs. ...


Evidence That Transmissible Mink Encephalopathy Results from Feeding Infected Cattle Over the next 8-10 weeks, approximately 40% of all the adult mink on the farm died from TME. snip... The rancher was a ''dead stock'' feeder using mostly (>95%) downer or dead dairy cattle... 

In Confidence - Perceptions of unconventional slow virus diseases of animals in the USA - APRIL-MAY 1989 - G A H Wells 3. Prof. A. Robertson gave a brief account of BSE. The US approach was to accord it a very low profile indeed. Dr. A Thiermann showed the picture in the ''Independent'' with cattle being incinerated and thought this was a fanatical incident to be avoided in the US at all costs. ... 


The occurrence of CWD must be viewed against the contest of the locations in which it occurred. It was an incidental and unwelcome complication of the respective wildlife research programmes. Despite its subsequent recognition as a new disease of cervids, therefore justifying direct investigation, no specific research funding was forthcoming.. The USDA veiwed it as a wildlife problem and consequently not their province! ...page 26.


U.S.A. 50 STATE BSE MAD COW CONFERENCE CALL Jan. 9, 2001 

Subject: BSE--U.S. 50 STATE CONFERENCE CALL Jan. 9, 2001

Date: Tue, 9 Jan 2001 16:49:00 -0800

From: "Terry S. Singeltary Sr."

Reply-To: Bovine Spongiform Encephalopathy

To: BSE-L@uni-karlsruhe.de 

######### Bovine Spongiform Encephalopathy #########

snip...

 [host Richard Barns] and now a question from Terry S. Singeltary of CJD Watch.

[TSS] yes, thank you, U.S. cattle, what kind of guarantee can you give for serum or tissue donor herds?

[no answer, you could hear in the back ground, mumbling and 'we can't. have him ask the question again.]

[host Richard] could you repeat the question?

[TSS] U.S. cattle, what kind of guarantee can you give for serum or tissue donor herds?

[not sure whom ask this] what group are you with?

[TSS] CJD Watch, my Mom died from hvCJD and we are tracking CJD world-wide.

[not sure who is speaking] could you please disconnect Mr. Singeltary

[TSS] you are not going to answer my question?

[not sure whom speaking] NO

snip...see full text and more; 


Freas, William

Terry S. Singeltary Sr. [flounder@wt.net]

Monday, January 08,200l 3:03 PM

freas@CBS5055530.CBER.FDA.GOV

CJD/BSE (aka madcow) Human/Animal TSE’s--U.S.--Submission To Scientific Advisors and Consultants Staff January 2001 Meeting (short version)

Greetings again Dr. Freas and Committee Members,

I wish to submit the following information to the Scientific Advisors and Consultants Staff 2001 Advisory Committee (short version).

I understand the reason of having to shorten my submission, but only hope that you add it to a copy of the long version, for members to take and read at their pleasure, (if cost is problem, bill me, address below).

So when they realize some time in the near future of the 'real' risks i speak of from human/animal TSEs and blood/surgical products. I cannot explain the 'real' risk of this in 5 or 10 minutes at some meeting, or on 2 or 3 pages, but will attempt here: 


Tuesday, March 20, 2018 

Variably protease-sensitive prionopathy (VPSPr), sporadic creutzfeldt jakob disease sCJD, the same disease, what if?


FRIDAY, MARCH 30, 2018 

Detection of Creutzfeldt-Jakob disease prions in skin: implications for healthcare


MONDAY, OCTOBER 02, 2017 

Creutzfeldt Jakob Disease United States of America USA and United Kingdom UK Increasing and Zoonotic Pontential From Different Species

http://creutzfeldt-jakob-disease.blogspot.com/2017/10/creutzfeldt-jakob-disease-united-states.html

THURSDAY, AUGUST 17, 2017 

*** Monitoring the occurrence of emerging forms of Creutzfeldt-Jakob disease in the United States revisited 2017

Singeltary et al

http://creutzfeldt-jakob-disease.blogspot.com/2017/08/monitoring-occurrence-of-emerging-forms.html

Re-Evidence for human transmission of amyloid-β pathology and cerebral amyloid angiopathy 

>>> The only tenable public line will be that "more research is required’’ <<< 

>>> possibility on a transmissible prion remains open<<< 

O.K., so it’s about 23 years later, so somebody please tell me, when is "more research is required’’ enough time for evaluation ? 

