PRION 2015 ORAL AND POSTER CONGRESSIONAL ABSTRACTS
THANK YOU PRION 2015 TAYLOR & FRANCIS, Professor Chernoff, and 
Professor Aguzzi et al, for making these PRION 2015 Congressional Poster and 
Oral Abstracts available freely to the public. ...Terry S. Singeltary Sr. 
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, Val erie 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 longe 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...TSS
===============
O.08: H-type bovine spongiform encephalopathy associated with E211K prion 
protein polymorphism: Clinical and pathologic features in wild-type and E211K 
cattle following intracranial inoculation 
S Jo Moore, M Heather West Greenlee, Jodi Smith, Eric Nicholson, Cathy 
Vrentas, and Justin Greenlee United States Department of Agriculture; Ames, IA 
USA 
In 2006 an H-type bovine spongiform encephalopathy (BSE) case was reported 
in an animal with an unusual polymorphism (E211K) in the prion protein gene. 
Although the prevalence of this polymorphism is low, cattle carrying the K211 
allele are predisposed to rapid onset of H-type BSE when exposed. The purpose of 
this study was to investigate the phenotype of this BSE strain in wild-type 
(E211E) and E211K heterozygous cattle. One calf carrying the wild-type allele 
and one E211K calf were inoculated intracranially with H-type BSE brain 
homogenate from the US 2006 case that also carried one K211 allelle. In 
addition, one wild-type calf and one E211K calf were inoculated intracranially 
with brain homogenate from a US 2003 classical BSE case. All animals succumbed 
to clinical disease. Survival times for E211K H-type BSE inoculated catttle (10 
and 18 months) were shorter than the classical BSE inoculated cattle (both 26 
months). Significant changes in retinal function were observed in H-type BSE 
challenged cattle only. Animals challenged with the same inoculum showed similar 
severity and neuroanatomical distribution of vacuolation and disease-associated 
prion protein deposition in the brain, though differences in neuropathology were 
observed between E211K H-type BSE and classical BSE inoculated animals. Western 
blot results for brain tissue from challenged animals were consistent with the 
inoculum strains. ***This study demonstrates that the phenotype of E211K H-type 
BSE remains stable when transmitted to cattle without the E211K polymorphism, 
and exhibits a number of features that differ from classical BSE in both 
wild-type and E211K cattle. 
==============
***This study demonstrates that the phenotype of E211K H-type BSE remains 
stable when transmitted to cattle without the E211K polymorphism, and exhibits a 
number of features that differ from classical BSE in both wild-type and E211K 
cattle.***
PLEASE SEE ;
Wednesday, May 27, 2015 
BSE Case Associated with Prion Protein Gene Mutation
==============
P.108: Successful oral challenge of adult cattle with classical BSE
Sandor Dudas1,*, Kristina Santiago-Mateo1, Tammy Pickles1, Catherine 
Graham2, and Stefanie Czub1 1Canadian Food Inspection Agency; NCAD Lethbridge; 
Lethbridge, Alberta, Canada; 2Nova Scotia Department of Agriculture; Pathology 
Laboratory; Truro, Nova Scotia, Canada
Classical Bovine spongiform encephalopathy (C-type BSE) is a feed- and 
food-borne fatal neurological disease which can be orally transmitted to cattle 
and humans. Due to the presence of contaminated milk replacer, it is generally 
assumed that cattle become infected early in life as calves and then succumb to 
disease as adults.
Here we challenged three 14 months old cattle per-orally with 100 grams of 
C-type BSE brain to investigate age-related susceptibility or resistance. During 
incubation, the animals were sampled monthly for blood and feces and subjected 
to standardized testing to identify changes related to neurological 
disease.
At 53 months post exposure, progressive signs of central nervous system 
disease were observed in these 3 animals, and they were euthanized. Two of the 
C-BSE animals tested strongly positive using standard BSE rapid tests, however 
in 1 C-type challenged animal, Prion 2015 Poster Abstracts S67 PrPsc was not 
detected using rapid tests for BSE. Subsequent testing resulted in the detection 
of pathologic lesion in unusual brain location and PrPsc detection by PMCA 
only.
Our study demonstrates susceptibility of adult cattle to oral transmission 
of classical BSE. We are further examining explanations for the unusual disease 
presentation in the third challenged animal.
========================
***Our study demonstrates susceptibility of adult cattle to oral 
transmission of classical BSE. ***
P.86: Estimating the risk of transmission of BSE and scrapie to ruminants 
and humans by protein misfolding cyclic amplification
Morikazu Imamura, Naoko Tabeta, Yoshifumi Iwamaru, and Yuichi Murayama 
National Institute of Animal Health; Tsukuba, Japan
To assess the risk of the transmission of ruminant prions to ruminants and 
humans at the molecular level, we investigated the ability of abnormal prion 
protein (PrPSc) of typical and atypical BSEs (L-type and H-type) and typical 
scrapie to convert normal prion protein (PrPC) from bovine, ovine, and human to 
proteinase K-resistant PrPSc-like form (PrPres) using serial protein misfolding 
cyclic amplification (PMCA).
Six rounds of serial PMCA was performed using 10% brain homogenates from 
transgenic mice expressing bovine, ovine or human PrPC in combination with PrPSc 
seed from typical and atypical BSE- or typical scrapie-infected brain 
homogenates from native host species. In the conventional PMCA, the conversion 
of PrPC to PrPres was observed only when the species of PrPC source and PrPSc 
seed matched. However, in the PMCA with supplements (digitonin, synthetic polyA 
and heparin), both bovine and ovine PrPC were converted by PrPSc from all tested 
prion strains. On the other hand, human PrPC was converted by PrPSc from typical 
and H-type BSE in this PMCA condition.
Although these results were not compatible with the previous reports 
describing the lack of transmissibility of H-type BSE to ovine and human 
transgenic mice, ***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.
================
***our findings suggest that possible transmission risk of H-type BSE to 
sheep and human. ***
ALSO, PLEASE SEE ;
31 Jan 2015 at 20:14 GMT 
*** Ruminant feed ban for cervids in the United States? ***
31 Jan 2015 at 20:14 GMT 
================
P.105: RT-QuIC models trans-species prion transmission
Kristen Davenport, Davin Henderson, Candace Mathiason, and Edward Hoover 
Prion Research Center; Colorado State University; Fort Collins, CO USA
The propensity for trans-species prion transmission is related to the 
structural characteristics of the enciphering and heterologous PrP, but the 
exact mechanism remains mostly mysterious. Studies of the effects of primary or 
tertiary prion protein structures on trans-species prion transmission have 
relied primarily upon animal bioassays, making the influence of prion protein 
structure vs. host co-factors (e.g. cellular constituents, trafficking, and 
innate immune interactions) difficult to dissect. As an alternative strategy, we 
used real-time quakinginduced conversion (RT-QuIC) to investigate trans-species 
prion conversion.
To assess trans-species conversion in the RT-QuIC system, we compared 
chronic wasting disease (CWD) and bovine spongiform encephalopathy (BSE) prions, 
as well as feline CWD (fCWD) and feline spongiform encephalopathy (FSE). Each 
prion was seeded into each host recombinant PrP (full-length rPrP of 
white-tailed deer, bovine or feline). We demonstrated that fCWD is a more 
efficient seed for feline rPrP than for white-tailed deer rPrP, which suggests 
adaptation to the new host.
Conversely, FSE maintained sufficient BSE characteristics to more 
efficiently convert bovine rPrP than feline rPrP. Additionally, human rPrP was 
competent for conversion by CWD and fCWD. ***This insinuates that, at the level 
of protein:protein interactions, the barrier preventing transmission of CWD to 
humans is less robust than previously estimated.
================
***This insinuates that, at the level of protein:protein interactions, the 
barrier preventing transmission of CWD to humans is less robust than previously 
estimated.***
================
Willingham, Erin McNulty, Kelly Anderson, Jeanette Hayes-Klug, Amy Nalls, 
and Candace Mathiason Colorado State University; Fort Collins, CO USA
Chronic wasting disease (CWD) is the transmissible spongiform 
encephalopathy (TSE), of free-ranging and captive cervids (deer, elk and moose). 
The presence of infectious prions in the tissues, bodily fluids and 
environments of clinical and preclinical CWD-infected animals is thought to 
account for its high transmission efficiency. Recently it has been recognized 
that mother to offspring transmission may contribute to the facile transmission 
of some TSEs. Although the mechanism behind maternal transmission is not yet 
known, the extended asymptomatic TSE carrier phase (lasting years to decades) 
suggests that it may have implications in the spread of prions.
Placental trafficking and/or secretion in milk are 2 means by which 
maternal prion transmission may occur. In these studies we explore these avenues 
during early and late infection using a transgenic mouse model expressing cervid 
prion protein. Na€Ä±ve and CWD-infected dams were bred at both timepoints, and 
were allowed to bear and raise their offspring. Milk was collected from the dams 
for prion analysis, and the offspring were observed for TSE disease progression. 
Terminal tissues harvested from both dams and offspring were analyzed for 
prions.
We have demonstrated that 
(1) CWDinfected TgCerPRP females successfully breed and bear offspring, and 
(2) the presence of PrPCWD in reproductive and mammary tissue from 
CWD-infected dams. 
We are currently analyzing terminal tissue harvested from offspring born to 
CWD-infected dams for the detection of PrPCWD and amplification competent 
prions. These studies will provide insight into the potential mechanisms and 
biological significance associated with mother to offspring transmission of 
TSEs.
==============
P.157: Uptake of prions into plants
Christopher Johnson1, Christina Carlson1, Matthew Keating1,2, Nicole 
Gibbs1, Haeyoon Chang1, Jamie Wiepz1, and Joel Pedersen1 1USGS National Wildlife 
Health Center; Madison, WI USA; 2University of Wisconsin - Madison; Madison, WI 
USA
Soil may preserve chronic wasting disease (CWD) and scrapie infectivity in 
the environment, making consumption or inhalation of soil particles a plausible 
mechanism whereby na€Ä±ve animals can be exposed to prions. Plants are known to 
absorb a variety of substances from soil, including whole proteins, yet the 
potential for plants to take up abnormal prion protein (PrPTSE) and preserve 
prion infectivity is not known. In this study, we assessed PrPTSE uptake into 
roots using laser scanning confocal microscopy with fluorescently tagged PrPTSE 
and we used serial protein misfolding cyclic amplification (sPMCA) and detect 
and quantify PrPTSE levels in plant aerial tissues. Fluorescence was identified 
in the root hairs of the model plant Arabidopsis thaliana, as well as the crop 
plants alfalfa (Medicago sativa), barley (Hordeum vulgare) and tomato (Solanum 
lycopersicum) upon exposure to tagged PrPTSE but not a tagged control 
preparation. Using sPMCA, we found evidence of PrPTSE in aerial tissues of A. 
thaliana, alfalfa and maize (Zea mays) grown in hydroponic cultures in which 
only roots were exposed to PrPTSE. Levels of PrPTSE in plant aerial tissues 
ranged from approximately 4 £ 10 ¡10 to 1 £ 10 ¡9 g PrPTSE g ¡1 plant dry weight 
or 2 £ 105 to 7 £ 106 intracerebral ID50 units g ¡1 plant dry weight. Both stems 
and leaves of A. thaliana grown in culture media containing prions are 
infectious when intracerebrally-injected into mice. ***Our results suggest that 
prions can be taken up by plants and that contaminated plants may represent a 
previously unrecognized risk of human, domestic species and wildlife exposure to 
prions.
===========
***Our results suggest that prions can be taken up by plants and that 
contaminated plants may represent a previously unrecognized risk of human, 
domestic species and wildlife exposure to prions.***
SEE ;
Friday, May 15, 2015 Grass Plants Bind, Retain, Uptake, and Transport 
Infectious Prions 
Report 
 ============ 
P.19: Characterization of chronic wasting disease isolates from freeranging 
deer (Odocoileus sp) in Alberta and Saskatchewan, Canada
Camilo Duque Velasquez1, Chiye Kim1, Nathalie Daude1, Jacques van der 
Merwe1, Allen Herbst1, Trent Bollinger2, Judd Aiken1, and Debbie McKenzie1 
1Centre for Prions and Protein Folding Diseases; University of Alberta; 
Edmonton, Canada; 2Western College of Veterinary Medicine; University of 
Saskatchewan; Saskatoon, Canada
Chronic wasting disease (CWD) is an emerging prion disease of free ranging 
and captive species of Cervidae. In North America, CWD is enzootic in some wild 
cervid populations and can circulate among different deer species. The 
contagious nature of CWD prions and the variation of cervid PRNP alleles, which 
influence host susceptibility, can result in the emergence and adaptation of 
different CWD strains. These strains may impact transmission host range, disease 
diagnosis, spread dynamics and efficacy of potential vaccines. We are 
characterizing different CWD agents by biochemical analysis of the PrPCWD 
conformers, propagation in vitro cell assays1 and by comparing transmission 
properties and neuropathology in Tg33 (Q95G96) and Tg60 (Q95S96) mice.2 Although 
Tg60 mice expressing S96- PrPC have been shown resistant to CWD infectivity from 
various cervid species,2,3 
***these transgenic mice are susceptible to H95 C CWD, a CWD strain derived 
from experimental infection of deer expressing H95G96-PrPC. The diversity of 
strains present in free-ranging mule deer (Odocoileus hemionus) and white-tailed 
deer (Odocoileus virginianus) from Alberta and Saskatchewan is being determined 
and will allow us to delineate the properties of CWD agents circulating in CWD 
enzootic cervid populations of Canada.
References
1. van der Merwe J, Aiken J, Westaway D, McKenzie D. The standard scrapie 
cell assay: Development, utility and prospects. Viruses 2015; 7(1):180–198; 
PMID:25602372; http://dx.doi.org/10.3390/v7010180
2. Meade-White K, Race B, Trifilo M, Bossers A, Favara C, Lacasse R, Miller 
M, Williams E, Oldstone M, Race R, Chesebro B. Resistance to chronic wasting 
disease in transgenic mice expressing a naturally occurring allelic variant of 
deer prion protein. J Virol 2007; 81(9):4533–4539; PMID: 17314157; http://dx. doi.org/10.1128/JVI.02762-06
3. Race B, Meade-White K, Miller MW, Fox KA, Chesebro B. In vivo comparison 
of chronic wasting disease infectivity from deer with variation at prion protein 
residue 96. J Virol 2011; 85(17):9235–9238; PMID: 21697479; http://dx.doi.org/10.1128/JVI.00790-11
=========
***these transgenic mice are susceptible to H95 C CWD, a CWD strain derived 
from experimental infection of deer expressing H95G96-PrPC.
========== 
P.136: Mother to offspring transmission of CWD—Detection in fawn tissues 
using the QuIC assay
Amy Nalls, Erin McNulty, Clare Hoover, Jeanette Hayes-Klug, Kelly Anderson, 
Edward Hoover, and Candace Mathiason Colorado State University; Fort Collins, CO 
USA
To investigate the role mother to offspring transmission plays in chronic 
wasting disease (CWD), we have employed a small, polyestrous breeding, indoor 
maintainable cervid model, the Reeves’ muntjac deer. Muntjac doe were inoculated 
with CWD and tested positive by lymphoid biopsy at 4 months post inoculation. 
From these CWD-infected doe, we obtained 3 viable fawns. These fawns tested 
IHC-positive for CWD by lymphoid biopsy as early as 40 d post birth, and all 
have been euthanized due to clinical disease at 31, 34 and 59 months post birth. 
The QuIC assay demonstrates sensitivity and specificity in the detection of 
conversion competent prions in peripheral IHC-positive tissues including tonsil, 
mandibular, partotid, retropharyngeal, and prescapular lymph nodes, adrenal 
gland, spleen and liver. In summary, using the muntjac deer model, we have 
demonstrated CWD clinical disease in offspring born to CWD-infected doe and 
found that the QuIC assay is an effective tool in the detection of prions in 
peripheral tissues. ***Our findings demonstrate that transmission of prions from 
mother to offspring can occur, and may be underestimated for all prion 
diseases.
===============
***Our findings demonstrate that transmission of prions from mother to 
offspring can occur, and may be underestimated for all prion diseases. 
SEE ;
Friday, April 24, 2015 
The placenta shed from goats with classical scrapie is infectious to goat 
kids and lambs 
Tuesday, September 17, 2013 
Mother to Offspring Transmission of Transmissible Spongiform Encephalopathy 
TSE prion disease 
================
P.139: Tissue distribution and in utero transmission of chronic-wasting 
diseaseassociated prions in free-ranging Rocky Mountain elk
Anca Selariu1, Jenny G Powers2, Margaret A Wild2, Monica Brandhuber1, Amber 
Mayfield1, Stephenie Fullaway1, Amy Nalls1, Edward A Hoover1, and Candace K 
Mathiason1 1Prion Research Center; Department of Microbiology, Immunology, and 
Pathology; College of Veterinary Medicine and Biomedical Sciences; Colorado 
State University; Fort Collins, CO USA; 2National Park Service; Biological 
Resources Division; Fort Collins, CO USA
The presence of disease-associated prions in tissues and bodily fluids of 
chronic wasting disease (CWD)-infected cervid has received much investigation, 
yet little is known about CWD mother to offspring transmission. Our previous 
work demonstrated that mother to offspring transmission is efficient in an 
experimental setting (34). To address the question of relevance in a 
naturally-exposed free-range population, we have assessed maternal and fetal 
tissues derived from 19 elk dam-calf pairs harvested from Rocky Mountain 
National Park (RMNP), a known CWD endemic region. Conventional 
immunohistochemistry (IHC) identified 3/19 CWD positive dams, whereas a more 
sensitive assay – the serial protein misfolding cyclic amplification (sPMCA) – 
detected cervid prions (PrPCWD) in 15/19 dams. PrPCWD tissue distribution, as 
demonstrated by sPMCA, was widespread and included the central nervous system 
(CNS), lymphoreticular system (LRS), reproductive, secretory, excretory and 
adipose tissues. Interestingly, 5 of the 15 sPMCA positive dams showed no 
evidence of PrPCWD in either CNS or LRS, sites typically assessed in diagnosing 
CWD. Analysis of fetal tissues harvested from the 15 sPMCA positive dams 
revealed PrPCWD in 80% of fetuses (12/15), regardless of gestational stage. 
***These findings demonstrate that PrPCWD is more abundant in free-range elk 
peripheral tissues than current diagnostic methods suggest, and that 
transmission of prions from mother to offspring may contribute to the efficient 
transmission of the CWD in native cervid populations.
===========
These findings demonstrate that PrPCWD is more abundant in free-range elk 
peripheral tissues than current diagnostic methods suggest, and that 
transmission of prions from mother to offspring may contribute to the efficient 
transmission of the CWD in native cervid populations.
=========== 
 P.142: Chronic wasting disease (CWD) transmission into hamsters
Elizabeth Triscott, Camilo Duque-Velasquez, Judd M Aiken, and Debbie 
McKenzie Center for Prions and Protein Folding Diseases; University of Alberta; 
Edmonton, Canada
KEYWORDS. chronic wasting disease, interspecies transmission, prion 
strains
Chronic wasting disease (CWD) is a contagious prion disease of cervids. The 
continued expansion of the disease in North America is resulting in the 
increasing number of mammalian species exposed to this infectious agent. As CWD 
is able to infect multiple cervid species, it is likely that variation of the 
agent might occur, due to PrP polymorphisms within and between cervid species. 
Using Syrian Golden hamsters as a model for interspecies transmission, we 
infected the hamsters with genetically defined CWD isolates from white-tailed 
deer as well as with hunter-harvested mule deer and white-tailed deer from 
Saskatchewan. ***The majority of the CWD isolates resulted in successful 
transmission to hamsters. Biochemical and neuropathological analyses suggests 
differences between the CWD isolates.
===========
P.144: Transmission of CWD to nonhuman primates: Interim results of a 6 
year risk assessment study on the transmissibility to humans
Bianka Mussil1, Dirk Motzkus1, Georgia Hesse1, Sabine Borchert1, Barbara 
Schiller1, Christiane Stahl-Hennig1 , Walter Schulz-Schaeffer2, Michael Beekes3, 
Martin Daus3, Hermann M Schatzl5, Sandor Dudas4, Jianmin Yang4, Jean-Philippe 
Deslys6, and Stefanie Czub4,5 1German Primate Center; Goettingen, Germany; 
2Faculty of Medicine; Department of Neuropathology; Goettingen, Germany; 3Robert 
Koch Institute; Berlin, Germany; 4University of Calgary; Faculty of Veterinary 
Medicine; Calgary, Canada; 5Canadian and OIE Reference Laboratories for BSE; 
Canadian Food Inspection Agency Lethbridge Laboratory; Lethbridge, Alberta, 
Canada; 6Commissariat  a l’Energie Atomique; Fontenay-aux-Roses, France
Rapid spread and high prevalence of CWD in North American captive and 
free-ranging cervids have raised concerns about a potential risk to human 
health. Evidence exists that skeletal muscles might harbor significant amount of 
prion infectivity which is of great importance to consumers of venison, velvet 
and other cervid products. In order to assess the risk of primary 
CWD-transmission, cynomolgus macaques (Macaca fascicularis) were inoculated with 
high-titer brain homogenates of CWD-infected white-tailed deer material by 
intracerebral, intragastric and dermal scarification routes. Another group 
obtained a total amount of 5 kg CWD-positive muscle homogenate using a repeated 
low-dose regimen (each received »125 applications of 40 g muscle homogenate over 
a 3 y period). Risk of secondary CWD-transmission via blood or bloodderived 
products is judged by blood transfusion of monkey-adapted CWD to naive 
recipients. Based on the in vitro conversion of recombinant prion protein, a 
real-time quaking-induced conversion (RT-QuiC) assay was optimized by using 
lymph node tissues, cerebrospinal fluid samples and brain homogenate derived 
from BSE-inoculated macaques. Results have shown robust, sensitive, specific 
detection, high interand moderate intra-assay variances in samples derived from 
BSE-infected macaques. ***So far, all analyzed samples from CWD-inoculated 
macaques did not reveal any seeding activity. ***Future findings of our risk 
assessment study will greatly contribute to policy decisions including 
monitoring of human blood products, CWD surveillance and CWD control in captive 
and free-ranging cervids. Here we will present an update on the current state of 
the ongoing project.
===========
***So far, all analyzed samples from CWD-inoculated macaques did not reveal 
any seeding activity.
***Future findings of our risk assessment study will greatly contribute to 
policy decisions including monitoring of human blood products, CWD surveillance 
and CWD control in captive and free-ranging cervids. Here we will present an 
update on the current state of the ongoing project.
SEE ;
Prion 
Volume 7, Issue 3, 2013 
Early detection of chronic wasting disease prions in urine of 
pre-symptomatic deer by real-time quaking-induced conversion assay 
Open access
DOI:10.4161/pri.24430Theodore R. Johna, Hermann M. Schätzlabc & Sabine 
Gilchad* 
pages 253-258
Publishing models and article dates explained
Received: 7 Feb 2013 Accepted: 24 Mar 2013 Published online: 10 Apr 
2013
Article Views: 105
Abstract 
Chronic wasting disease (CWD) is a prion disease of captive and 
free-ranging deer (Odocoileus spp), elk (Cervus elaphus nelsonii) and moose 
(Alces alces shirasi). Unlike in most other prion diseases, in CWD prions are 
shed in urine and feces, which most likely contributes to the horizontal 
transmission within and between cervid species. To date, CWD ante-mortem 
diagnosis is only possible by immunohistochemical detection of protease 
resistant prion protein (PrPSc) in tonsil or recto-anal mucosa-associated 
lymphoid tissue (RAMALT) biopsies, which requires anesthesia of animals. We 
report on detection of CWD prions in urine collected from pre-symptomatic deer 
and in fecal extracts by using real time quaking-induced conversion (RT-QuIC). 
This assay can be useful for non-invasive pre-symptomatic diagnosis and 
surveillance of CWD.
snip...
