Thursday, February 17, 2011

Imported cow from Switzerland aged over 30 months not tested for BSE

Imported cow aged over 30 months not tested for BSE

Wednesday 16 February 2011

The Agency has been notified that meat has entered the food supply from an Over Thirty Month (OTM) cow imported from Switzerland that had not been tested for BSE.

It is very unlikely that the cow was infected with BSE and, as specified risk material (SRM) was removed, any risk to human health is extremely low. SRM is those parts of an animal likely to be infected if the animal has BSE.

Nevertheless, according to BSE regulations the untested cow, the one slaughtered before and the two slaughtered after must not enter the food supply. Negative BSE test results were received for the 'one before' and 'two after'.

The cow had been imported into the UK in December 2009 and was slaughtered at William Taylor & Son Ltd's abattoir in Bamber Bridge, near Preston, on 15 October 2010 at just over 41 months of age. BSE testing is mandatory for cattle born in Switzerland if slaughtered for human consumption at over 30 months of age. The missing BSE test result was discovered on 17 November during routine cross checks of slaughter and BSE test data. By the time the failure was discovered, all of the associated carcasses had left the premises.

The Agency has established that the carcase of the Swiss-born bovine was sold as fresh meat and is likely to have been eaten. We also traced the batch of carcases that included the 'one before' and 'two after'. This showed that:

the majority of the meat was no longer in the food supply and is likely to have been eaten a small portion of the batch was found in cold storage and has since been destroyed a small portion of the batch was mixed with a large quantity of meat from other batches and used in Iceland's own brand 1.4kg steak pies with 'best before' dates of 23.11.11 and 26.11.11. Although any food safety risk from consuming these pies would be extremely low, Iceland has taken the decision to withdraw the affected pies from sale some had been exported to Ireland and the authorities there have been informed.

http://www.food.gov.uk/news/newsarchive/2011/feb/otm160211




Sweden probes possible mad cow death Published: 16 Feb 11 07:00 CET | Double click on a word to get a translation Online: http://www.thelocal.se/32068/20110216/

Share A woman in her fifties from Värnamo in central Sweden died recently of the rare brain-debilitating disease Creutzfeldt-Jakob (CJD), Sveriges Radio (SR) reported on Tuesday.

.Fruits, vegetables may trigger child allergies (13 Feb 11) .Dengue fever rises among Swedes (6 Feb 11) .Sweden set for diabetes explosion: researchers (13 Nov 10) "A patient who had been sick for about six months died the other week. In the last month we established that she had Creutzfeldt-Jakob disease," infectious disease specialist Peter Iveroth told SR.

Health officials will now carry out an investigation into the woman's death to determine if it may have been caused by the variant of CJD associated with mad cow disease.

The woman's doctor, however, doubts there is any link between her death and Bovine Spongiform Encephalopathy (BSE), commonly known as mad cow disease.

"It's a very hard disease to diagnose and we aren't 100 percent certain of the diagnosis," the doctor said, adding the patient was not believed to have Variant Creutzfeldt-Jakob (vCJD).

Variant Creutzfeldt-Jakob (vCJD) is thought to be passed on to humans who have eaten meat contaminated with BSE.

Over 150 people around the world have died from the disease since it first emerged in 1995.

The other variant of CJD is unrelated to mad cow disease and non-transmissible.

"In this case it is our assessment that it is the older (non-transmissible) variant ... we have had that variant in Sweden for many years, before the occurrence of mad cow," the doctor said, describing sporadic CJD as "extremely unusual."

Swedish radio reported results for the patient's complete autopsy could take up to six months.


http://www.thelocal.se/32068/20110216/



DR. Adriano Agutzy is one of the world's experts on prion diseases. He says he has ruled out most of the other explanations, and now his main working hypothesis is that at least some Sporadic C.J.D. in Switzerland could be another form of human Mad Cow Disease.

ADRIANO AGUTZY (SCIENTIST):

But this by no means excludes that B.S.E. may manifest itself in humans with different characteristics, and maybe B.S.E. in Switzerland is also different from B.S.E. in the U.K., and then variant C.J.D. will also be different. So I think from the U.K. experience, it's impossible to draw the conclusion that B.S.E. will only give rise to what we know as variant C.J.D.


http://creutzfeldt-jakob-disease.blogspot.com/2009/07/usa-hiding-mad-cow-disease-victims-as.html




BSE May Have Caused Some Cases Of CJD As Well As vCJD

By James Meikle The Guardian - UK 11-29-2

Measures to protect the public from bovine spongiform encephalopathy (BSE)-like diseases were called into serious question last night as researchers suggested that the BSE epidemic in cattle might have caused 2 separate fatal brain conditions, not one as thought. Their stunning conclusion, that eating cheap cow meat might be responsible for some cases of sporadic Creutzfeldt-Jakob disease (CJD), as well as variant CJD [abbreviated as vCJD or CJD (new var.) in ProMED-mail] or human BSE, will cause further reassessment of risks still posed by food and by infection through cross-contamination of surgical instruments and blood.

Experiments with mice by John Collinge and colleagues at University College London appear to strengthen the possibility that more animals, and by extension humans, can act as infective carriers of the killer diseases well before full-blown symptoms occur. They cast another shadow over the safety of sheep, reinforcing concerns that they were infected with BSE as well as scrapie, a disease not known to be harmful to humans, and that one disease had "masked" the other.

The Department of Health will have to reconsider the operation and size of its compensation scheme for families that have a human BSE sufferer. The money is not available for sporadic CJD victims or relatives, and there is no way yet that scientists can distinguish between cases that arose from spontaneous changing in the form of the prion protein linked to both diseases, and those that might be diet-related. The research, outlined in the journal of the European Molecular Biology Organisation (EMBO) [see comment below], could mean huge changes in the counselling of sporadic CJD patients and their families. Professor Collinge said last night: "When you counsel those who have the classical sporadic disease, you tell them that it arises spontaneously out of the blue. I guess we can no longer say that."

The results come from a continuing long term study of laboratory mice [engineered to express] the human prion protein, then injected in the brain with BSE-infected material. Some showed a molecular signature indistinguishable from human BSE; others a signature the same as that left by one of 3 forms of sporadic CJD.

Deaths from sporadic CJD reported in Britain in the 1990s peaked at around 60 a year between 1997 and 1999, far more than the 28 variant CJD cases in 2000, the worst year so far for variant CJD. Urgent reviews will be made as to whether some sporadic cases might be BSE-related, although hard evidence would be extremely difficult to find. The pattern of infectivity through the body is markedly different between sporadic CJD and variant CJD, meaning surveillance might now become more complicated.

There are no blood tests yet available. Hemophiliac patients who were treated with blood clotting factors by the Scottish blood transfusion service between 1987 and 1989 are being informed that one donor of blood for the concentrates had later contracted variant CJD. All hemophiliacs in Scotland are now treated with genetically engineered substitutes, but these are not universally available in England, where warnings of possible contamination have been issued several times. The Haemophilia Society last night said it would increase pressure on the Department of Health to ensure that alternatives were available to patients in England.

Gillian Turner, of the CJD Support Network, said: "This research will be welcomed by many families who have been affected by sporadic CJD. They have been concerned for a long time that it was diet-related." Lester Firkins, of the Human BSE Foundation, said: "This could throw all the work that people have been doing on modelling [the possible spread of diseases] up in the air again. You might see clustering of cases if you have more numbers."

Sporadic CJD was identified in 1920s. The disease affects mainly the middle-aged and elderly. The incidence is roughly one in a million, between 29 and 63 a year since 1990. The disease is found worldwide. Time between obvious symptoms and death is typically a few months. Until now it has been assumed that a normal prion protein in the brain spontaneously changed into abnormal dangerous form. BSE or similar diseases could now be factor

vCJD was identified in 1996, with the average age of onset in the late 20s. Found mainly in Britain: 129 cases with 117 deaths so far, plus 6 in France, 1 each in Italy, Ireland, Canada & the USA. Largely blamed on consumption of cheap cattle meat and offal during 1980s. Tough food controls were meant to have significantly reduced risk. Concern remains over whether sheep might also have become infected with BSE and entered the food chain. First symptoms often [imitate] psychological problems. Duration is often well over a year. Several physical symptoms are similar to sporadic CJD.

http://www.guardian.co.uk/bse/article/0,2763,849293,00.html



_____




Research article Open Access

A case-control study of sporadic Creutzfeldt-Jakob disease in Switzerland: analysis of potential risk factors with regard to an increased CJD incidence in the years 2001–2004

Jessica Ruegger†1, Katharina Stoeck†2,3, Lorenz Amsler4,5, Thomas Blaettler2,6,

Marcel Zwahlen7, Adriano Aguzzi2, Markus Glatzel2,8, Klaus Hess1 and

Tobias Eckert*4,9

Address: 1Department of Neurology, University Hospital Zurich, Zurich, Switzerland, 2Institute of Neuropathology, University Hospital Zurich,

Zurich, Switzerland, 3Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg-Eppendorf, Hamburg, Germany, 4Federal

Office of Public Health, Bern, Switzerland, 5CSL Behring, Bern, Switzerland, 6Bristol-Myers Squibb, Wallingford, CT, USA, 7Institute of Social and

Preventive Medicine, University of Bern, Bern, Switzerland, 8Institute of Neuropathology, University Hospital Hamburg-Eppendorf, Hamburg-

Eppendorf, Hamburg, Germany and 9Swiss Tropical Institute, Basel, Switzerland

* Corresponding author †Equal contributors

Abstract

Background: In 2001, the observed annual mortality from Creutzfeldt-Jakob disease (CJD) in Switzerland increased from less than 1.5 to 2.6 per million inhabitants. An underlying cause could not be identified.

Methods: To analyse potential risk factors for sCJD in Switzerland, close relatives of 69 sCJD-patients and 224 frequency age-matched controls were interviewed in a case-control study using a standardised questionnaire. 135 potential risk factors including socio-demographics, medical history, occupation and diet were analysed by logistic regression adjusting for age, sex and education.