Re-Evidence for human transmission of amyloid-β pathology and cerebral amyloid angiopathy 

Nature 525, 247?250 (10 September 2015) doi:10.1038/nature15369 Received 26 April 2015 Accepted 14 August 2015 Published online 09 September 2015 Updated online 11 September 2015 Erratum (October, 2015) 

snip...see full Singeltary Nature comment here; 

Alzheimer's disease

let's not forget the elephant in the room. curing Alzheimer's would be a great and wonderful thing, but for starters, why not start with the obvious, lets prove the cause or causes, and then start to stop that. think iatrogenic, friendly fire, or the pass it forward mode of transmission. think medical, surgical, dental, tissue, blood, related transmission. think transmissible spongiform encephalopathy aka tse prion disease aka mad cow type disease... 

Commentary: Evidence for human transmission of amyloid-β pathology and cerebral amyloid angiopathy





Self-Propagative Replication of Ab Oligomers Suggests Potential Transmissibility in Alzheimer Disease 

*** Singeltary comment PLoS *** 

Alzheimer’s disease and Transmissible Spongiform Encephalopathy prion disease, Iatrogenic, what if ? 

Posted by flounder on 05 Nov 2014 at 21:27 GMT 


IN CONFIDENCE

5 NOVEMBER 1992

TRANSMISSION OF ALZHEIMER TYPE PLAQUES TO PRIMATES

[9. Whilst this matter is not at the moment directly concerned with the iatrogenic CJD cases from hgH, there remains a possibility of litigation here, and this presents an added complication. 

There are also results to be made available shortly 

(1) concerning a farmer with CJD who had BSE animals, 

(2) on the possible transmissibility of Alzheimer’s and 

(3) a CMO letter on prevention of iatrogenic CJD transmission in neurosurgery, all of which will serve to increase media interest.]




snip...see full Singeltary Nature comment here; 

re-Evidence for human transmission of amyloid-? pathology and cerebral amyloid angiopathy Nature 525, 247?250 (10 September 2015) doi:10.1038/nature15369 Received 26 April 2015 Accepted 14 August 2015 Published online 09 September 2015 Updated online 11 September 2015 Erratum (October, 2015)


I would kindly like to comment on the Nature Paper, the Lancet reply, and the newspaper articles.

First, I applaud Nature, the Scientist and Authors of the Nature paper, for bringing this important finding to the attention of the public domain, and the media for printing said findings.

Secondly, it seems once again, politics is getting in the way possibly of more important Transmissible Spongiform Encephalopathy TSE Prion scientific findings. findings that could have great implications for human health, and great implications for the medical surgical arena. but apparently, the government peer review process, of the peer review science, tries to intervene again to water down said disturbing findings.

where have we all heard this before? it's been well documented via the BSE Inquiry. have they not learned a lesson from the last time?

we have seen this time and time again in England (and other Country's) with the BSE mad cow TSE Prion debacle.

That 'anonymous' Lancet editorial was disgraceful. The editor, Dick Horton is not a scientist.

The pituitary cadavers were very likely elderly and among them some were on their way to CJD or Alzheimer's. Not a bit unusual. Then the recipients, who got pooled extracts injected from thousands of cadavers, were 100% certain to have been injected with both seeds. No surprise that they got both diseases going after thirty year incubations.

That the UK has a "system in place to assist science journalists" to squash embargoed science reports they find 'alarming' is pathetic.

Sounds like the journalists had it right in the first place: 'Alzheimer's may be a transmissible infection? in The Independent to 'You can catch Alzheimer's' in The Daily Mirror or 'Alzheimer's bombshell' in The Daily Express

if not for the journalist, the layperson would not know about these important findings.

where would we be today with sound science, from where we were 30 years ago, if not for the cloak of secrecy and save the industry at all cost mentality?

when you have a peer review system for science, from which a government constantly circumvents, then you have a problem with science, and humans die.

to date, as far as documented body bag count, with all TSE prion named to date, that count is still relatively low (one was too many in my case, Mom hvCJD), however that changes drastically once the TSE Prion link is made with Alzheimer's, the price of poker goes up drastically.

so, who makes that final decision, and how many more decades do we have to wait?

the iatrogenic mode of transmission of TSE prion, the many routes there from, load factor, threshold from said load factor to sub-clinical disease, to clinical disease, to death, much time is there to spread a TSE Prion to anywhere, but whom, by whom, and when, do we make that final decision to do something about it globally? how many documented body bags does it take? how many more decades do we wait? how many names can we make up for one disease, TSE prion?

