MEXICO IS UNDER or MIS DIAGNOSING CREUTZFELDT JAKOB DISEASE AND OTHER PRION DISEASE SOME WITH POSSIBLE nvCJD
MEXICO IS UNDER or MIS DIAGNOSING CREUTZFELDT JAKOB DISEASE AND OTHER
PRION DISEASE SOME WITH POSSIBLE nvCJD
Can prion disease suspicion be supported earlier?
Clinical, radiological and laboratory findings in a series of cases
Alejandra González-Duarte,1,* Zaira Medina,1 Rainier Rodriguez Balaguer1
and Jesus Higuera Calleja2 1Department of Neurology and 2Neuroradiology; The
Insituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Mexico City,
Mexico Key words: Creutzfeldt-Jacob disease, prions
The subacute spongiform encephalopathies are prion diseases characterized
by acute and rapid neurodegeneration that lead to the death of the patient
within months to a few years. The epidemiology of CJD is complicated and the
frequency in Mexico is unknown. We aim to describe the cases of prion disease in
Mexico. Consecutive patients who met the diagnostic criteria by the WHO were
enrolled. We describe 26 patients with clinical manifestations, imaging and
laboratory studies compatible with prion disease. The mean age at onset was 52
years old. The main clinical manifestations were cognitive alterations (69%)
followed by extrapyramidal movements (50%), abnormal cerebellar function (46%),
behavioral alterations (46%), myoclonus (46%) and mood depression (23%), among
other features. Half of the patients progressed rapidly to a state of akinetic
mutism (53%). Only 2 (7.6%) patients had a family history of a similar disease.
Time interval between onset and diagnosis varied between 71 days to 24 months,
with a median of 6 months. The classical bilateral basal ganglia
hyperintensities were present in the very early stage of the disease. Protein
14-3-3 immuneassay in the CSF was positive in all measured cases. Bilateral
basal ganglia hyperintensities was the most important early finding, while
protein 14-3-3 was a late finding and the results were usually obtained after
the patient was discharged. Around 1.5 cases of CJD cases per year are reported
in our country. When suspected, MRI can support the diagnosis earlier than other
studies.
*Correspondence to: Alejandra González-Duarte; Email:
gonzalezduarte@aol.com Submitted: 04/04/11; Accepted: 07/24/11 DOI:
10.4161/pri.5.3.16187
snip...
The sporadic CJD (sCJD) form is responsible for 85–90% of CJD cases.
Several hypothetical mechanism for the origin and spread of sporadic CJD have
been proposed, including exposure to infected meat, or the appearance of
spontaneous somatic mutations to yield an infectious protein agent de novo. On
the other hand, the familial form features a dominant inheritance pattern.1,3
This form is caused by somatic mutations that occur in the prionic gene (PRNP)
located on the short arm of chromosome 20 at codon 102.1 Lastly, iatrogenic
transmission has also been described.
The epidemiology of CJD is very complicated. It has been recognized
worldwide, at rates of 0.25 to 2 cases per million per year. In Mexico, there
are only three previous reports of CJD cases3-5 among other reasons, due to
limited knowledge concerning this disease on the part of the medical staff,
which causes a lack of notification of cases, and an under-registration of the
disease.1 On the other hand, there are no centers or laboratories of
microbiology and genetics where tests to support the diagnosis of the disease
can be conducted.1 This is the case of most developing countries. However, the
following cases demonstrate that the clinical course is surprisingly
characteristic, and the findings in the MRI and EEG can accurately support the
diagnosis if the clinical suspicion is strong. We aim to provide evidence that
prion disease is more common than supposed. With this, we hope to increase the
awareness of the clinical features of CJD.
snip...
Results
Seven cases of suspected CJD cases were admitted to our Institution from
1999 to 2011. Demographic and clinical characteristics are individually
described and summarized on Table 1. Figure 1 shows the MRI images and Figure 2
the characteristic EEGs of these cases. In addition, we included two videos of
cases 1 and 7. Table 2 summarizes our findings with other the three reports of
Mexican CJD cases found in the literature. Searches were performed through
Pubmed using the terms “Creutzfeld- Jakob disease,” “prion disease,” “Protein
14-3-3,” “Mexico,” “Mexican.” To our knowledge, only 26 cases of CJFD have been
reported in our country.
Case 1. A 59-year old right-handed woman developed a rapidly progressive
mental disease and involuntary movements. Her family history was relevant for an
uncle with an unknown rapidly progressive mental disease. She was born in
Pachuca, Estado de México and lived in Mexico City. She did not eat red meat
regularly, nor did travel frequently, and was not exposed animals or toxins. She
had been diagnosed with type-2 diabetes mellitus 8 years earlier and developed
peripheral neuropathy and retinopathy. She was admitted for a 2 month history of
feeling anxious, irritable and forgetful, with loss of the circadian rhythm of
sleep. One month later she developed involuntary myoclonic movements of the
upper extremities. Her gait became unstable and her speech dysarthric. She lost
37 pounds (17 kilos). Bilateral tremor in upper extremities emerged along with
severe incoordination. She began to tumble and crash with objects. One week
before her admission she had a severe fall and she was brought to the emergency
department. At her arrival she was sleepy. When woken-up, her language was
non-fluent and very soft. Her facial expression was lost. She was able to
understand and follow orders, to name objects and repeat sentences, but she was
easily distracted and her thought was slow. Her left arm was clumsy. At that
time her MMSE was 26 points. Cranial nerve examination showed slow eye
movements. Muscle strength was normal. Tone was generalized increased. Deep
tendon reflexes were 2+ in the left side and 3+ in the right side. Plantar
reflexes were normal. She had bilateral tremor that was worse in the left side.
The finger-to-nose test was abnormal, as were the other coordination movements.
Gait was ataxic. Frontal release signs were present. Five days after her
hospitalization her MMSE declined to 11 points. Blood tests were normal,
including thyroid function tests, VDRL and serology for EBV. CSF analysis showed
glucose of 74 mg/dL, proteins of 52 mg/dL and no cells. PCR for herpes simplex
virus, varicella zoster virus and JC virus were negative. CSF gram stain,
Ziehl-Nilsen stain and the cryptococcal antigen were negative. Antineoplasic
antibodies (anti-Ri and anti-Yo) in CSF were also negative. The brain MRI showed
bilateral hiperintesities in caudate and putamen nucleus (Fig. 1A). Protein
14-3-3 was positive (4,200 UI) in CSF. She died one month after being
discharged.