Introduction 
Chronic wasting disease (CWD) is to date the most contagious prion disease 
and affects captive and free-ranging elk, deer and moose in North America.1 The 
disease is caused by the accumulation of an abnormally folded isoform of the 
cellular prion protein PrPc, denominated PrPSc.3 CWD is the cervid equivalent of 
bovine spongiform encephalopathy (BSE), scrapie in sheep and goat5 or 
Creutzfeldt-Jakob disease (CJD) in humans.6 Although transmission studies of CWD 
prions to humanized transgenic mice or non-human primates suggest a strong 
species barrier,7 recent in vitro studies have demonstrated that human PrP can 
be converted by CWD prions into PrPSc upon adaptation.10 ***Therefore, a 
potential for zoonotic transmission, as exemplified by BSE,11 cannot be 
completely excluded.
A huge body of evidence suggests that CWD can be efficiently transmitted 
horizontally within and between cervid species,12 which may be the reason for 
geographical spread and increase in case numbers. Horizontal transmission is 
explained by the rather unusual peripheral distribution of prions in CWD 
affected animals and the high susceptibility to the disease by oral infection.13 
Unlike in most other prion diseases, CWD prions can be found in a wide variety 
of tissues, such as skeletal and cardiac muscle15 or kidney,17 in addition to 
the lymphoreticular system and blood.18 Furthermore, they are shed in 
significant amounts in saliva,18 ,19 urine19 or feces,20 which enables oral 
infection of animals by foraging on contaminated pastures. In addition, it has 
been demonstrated that prions can persist in soil21 and that water in endemic 
areas can contain CWD-associated PrPSc 22. 
 ***Therefore, a potential for zoonotic transmission, as exemplified by 
BSE,11 cannot be completely excluded. 
*** PPo3-7: Prion Transmission from Cervids to Humans is Strain-dependent 
 *** Here we report that a human prion strain that had adopted the cervid 
prion protein (PrP) sequence through passage in cervidized transgenic mice 
efficiently infected transgenic mice expressing human PrP, 
 *** indicating that the species barrier from cervid to humans is prion 
strain-dependent and humans can be vulnerable to novel cervid prion strains. 
 PPo2-27: 
 Generation of a Novel form of Human PrPSc by Inter-species Transmission of 
Cervid Prions 
 *** Our findings suggest that CWD prions have the capability to infect 
humans, and that this ability depends on CWD strain adaptation, implying that 
the risk for human health progressively increases with the spread of CWD among 
cervids. 
 PPo2-7: 
 Biochemical and Biophysical Characterization of Different CWD Isolates 
 *** The data presented here substantiate and expand previous reports on 
the existence of different CWD strains. 
 Envt.07: 
 Pathological Prion Protein (PrPTSE) in Skeletal Muscles of Farmed and Free 
Ranging White-Tailed Deer Infected with Chronic Wasting Disease 
 ***The presence and seeding activity of PrPTSE in skeletal muscle from 
CWD-infected cervids suggests prevention of such tissue in the human diet as a 
precautionary measure for food safety, pending on further clarification of 
whether CWD may be transmissible to humans. 
 >>>CHRONIC WASTING DISEASE , THERE WAS NO ABSOLUTE BARRIER TO 
CONVERSION OF THE HUMAN PRION PROTEIN<<< 
 *** PRICE OF CWD TSE PRION POKER GOES UP 2014 *** 
 Transmissible Spongiform Encephalopathy TSE PRION update January 2, 2014 
 Wednesday, January 01, 2014 
 Molecular Barriers to Zoonotic Transmission of Prions 
 *** chronic wasting disease, there was no absolute barrier to conversion 
of the human prion protein. 
 *** Furthermore, the form of human PrPres produced in this in vitro assay 
when seeded with CWD, resembles that found in the most common human prion 
disease, namely sCJD of the MM1 subtype. 
 PRION2013 CONGRESSIONAL ABSTRACTS CWD 
 Sunday, August 25, 2013 
 HD.13: CWD infection in the spleen of humanized transgenic mice 
 ***These results indicate that the CWD prion may have the potential to 
infect human peripheral lymphoid tissues. 
 Oral.15: Molecular barriers to zoonotic prion transmission: Comparison of 
the ability of sheep, cattle and deer prion disease isolates to convert normal 
human prion protein to its pathological isoform in a cell-free system 
***However, they also show that there is no absolute barrier to conversion of 
human prion protein in the case of chronic wasting disease. 
 PRION2013 CONGRESSIONAL ABSTRACTS CWD 
 Sunday, August 25, 2013 
 ***Chronic Wasting Disease CWD risk factors, humans, domestic cats, blood, 
and mother to offspring transmission 
 PPo3-7: 
 Prion Transmission from Cervids to Humans is Strain-dependent 
 Qingzhong Kong, Shenghai Huang,*Fusong Chen, Michael Payne, Pierluigi 
Gambetti and Liuting Qing Department of Pathology; Case western Reserve 
University; Cleveland, OH USA *Current address: Nursing Informatics; Memorial 
Sloan-Kettering Cancer Center; New York, NY USA 
 Key words: CWD, strain, human transmission 
 Chronic wasting disease (CWD) is a widespread prion disease in cervids 
(deer and elk) in North America where significant human exposure to CWD is 
likely and zoonotic transmission of CWD is a concern. Current evidence indicates 
a strong barrier for transmission of the classical CWD strain to humans with the 
PrP-129MM genotype. A few recent reports suggest the presence of two or more CWD 
strains. What remain unknown is whether individuals with the PrP-129VV/MV 
genotypes are also resistant to the classical CWD strain and whether humans are 
resistant to all natural or adapted cervid prion strains. Here we report that a 
human prion strain that had adopted the cervid prion protein (PrP) sequence 
through passage in cervidized transgenic mice efficiently infected transgenic 
mice expressing human PrP, indicating that the species barrier from cervid to 
humans is prion strain-dependent and humans can be vulnerable to novel cervid 
prion strains. Preliminary results on CWD transmission in transgenic mice 
expressing human PrP-129V will also be discussed. 
 Acknowledgement Supported by NINDS NS052319 and NIA AG14359. 
 PPo2-27: 
 Generation of a Novel form of Human PrPSc by Inter-species Transmission of 
Cervid Prions 
 Marcelo A. Barria,1 Glenn C. Telling,2 Pierluigi Gambetti,3 James A. 
Mastrianni4 and Claudio Soto1 1Mitchell Center for Alzheimer’s disease and 
related Brain disorders; Dept of Neurology; University of Texas Houston Medical 
School; Houston, TX USA; 2Dept of Microbiology, Immunology & Molecular 
Genetics and Neurology; Sanders Brown Center on Aging; University of Kentucky 
Medical Center; Lexington, KY USA; 3Institute of Pathology; Case western Reserve 
University; Cleveland, OH USA; 4Dept of Neurology; University of Chicago; 
Chicago, IL USA 
 Prion diseases are infectious neurodegenerative disorders affecting humans 
and animals that result from the conversion of normal prion protein (PrPC) into 
the misfolded and infectious prion (PrPSc). Chronic wasting disease (CWD) of 
cervids is a prion disorder of increasing prevalence within the United States 
that affects a large population of wild and captive deer and elk. CWD is highly 
contagious and its origin, mechanism of transmission and exact prevalence are 
currently unclear. The risk of transmission of CWD to humans is unknown. 
Defining that risk is of utmost importance, considering that people have been 
infected by animal prions, resulting in new fatal diseases. To study the 
possibility that human PrPC can be converted into the infectious form by CWD 
PrPSc we performed experiments using the Protein Misfolding Cyclic Amplification 
(PMCA) technique, which mimic in vitro the process of prion replication. Our 
results show that cervid PrPSc can induce the pathological conversion of human 
PrPC, but only after the CWD prion strain has been stabilized by successive 
passages in vitro or in vivo. Interestingly, this newly generated human PrPSc 
exhibits a distinct biochemical pattern that differs from any of the currently 
known forms of human PrPSc, indicating that it corresponds to a novel human 
prion strain. Our findings suggest that CWD prions have the capability to infect 
humans, and that this ability depends on CWD strain adaptation, implying that 
the risk for human health progressively increases with the spread of CWD among 
cervids. 
 PPo2-7: 
 Biochemical and Biophysical Characterization of Different CWD Isolates 
 Martin L. Daus and Michael Beekes Robert Koch Institute; Berlin, Germany 
 Key words: CWD, strains, FT-IR, AFM 
 Chronic wasting disease (CWD) is one of three naturally occurring forms of 
prion disease. The other two are Creutzfeldt-Jakob disease in humans and scrapie 
in sheep. CWD is contagious and affects captive as well as free ranging cervids. 
As long as there is no definite answer of whether CWD can breach the species 
barrier to humans precautionary measures especially for the protection of 
consumers need to be considered. In principle, different strains of CWD may be 
associated with different risks of transmission to humans. Sophisticated strain 
differentiation as accomplished for other prion diseases has not yet been 
established for CWD. However, several different findings indicate that there 
exists more than one strain of CWD agent in cervids. We have analysed a set of 
CWD isolates from white-tailed deer and could detect at least two biochemically 
different forms of disease-associated prion protein PrPTSE. Limited proteolysis 
with different concentrations of proteinase K and/or after exposure of PrPTSE to 
different pH-values or concentrations of Guanidinium hydrochloride resulted in 
distinct isolate-specific digestion patterns. Our CWD isolates were also 
examined in protein misfolding cyclic amplification studies. This showed 
different conversion activities for those isolates that had displayed 
significantly different sensitivities to limited proteolysis by PK in the 
biochemical experiments described above. We further applied Fourier transform 
infrared spectroscopy in combination with atomic force microscopy. This 
confirmed structural differences in the PrPTSE of at least two disinct CWD 
isolates. The data presented here substantiate and expand previous reports on 
the existence of different CWD strains. 
 2012 
 Envt.06: 
 Zoonotic Potential of CWD: Experimental Transmissions to Non-Human 
Primates 
 Emmanuel Comoy,1,† ValĂ©rie Durand,1 Evelyne Correia,1 Aru Balachandran,2 
JĂĽrgen Richt,3 Vincent Beringue,4 Juan-Maria Torres,5 Paul Brown,1 Bob Hills6 
and Jean-Philippe Deslys1 
 1Atomic Energy Commission; Fontenay-aux-Roses, France; 2Canadian Food 
Inspection Agency; Ottawa, ON Canada; 3Kansas State University; Manhattan, KS 
USA; 4INRA; Jouy-en-Josas, France; 5INIA; Madrid, Spain; 6Health Canada; Ottawa, 
ON Canada 
 †Presenting author; Email: emmanuel.comoy@cea.fr 
 The constant increase of chronic wasting disease (CWD) incidence in North 
America raises a question about their zoonotic potential. A recent publication 
showed their transmissibility to new-world monkeys, but no transmission to 
old-world monkeys, which are phylogenetically closer to humans, has so far been 
reported. Moreover, several studies have failed to transmit CWD to transgenic 
mice overexpressing human PrP. Bovine spongiform encephalopathy (BSE) is the 
only animal prion disease for which a zoonotic potential has been proven. We 
described the transmission of the atypical BSE-L strain of BSE to cynomolgus 
monkeys, suggesting a weak cattle-to-primate species barrier. We observed the 
same phenomenon with a cattleadapted strain of TME (Transmissible Mink 
Encephalopathy). Since cattle experimentally exposed to CWD strains have also 
developed spongiform encephalopathies, we inoculated brain tissue from 
CWD-infected cattle to three cynomolgus macaques as well as to transgenic mice 
overexpressing bovine or human PrP. Since CWD prion strains are highly 
lymphotropic, suggesting an adaptation of these agents after peripheral 
exposure, a parallel set of four monkeys was inoculated with CWD-infected cervid 
brains using the oral route. Nearly four years post-exposure, monkeys exposed to 
CWD-related prion strains remain asymptomatic. In contrast, bovinized and 
humanized transgenic mice showed signs of infection, suggesting that CWD-related 
prion strains may be capable of crossing the cattle-to-primate species barrier. 
Comparisons with transmission results and incubation periods obtained after 
exposure to other cattle prion strains (c-BSE, BSE-L, BSE-H and cattle-adapted 
TME) will also be presented, in order to evaluate the respective risks of each 
strain. 
 Envt.07: 
 Pathological Prion Protein (PrPTSE) in Skeletal Muscles of Farmed and Free 
Ranging White-Tailed Deer Infected with Chronic Wasting Disease 
 Martin L. Daus,1,† Johanna Breyer,2 Katjs Wagenfuehr,1 Wiebke Wemheuer,2 
Achim Thomzig,1 Walter Schulz-Schaeffer2 and Michael Beekes1 1Robert Koch 
Institut; P24 TSE; Berlin, Germany; 2Department of Neuropathology, Prion and 
Dementia Research Unit, University Medical Center Göttingen; Göttingen, Germany 
†Presenting author; Email: dausm@rki.de 
 Chronic wasting disease (CWD) is a contagious, rapidly spreading 
transmissible spongiform encephalopathy (TSE) occurring in cervids in North 
America. Despite efficient horizontal transmission of CWD among cervids natural 
transmission of the disease to other species has not yet been observed. Here, we 
report a direct biochemical demonstration of pathological prion protein PrPTSE 
and of PrPTSE-associated seeding activity in skeletal muscles of CWD-infected 
cervids. The presence of PrPTSE was detected by Western- and postfixed frozen 
tissue blotting, while the seeding activity of PrPTSE was revealed by protein 
misfolding cyclic amplification (PMCA). The concentration of PrPTSE in skeletal 
muscles of CWD-infected WTD was estimated to be approximately 2000- to 
10000-fold lower than in brain tissue. Tissue-blot-analyses revealed that PrPTSE 
was located in muscle- associated nerve fascicles but not, in detectable 
amounts, in myocytes. The presence and seeding activity of PrPTSE in skeletal 
muscle from CWD-infected cervids suggests prevention of such tissue in the human 
diet as a precautionary measure for food safety, pending on further 
clarification of whether CWD may be transmissible to humans. 
 P.10.15 
 ADAPTATION OF CHRONIC WASTING DISEASE (CWD) INTO HAMSTERS, EVIDENCE OF A 
WISCONSIN STRAIN OF CWD 
 Chad Johnson1, Judd Aiken2,3,4 and Debbie McKenzie4,5 1 Department of 
Comparative Biosciences, University of Wisconsin, Madison WI, USA 53706 2 
Department of Agriculture, Food and Nutritional Sciences, 3 Alberta Veterinary 
Research Institute, 4.Center for Prions and Protein Folding Diseases, 5 
Department of Biological Sciences, University of Alberta, Edmonton AB, Canada 
T6G 2P5 
 The identification and characterization of prion strains is increasingly 
important for the diagnosis and biological definition of these infectious 
pathogens. Although well-established in scrapie and, more recently, in BSE, 
comparatively little is known about the possibility of prion strains in chronic 
wasting disease (CWD), a disease affecting free ranging and captive cervids, 
primarily in North America. We have identified prion protein variants in the 
white-tailed deer population and demonstrated that Prnp genotype affects the 
susceptibility/disease progression of white-tailed deer to CWD agent. The 
existence of cervid prion protein variants raises the likelihood of distinct CWD 
strains. Small rodent models are a useful means of identifying prion strains. We 
intracerebrally inoculated hamsters with brain homogenates and phosphotungstate 
concentrated preparations from CWD positive hunter-harvested (Wisconsin CWD 
endemic area) and experimentally infected deer of known Prnp genotypes. These 
transmission studies resulted in clinical presentation in primary passage of 
concentrated CWD prions. Subclinical infection was established with the other 
primary passages based on the detection of PrPCWD in the brains of hamsters and 
the successful disease transmission upon second passage. Second and third 
passage data, when compared to transmission studies using different CWD inocula 
(Raymond et al., 2007) indicate that the CWD agent present in the Wisconsin 
white-tailed deer population is different than the strain(s) present in elk, 
mule-deer and white-tailed deer from the western United States endemic region. 
 CHRONIC WASTING DISEASE CWD 
 Transmissibility to humans. 
 The current state of epidemiological research suggests a rather robust 
barrier for the transmission of CWD to humans. Particularly, the surveillance of 
human prion diseases in areas with a long history of endemic CWD such as 
Colorado and Wyoming did not reveal evidence for zoonotic transmissions of the 
disease to cervid hunters or consumers of meat from elk and deer.66. Belay ED, 
Maddox RA, Williams ES, Miller MW, Gambetti P, Schonberger LB. Chronic wasting 
disease and potential transmission to humans. Emerg Infect Dis 2004; 10:977 - 
984; PMID: 15207045 [CrossRef] View all references,1111. Belay ED, Abrams J, 
Kenfield J, Weidenbach K, Maddox RA, Lawaczeck E, et al. Monitoring the 
potential transmission of chronic wasting disease to humans (Abstract Oral.40, 
Prion 2011 Oral Presentations). Prion 2011; 5:17 Supplemental Issue 
April/May/June 2011 View all references 
 However, as discussed by Belay et al.66. Belay ED, Maddox RA, Williams ES, 
Miller MW, Gambetti P, Schonberger LB. Chronic wasting disease and potential 
transmission to humans. Emerg Infect Dis 2004; 10:977 - 984; PMID: 15207045 
[CrossRef] View all references 
 the intensity of human exposure to CWD prions may increase due to a 
further spread and rising prevalence of the disease in cervids. Therefore, and 
with the generally long latency periods of human prion diseases in mind, 
previous epidemiological findings cannot be readily extrapolated. Until 
recently, experimental studies that pursued biochemical approaches or used 
transgenic mice to ascertain the susceptibility of humans to CWD infections 
consistently seemed to corroborate current epidemiological findings: 
CWD-infected cervid brain tissue did not seed the conversion of PrPC into PrPres 
in PMCA assays using brain homogenate from macaques or transgenic mice 
expressing human PrPC as test substrate,1212. Kurt TD, Telling GC, Zabel MD, 
Hoover EA. Trans-species amplification of PrP(CWD) and correlation with rigid 
loop 170N. Virology 2009; 387:235 - 243; PMID: 19269662; http://dx.doi.org/10.1016/j.virol.2009.02.025 
[CrossRef] View all references 
 and transgenic mice overexpressing human PrPC were resistant to infection 
after intracerebral challenge with CWD prions from mule deer.1313. Sandberg MK, 
Al-Doujaily H, Sigurdson CJ, Glatzel M, O'Malley C, Powell C, et al. Chronic 
wasting disease prions are not transmissible to transgenic mice overexpressing 
human prion protein. J Gen Virol 2010; 91:2651 - 2657; PMID: 20610667; http://dx.doi.org/10.1099/vir.0.024380-0 
[CrossRef] View all references 
 However, a study published by Barria et al.1414. Barria MA, Telling GC, 
Gambetti P, Mastrianni JA, Soto C. Generation of a new form of human PrPSc in 
vitro by interspecies transmission from cervid prions. J Biol Chem 2011; 
286:7490 - 7495; PMID: 21209079; http://dx.doi.org/10.1074/jbc.M110.198465 
[CrossRef] View all references 
 in March 2011 found that cervid PrPTSE can seed the conversion of human 
PrPC into PrPres by PMCA when the CWD agent has been previously passaged in 
vitro or in vivo. Specifically, this was demonstrated for CWD prions from 
naturally affected mule deer either passaged by serial PMCA using deer PrPC as 
conversion substrate or in transgenic mice expressing cervid PrPC. The authors 
of this study pointed out that CWD prions may undergo a gradual process of 
change and adaptation via successive passages in the cervid population. They 
concluded that the reported findings, if corroborated by infectivity assays, may 
imply “that CWD prions have the potential to infect humans and that this ability 
progressively increases with CWD spreading.” Cynomolgus macaques used as a 
primate model for testing the susceptibility of humans to CWD as close to 
reality as possible have not shown clinical signs of a prion disease at nearly 6 
years after intracerebral or peroral inoculation of CWD agents from white-tailed 
deer, Rocky Mountain elk or mule deer.1515. Race B, Meade-White KD, Miller MW, 
Barbian KD, Rubenstein R, LaFauci G, et al. Susceptibilities of nonhuman 
primates to chronic wasting disease. Emerg Infect Dis 2009; 15:1366 - 1376; 
PMID: 19788803; http://dx.doi.org/10.3201/eid1509.090253 
[CrossRef] View all references 
 In contrast to macaques, squirrel monkeys were susceptible to CWD 
infection by the intracerebral route and showed even a low rate of disease 
transmission after oral challenge.1515. Race B, Meade-White KD, Miller MW, 
Barbian KD, Rubenstein R, LaFauci G, et al. Susceptibilities of nonhuman 
primates to chronic wasting disease. Emerg Infect Dis 2009; 15:1366 - 1376; 
PMID: 19788803; http://dx.doi.org/10.3201/eid1509.090253 
[CrossRef] View all references,1616. Marsh RF, Kincaid AE, Bessen RA, Bartz JC. 
Interspecies transmission of chronic wasting disease prions to squirrel monkeys 
(Saimiri sciureus). J Virol 2005; 79:13794 - 13796; PMID: 16227298; http://dx.doi.org/10.1128/JVI.79.21.13794-6.2005 
[CrossRef] View all references 
 Since humans are phylogenetically closer related to macaques than to 
squirrel monkeys, macaques are regarded as the more relevant primate model for 
assessing the zoonotic transmissibility of CWD.1515. Race B, Meade-White KD, 
Miller MW, Barbian KD, Rubenstein R, LaFauci G, et al. Susceptibilities of 
nonhuman primates to chronic wasting disease. Emerg Infect Dis 2009; 15:1366 - 
1376; PMID: 19788803; http://dx.doi.org/10.3201/eid1509.090253 
[CrossRef] View all references 
 Ongoing transmission studies in macaques. In addition to the primate study 
by Race et al.1515. Race B, Meade-White KD, Miller MW, Barbian KD, Rubenstein R, 
LaFauci G, et al. Susceptibilities of nonhuman primates to chronic wasting 
disease. Emerg Infect Dis 2009; 15:1366 - 1376; PMID: 19788803; http://dx.doi.org/10.3201/eid1509.090253 
[CrossRef] View all references 
 two further studies in which macaques were challenged with tissue 
homogenates from CWD-affected cervids by intracerebral inoculation or via the 
oral route have been reported to be in progress.1717. Comoy E, Durand V, Correia 
E, Balachandran A, Richt JA, Beringue V, et al. Zoonotic potential of CWD: 
Experimental transmissions to non-human primates (Abstract Envt.06, Prion 2011 
Poster Presentations). Prion 2011; 5:101 View all references,1818. Motzkus D, 
Schulz-Schaeffer WJ, Beekes M, Schätzl HM, Jirik FR, Schmädicke AC, et al. 
Transmission of CWD to non-human primates: Interim results of a comprehensive 
study on the transmissibility to humans (Abstract Envt. 22, Prion 2011 Poster 
Presentations). Prion 2011; 5:107 Supplemental Issue April/May/June 2011 View 
all references 
 The purpose, research effort, financial investment and ethical aspects of 
these studies demand an utmost experimental scrutiny, careful data analysis and 
thorough exploitation of results. This has two immediate implications: (1) Since 
the incubation period of CWD may be very long in case of primary (i.e., 
inter-species) transmission to macaques a sustained monitoring of the animals 
appears mandatory for many years despite negative interim findings. (2) 
Increasing evidence suggests the existence of different CWD agents (see below), 
and theoretically, CWD prions may also change over time thereby possibly 
altering their potential host range. Thus, CWD isolates used in individual or 
pooled inocula for the challenge of macaques should be typed as precisely as 
possible in terms of their strain characteristics and molecular identity. Other 
field isolates could then be checked for their similarity or dissimilarity to 
the macaque-tested CWD agents in order to ascertain whether or not they are 
covered by the ongoing primate risk assessments. Evidence for Distinct CWD 
Strains Jump to section Transmissible Spongiform... Exposure of Humans to CWD 
Prions CWD Risk Assessments Evidence for Distinct CWD Strains Outlook Disclosure 
of Potential Conflicts of Interest Funding Figures and Tables Biochemical 
indications for isolate-dependent structural differences of PrPTSE. In 2002 it 
was reported that glycoform patterns of PrPTSE showed differences among 
individual CWD-affected cervids.1919. Race RE, Raines A, Baron TG, Miller MW, 
Jenny A, Williams ES. Comparison of abnormal prion protein glycoform patterns 
from transmissible spongiform encephalopathy agent-infected deer, elk, sheep and 
cattle. J Virol 2002; 76:12365 - 12368; PMID: 12414979; http://dx.doi.org/10.1128/JVI.76.23.12365-8.2002 
[CrossRef] View all references 
 In a variety of studies the glycosylation of PrPTSE had been previously 
established as a biochemical feature that may differ between distinct TSE 
agents.2020. Parchi P, Capellari S, Chen SG, Petersen RB, Gambetti P, Kopp N, et 
al. Typing prion isoforms. Nature 1997; 386:232 - 234; PMID: 9069279; http://dx.doi.org/10.1038/386232a0 
[CrossRef] View all references,2121. Aguzzi A, Heikenwalder M, Polymenidou M. 