Results: sCJD patients were more likely to have travelled abroad, worked at an animal laboratory, undergone invasive dental treatment, orthopaedic surgery, ophthalmologic surgery after 1980, regular GP visits, taken medication regularly, and consumed kidney. No differences between patients and controls were found for residency, family history, and exposure to environmental and other dietary factors.

Conclusion: Although some factors were significantly more frequent among sCJD-cases, this study did not reveal specific explanations for the increased incidence of deaths due to sporadic CJD observed in Switzerland since 2001. Results have to be interpreted with caution due to multiple testing and possible recall bias in association with a long incubation period. The most plausible reason for the increase in Swiss sCJD cases after 2000 is an improved case ascertainment. Therefore, underreporting of cases might well have occurred before the year 2001, and the "real" yearly incidence of sCJD might not be lower than, but rather above 2 per million inhabitants.

snip...

The third hypothesis to explain the increase in annual mortality rates from sCJD in Switzerland between 2001 and 2004 is a better case ascertainment. Over recent years in Europe, as a general tendency incidences have been rising, however not to such extent as in Switzerland. Given that our results do not support strong evidence for the hypotheses of a zoonotic or iatrogenic cause, ascertainment bias due to a heightened perception and awareness of the disease in physicians must be regarded as the most likely cause for the observed increase. One factor that might be jointly responsible for this increase might be altered reporting requirements in 1999. Since that year all suspected cases in Switzerland had to be reported. In this respect, also the role of chance must be considered, as it is possible that the observed increase of Swiss sCJD-deaths was due to random fluctuation. The rise in annual mortality rate from the years before 2000 to the period 2001– 2004, however, was statistically significant, and therefore, chance must be considered a less likely explanation. In the most recent years, the observed incidence in sCJD deaths (2005: 10; 2006: 13, 2007: 15) dropped to levels just slightly above those before 2000. When recent incidence data until 2007 are included, however, the rise in the annual mortality rate after 2001 was still significant. The sudden increase in 2001 and the slow decrease afterwards are well in line with the media coverage of the CJD topic in the respective years.

http://www.biomedcentral.com/1471-2458/9/18


Worst-case scenario If BSE is the cause of Swiss sporadic CJD - the worst-case scenario - researchers have to work out how the cattle disease can cause two different forms of the human disease: variant CJD in Britain and elsewhere in Europe, and sporadic CJD in Switzerland.

This could be explained if British and Swiss cattle harboured different strains of the infectious prion protein - but preliminary experiments suggest that they are the same.

Alternatively, Swiss CJD could have leapt to humans through the injection of vaccines or medicines produced using serum made from cows, suggests Cornelia van Duijn of the European collaborative group on CJD incidence at the Erasmus University Medical School in Rotterdam, The Netherlands. Finding the source of the disease has "got to be priority number one for Europe", she says.

Researchers now hope to establish whether sporadic CJD came from BSE. They will use 'strain typing': infecting mice with the prions causing the two diseases and seeing if the symptoms match up. "It's the best way to establish or exclude any suspected link," says Moira Bruce of the Institute for Animal Health Neuropathogenesis Unit in Edinburgh, UK. These experiments will take at least a year.

Imperial College London

References 1.Glatzel, M. et al. Sharply increased Creutzfeld-Jakob disease mortality in Switzerland. Lancet 360, 139 - 141 (2002). | Article | ISI |

http://www.nature.com/news/1998/020708/full/news020708-18.html







ProMED-mail


The scientific paper upon which this report is based is published in the current issue of the EMBO Joural, Vol. 21, No. 23, 6358-6368, 2002.


http://emboj.oupjournals.org/cgi/content/abstract/21/23/6358?etoc




Title: BSE prions propagate as either variant CJD-like or sporadic CJD-like prion strains in transgenic mice expressing human prion protein.

Authors: Emmanuel A. Asante, Jacqueline M. Linehan, Melanie Desbruslais, Susan Joiner, Ian Gowland, Andrew L. Wood, Julie Welch, Andrew F. Hill, Sarah E. Lloyd, Jonathan D.F. Wadsworth and John Collinge. MRC Prion Unit and Department of Neuro-degenerative Disease, Institute of Neurology, University College, Queen Square, London WC1N 3BG, UK.

Abstract: Variant Creutzfeldt-Jakob disease (vCJD) has been recognized to date only in individuals homozygous for methionine at PRNP codon 129. Here we show that transgenic mice expressing human PrP methionine 129, inoculated with either bovine spongiform encephalopathy (BSE) or variant CJD prions, may develop the neuropathological and molecular phenotype of vCJD, consistent with these diseases being caused by the same prion strain. 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 PrP\Sc type 2. These data suggest that more than one BSE-derived 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.

In an interview with the London Times Health Editor, Professor Collinge stated that the number of cases of sporadic CJD cases had been increasing at about the same rate as the vCJD figures, and that the Swiss had reported recently a 2 to 3 fold increase in sporadic CJD. He also expressed concern that the transgenic mouse experiments had revealed instances of subclinical infection; although appearing normal in life, these mice when examined post-mortem exhibited extensive brain lesions. Subtle changes in mice are hard to detect, but changes might be more obvious in humans in terms of psychiatric symptoms. A subclinical form of CJD in humans would increase the hazard of transmission of disease via surgical instruments.

Professor Collinge stated that it was now a matter of urgency to conduct a large scale study of tonsil tissue in order to establish how widespread CJD infection is. He said that he remained concerned about the ultimate size of the CJD epidemic. The tonsil study that has been carried out so far employed a relatively crude test. He stated that new cases of kuru, the neurological disease caused by cannibalism some 50 years ago are still coming to light. Consequently these are very early days for a human prion epidemic, which could have a 30 year incubation period. - Mod.CP]

[see also: CJD, increased incidence - Switzerland 20020714.4756 CJD, long incubation period 20020612.4478 CJD, surgical instrument re-use - UK 20021030.5671 CJD, suspected cluster - USA (Wisconsin) 20020721.4827 CJD (new var.) - UK: 10th Annual Report 20020711.4727 CJD (new var.) - UK: update Sep 2002 20020908.5258 2001 ---- CJD, death rate increase - Switzerland 20011225.3110 CJD, surgical transmission? - Canada (Ontario) 20010512.09 2000 ---- CJD, possible surgical transmission - USA (Louisiana) 20001027.1872] ..................cp/jw



Wednesday, July 28, 2010

Atypical prion proteins and IBNC in cattle DEFRA project code SE1796 FOIA Final report

http://bse-atypical.blogspot.com/2010/07/atypical-prion-proteins-and-ibnc-in.html




IBNC

"All of the 15 cattle tested showed that the brains had abnormally accumulated prion protein."

Saturday, February 28, 2009

NEW RESULTS ON IDIOPATHIC BRAINSTEM NEURONAL CHROMATOLYSIS "All of the 15 cattle tested showed that the brains had abnormally accumulated PrP" 2009

SEAC 102/2

http://bse-atypical.blogspot.com/2009/02/new-results-on-idiopathic-brainstem.html




Thursday, December 23, 2010

Molecular Typing of Protease-Resistant Prion Protein in Transmissible Spongiform Encephalopathies of Small Ruminants, France, 2002-2009 Volume 17, Number 1-January 2011

http://transmissiblespongiformencephalopathy.blogspot.com/2010/12/molecular-typing-of-protease-resistant.html




Saturday, January 29, 2011

Atypical L-Type Bovine Spongiform Encephalopathy (L-BSE) Transmission to Cynomolgus Macaques, a Non-Human Primate

Jpn. J. Infect. Dis., 64 (1), 81-84, 2011

http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/atypical-l-type-bovine-spongiform.html





Monday, November 22, 2010

Atypical transmissible spongiform encephalopathies in ruminants: a challenge for disease surveillance and control

REVIEW ARTICLES

http://transmissiblespongiformencephalopathy.blogspot.com/2010/11/atypical-transmissible-spongiform.html




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



CONSUMPTION OF VEAL AND VENISON AND SIGNIFICANT INCREASE CJD

Sat Apr 28, 2007 07:10 68.238.100.254

greetings,

i have been working on something for a while 'the big lie', the following data to be added in, but i thought due to what i think the importance of this is, i thought i would go ahead and put this out now for those that might be interested. ........tss

CHANGING SCIENCE TO FIT YOUR INDUSTRY NEEDS COVER-UP IN FULL MODE NOW

POLICY - RESTRICTED

CREUTZFELDT-JAKOB DISEASE: 3RD ANNUAL REPORT OF THE UK SURVEILLANCE UNIT

1. This submission, which has been agreed with colleagues in HEF(M). alerts PS(L) to the contents of the forthcoming annual report of the CJD Surveillance Unit and presents options for publication. It also highlights concern over the presentation of results which could be misrepresented by the media and others as evidence of a lilnk between CJD and the consumption of veal. ...

RECOMMENDATION

2. PS(L) is invited to agree the recommendation at para 13.

PROBLEM

7. The main findings in the case-control study were STATISTICALLY SIGNIFICANT ASSOCIATIONS BETWEEN CONSUMPTION OF VEAL OR VENISON AND THE DEVELOPMENT OF CJD (INCREASED RISKS OF 2-13x). There was also evidence of a dose-response relationship between dietary exposure and development of the disease. (Last year's findings showed an apparent association between eating black pudding and risk of CJD which was neither statistically significant nor biologically plausible - interestingly, this has not been (replicated was marked out with something i cannot read), and then this complete sentence was marked through to be replaced ;

THIS YEAR'S FINDINGS SHOW A NUMBER OF ASSOCIATIONS BUT THE STRONGEST IS FOR VEAL.

IP PS(L) wishes to probe this further we think it best to explain the matter VERBALLY. The problem is how to present the findings in this year's annual report in a way which avoids unnecessary public alarm and limits the scope for media scare stores. (or the facts...TSS)

This is of considerable concern given recent development. In particular Ministers will be particularly concerned about the European dimension given the recent troubles with the Germans.