Case 2. A 60-year old man developed dementia rapidly. His mother died of a
similar disease at an unknown age. He was born and lived in Poza Rica, Veracruz.
He had finished elementary school and was a businessman. He denied toxic
exposures or drug use. He was admitted to the hospital for a 3 month history of
altered mental status, dizziness and weakness in the lower extremities. One
month later he presented spontaneous involuntary movements during sleep. He was
prescribed carbamazepine without improvement. Two weeks later he developed
aggressive behavior that alternated with a state of perplexity and indifference
to the surroundings. He also developed speech alterations and visual
hallucinations. There was an involuntary weight loss of 20 kg. He was admitted
to our hospital for further study. Upon admission he was awake, but he did not
follow simple commands. He was disoriented in time and place. His language was
soft, non-fluent and dysarthric. MMS was of 14 points. His muscle strength was
decreased, worse in lower than in the upper extremities. He had a left Babinski
sign. The cerebellar function was severely impaired, he had altered
finger-to-nose test and impaired coordinating movements worse in the left side.
He showed normal liver function tests, normal thyroid tests and negative
antithyroid antibodies. Vitamin B12 levels (1,297 pg/ml) and serum calcium (9.7
mg/dL) were within normal range. HIV was negative. A brain CT only showed
cortical atrophy. The EEG showed generalized spikes (Fig. 2A). In the CSF
analysis cell count was negative as were the cultures and stains, but there was
a marked increase in the 14-3-3 protein. He was discharged and did not have
further follow-up.
Case 3. A 66-years old woman developed a rapidly dementing syndrome. She
was a widower and housekeeper. She lived in Michoacán. She was exposed to wood
smoke for over 20 years. She denied other toxic exposures or drug use. She had
contact with hens and dogs. Her left kidney was removed for unknown reasons 20
years before, and two years ago she was diganosed with type-2 diabetes. She was
admitted for headache, dizziness, slowness in thinking and speech that began one
year earlier and worsened three months before addmission. At her arrival she was
alert but her attention span was impaired, and she was disoriented. Her speech
was fluent but incongruent. The cranial nerve examination, muscle strength and
reflexes were normal. Babinski signs were absent. The sensory examination was
normal. There were no abnormal movements. She had frontal release signs. The
finger-nose test was abnormal in both sides, as were the rapid alternating
movements. She had severe ataxia and her gait was unstable. One month later she
had difficulty for making eye contact, her speech became nonfluent and
dysarthric. She had eye wondering and was unable to follow simple commands. VDRL
was negative, vitamin B12 serum levels were inbeteween ranges and she had normal
liver and thyroid function tests. Anti-Hu antibodies were indetermiated, but
anti-Yo antibodies were negative. CSF analysis showed a leucocyte count of 2
cells/mm3, and PCR for tuberculosis was negative. Her MRI showed hyperintensity
of basal ganglia suggestive of CJD. Her EEG showed diffuse slow activity with
periodics sharp waves. She worsened in weeks, as she was unable to follow
commands and was mute and acinetic. She was discharged home.
Case 4. A male of 57 years of age came for altered mental function and
involuntary movements. He lived in Morelos, finished elementary school and
worked as a gardener. He had a cousin that died of a neurological disease that
consisted of encephalopathy and seizures. He smoked tobacco occasionally, but
had no other toxic exposures or drug use. He began 3 months before his admission
with involuntary movements on his left upper arm and slow speech. He had a
normal CT scan. One month later he was unable to communicate or walk. He had
trouble swallowing, generalized rigidity and slowness in his movements. His
coordination was worse on the left side. His laboratory studies were normal. CSF
analysis was normal. The MRI showed bilateral hyperintensities in the basal
ganglia (Fig. 1B). His EEG showed slow activity with triphasic waves in the
right midtemporal region. He was discharged and no further follow-up.
Case 5. A 60-years old male had rapid dementia. He was married, completed
elementary school and worked as a policeman. He was from Coacalco, Estado de
México and lived in Mexico City. He smoked (Tobacco index of 21) and drank
alcohol heavily every other week since age 22. He began two months before
admission with dizziness, sleepiness and severe headache that woke him at night.
He was irritable, very emotional and complained of auditory hallucinations. One
month later, involuntary myoclonic movements developed on the right arm, as well
as tremor in his left arm. At his arrival he showed impaired concentration and
difficulties in performing mental tasks, and he had impaired short span memory.
His thought was slow and his speech was dysarthric. He had severe difficulties
in finding objects in front of him. His cranial nerve examination was relevant
for vertical nistagmus and bilateral sensoryneural hypoacusia. Mucular tone was
increased in the left side. He had spontaneous myclonic movements in the upper
and lower extremities. He had ataxia and altered rapid alternating movements.
While walking he tended to fall to the left side. His laboratory studies showed
marked elevation of TSH and he was prescribed with levothyroxine. Liver function
tests and electrolytes were normal. Vitamin B12 levels were normal (>15,000).
Nor VRDL or anti-thyroid antibodies were done. He had a first EEG that showed
diffuse slow activity and a second EEG performed one week later showed periodic
sharp waves (Fig. 2C). His CSF analysis showed proteins of 60 mg/dL, and severe
elevation of 14-3-3 protein. He died one month later.
Case 6. A 50 year-old woman developed dementia rapidly. She was divorced
and worked as a secretary. She lived in Mexico City. She smoked and drank
alcohol occasionally. She began one year before with muscular weakness, muscular
atrophy and involuntary movements in the upper extremities. She began falling to
the right side and experiencing dizziness and upper extremity rigidity. At her
arrival she was inattentive, disoriented and unable to follow simple commands.