Professor Collinge et al, and others, have had troubles in the past with the Government meddling in scientific findings, that might in some way involve industry, never mind human and or animal health.

FOR any government to continue to circumvent science for monetary gain, fear factor, or any reason, shame, shame on you.

in my opinion, it's one of the reasons we are at where we are at to date, with regards to the TSE Prion disease science i.e. money, industry, politics, then comes science, in that order.

greed, corporate, lobbyist there from, and government, must be removed from the peer review process of sound science, it's bad enough having them in the pharmaceutical aspect of healthcare policy making, in my opinion.

my mother died from confirmed hvCJD, and her brother (my uncle) Alzheimer's of some type (no autopsy?). just made a promise, never forget, and never let them forget, before I do.

I kindly wish to remind the public of the past, and a possible future we all hopes never happens again. ...



2012

Alzheimer’s disease and Transmissible Spongiform Encephalopathy prion disease, Iatrogenic, what if ?

Background

Alzheimer’s disease and Transmissible Spongiform Encephalopathy disease have both been around a long time, and was discovered in or around the same time frame, early 1900’s. Both diseases are incurable and debilitating brain disease, that are in the end, 100% fatal, with the incubation/clinical period of the Alzheimer’s disease being longer (most of the time) than the TSE prion disease. Symptoms are very similar, and pathology is very similar.

Methods

Through years of research, as a layperson, of peer review journals, transmission studies, and observations of loved ones and friends that have died from both Alzheimer’s and the TSE prion disease i.e. Heidenhain Variant Creutzfelt Jakob Disease CJD.

Results

I propose that Alzheimer’s is a TSE disease of low dose, slow, and long incubation disease, and that Alzheimer’s is Transmissible, and is a threat to the public via the many Iatrogenic routes and sources. It was said long ago that the only thing that disputes this, is Alzheimer’s disease transmissibility, or the lack of. The likelihood of many victims of Alzheimer’s disease from the many different Iatrogenic routes and modes of transmission as with the TSE prion disease.

Conclusions

There should be a Global Congressional Science round table event set up immediately to address these concerns from the many potential routes and sources of the TSE prion disease, including Alzheimer’s disease, and a emergency global doctrine put into effect to help combat the spread of Alzheimer’s disease via the medical, surgical, dental, tissue, and blood arena’s. All human and animal TSE prion disease, including Alzheimer’s should be made reportable in every state, and Internationally, WITH NO age restrictions. Until a proven method of decontamination and autoclaving is proven, and put forth in use universally, in all hospitals and medical, surgical arena’s, or the TSE prion agent will continue to spread. IF we wait until science and corporate politicians wait until politics lets science _prove_ this once and for all, and set forth regulations there from, we will all be exposed to the TSE Prion agents, if that has not happened already.

end...tss

Alzheimer’s disease and Transmissible Spongiform Encephalopathy prion disease, Iatrogenic, what if ?

source references ...end...tss 

Hello Nicole,

by all means, please do use my poster. but I thought this was already taken care of, and I could not attend for my poster presentation, therefore, it was not going to be presented. I have some health issues and could not make the trip.

please see old correspondence below...

From: Nicole Sanders Sent: Tuesday, April 10, 2012 5:37 PM To: Terry S. Singeltary Sr. Subject: RE: re-submission

Dear Terry,

The decline of proposal number 30756 is registered in the system. Thank you for your consideration.

Best Regards,

Nicole

Nicole Sanders

Senior Specialist, Membership & Conference Programming

______________________________________


From: xxxx 

To: Terry Singeltary 

Sent: Saturday, December 05, 2009 9:09 AM 

Subject: 14th ICID - abstract accepted for 'International Scientific Exchange'

Your preliminary abstract number: 670

Dear Mr. Singeltary,

On behalf of the Scientific Committee, I am pleased to inform you that your abstract

'Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America update October 2009'

WAS accepted for inclusion in the INTERNATIONAL SCIENTIFIC EXCHANGE (ISE) section of the 14th International Congress on Infectious Diseases. Accordingly, your abstract will be included in the "Intl. Scientific Exchange abstract CD-rom" of the Congress which will be distributed to all participants.