Insights into prion strains and neurotoxicity. Nat Rev Mol Cell Biol 2007; 8:552 
- 561; PMID: 17585315; http://dx.doi.org/10.1038/nrm2204 
[CrossRef] View all references 
 Accordingly, the finding by Race et al. possibly indicated CWD infections 
with different or multiple strains of agent, although, alternatively, it could 
also be explained by random selection from a heterogeneous population of 
CWD-affected ruminants.1919. Race RE, Raines A, Baron TG, Miller MW, Jenny A, 
Williams ES. Comparison of abnormal prion protein glycoform patterns from 
transmissible spongiform encephalopathy agent-infected deer, elk, sheep and 
cattle. J Virol 2002; 76:12365 - 12368; PMID: 12414979; http://dx.doi.org/10.1128/JVI.76.23.12365-8.2002 
[CrossRef] View all references 
 Using a conformation-dependent immunoassay (CDI), Safar et al. found 
evidence for different conformations of PrPTSE in elk CWD as compared with 
white-tailed and mule deer CWD.2222. Safar JG, Scott M, Monaghan J, Deering C, 
Didorenko S, Vergara J, et al. Measuring prions causing bovine spongiform 
encephalopathy or chronic wasting disease by immunoassays and transgenic mice. 
Nat Biotechnol 2002; 20:1147 - 1150; PMID: 12389035; http://dx.doi.org/10.1038/nbt748 
[CrossRef] View all references 
 However, the amino acid sequences of elk and deer PrPC differ at residues 
226 (glutamic acid in elk and glutamine in deer), and it remained to be 
established whether the structural differences detected by CDI were related to 
biologically distinct CWD strains. Isolation of CWD-associated agents causing 
distinct phenotypes in laboratory rodents. Classically, prion strains are 
differentiated based on their incubation periods in inbred mice with distinct 
PrP genotypes and by lesion profiles of the vacuolation in selected brain areas 
of reporter animals.2323. Bruce ME, Fraser H. Scrapie strain variation and its 
implications. Curr Top Microbiol Immunol 1991; 172:125 - 138; PMID: 1810707 
[CrossRef] View all references 
 When Raymond et al. serially passaged a CWD inoculum from mule deer either 
in Syrian hamsters or first into transgenic mice expressing hamster PrPC, and 
then further on in hamsters, they obtained two distinct isolates termed 
SghaCWDmd-f and SghaCWDmd-s, respectively.2424. Raymond GJ, Raymond LD, 
Meade-White KD, Hughson AG, Favara C, Gardner D, et al. Transmission and 
adaptation of chronic wasting disease to hamsters and transgenic mice: evidence 
for strains. J Virol 2007; 81:4305 - 4314; PMID: 17287284; http://dx.doi.org/10.1128/JVI.02474-06 
[CrossRef] View all references 
 The first isolate showed an about 5-fold shorter incubation period in 
Syrian hamsters than the latter, and the cerebral patterns of PrPTSE deposition 
and gliosis in clinically affected hamsters were also different. Based on their 
findings the authors concluded that the “cervid-derived inocula may have 
contained or diverged into at least two distinct transmissible spongiform 
encephalopathy strains.” Angers et al. transmitted CWD inocula from elk and deer 
to transgenic mice expressing cervid PrP and found that these mice were affected 
by one of two strains, referred to as CWD1 and CWD2, that caused different 
incubation times and lesion profiles.2525. Angers RC, Kang HE, Napier D, 
Browning S, Seward T, Mathiason C, et al. Prion strain mutation determined by 
prion protein conformational compatibility and primary structure. Science 2010; 
328:1154 - 1158; PMID: 20466881; http://dx.doi.org/10.1126/science.1187107 
[CrossRef] View all references 
 The results of this study “appear to reflect strain constitutions in the 
natural host, rather than adaptation and divergence of progenitor strains in 
recipient mice,” according to the authors. Interestingly, CWD1 and CWD2 did not 
show recognizably different biochemical properties of their PrPTSE. The 
electrophoretic migration and glycosylation patterns as well as the stability 
characteristics after treatment with guanidine hydrochloride were 
indistinguishable for CWD1- and CWD2-associated PrPTSE. Consistent with these 
findings it has been previously reported that biologically distinct prion 
strains cannot always be differentiated by biochemical PrPTSE-typing or 
characterization of the conformational stability of PrPTSE.2626. Thomzig A, 
Spassov S, Friedrich M, Naumann D, Beekes M. Discriminating scrapie and bovine 
spongiform encephalopathy isolates by infrared spectroscopy of pathological 
prion protein. J Biol Chem 2004; 279:33847 - 33854; PMID: 15155741; http://dx.doi.org/10.1074/jbc.M403730200 
[CrossRef] View all references,2727. Peretz D, Scott MR, Groth D, Williamson RA, 
Burton DR, Cohen FE, et al. Strain-specified relative conformational stability 
of the scrapie prion protein. Protein Sci 2001; 10:854 - 863; PMID: 11274476; http://dx.doi.org/10.1110/ps.39201 
[CrossRef] View all references 
 UPDATED DATA ON 2ND CWD STRAIN Wednesday, September 08, 2010 CWD PRION 
CONGRESS SEPTEMBER 8-11 2010 
 OR-12: Chronic wasting disease transmission and pathogenesis in cervid and 
non-cervid Species 
 Edward A. Hoover, Candace K. Mathiason, Nicholas J. Haley, Timothy D. 
Kurt, Davis M. Seelig, Nathaniel D. Denkers, Amy V. Nalls, Mark D. Zabel, and 
Glenn C. Telling 
 Prion Research Program, Department of Microbiology, Immunology, and 
Pathology; Colorado State University; Fort Collins, CO USA 
 Since its recognition as a TSE in the late 1970s, chronic wasting disease 
(CWD) of cervids has been distinguished by its facile spread and is now 
recognized in 18 states, 2 Canadian provinces, and South Korea. The efficient 
horizontal spread of CWD reflects a prion/host relationship that facilitates 
efficient mucosal uptake, peripheral lymphoid amplification, and dissemination 
by exploiting excretory tissues and their products, helping to establish 
indirect/environmental and well as direct (e.g., salivary) transmission. Recent 
studies from our group also support the likelihood of early life mother to 
offspring and aerosol CWD prion transmission. Studies of cervid CWD exposure by 
natural routes indicate that incubation period for detection of overt infection, 
while still uncertain, may be much longer than originally thought. 
 Several non-cervid species can be infected by CWD experimentally (e.g., 
ferrets, voles, cats) with consequent species-specific disease phenotypes. The 
species-adapted prions so generated can be transmitted by mucosal, i.e., more 
natural, routes. Whether non-cervid species sympatric with deer/elk can be 
infected in nature, however, remains unknown. In vitro CWD prion amplification 
studies, in particular sPMCA, can foreshadow in vivo susceptibility and suggest 
the importance of the PrPC rigid loop region in species barrier permissiveness. 
Trans-species CWD amplification appears to broaden the host range/strain 
characteristics of the resultant prions. The origins of CWD remain unknown, 
however, the existence of multiple CWD prion strains/ quasi-species, the 
mechanisms of prion shedding/dissemination, and the relationship between sheep 
scrapie and CWD merit further investigation. 
 Monday, May 23, 2011 
 CDC Assesses Potential Human Exposure to Prion Diseases Travel Warning 
 Public release date: 23-May-2011 
 Contact: Francesca Costanzo adajmedia@elsevier.com 215-239-3249 Elsevier 
Health Sciences 
 CDC assesses potential human exposure to prion diseases Study results 
reported in the Journal of the American Dietetic Association Philadelphia, PA, 
May 23, 2011 – Researchers from the Centers for Disease Control and Prevention 
(CDC) have examined the potential for human exposure to prion diseases, looking 
at hunting, venison consumption, and travel to areas in which prion diseases 
have been reported in animals. Three prion diseases in particular – bovine 
spongiform encephalopathy (BSE or “Mad Cow Disease”), variant Creutzfeldt-Jakob 
disease (vCJD), and chronic wasting disease (CWD) – were specified in the 
investigation. The results of this investigation are published in the June issue 
of the Journal of the American Dietetic Association. 
 “While prion diseases are rare, they are generally fatal for anyone who 
becomes infected. More than anything else, the results of this study support the 
need for continued surveillance of prion diseases,” commented lead investigator 
Joseph Y. Abrams, MPH, National Center for Emerging and Zoonotic Infectious 
Diseases, CDC, Atlanta.”But it’s also important that people know the facts about 
these diseases, especially since this study shows that a good number of people 
have participated in activities that may expose them to infection-causing 
agents.” 
 Although rare, human prion diseases such as CJD may be related to BSE. 
Prion (proteinaceous infectious particles) diseases are a group of rare brain 
diseases that affect humans and animals. When a person gets a prion disease, 
brain function is impaired. This causes memory and personality changes, 
dementia, and problems with movement. All of these worsen over time. These 
diseases are invariably fatal. Since these diseases may take years to manifest, 
knowing the extent of human exposure to possible prion diseases could become 
important in the event of an outbreak. 
 CDC investigators evaluated the results of the 2006-2007 population survey 
conducted by the Foodborne Diseases Active Surveillance Network (FoodNet). This 
survey collects information on food consumption practices, health outcomes, and 
demographic characteristics of residents of the participating Emerging 
Infections Program sites. The survey was conducted in Connecticut, Georgia, 
Maryland, Minnesota, New Mexico, Oregon, and Tennessee, as well as five counties 
in the San Francisco Bay area, seven counties in the Greater Denver area, and 34 
counties in western and northeastern New York. 
 Survey participants were asked about behaviors that could be associated 
with exposure to the agents causing BSE and CWD, including travel to the nine 
countries considered to be BSE-endemic (United Kingdom, Republic of Ireland, 
France, Portugal, Switzerland, Italy, the Netherlands, Germany, Spain) and the 
cumulative length of stay in each of those countries. Respondents were asked if 
they ever had hunted for deer or elk, and if that hunting had taken place in 
areas considered to be CWD-endemic (northeastern Colorado, southeastern Wyoming 
or southwestern Nebraska). They were also asked if they had ever consumed 
venison, the frequency of consumption, and whether the meat came from the wild. 
 The proportion of survey respondents who reported travel to at least one 
of the nine BSE endemic countries since 1980 was 29.5%. Travel to the United 
Kingdom was reported by 19.4% of respondents, higher than to any other 
BSE-endemic country. Among those who traveled, the median duration of travel to 
the United Kingdom (14 days) was longer than that of any other BSE-endemic 
country. Travelers to the UK were more likely to have spent at least 30 days in 
the country (24.9%) compared to travelers to any other BSE endemic country. The 
prevalence and extent of travel to the UK indicate that health concerns in the 
UK may also become issues for US residents. 
 The proportion of survey respondents reporting having hunted for deer or 
elk was 18.5% and 1.2% reported having hunted for deer or elk in CWD-endemic 
areas. Venison consumption was reported by 67.4% of FoodNet respondents, and 
88.6% of those reporting venison consumption had obtained all of their meat from 
the wild. These findings reinforce the importance of CWD surveillance and 
control programs for wild deer and elk to reduce human exposure to the CWD 
agent. Hunters in CWD-endemic areas are advised to take simple precautions such 
as: avoiding consuming meat from sickly deer or elk, avoiding consuming brain or 
spinal cord tissues, minimizing the handling of brain and spinal cord tissues, 
and wearing gloves when field-dressing carcasses. 
 According to Abrams, “The 2006-2007 FoodNet population survey provides 
useful information should foodborne prion infection become an increasing public 
health concern in the future. The data presented describe the prevalence of 
important behaviors and their associations with demographic characteristics. 
Surveillance of BSE, CWD, and human prion diseases are critical aspects of 
addressing the burden of these diseases in animal populations and how that may 
relate to human health.” 
 ### 
 The article is “Travel history, hunting, and venison consumption related 
to prion disease exposure, 2006-2007 FoodNet population survey” by Joseph Y. 
Abrams, MPH; Ryan A. Maddox, MPH; Alexis R Harvey, MPH; Lawrence B. Schonberger, 
MD; and Ermias D. Belay, MD. It appears in the Journal of the American Dietetic 
Association, Volume 111, Issue 6 (June 2011) published by Elsevier. 
 In an accompanying podcast CDC’s Joseph Y. Abrams discusses travel, 
hunting, and eating venison in relation to prion diseases. It is available at http://adajournal.org/content/podcast. 
 Thursday, May 26, 2011 
 Travel History, Hunting, and Venison Consumption Related to Prion Disease 
Exposure, 2006-2007 FoodNet Population Survey 
 Journal of the American Dietetic Association Volume 111, Issue 6 , Pages 
858-863, June 2011. 
 Travel History, Hunting, and Venison Consumption Related to Prion Disease 
Exposure, 2006-2007 FoodNet Population Survey 
 Joseph Y. Abrams, MPH, Ryan A. Maddox, MPH , Alexis R. Harvey, MPH , 
Lawrence B. Schonberger, MD , Ermias D. Belay, MD 
 Accepted 15 November 2010. Abstract Full Text PDF References . 
 Abstract 
 The transmission of bovine spongiform encephalopathy (BSE) to human beings 
and the spread of chronic wasting disease (CWD) among cervids have prompted 
concerns about zoonotic transmission of prion diseases. Travel to the United 
Kingdom and other European countries, hunting for deer or elk, and venison 
consumption could result in the exposure of US residents to the agents that 
cause BSE and CWD. The Foodborne Diseases Active Surveillance Network 2006-2007 
population survey was used to assess the prevalence of these behaviors among 
residents of 10 catchment areas across the United States. Of 17,372 survey 
respondents, 19.4% reported travel to the United Kingdom since 1980, and 29.5% 
reported travel to any of the nine European countries considered to be 
BSE-endemic since 1980. The proportion of respondents who had ever hunted deer 
or elk was 18.5%, and 1.2% had hunted deer or elk in a CWD–endemic area. More 
than two thirds (67.4%) reported having ever eaten deer or elk meat. Respondents 
who traveled spent more time in the United Kingdom (median 14 days) than in any 
other BSE-endemic country. Of the 11,635 respondents who had consumed venison, 
59.8% ate venison at most one to two times during their year of highest 
consumption, and 88.6% had obtained all of their meat from the wild. The survey 
results were useful in determining the prevalence and frequency of behaviors 
that could be important factors for foodborne prion transmission. 
 CDC 
 Saturday, February 18, 2012 
 Occurrence, Transmission, and Zoonotic Potential of Chronic Wasting 
Disease 
 CDC Volume 18, Number 3—March 2012 
 SNIP… 
 Interspecies transmission of CWD to noncervids has not been observed under 
natural conditions. CWD infection of carcass scavengers such as raccoons, 
opossums, and coyotes was not observed in a recent study in Wisconsin (22). In 
addition, natural transmission of CWD to cattle has not been observed in 
experimentally controlled natural exposure studies or targeted surveillance (2). 
However, CWD has been experimentally transmitted to cattle, sheep, goats, mink, 
ferrets, voles, and mice by intracerebral inoculation (2,29,33). 
 CWD is likely transmitted among mule, white-tailed deer, and elk without a 
major species barrier (1), and other members of the cervid family, including 
reindeer, caribou, and other species of deer worldwide, may be vulnerable to CWD 
infection. Black-tailed deer (a subspecies of mule deer) and European red deer 
(Cervus elaphus) are susceptible to CWD by natural routes of infection (1,34). 
Fallow deer (Dama dama) are susceptible to CWD by intracerebral inoculation 
(35). Continued study of CWD susceptibility in other cervids is of considerable 
interest. 
 Reasons for Caution There are several reasons for caution with respect to 
zoonotic and interspecies CWD transmission. First, there is strong evidence that 
distinct CWD strains exist (36). Prion strains are distinguished by varied 
incubation periods, clinical symptoms, PrPSc conformations, and CNS PrPSc 
depositions (3,32). Strains have been identified in other natural prion 
diseases, including scrapie, BSE, and CJD (3). Intraspecies and interspecies 
transmission of prions from CWD-positive deer and elk isolates resulted in 
identification of >2 strains of CWD in rodent models (36), indicating that 
CWD strains likely exist in cervids. However, nothing is currently known about 
natural distribution and prevalence of CWD strains. Currently, host range and 
pathogenicity vary with prion strain (28,37). Therefore, zoonotic potential of 
CWD may also vary with CWD strain. In addition, diversity in host (cervid) and 
target (e.g., human) genotypes further complicates definitive findings of 
zoonotic and interspecies transmission potentials of CWD. 
 Intraspecies and interspecies passage of the CWD agent may also increase 
the risk for zoonotic CWD transmission. The CWD prion agent is undergoing serial 
passage naturally as the disease continues to emerge. In vitro and in vivo 
intraspecies transmission of the CWD agent yields PrPSc with an increased 
capacity to convert human PrPc to PrPSc (30). Interspecies prion transmission 
can alter CWD host range (38) and yield multiple novel prion strains (3,28). The 
potential for interspecies CWD transmission (by cohabitating mammals) will only 
increase as the disease spreads and CWD prions continue to be shed into the 
environment. This environmental passage itself may alter CWD prions or exert 
selective pressures on CWD strain mixtures by interactions with soil, which are 
known to vary with prion strain (25), or exposure to environmental or gut 
degradation. 
 Given that prion disease in humans can be difficult to diagnose and the 
asymptomatic incubation period can last decades, continued research, 
epidemiologic surveillance, and caution in handling risky material remain 
prudent as CWD continues to spread and the opportunity for interspecies 
transmission increases. Otherwise, similar to what occurred in the United 
Kingdom after detection of variant CJD and its subsequent link to BSE, years of 
prevention could be lost if zoonotic transmission of CWD is subsequently 
identified, CWD will likely continue to emerge in North America. … 
 SNIP… 
 Generation of a new form of human PrPSc in vitro by inter-species 
transmission from cervids prions 
 Our results have far-reaching implications for human health, since they 
indicate that cervid PrPSc can trigger the conversion of human PrPC into PrPSc, 
suggesting that CWD might be infectious to humans. Interestingly our findings 
suggest that unstable strains from CWD affected animals might not be a problem 
for humans, but upon strain stabilization by successive passages in the wild, 
this disease might become progressively more transmissible to man. 
 Our results also have profound implications for understanding the 
mechanisms of the prion species barrier and indicate that the transmission 
barrier is a dynamic process that depends on the strain and moreover the degree 
of adaptation of the strain. If our findings are corroborated by infectivity 
assays, they will imply that CWD prions have the potential to infect humans and 
that this ability progressively increases with CWD spreading. 
 I thought your readers and hunters and those that consume the venison, 
should have all the scientific facts, personally, I don’t care what you eat, but 
if it effects me and my family down the road, it should then concern everyone, 
and the potential of iatrogenic transmission of the TSE prion is real i.e. 
‘friendly fire’, medical, surgical, dental, blood, tissue, and or products there 
from...like deer antler velvet and TSE prions and nutritional supplements there 
from, all a potential risk factor that should not be ignored or silenced. ... 
 the prion gods at the cdc state that there is ; 
 ''no strong evidence'' 
 but let's see exactly what the authors of this cwd to human at the cdc 
state ; 
 now, let’s see what the authors said about this casual link, personal 
communications years ago. see where it is stated NO STRONG evidence. so, does 
this mean there IS casual evidence ???? 
 “Our conclusion stating that we found no strong evidence of CWD 
transmission to humans” 
 From: TSS (216-119-163-189.ipset45.wt.net) 
 Subject: CWD aka MAD DEER/ELK TO HUMANS ??? 
 Date: September 30, 2002 at 7:06 am PST 
 From: "Belay, Ermias" 
 To: 
 Cc: "Race, Richard (NIH)" ; ; "Belay, Ermias" 
 Sent: Monday, September 30, 2002 9:22 AM 
 Subject: RE: TO CDC AND NIH - PUB MED- 3 MORE DEATHS - CWD - YOUNG HUNTERS 
 Dear Sir/Madam, 
 In the Archives of Neurology you quoted (the abstract of which was 
attached to your email), we did not say CWD in humans will present like variant 
CJD. 
 That assumption would be wrong. I encourage you to read the whole article 
and call me if you have questions or need more clarification (phone: 
404-639-3091). Also, we do not claim that "no-one has ever been infected with 
prion disease from eating venison." Our conclusion stating that we found no 
strong evidence of CWD transmission to humans in the article you quoted or in 
any other forum is limited to the patients we investigated. 
 Ermias Belay, M.D. Centers for Disease Control and Prevention 
 -----Original Message----- 
 From: 
 Sent: Sunday, September 29, 2002 10:15 AM 
 To: rr26k@nih.gov; rrace@niaid.nih.gov; ebb8@CDC.GOV 
 Subject: TO CDC AND NIH - PUB MED- 3 MORE DEATHS - CWD - YOUNG HUNTERS 
 Sunday, November 10, 2002 6:26 PM ......snip........end..............TSS 
 Thursday, April 03, 2008 
 A prion disease of cervids: Chronic wasting disease 
 2008 1: Vet Res. 2008 Apr 3;39(4):41 
 A prion disease of cervids: Chronic wasting disease 
 Sigurdson CJ. 
 snip... 
 *** twenty-seven CJD patients who regularly consumed venison were reported 
to the Surveillance Center***, 
 snip... 
 full text ; 
 ***********CJD REPORT 1994 increased risk for consumption of veal and 
venison and lamb*********** 
 CREUTZFELDT JAKOB DISEASE SURVEILLANCE IN THE UNITED KINGDOM THIRD ANNUAL 
REPORT AUGUST 1994 
 Consumption of venison and veal was much less widespread among both cases 
and controls. For both of these meats there was evidence of a trend with 
increasing frequency of consumption being associated with increasing risk of 
CJD. (not nvCJD, but sporadic CJD...tss) 
 These associations were largely unchanged when attention was restricted to 
pairs with data obtained from relatives. ... 
 Table 9 presents the results of an analysis of these data. 
 There is STRONG evidence of an association between ‘’regular’’ veal eating 
and risk of CJD (p = .0.01). 
 Individuals reported to eat veal on average at least once a year appear to 
be at 13 TIMES THE RISK of individuals who have never eaten veal. 
 There is, however, a very wide confidence interval around this estimate. 
There is no strong evidence that eating veal less than once per year is 
associated with increased risk of CJD (p = 0.51). 
 The association between venison eating and risk of CJD shows similar 
pattern, with regular venison eating associated with a 9 FOLD INCREASE IN RISK 
OF CJD (p = 0.04). 
 There is some evidence that risk of CJD INCREASES WITH INCREASING 
FREQUENCY OF LAMB EATING (p = 0.02). 
 The evidence for such an association between beef eating and CJD is weaker 
(p = 0.14). When only controls for whom a relative was interviewed are included, 
this evidence becomes a little STRONGER (p = 0.08). 
 snip... 
 It was found that when veal was included in the model with another 
exposure, the association between veal and CJD remained statistically 
significant (p = < 0.05 for all exposures), while the other exposures ceased 
to be statistically significant (p = > 0.05). 
 snip... 