Her speech was non-fluent. Cranial nerve examination was relevant for vertical
nistagmus and left XI nerve paralysis. Muscle strength was 3/5 in upper
extremities and 0/5 in the lower extremities. Deep tendon reflexes were 3+ in
the upper and lower extremities. She had a fixed flexed posture on both arms
above the torax and of both legs above the hip. There was severe spasticity.
There were muscle fasciculations in the upper extremities. She was unable to
perform the finger-nose test and her movements were uncoordinated on both sides.
Frontal release reflexes were present. Cognitive functions declined within three
months. The patient was mute and did not make eye contact with other persons.
Liver function tests were normal, seric sodium was 128 mEq/L, VDRL, HIV and PPD
were negative. Thyroid function was normal, as it was the vitamin B12 levels,
and the antithyroid, anti-Yo and anti-borrellia antibodies. Seric heavy metal
levels were normal. Her CSF showed increased proteins of 64 mg/dL with normal
glucose and no cells. VHS PCR, cryptococcus antigen and black ink stain were
negative. Her MRI showed hyperintensity in the basal ganglia, and the EEG showed
triphasic waves (Fig. 2B). The 14-3-3 protein on the CSF was positive. She died
two months later.
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Case 7. A 38-year old woman born in Guerrero came because a rapidly
developing psychiatric illness associated with involuntary movements. She began
11 months earlier with abnormal behavior, easy crying and somnolence. She was
very irritable and fought constantly with her husband. She was diagnosed with
mood depression and started on SSRIs. She began having episodes of unexplained
aggression and haloperidol and quetiapine were prescribed. Five months later she
developed visual hallucination and insomnia. She presented rapid and
non-rhythmic coarse involuntary movements of the lower and upper extremities.
She began walking on her toes and her balance was impaired. She stumbled and
fell frequently. She began presenting continuous involuntary movements that were
also present at night. Soon after she was unable to walk. Ten months later she
was admitted to the hospital. Her MMSS was 12/30 and her speech was dysarthric.
Muscle strength was 4/5, but deep tendon reflexes and muscle tone were normal.
Hoffmann and Tromner signs were present, but she did not show Babinski signs.
She had severe ataxia and severe alterations on the finger-to-nose test and of
the rapid alternating movements. She had myoclonus of the upper and lower limbs.
Frontal release signs were not present. She had normal laboratory results
including thyroid function tests and antinuclear antibodies. HIV and VDRL were
negative. Heavy metal screening for aluminum, copper, arsenic, nickel, zinc and
lead were negative. The CSF examination showed glucose of 58 mg/dL, proteins of
38 mg/dL and cero cells. Oligoclonal bands were negative. The MRI showed
bilateral hypeintense images in the basal ganglia (Fig. 1C) with enlarged
ventricles. The EEG showed slow background activity, poor gradient, poor
reactivity to stimuli and sparse triphasic waves on the left frontotemporal
region. Protein 14-3-3 was positive in the CSF. Akinetic mutism developed and
she was discharged.
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Discussion
The occurrence and significance of spongiform encephalopathies in Mexico is
unknown. Four cases were reported from 1996– 2001,4,5 and 18 more cases were
detected between 2000–2005.3 We are adding seven new cases identified in our
Institution from January 1999 to February 2010, counting for a total of 26
patients (Table 2). According to the World Health Organization criteria,1 six
(23%) were classified as definite, ten (38%) as probable and ten (38%) possible.
The overall incidence is relatively low when compared to the reports from other
countries.
The mean age at onset was 52 years old, slightly younger than what it is
reported in the literature,1,3,4 where mean age for sporadic CJD is 60 to 69
years old. The main clinical manifestations were cognitive alterations (69%),
followed by extrapyramidal movements (50%), abnormal cerebellar function (46%),
behavioral alterations (46%), myoclonus (46%) and mood depression (23%), among
other features (Table 2). Half of the patients progressed rapidly to a state of
akinetic mutism (53%). Only two (7.6%) patients had a family history of a
similar disease. More than one third (39%) of the patients were born and lived
in Mexico City, and three of the four centers that reported the cases were also
in this location.
Time interval between onset and diagnosis varied between 71 days to 24
months, with a median of 6 months. According to the Slow Virus Infection
Research Committee stages of the disease6 most of the patients were seen on
stages I (nervousness, insomnia, headache, dizziness, mood depression or
anxiety) before admission to our facilities, 19 (65%) were seen at stage II
(occurrence of a distinct neurological syndrome with a prominent involvement of
cortical functions and hallucinations) and only ten (38%) arrived at a later
stage (severe reduced movement or complete akinetic mutism).
CSF findings were irrelevant in most cases, as only mild proteinorraquia
was present in some. However, for the past decade, new diagnostic tests have
shown to be extremely helpful. Albeit virtually all patients with CJD have
abnormal EEG findings, most of them are non-specific at the early stages.2,11
However, the importance of performing an EEG relies on the fact that
abnormalities only rarely occur in patients with rapidly progressive dementia of
other etiologies such as Alzheimer disease, vascular dementia or Lewy body
disease.2,11
Increased signal intensity in caudate nucleus, putamen and parietal or
occipital cortical areas in fluid-attenuated inversion recovery (FLAIR) and
diffusion-weighted (DW) MRI sequences were seen in all of the cases who had an
MRI (Fig. 1) and in almost half of the patients of the other series. This
finding was the earliest and most consistent positive result. We think that the
distinguishing features of the MRI, along with a typical clinical course, can be
used as the basis of the diagnosis when 14-3-3 protein in the CSF is not
available. As described before, DWI abnormalities have a higher sensitivity
(92%) and specificity (93–98%), and may be detected as early as 3 weeks of
symptom duration.7-9 Detection of protein 14-3-3 in the CSF has been the most
promising surrogate marker for prion disease in the last years, for which a
specificity of 84% and a sensitivity of 94% have been reported in reference 5,
10 and 11. Although CSF protein 14-3-3 was positive in most cases, the result
often came back after the patient was discharged. Brain biopsy may be diagnostic
of CJD, however, this procedure can be recommended only if some other
potentially treatable disease remains to be excluded.