9. DH doctors advise - and we understand Dr Wills agrees - that the association the study found between the developments of CJD and veal consumption cannot be regarded as demonstrating a causal relationship or give any reason to change the advice that eating beef and veal is safe. IF PS(L) wishes to probe this further we think it best to explain the matter verbally. The problem is how to present the findings in this year's annual report in a way which avoids unnecessary public alarm and limits the scope for media scare stories.

Next steps ...

snip... full text ;

http://collections.europarchive.org/tna/20080103020408/http://www.bseinquiry.gov.uk/files/yb/1994/07/00001001.pdf



PROBLEM

7. The main findings in the case-control study were STATISTICALLY SIGNIFICANT ASSOCIATIONS BETWEEN CONSUMPTION OF VEAL OR VENISON AND THE DEVELOPMENT OF CJD (INCREASED RISKS OF 2-13x). There was also evidence of a dose-response relationship between dietary exposure and development of the disease. (Last year's findings showed an apparent association between eating black pudding and risk of CJD which was neither statistically significant nor biologically plausible - interestingly, this has not been (replicated was marked out with something i cannot read), and then this complete sentence was marked through to be replaced ;

see watered down report here ;

http://web.archive.org/web/20030511211625/http://www.bseinquiry.gov.uk/files/yb/1994/10/00004001.pdf




Seven main threats for the future linked to prions

The NeuroPrion network has identified 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...

http://www.neuroprion.org/en/np-neuroprion.html



Wednesday, March 31, 2010

Atypical BSE in Cattle

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.

This study will contribute to a correct definition of specified risk material (SRM) in atypical BSE. The incumbent of this position will develop new and transfer existing, ultra-sensitive methods for the detection of atypical BSE in tissue of experimentally infected cattle.

http://www.prionetcanada.ca/detail.aspx?menu=5&dt=293380&app=93&cat1=387&tp=20&lk=no&cat2




snip...

please see all seven threats listed in the USA, and more...FULL TEXT ;



Thursday, August 12, 2010

Seven main threats for the future linked to prions


http://prionpathy.blogspot.com/2010/08/seven-main-threats-for-future-linked-to.html




http://prionpathy.blogspot.com/





Saturday, January 29, 2011

Atypical L-Type Bovine Spongiform Encephalopathy (L-BSE) Transmission to Cynomolgus Macaques, a Non-Human Primate

Jpn. J. Infect. Dis., 64 (1), 81-84, 2011


http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/atypical-l-type-bovine-spongiform.html




Thursday, February 17, 2011

Environmental Sources of Scrapie Prions

http://scrapie-usa.blogspot.com/2011/02/environmental-sources-of-scrapie-prions.html




Friday, February 11, 2011

Atypical/Nor98 Scrapie Infectivity in Sheep Peripheral Tissues

http://nor-98.blogspot.com/2011/02/atypicalnor98-scrapie-infectivity-in.html




Sunday, April 18, 2010

SCRAPIE AND ATYPICAL SCRAPIE TRANSMISSION STUDIES A REVIEW 2010

http://scrapie-usa.blogspot.com/2010/04/scrapie-and-atypical-scrapie.html



Wednesday, February 16, 2011

IN CONFIDENCE SCRAPIE TRANSMISSION TO CHIMPANZEES

IN CONFIDENCE

http://scrapie-usa.blogspot.com/2011/02/in-confidence-scrapie-transmission-to.html





Our findings demonstrate that cervid PrPSc, upon strain adaptation by serial passages in vitro or in cervid transgenic mice, is capable of converting human PrPC to produce PrPSc with unique biochemical properties, likely representing a new human prion strain. The newly generated CWD-huPrPSc material has been inoculated into transgenic mice expressing human PrP to study infectivity and disease phenotype and this data will be published elsewhere. ...end






http://www.jbc.org/content/early/2011/01/04/jbc.M110.198465.long




UPDATED DATA ON 2ND CWD STRAIN

Wednesday, September 08, 2010

CWD PRION CONGRESS SEPTEMBER 8-11 2010




http://chronic-wasting-disease.blogspot.com/2010/09/cwd-prion-2010.html




Friday, February 11, 2011

Creutzfeldt-Jakob disease (CJD) biannual update (2010/1) Emerging infections/CJD


http://creutzfeldt-jakob-disease.blogspot.com/2011/02/creutzfeldt-jakob-disease-cjd-biannual.html






TSS

Labels:

Saturday, February 12, 2011

Another Pathologists dies from CJD, another potential occupational death ?

Another Pathologists dies from CJD, another potential occupational death ?




another happenstance of bad luck, a spontaneous event from nothing, or friendly fire ???



i will give you 3 guesses what the cdc et al will say, and the first two don't count. ...



sCJD...something from nothing...and that is sad.



our condolences go out to the family and friends of Dr. Anthony Manoukian. ...





with kindest regards,

terry









is much less’ with death of Manoukian



May 21, 1952 — Feb. 6, 2011 February 11, 2011 - By LILA FUJIMOTO, Staff Writer Save
WAILUKU



Dr. Anthony Manoukian, Maui County coroner's physician who was known as much for his generosity and humility as his expertise in death investigations, is being mourned by friends, colleagues and family members.



Many remember the island's first forensic-trained pathologist for his expert testimony on autopsies he conducted in connection with murders and other criminal cases in 2nd Circuit Court.



After being diagnosed in November with Creutzfeldt-Jakob disease, Manoukian died Sunday. He was 58.



Fellow pathologist and longtime friend Dr. Barry Shitamoto said Manoukian's loss will be felt keenly by Maui's medical community and beyond.



"Whoever Tony was friends with, they all felt like they were his best friend," Shitamoto said. "Tony had a knack for making people feel that way. He had many best friends."



In 1997, Manoukian served as chief of the medical staff at Maui Memorial Medical Center. He was a passionate supporter of the hospital, serving on various committees, Shitamoto said. And members of his family said Manoukian's favorite charity was the Maui Memorial Medical Center Foundation.



Shitamoto said Manoukian served as a teacher and mentor for high school students and police officers.



"Tony's influence on youth, students, new police officers (and) others was enormous," he said. "There are more than several students that are following their dreams in the forensic sciences due to Tony's mentorship. His professional legacy may live through these professionals and serve our Hawaii communities."



Another longtime friend, attorney Tony Takitani, said he met Manoukian more than a dozen years ago when, while he was working for a client, he had a conversation with him about an autopsy.



He said Manoukian was an "impressive guy," and he felt nervous talking with him.



But Takitani's uneasy feeling quickly evaporated when he found how personable Manoukian was.



"He was the nicest, easiest guy to talk to," he recalled. "He didn't talk down to anybody. He could explain things in a simple, clear way. ... You'd never guess he's one of the most capable professionals in America.



"So many people felt like he was their best friend," he said.



According to a biography provided by his family, Manoukian was born May 21, 1952, in Chicago, where he started a lifelong love affair with the Cubs. In 1960, the family moved to the San Francisco Bay area, and Manoukian eventually attended the University of California at Davis, earning a bachelor of science degree in zoology in 1974.



He received his graduate degree in public health from the University of Minnesota in 1983 and his medical degree in 1987 from St. George's University School of Medicine in Grenada, West Indies.



"Tony excelled in anatomy, becoming a teaching assistant and preparing tissue specimens that would be used to train future students," his family's website said.



His studies in Grenada were interrupted by the U.S. invasion of the island in October 1983. He was evacuated with other students but later returned to complete his medical degree.



Following a pathology residency at the Kaiser hospital in Honolulu and a one-year forensic pathology fellowship in Baltimore, Manoukian came to Maui in the early 1990s to work as one of the few forensic pathologists in the Pacific basin.



A doctor in general practice had been doing autopsies on Maui. But after the state Legislature passed a law requiring that autopsies be done by a pathologist, Manoukian became the first permanent resident forensic pathologist for Maui County. He also did autopsies on Kauai and the Big Island and in other parts of the Pacific.



As assistant to the medical examiner, Burt Freeland worked with Manoukian for 18 years, doing about 200 autopsies a year.



A few years ago, the two hiked to the top of a mountain in Waihee to perform an autopsy on a body that was too fragile to move, Freeland recalled. They had to make sure the man hadn't been shot or otherwise met with foul play. The man, a military deserter, had been camping in the area before running out of food and living off the land, Freeland said. He said an investigation determined that the man may have poisoned himself.



Manoukian worked with the Hawaii Disaster Medical Assistance Team and the Federal Disaster Mortuary Operational Response Team to provide assistance after disasters, including a tsunami in Samoa, Hurricane Katrina and the earthquake in Haiti.



Freeland, who is also part of the federal mortuary team, said volunteers in those situations sometimes must live in tents.



"You've got to be able to really rough it and get used to eating MREs when they don't have kitchen facilities," he said. "Even though you're not doing armed combat, it gets a little rough. But he and I both enjoyed serving our country that way."



Manoukian was deputy commander of Region 9 of the Federal Disaster Mortuary Operational Response Team.



"We were pretty close friends," Freeland said. "We had good times. He was a lot of fun.



"Anybody can become a great pathologist, but Dr. Manoukian wasn't known to be just in the morgue. He got out in the community and did a lot of things.



"I just remember him as a really happy guy, and all of a sudden he's gone. He'll be missed."



Acting Maui County Prosecuting Attorney John D. Kim said attorneys in the office worked closely with Manoukian on many cases.



"He was just the best," Kim said. "He knew everything, and he explained it so we could explain it in layman's terms. He was always there. He'd give you his direct line when nobody else would.



"It's a very big loss for the county."



Manoukian testified about his autopsy findings at many murder trials, including those of convicted double-murderer Daniel Kosi in 1999 and Michael Arlo Pavich in 2005 for strangling to death an 82-year-old Kihei man.



"He was able to speak for the deceased or the victims and tell their story," said First Deputy Prosecuting Attorney Robert Rivera, who handled many of the high-profile cases during Manoukian's tenure. "That's how we got a lot of the evidence.



"The thing that stood out about Dr. Manoukian was he explained it in a way that the layperson could understand."



Rivera said jurors he talked to after trials would mention how Manoukian's testimony was "extremely helpful and insightful."



"He captivated them," Rivera said. "It made it easier for them to come up with a decision.