 In conclusion, an analysis of dietary histories revealed statistical 
associations between various meats/animal products and INCREASED RISK OF CJD. 
When some account was taken of possible confounding, the association between 
VEAL EATING AND RISK OF CJD EMERGED AS THE STRONGEST OF THESE ASSOCIATIONS 
STATISTICALLY. ... 
 snip... 
 In the study in the USA, a range of foodstuffs were associated with an 
increased risk of CJD, including liver consumption which was associated with an 
apparent SIX-FOLD INCREASE IN THE RISK OF CJD. By comparing the data from 3 
studies in relation to this particular dietary factor, the risk of liver 
consumption became non-significant with an odds ratio of 1.2 (PERSONAL 
COMMUNICATION, PROFESSOR A. HOFMAN. ERASMUS UNIVERSITY, ROTTERDAM). (???...TSS) 
 snip...see full report ; 
 Thursday, October 10, 2013 
 *************CJD REPORT 1994 increased risk for consumption of veal and 
venison and lamb************** 
 CJD9/10022 
 October 1994 
 Mr R.N. Elmhirst Chairman British Deer Farmers Association Holly Lodge 
Spencers Lane BerksWell Coventry CV7 7BZ 
 Dear Mr Elmhirst, 
 CREUTZFELDT-JAKOB DISEASE (CJD) SURVEILLANCE UNIT REPORT 
 Thank you for your recent letter concerning the publication of the third 
annual report from the CJD Surveillance Unit. I am sorry that you are 
dissatisfied with the way in which this report was published. 
 The Surveillance Unit is a completely independant outside body and the 
Department of Health is committed to publishing their reports as soon as they 
become available. In the circumstances it is not the practice to circulate the 
report for comment since the findings of the report would not be amended. In 
future we can ensure that the British Deer Farmers Association receives a copy 
of the report in advance of publication. 
 The Chief Medical Officer has undertaken to keep the public fully informed 
of the results of any research in respect of CJD. This report was entirely the 
work of the unit and was produced completely independantly of the the 
Department. 
 The statistical results reqarding the consumption of venison was put into 
perspective in the body of the report and was not mentioned at all in the press 
release. Media attention regarding this report was low key but gave a realistic 
presentation of the statistical findings of the Unit. This approach to 
publication was successful in that consumption of venison was highlighted only 
once by the media ie. in the News at one television proqramme. 
 I believe that a further statement about the report, or indeed statistical 
links between CJD and consumption of venison, would increase, and quite possibly 
give damaging credence, to the whole issue. From the low key media reports of 
which I am aware it seems unlikely that venison consumption will suffer 
adversely, if at all. 
 http://web.archive.org/web/20030511010117/http://www.bseinquiry.gov.uk/files/yb/1994/10/00003001.pdf 
 *** our results raise the possibility that CJD cases classified as VV1 may 
include cases caused by iatrogenic transmission of sCJD-MM1 prions or food-borne 
infection by type 1 prions from animals, e.g., chronic wasting disease prions in 
cervid. In fact, two CJD-VV1 patients who hunted deer or consumed venison have 
been reported (40, 41). The results of the present study emphasize the need for 
traceback studies and careful re-examination of the biochemical properties of 
sCJD-VV1 prions. *** 
 snip...see full text ; 
 Thursday, January 2, 2014 
 *** CWD TSE Prion in cervids to hTGmice, Heidenhain Variant 
Creutzfeldt-Jacob Disease MM1 genotype, and iatrogenic CJD ??? *** 
 *** The potential impact of prion diseases on human health was greatly 
magnified by the recognition that interspecies transfer of BSE to humans by beef 
ingestion resulted in vCJD. While changes in animal feed constituents and 
slaughter practices appear to have curtailed vCJD, there is concern that CWD of 
free-ranging deer and elk in the U.S. might also cross the species barrier. 
Thus, consuming venison could be a source of human prion disease. Whether BSE 
and CWD represent interspecies scrapie transfer or are newly arisen prion 
diseases is unknown. Therefore, the possibility of transmission of prion disease 
through other food animals cannot be ruled out. There is evidence that vCJD can 
be transmitted through blood transfusion. There is likely a pool of unknown size 
of asymptomatic individuals infected with vCJD, and there may be asymptomatic 
individuals infected with the CWD equivalent. These circumstances represent a 
potential threat to blood, blood products, and plasma supplies. 
 *** We hypothesize that both BSE prions and CWD prions passaged through 
felines will seed human recPrP more efficiently than BSE or CWD from the 
original hosts, evidence that the new host will dampen the species barrier 
between humans and BSE or CWD. The new host effect is particularly relevant as 
we investigate potential means of trans-species transmission of prion disease. 
 *** We hypothesize that both BSE prions and CWD prions passaged through 
felines will seed human recPrP more efficiently than BSE or CWD from the 
original hosts, evidence that the new host will dampen the species barrier 
between humans and BSE or CWD. The new host effect is particularly relevant as 
we investigate potential means of trans-species transmission of prion disease. 
 Monday, August 8, 2011 
 *** Susceptibility of Domestic Cats to CWD Infection *** 
 Oral.29: Susceptibility of Domestic Cats to CWD Infection 
 Amy Nalls, Nicholas J. Haley, Jeanette Hayes-Klug, Kelly Anderson, Davis 
M. Seelig, Dan S. Bucy, Susan L. Kraft, Edward A. Hoover and Candace K. 
Mathiason† 
 Colorado State University; Fort Collins, CO USA†Presenting author; Email: 
ckm@lamar.colostate.edu 
 Domestic and non-domestic cats have been shown to be susceptible to one 
prion disease, feline spongiform encephalopathy (FSE), thought to be transmitted 
through consumption of bovine spongiform encephalopathy (BSE) contaminated meat. 
Because domestic and free ranging felids scavenge cervid carcasses, including 
those in CWD affected areas, we evaluated the susceptibility of domestic cats to 
CWD infection experimentally. Groups of n = 5 cats each were inoculated either 
intracerebrally (IC) or orally (PO) with CWD deer brain homogenate. Between 
40–43 months following IC inoculation, two cats developed mild but progressive 
symptoms including weight loss, anorexia, polydipsia, patterned motor behaviors 
and ataxia—ultimately mandating euthanasia. Magnetic resonance imaging (MRI) on 
the brain of one of these animals (vs. two age-matched controls) performed just 
before euthanasia revealed increased ventricular system volume, more prominent 
sulci, and T2 hyperintensity deep in the white matter of the frontal hemisphere 
and in cortical grey distributed through the brain, likely representing 
inflammation or gliosis. PrPRES and widely distributed peri-neuronal vacuoles 
were demonstrated in the brains of both animals by immunodetection assays. No 
clinical signs of TSE have been detected in the remaining primary passage cats 
after 80 months pi. Feline-adapted CWD was sub-passaged into groups (n=4 or 5) 
of cats by IC, PO, and IP/SQ routes. Currently, at 22 months pi, all five IC 
inoculated cats are demonstrating abnormal behavior including increasing 
aggressiveness, pacing, and hyper responsiveness. 
 *** Two of these cats have developed rear limb ataxia. Although the 
limited data from this ongoing study must be considered preliminary, they raise 
the potential for cervid-to-feline transmission in nature. 
 AD.63: 
 Susceptibility of domestic cats to chronic wasting disease 
 Amy V.Nalls,1 Candace Mathiason,1 Davis Seelig,2 Susan Kraft,1 Kevin 
Carnes,1 Kelly Anderson,1 Jeanette Hayes-Klug1 and Edward A. Hoover1 1Colorado 
State University; Fort Collins, CO USA; 2University of Minnesota; Saint Paul, MN 
USA 
 Domestic and nondomestic cats have been shown to be susceptible to feline 
spongiform encephalopathy (FSE), almost certainly caused by consumption of 
bovine spongiform encephalopathy (BSE)-contaminated meat. Because domestic and 
free-ranging nondomestic felids scavenge cervid carcasses, including those in 
areas affected by chronic wasting disease (CWD), we evaluated the susceptibility 
of the domestic cat (Felis catus) to CWD infection experimentally. Cohorts of 5 
cats each were inoculated either intracerebrally (IC) or orally (PO) with 
CWD-infected deer brain. At 40 and 42 mo post-inoculation, two IC-inoculated 
cats developed signs consistent with prion disease, including a stilted gait, 
weight loss, anorexia, polydipsia, patterned motor behaviors, head and tail 
tremors, and ataxia, and progressed to terminal disease within 5 mo. Brains from 
these two cats were pooled and inoculated into cohorts of cats by IC, PO, and 
intraperitoneal and subcutaneous (IP/SC) routes. Upon subpassage, feline-adapted 
CWD (FelCWD) was transmitted to all IC-inoculated cats with a decreased 
incubation period of 23 to 27 mo. FelCWD was detected in the brains of all the 
symptomatic cats by western blotting and immunohistochemistry and abnormalities 
were seen in magnetic resonance imaging, including multifocal T2 fluid 
attenuated inversion recovery (FLAIR) signal hyper-intensities, ventricular size 
increases, prominent sulci, and white matter tract cavitation. Currently, 3 of 4 
IP/SQ and 2 of 4 PO inoculared cats have developed abnormal behavior patterns 
consistent with the early stage of feline CWD. 
 *** These results demonstrate that CWD can be transmitted and adapted to 
the domestic cat, thus raising the issue of potential cervid-to- feline 
transmission in nature. 
 Tuesday, November 04, 2014 
 *** Six-year follow-up of a point-source exposure to CWD contaminated 
venison in an Upstate New York community: risk behaviours and health outcomes 
2005–2011 
 www.landesbioscience.com 
 PO-081: Chronic wasting disease in the cat— Similarities to feline 
spongiform encephalopathy (FSE) 
 FELINE SPONGIFORM ENCEPHALOPATHY FSE 
 Thursday, July 03, 2014 
 *** How Chronic Wasting Disease is affecting deer population and what’s 
the risk to humans and pets? 
 Saturday, January 31, 2015 
 European red deer (Cervus elaphus elaphus) are susceptible to Bovine 
Spongiform Encephalopathy BSE by Oral Alimentary route 
 *** Singeltary reply ; 
 ruminant feed ban for cervids in the United States ? 
 31 Jan 2015 at 20:14 GMT 
 Friday, January 30, 2015 
 *** Scrapie: a particularly persistent pathogen *** 
===========
P.153: An independent and blinded confirmation of real-time quakinginduced 
conversion (RT-QuIC) analysis of cervid rectal biopsies for detection of chronic 
wasting disease
Sireesha Manne1,*, Naveen Kondru1, Nicholas Haley2, Tracy Nichols3, Bruce 
Thomsen4, Roger Main5, Patrick Halbur5, Arthi Kanthasamy1, and Anumantha 
Kanthasamy1 1Biomedical Sciences; Iowa State University; Ames, IA USA; 2Kansas 
State University; Manhattan, KS USA; 3United States Department of Agriculture; 
Fort Collins, CO USA; 4National Veterinary Service Laboratories; Ames, IA USA; 
5VDPAM; Iowa State University; Ames, IA USA
Prion diseases are transmissible spongiform encephalopathies (TSEs) 
characterized by an always fatal, progressive neuronal degeneration in the brain 
due to infectious misfolded prion proteins whose prolonged incubation periods 
often make ante-mortem diagnosis difficult. Chronic wasting disease (CWD) is a 
TSE affecting both wild and captive populations of mule deer, whitetailed deer, 
elk and moose. CWD in cervids was first identified in Rocky Mountain States and 
has recently spread to several other states including Iowa. In this current 
study, we attempted to independently confirm the results of a Real-Time 
Quaking-Induced Conversion (RT-QuIC) assay to diagnose CWD using rectal biopsy 
sections from farmed white-tailed deer. First, we generated recombinant prion 
protein substrate and then validated the quality of protein for RT-QuIC using a 
reference prion protein kindly provided by Dr. Caughey’s lab. After validating 
the assay, we blindly evaluated approximately 350 rectal biopsy samples analyzed 
previously by another institution. All assay plates included positive and 
negative controls and were analyzed in triplicate. Samples were analyzed using 
the Biotek Cytation-3 multimode plate reader for 24-hrs duration. Our RT-QuIC 
assays showed 55% positivity for 356 rectal samples analyzed. Comparison of 
RT-QuIC results with the immunohistochemical results of obex revealed 93% 
sensitivity (95% confidence limits: 88.05–95.78%) and 96% specificity (95% CL: 
91–99%), confirming that the RT-QuIC assay may be one of the most promising 
rapid assays for detecting CWD prions. We are currently working on applying the 
RT-QuIC assay to other test samples (ISU Presidential Wildlife initiative, 
ISU-CVM Diagnostic lab and ES10586).
==========
P.154: Brain derived lipids inhibit prion amyloid formation in vitro 
Clare Hoover, Davin Henderson, Mark Zabel, and Edward Hoover Colorado State 
University; Fort Collins, CO USA
The normal cellular prion protein (PrPC) resides in cellular outer membrane 
lipid rafts and conversion from PrPC to the pathogenic misfolded isoform is 
believed to occur at the lipid membrane. In vitro assays have demonstrated the 
intimate association between prion conversion and lipids, specifically 
phosphatidylethanolamine, which is a critical cofactor in the formation of 
synthetic infectious prions. In the current work, we demonstrate an opposing 
property of lipids, the ability to inhibit amyloid formation in vitro. The 
real-time quakinginduced conversion assay (RT-QuIC) was used to investigate 
whole brain lipid effects on prion amyloid formation. An alcohol based 
extraction technique was used to remove the lipid content from terminal chronic 
wasting disease (CWD)- infected white tailed deer brain homogenates. Eliminating 
lipids increased the sensitivity of RT-QuIC detection of CWD in brain samples 
one hundred-fold. Addition of brain-derived lipid extracts to CWD prion samples 
inhibited amyloid formation in a dose-dependent manner. Brain-derived lipids 
also inhibited prion amyloid formation in RT-QuIC reaction seeds derived from 
lymphoid tissues. This is the first demonstration of brain derived lipids 
directly inhibiting prion amyloid formation in vitro and highlights the diverse 
roles lipids play in the conversion process. Further experiments will identify 
the individual lipid species or groups of lipids responsible for this inhibitory 
activity.
============
P.160: Detecting the temporal status of prionemia in transmissible 
spongiform encephalopathy-infected hosts
Alan Elder1, Davin Henderson1, Amy Nalls1, Kristen Davenport1, Anthony 
Kincaid2, Edward Hoover1, Jason Bartz2, and Candace Mathiason1 1Colorado State 
University; Fort Collins, CO USA; 2Creighton University; Omaha, NE USA
Infectious prions can traverse epithelial barriers and gain access to the 
circulatory system early in infection. The details of prion entry, temporal 
status, and persistence in the blood remain unknown. Furthermore, it is unknown 
if the route of inoculation plays a role in the development of prionemia. We 
previously demonstrated PrPC amyloid conversion activity in the blood 
(prionemia) of deer and hamsters infected with transmissible spongiform 
encephalopathies (TSEs) using whole blood real-time quaking-induced conversion 
(wbRT-QuIC). In this study we analyzed the temporal status of prionemia, 
spanning 0–100% of the disease course, in hosts exposed to TSEs via blood 
transfusion or other peripheral means (i.e. oral, aerosol, extranasal, and 
subcutaneous). Our results demonstrate the presence of PrPC amyolid conversion 
activity in the blood of all TSE-inoculated hosts as early as 15 minutes post 
inoculation likely-representing the point source inoculum–which was cleared from 
the circulatory system by 72 hours post exposure. De novo host generated 
hematogenous PrPC amyloid conversion activity, or prionemia, was identified at 
4–5% of the TSE disease course and persisted throughout disease. ***Our results 
indicate that hematogenous prions can traverse mucosal surfaces and enter the 
circulatory system with the same speed and efficiency as those entering the 
blood directly by blood transfusion, and that an asymptomatic carrier state is 
established within minutes of TSE exposure.
==========
***Our results indicate that hematogenous prions can traverse mucosal 
surfaces and enter the circulatory system with the same speed and efficiency as 
those entering the blood directly by blood transfusion, and that an asymptomatic 
carrier state is established within minutes of TSE exposure.***
=========== 
P.161: Prion soil binding may explain efficient horizontal CWD 
transmission
Nathaniel Denkers1, Davin Henderson1, Shannon Bartelt-Hunt2, Jason Bartz3, 
and Edward Hoover1 1Colorado State University; Fort Collins, Colorado USA; 
2University of Nebraska-Lincoln; Omaha, Nebraska USA; 3Creighton University; 
Omaha, Nebraska USA
Background. Chronic wasting disease (CWD) is unique due to the facile 
spread in nature. The interaction of excreted CWD prions and soil is a 
hypothesized contributor in environmental transmission. The present study 
examines whether and to what degree CWD prions bind to silty clay loam (SCL) 
using an adapted version of real-time quaking-induced conversion (RT-QuIC) 
methodology.
Materials and Methods. Varying amounts (50–3.12 mg) of SCL were incubated 
with 1 mL-serial dilutions of CWD (C), CWD (¡), or no brain homogenate (BH). 
Samples were centrifuged, washed, diluted 1:10 in 0.1% SDS, and 2.5 uL seeded in 
RT-QuIC assays employing recombinant Syrian hamster prion PrP substrate. 
Multiple well replicates of sample and supernatant fractions were assayed for 
positive seeding activity (recorded as thioflavin T fluorescence emission; 480 
nm). Samples were considered positive if they crossed a threshold of 25,000. 
Reaction rates (RR) were calculated, averaged, and expressed as 1/RR.
Results. Positive seeding activity was detected for most SCL samples 
incubated with CWD (C) BH dilutions. Higher SCL concentrations (50 mg) produced 
low fluorescent readings due to optical interference. Lower SCL concentrations 
(6.25 mg) produced minimal optical interference and removed the vast majority of 
seeding activity from CWDC BH in a concentration-dependent manner; determined by 
seeding activity in residual BH supernatants. Control SCL and supernatants 
produced minimal falsepositive reactions (8 of 240 replicates; 3.3%). We 
estimated the prion binding capacity of SCL to be 0.16 ng/mg.
***Conclusion. Silty clay loam exhibits highly efficient prion binding, 
inferring a durable environmental reservoir, and an efficient mechanism for 
indirect horizontal CWD transmission.
==============
***Conclusion. Silty clay loam exhibits highly efficient prion binding, 
inferring a durable environmental reservoir, and an efficient mechanism for 
indirect horizontal CWD transmission.
=============
P.66: Transport of CWD prions in Alberta soils
Alsu Kuznetsova1, Debbie McKenzie2, Tariq Siddique1, and Judd Aiken2 
1University of Alberta; Department of Renewable Resources; Edmonton, Canada; 
2University of Alberta; Centre for Prions and Protein Folding Diseases; 
Edmonton, Canada
The transmission of chronic wasting disease (CWD) includes environmental 
pathways, particularly soils as disease reservoirs. Soils differ dramatically in 
their capacity to adsorb PrPCWD due to differences in mineral composition, humus 
content and particle surface area. Mineral and organic compounds have the 
ability to bind PrPCWD impacting infectious properties. The extreme variability 
of these soil constituents suggests that the PrPCWD fate and behavior will 
depend on specific soil properties. The soil moisture regime also has the 
potential to affect transportation of compounds through a soil profile. PrPCWD 
can be bound to soil particles with Prion 2015 Poster Abstracts S45 3 
hypothetical scenarios for prion fate: (i) prions stay in the surface soil 
horizon and remain bioavailable for grazing animals; (ii) prions can be 
transported into lower soil horizons and become unavailable for consumption; or 
(iii) prions can migrate through the soil profile and end up in ground water. We 
performed bench-scale experiments with soil columns to evaluate the potential 
for transportation of PrPCWD using soils from different regions of Alberta, 
Canada. The Luvisols found in northern Alberta have an ustic/udic moisture 
regime and illite as a predominant clay mineral. The prion binding capacity of 
illite is poor suggesting it cannot contribute to prion binding and PrPCWD can 
migrate through the soil profile. Chernozems are found in the CWD-endemic region 
in southern Alberta and have an aridic soil moisture regime, high amount of 
humus content and contain montmorillonite. In the Chernozem soil columns PrPCWD 
remains on the soil surface and does not migrate in lower horizons.
===========
PLEASE SEE;
Friday, May 22, 2015 
Chronic Wasting Disease and Program Updates - 2014 NEUSAHA Annual Meeting 
12-14 May 2014
============
P.70: Experimental transmission of chronic wasting disease to sheep and 
goats
Gordon Mitchell, Nishandan Yogasingam, Ines Walther, and Aru Balachandran 
National and OIE Reference Laboratory for Scrapie and CWD; Canadian Food 
Inspection Agency; Ottawa, ON, Canada
The persistence of chronic wasting disease (CWD) in North American cervids, 
coupled with efforts to eradicate scrapie in sheep and goats, necessitates an 
understanding of the transmission, clinical and diagnostic characteristics of 
CWD in small ruminants. Oral and intracerebral transmission studies were 
conducted in sheep and goats using tissues from CWD-infected elk. Four lambs and 
4 goats were orally inoculated with a pooled brain and lymph node homogenate 
from a group of farmed elk with clinical CWD. At study endpoint, there was no 
evidence of primary CWD transmission in the sheep or goat tissues examined by 
ELISA, western blot and immunohistochemistry (IHC). Two lambs which were 
challenged intracerebrally with the same pooled elk inoculate displayed 
neurological signs beginning at 27 months postinoculation (mpi) and were 
euthanized within 10 d of each other at 28 mpi. Testing of tissues by ELISA and 
IHC confirmed disease transmission and revealed differences in the distribution 
and intensity of PrPd deposition between animals. Western immunoblot analysis 
identified characteristics permitting the differentiation of CWD in sheep from 
other prion diseases in small ruminants. CWD-infected tissue from the 
intracerabrally-inoculated sheep has undergone secondary passage into sheep and 
goats and currently shows no evidence of oral transmission in rectal mucosa 
biopsies at 20 mpi. These findings corroborate evidence of a significant species 
barrier preventing the oral transmission of CWD to sheep and goats, and identify 
diagnostic characteristics to enable the differentiation of prion diseases 
affecting small ruminants.
===========
P.97: Scrapie transmits to white-tailed deer by the oral route and has a 
molecular profile similar to chronic wasting disease and distinct from the 
scrapie inoculum
Justin Greenlee1, S Jo Moore1, Jodi Smith1, M Heather West Greenlee2, and 
Robert Kunkle1 1National Animal Disease Center; Ames, IA USA; 2Iowa State 
University; Ames, IA USA
The purpose of this work was to determine susceptibility of white-tailed 
deer (WTD) to the agent of sheep scrapie and to compare the resultant PrPSc to 
that of the original inoculum and chronic wasting disease (CWD). We inoculated 
WTD by a natural route of exposure (concurrent oral and intranasal (IN); n D 5) 
with a US scrapie isolate. All scrapie-inoculated deer had evidence of PrPSc 
accumulation. PrPSc was detected in lymphoid tissues at preclinical time points, 
and deer necropsied after 28 months post-inoculation had clinical signs, 
spongiform encephalopathy, and widespread distribution of PrPSc in neural and 
lymphoid tissues. Western blotting (WB) revealed PrPSc with 2 distinct molecular 
profiles. WB on cerebral cortex had a profile similar to the original scrapie 
inoculum, whereas WB of brainstem, cerebellum, or lymph nodes revealed PrPSc 
with a higher profile resembling CWD. Homogenates with the 2 distinct profiles 
from WTD with clinical scrapie were further passaged to mice expressing cervid 
prion protein and intranasally to sheep and WTD. In cervidized mice, the 2 
inocula have distinct incubation times. Sheep inoculated intranasally with WTD 
derived scrapie developed disease, but only after inoculation with the inoculum 
that had a scrapie-like profile. The WTD study is ongoing, but deer in both 
inoculation groups are positive for PrPSc by rectal mucosal biopsy.*** In 
summary, this work demonstrates that WTD are susceptible to the agent of 
scrapie, 2 distinct molecular profiles of PrPSc are present in the tissues of 
affected deer, and inoculum of either profile readily passes to deer.