The patient of case 7 has several interesting findings. First, she was
relatively young for sporadic (sCJD), as she was 38 years old at admission. The
median age at death for sCJD is 68 years old, and for vCJD is 28 years old. She
also displayed prominent psychiatric and behavioral symptoms at onset, and the
overall duration of illness was 11 months. Although these features are more
consistent with the variant form of the disease (vCJD) than with sCJD, in which
duration of the disease is usually shorter, between 4 and 5 months and dementia
and neurologic signs are present earlier or at the same time of the psychiatric
manifestations, against vCJD is the presence of periodic sharp waves on the
electroencephalogram and no evidence for suspecting iatrogenic or acquired
disease.
No occupational activities were more prevalent and the origin of the
sporadic disease could not be eluded from this study. We found two patients who
had a family history of a similar disease. It is generally considered that
between 10 and 15% of CJD cases have a family history of the disease.3
Our study has several deficiencies. First, we do not perform biopsies or
autopsies in all of our patients. Second, PrP genotyping is available in other
countries and is useful for genotyping the patients, unfortunately it is not
performed in our country or similar developing countries. Even when CSF 14-3-3
protein determination may be carried out in some medical centers as special
studies, it was not possible to perform it in all the patients. Lastly, we do
not have the time of the duration of the disease in many cases, mostly because
it was considered that a close followup in a specialized center far from their
local environment would not change the clinical course and would only add the
inconvenience of the trip.
Non-the less, we consider that this study reveal important information
about CJD in our country. There is a tendency to underestimate the real
frequency of the disease, and it is possible that it is more common than it
appears, but less diagnosed due to technical and clinical deficiencies.
snip...
Conclusions CJD is rarely recognized, however, the rapid development of
signs and symptoms in addition to abnormalities in the MRI and EEG will aid the
diagnosis in many cases despite not having timely access to CSF protein 14-3-3.
Specially, the early identification of new onset of depression, agitation,
irritability or memory loss should not be overlooked in middle age patients who
do not have a previous history of a psychiatric or neurologic illness.
Unfortunately, there is no treatment available, however, the recognition of more
cases will allow us to understand the epidemiology and pathophysiology of this
rare and devastating disease.
Disclosure of Potential Conflicts of Interest
No potential conflicts of interest were disclosed.
snip...see full text ;
Monday, May 21, 2012
Creutzfeldt-Jakob disease cluster in the health area of Meixoeiro Hospital
Conclusions The incidence of CJD in the health area of Meixoeiro Hospital
is three times higher than expected. The hypothesis that at least some cases of
sCJD are apparently because of covert transmission or zoonosis events should not
be formally refuted and might explain the high rate found.
snip...see full text ;
IMPORTATION OF LIVE CATTLE FROM MEXICO INTO THE UNITED STATES FOR IMMEDIATE
SLAUGHTER
Bovine Spongiform Encephalopathy never mentioned, and Mexico has NO idea
what their BSE risk status is.
Scientific Report of the European Food Safety Authority on the Assessment
of the Geographical BSE-Risk (GBR) of MEXICO
Question N° EFSA-Q-2003-083
Adopted July 2004
Summary
The European Food Safety Authority and its Scientific Expert Working Group
on the Assessment of the Geographical Bovine Spongiform Encephalopathy (BSE)
Risk (GBR) were asked by the European Commission (EC) to provide an up-to-date
scientific report on the GBR in Mexico, i.e. the likelihood of the presence of
one or more cattle being infected with BSE, pre-clinically as well as
clinically, in Mexico. This scientific report addresses the GBR of Mexico as
assessed in 2004 based on data covering the period 1980-2003.
The BSE agent was probably imported into Mexico and could have reached
domestic cattle. These cattle imported could have been rendered and therefore
led to an internal challenge in the mid to late 1990’s. It is possible that
imported meat and bone meal (MBM) into Mexico reached domestic cattle and leads
to an internal challenge around 1993.
It is likely that BSE infectivity entered processing at the time of
imported ‘at - risk’ MBM (1993) and at the time of slaughter of imported live
‘at - risk’ cattle (mid to late 1990s). The high level of external challenge is
maintained throughout the reference period, and the system has not been made
stable. Thus it is likely that BSE infectivity was recycled and propagated from
approximately 1993. The risk has since grown consistently due to a maintained
internal and external challenge and lack of a stable system.
EFSA concludes that the current geographical BSE risk (GBR) level is III,
i.e. it is likely but not confirmed that domestic cattle are (clinically or
pre-clinically) infected with the BSEagent. The GBR is likely to increase due to
continued internal and external challenge, coupled with a very unstable system.
Key words: BSE, geographical risk assessment, GBR, Mexico, third countries
SNIP...
Annex to the EFSA Scientific Report (2004) 4, 1-13 on the Assessment of the
Geographical BSE Risk of Mexico
- 7 -
2.3 Overall assessment of the external challenge
The level of the external challenge that has to be met by the BSE/cattle
system is estimated according to the guidance given by the SSC in its final
opinion on the GBR of July 2000 (as updated in January 2002).
Live cattle imports:
According to the CD the country imported in total over the period 1980 to
2003, approximately 3.2 million live cattle from BSE - risk countries, of which
conclusively none came from the UK. The numbers shown in table 1 are the raw
import figures and are not reflecting the adjusted imports for the assessment of
the external challenge. Broken down to 5 - years periods the resulting external
challenge is as given in table 3. This assessment takes into account the
evidence that certain imported cattle did not enter the domestic BSE/cattle
system, i.e. were not rendered into feed. In the case of Mexico, it is assumed
that “cattle still alive” (imports from Spain) did not enter the rendering
system.
MBM imports:
According to the CD the country imported in total over the period 1980 -
2003 approximately 826,000 tons MBM from BSE - risk countries (according to
“other data”: ~ 919,000 tons), of which none came from the UK. The numbers shown
in table 2 are the raw import figures and are not reflecting the adjusted
imports for the assessment of the external challenge. Broken down to 5 - years
periods the resulting external challenge is as given in table 3. This assessment
takes into account the evidence that certain imported MBM did not enter the
domestic BSE/cattle system or did not represent an external challenge for other
reasons. However, in the case of Mexico, there was not sufficient evidence to
remove any quantities of MBM from the external challenge.