"He had his quirkiness and his long hair. That just endeared him even more to the jury. He wasn't stuffy."



For a time, Manoukian was owner of Molina's bar in Wailuku. He purchased the business in 2000 before later selling it.



"He was a proud bar owner," said Rivera, who was a deputy corporation counsel when the liquor board reviewed the matter.



Rivera said he appreciated how Manoukian would make himself available to testify in cases, even when hearings were delayed and he would have to return to court more than once.



"Although he was the expert, he would come back," Rivera said. "He's one of the nicer persons."



When he headed the Maui police Traffic Section, retired Capt. Charles Hirata worked closely with Manoukian in the investigation of traffic deaths.



"I enjoyed his friendship both on and off the job," Hirata said. "He's one of the few that took the time to teach others as he went about his job. I pass on some of his lessons when I teach car seat safety. We actually learn a lot from the dead, which helps us to protect the living."



Manoukian was instrumental in planning a new forensic facility that will move the county morgue out of its cramped quarters, said police Assistant Chief Larry Hudson.



Manoukian was there for the blessing of the new facility Dec. 28.



"In dealing with him, he was humble," Hudson said. "He would talk to anybody. He didn't care about where you were in life. He treated everybody exactly the same.



"He was a super intelligent man who would listen, who was compassionate. He was just a likable guy.



"He was a good man. The community is much less because he's gone."



According to his family, beginning last autumn, Manoukian had difficulty speaking and needed to type his pathology reports by hand instead of dictating them. Later, he was diagnosed with Creutzfeldt-Jakob disease, a rapidly progressive and incurable neurological disorder.



Jerry Manoukian, an internal medicine physician in Mountain View, Calif., said family members don't know how his brother became infected with the illness, although it's possible he was exposed to it through his work.



The disease is rare, with about 300 cases reported in the United States each year, or about 1 in a million, he said.



In a day or two, family and friends plan to gather in California to have a barbecue and party in Manoukian's honor - no service, just friends and good food, his brother said.



"We'll mostly enjoy ourselves and remember him," he said. "It's very hard . . . It's very hard being without him."



Jerry Manoukian said he'd like to hold a similar event on Maui for family members to be with his brother's friends and colleagues here. But it was undecided when that might be.



Manoukian is survived by his wife, Downey, and brothers Pete, Jerry and Phil.



In a letter to the Maui County Council dated Thursday, Maui County Police Chief Gary Yabuta asked that Manoukian be recognized posthumously for commitment to his work in death investigations.



"What was further remarkable about the character of Dr. Manoukian was his ability to interact with every officer and employee of the Maui Police Department," Yabuta said. "He was a true friend to all of us.



"Through his professional findings, the families of the deceased were provided with personal closure. And, in the case of a criminal homicide, we were all given a sense of satisfaction that justice was served through the methodology and skills of Dr. Anthony Manoukian."



* Lila Fujimoto can be reached at lfujimoto@mauinews.com. City Editor Brian Perry contributed to this report.



http://mauinews.com/page/content.detail/id/546026/-Community-is-much-less--with-death-of-Manoukian.html?nav=10





Pathologist dies of suspected Creutzfeldt-Jakob (Mad cow) disease 29 March, 2009 03:33:00



Creutzfeldt-Jakob disease (mad cow) research pathologist Antonio Ruiz Villaescusa died Sat., March 28, from the disease. Colleagues suspect he may have contracted the disease from exposure to infected human tissue, according to the Barcelona Reporter newspaper.



Ruiz headed the department of pathology at the University Hospital in Madrid and was studying whether the disease is passed on to people who have been exposed to infected tissue.



The head of the pathology department at the Fundación Alcorcón, Dr. Radish, will perform an autopsy to clarify the cause of death and the final results will be announced in about a month, according to the Spanish news site.



Ruiz was recognized internationally for his study in the fields of neuropathology and anatomopatología, and devoted much of his professional life to the study of human transmissible spongiform encephalopathy.



Creutzfeldt-Jakob disease is a rare and invariably fatal brain disorder, according to the National Institute of Neurological Disorders and Stroke. There is currently no single diagnostic test for the disease. The only way to confirm a Creutzfeldt-Jakob disease diagnosis is by brain biopsy or autopsy.



http://www.fleshandstone.net/healthandsciencenews/ruiz.html





http://www.barcelonareporter.com/index.php?/news/comments/pathologist_dies_of_suspected_creutzfeldt-jakob_mad_cow_disease/





gabinetedecomunicacion@fhalcorcon.es



e-mail: fpinedo@fhalcorcon.es e-mail: mpdominguez@fhalcorcon.es



Dr. Alberto Rábano Gutiérrez. Fundación Hospital Alcorcón. Madrid



http://www.neuroprion.org/en/np-event-prion-2008.html





Monday, March 29, 2010



CJD TEXAS 38 YEAR OLD FEMALE WORKED SLAUGHTERING CATTLE EXPOSED TO BRAIN AND SPINAL CORD MATTER



URGENT, PLEASE NOTE ;



>>> Up until about 6 years ago, the pt worked at Tyson foods where she worked on the assembly line, slaughtering cattle and preparing them for packaging. She was exposed to brain and spinal cord matter when she would euthanize the cattle. <<<



http://cjdtexas.blogspot.com/2010/03/cjd-texas-38-year-old-female-worked.html




Monday, March 29, 2010



CJD TEXAS 38 YEAR OLD FEMALE WORKED SLAUGHTERING CATTLE EXPOSED TO BRAIN AND SPINAL CORD MATTER



URGENT, PLEASE NOTE ;



>>> Up until about 6 years ago, the pt worked at Tyson foods where she worked on the assembly line, slaughtering cattle and preparing them for packaging. She was exposed to brain and spinal cord matter when she would euthanize the cattle. <<<



Irma Linda Andablo CJD Victim, she died at 38 years old on February 6, 2010 in Mesquite Texas.



She left 6 Kids and a Husband.The Purpose of this web is to give information in Spanish to the Hispanic community, and to all the community who want's information about this terrible disease.- Physician Discharge Summary, Parkland Hospital, Dallas Texas Admit Date: 12/29/2009 Discharge Date: 1/20/2010 Attending Provider: Greenberg, Benjamin Morris; General Neurology Team: General Neurology Team Linda was a Hispanic female with no past medical history presents with 14 months of incresing/progressive altered mental status, generalized weakness, inability to walk, loss of appetite, inability to speak, tremor and bowel/blader incontinence. She was, in her usual state of health up until February, 2009, when her husbans notes that she began forgetting things like names and short term memories. He also noticed mild/vague personality changes such as increased aggression. In March, she was involved in a hit and run MVA,although she was not injured. The police tracked her down and ticketed her. At that time, her son deployed to Iraq with the Army and her husband assumed her mentation changes were due to stress over these two events. Also in March, she began to have weakness in her legs, making it difficult to walk. Over the next few months, her mentation and personality changes worsened, getting to a point where she could no longer recognized her children. She was eating less and less. She was losing more weight. In the last 2-3 months, she reached the point where she could not walk without an assist, then 1 month ago, she stopped talking, only making grunting/aggressive sounds when anyone came near her. She also became both bowel and bladder incontinent, having to wear diapers. Her '"tremor'" and body jerks worsened and her hands assumed a sort of permanent grip position, leading her family to put tennis balls in her hands to protect her fingers. The husband says that they have lived in Nebraska for the past 21 years. They had seen a doctor there during the summer time who prescribed her Seroquel and Lexapro, Thinking these were sx of a mood disorder. However, the medications did not help and she continued to deteriorate clinically. Up until about 6 years ago, the pt worked at Tyson foods where she worked on the assembly line, slaughtering cattle and preparing them for packaging. She was exposed to brain and spinal cord matter when she would euthanize the cattle. The husband says that he does not know any fellow workers with a similar illness. He also says that she did not have any preceeding illness or travel.



http://www.recordandoalinda.com/index.php?option=com_content&view=article&id=19:cjd-english-info&catid=9:cjd-ingles&Itemid=8




Monday, March 29, 2010 Irma Linda Andablo CJD Victim, she died at 38 years old on February 6, 2010 in Mesquite Texas



http://creutzfeldt-jakob-disease.blogspot.com/2010/03/irma-linda-andablo-cjd-victim-she-died.html





Monday, February 7, 2011



FDA's Currently-Recommended Policies to Reduce the Possible Risk of Transmission of CJD and vCJD by Blood and Blood Products 2011 ???



http://tseac.blogspot.com/2011/02/fdas-currently-recommended-policies-to.html




Wednesday, February 2, 2011



Detection of prion infection in variant Creutzfeldt-Jakob disease: a blood-based assay



http://transmissiblespongiformencephalopathy.blogspot.com/2011/02/detection-of-prion-infection-in-variant.html




Monday, January 17, 2011



Aerosols Transmit Prions to Immunocompetent and Immunodeficient Mice



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/aerosols-transmit-prions-to.html





Tuesday, December 14, 2010



Infection control of CJD, vCJD and other human prion diseases in healthcare and community settings part 4, Annex A1, Annex J, UPDATE DECEMBER 2010



http://creutzfeldt-jakob-disease.blogspot.com/2010/12/infection-control-of-cjd-vcjd-and-other.html





Thursday, September 02, 2010


NEUROSURGERY AND CREUTZFELDT-JAKOB DISEASE Health Law, Ethics, and Human Rights The Disclosure Dilemma



http://creutzfeldt-jakob-disease.blogspot.com/2010/09/neurosurgery-and-creutzfeldt-jakob.html





Thursday, July 08, 2010



Nosocomial transmission of sporadic Creutzfeldt–Jakob disease: results from a risk-based assessment of surgical interventions Public release date: 8-Jul-2010



http://creutzfeldt-jakob-disease.blogspot.com/2010/07/nosocomial-transmission-of-sporadic.html





Thursday, July 08, 2010



GLOBAL CLUSTERS OF CREUTZFELDT JAKOB DISEASE - A REVIEW 2010



http://creutzfeldt-jakob-disease.blogspot.com/2010/07/global-clusters-of-creutzfeldt-jakob.html