=================
*** In summary, this work demonstrates that WTD are susceptible to the 
agent of scrapie, 2 distinct molecular profiles of PrPSc are present in the 
tissues of affected deer, and inoculum of either profile readily passes to deer. 
*** 
================ 
P.128: Bioassay using ovine and cervid PrP transgenic mice for 
discrimination of scrapie and CWD origins in sheep and goats
Sally Madsen-Bouterse1,*, Dongyue Zhuang2, David Schneider2, Rohana 
Dassanayake1, Aru Balachandran3, Gordon Mitchell3, and Katherine O’Rourke1 
1Department of Veterinary Microbiology and Pathology; College of Veterinary 
Medicine; Washington State University; Pullman, WA USA; 2Animal Disease Research 
Unit; Agricultural Research Service; US. Department of Agriculture; Pullman, WA 
USA; 3National and OIE Reference Laboratory for Scrapie and CWD; Canadian Food 
Inspection Agency; Ottawa Laboratory– Fallowfield; Ottawa, ON Canada
As the United States works toward the eradication of scrapie, identifying 
TSE reservoirs that could lead to disease re-emergence is imperative. 
Development of transgenic mice expressing either the ovine or cervid prion 
protein has aided characterization of scrapie and CWD, respectively. We 
hypothesize that transgenic mouse models will discern whether new incidents of 
scrapie in sheep and goats with clinical disease originated from CWD exposure. 
Two transgenic mouse lines (Tg338 and TgElk; minimum 5 mice/strain) were 
inoculated with brain homogenate from clinically affected animals including 
sheep or goats with naturally acquired classical scrapie, white-tailed deer with 
naturally acquired CWD (WTD-CWD), or sheep experimentally inoculated with 
elk-CWD (sheepelk- CWD). Transmission was assessed via survival analysis and 
western blot characterization of brain PrPres. WTD-CWD transmitted efficiently 
to TgElk with all mice culled due to clinical disease, whereas all Tg338 
remained asymptomatic at endpoint with no PrPres detected in the brain. Ovine 
and caprine scrapie transmitted poorly to TgElk with all mice asymptomatic at 
endpoint and 6.8% brain-positive for PrPres, whereas all Tg338 were culled due 
to clinical disease. Sheep elk-CWD yielded Tg338 that were all asymptomatic at 
endpoint and were all brainpositive for PrPres. However, sheepelk-CWD yielded 
TgElk with 5/22 displaying clinical disease near endpoint but 16/22 
brain-positive for PrPres. Furthermore, TgElk-PrPres molecular mass appeared 
lower when inoculated with caprine scrapie versus WTD-CWD and both molecular 
masses were yielded when inoculated with sheepelk-CWD. ***These findings suggest 
primary passage in Tg338 and TgElk could discern whether scrapie in sheep and 
goats originated from CWD exposure.
===========
P.73: Oral challenge of goats with atypical scrapie
Silvia Colussi1, Maria Mazza1, Francesca Martucci1, Simone Peletto1, 
Cristiano Corona1, Marina Gallo1, Cristina Bona1, Romolo Nonno2, Michele Di 
Bari2, Claudia D’Agostino2, Nicola Martinelli3, Guerino Lombardi3, and Pier 
Luigi Acutis1 1Istituto Zooprofilattico Sperimentale del Piemonte; Liguria e 
Valle d’Aosta; Turin, Italy; 2Istituto Superiore di Sanit a; Rome, Italy; 
3Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna; 
Brescia, Italy
Atypical scrapie transmission has been demonstrated in sheep by 
intracerebral and oral route (Simmons et al., Andreoletti et al., 2011) but data 
about goats are not available yet. In 2006 we orally challenged four goats, five 
months old, with genotype R/H and R/R at codon 154. Animals died starting from 
24 to 77 months p.i. without clinical signs. They all resulted negative for 
scrapie in CNS and peripheral tissues using Western blot and 
immunohistochemistry. Nevertheless these goats could still represent carriers. 
This hypothesis was investigated through bioassay in tg338 mice, a sensitive 
animal model for atypical scrapie infectivity. By end-point dilution titration, 
the starting inoculum contained 106.8 ID50/g. In contrast, all tissues from 
challenged goats were negative by bioassay. These negative results could be 
explained with the low infectivity of the starting inoculum, which could have 
been unable to induce disease or infectivity within our period of observation. 
However the challenge conditions could have been a bias too: as the matter of 
the fact, while the oral challenge of classical scrapie is still effective in 
sheep 6–10 months old (Andreoletti et al., 2011), Simmons et al. (2011) 
demonstrated a very short efficacy period for atypical scrapie (24 hours after 
birth), hypothesizing that natural transmission could occur mainly via milk. 
***Our work suggests that this could be true also for goats and it should be 
taken into account in oral challenges. However a low susceptibility of goats to 
atypical scrapie transmission via oral route cannot be excluded.
============= 
P.74: Transmission of experimental CH1641 scrapie to wild-type mice
Lucien van Keulen1,*, Jan Langeveld1, Corry Dolstra1, Jorg Jacobs1, Alex 
Bossers1, and Fred van Zijderveld2 1Department of Infection Biology; Central 
Veterinary Institute of Wageningen UR, Lelystad, The Netherlands; 2Department of 
Bacteriology and TSEs; Central Veterinary Institute of Wageningen UR, Lelystad, 
The Netherlands
Introduction. CH1641 was isolated in the UK in 1970 from a natural case of 
scrapie in a Cheviot sheep and was further passaged intracerebrally in sheep. 
CH1641 has been the subject of extensive research because of the biochemical 
similarities of PrPres from CH1641- and BSE-affected sheep brains. Previous 
attempts to transmit CH1641 to wild type mice have been unsuccessful. We report 
here for the first time, the positive transmission of experimental CH1641 to 
RIII mice and compare the incubation period, PrPSc profile and PrPres Western 
blot properties to those of known scrapie and BSE reference strains.
Methods. The CH1641 brain homogenate used in this study came from a pool a 
5 sheep brains which had been challenged intracerebrally with brain material 
from the third passage of CH1641 in sheep. Groups of 15–20 RIII mice were 
inoculated intracerebrally with a 10% brain homogenate of CH1641. The brains of 
the mice were examined by PrPSc profiling and triplex Western blot as reported 
previously.
Results. Surprisingly CH1641 transmitted to RIII mice with a 100% attack 
rate although with a long incubation period (794 § 149 d). The resulting PrPSc 
profile was unlike any of the profiles of the scrapie and BSE reference strains 
reported previously. Triplex Western blot pointed after first passage to a very 
low PrPres level. We observed a reduction of molecular mass of the non-glycosyl 
PrPres moiety and concomittant N-terminal 12B2 epitope signal. In comparison to 
the original CH1641 inoculum there was a lack of a dual population of 
PrPres.
===========
***The serial transmission of different scrapie isolates in these mice led 
to the propagation of prions that are phenotypically identical to those causing 
sporadic CJD (sCJD) in humans. 
***These results demonstrate that scrapie prions have a zoonotic potential 
and raise new questions about the possible link between animal and human 
prions.
Subject terms: Biological sciences• Medical research At a glance
Wednesday, January 18, 2012 
Selection of Distinct Strain Phenotypes in Mice Infected by Ovine Natural 
Scrapie Isolates Similar to CH1641 Experimental Scrapie 
Journal of Neuropathology & Experimental Neurology: February 2012 - 
Volume 71 - Issue 2 - p 140–147 
Thursday, July 14, 2011 
Histopathological Studies of "CH1641-Like" Scrapie Sources Versus Classical 
Scrapie and BSE Transmitted to Ovine Transgenic Mice (TgOvPrP4) 
=========== 
P.164: Blood transmission of prion infectivity in the squirrel monkey: The 
Baxter study 
 Paul Brown1, Diane Ritchie2, James Ironside2, Christian Abee3, Thomas 
Kreil4, and Susan Gibson5 1NIH (retired); Bethesda, MD USA; 2University of 
Edinburgh; Edinburgh, UK; 3University of Texas; Bastrop, TX USA; 4Baxter 
Bioscience; Vienna, Austria; 5University of South Alabama; Mobile, AL USA
Five vCJD disease transmissions and an estimated 1 in 2000 ‘silent’ 
infections in UK residents emphasize the continued need for information about 
disease risk in humans. A large study of blood component infectivity in a 
non-human primate model has now been completed and analyzed. Among 1 GSS, 4 
sCJD, and 3 vCJD cases, only GSS leukocytes transmitted disease within a 5–6 
year surveillance period. A transmission study in recipients of multiple whole 
blood transfusions during the incubation and clinical stages of sCJD and vCJD in 
ic-infected donor animals was uniformly negative. These results, together with 
other laboratory studies in rodents and nonhuman primates and epidemiological 
observations in humans, ***suggest that blood donations from cases of GSS (and 
perhaps other familial forms of TSE) carry more risk than from vCJD cases, and 
that little or no risk is associated with sCJD. The issue of decades-long 
incubation periods in ‘silent’ vCJD carriers remains open.
=============
***suggest that blood donations from cases of GSS (and perhaps other 
familial forms of TSE) carry more risk than from vCJD cases, and that little or 
no risk is associated with sCJD...see;
Wednesday, December 11, 2013 
*** Detection of Infectivity in Blood of Persons with Variant and Sporadic 
Creutzfeldt-Jakob Disease ***
THE BAXTER STUDY...SEE MORE HERE ;
============== 
 P.23: An improved test for the detection of Creutzfeldt-Jakob Disease from 
human CSF using new RT-QuIC conditions 
Bradley R Groveman1, Christina D Orr u1, Andrew G Hughson1, Gianluigi 
Zanusso2, Maurizio Pocchiari3, Michael B Coulthart4, and Byron Caughey1 
1Laboratory of Persistent Viral Diseases; Rocky Mountain Laboratories; NIAID; 
NIH; Hamilton, MT USA; 2Department of Neurological and Movement Sciences; 
University of Verona; Verona, Italy; 3Department of Cell Biology and 
Neurosciences; Istituto Superiore di Sanit a; Rome, Italy; 4Canadian CJD 
Surveillance System; Public Health Agency of Canada; Ottawa, ON Canada
Neurodegenerative protein misfolding diseases are difficult to diagnose 
early and accurately. This is particularly worrisome with human prion diseases, 
such as Creutzfeldt- Jakob disease (CJD), because prions are transmissible, 
deadly, and unusually resistant to decontamination. Real-time quaking-induced 
conversion (RT-QuIC) assays allow highly sensitive and specific testing for CJD 
using human cerebrospinal fluid (CSF) or nasal brushings and are being widely 
implemented as important diagnostic tools. However, such laboratory analyses 
have required 2.5 to 5 d to complete. Furthermore, CSF testing using previously 
evaluated RT-QuIC conditions still yields false negative results in 11 to 23% of 
CJD cases. We have now developed an improved RT-QuIC assay which can identify 
positive CSF samples within 4 to 14 h with better analytical and diagnostic 
sensitivity. Analysis of CSF samples from 11 CJD patients demonstrated that 
while 7 were RT-QuIC positive using previous conditions, an additional 3 samples 
were positive using the new assay. In these and subsequent analyses, a total of 
46 of 48 CSF samples from sporadic CJD patients gave positive RT-QuIC responses, 
while all 39 non-CJD patients were negative, giving 95.8% diagnostic sensitivity 
and 100% specificity. This diagnostic sensitivity was significantly better than 
that obtained using the previous conditions. We continue to expand the testing 
of CJD-positive and -negative CSF samples to further establish the diagnostic 
utility of this new assay for various human prion diseases. So far, our improved 
RT-QuIC assay appears to allow for much faster, more accurate and practical 
antemortem testing for CJD using CSF samples.
===========
P.159: Improvements of nasal brushing procedure for Creutzfeldt-Jakob 
disease diagnosis 
Matilde Bongianni1, Christina Orr u2, Giovanni Tonoli3, Bradley Groveman2, 
Giorgo Triva4, Santina Castriciano4, Luca Sacchetto1, Andrew Hughson2, 
Annachiara Cagnin5, Stefano Capaldi1, Sergio Ferrari1, Michele Fiorini1, 
Salvatore Monaco1, Maurizio Pocchiari6, Byron Caughey2, and Gianluigi Zanusso1 
1University of Verona; Verona, Italy; 2Rocky Montain Laboratories; Hamilton, MT 
USA; 3Ospedale “Santa Maria della Misericordia”; Rovigo, Italy; 4Copan Italia 
S.P.A.; Brescia, Italy; 5University of Padua; Padua, Italy; 6Istituto Superiore 
di Sanit a; Rome, Italy
Introduction. We previously identified prion seeding activity in olfactory 
mucosa (OM) of CJD patients using nasal brushings coupled with Real Time Quaking 
induced Conversion (RT-QuIC) with 100% specificity and >97% sensitivity. OM 
samples were collected using a sterile disposable Cyto-brush (Kito-Brush, 
Kaltek) which might provoke a mild discomfort for patients. Therefore, we aimed 
to use a more gentle tool for OM samplings such as short nylon fiber Flocked 
swabs (Copan technologies).
Materials and Methods. We collected OM and CSF samples in 43 CJD patients. 
To ensure efficient OM sample collection, each patient underwent to two OM 
samplings using flocked swabs one in each nostril and a final with Cytobrush. OM 
samples were processed and analyzed by RT-QuIC, as previously described.
Results. Using Cyto-brushes 32 out of 35 OM samples were positive by 
RT-QuIC analysis, while flocked swabs in 40 out of 43 OM samples. In contrast, 
CSF samples were positive in 33 out of 43. Two OM samples resulted negative for 
both Cyto-brush and Flocked swab. Neither OM sampling technique or CSF produced 
false positives.
***Conclusion. This study demonstrates that OM brushing following RT-QuIC 
ssay is 95% sensitive and 100% specific in CJD diagnosis while CSF resulted 77% 
sensitive. OM collection using flocked swabs is preferred and provides same 
sensitivity as cyto-brush. These data recommend four separate samplings possibly 
from both nostrils to maximize the sensitivity, using three Flocked swabs and 
lastly a brush.
============
P.24: A comparative study of dura mater graft-associated Creutzfeldt-Jakob 
disease between Japan and other countries
Tsuyoshi Hamaguchi1, Kenji Sakai1, Moeko Noguchi-Shinohara1, Ichiro 
Nozaki1, Ichiro Takumi2, Nobuo Sanjo3, Yosikazu Nakamura4, Tetsuyuki Kitamoto5, 
Nobuhito Saito6, Hidehiro Mizusawa7, and Masahito Yamada1 1Department of 
Neurology and Neurobiology of Aging; Kanazawa University Graduate School of 
Medical Science; Kanazawa, Japan; 2Department of Neurosurgery; Nippon Medical 
School Musashi Kosugi Hospital; Kawasaki, Japan; 3Department of Neurology and 
Neurological Science; Graduate School; Tokyo Medical and Dental University; 
Tokyo, Japan; 4Department of Public Health; Jichi Medical University; 
Shimotsuke, Japan; 5Departments of Prion Protein Research; Division of CJD 
Science and Technology; Tohoku University Graduate School of Medicine; Sendai, 
Japan; 6Department of Neurosurgery; Faculty of Medicine; The University of 
Tokyo; Tokyo, Japan; 7National Center Hospital; National Center of Neurology and 
Psychiatry; Tokyo, Japan
Objective. More than 60% of patients worldwide diagnosed with 
Creutzfeldt-Jakob disease
(CJD) associated with dura mater graft (dCJD) have been identified in 
Japan. The remarkable frequency of dura mater graft use in Japan might 
contribute to the elevated incidence of dCJD, but the possible reasons for the 
disproportionate use of this procedure in Japan remain unclear. We investigated 
the differences between dCJD patients in Japan and those elsewhere to help 
uncover an explanation for the unusually more frequent use of cadaveric dura 
mater and high incidence of dCJD in Japan.
Methods. We obtained data of dCJD patients in Japan from the nationwide 
surveillance of CJD in Japan and of those in other countries from extant 
literature. We compared demographic, clinical, and pathological features of dCJD 
patients between Japan and elsewhere.
Results. Data from 142 dCJD patients in Japan and 53 in other countries 
were obtained. The medical conditions precipitating dura mater graft were 
significantly different between Japan and other countries (P < 0.001); in 
Japan, there were more cases of cerebrovascular disease and hemifacial spasm or 
trigeminal neuralgia. Patients with dCJD in Japan received dura mater graft more 
often for non-life-threatening conditions, such as meningioma, hemifacial spasm 
and trigeminal neuralgia, than those in other countries.
Conclusion. Differences in the medical conditions precipitating dura mater 
graft may contribute to the frequent use of cadaveric dura mater and the higher 
incidence of dCJD in Japan.
===============
P.34: Preliminary study of Alzheimer’s disease transmission to bank 
vole
Guido Di Donato1, Geraldina Riccardi1, Claudia D’Agostino1, Flavio 
Torriani1, Maurizio Pocchiari2, Romolo Nonno1, Umberto Agrimi1, and Michele 
Angelo Di Bari1 1Department of Food Safety and Veterinary Public Health Istituto 
Superiore di Sanit a, Rome, Italy; 2Department of Cellular Biology and 
Neuroscience; Istituto Superiore di Sanit a, Rome, Italy
Extensive experimental findings indicate that prion-like mechanisms underly 
the pathogenesis of Alzheimer disease (AD). Transgenic mice have been pivotal 
for investigating prionlike mechanisms in AD, still these models have not been 
able so far to recapitulate the complex clinical-pathological features of AD. 
Here we aimed at investigating the potential of bank vole, a wild-type rodent 
highly susceptible to prions, in reproducing AD pathology upon experimental 
inoculation.
Voles were intracerebrally inoculated with brain homogenate from a familial 
AD patient. Animals were examined for the appearance of neurological signs until 
the end of experiment (800 d post-inoculation, d.p.i.). Brains were studied by 
immunohistochemistry for pTau Prion 2015 Poster Abstracts S29 (with AT180 and 
PHF-1 antibodies) and b-amyloid (4G8).
Voles didn’t show an overt clinical signs, still most of them (11/16) were 
found pTau positive when culled for intercurrent disease or at the end of 
experiment. Interestingly, voles culled as early as 125 d.p.i. already showed 
pTau aggregates. Deposition of pTau was similar in all voles and was 
characterized by neuropil threads and coiled bodies in the alveus, and by rare 
neurofibrillary tangles in gray matter. Conversely, b-amyloid deposition was 
rather rare (2/16). Nonetheless, a single vole showed the contemporaneous 
presence of pTau in the alveus and a few Ab plaque-like deposits in the 
subiculum. Uninfected age-matched voles were negative for pTau and Ab.
These findings corroborate and extend previous evidences on the 
transmissibility of pTau and Ab aggregation. Furthermore, the observation of a 
vole with contemporaneous propagation of pTau and Ab is intriguing and deserves 
further studies. 
=================
PLEASE SEE ;
Self-Propagative Replication of Ab Oligomers Suggests Potential 
Transmissibility in Alzheimer Disease
Received July 24, 2014; Accepted September 16, 2014; Published November 3, 
2014
Singeltary comment ;
=============== 
P.36: Spontaneous in vitro conversion of full length recombinant human 
prion protein in unseeded RT-QuIC reactions 
 Marcelo Barria Matus, Alexander Peden, Richard Knight, James Ironside, and 
Mark Head National CJD Research & Surveillance Unit; The University of 
Edinburgh, Edinburgh, UK
Sporadic Creutzfeldt–Jakob disease (sCJD) is the most common human prion 
disease, affecting approximately 1–2 persons per one million of the population 
per year. It is thought to arise as a result of spontaneous conversion of PrPC 
to PrPSc, which becomes self-propagating. The prion protein polymorphism at 
codon 129 encodes either methionine (M) or valine (V). Comparison of the codon 
129 genotype distribution in sCJD cohorts with that of the normal Caucasian 
population suggests that heterozygosity (MV) protects against sCJD and the 
comparison has also been widely interpreted to mean that methionine homozygosity 
predisposes to CJD.
We have used real-time quaking induced conversion (RT-QuIC) to model the 
S30 Prion 2015 Poster Abstracts spontaneous formation of the abnormal form of 
human PrP and to determine whether methionine or valine at the position 129 of 
PrPC confers a greater susceptibility to spontaneous conversion to PrP 
amyloid.
Unseeded RT-QuIC reactions using fulllength recombinant human prion protein 
with either methionine or valine at position 129 both resulted in spontaneous 
amyloid formation. The process appeared to have a pronounced stochastic element, 
but when a sufficient number of replicates were performed a clear and 
reproducible effect of codon 129 genotype was also evident, in which PrPC with 
valine at codon 129 showed a greater predisposition to form amyloid than its 
allelic counterpart containing methionine.
***These results question whether methionine at position 129 in PrPC can be 
considered an intrinsic susceptibility factor for conversion to PrPSc, at least 
in terms of the initiation of spontaneous, as opposed to seeded PrP amyloid 
formation.
========== 
P.69: Distinct pathological phenotypes of Creutzfeldt-Jakob disease in 
recipients of prion-contaminated growth hormone
Ignazio Cali1,2, Cathleen Miller3, Tetsuyuky Kitamoto4, Joseph Parisi5, 
Michael Geschwind6, Pierluigi Gambetti1, and Lawrence Schonberger7 1National 
Prion Disease Pathology Surveillance Center (NPDPSC); Department of Pathology; 
Case Western Reserve University; School of Medicine; Cleveland, OH USA; 
2Department of Clinical and Experimental Medicine; Second University of Naples; 
Naples, Italy; 3Kaiser Permanente Vancouver Medical Center; Vancouver, WA USA; 
4Graduate School of Medicine; Tohoku University; Sendai, Japan; 5Departments of 
Laboratory Medicine & Pathology and Neurology; Mayo Clinic; Rochester, MN 
USA; 6Department of Neurology; Memory and Aging Center; University of 
California; San Francisco, CA USA; 7National Center for Emerging and Zoonotic 
Infectious Diseases; Centers for Disease Control and Prevention; Atlanta, GA 
USA
The peripheral administration of growth hormone (GH) from 
prion-contaminated cadaveric pituitary glands is believed to be causative of 
iatrogenic Creutzfeldt-Jakob disease (iCJD) in more than 225 subjects worldwide. 
The present study describes the neuropathology and molecular features of 3 of 
the 30 identified iCJD cases among the approximately 7,700 recipients of 
cadaveric pituitary hormone in the US National Hormone and Pituitary Program 
(NHPP). All three cases were methionine (M) homozygous at codon 129 of the prion 
protein (PrP) gene (GH-CJDMM) and all received NHPP hormone produced before 1977 
when a new hormone purification protocol was introduced that reduced the risk of 
prion contamination. Neuropathological examination revealed divergent 
phenotypes. The first phenotype, observed in the most recent US NHPP GH-CJD 
case, was characterized by the presence of amyloid plaques and reminiscent of 
sCJDMV2-K and, to some extent, variant CJD (vCJD). The second phenotype showed 
no plaques and shared several, but not all, characteristics with the sCJDMM(MV)1 
subtype. However, PKresistant PrPSc (resPrPSc) from GH-CJDMM co-migrated with 
resPrPSc type 1 (GHCJDMM1) of sCJDMM1, but not with type 2 of sCJDMV2-K. 
Histopathological phenotypes with or without plaques also have been described in 
2 groups of Japanese dura mater (d) graft-associated CJD (dCJD) with the same 
129MM genotype but apparently different gel mobility of resPrPSc type 1. ***Our 
study suggests that phenotypic diversity in these iatrogenic diseases reflects 
adaptation of different exogenous prion strains to the 129MM host and/or to 
different locations of the initial PrPC to PrPSc conversion.