SNIP...
Annex to the EFSA Scientific Report (2004) 4, 1-13 on the Assessment of the
Geographical BSE Risk of Mexico
- 12 -
would harbour, while being pre - clinical, as much infectivity as a
clinical BSE case. Hence cattle imports could have led to an internal challenge
about 3 years after the import of breeding cattle (that are normally imported at
20 - 24 months of age) that could have been infected prior to import. In case of
Mexico this implies that an internal challenge caused by live cattle imports
(predominantly from USA or Canada) first occurred in the mid to late 1990’s and
continued to the present.
On the other hand imports of contaminated MBM would lead to an internal
challenge in the year of import, if fed to cattle. The feeding system is of
utmost importance in this context. If it could be excluded that imported,
potentially contaminated feed stuffs reached cattle, such imports might not lead
to an internal challenge at all. In case of Mexico this implies that an internal
challenge caused by MBM imports (predominantly from USA or Canada) first
occurred around 1993 and continued to the present.
In view of the above - described consideration the combination of the very
/ extremely high external challenges with a very unstable system makes the
occurrence of an internal challenge likely in Mexico from approximately 1993
onwards.
4.2 Risk that BSE infectivity entered processing
It is likely that BSE infectivity entered processing at the time of
imported ‘at - risk’ MBM (1993) and at the time of slaughter of imported live
‘at - risk’ cattle (mid to late 1990’s). The high level of external challenge is
maintained throughout the reference period, and the system has not been made
stable, leading to increased internal challenge.
4.3 Risk that BSE infectivity was recycled and propagated
It is likely that BSE infectivity was recycled and propagated from
approximately 1993. The risk has since grown consistently due to a maintained
internal and external challenge and lack of a stable system.
5. CONCLUSION ON THE GEOGRAPHICAL BSE – RISK
5.1 The current GBR as function of the past stability and challenge
The current geographical BSE risk (GBR) level is III, i.e. it is likely but
not confirmed that domestic cattle are (clinically or pre-clinically) infected
with the BSE-agent.
5.2 The expected development of the GBR as a function of the past and
present stability and challenge
• The GBR is likely to increase due to continued internal and external
challenge, coupled with a very unstable system.
SNIP...
The most recent assessments (and reassessments) were published in June 2005
(Table I; 18), and included the categorisation of Canada, the USA, and Mexico as
GBR III. Although only Canada and the USA have reported cases, the historically
open system of trade in North America suggests that it is likely that BSE is
present also in Mexico.
Subject: Mexico SAGARPA Assessment of BSE VS EFSA Scientific Report on the
Assessment of the Geographical BSE-Risk (GBR) of Mexico
Date: February 5, 2007 at 1:11 pm PST
Empresa solicitante: SAGARPA
Tipo del análisis efectuado: Cuantitativo
Temática: “Análisis de riesgo sobre la ocurrencia de la encefalopatía
espongiforme bovina en México”
INTRODUCTION:
The bovine spongiform encephalopathy (BSE), it is a neurological disease,
invariably fatal and with long period of incubation, that affects cattle. Its
etiologic agent is the prion. General consensus exists with respect to that the
feeding of contaminated meat and bone flours, it is the most significant source
in the dissemination and transmission of this etiologic agent. At this time
there is no exist evidence that BSE is transmitted by means of embryos, their
semen and in case of existing maternal transmission, if this could happened it
would be in a so extremely low rate that it could not be considered like a
trigger or leading factor of an epidemic. Controversy in respect to other
probable ways of transmission remains. The BSE was diagnosed for the first time
in 1986 in the United Kingdom. At this time it exists in 26 countries, including
a Canada and the United States of North America (USA).
This document summarizes the analyzed elements and the results of the study
of the evaluation of the risk factors, of the epidemiology surveillance and
related activities, as well as the quantitative estimation of the risk with
respect to the probability of introduction of the disease to the Mexican
herd.
EVALUATED ELEMENTS:
Demography and characteristics of the Mexican cattle industry: Cattle is
one of the main activities in the Mexican farming sector, due to its
contribution in the supply of meat (beef) products, dairy, among others; as well
as its participation in the international trade on cattle exports, mainly to the
United States of North America.
According to data of the 2001, cattle population is of 30.620.933 of heads,
of which 28.480.803 are beef cattle and 2.140.130 dairy cattle. The main cattle
production states are located in the center-north, where its operation is
intensive and its feeding is based on grains; as well as in the coast of the
Gulf of Mexico and the south-southeastern, with intensive programs and feeding
is based mainly on the pasturing (grass). The national dairy herd, is calculated
as specialized or technified that represent 17,44% of the herd, semi-specialized
14,90% of the herd, double-purpose herd (beef and dairy) 59,68% and the small
family-run herd or the referred as “backyard” (traspatio) 7,98%.Previous numbers
are to be considered as an estimation of the dairy livestock inventory by
production units. Nevertheless, it is necessary to consider that all races of
pure breed can be found in anyone of those groups.
Legal grounds: Mexico counts on a normative frame that covers (deals with)
the relevant aspects of the Epidemiology Surveillance of the BSE, like the
Federal Law of Animal Health, the Federal Law of Metrology and Regulation, the
General Law of Health and several Mexican Official Norms (NOM-009-Z00-1994,
Sanitary process of the meat, NOM-030-ZOO-1995, Specifications and procedures
for the import of beef, carcasses, viscera and offal at zoo-sanitary inspection
points, NOM-061-ZOO-1999, Zoo-sanitary specifications of nutritional products
destined for animal feed and NOM-060-ZOO-1999, Zoo-sanitary specifications for
the transformation of animals offal and its use in animal feeding). Wider and
extended covertures of these regulations were evaluated.
Veterinary infrastructure: The veterinary services in the country are
structural and normative organized by the Mexican State through the Secretariat
of Agriculture, Livestock, Rural Affairs, Fishery and Alimentary (SAGARPA)
Federally Empower, that is to say, that has the capacity and authority to
negotiate an to come to agreement with the States Governments that integrate the
Republic; to coordinate itself with the other Secretariats of State; to deal
with organizations of the Private and Social sector as well as with the rest of
the Civil Society as a whole.