Wednesday, June 02, 2010



CJD Annex H UPDATE AFTER DEATH PRECAUTIONS Published: 2 June 2003 Updated: May 2010



http://creutzfeldt-jakob-disease.blogspot.com/2010/06/cjd-annex-h-update-after-death.html





Tuesday, May 11, 2010



Current risk of iatrogenic Creutzfeld–Jakob disease in the UK: efficacy of available cleaning chemistries and reusability of neurosurgical instruments



http://creutzfeldt-jakob-disease.blogspot.com/2010/05/current-risk-of-iatrogenic.html





Tuesday, March 16, 2010



Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Part 4 REVISED FEB. 2010



http://creutzfeldt-jakob-disease.blogspot.com/2010/03/transmissible-spongiform-encephalopathy.html





Saturday, January 16, 2010



Evidence For CJD TSE Transmission Via Endoscopes 1-24-3 re-Singeltary to Bramble et al



http://creutzfeldt-jakob-disease.blogspot.com/2010/01/evidence-for-cjd-tse-transmission-via.html





Monday, July 20, 2009



Pre-surgical risk assessment for variant Creutzfeldt-Jakob disease (vCJD) risk in neurosurgery and eye surgery units



http://vcjdtransfusion.blogspot.com/2009/07/pre-surgical-risk-assessment-for.html





[2] UK: SEAC position statement on dentistry Date: Sat 30 Jun 2007 Source: Position Statement vCJD and Dentistry, Spongiform Encephalopathy Advisory Committee (SEAC) Update, June 2007 [edited]



Position Statement vCJD and Dentistry ------------------------------------- Issue ----- 1. The Department of Health (DH) asked SEAC to advise on the findings of preliminary research aimed at informing estimates of the risk of variant Creutzfeldt-Jakob Disease (vCJD) transmission via dentistry.



Background ---------- 2. Prions are more resistant than other types of infectious agents to the conventional cleaning and sterilization practices used to decontaminate dental instruments (1). Appreciable quantities of residual material may remain adherent to the surface after normal cleaning and sterilization (2). Therefore, if dental tissues are both infectious and susceptible to infection, the dental instruments are a potential mechanism for the secondary transmission of vCJD. Dentistry could be a particularly significant route of transmission for the population as a whole, due to the large number of routine procedures undertaken and also because dental patients have a normal life expectancy.



This is in contrast with other transmission routes, such as blood transfusion and neurosurgery, where procedures are often carried out in response to some life-threatening condition. Additionally, the ubiquity of dental procedures and the lack of central records on dental procedures means that should such transmission occur, then it would be difficult to detect and control.



3. No cases of vCJD transmission arising from dental procedures have been reported to date (3). Previous DH risk assessments (4,5) have focused on 2 possible mechanisms for the transfer of vCJD infectivity via dental instruments; accidental abrasion of the lingual tonsil and endodontic procedures that involve contact with dental pulp. In considering these assessments, SEAC agreed that the risk of transmission via accidental abrasion of the lingual tonsil appears very low. However, the risk of transmission via endodontic procedures may be higher and give rise to a self sustaining vCJD epidemic under circumstances where (i) dental pulp is infective, (ii) transmission via endodontic instruments is efficient and (iii) a large proportion of vCJD infections remain in a subclinical carrier state (SEAC 91, February 2006). In light of this, SEAC advised that restricting endodontic files and reamers to single use be considered (6). SEAC recommended reassessment of these issues as new data emerge.



New research ------------ 4. Preliminary, unpublished results of research from the Health Protection Agency, aimed at addressing some of the uncertainties in the risk assessments, were reviewed by SEAC (SEAC 97, May 2007). The prion agent used in these studies is closely related to the vCJD agent. This research, using a mouse model, shows that following inoculation of mouse-adapted bovine spongiform encephalopathy (BSE) directly into the gut, infectivity subsequently becomes widespread in tissues of the oral cavity, including dental pulp, salivary glands and gingiva, during the preclinical as well as clinical stage of disease.



5. It is not known how closely the level and distribution of infectivity in the oral cavity of infected mice reflects those of humans infected with vCJD, as there are no comparable data from oral tissues, in particular dental pulp and gingiva, from human subclinical or clinical vCJD cases (7). Although no abnormal prion protein was found in a study of human dental tissues, including dental pulp, salivary glands and gingiva from vCJD cases, the relationship between levels of infectivity and abnormal prion protein is unclear (8). Infectivity studies underway using the mouse model and oral tissues that are presently available from human vCJD cases will provide some comparable data. On the basis of what is currently known, there is no reason to suppose that the mouse is not a good model for humans in respect to the distribution of infectivity in oral tissues. Furthermore, the new data are consistent with published results from experiments using a hamster scrapie model (9).



6. A 2nd set of experiments using the same mouse model showed that non-invasive and transient contact between gingival tissue and fine dental files contaminated with mouse-adapted BSE brain homogenate transmits infection very efficiently. It is not known how efficient gingival transmission would be if dental files were contaminated with infectious oral tissues and then subsequently cleaned and sterilized, a situation which would more closely model human dental practice. Further studies using the mouse model that would be more representative of the human situation, comparing oral tissues with a range of doses of infectivity, cleaned and sterilized files and the kind of tissue contact with instruments that occurs during dentistry, should be considered.



7. SEAC considered that the experiments appear well designed and the conclusions justified and reliable, while recognizing that the research is incomplete and confirmatory experiments have yet to be completed. It is recommended that the research be completed, submitted for peer-review and widely disseminated as soon as possible so others can consider the implications. Nevertheless, these preliminary data increase the possibility that some oral tissues of humans infected with vCJD may potentially become infective during the preclinical stage of the disease. In addition, they increase the possibility that infection could potentially be transmitted not only via accidental abrasion of the lingual tonsil or endodontic procedures but a variety of routine dental procedures.



Implications for transmission risks ----------------------------------- 8. The new findings help refine assumptions made about the level of infectivity of dental pulp and the stage of incubation period when it becomes infective in the risk assessment of vCJD transmission from the reuse of endodontic files and reamers (10). For example, if one patient in 10 000 were to be carrying infection (equivalent to about 6000 people across the UK, the best current estimate (11), the data suggest that in the worst case scenario envisaged in the risk assessment, reuse of endodontic files and reamers might lead to up to 150 new infections per annum. It is not known how many of those infected would go on to develop clinical vCJD. In addition, transmission via the reuse of endodontic files and reamers could be sufficiently efficient to cause a self-sustaining vCJD epidemic arising via this route.



9. These results increase the importance of obtaining reliable estimates of vCJD infection prevalence. Data that will soon be available from the National Anonymous Tonsil Archive may help refine this assessment and provide evidence of the existence and extent of subclinical vCJD infection in tonsillectomy patients. Further data, such as from post mortem tissue or blood donations, will be required to assess prevalence in the general UK population (12).



10. Recent guidance issued by DH to dentists to ensure that endodontic files and reamers are treated as single use (13) is welcomed and should, as long as it is effectively and quickly implemented, prevent transmission and a self-sustaining epidemic arising via this route. However, the extent and monitoring of compliance with this guidance in private and National Health Service dental practice is unclear.



11. The new research also suggests that dental procedures involving contact with other oral tissues, including gingiva, may also be capable of transmitting vCJD. In the absence of a detailed risk assessment examining the potential for transmission via all dental procedures, it is not possible to come to firm conclusions about the implications of these findings for transmission of vCJD. However, given the potential for transmission by this route, serious consideration should be given to assessing the options for reducing transmission risks, such as improving decontamination procedures and practice or the implementation of single use instruments.



12. The size of the potential risk from interactions between the dental and other routes of secondary transmission, such as blood transfusion and hospital surgery, to increase the likelihood of a self-sustaining epidemic is unclear.



13. It is likely to be difficult to distinguish clinical vCJD cases arising from dietary exposure to BSE from secondary transmissions via dental procedures, should they arise, as a large proportion of the population is likely both to have consumed contaminated meat and undergone dentistry.



However, an analysis of dental procedures by patient age may provide an indication of the age group in which infections, if they occur, would be most likely to be observed. Should the incidence of clinical vCJD cases in this age group increase significantly, this may provide an indication that secondary transmission via dentistry is occurring. Investigation of the dental work for these cases may provide supporting data. There is no clear evidence, to date, based on surveillance or investigations of clinical vCJD cases, that any vCJD cases have been caused by dental procedures, but this possibility cannot be excluded.



Conclusions ----------- 14. Preliminary research findings suggest that the potential risk of transmission of vCJD via dental procedures may be greater than previously anticipated. Although this research is incomplete, uses an animal model exposed to relatively high doses of infectivity, and there are no data from infectivity studies on human oral tissues, these findings suggest an increased possibility that vCJD may be relatively efficiently transmitted via a range of dental procedures. Ongoing infectivity studies using human oral tissues and the other studies suggested here will enable more precise assessment of the risks of vCJD transmission through dental procedures.



15. Guidance was issued to dentists earlier this year [2007] recommending that endodontic files and reamers be treated as single use, which, provided this policy is adhered to, will remove any risk of a self-sustaining epidemic arising from reuse of these instruments. To minimize risk, it is critical that appropriate management and audit is in place, both for NHS and private dentistry.



16. It is also critical that a detailed and comprehensive assessment of the risks of all dental procedures be conducted as a matter of urgency. While taking into account the continuing scientific uncertainties, this will allow a more thorough consideration of the possible public health implications of vCJD transmission via dentistry and the identification of possible additional precautionary risk reduction measures. The assessment will require continued updating as more evidence becomes available on the transmissibility of vCJD by dental routes, and on the prevalence of infection within the population. A DH proposal to convene an expert group that includes dental professionals to expedite such an assessment is welcomed. Given the potential for transmission via dentistry, consideration should be given to the urgent assessment of new decontamination technologies which, if proven robust and effective, could significantly reduce transmission risks.