Abstracts accepted for INTERNATIONAL SCIENTIFIC EXCHANGE are NOT PRESENTED in the oral OR poster sessions.

Your abstract below was accepted for: INTERNATIONAL SCIENTIFIC EXCHANGE

#0670: Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America update October 2009

Author: T. Singeltary; Bacliff, TX/US

Topic: Emerging Infectious Diseases Preferred type of presentation: International Scientific Exchange

This abstract has been ACCEPTED.

#0670: Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America update October 2009

Authors: T. Singeltary; Bacliff, TX/US

Title: Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America update October 2009

Body: Background

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.

Methods

12 years independent research of available data

Results

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.

Conclusion

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.

Keywords: Transmissible Spongiform Encephalopathy Creutzfeldt Jakob Disease Prion

page 114 ;

http://ww2.isid.org/Downloads/14th_ICID_ISE_Abstracts.pdf

http://www.isid.org/14th_icid/

http://www.isid.org/publications/ICID_Archive.shtml

http://ww2.isid.org/Downloads/IMED2009_AbstrAuth.pdf
Diagnosis and Reporting of Creutzfeldt-Jakob Disease 

Singeltary, Sr et al. JAMA.2001; 285: 733-734. Vol. 285 No. 6, February 14, 2001 JAMA Diagnosis and Reporting of Creutzfeldt-Jakob Disease 

To the Editor: 

In their Research Letter, Dr Gibbons and colleagues1 reported that the annual US death rate due to Creutzfeldt-Jakob disease (CJD) has been stable since 1985. These estimates, however, are based only on reported cases, and do not include misdiagnosed or preclinical cases. It seems to me that misdiagnosis alone would drastically change these figures. An unknown number of persons with a diagnosis of Alzheimer disease in fact may have CJD, although only a small number of these patients receive the postmortem examination necessary to make this diagnosis. Furthermore, only a few states have made CJD reportable. Human and animal transmissible spongiform encephalopathies should be reportable nationwide and internationally. 

Terry S. Singeltary, Sr Bacliff, Tex 

1. Gibbons RV, Holman RC, Belay ED, Schonberger LB. Creutzfeldt-Jakob disease in the United States: 1979-1998. JAMA. 2000;284:2322-2323. 


Tracking spongiform encephalopathies in North America

Xavier Bosch

Published: August 2003


Summary;

“My name is Terry S Singeltary Sr, and I live in Bacliff, Texas. I lost my mom to hvCJD (Heidenhain variant CJD) and have been searching for answers ever since. What I have found is that we have not been told the truth. CWD in deer and elk is a small portion of a much bigger problem.”

49-year-old Singeltary is one of a number of people who have remained largely unsatisfied after being told that a close relative died from a rapidly progressive dementia compatible with spontaneous Creutzfeldt-Jakob disease (CJD). So he decided to gather hundreds of documents on transmissible spongiform encephalopathies (TSE) and realised that if Britons could get variant CJD from bovine spongiform encephalopathy (BSE), Americans might get a similar disorder from chronic wasting disease (CWD) the relative of mad cow disease seen among deer and elk in the USA. Although his feverish search did not lead him to the smoking gun linking CWD to a similar disease in North American people, it did uncover a largely disappointing situation.

Singeltary was greatly demoralised at the few attempts to monitor the occurrence of CJD and CWD in the USA. Only a few states have made CJD reportable. Human and animal TSEs should be reportable nationwide and internationally, he complained in a letter to the Journal of the American Medical Association (JAMA 2003; 285: 733). "I hope that the CDC does not continue to expect us to still believe that the 85% plus of all CJD cases which are sporadic are all spontaneous, without route or source."

Until recently, CWD was thought to be confined to the wild in a small region in Colorado. But since early 2002, it has been reported in other areas, including Wisconsin, South Dakota, and the Canadian province of Saskatchewan. Indeed, the occurrence of CWD in states that were not endemic previously increased concern about a widespread outbreak and possible transmission to people and cattle.