The National Service of Health, Food Safety and Ag-alimentary Quality
(SENASICA), it is an organism of this Secretariat, which has attributions in the
matter of vegetable health, animal health and ag-alimentary safety and is
conformed by the following main directorates: Sanidad Vegetal, Salud Animal,
Inocuidad Agroalimentaria, Acuícola y Pesquera, Inspección Fitozoosanitaria,
(equivalent to U.S. APHIS, FSIS and VS –Veterinary Services) Jurídica,
Administración e Informática. In accordance with the assigned attributions, it
corresponds to central offices the substantive part and the operative part, to
the personnel assigned to the State Delegations of the SAGARPA and other
instances of the SENASICA.
Consequently, the four main areas are assigned to the Main directorate of
Salud Animal-Animal Health (DGSA) and to the Main directorate of Inspección
Fotozoosanitaria-Plant Inspection (DGIF) and Veterinary Services (SV) in Mexico
are in charge of: surveillance, epidemiology, animal movement, zoo-sanitary
campaigns and emergencies.
Imports This is perhaps one of the medullar points, in the sense that it
represents the information of the imports made during the risk periods and
therefore, it provides the fundamental information for the risk assessment. In
1991, Mexico implemented measures to avoid the appearance of BSE, as the disease
had become a serious worldwide problem, reason why, live bovines imports were
prohibited, beef, beef products and by-products and in 1994 flour of meat and
bone from countries affected by this disease was also prohibited and in the 2000
MBM feeding ban was imposed. In order to mitigate the risk of transmission of
the EEB, a revision of the established requirements for import for ruminants’
products began.
Cattle imports and its products and by-products, as well as specific risk
materials played a very important role in this study, where considerable amounts
of cattle imports from countries now affected by BSE were identified, countries
that at the time of the import they remained clean and therefore just some
preventive risk measures were in place.
Slaughter, Cattle disposition and Offal.- Different cattle slaughter
schemes were analyzed as well as the processes in use, finding some significant
differences among them, being the most important the sanitary jurisdiction of
the organizations that regulate us.
In Mexico, the slaughter is divided in three different systems, Federal
Inspection Type Plants (TIF), which has been increased in the past years; in
1992 they participated with the 13,5%, in 1997 with the 19,40% and in 2002 with
the 26,60% of the national total. In the case of the municipal slaughterhouses
from 1992 to 1997, their slaughtered animals corresponded to the 49,5% and for
2002 it was increased to 73,4%, whereas the slaughter in private plants
decreased of 37,10% in 1992 to 31,10%, in 1997 and from 1998 to date, we have no
information.
The procedures to be followed by the establishments in the animal slaughter
and those that industrialize, process, packing, chilled/froze beef products or
by-products for human consumption, in order to obtain products of optimal
hygienic quality, are written in the NOM-009-ZOO-1994 “sanitary Process of
Beef”.
The direct consumption of beef can be stratified in three great destinies,
differentiated by the market that are destined to, the rural one, the one of
small centers of population, (and) the one of the big cities, characterized each
one of them by its consumption and the partial or integral industrialization by
direct consumer and by means of commercialization or points of sale, as well as
for the origin of the own supplier.(?)
Rendering of Cattle Products.
The processes applied by the rendering plants for obtaining the protein
from inedible offal, were evaluated.
Food elaboration and its use for animal feeding.- This analysis was focused
in the processes of food elaboration for animal consumption.
In Mexico, the control in the production of food from animal origin, as
much as the elaboration of the meat flour as that of the balanced food
manufacture it is regulated by the Mexican Official Norm NOM-061-ZOO-1999,
“Zoo-sanitary Specifications of nutritional products for animal consumption”,
which bans the use of MBM flours of ruminant origin or any mixture that contains
it for the elaboration of balanced meals for ruminants, and the Mexican Official
Norm NOM-060-ZOO-1999, “Zoo-sanitary Specifications for the transformation of
animal offal and its use in the animal feeding”.
In accordance with the Section of Manufacturers of Balanced Food for
Animals of the National Camera of the Industry of Transformation (CANACINTRA),
there are 396 balanced food plants registered, same that have the capacity to
produce more than 20 million tons a year, according to the numbers registered
during 1999-2002. 63% of such plants are integrated and produce 64% of the
animal feed produced nationwide, the rest corresponds to commercial
plants.
The animal feed produced by the integrated plants, that is the most
significant part, during the 2002 it produced the 58,7% of the products destined
for raising of poultry, the 16,5% for swine, the 14,3% for dairy and 9,2% for
feedlots (cattle) and 1,3% for other species.
As far as the composition of the main raw materials to produce balanced
foods, these mainly correspond in 45% to domestic sorghum and 55% sorghum
concentrated; 16% to domestic yellow maize and 84% imported; 91% domestic
protein pastes and 9% imported; 80% of other domestic forage grains (broken
maize, wheat, barley, oats, etc.) and 20% imported and other ingredients (wheat
by-products, maize, vitamins, minerals, oils, etc.).
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Neuropathies in Mexico, Epidemiology Surveillance Program.- For this
analysis, the legal elements related to the notification of the BSE were taken
into account, in Mexico, as well as the activities made by the Commission Mexico
- United States for the Prevention of the Aftosa Fever and Other Exotic Diseases
of Animals (CPA), official entity in charge of carrying out this activity and
other connected activities as training, taking of samples and the diagnosis of
laboratory.
BSE Diagnosis.
Veterinary Services diagnoses capacity was evaluated as well as its
adherence to the international standards, according to what is indicated by the
International Organization of Animal Health (OIE), as well as the processes of
taking and shipping of samples.
For the diagnosis of the BSE, the OIE recommends five laboratory tests:
Histopathology (HP), Immunohistochemistry (IHQ), Western blot
(immunotransferency), ELISA (enzimoinmunoassay) and Bio-assay in mouse. At this
time Mexico counts with two laboratories of diagnosis for this disease: the
National Center of Services of Diagnosis in Animal Health (CENASA) and the
Laboratory of high security of the CPA. The CENASA performs the histopathology
test and at the CPA the Immunohistochemistry test is carried out.