References ---------- (1) Smith et al. (2003) Prions and the oral cavity. J. Dent. Res. 82, 769-775. (2) Smith et al. (2005) Residual protein levels on reprocessed dental instruments. J. Hosp. Infect. 61, 237-241. (3) Everington et al. (2007) Dental treatment and risk of variant CJD - a case control study. Brit. Den. J. 202, 1-3. (4) Department of Health. (2003) Risk assessment for vCJD and dentistry. (5) Department of Health (2006) Dentistry and vCJD: the implications of a carrier-state for a self-sustaining epidemic. Unpublished. (6) SEAC (2006) Position statement on vCJD and endodontic dentistry . (7) Head et al. (2003) Investigation of PrPres in dental tissues in variant CJD. Br. Dent. J. 195, 339-343. (8) SEAC 90 reserved business minutes. (9) Ingrosso et al. (1999) Transmission of the 263K scrapie strain by the dental route. J. Gen. Virol. 80, 3043-3047. (10) Department of Health (2006) Dentistry and vCJD: the implications of a carrier-state for a self-sustaining epidemic. Unpublished. (11) Clarke & Ghani (2005) Projections of future course of the primary vCJD epidemic in the UK: inclusion of subclinical infection and the possibility of wider genetic susceptibility R. J. Soc. Interface. 2, 19-31. (12) SEAC Epidemiology Subgroup (2006) position statement of the vCJD epidemic . (13) DH (2007) Precautionary advice given to dentists on re-use of instruments .



-- Communicated by Terry S. Singletary, Sr.



******



http://www.promedmail.org/pls/otn/f?p=2400:1001:19224::::F2400_P1001_BACK_PAGE,F2400_P1001_ARCHIVE_NUMBER,F2400_P1001_USE_ARCHIVE:1001,20070702.2112,Y





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Monday, December 31, 2007



Risk Assessment of Transmission of Sporadic Creutzfeldt-Jakob Disease in Endodontic Practice in Absence of Adequate Prion Inactivation



http://creutzfeldt-jakob-disease.blogspot.com/2007_12_01_archive.html





Subject: CJD: update for dental staff Date: November 12, 2006 at 3:25 pm PST



1: Dent Update. 2006 Oct;33(8):454-6, 458-60.



CJD: update for dental staff.



http://seac992007.blogspot.com/2008/06/seac-2008-one-hundredth-meeting-of.html





Friday, July 17, 2009



Revision to pre-surgical assessment of risk for vCJD in neurosurgery and eye surgery units Volume 3 No 28; 17 July 2009



http://creutzfeldt-jakob-disease.blogspot.com/2009/07/revision-to-pre-surgical-assessment-of.html





Tuesday, August 12, 2008



Biosafety in Microbiological and Biomedical Laboratories Fifth Edition 2007 (occupational exposure to prion diseases)



http://creutzfeldt-jakob-disease.blogspot.com/2008/08/biosafety-in-microbiological-and.html





Thursday, January 29, 2009



Medical Procedures and Risk for Sporadic Creutzfeldt-Jakob Disease, Japan, 1999-2008 (WARNING TO Neurosurgeons and Ophthalmologists) Volume 15, Number 2-February 2009 Research



http://creutzfeldt-jakob-disease.blogspot.com/2009/01/medical-procedures-and-risk-for.html





Wednesday, August 20, 2008 Tonometer disinfection practice in the United Kingdom: A national survey



http://creutzfeldt-jakob-disease.blogspot.com/2008/08/tonometer-disinfection-practice-in.html





Tuesday, August 12, 2008 Biosafety in Microbiological and Biomedical Laboratories Fifth Edition 2007 (occupational exposure to prion diseases)



http://creutzfeldt-jakob-disease.blogspot.com/2008/08/biosafety-in-microbiological-and.html





Tuesday, May 04, 2010



Review of the Human Pituitary Trust Account and CJD Issue 20 January 2010



http://creutzfeldt-jakob-disease.blogspot.com/2010/05/review-of-human-pituitary-trust-account.html





Monday, May 19, 2008



SPORADIC CJD IN FARMERS, FARMERS WIVES, FROM FARMS WITH BSE HERD AND ABATTOIRS



http://bseinquiry.blogspot.com/2008/05/sporadic-cjd-in-farmers-farmers-wives.html





Friday, February 11, 2011



Creutzfeldt-Jakob disease (CJD) biannual update (2010/1) Emerging infections/CJD



http://creutzfeldt-jakob-disease.blogspot.com/2011/02/creutzfeldt-jakob-disease-cjd-biannual.html





Friday, February 19, 2010 Creutzfeldt-Jakob disease (CJD) biannual update (2010/1)



http://creutzfeldt-jakob-disease.blogspot.com/2010/02/creutzfeldt-jakob-disease-cjd-biannual.html





Monday, February 7, 2011



FDA's Currently-Recommended Policies to Reduce the Possible Risk of Transmission of CJD and vCJD by Blood and Blood Products 2011 ???



http://tseac.blogspot.com/2011/02/fdas-currently-recommended-policies-to.html





Saturday, January 29, 2011



Atypical L-Type Bovine Spongiform Encephalopathy (L-BSE) Transmission to Cynomolgus Macaques, a Non-Human Primate



Jpn. J. Infect. Dis., 64 (1), 81-84, 2011



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/atypical-l-type-bovine-spongiform.html





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



http://madcowtesting.blogspot.com/2011/02/transmissible-spongiform-encephalopathy.html





Friday, February 11, 2011



Atypical/Nor98 Scrapie Infectivity in Sheep Peripheral Tissues



http://nor-98.blogspot.com/2011/02/atypicalnor98-scrapie-infectivity-in.html





UPDATED DATA ON 2ND CWD STRAIN



Wednesday, September 08, 2010



CWD PRION CONGRESS SEPTEMBER 8-11 2010



http://chronic-wasting-disease.blogspot.com/2010/09/cwd-prion-2010.html





Tuesday, January 25, 2011



Generation of a new form of human PrPSc in vitro by inter-species transmission from cervids prions



http://chronic-wasting-disease.blogspot.com/2011/01/generation-of-new-form-of-human-prpsc.html





Journal of Virology, September 2009, p. 9608-9610, Vol. 83, No. 18 0022-538X/09/$08.00+0 doi:10.1128/JVI.01127-09 Copyright © 2009, American Society for Microbiology. All Rights Reserved.



Prion Infectivity in Fat of Deer with Chronic Wasting Disease



Brent Race,# Kimberly Meade-White,# Richard Race, and Bruce Chesebro* Rocky Mountain Laboratories, 903 South 4th Street, Hamilton, Montana 59840



Received 2 June 2009/ Accepted 24 June 2009



ABSTRACT Top ABSTRACT TEXT REFERENCES



Chronic wasting disease (CWD) is a neurodegenerative prion disease of cervids. Some animal prion diseases, such as bovine spongiform encephalopathy, can infect humans; however, human susceptibility to CWD is unknown. In ruminants, prion infectivity is found in central nervous system and lymphoid tissues, with smaller amounts in intestine and muscle. In mice, prion infectivity was recently detected in fat. Since ruminant fat is consumed by humans and fed to animals, we determined infectivity titers in fat from two CWD-infected deer. Deer fat devoid of muscle contained low levels of CWD infectivity and might be a risk factor for prion infection of other species.



snip...



The highest risk of human contact with CWD might be through exposure to high-titer CNS tissue through accidental skin cuts or corneal contact at the time of harvest and butchering. However, the likelihood of a human consuming fat infected with a low titer of the CWD agent is much higher. It is impossible to remove all the fat present within muscle tissue, and fat consumption is inevitable when eating meat. Of additional concern is the fact that meat from an individual deer harvested by a hunter is typically consumed over multiple meals by the same group of people. These individuals would thus have multiple exposures to the CWD agent over time, which might increase the chance for transfer of infection.



In the Rocky Mountain region of North America, wild deer are subject to predation by wolves, coyotes, bears, and mountain lions. Although canines such as wolves and coyotes are not known to be susceptible to prion diseases, felines definitely are susceptible to BSE (9) and might also be infected by the CWD agent. Deer infected with the CWD agent are more likely to be killed by predators such as mountain lions (11). Peripheral tissues, including lymph nodes, muscle, and fat, which harbor prion infectivity are more accessible for consumption than CNS tissue, which has the highest level of infectivity late in disease. Therefore, infectivity in these peripheral tissues may be important in potential cross-species CWD transmissions in the wild.



The present finding of CWD infectivity in deer fat tissue raises the possibility that prion infectivity might also be found in fat tissue of other infected ruminants, such as sheep and cattle, whose fat and muscle tissues are more widely distributed in both the human and domestic-animal food chains. Although the infectivity in fat tissues is low compared to that in the CNS, there may be significant differences among species and between prion strains. Two fat samples from BSE agent-infected cattle were reported to be negative by bioassay in nontransgenic RIII mice (3, 6). However, RIII mice are 10,000-fold-less sensitive to BSE agent infection than transgenic mice expressing bovine PrP (4). It would be prudent to carry out additional infectivity assays on fat from BSE agent-infected cattle and scrapie agent-infected sheep using appropriate transgenic mice or homologous species to determine the risk from these sources.



http://jvi.asm.org/cgi/content/full/83/18/9608





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.



Reference List



snip...



please see full text and many thanks to the Professor Soto and the other Authors of this study AND to The Journal Of Biological Chemistry for the free full text !!!



http://www.jbc.org/content/early/2011/01/04/jbc.M110.198465.long





PLEASE NOTE ;



there are now two documented strains of CWD, and science is showing that indeed CWD could transmit to humans via transmission studies ;



P35



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.



http://www.istitutoveneto.it/prion_09/Abstracts_09.pdf





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.



http://www.prion2010.org/bilder/prion_2010_program_latest_w_posters_4_.pdf?139&PHPSESSID=a30a38202cfec579000b77af81be3099





UPDATED DATA ON 2ND CWD STRAIN



Wednesday, September 08, 2010



CWD PRION CONGRESS SEPTEMBER 8-11 2010



http://chronic-wasting-disease.blogspot.com/2010/09/cwd-prion-2010.html





Friday, February 11, 2011



AN EPIDEMIOLOGIC CRITIQUE OF CREUTZFELDT-JAKOB DISEASE Vol. 2, 1980 Paul Brown vs Zohreh Davanipour and Scrapie



EPIDEMIOLOGIC REVIEWS



http://scrapie-usa.blogspot.com/2011/02/epidemiologic-critique-of-creutzfeldt.html





DID EVERYONE THAT LOST A LOVED ONE FROM CJD/TSE FILL OUT THEIR CJD/TSE QUESTIONNAIRE FROM THE CDC, NIH, PRION UNIT, CJD FOUNDATION ???