===========
P.75: Development of pre-mortem diagnosis for suspected Creutzfeldt- Jakob 
diseases’ patients
SuYeon Kim, JaeWook Hyeon, YeongRan Ju, JiYeon Lee, WonCheol Lee, and 
YeongSeon Lee Korea NIH (KCDC); Cheonju, Chungcheongbukdo, Republic of 
Korea
Creutzfeldt-Jakob disease (CJD) is the most representative human prion 
disease caused by abnormal accumulation of misfolding prion protein. The 
diagnosis is performed with features of magnetic resonance imaging, 
electroencephalogram and elevated the 14-3-3 protein findings, prion protein 
gene polymorphisms. In laboratory, the protein detection and analysis of the 
gene polymorphisms have been monitored, and then clinicians determined as CJD 
patient or not CJD case combining specific clinical opinions in Korea. We aimed 
evaluate the epidemiological tendency, and the possibility of early diagnosis 
through the application of clinical features included the protein tests and 
genetic analysis. We detected 14-3-3 protein, and analyzed PRNP genotypes for 
suspected cases (2010–2014). The results were combined with progressive 
dementia, myoclonus, and memory decline, and their relationships were analyzed. 
They were almost within the age range of 60–80 years, and the numbers of male 
and female were similar. Approximately 49% showed positive for 14-3-3 protein, 
and the polymorphisms reported to genetic pathogenic factor inherited CJD showed 
in 11 patients. Three definite and 14 possible sCJD patients defined except for 
one were positive for 14-3-3, and several probable sporadic cases had pathogenic 
genetic factors like P102L, E200K and V180I. The clinical presentations showed 
progressive dementia, visual illusion, myoclonus, ataxia, akinetic mutism, and 
memory decline. Some MRI and EEG findings showed high signal abnormalities in 
the fronto-temporal cortex and typical periodic sharp wave complexes. We 
consider that the active following surveillance for patients would be added to 
improve the specificity of early CJD diagnosis.
===============
==============
P.13: Detection of sCJD prions in human saliva by RT-QuIC
Matteo Manca1, Gianluigi Zanusso2, and Byron Caughey1 1Laboratory of 
Persistent Viral Diseases; Rocky Mountain Laboratories (RML); National Institute 
of Allergy and Infectious Disease (NIAID); National Institutes of Health (NIH); 
Hamilton, MT USA; 2Department of Neurological and Movement Sciences; University 
of Verona; Verona, Verona, Italy
Sporadic Creutzfeldt-Jakob Disease (sCJD) is the most common form of human 
prion disease. A recent study showed that prion seeding activity is 
RT-QuIC-detectable in the olfactory neuroepithelium of sCJD patients. Relatively 
rapid turnover of the olfactory neuroepithelium and nasal mucus clearance 
systems might lead to the transportation of prion seeds into the oral cavity and 
shedding through saliva. Pooled human saliva was spiked with sCJD prions and 
subjected to different treatments to investigate the suitability of such a 
sample as a new and non-invasive diagnostic specimen. Our findings highlighted 
the presence of yet unidentified factor( s) that could lead to spontaneous 
conversion in the RT-QuIC assay. We will show our ongoing results on the attempt 
to identify the factor (s) and eliminate it/them.
=================
P.85: Improving Creutzfeldt-Jakob disease incidence estimates by 
incorporating results of neuropathological analyses, United States, 
2003–2011
Ryan Maddox1, Marissa Person1, Arialdi Minino2, Janis Blevins3, Lawrence 
Schonberger1, and Ermias Belay1 1National Center for Emerging and Zoonotic 
Infectious Diseases; Centers for Disease Control and Prevention, Atlanta GA USA; 
2National Center for Health Statistics; Centers for Disease Control and 
Prevention; Hyattsville, MD USA; 3National Prion Disease Pathology Surveillance 
Center; Case Western Reserve University; Cleveland, OH USA
Introduction. The incidence of invariably fatal prion diseases such as 
Creutzfeldt-Jakob disease (CJD) can be estimated by analyzing death certificate 
data, but there are limitations.
Methods. Prion disease decedents were identified from the US national 
multiple cause-ofdeath data and the National Prion Disease Pathology 
Surveillance Center (NPDPSC) database for 2003–2011. Due to limited personal 
identifying information, an algorithm was constructed to determine likely 
decedent matches between the 2 databases. NPDPSC decedents with a positive prion 
disease autopsy or biopsy result or genetic mutation for whom no match was found 
in the multiple cause-of-death data were added as cases for incidence 
calculations; those with negative neuropathology results but
Prion 2015 Poster Abstracts S55
with a death certificate indicating prion disease were removed. The 
resulting average annual age-adjusted incidence was then calculated. Results. A 
total of 2986 decedents were identified as having prion disease indicated as a 
cause of death in the multiple cause-of-death data; 469 additional NPDPSC 
decedents were identified with positive neuropathology and/or genetic findings, 
while 140 decedents with death certificates indicating prion disease had 
negative neuropathology results. Incorporating the matched data, the average 
annual age adjusted incidence of CJD in the United States was 1.2 per 
million.
Conclusion. Analysis of multiple cause-ofdeath data is an efficient means 
of conducting CJD surveillance. However, not all decedents are captured as the 
death certificate may not list the diagnosis; conversely, a CJD diagnosis on the 
certificate may be contradicted by neuropathology results. Incorporating 
findings from NPDPSC neuropathological and genetic analyses produces an estimate 
closer to the true incidence of the disease. 
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. 
 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? 
 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 
 vCJD in the USA * BSE in U.S. 
 The Lancet Infectious Diseases, Volume 3, Issue 8, Page 463, August 2003 
doi:10.1016/S1473-3099(03)00715-1Cite or Link Using DOI 
 Tracking spongiform encephalopathies in North America 
 Original 
 Xavier Bosch 
 “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 ... 
 Suspect symptoms 
 What if you can catch old-fashioned CJD by eating meat from a sheep 
infected with scrapie? 
 28 Mar 01 Most doctors believe that sCJD is caused by a prion protein 
deforming by chance into a killer. But Singeltary thinks otherwise. He is one of 
a number of campaigners who say that some sCJD, like the variant CJD related to 
BSE, is caused by eating meat from infected animals. Their suspicions have 
focused on sheep carrying scrapie, a BSE-like disease that is widespread in 
flocks across Europe and North America. 
 Now scientists in France have stumbled across new evidence that adds 
weight to the campaigners' fears. To their complete surprise, the researchers 
found that one strain of scrapie causes the same brain damage in mice as sCJD. 
 "This means we cannot rule out that at least some sCJD may be caused by 
some strains of scrapie," says team member Jean-Philippe Deslys of the French 
Atomic Energy Commission's medical research laboratory in Fontenay-aux-Roses, 
south-west of Paris. Hans Kretschmar of the University of Göttingen, who 
coordinates CJD surveillance in Germany, is so concerned by the findings that he 
now wants to trawl back through past sCJD cases to see if any might have been 
caused by eating infected mutton or lamb... 
 Tuesday, December 16, 2014 
 Evidence for zoonotic potential of ovine scrapie prions 
 Scrapie from sheep could infect humans with 'mad cow disease', study finds 
 The Pathological Protein: 
 Mad Cow, Chronic Wasting, and Other Deadly Prion Diseases 
 Philip Yam 
 ''Answering critics like Terry Singeltary, who feels that the US 
undercounts CJD, Schonberger _conceded_ that the current surveillance system has 
errors but stated that most of the errors will be confined to the older 
population''....end 
 snip... 
 His combative, blunt, opinion- ated style sometimes borders on obsessive 
ranting that earns praise from some officials and researchers but infuriates 
others especially when he repeats his conviction that "the government has lied 
to us, the feed industry has lied to us all over a buck." As evidence, 
Singeltary cites the USDA's testing approach, which targets downer cows and 
examined 19,900 of them in 2002. To him, the USDA should test 1 mil- lion 
cattle, because the incidence of BSE may be as low as one in a mil- lion, as it 
was in some European countries. That the U.S. does not, he thinks, is a sign 
that the government is really not interested in finding mad cows because of 
fears of an economic disaster. 
 Singeltary got into the field of transmissible spongiform encepha- lopathy 
in 1997, just after his mother died of sporadic CJD. She had an especially 
aggressive version the Heidenhain variant that first causes the patient to go 
blind and then to deteriorate rapidly She died just ten weeks after her symptoms 
began. Singeltary, who said he had watched his grandparents die of cancer, 
considered her death by CJD to be much, much worse: "It's something you never 
forget." Her uncon- trollable muscle twitching became so bad "that it took three 
of us to hold her one time," Singeltary recalled. "She did everything but 
levitate in bed and spin her head." 
 14th ICID International Scientific Exchange Brochure - 
 Final Abstract Number: ISE.114 
 Session: International Scientific Exchange 
 Transmissible Spongiform encephalopathy (TSE) animal and human TSE in 
North America update October 2009 
 T. Singeltary 
 Bacliff, TX, USA 
 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. 
 re-Self-Propagative Replication of Ab Oligomers Suggests Potential 
Transmissibility in Alzheimer Disease 
 Received July 24, 2014; Accepted September 16, 2014; Published November 3, 
2014 
 Singeltary comment ; 
 RE: re-Human Prion Diseases in the United States 
 part 2 flounder replied to flounder on 02 Jan 2010 at 21:26 GMT 
 No competing interests declared. 
 No competing interests declared. 
 see full text ; 
 *** PLOS Singeltary reply ; 
 Molecular, Biochemical and Genetic Characteristics of BSE in Canada 
Singeltary reply ; 
 PLOS Singeltary reply ; 
ruminant feed ban for cervids in the United States ? 
 Singeltary T. S. 
31 Jan 2015 at 20:14 GMT 
 "Löcher wie in einem Schweizer Käse" hat auch Terry Singeltary im 
Regelwerk der FDA ausgemacht. Der Texaner kam auf einem tragischen Umweg zu dem 
Thema: Nachdem seine Mutter 1997 binnen weniger Wochen an der 
Creutzfeldt-Jakob-Krankheit gestorben war, versuchte er, die Ursachen der 
Infektion aufzuspĂĽren. Er klagte auf die Herausgabe von Regierungsdokumenten und 
arbeitete sich durch Fachliteratur; heute ist er ĂĽberzeugt, dass seine Mutter 
durch die stetige Einnahme von angeblich kräftigenden Mitteln erkrankte, in 
denen - völlig legal - Anteile aus Rinderprodukten enthalten sind. 
 Von der Fachwelt wurde Singeltary lange als versponnener AuĂźenseiter 
belächelt. Doch mittlerweile sorgen sich auch Experten, dass ausgerechnet diese 
verschreibungsfreien Wundercocktails zur Stärkung von Intelligenz, Immunsystem 
oder Libido von den Importbeschränkungen ausgenommen sind. Dabei enthalten die 
Pillen und Ampullen, die in Supermärkten verkauft werden, exotische Mixturen aus 
Rinderaugen; dazu Extrakte von Hypophyse oder Kälberföten, Prostata, Lymphknoten 
und gefriergetrocknetem Schweinemagen. In die USA hereingelassen werden auch 
Blut, Fett, Gelatine und Samen. Diese Stoffe tauchen noch immer in US-Produkten 
auf, inklusive Medizin und Kosmetika. Selbst in Impfstoffen waren möglicherweise 
gefährliche Rinderprodukte enthalten. Zwar fordert die FDA schon seit acht 
Jahren die US-Pharmaindustrie auf, keine Stoffe aus Ländern zu benutzen, in 
denen die Gefahr einer BSE-Infizierung besteht. Aber erst kĂĽrzlich 
verpflichteten sich fĂĽnf Unternehmen, darunter BranchenfĂĽhrer wie 
GlaxoSmithKline, Aventis und American Home Products, ihre Seren nur noch aus 
unverdächtigem Material herzustellen. 
 "Its as full of holes as Swiss Cheese" says Terry Singeltary of the FDA 
regulations. ... 
 New York Times Magazine The Case of the Cherry Hill Cluster By D.T. MAX 
 Published: March 28, 2004 
 snip... 
 Skarbek did not know how to surmount this objection. But she was a 
go-getter. She wasn't about to give up on her cluster so easily. Fortunately, 
she was in contact with Terry Singeltary. She had seen his name quoted often on 
the Web in articles on C.J.D. and mad cow. Singeltary lost his mother to an 
extremely rare strain of sporadic C.J.D. in 1997. Soon after, he learned that a 
year earlier to the day, the mother of his next-door neighbor died of the 
disease. Since that time, he has become convinced that these sporadic cases are 
not sporadic at all, that mad cow is now a disease of humans in America. He said 
he believes that his mother was accidentally infected during surgery and the 
mother of his neighbor from taking nutritional supplements made from high-risk 
bovine tissue, which he calls ''mad cow in a pill.'' 
 Singeltary has a sloping face and slicked-back hair. He is nearsighted, 
with small blue eyes. He looks like Lewis Carroll's White Rabbit. From his 
living room in Bacliff, Tex., he dominates the listservs and message boards of 
an online debate over sporadic C.J.D. -- the scientists who say it exists; the 
heartbroken family members who doubt it. Early, deep in his grief, he would sign 
his e-mail messages to scientists, ''I am the madson of a deadmom who died of 
madcow.'' Singeltary turned out to be helpful for Skarbek. He pointed her to a 
paper that was published in 2002 in the journal of the European Molecular 
Biology Organization by John Collinge, the premier prion researcher in England. 
Collinge argued that experiments conducted in mice suggest that infections with 
mad cow can sometimes look like sporadic C.J.D. Collinge accepted the 
implications: he recommended that ''serious consideration should be given'' to 
the idea that some of the more recent sporadic C.J.D. cases in Europe were in 
fact related to mad cow disease. 
 2014 
 ***Moreover, L-BSE has been transmitted more easily to transgenic mice 
overexpressing a human PrP [13,14] or to primates [15,16] than C-BSE. 
 ***It has been suggested that some sporadic CJD subtypes in humans may 
result from an exposure to the L-BSE agent. 
 *** Lending support to this hypothesis, pathological and biochemical 
similarities have been observed between L-BSE and an sCJD subtype (MV genotype 
at codon 129 of PRNP) [17], and between L-BSE infected non-human primate and 
another sCJD subtype (MM genotype) [15]. 
 snip... 
 BSE prions propagate as either variant CJD-like or sporadic CJD-like prion 
strains in transgenic mice expressing human prion protein 
 *** Surprisingly, however, BSE transmission to these transgenic mice, in 
addition to producing a vCJD-like phenotype, can also result in a distinct 
molecular phenotype that is indistinguishable from that of sporadic CJD with 
PrPSc type 2. 
 These data suggest that more than one BSEderived prion strain might infect 
humans; 
 ***it is therefore possible that some patients with a phenotype consistent 
with sporadic CJD may have a disease arising from BSE exposure. 
 snip... 
 These studies further strengthen the evidence that vCJD is caused by a 
BSE-like prion strain. 
 Also, remarkably, the key neuropathological hallmark of vCJD, the presence 
of abundant florid PrP plaques, can be recapitulated on BSE or vCJD transmission 
to these mice. 
 ***However, the most surprising aspect of the studies was the finding that 
an alternate pattern of disease can be induced in 129MM Tg35 mice from primary 
transmission of BSE, with a molecular phenotype indistinguishable from that of a 
subtype of sporadic CJD. This finding has important potential implications as it 
raises the possibility that some humans infected with BSE prions may develop a 
clinical disease indistinguishable from classical CJD associated with type 2 
PrPSc. This is, in our experience, the commonest molecular sub-type of sporadic 
CJD. In this regard, it is of interest that the reported incidence of sporadic 
CJD has risen in the UK since the 1970s (Cousens et al., 1997)... 
 To date the OIE/WAHO assumes that the human and animal health standards 
set out in the BSE chapter for classical BSE (C-Type) applies to all forms of 
BSE which include the H-type and L-type atypical forms. This assumption is 
scientifically not completely justified and accumulating evidence suggests that 
this may in fact not be the case. Molecular characterization and the spatial 
distribution pattern of histopathologic lesions and immunohistochemistry (IHC) 
signals are used to identify and characterize atypical BSE. Both the L-type and 
H-type atypical cases display significant differences in the conformation and 
spatial accumulation of the disease associated prion protein (PrPSc) in brains 
of afflicted cattle. Transmission studies in bovine transgenic and wild type 
mouse models support that the atypical BSE types might be unique strains because 
they have different incubation times and lesion profiles when compared to C-type 
BSE. When L-type BSE was inoculated into ovine transgenic mice and Syrian 
hamster the resulting molecular fingerprint had changed, either in the first or 
a subsequent passage, from L-type into C-type BSE. 
 ***In addition, non-human primates are specifically susceptible for 
atypical BSE as demonstrated by an approximately 50% shortened incubation time 
for L-type BSE as compared to C-type. Considering the current scientific 
information available, it cannot be assumed that these different BSE types pose 
the same human health risks as C-type BSE or that these risks are mitigated by 
the same protective measures. 
 -------- Original Message -------- 
 Subject: re-BSE prions propagate as either variant CJD-like or sporadic 
CJD 
 Date: Thu, 28 Nov 2002 10:23:43 -0000 
 From: "Asante, Emmanuel A" e.asante@ic.ac.uk 
 To: "'flounder@wt.net'" flounder@wt.net 
 Dear Terry, 
 I have been asked by Professor Collinge to respond to your request. I am a 
Senior Scientist in the MRC Prion Unit and the lead author on the paper. I have 
attached a pdf copy of the paper for your attention. 
 Thank you for your interest in the paper. 
 In respect of your first question, the simple answer is, ***yes. As you 
will find in the paper, we have managed to associate the alternate phenotype to 
type 2 PrPSc, the commonest sporadic CJD. It is too early to be able to claim 
any further sub-classification in respect of Heidenhain variant CJD or Vicky 
Rimmer's version. It will take further studies, which are on-going, to establish 
if there are sub-types to our initial finding which we are now reporting. The 
main point of the paper is that, as well as leading to the expected new variant 
CJD phenotype, BSE transmission to the 129-methionine genotype can lead to an 
alternate phenotype which is indistinguishable from type 2 PrPSc. 
 I hope reading the paper will enlighten you more on the subject. If I can 
be of any further assistance please to not hesitate to ask. Best wishes. 
 Emmanuel Asante 
 <> 
 ____________________________________ 
 Dr. Emmanuel A Asante MRC Prion Unit & Neurogenetics Dept. Imperial 
College School of Medicine (St. Mary's) Norfolk Place, LONDON W2 1PG Tel: +44 
(0)20 7594 3794 Fax: +44 (0)20 7706 3272 email: e.asante@ic.ac.uk (until 
9/12/02) New e-mail: e.asante@prion.ucl.ac.uk (active from now) 
 ____________________________________ END 
 Aug. 5, 2001, 12:25AM 
 Mad cow disease: Could it be here? 
 Man's stubborn crusade attracts experts' notice 
 By CAROL CHRISTIAN Copyright 2001 Houston Chronicle 
 Like Paul Revere with e-mail, Terry Singeltary Sr. is on a mission to 
sound an alarm: Beware of mad cow disease. 
 As is true of many crusaders, however, his pleas often fall on deaf ears. 
Health officials here and abroad insist that bovine spongiform encephalopathy -- 
popularly known as mad cow disease, a fatal brain disorder that can make cows 
shake uncontrollably -- has been kept out of this country through surveillance 
of the cattle industry. 
 But since his mother's death in December 1997, the Galveston County man 
has been obsessed with possible connections between her deadly brain disorder, 
sporadic Creutzfeldt-Jakob Disease, and mad cow disease. 
 And after much persistence on his part, people are taking notice of this 
former machinist and high school dropout who jokes that he has a Ph.D. -- a Pool 
Hall Degree. 
 "They called me Chicken Little for four years," he said. "Now they're 
calling back, asking for more information." 
 For the past year he has been U.S. co-coordinator of an international 
monitoring group called CJD Watch. He regularly gets e-mail from scientists and 
journalists around the world. 
 Debora MacKenzie, a reporter for the British magazine New Scientist, 
described Singeltary, 47, as a "dogged unearther and tabulator of government 
documents." Singeltary monitors "every word written about CJD/BSE," said Anita 
Manning of USA Today, also by e-mail. 
 "He's passionate, opinionated and not always tactful, although I like him 
because he's such a character and he is so transparent," Manning said. "He is 
what he appears to be." 
 Science and environment writer Jonathan Leake of the Sunday Times in 
London said Singeltary has helped him track down families of people with CJD 
along with academic research papers. 
 "I strongly suspect he is right in thinking the USA has had BSE cases," 
Leake said by e-mail. 
 "The American government is making the same mistake as the British in 
putting the short-term commercial interests of its farmers before health 
considerations," he added. 
 "It should start formal and widespread testing of cattle plus compulsory 
autopsies for all human CJD victims at the state's expense. If there is BSE, 
then leaving it to spread will kill people -- and that would eventually destroy 
the industry, too." 
 Texas Department of Health epidemiologist Julie Rawlings said Singeltary's 
careful monitoring of the disease had proven useful. 
 "Terry has been helpful in providing contact information regarding suspect 
CJD cases so that the Health Department can initiate case investigations and 
learn more about CJD in Texas," she said. 
 Noting that the department cannot release records on individual patients, 
she added, "I think we learn more from him than he does from us." 
 Mad cow disease surfaced in England in 1986 and quickly became an 
epidemic. It since has been reported in 15 European countries, most recently 
Greece on July 2, and the Czech Republic on June 14. Two German-born cows tested 
positive for BSE in November. 
 Singeltary said he became convinced that BSE is here as he watched his 
mother, Barbara Poulter of Crystal Beach, dying of sporadic Creutzfeldt-Jakob 
Disease. The rare, fatal brain disease is sometimes accompanied by severe 
jerking. 
 "She would jerk so bad at times, it would take three of us to hold her 
down," Singeltary said. "They can call it whatever they want, but I know what I 
saw, and what she went through. `Sporadic' simply means they don't know." 
 Poulter, a retired telephone-company field worker, had a form of sporadic 
CJD -- Haidenhain variant -- that is even less common than the typical sporadic 
case. One of its first symptoms is loss of vision. 
 She started seeing brown spots in September 1997 and was virtually blind 
within two weeks. By the eighth week of the illness Poulter was bedridden, and 
in the 10th week she died. Before that she had been in good health. 
 In many countries and most U.S. states, physicians are not required to 
report CJD cases to health officials. Texas made the disease reportable in 1998. 
Through 2000, there were 17 probable or confirmed cases, according to the Texas 
Department of Health. 
 In mid-June, a case of sporadic CJD was confirmed through brain biopsy at 
Christus Spohn Hospital Shoreline in Corpus Christi, said Jane Bakos, hospital 
vice president. The patient has since died, the hospital reported. 
 CJD and mad cow disease leave their victims' brains full of holes like a 
sponge. 
 Although not contagious, the illnesses are thought to be transmissible 
through prions, or nearly indestructible abnormal proteins. 
 Because the prion protein is not killed by standard sterilization, 
sporadic CJD can be spread by contaminated surgical instruments. 
 In March 1996, the British government announced the discovery of a new 
variant of CJD, most likely explained by exposure to bovine spongiform 
encephalopathy. 
 Through June, 101 cases of new-variant CJD have been reported in the 
United Kingdom, three in France and one in Ireland. In contrast to sporadic CJD, 
the new variant usually affects younger patients and lasts longer. 
 No cases of new-variant CJD or BSE have been reported in the United 
States. No relationship has been shown between sporadic CJD and mad cow disease. 
 There is no indication that new-variant CJD can be spread through blood 
transfusions, but a U.S. Food and Drug Administration advisory committee voted 
in June to broaden the categories for excluding potential donors. The 
recommendations have not yet been approved by the FDA. 
 The American Red Cross has announced that on Sept. 17 it will begin 
rejecting potential blood donors who, since 1980, have spent at least three 
months in the United Kingdom or at least six months in any European country or 
combination of countries. Those who have received a blood transfusion in Britain 
since 1980 also will be rejected. 
 The primary collector of local blood donations is the Gulf Coast Regional 
Blood Center, which will follow the FDA's guidelines, said Bill Teague, 
president and chief executive officer. 
 Singeltary said it's naive to think that U.S. prevention efforts have kept 
mad cow and new-variant CJD out of the United States. 