The reception of samples at CPA, it depends to a great extent on the
economic resources which are accounted for this activity, expense that is
approximately of $400,00 ($ 36.50 USD.) per sample received (includes the
material for conservation, packing and shipping), reason for what, have to wait
for the collection of several to be sent at the same time and in order to reduce
costs, but delaying the result. As the CPA does not have a certified pathologist
to carry-out the HP test technique, these samples are sent to the CENASA for
their diagnosis; this implies that such samples are stored by approximately one
week, since it doesn’t have the human resources for its transfer.
The main problem at CENASA, for the right operation of the diagnosis of the
BSE, it is the lack of coordination on shipping and receiving of samples, which
is not done accordingly to the calendar of the laboratory and the operative
area, because in a short period of time the expected/projected number of samples
is exceeded, resulting in delays in accomplishment of the tests and the
disposition in excess of material and human resources.
At this moment, the techniques are being standardized, Immunohistochemistry
at the CENASA and the western blot (immunmotransferency) at the CPA, which will
allow us to have more tools for the diagnose in Mexico; in addition, the WB
allow us to count on another technique of the higher sensitivity and
specificity, that guarantees optimal result in less time (approximately 8
hours).
It must be mentioned that, we have had contemplated the formation of a
network of laboratories of diagnosis of TSE´s to specialized on the HP
technique, where we will have 6 regional laboratories and 4 universities
involved, this will in the future allow the processing and diagnosis of the
sample from its place of origin and only its confirmation by other techniques at
central level. For this, we already count with the procedure for the
authorization and verification of a laboratory of histopathology for the
diagnosis of the BSE.
Monetary Compensation to cattle dealers: Because the BSE is considered as
an exotic disease, a contingency fund that could be put to work in case the
disease appears, does not exist at this time.
In the case of the contingency funds, the national campaign for diseases
relies on a section on this subject. Nevertheless, for the exotic diseases
official norms do not exist and article 36 of the Federal Law of Animal Health
only establishes that will be due to create, but it does not explain the
mechanism to be considered for its creation.
The pre-established form to compensate the possible producers that are
themselves affected by the presence of BSE in their cattle, it will be from the
federal budget that is agreed upon the program Alliance for the Country for the
corresponding fiscal year.
In this sense, it is necessary to pinpoint that the minimum amount to
consider for this budget will be a 4% of the total assigned to the
Fito-zoo-sanitary Contingencies Plan on behalf of the Federal Government.
This will have a distribution by federal entity, which a specific amount
will be able to be assigned to joint, if necessary, to the DINESA against the
BSE. Also, the State Governments will proportionally contribute an equal amount
to the federal to be incorporated to the compensation funds of the Device of
Emergency. As for the cattlemen, they will have to come-up with resources
equivalent to the third part of the total amount assigned by the Federal and
State governments.
Animal identification and traceability of cattle products.- Different
elements were considered with which Mexico counts on to carry out the
traceability of animals and its products upon a sanitary problem, including the
animal identification and the organizations related to this activity.
Actually, the identification system of the cattle in Mexico is organized in
two forms, one State-ID with aims of demonstration of property and control of
cattle rustling and another Federal-ID, with aims of identification for the
development of the zoo-sanitary campaigns against the bovine tuberculosis and
brucellosis, first it is based on the registry and recognition of the Hot-Brands
of each producer, and the second in addition to the previous system, one is
based on a metallic earring of blue color with a number of identification, which
is described in the NOM-031-ZOO-1995, Campaña Nacional Contra la Tuberculosis
Bovina (Mycobacterium bovis), National Campaign Against Bovine
Tuberculosis.
This procedure assigns a number to an animal, which is used during
zoo-sanitary surveillance campaigns, these activities are registered along with
an identification number, in a document called test-opinion, in which it is
written down, in addition to the test results applied to the animals, the
identification and data of the cattle herd and ranch of origin of the animal for
its later traceability. This test-opinion is along with the certificate of “Herd
free of bovine tuberculosis” as described in the same Mexican Official
Norm.
According to the procedure previously described, in Mexico, there were
around 3.291 registered herds with 282.932 heads of bovines identified in 2003,
that represents 0,94% of the total population in this country.
Nevertheless, in the same NOM, it’s expressed in point 11 referring to
mobilization that the animals coming from disease-free herds, they will be able
to be mobilized to any destination within the national territory with no need to
be tested for tuberculosis before its mobilization, if the following
requirements are met: obtain a zoo-sanitary certificate, and for the
zoo-sanitary certificate to be issued, certification that they come from a
disease-free herd and that the animals must have a disease-free herd
identification.
Considering that in order to mobilize the animals it is necessary to have a
valid disease-free zoo-sanitary certificate, we can estimate that there are more
than 3,431,022 identified animals, according to the information obtained from
the Statistical Report of the Cattle Mobilization of FY2000, with information
captured up to the 24 of August of 2001 by the National Organism of Herd
Certification, A.C., that represents the 11,4% of the bovine total population on
which we can observe that more than 50% of these mobilizations are directed to
slaughterhouses, 17% to feedlots, 15% for export and 11% for pasturing.
Based on the above, experience of a suitable animal traceability is shown
specially in the case of the animals destined to be exported, where the USDA
when finding a positive animal reactor to the tests of tuberculosis in the
United States, it has been possible to trace it back to its the original herd;
on the other hand, the identification system used on dairy cattle, which counts
on a homogenous system of identification for production and genetic improvement
control, nevertheless, this mechanism although is available for the federal
government, it would make use of, only in the presence of a serious epidemiology
event.
Educational Programs, Awareness and Training.- The CPA, one of its
activities, is to maintain a permanent program of training courses on exotic
diseases of the animals, on a national context. In 1994, BSE awareness programs
were incorporated , with the diffusion of information, talks and courses on the
following areas: disease history, economic consequences, etiology, transmission
mechanisms, clinical signage, histopathology injuries, differential diagnosis,
measures of prevention and activities of epidemiologist surveillance, supported
by audio-visual means, these programs are taken to a diverse audience, including
the students of the last semesters of Veterinary Medicine, to the personnel that
conforms the Quarantine National System, as well as Veterinary Doctors,
government, private and to other specialists.