To date, experimental studies have proven that the CWD agent can be transmitted to cattle by intracerebral inoculation and that it can cross the mucous membranes of the digestive tract to initiate infection in lymphoid tissue before invasion of the central nervous system. Yet the plausibility of CWD spreading to people has remained elusive.

Part of the problem seems to stem from the US surveillance system. CJD is only reported in those areas known to be endemic foci of CWD. Moreover, US authorities have been criticised for not having performed enough prionic tests in farm deer and elk.

Although in November last year the US Food and Drug Administration issued a directive to state public-health and agriculture officials prohibiting material from CWD-positive animals from being used as an ingredient in feed for any animal species, epidemiological control and research in the USA has been quite different from the situation in the UK and Europe regarding BSE.

"Getting data on TSEs in the USA from the government is like pulling teeth", Singeltary argues. "You get it when they want you to have it, and only what they want you to have."

Norman Foster, director of the Cognitive Disorders Clinic at the University of Michigan (Ann Arbor, MI, USA), says that "current surveillance of prion disease in people in the USA is inadequate to detect whether CWD is occurring in human beings"; adding that, "the cases that we know about are reassuring, because they do not suggest the appearance of a new variant of CJD in the USA or atypical features in patients that might be exposed to CWD. However, until we establish a system that identifies and analyses a high proportion of suspected prion disease cases we will not know for sure". The USA should develop a system modelled on that established in the UK, he points out.

Ali Samii, a neurologist at Seattle VA Medical Center who recently reported the cases of three hunters "two of whom were friends" who died from pathologically confirmed CJD, says that "at present there are insufficient data to claim transmission of CWD into humans"; adding that "[only] by asking [the questions of venison consumption and deer/elk hunting] in every case can we collect suspect cases and look into the plausibility of transmission further". Samii argues that by making both doctors and hunters more aware of the possibility of prions spreading through eating venison, doctors treating hunters with dementia can consider a possible prion disease, and doctors treating CJD patients will know to ask whether they ate venison.

CDC spokesman Ermias Belay says that the CDC "will not be investigating the [Samii] cases because there is no evidence that the men ate CWD-infected meat". He notes that although "the likelihood of CWD jumping the species barrier to infect humans cannot be ruled out 100%" and that "[we] cannot be 100% sure that CWD does not exist in humans& the data seeking evidence of CWD transmission to humans have been very limited". 



26 March 2003 

Terry S. Singeltary, retired (medically) CJD WATCH 

I lost my mother to hvCJD (Heidenhain Variant CJD). I would like to comment on the CDC's attempts to monitor the occurrence of emerging forms of CJD. Asante, Collinge et al [1] have reported that BSE transmission to the 129-methionine genotype can lead to an alternate phenotype that is indistinguishable from type 2 PrPSc, the commonest sporadic CJD. However, CJD and all human TSEs are not reportable nationally. CJD and all human TSEs must be made reportable in every state and internationally. I hope that the CDC does not continue to expect us to still believe that the 85%+ of all CJD cases which are sporadic are all spontaneous, without route/source. We have many TSEs in the USA in both animal and man. CWD in deer/elk is spreading rapidly and CWD does transmit to mink, ferret, cattle, and squirrel monkey by intracerebral inoculation. With the known incubation periods in other TSEs, oral transmission studies of CWD may take much longer. Every victim/family of CJD/TSEs should be asked about route and source of this agent. To prolong this will only spread the agent and needlessly expose others. In light of the findings of Asante and Collinge et al, there should be drastic measures to safeguard the medical and surgical arena from sporadic CJDs and all human TSEs. I only ponder how many sporadic CJDs in the USA are type 2 PrPSc? 


2001 FDA CJD TSE Prion Singeltary Submission 


*** U.S.A. 50 STATE BSE MAD COW CONFERENCE CALL Jan. 9, 2001 


2 January 2000 British Medical Journal U.S. 

Scientist should be concerned with a CJD epidemic in the U.S., as well 


15 November 1999 British Medical Journal hvCJD in the USA * BSE in U.S. 



Terry S. Singeltary Sr. Bacliff, Texas USA 77518 <flounder9@verizon.net>


 

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