 "They haven't found it," he said, "because they haven't looked." 
 For one thing, he said, too few cows are tested for the disease. In the 
first six months of this year, the European Union tested more than 3.2 million 
cows, David Byrne of the European Commission said in a speech last month. 
 By contrast, it took the U.S. Department of Agriculture nearly 10 years to 
analyze about 13,000 cow brains, according to the department's Web site. 
 With more than 68 million cattle slaughtered since 1990 in the United 
States, according to the USDA, checking about 13,000 falls far short, Singeltary 
said. 
 Though not a scholar, Singeltary has collected voluminous material on mad 
cow and CJD. Disabled from a neck injury, Singeltary never used a computer until 
1998. 
 He now spends hours each day on the Internet while his wife, Bonnie 
Singeltary, runs a flower shop in their home in Bacliff, in north Galveston 
County. 
 His challenge to the CJD/BSE establishment is courageous and refreshing, 
said Dr. Lynette Dumble, former visiting professor of surgery at University of 
Texas Medical School at Houston and a former senior research fellow in the 
history and philosophy of science at the University of Melbourne in Australia. 
 "I certainly have no problem with Terry's ideas on BSE/CJD," said Dumble, 
who coordinates the Global Sisterhood Network, a computer service that posts 
media reports on developments affecting women. "His research skills are 
excellent, and he is abreast of each and every development in the field." 
 Among Singeltary's worries now, he said, are widespread violations of an 
August 1997 ban on feeding animal products to U.S. cattle. The FDA reported in 
January that hundreds of feed manufacturers were not complying with regulations 
designed to keep BSE out of this country. 
 (That same month, a Purina Mills feedlot near San Antonio told the FDA 
that a "very low level" of cow parts had been found in cattle feed. The company 
voluntarily removed 1,222 animals who had been fed the prohibited materials.) 
 He obtained copies of FDA letters to various feed mills that had been 
found in violation of the regulations and immediately sent them by e-mail to 
hundreds of people around the world. 
 Singeltary might not be so zealous in getting the word out if he weren't 
convinced that someone is covering up the truth. 
 "They used to say BSE would never transmit to humans," he said, "and it 
has. They lied about the feed ban being in place. 
 "I've lost faith in the whole process. I've discovered too many things." 
 Tuesday, March 16, 2010 
 COMMONWEALTH OF AUSTRALIA Hansard Import restrictions on beef FRIDAY, 5 
FEBRUARY 2010 AUSTRALIA 
 COMMONWEALTH OF AUSTRALIA 
 Proof Committee Hansard 
 RRA&T 2 Senate Friday, 5 February 2010 
 RURAL AND REGIONAL AFFAIRS AND TRANSPORT 
 [9.03 am] 
 BELLINGER, Mr Brad, Chairman, Australian Beef Association CARTER, Mr John 
Edward, Director, Australian Beef Association CHAIR—Welcome. Would you like to 
make an opening statement? Mr Bellinger—Thank you. The ABA stands by its 
submission, which we made on 14 December last year, that the decision made by 
the government to allow the importation of beef from BSE affected countries is 
politically based, not science based. During this hearing we will bring forward 
compelling new evidence to back up this statement. When I returned to my 
property after the December hearing I received a note from an American citizen. 
I will read a small excerpt from the mail he sent me in order to reinforce the 
dangers of allowing the importation of beef from BSE affected countries. I have 
done a number of press releases on this topic, and this fellow has obviously 
picked my details up from the internet. His name is Terry Singeltary and he is 
from Bacliff, Texas. He states, and rightfully so: You should be worried. Please 
let me explain. I’ve kept up with the mad cow saga for 12 years today, on 
December 14th 1997, some four months post voluntary and partial mad cow feed ban 
in the USA, I lost my mother to the Heinemann variant Creutzfeldt-Jakob disease 
(CJD). I know this is just another phenotype of the infamous sporadic CJDs. Here 
in the USA, when USA sheep scrapie was transmitted to USA bovine, the agent was 
not UK BSE—it was a different strain. So why then would human TSE from USA 
cattle look like UK CJD from UK BSE? It would not. So this accentuates that the 
science is inconclusive still on this devastating disease. He goes on to state: 
 snip...see full text 110 pages ; 
 for those interested, please see much more here ; 
 This document provides itemized replies to the public comments received on 
the 2005 updated Harvard BSE risk assessment. Please bear the following points 
in mind: 
 Owens, Julie From: Terry S. Singeltary Sr. [flounder9@verizon.net] 
 Sent: Monday, July 24, 2006 1:09 PM To: FSIS RegulationsComments 
 Subject: [Docket No. FSIS-2006-0011] FSIS Harvard Risk Assessment of 
Bovine Spongiform Encephalopathy (BSE) Page 1 of 98 8/3/2006 
 Greetings FSIS, I would kindly like to comment on the following ; 
 Nature | Editorial 
 Needless conflict Nature 485, 279–280 (17 May 2012) doi:10.1038/485279b 
Published online 16 May 2012 
 Tuesday, December 2, 2014 
 UK EXPORTS OF MBM TO WORLD Bovine Spongiform Encephalopathy BSE TSE Prion 
aka Mad Cow Disease 
 USA, NORTH AMERICA, MBM (or any potential TSE prion disease) EXPORTS TO 
THE WORLD (?) [protected by the BSE MRR policy] $$$ 
 *** Qualitative Analysis of BSE Risk Factors in the United States 
 February 13, 2000 at 3:37 pm PST (BSE red book) 
 Tuesday, July 14, 2009 U.S. 
 *** Emergency Bovine Spongiform Encephalopathy Response Plan Summary and 
BSE Red Book 
 Date: February 14, 2000 at 8:56 am PST 
 WHERE did we go wrong $$$ 
 Friday, November 22, 2013 
 Wasting disease is threat to the entire UK deer population CWD TSE PRION 
disease in cervids 
 ***SINGELTARY SUBMISSION 
 The Scottish Parliament’s Rural Affairs, Climate Change and Environment 
Committee has been looking into deer management, as you can see from the 
following press release, 
 ***and your email has been forwarded to the committee for information: 
 Sunday, July 21, 2013 
 Welsh Government and Food Standards Agency Wales Joint Public Consultation 
on the Proposed Transmissible Spongiform Encephalopathies (Wales) Regulations 
2013 
 *** Singeltary Submission WG18417 
 *** The potential impact of prion diseases on human health was greatly 
magnified by the recognition that interspecies transfer of BSE to humans by beef 
ingestion resulted in vCJD. While changes in animal feed constituents and 
slaughter practices appear to have curtailed vCJD, there is concern that CWD of 
free-ranging deer and elk in the U.S. might also cross the species barrier. 
Thus, consuming venison could be a source of human prion disease. Whether BSE 
and CWD represent interspecies scrapie transfer or are newly arisen prion 
diseases is unknown. Therefore, the possibility of transmission of prion disease 
through other food animals cannot be ruled out. There is evidence that vCJD can 
be transmitted through blood transfusion. There is likely a pool of unknown size 
of asymptomatic individuals infected with vCJD, and there may be asymptomatic 
individuals infected with the CWD equivalent. These circumstances represent a 
potential threat to blood, blood products, and plasma supplies. 
 Subject: OIE cuts six European countries' mad cow risk level, while 
increasing risk factors for humans to the BSE TSE PRION DISEASE around the 
globe
Published May 27, 2015, 03:42 PM 
OIE cuts six European countries' mad cow risk level 
The World Organization for Animal Health said on Wednesday it had lowered 
to the safest level the official risk of six countries for mad cow disease, a 
move expected to open international market access for their beef exports. By: 
Reuters , 
PARIS -- The World Organization for Animal Health said on Wednesday it had 
lowered to the safest level the official risk of six countries for mad cow 
disease, a move expected to open international market access for their beef 
exports.
These countries are France, Ireland, Switzerland, the Czech Republic, 
Cyprus and the Lichtenstein.
OIE members in Paris eased their status on bovine spongiform encephalopathy 
(BSE), commonly known as mad cow disease, to "negligible risk" from "controlled 
risk".
One of the OIE criteria to be categorized as a negligible BSE risk country 
is to demonstrate that the last infected native animal was born more than 11 
years ago, it said.
"The main advantage will be at international trade level because many 
countries insist on limiting trade exchange to countries that have the same risk 
status," Karin Schwabenbauer, head the OIE Council and World Assembly, told 
reporters.
France welcomed the decision, noting that the BSE epidemic that spread from 
Britain to mainland Europe in the 1980s because of contaminated meal had 
prompted consumer distrust and trade restrictions.
"I appeal to countries that still have an embargo on exports of this sector 
to lift it very quickly," French Agriculture Minister Stephane Le Foll said in a 
statement.
Thirteen countries ban French beef and beef products because of BSE - 
Brazil, China, Argentina, Saudi Arabia, Taiwan, South Africa, Botswana, Mali, 
Uganda, South Korea, Iraq, Syria and Qatar - a Farm Ministry spokesman said. 
Japan, Vietnam and Singapore ban meat from cattle older than 30 months.
Ireland earlier this year signed export deals with China and the United 
States, making it the only European country to be allowed to export beef to both 
countries. 
Tags: mad cow, livestock, agribusiness, updates, cattle - See more at: http://www.agweek.com/event/article/id/26479/#sthash.2opRk32H.dpuf
 it’s all about trade now, nothing else matters $$$ 
>>>PARIS -- The World Organization for Animal Health said on 
Wednesday it had lowered to the safest level the official risk of six countries 
for mad cow disease, a move expected to open international market access for 
their beef exports. These countries are France, Ireland, Switzerland, the Czech 
Republic, Cyprus and the Lichtenstein.<<<
THIS move is _not_ based on science, but on corporate profits and big ag. 
to say now that France is a "negligible risk", would be like saying North 
America is a "negligible risk", which is preposterous. not based on sound 
science, but on greed and special interest. the only _move_ this ‘’BSE mad cow 
negligible risk’’ assessment makes, is a move to increase global Transmissible 
Spongiform Encephalopathy prion mad cow type disease, via the legal trading of 
the TSE prion aka mad cow type disease via the BSE MRR i.e. Minimal Risk Region 
policy, a policy set up to fail from the start. please, for whatever God you 
pray to sake, please be warned.
‘’AS i said before, OIE should hang up there jock strap now, since it 
appears they will buckle every time a country makes some political hay about 
trade protocol, commodities and futures. IF they are not going to be science 
based, they should do everyone a favor and dissolve there organization.’’ 
IN A NUT SHELL ; 
(Adopted by the International Committee of the OIE on 23 May 2006) 
11. Information published by the OIE is derived from appropriate 
declarations made by the official Veterinary Services of Member Countries. The 
OIE is not responsible for inaccurate publication of country disease status 
based on inaccurate information or changes in epidemiological status or other 
significant events that were not promptly reported to the Central Bureau, 
Wednesday, March 11, 2015 
OIE and Centers for Disease Control and Prevention Reinforce Collaboration 
Friday, April 4, 2014 
China, Australia, Argentina, Brazil, Uruguay, Morocco, Israel, South Africa 
and Saudi Arabia still retain BSE-related closures 
Thursday, May 30, 2013 
World Organization for Animal Health (OIE) has upgraded the United States' 
risk classification for mad cow disease to "negligible" from "controlled", and 
risk further exposing the globe to the TSE prion mad cow type disease 
U.S. gets top mad-cow rating from international group and risk further 
exposing the globe to the TSE prion mad cow type disease 
The OIE is nothing more than a trading brokerage for the Transmissible 
Spongiform Encephalopathy TSE prion disease aka mad cow type disease. Frances is 
still in the midst of a mad cow disease outbreak with atypical BSE cases still 
growing. mad cow disease is so bad in France, as with the USA, they stopped 
testing for mad cow disease (France altogether and the USA to figures so low, 
you would only detect a case of mad cow disease, only by chance). 
from the inside looking out ; 
Quote: Maybe familirise yourself with the OIE. The primary concern is 
animal health of the world they are the animal version of the WHO. It is a long 
way down from that ivory tower but here we go, until pressured by the USA 
repesentatives a country could not export animals for 6 years after finding a 
BSE/BASE positive animal so under the old rules the US would not be able to 
export anywhere in the world for another 4 1/2 years. Who got the risk levels 
system put in to allow some trade - your US representatives. You guys want to 
change rules - OK , but you do not get special rules that only apply to the US. 
As i have told you before Sand h I market all my own slaughter animals and you 
know that, so don't do the whole holier than thow act. 
With all due respect, it is obvious that you know little about the OIE and 
how it actually works. Having been to their offices in Paris and talked 
personally with the Head of the Animal Test Section, you would choke if you knew 
how many lobby groups attend that office daily. There is a steady stream of paid 
lobby groups that have one goal in life and that is to sway the Section Heads of 
each department within the OIE to suit the needs of different juristictions 
around the world, which curiously enough, also includes the USA and Canada. 
Anyone can go there and chat with them - providing they can privide valid cause 
to be let in. To say that the only goal of the OIE is animal health is actually 
only part of their function. They are more than that and my discussions with Dr. 
Diaz there has showed me that. But to blindly make a statement regarding what 
they do when you have no idea what they actually do is like eating the skin of 
the orange and not knowing what is actually under. 
Interstingly you state that the US Government applied pressure (to the OIE) 
I assume and that is a great example of the lobby groups doing their job. So, at 
the end of the day, one can safely assume that it is the pressure applied by 
certain influential lobby groups that will determine a likely aoutcome to an 
apparent OIE directive. Man alive, isn't it great to live in a democracy wherein 
the people get to make the choices and not just some "other" interested party or 
group - say like........Cargyll or Tyson for example? 
So, one last question, question? 
Who wags the tail of that dog?? And for what reason other than one that is 
purely associated with trade and international agreements and greed? 
And you think it is so simply explainable. 
end...tss 
please see ; 
spontaneous atypical BSE ??? 
don’t let anyone fool you. spontaneous TSE prion disease is a hoax in 
natural cases, never proven. 
all one has to do is look at France. France is having one hell of an 
epidemic of atypical BSE, probably why they stopped testing for BSE, problem 
solved $$$ same as the USA, that’s why they stopped testing for BSE mad cow 
disease in numbers they could find any with, after those atypical BSE cases 
started showing up. shut down the testing to numbers set up by OIE that are so 
low, you could only by accident find a case of BSE aka mad cow disease. and this 
brilliant idea by the WHO et al, to change the name of mad cow disease, thinking 
that might change things is preposterous. it’s all about money now folks, when 
the OIE, USDA and everyone else went along and made the TSE prion disease aka 
mad cow type disease a legal trading commodity by the BSE MRR policy, I would 
say everyone bit off more then they can chew, and they will just have to digest 
those TSE Prions coming from North America, and like it, and just prey you don’t 
get a mad cow type disease i.e. Transmissible Spongiform Encephalopathy TSE 
prion disease in the decades to come, and or pass it to some other poor soul via 
the iatrogenic medical surgical tissue friendly fire mode of transmission i.e. 
second hand transmission. it’s real folks, just not documented much, due to lack 
of trace back efforts. all iatrogenic cjd is, is sporadic cjd, until the 
iatrogenic event is tracked down and documented, and put into the academic and 
public domain, which very seldom happens. ...
As of December 2011, around 60 atypical BSE cases have currently been 
reported in 13 countries, *** with over one third in France. 
FRANCE STOPS TESTING FOR MAD COW DISEASE BSE, and here’s why, to many 
spontaneous events of mad cow disease $$$ 
so 20 cases of atypical BSE in France, compared to the remaining 40 cases 
in the remaining 12 Countries, divided by the remaining 12 Countries, about 3+ 
cases per country, besides Frances 20 cases. you cannot explain this away with 
any spontaneous BSe. ...TSS 
Sunday, October 5, 2014 
France stops BSE testing for Mad Cow Disease 
*** Singeltary reply ; Molecular, Biochemical and Genetic Characteristics 
of BSE in Canada Singeltary reply ; 
Saturday, May 09, 2015 
Expression of genes involved in the T cell signalling pathway in 
circulating immune cells of cattle 24 months following oral challenge with 
Bovine Amyloidotic Spongiform Encephalopathy (BASE) 
(c) The commonest form of CJD occurs as a sporadic disease, the cause of 
which is unknown, although genetic factors (particularly the codon 129 
polymorphism in the prion protein gene (PRNP)) influence disease susceptibility. 
The familial forms of human TSEs (see Box 1) appear to have a solely genetic 
origin and are closely associated with mutations or insertions in the PRNP gene. 
Most, but not all, of the familial forms of human TSEs have been transmitted 
experimentally to animals. There are no known familial or genetic TSEs of 
animals, although polymorphisms in the PRNP gene of some species (sheep for 
example) may influence the length of the incubation period and occurrence of 
disease. (
31 Jan 2015 at 20:14 GMT 
*** Ruminant feed ban for cervids in the United States? ***
31 Jan 2015 at 20:14 GMT 
Wednesday, May 27, 2015 
*** BSE Case Associated with Prion Protein Gene Mutation ***
Saturday, May 09, 2015 
Expression of genes involved in the T cell signalling pathway in 
circulating immune cells of cattle 24 months following oral challenge with 
Bovine Amyloidotic Spongiform Encephalopathy (BASE) 
Tuesday, May 19, 2015 
COUNTRY OF ORIGIN LABELING COOL H.R. 2393 Agriculture Chairman K. Michael 
Conaway (R-TX) Fears of US imports infected with mad cow disease is emerging as 
an issue in trans-Pacific trade talks 
Tuesday, December 16, 2014 
Evidence for zoonotic potential of ovine scrapie prions 
Hervé Cassard,1, n1 Juan-Maria Torres,2, n1 Caroline Lacroux,1, Jean-Yves 
Douet,1, Sylvie L. Benestad,3, Frédéric Lantier,4, Séverine Lugan,1, Isabelle 
Lantier,4, Pierrette Costes,1, Naima Aron,1, Fabienne Reine,5, Laetitia 
Herzog,5, Juan-Carlos Espinosa,2, Vincent Beringue5, & Olivier 
Andréoletti1, Affiliations Contributions Corresponding author Journal name: 
Nature Communications Volume: 5, Article number: 5821 DOI: 
doi:10.1038/ncomms6821 Received 07 August 2014 Accepted 10 November 2014 
Published 16 December 2014 Article tools Citation Reprints Rights & 
permissions Article metrics 
Abstract 
Although Bovine Spongiform Encephalopathy (BSE) is the cause of variant 
Creutzfeldt Jakob disease (vCJD) in humans, the zoonotic potential of scrapie 
prions remains unknown. Mice genetically engineered to overexpress the human 
prion protein (tgHu) have emerged as highly relevant models for gauging the 
capacity of prions to transmit to humans. These models can propagate human 
prions without any apparent transmission barrier and have been used used to 
confirm the zoonotic ability of BSE. Here we show that a panel of sheep scrapie 
prions transmit to several tgHu mice models with an efficiency comparable to 
that of cattle BSE. The serial transmission of different scrapie isolates in 
these mice led to the propagation of prions that are phenotypically identical to 
those causing sporadic CJD (sCJD) in humans. These results demonstrate that 
scrapie prions have a zoonotic potential and raise new questions about the 
possible link between animal and human prions. 
Subject terms: Biological sciences• Medical research At a glance 
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 
Suspect symptoms 
What if you can catch old-fashioned CJD by eating meat from a sheep 
infected with scrapie? 
28 Mar 01 Most doctors believe that sCJD is caused by a prion protein 
deforming by chance into a killer. But Singeltary thinks otherwise. He is one of 
a number of campaigners who say that some sCJD, like the variant CJD related to 
BSE, is caused by eating meat from infected animals. Their suspicions have 
focused on sheep carrying scrapie, a BSE-like disease that is widespread in 
flocks across Europe and North America. 
Now scientists in France have stumbled across new evidence that adds weight 
to the campaigners' fears. To their complete surprise, the researchers found 
that one strain of scrapie causes the same brain damage in mice as sCJD. 
"This means we cannot rule out that at least some sCJD may be caused by 
some strains of scrapie," says team member Jean-Philippe Deslys of the French 
Atomic Energy Commission's medical research laboratory in Fontenay-aux-Roses, 
south-west of Paris. Hans Kretschmar of the University of Göttingen, who 
coordinates CJD surveillance in Germany, is so concerned by the findings that he 
now wants to trawl back through past sCJD cases to see if any might have been 
caused by eating infected mutton or lamb... 
2001 
Suspect symptoms 
What if you can catch old-fashioned CJD by eating meat from a sheep 
infected with scrapie? 
28 Mar 01 
Like lambs to the slaughter 
31 March 2001 
by Debora MacKenzie Magazine issue 2284. 
FOUR years ago, Terry Singeltary watched his mother die horribly from a 
degenerative brain disease. Doctors told him it was Alzheimer's, but Singeltary 
was suspicious. The diagnosis didn't fit her violent symptoms, and he demanded 
an autopsy. It showed she had died of sporadic Creutzfeldt-Jakob disease. 
Most doctors believe that sCJD is caused by a prion protein deforming by 
chance into a killer. But Singeltary thinks otherwise. He is one of a number of 
campaigners who say that some sCJD, like the variant CJD related to BSE, is 
caused by eating meat from infected animals. Their suspicions have focused on 
sheep carrying scrapie, a BSE-like disease that is widespread in flocks across 
Europe and North America. 
Now scientists in France have stumbled across new evidence that adds weight 
to the campaigners' fears. To their complete surprise, the researchers found 
that one strain of scrapie causes the same brain damage in mice as sCJD. 
"This means we cannot rule out that at least some sCJD may be caused by 
some strains of scrapie," says team member Jean-Philippe Deslys of the French 
Atomic Energy Commission's medical research laboratory in Fontenay-aux-Roses, 
south-west of Paris. Hans Kretschmar of the University of Göttingen, who 
coordinates CJD surveillance in Germany, is so concerned by the findings that he 
now wants to trawl back through past sCJD cases to see if any might have been 
caused by eating infected mutton or lamb. 
Scrapie has been around for centuries and until now there has been no 
evidence that it poses a risk to human health. But if the French finding means 
that scrapie can cause sCJD in people, countries around the world may have 
overlooked a CJD crisis to rival that caused by BSE. 
Deslys and colleagues were originally studying vCJD, not sCJD. They 
injected the brains of macaque monkeys with brain from BSE cattle, and from 
French and British vCJD patients. The brain damage and clinical symptoms in the 
monkeys were the same for all three. Mice injected with the original sets of 
brain tissue or with infected monkey brain also developed the same symptoms. 
As a control experiment, the team also injected mice with brain tissue from 
people and animals with other prion diseases: a French case of sCJD; a French 
patient who caught sCJD from human-derived growth hormone; sheep with a French 
strain of scrapie; and mice carrying a prion derived from an American scrapie 
strain. As expected, they all affected the brain in a different way from BSE and 
vCJD. But while the American strain of scrapie caused different damage from 
sCJD, the French strain produced exactly the same pathology. 
"The main evidence that scrapie does not affect humans has been 
epidemiology," says Moira Bruce of the neuropathogenesis unit of the Institute 
for Animal Health in Edinburgh, who was a member of the same team as Deslys. 
"You see about the same incidence of the disease everywhere, whether or not 
there are many sheep, and in countries such as New Zealand with no scrapie." In 
the only previous comparisons of sCJD and scrapie in mice, Bruce found they were 
dissimilar. 
But there are more than 20 strains of scrapie, and six of sCJD. "You would 
not necessarily see a relationship between the two with epidemiology if only 
some strains affect only some people," says Deslys. Bruce is cautious about the 
mouse results, but agrees they require further investigation. Other trials of 
scrapie and sCJD in mice, she says, are in progress. 
People can have three different genetic variations of the human prion 
protein, and each type of protein can fold up two different ways. Kretschmar has 
found that these six combinations correspond to six clinical types of sCJD: each 
type of normal prion produces a particular pathology when it spontaneously 
deforms to produce sCJD. 
But if these proteins deform because of infection with a disease-causing 
prion, the relationship between pathology and prion type should be different, as 
it is in vCJD. "If we look at brain samples from sporadic CJD cases and find 
some that do not fit the pattern," says Kretschmar, "that could mean they were 
caused by infection." 