Friday, November 30, 2007



CJD QUESTIONNAIRE USA CWRU AND CJD FOUNDATION



http://cjdquestionnaire.blogspot.com/





Terry S. Singeltary Sr. P.O. Box 42 Bacliff, Texas USA 77518

Labels:

Friday, February 11, 2011

Creutzfeldt-Jakob disease (CJD) biannual update (2010/1)

Emerging infections/CJD




Creutzfeldt-Jakob disease (CJD) biannual update (2010/1)



This six-monthly report provides an update on reports of incidents of potential iatrogenic (healthcareacquired) exposure to CJD via surgery, and on the National Anonymous Tonsil Archive. Data are correct as of 26 January 2010.



For numbers of CJD case reports, readers should consult data provided by the national CJD Surveillance Unit (NCJDSU), Edinburgh [1]. The latest yearly analysis of vCJD reports (onsets and deaths) is also available from the NCJDSU website [2].



Reports of incidents of potential iatrogenic exposure to CJD via surgery: 2000 to 31 December 2009



Since the previous update report [3], 19 surgical incidents were reported – between 1 July and 31 December 2009 – bringing the total number reported since 2000 to 407 (table 1). A surgical incident occurs when a patient undergoes surgery but is only identified as having CJD or being at risk of CJD at a later date. This means that the ACDP TSE Working Group infection control guidelines would not have been followed. The surgery carried out on an index patient with, or at risk of CJD, may result in contamination of the instruments with abnormal prion protein. Table 1 shows the number of CJD surgical incidents reported to the CJD Incidents Panel from January 2000 to 31st December 2009 by the diagnosis of the index patient. Information about the CJD Incidents Panel can be found on the HPA website [4].



Table 1. Closed CJD Surgical Incidents (n=407) reported to the CJD Incidents Panel, by diagnosis of index patient: 1 January 2000 to 30 June 2009



Incident type 2000 2001 2002 2003 2004 2005 2006 2007 2008 First half 2009 Total



1. Sporadic (possible, probable or definite) 7 19 22 24 16 18 31 17 21 11 186(46%)



2. vCJD (possible, probable or definite) 6 14 22 5 4 1 2 – 1 1 56(14%)



3. Familial including 'at risk' familial – 2 2 7 1 3 7 – 2 2 26(6%)



4. 'At risk' vCJD blood component recipient – – – – 4 10 6 1 – – 21(5%)



5. 'At risk' - vCJD plasma product recipient – 1 2 – 10 18 9 8 6 8 62(15%)



6. 'At risk' - other – – 2 2 1 2 4 – – 1 12(3%)



7. CJD type unclear/ CJD unlikely 1 1 4 1 1 2 – – – 10(2%)



8. Not CJD 2 1 4 7 7 1 1 – 3 – 26(6%)



9.Other – – 1 1 1 2 1 – – – 6(1%)



10. No longer considered 'at-risk' – – 1 – – – – 1 – – 2(0%)



Total 16 38 56 50 45 56 63 27 33 23 407(100%)



Investigation of surgical incidents may result in advice to remove surgical instruments from clinical use (to quarantine, destroy, or donate for research). Such advice is generally only given for instruments considered to be potentially contaminated with the CJD agent that have not undergone a certain number of cycles of use and decontamination since their use on an index patient. Hospitals are asked to consider sending any instruments to be permanently removed from use to the Surgical Instrument Store (held by the Health Protection Agency, Porton Down) for research. Since 2000, there have been 46 incidents in which instruments were permanently removed from use.



The Panel may advise contacting and informing some patients of their possible exposure to CJD in a surgical incident. Such advice is generally only given for patients who have definitely been exposed to



Health Protection Report Vol 4 No. 7 - 19 February 2010



potentially contaminated instruments which have been used on risk tissues in certain index patients. The Panel may advise that some of these patients should be considered „at-risk of CJD for public health purposes' and asked to take certain precautions (ie, not to donate blood or other tissues and to inform their medical and dental carers prior to any invasive procedures) in order to reduce the risk of transmitting the CJD agent further. Since 2000, 22 incidents have given rise to such advice. There are currently nine incidents in which 77 patients have been categorised as „at-risk' by the Panel, according to the current risk assessment. Seven of these patients died before notification. A total of 31 patients are currently notified of their „at-risk' status. Notifications are pending for another 31 patients. Three patients have not been notified due to local, clinical decisions.



The Panel has revised its advice on endoscopy and anterior eye patients. This has led to patients being denotified in 2006 and 2009. This resulted in reclassification of 38 patients from the „at-risk' category; 32 in anterior eye surgery, two in invasive endoscopy.



Table 2. Panel advice to inform patients that they are ‘at-risk' of CJD/vCJD: 1 January 2000 to 30 June 2009



Diagnosis of index patient Procedure on index patient Number of Incidents Alive 'at-risk' Died before notification Total Notified Not notified Total



Sporadic CJD Brain biopsy 2 20 1* 21 2 28



vCJD Appendectomy 1 – 2* 2 – 2



Endoscopy and GI surgery 2† 3 1 ** 4 1 5



'At risk' vCJD Endoscopy and GI surgery 4 8 30** 38 4 42



Total – 9 31 34 65 7 77



*Local decision not to notify.



† The index patient in one of these incidents was a haemophiliac plasma product recipient with evidence of vCJD infection.



** Notification pending.



National anonymous tonsil archive for studies of detectable abnormal prion protein



The National Anonymous Tonsil Archive (NATA) continues to receive approximately 250 tonsil pairs per week (figure 1). The archive had received a total of 81,604 tonsil pairs up to the end of December 2009 from hospitals in England and Scotland. A further 3,000 tonsil pairs have been received from the Medical Research Council Prion Unit at the Institute for Neurology, National Hospital for Neurology and Neurosurgery. Therefore the total number of tonsil pairs in the archive was 84,604. The number of collection forms that were completed but no tonsil tissue collected was 2,395 (1,565 due to patient objection and 830 due to clinical pathology being requested).



Out of the 100 NHS Hospital Trusts that perform over 200 tonsillectomies per year in England, 91 have been recruited and are currently sending tonsil pairs to NATA on a regular basis. There are 120 hospitals sites within these trusts taking part in NATA. At present, approximately 50,000 tonsillectomies are performed annually in England. Figure 2 shows the number of tonsil pairs received from each Strategic Health Authority.



Health Protection Report Vol 4 No. 7 - 19 February 2010 Figure 1. Number of tonsil pairs collected for NATA quarterly: Q1 2004 – Q4 2009 Just over 5,000 tonsillectomies are performed in Scotland each year. The project in Scotland, where there are 14 hospitals that each carry out more than 200 tonsillectomies per year, is being coordinated by Health Protection Scotland. All fourteen of these hospitals have been recruited and are collecting tonsils for NATA. The tonsil tissue is being transported to the Health Protection Agency in Colindale for inclusion in the archive. Figure 3 shows all hospitals in England and Scotland currently recruited in the study. Figure 2. Tonsils pairs collected by Strategic Health Authority, January 2004 - December 2009 Health Protection Report Vol 4 No. 7 - 19 February 2010 Figure 3. NHS Trusts and Scottish Hospitals currently collecting and sending tonsil tissue to the archive December 2009 Testing of homogenates of the tonsil tissue from the archive began at the end of January 2007. Two enzyme immunoassays (EIAs) are being used for the initial screening of the homogenates for the presence of abnormal prion protein. These EIAs allow the identification of any tonsils that need to be investigated further by the more specific tests of Western blotting (WB) and immunohistochemistry (IHC) [5]. References 1. The National Creutzfeldt-Jakob Disease Surveillance Unit, The University of Edinburgh. CJD statistics. Available at:



http://www.cjd.ed.ac.uk/figures.htm.





2.The National Creutzfeldt-Jakob Disease Surveillance Unit, The University of Edinburgh. Incidence of variant Creutzfeldt-Jakob Disease Onsets and Deaths in the UK January 1994 - December 2006. Edinburgh: NCJDSU, 2 February 2007. Available at:



http://www.cjd.ed.ac.uk/vcjdqdec06.htm.




3. HPA. Biannual CJD update (2009/1). Health Protection Report [serial online] 2009; 3(27): Emerging Infections/CJD. Available at:



http://www.hpa.org.uk/hpr/archives/2009/hpr2709.pdf.




4. HPA. CJD Incidents Panel [online]. London: HPA, 2010. Available at:



http://www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1204031511121.




5. Spongiform Encephalopathy Advisory Committee. Combining evidence from tissue surveys to estimate the prevalence of subclinical vCJD. London: SEAC, 2008. Available at:



http://www.seac.gov.uk/papers/paper100-2.pdf.




http://www.hpa.org.uk/hpr/archives/2010/hpr0710.pdf




PLEASE notice where in 1990 in the UK, the sporadic CJD cases went from 28, to 88 cases of sporadic CJD in 2008, a steady increase.