There are 250 deaths per year from sCJD in the US, and a similar incidence 
elsewhere. Singeltary and other US activists think that some of these people 
died after eating contaminated meat or "nutritional" pills containing dried 
animal brain. Governments will have a hard time facing activists like Singeltary 
if it turns out that some sCJD isn't as spontaneous as doctors have insisted. 
Deslys's work on macaques also provides further proof that the human 
disease vCJD is caused by BSE. And the experiments showed that vCJD is much more 
virulent to primates than BSE, even when injected into the bloodstream rather 
than the brain. This, says Deslys, means that there is an even bigger risk than 
we thought that vCJD can be passed from one patient to another through 
contaminated blood transfusions and surgical instruments. 
Friday, January 30, 2015 
*** Scrapie: a particularly persistent pathogen *** 
Monday, November 30, 2009 
USDA AND OIE COLLABORATE TO EXCLUDE ATYPICAL SCRAPIE NOR-98 ANIMAL HEALTH 
CODE 
I strenuously urge the USDA and the OIE et al to revoke the exemption of 
the legal global trading of atypical Nor-98 scrapie TSE. ...TSS 
Sunday, April 12, 2015 
*** Research Project: Transmission, Differentiation, and Pathobiology of 
Transmissible Spongiform Encephalopathies 2014 Annual Report *** 
 http://transmissiblespongiformencephalopathy.blogspot.com/2015/04/research-project-transmission.html 
Friday, May 22, 2015 
Chronic Wasting Disease and Program Updates - 2014 NEUSAHA Annual Meeting 
12-14 May 2014
Comment from Terry Singeltary This is a Comment on the Food and Drug 
Administration (FDA) Notice: Draft Guidance for Industry on Ensuring Safety of 
Animal Feed Maintained and Fed On-Farm; Availability
For related information, Open Docket Folder Docket folder icon 
--------------------------------------------------------------------------------
Show agency attachment(s) Attachments View All (0) 
--------------------------------------------------------------------------------
Comment View document:
WI 
REASON 
Products manufactured from bulk feed containing blood meal that was cross 
contaminated with prohibited meat and bone meal and the labeling did not bear 
cautionary BSE statement. 
VOLUME OF PRODUCT IN COMMERCE 
9,997,976 lbs. 
DISTRIBUTION 
ID and NV 
END OF ENFORCEMENT REPORT FOR MARCH 21, 2007 
Terry S. Singeltary Sr.
*** See attached file(s) No documents available. Attachments View All (1) 
Guidance for Industry Ensuring Safety of Animal Feed Maintained and Fed On-Farm 
Terry Singeltary Comment View Attachment: 
Sunday, April 5, 2015 
*** Guidance for Industry Ensuring Safety of Animal Feed Maintained and Fed 
On-Farm Draft Guidance FDA-2014-D-1180 ***
Guidance for Industry Ensuring Safety of Animal Feed Maintained and Fed 
On-Farm Draft Guidance FDA-2014-D-1180 Singeltary Comment
Greetings FDA et al, 
I wish to comment on Guidance for Industry Ensuring Safety of Animal Feed 
Maintained and Fed On-Farm Draft Guidance FDA-2014-D-1180.
Once again, I wish to kindly bring up the failed attempt of the FDA and the 
ruminant to ruminant mad cow feed ban of August 4, 1997. This feed ban is still 
failing today, as we speak. Even more worrisome, is the fact it is still legal 
to feed cervids to cervids in the USA, in fact, the FDA only _recommends_ that 
deer and elk considered to be of _high_ risk for CWD do not enter the animal 
food chain, but there is NO law, its only voluntary, a recipe for a TSE prion 
disaster, as we have seen with the ruminant to ruminant feed ban for cattle, 
where in 2007, one decade post August 1997 mad cow feed ban, where in 2007 
10,000,000 POUNDS OF BANNED BLOOD LACED MEAT AND BONE MEAL WHEN OUT INTO 
COMMERCE, TO BE FED OUT. Since 2007, these BSE feed ban rules have been breached 
time and time again. tons and tons of mad cow feed went out in Alabama as well, 
where one of the mad cows were documented, just the year before in 2006, and in 
2013 and 2014, breaches so bad (OAI) Official Action Indicated were issued. 
those are like the one issued where 10 million pounds of banned blood laced meat 
and bone meal were fed out. 
What is the use of having a Guidance for Industry Ensuring Safety of Animal 
Feed Maintained and Fed On-Farm Draft Guidance FDA-2014-D-1180, if it cannot be 
enforced, as we have seen with a mandatory ruminant to ruminant feed ban?
I strenuously once again urge the FDA and its industry constituents, to 
make it MANDATORY that all ruminant feed be banned to all ruminants, and this 
should include all cervids as soon as possible for the following 
reasons...
======
In the USA, under the Food and Drug Administrations 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. 
======
31 Jan 2015 at 20:14 GMT 
*** Ruminant feed ban for cervids in the United States? ***
31 Jan 2015 at 20:14 GMT 
19 May 2010 at 21:21 GMT 
*** Singeltary reply ; Molecular, Biochemical and Genetic Characteristics 
of BSE in Canada Singeltary reply ; 
Tuesday, December 23, 2014 
FDA PART 589 -- SUBSTANCES PROHIBITED FROM USE IN ANIMAL FOOD OR FEED 
VIOLATIONS OFFICIAL ACTION INDICATED OAI UPDATE DECEMBER 2014 BSE TSE PRION 
2013
Sunday, December 15, 2013 
FDA PART 589 -- SUBSTANCES PROHIBITED FROM USE IN ANIMAL FOOD OR FEED 
VIOLATIONS OFFICIAL ACTION INDICATED OAI UPDATE DECEMBER 2013 UPDATE
DOCKET-- 03D-0186 -- FDA Issues Draft Guidance on Use of Material From Deer 
and Elk in Animal Feed; Availability Date: Fri, 16 May 2003 11:47:37 0500 EMC 1 
Terry S. Singeltary Sr. Vol #: 1 
PLEASE SEE FULL TEXT SUBMISSION ; 
10,000,000+ LBS. of PROHIBITED BANNED MAD COW FEED I.E. BLOOD LACED MBM IN 
COMMERCE USA 2007 
Date: March 21, 2007 at 2:27 pm PST 
REASON 
Blood meal used to make cattle feed was recalled because it was cross- 
contaminated with prohibited bovine meat and bone meal that had been 
manufactured on common equipment and labeling did not bear cautionary BSE 
statement. 
VOLUME OF PRODUCT IN COMMERCE 
42,090 lbs. 
DISTRIBUTION 
WI 
REASON 
Products manufactured from bulk feed containing blood meal that was cross 
contaminated with prohibited meat and bone meal and the labeling did not bear 
cautionary BSE statement. 
VOLUME OF PRODUCT IN COMMERCE 
9,997,976 lbs. 
DISTRIBUTION 
ID and NV 
END OF ENFORCEMENT REPORT FOR MARCH 21, 2007 
Terry S. Singeltary Sr.
*** See attached file(s) No documents available. Attachments View All (1) 
Guidance for Industry Ensuring Safety of Animal Feed Maintained and Fed On-Farm 
Terry Singeltary Comment View Attachment: 
Sunday, April 5, 2015 
*** Guidance for Industry Ensuring Safety of Animal Feed Maintained and Fed 
On-Farm Draft Guidance FDA-2014-D-1180 ***
Sunday, January 11, 2015 
Docket No. APHIS-2014-0107 Bovine Spongiform Encephalopathy; Importation of 
Animals and Animal Products Singeltary Submission 
This is a Comment on the Animal and Plant Health Inspection Service (APHIS) 
Notice: Agency Information Collection Activities; Proposals, Submissions, and 
Approvals: Bovine Spongiform Encephalopathy; Importation of Animals and Animal 
Products
For related information, Open Docket Folder Docket folder icon 
--------------------------------------------------------------------------------
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Comment View document:Docket No. APHIS-2014-0107 Bovine Spongiform 
Encephalopathy; Importation of Animals and Animal Products Singeltary Submission 
;
I believe that there is more risk to the world from Transmissible 
Spongiform Encephalopathy TSE prion aka mad cow type disease now, coming from 
the United States and all of North America, than there is risk coming to the USA 
and North America, from other Countries. I am NOT saying I dont think there is 
any risk for the BSE type TSE prion coming from other Countries, I am just 
saying that in 2015, why is the APHIS/USDA/FSIS/FDA still ignoring these present 
mad cow risk factors in North America like they are not here? 
North America has more strains of TSE prion disease, in more species 
(excluding zoo animals in the early BSE days, and excluding the Feline TSE and 
or Canine TSE, because they dont look, and yes, there has been documented 
evidence and scientific studies, and DEFRA Hound study, that shows the canine 
spongiform encephalopathy is very possible, if it has not already happened, just 
not documented), then any other Country in the world. Mink TME, Deer Elk cervid 
CWD (multiple strains), cBSE cattle, atypical L-type BSE cattle, atypical H-type 
BSE cattle, atyical HG type BSE cow (the only cow documented in the world to 
date with this strain), typical sheep goat Scrapie (multiple strains), and the 
atypical Nor-98 Scrapie, which has been linked to sporadic CJD, Nor-98 atypical 
Scrapie has spread from coast to coast. sporadic CJD on the rise, with different 
strains mounting, victims becoming younger, with the latest nvCJD human mad cow 
case being documented in Texas again, this case, NOT LINKED TO EUROPEAN TRAVEL 
CDC. 
typical BSE can propagate as nvCJD and or sporadic CJD (Collinge et al), 
and sporadic CJD has now been linked to atypical BSE, Scrapie and atypical 
Scrapie, and scientist are very concerned with CWD TSE prion in the Cervid 
populations. in my opinion, the BSE MRR policy, which overtook the BSE GBR risk 
assessments for each country, and then made BSE confirmed countries legal to 
trade mad cow disease, which was all brought forth AFTER that fateful day 
December 23, 2003, when the USA lost its gold card i.e. BSE FREE status, thats 
the day it all started. once the BSE MRR policy was shoved down every countries 
throat by USDA inc and the OIE, then the legal trading of Scrapie was validated 
to be a legal trading commodity, also shoved through by the USDA inc and the 
OIE, the world then lost 30 years of attempted eradication of the BSE TSE prion 
disease typical and atypical strains, and the BSE TSE Prion aka mad cow type 
disease was thus made a legal trading commodity, like it or not. its all about 
money now folks, trade, to hell with human health with a slow incubating 
disease, that is 100% fatal once clinical, and forget the fact of exposure, 
sub-clinical infection, and friendly fire there from i.e. iatrogenic TSE prion 
disease, the pass it forward mode of the TSE PRION aka mad cow type disease. its 
all going to be sporadic CJD or sporadic ffi, or sporadic gss, or now the 
infamous VPSPr. ...problem solved $$$ 
the USDA/APHIS/FSIS/FDA triple mad cow BSE firewall, well, that was nothing 
but ink on paper. 
for this very reason I believe the BSE MRR policy is a total failure, and 
that this policy should be immediately withdrawn, and set back in place the BSE 
GBR Risk Assessments, with the BSE GBR risk assessments set up to monitor all 
TSE PRION disease in all species of animals, and that the BSE GBR risk 
assessments be made stronger than before. 
lets start with the recent notice that beef from Ireland will be coming to 
America. 
Ireland confirmed around 1655 cases of mad cow disease. with the highest 
year confirming about 333 cases in 2002, with numbers of BSE confirmed cases 
dropping from that point on, to a documentation of 1 confirmed case in 2013, to 
date. a drastic decrease in the feeding of cows to cows i.e. the ruminant mad 
cow feed ban, and the enforcement of that ban, has drastically reduced the 
number of BSE cases in Europe, minus a few BABs or BARBs. a far cry from the 
USDA FDA triple BSE firewall, which was nothing more than ink on paper, where in 
2007, in one week recall alone, some 10 MILLION POUNDS OF BANNED POTENTIAL MAD 
COW FEED WENT OUT INTO COMMERCE IN THE USA. this is 10 years post feed ban. in 
my honest opinion, due to the blatant cover up of BSE TSE prion aka mad cow 
disease in the USA, we still have no clue as to the true number of cases of BSE 
mad cow disease in the USA or North America as a whole. ...just saying. 
Number of reported cases of bovine spongiform encephalopathy (BSE) in 
farmed cattle worldwide* (excluding the United Kingdom) 
Country/Year 
snip...please see attached pdf file, with references of breaches in the USA 
triple BSE mad cow firewalls, and recent science on the TSE prion disease. 
...TSS 
No documents available. AttachmentsView All (1) Empty Docket No. 
APHIS-2014-0107 Bovine Spongiform Encephalopathy; Importation of Animals and 
Animal Products Singeltary Submission View Attachment: 
Sunday, January 11, 2015 
Docket No. APHIS-2014-0107 Bovine Spongiform Encephalopathy; Importation of 
Animals and Animal Products Singeltary Submission 
Tuesday, February 17, 2015 
*** Could we spot the next BSE?, asks BVA President *** 
UK EXPORTS OF MBM TO WORLD 
OTHERS BEEF AND VEAL 
LIVE CATTLE http://web.archive.org/web/20060517075059/http://www.bseinquiry.gov.uk/files/mb/m11f/tab11.pdf 
EMBRYOS http://web.archive.org/web/20060517075116/http://www.bseinquiry.gov.uk/files/mb/m11g/tab03.pdf 
GELATIN ETC http://web.archive.org/web/20060517075315/http://www.bseinquiry.gov.uk/files/mb/m11g/tab02.pdf 
SEMEN http://web.archive.org/web/20060517075135/http://www.bseinquiry.gov.uk/files/mb/m11g/tab04.pdf 
Tuesday, September 2, 2014 
COOL UPDATE September 2, 2014 
Monday, February 23, 2015 
20th BSE Case Raises New Concerns about Canada's Feeding Practices and 
Voluntary Testing Program; Highlights Importance of COOL 
Friday, February 20, 2015 
A BSE CANADIAN COW MAD COW UPDATE Transcript - Briefing (February 18, 2015) 
EDMONTON - Some of former Alberta premier Ralph Klein's most colourful 
quotes — and the reactions they elicited: 
SNIP... 
"This all came about through the discovery of a single, isolated case of 
mad cow disease in one Alberta cow on May 20th. The farmer — I think he was a 
Louisiana fish farmer who knew nothing about cattle ranching. I guess any 
self-respecting rancher would have shot, shovelled and shut up, but he didn't do 
that." — Klein recalls how the mad cow crisis started and rancher Marwyn 
Peaster's role. The premier was speaking at the Western Governors Association 
meeting in Big Sky, Mont. September 2004. 
"The premier meant that in an ironic or almost a sarcastic way." — Klein 
spokesman Gordon Turtle. 
--- 
"You would have to eat 10 billion meals of brains, spinal cords, ganglia, 
eyeballs and tonsils." — Klein speaking in Montreal in January 2005 on the risk 
of humans contracting mad cow disease. 
--- 
"I would offer $5 billion to have a Japanese person to come over here and 
eat nothing but Alberta beef for a year. And if he gets mad cow disease, I would 
be glad to give him $5 billion — make it $10 billion — Canadian." — Klein 
speaking after Japan closed its borders to Canadian beef. 
--- 
Thursday, February 10, 2011 
TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHY REPORT UPDATE CANADA FEBRUARY 2011 
and how to hide mad cow disease in Canada Current as of: 2011-01-31 
Wednesday, August 11, 2010 
REPORT ON THE INVESTIGATION OF THE SIXTEENTH CASE OF BOVINE SPONGIFORM 
ENCEPHALOPATHY (BSE) IN CANADA 
Thursday, August 19, 2010 
REPORT ON THE INVESTIGATION OF THE SEVENTEENTH CASE OF BOVINE SPONGIFORM 
ENCEPHALOPATHY (BSE) IN CANADA 
Friday, March 4, 2011 
Alberta dairy cow found with mad cow disease 
Tuesday, May 21, 2013 
Canada, USA, Bad feed, mad cows: Why we know three BSE cases had a common 
origin and why the SSS policy is in full force $$$ 
Increased Atypical Scrapie Detections 
Press reports indicate that increased surveillance is catching what 
otherwise would have been unreported findings of atypical scrapie in sheep. In 
2009, five new cases have been reported in Quebec, Ontario, Alberta, and 
Saskatchewan. With the exception of Quebec, all cases have been diagnosed as 
being the atypical form found in older animals. Canada encourages producers to 
join its voluntary surveillance program in order to gain scrapie-free status. 
The World Animal Health will not classify Canada as scrapie-free until no new 
cases are reported for seven years. The Canadian Sheep Federation is calling on 
the government to fund a wider surveillance program in order to establish the 
level of prevalence prior to setting an eradication date. Besides long-term 
testing, industry is calling for a compensation program for farmers who report 
unusual deaths in their flocks. 
Current as of: 2015-01-31 
Sheep flocks and/or goat herds confirmed to be infected with classical 
scrapie in Canada in 2015 Date confirmed Location Animal type infected January 5 
Ontario Goat 
Tuesday, February 10, 2015 
Alberta Canada First case of chronic wasting disease found in farm elk 
since 2002 
Saturday, March 21, 2015 
***Canada and United States Creutzfeldt Jakob TSE Prion Disease Incidence 
Rates Increasing 
Tuesday, May 26, 2015 
*** Minimise transmission risk of CJD and vCJD in healthcare settings Last 
updated 15 May 2015 ***
Tuesday, April 21, 2015 
Transmissible Spongiform Encephalopathy Advisory Committee TSEAC MEETING 
SCHEDULED FOR June 1, 2015
Saturday, April 18, 2015 
*** vCJD TEXAS CDC Emerging Infectious Diseases May 2015 Baylor College of 
Medicine Neuroscience 2014 case of human form of “mad cow disease” highlights 
need for continued surveillance 
Saturday, May 09, 2015 
*** Psychiatric Symptoms in Patients With Sporadic Creutzfeldt-Jakob 
Disease ***
Sunday, May 3, 2015 
PRION2015 FORT COLLINS 
Transmissible Spongiform Encephalopthy TSE Prion Disease 
*** Kuru Video 
Kuru: The Science and The Sorcery 
*** Scrapie Video 
*** Human Mad Cow Video 
*** USA sporadic CJD MAD COW DISEASE HAS HUGE PROBLEM Video 
2014 
***Moreover, L-BSE has been transmitted more easily to transgenic mice 
overexpressing a human PrP [13,14] or to primates [15,16] than C-BSE. 
***It has been suggested that some sporadic CJD subtypes in humans may 
result from an exposure to the L-BSE agent. 
*** Lending support to this hypothesis, pathological and biochemical 
similarities have been observed between L-BSE and an sCJD subtype (MV genotype 
at codon 129 of PRNP) [17], and between L-BSE infected non-human primate and 
another sCJD subtype (MM genotype) [15]. 
snip... 
Monday, October 10, 2011 
EFSA Journal 2011 The European Response to BSE: A Success Story 
snip... 
EFSA and the European Centre for Disease Prevention and Control (ECDC) 
recently delivered a scientific opinion on any possible epidemiological or 
molecular association between TSEs in animals and humans (EFSA Panel on 
Biological Hazards (BIOHAZ) and ECDC, 2011). This opinion confirmed Classical 
BSE prions as the only TSE agents demonstrated to be zoonotic so far 
*** but the possibility that a small proportion of human cases so far 
classified as "sporadic" CJD are of zoonotic origin could not be excluded. 
*** Moreover, transmission experiments to non-human primates suggest that 
some TSE agents in addition to Classical BSE prions in cattle (namely L-type 
Atypical BSE, Classical BSE in sheep, transmissible mink encephalopathy (TME) 
and chronic wasting disease (CWD) agents) might have zoonotic potential. 
snip... 
Thursday, August 12, 2010 
Seven main threats for the future linked to prions 
First threat 
The TSE road map defining the evolution of European policy for protection 
against prion diseases is based on a certain numbers of hypotheses some of which 
may turn out to be erroneous. In particular, a form of BSE (called atypical 
Bovine Spongiform Encephalopathy), recently identified by systematic testing in 
aged cattle without clinical signs, may be the origin of classical BSE and thus 
potentially constitute a reservoir, which may be impossible to eradicate if a 
sporadic origin is confirmed. 
*** Also, a link is suspected between atypical BSE and some apparently 
sporadic cases of Creutzfeldt-Jakob disease in humans. 
*** These atypical BSE cases constitute an unforeseen first threat that 
could sharply modify the European approach to prion diseases. 
Second threat 
snip... 
Sunday, November 23, 2014 
*** Confirmed Variant Creutzfeldt-Jakob Disease (variant CJD) Case in Texas 
in June 2014 confirmed as USA case NOT European *** 
Monday, November 3, 2014 
USA CJD TSE PRION UNIT, TEXAS, SURVEILLANCE UPDATE NOVEMBER 2014 
National Prion Disease Pathology Surveillance Center Cases Examined1 
(October 7, 2014) 
***6 Includes 11 cases in which the diagnosis is pending, and 19 
inconclusive cases; 
***7 Includes 12 (11 from 2014) cases with type determination pending in 
which the diagnosis of vCJD has been excluded. 
***The sporadic cases include 2660 cases of sporadic Creutzfeldt-Jakob 
disease (sCJD), 
***50 cases of Variably Protease-Sensitive Prionopathy (VPSPr) 
***and 21 cases of sporadic Fatal Insomnia (sFI). 
Thursday, January 15, 2015 
41-year-old Navy Commander with sporadic Creutzfeldt–Jakob disease CJD TSE 
Prion: Case Report 
Subject: *** Becky Lockhart 46, Utah’s first female House speaker, dies 
diagnosed with the extremely rare Creutzfeldt-Jakob disease aka mad cow type 
disease 
what is CJD ? just ask USDA inc., and the OIE, they are still feeding the 
public and the media industry fed junk science that is 30 years old. 
why doesn’t some of you try reading the facts, instead of rubber stamping 
everything the USDA inc says. 
sporadic CJD has now been linked to BSE aka mad cow disease, Scrapie, and 
there is much concern now for CWD and risk factor for humans. 
My sincere condolences to the family and friends of the House Speaker Becky 
Lockhart. I am deeply saddened hear this. 
with that said, with great respect, I must ask each and every one of you 
Politicians that are so deeply saddened to hear of this needless death of the 
Honorable House Speaker Becky Lockhart, really, cry me a friggen river. I am 
seriously going to ask you all this...I have been diplomatic for about 17 years 
and it has got no where. people are still dying. so, are you all stupid or 
what??? how many more need to die ??? how much is global trade of beef and other 
meat products that are not tested for the TSE prion disease, how much and how 
many bodies is this market worth? 
Saturday, January 17, 2015 
*** Becky Lockhart 46, Utah’s first female House speaker, dies diagnosed 
with the extremely rare Creutzfeldt-Jakob disease 
*** ALERT new variant Creutzfeldt Jakob Disease nvCJD or vCJD, sporadic CJD 
strains, TSE prion aka Mad Cow Disease United States of America Update December 
14, 2014 Report *** 
*** Creutzfeldt-Jakob Disease Public Health Crisis VIDEO
Saturday, December 13, 2014 
Terry S. Singeltary Sr. Publications TSE prion disease 
Diagnosis and Reporting of Creutzfeldt-Jakob Disease 
Singeltary, Sr et al. JAMA.2001; 285: 733-734. Vol. 285 No. 6, February 14, 
2001 JAMA 
snip... 
lost my mom to the Heidenhain Variant of Creutzfeldt Jakob Disease hvCJD 
12/14/97 confirmed. I just made a promise to mom, never forget (I could never 
ever forget what I saw), and never let them forget... 
layperson 
Terry S. Singeltary Sr., Bacliff, Texas USA 77518 flounder9@verizon.net 
Thursday, May 28, 2015 
OIE cuts six European countries' mad cow risk level, while increasing risk 
factors for humans to the BSE TSE PRION DISEASE around the globe 