CJD Figures These figures show the number of suspect cases referred to the CJD surveillance unit in Edinburgh, and the number of deaths of definite and probable cases in the UK, from 1 January 1990 up to 8th February 2011



http://www.cjd.ed.ac.uk/figures.htm




USA



National Prion Disease Pathology Surveillance Center



Cases Examined1



(November 1, 2010)



Year Total Referrals2 Prion Disease Sporadic Familial Iatrogenic vCJD



1996 & earlier 51 33 28 5 0 0



1997 114 68 59 9 0 0



1998 87 51 43 7 1 0



1999 121 73 65 8 0 0



2000 146 103 89 14 0 0



2001 209 119 109 10 0 0



2002 248 149 125 22 2 0



2003 274 176 137 39 0 0



2004 325 186 164 21 0 13



2005 344 194 157 36 1 0



2006 383 197 166 29 0 24



2007 377 214 187 27 0 0



2008 394 231 205 25 0 0



2009 425 258 215 43 0 0



2010 333 213 158 33 0 0



TOTAL 38315 22656 1907 328 4 3



1 Listed based on the year of death or, if not available, on year of referral;



2 Cases with suspected prion disease for which brain tissue and/or blood (in familial cases) were submitted;



3 Disease acquired in the United Kingdom;



4 Disease was acquired in the United Kingdom in one case and in Saudi Arabia in the other case;



5 Includes 18 cases in which the diagnosis is pending, and 18 inconclusive cases;



6 Includes 23 (22 from 2010) cases with type determination pending in which the diagnosis of vCJD has been excluded.



http://www.cjdsurveillance.com/pdf/case-table.pdf





Please notice where sporadic CJD cases in 1996 went from 28 cases, to 215 cases in 2009, the highest recorded year to date. sporadic CJD is on a steady rise, and has been since 1996.



I also urge you to again notice these disturbing factors in lines 5 and 6 ;



5 Includes 18 cases in which the diagnosis is pending, and 18 inconclusive cases;



6 Includes 23 (22 from 2010) cases with type determination pending in which the diagnosis of vCJD has been excluded.



========end=====tss=====2011



Monday, August 9, 2010



National Prion Disease Pathology Surveillance Center Cases Examined (July 31, 2010)



(please watch and listen to the video and the scientist speaking about atypical BSE and sporadic CJD and listen to Professor Aguzzi)



http://prionunitusaupdate2008.blogspot.com/2010/08/national-prion-disease-pathology.html




Tuesday, December 14, 2010



Infection control of CJD, vCJD and other human prion diseases in healthcare and community settings part 4, Annex A1, Annex J, UPDATE DECEMBER 2010



http://creutzfeldt-jakob-disease.blogspot.com/2010/12/infection-control-of-cjd-vcjd-and-other.html




Saturday, June 13, 2009



Monitoring the occurrence of emerging forms of Creutzfeldt-Jakob disease in the United States 2003 revisited 2009



http://cjdusa.blogspot.com/2009/06/monitoring-occurrence-of-emerging-forms.html




Saturday, January 2, 2010



Human Prion Diseases in the United States January 1, 2010 ***FINAL***



http://prionunitusaupdate2008.blogspot.com/2010/01/human-prion-diseases-in-united-states.html




my comments to PLosone here ;



http://www.plosone.org/annotation/listThread.action?inReplyTo=info%3Adoi%2F10.1371%2Fannotation%2F04ce2b24-613d-46e6-9802-4131e2bfa6fd&root=info%3Adoi%2F10.1371%2Fannotation%2F04ce2b24-613d-46e6-9802-4131e2bfa6fd




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.



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





Seven main threats for the future linked to prions



The NeuroPrion network has identified 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...



http://www.neuroprion.org/en/np-neuroprion.html




Wednesday, March 31, 2010



Atypical BSE in Cattle



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.



This study will contribute to a correct definition of specified risk material (SRM) in atypical BSE. The incumbent of this position will develop new and transfer existing, ultra-sensitive methods for the detection of atypical BSE in tissue of experimentally infected cattle.



http://www.prionetcanada.ca/detail.aspx?menu=5&dt=293380&app=93&cat1=387&tp=20&lk=no&cat2




snip...



please see all seven threats listed in the USA, and more...FULL TEXT ;



Thursday, August 12, 2010



Seven main threats for the future linked to prions



http://prionpathy.blogspot.com/2010/08/seven-main-threats-for-future-linked-to.html




http://prionpathy.blogspot.com/




Friday, February 11, 2011



AN EPIDEMIOLOGIC CRITIQUE OF CREUTZFELDT-JAKOB DISEASE Vol. 2, 1980 Paul Brown vs Zohreh Davanipour and Scrapie



EPIDEMIOLOGIC REVIEWS



http://scrapie-usa.blogspot.com/2011/02/epidemiologic-critique-of-creutzfeldt.html




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



http://madcowtesting.blogspot.com/2011/02/transmissible-spongiform-encephalopathy.html




Saturday, January 29, 2011



Atypical L-Type Bovine Spongiform Encephalopathy (L-BSE) Transmission to Cynomolgus Macaques, a Non-Human Primate



Jpn. J. Infect. Dis., 64 (1), 81-84, 2011



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/atypical-l-type-bovine-spongiform.html




Friday, January 21, 2011



Strain-Specific Barriers against Bovine Prions in Hamsters



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/strain-specific-barriers-against-bovine.html




Tuesday, January 25, 2011



Generation of a new form of human PrPSc in vitro by inter-species transmission from cervids prions



http://chronic-wasting-disease.blogspot.com/2011/01/generation-of-new-form-of-human-prpsc.html




Wednesday, January 19, 2011



EFSA BIOHAZ Scientific Opinion on the revision of the quantitative risk assessment (QRA) of the BSE risk posed by processed animal proteins (PAPs)



EFSA Journal 2011;9(1):1947



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/efsa-biohaz-scientific-opinion-on.html




Monday, January 17, 2011



MAD COW Update on Feed Enforcement Activities to Limit the Spread of BSE January 13, 2011



January 2011



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/mad-cow-update-on-feed-enforcement.html




Thursday, November 18, 2010



Increased susceptibility of human-PrP transgenic mice to bovine spongiform encephalopathy following passage in sheep



http://bse-atypical.blogspot.com/2010/11/increased-susceptibility-of-human-prp.html




Tuesday, January 18, 2011



Agent strain variation in human prion disease: insights from a molecular and pathological review of the National Institutes of Health series of experimentally transmitted disease



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/agent-strain-variation-in-human-prion.html




Thursday, December 23, 2010



Molecular Typing of Protease-Resistant Prion Protein in Transmissible Spongiform Encephalopathies of Small Ruminants, France, 2002-2009 Volume 17, Number 1-January 2011



http://transmissiblespongiformencephalopathy.blogspot.com/2010/12/molecular-typing-of-protease-resistant.html




Wednesday, January 19, 2011



EFSA and ECDC review scientific evidence on possible links between TSEs in animals and humans Webnachricht 19 Januar 2011



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/efsa-and-ecdc-review-scientific.html




Friday, January 21, 2011



Strain-Specific Barriers against Bovine Prions in Hamsters



http://transmissiblespongiformencephalopathy.blogspot.com/2011/01/strain-specific-barriers-against-bovine.html




Saturday, December 18, 2010



OIE Global Conference on Wildlife Animal Health and Biodiversity - Preparing for the Future (TSE AND PRIONS) Paris (France), 23-25 February 2011



http://transmissiblespongiformencephalopathy.blogspot.com/2010/12/oie-global-conference-on-wildlife.html




Monday, November 30, 2009



USDA AND OIE COLLABORATE TO EXCLUDE ATYPICAL SCRAPIE NOR-98 ANIMAL HEALTH CODE



http://nor-98.blogspot.com/2009/11/usda-and-oie-collaborate-to-exclude.html




http://bseusa.blogspot.com/2010/04/usda-and-oie-out-of-touch-with-risk.html




Tuesday, November 02, 2010



BSE - ATYPICAL LESION DISTRIBUTION (RBSE 92-21367) statutory (obex only) diagnostic criteria CVL 1992



http://bse-atypical.blogspot.com/2010/11/bse-atypical-lesion-distribution-rbse.html




Friday, February 11, 2011



Atypical/Nor98 Scrapie Infectivity in Sheep Peripheral Tissues



http://nor-98.blogspot.com/2011/02/atypicalnor98-scrapie-infectivity-in.html




Friday, February 04, 2011



NMLB and USDA allow scrapie prion infected mutton to enter food chain on the Navajo Reservation in New Mexico



----- Original Message -----



From: Terry S. Singeltary Sr.



To: President.BenShelly



Cc: sroanhorse ; opvp.nelson ; alaughing; georgehardeen; pressoffice



Sent: Thursday, February 03, 2011 12:15 PM



Subject: NMLB and USDA allow scrapie prion infected mutton to enter food chain on the Navajo Reservation in New Mexico



Greetings Honorable People of the Great Navajo Nation, and the Honorable President Ben Shelly,



I send this to you with great concern. ...



http://scrapie-usa.blogspot.com/2011/02/nmlb-and-usda-allow-scrapie-prion.html




Thursday, February 10, 2011



CWD ILLINOIS UPDATE FEBRUARY 2011 Locations of CWD-Positive Deer - Updated 2/07/2011



http://chronic-wasting-disease.blogspot.com/2011/02/cwd-illinois-update-february-2011.html




Thursday, February 10, 2011



Chronic Wasting Disease Found In A White-Tailed Deer In Maryland



http://chronic-wasting-disease.blogspot.com/2011/02/chronic-wasting-disease-found-in-white.html




Tuesday, January 25, 2011



Minnesota, National Veterinary Services Laboratory in Ames, Iowa, has confirmed CWD case near Pine Island



http://chronic-wasting-disease.blogspot.com/2011/01/minnesota-national-veterinary-services.html




Tuesday, January 25, 2011



Generation of a new form of human PrPSc in vitro by inter-species transmission from cervids prions



http://chronic-wasting-disease.blogspot.com/2011/01/generation-of-new-form-of-human-prpsc.html




http://chronic-wasting-disease.blogspot.com/





Monday, February 7, 2011



FDA's Currently-Recommended Policies to Reduce the Possible Risk of Transmission of CJD and vCJD by Blood and Blood Products 2011 ???



http://tseac.blogspot.com/2011/02/fdas-currently-recommended-policies-to.html




DID EVERYONE FILL OUT THEIR CJD QUESIONNAIRE FROM THE CDC AND OR THE CJD FOUNDATION ???



Friday, November 30, 2007



CJD QUESTIONNAIRE USA CWRU AND CJD FOUNDATION



http://cjdquestionnaire.blogspot.com/




Terry S. Singeltary Sr. P.O. Box 42 Bacliff, Texas USA 77518

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