ESTIMATION OF RISK (Risk Assessment)
According to the qualitative estimation in this assessment, it was
determined that the risk of occurrence of the disease in the bovine population,
is low.
The quantitative estimation index was located at 5.268908E 08 of the risk
of disease exposure of the national herd, number that represents numerically
like a low probability of occurrence of the problem in Mexico.
CONCLUSIONS AND RECOMMENDATIONS
Conclusions
The BSE is a disease that was described for the first time in 1986,
nevertheless, today, epidemiologists have many unanswered questions on how is
transmitted.
The introduction of the BSE in Mexico would cause a serious socioeconomic
impact, commercial, political and probably of public health concern, because the
presence of the disease would restrict sanitarily and commercially, disrupting
the actual distribution of meat products at national level and to other
countries, independently of the impact in the consumption of the inhabitants
with respect to the beef consumption and products of bovine origin.
Considering the way of transmission, in case of a breakout, the native
animals that are at greater risk of being infected in Mexico, those are the
dairy cattle in specialized systems and the bovines at feedlots in the arid and
tropical regions.
In Mexico, we got Laws, Mexican Official Norms and Agreements, that cover
relevant aspects of the epidemiology surveillance of the BSE, same that must be
fortified in its operative phase, mainly in its application and
enforcement.
The Mexican Official Norm NOM-030-ZOO-1995, Specifications and procedures
for the import of beef, carcasses, viscera and offal at zoo-sanitary inspection
points, prohibits the import of cattle products, however, fresh beef has been
imported, chilled, frozen and beef preparations, as long as it comes from
animals smaller of thirty months of age, which diminishes the risk but does not
exclude it.
The evaluation showed that the four great areas of concern are assigned to
the Main Directorate of Animal Health (DGSA) and to the Main Directorate of
Fito-zoo-sanitary Inspection (DGIF); responsibility of the Veterinary Services
in Mexico, in relation to the BSE are: epidemiology surveillance, animal
movement control, zoo-sanitary campaigns and emergencies; functionality and
capability of communicating among them was evaluated as we as the capacity of
response before a sanitary emergency caused by the BSE.
It is necessary to increase and to better coordination of the surveillance
activities, particularity between the areas of diagnoses and operational, for
the correct execution of the surveillance activities in the field.
The imported bovines (1996-2003) have been slaughtered and those destined
to improve genetics, once they conclude their productive life and are discarded,
will also be slaughtered.
The actions of detection of downer-cows need to be reinforced for its
processing at TIF plants, till now a deficient activity, where the majority of
the animals with such clinical characteristics, regularly are not taken this
plants but rather are slaughtered at same ranch/location and consumed regionally
or they are taken to slaughterhouses without supervision and sanitary
inspection.
Ante mortem inspections need to be reinforced at Federal Inspection Type
Plants, municipal and private slaughterhouses, mainly in these two last ones,
with the purpose of detecting bovines clinically affected by BSE.
There is commercial interest to incorporate flours of meat and bone of
ruminants in the rations destined to the feeding of the bovines, like an
alternative source of protein matter, reason why official mechanisms must be
reinforced in preventing this type of illegal practices.
One of the tools in preventing the BSE is to avoid the exposure of the
native bovines to the consumption of presumably contaminated feed with the
pathological agent or unless is processed by means of a thermal process that
guarantees its inactivation. However, the heat treatment that the flours of meat
and bone are put under in XXXXXX XXXXX XXXXX XXXXXX XXXXXX XXXXXX XXXXXX XXXXX
XXXXX XXXX XXXXX XXXXXX XXXXX XXXXX XXXXXX XXXXX XXXXX XXXX during 20 minutes),
even though this one, it does not guarantee the destruction of the prion either,
but it reduces its infectivity significantly.
The Country counts on regulations, in respect to the transformation of
offal (NOM-061-ZOO-1999), there still are deficiencies as to the number and
qualification of the personnel responsible in supervising their fulfillment
through inspection and verification.
Deficiencies in the availability of technical information at official and
private levels were detected, crucial information necessary for the elaboration
of the present assessment, such as the case of the information on product
imports and on rendering plants, were not available for the study.
Blood was not considered as a potential source of transmission of the BSE,
by-product in form of flour (dry blood), that is also produced by the rendering
plants and is used in animals feeds.
The BSE epidemiology surveillance program in Mexico must be reinforced by
focusing on a target animal study (bovine suspected of BSE and with suggestive
clinical signs of the disease). On the other hand, as a result from this study,
we found that a percentage of the obtained samples for BSE testing have been
inadequately collected and among other causes were: absence of cerebral stem,
incomplete cerebral stem, over-manipulated samples, advanced changes (decompose)
postmortem, not enough tissue to work on, low concentration of conservative
(solution) or samples taken from inadequate age of animal (too young); showing
all of these, a necessity to review these procedures.
It was also detected the fact that, as a routine practice the samples sent
for the diagnosis of bovine rabies, whenever they come out positive to this
disease, they are no longer processed for the BSE testing, discarding with this,
the possibility of finding both diseases in a same animal, rabies virus and the
BSE prion. It is also concluded that with the loss of diagnosis material, it
prevented us from obtaining valuable epidemiology information useful in
restructuring our surveillance program.
The identification of the cattle, as well as the traceability of its
products and by-products, presents serious deficiencies at national level, which
is important in case the BSE is detected in the Country, given its importance
like a primordial component to trace, to prevent and to eradicate this and other
animal diseases, turning out to be an additional vital tool to determine the
dissemination degree in case of break-out in the country, that would immediately
allow us to be able to establish its origin (native or imported) and to take the
appropriate counter-epidemic measures.
From 1994, the Commission Mexico - United States for the Prevention of
Foot-and-Mouth Disease (FMD) and other Exotic Diseases (CPA), it has carried out
activities of awareness and training on BSE, however, this has been centered to
certain zones of the country, leaving some other zones, particularly the rural
zones without cover, same that can provide with valuable epidemiology
information and some cases for diagnosis of neuropathy in ruminants.
According to the analysis made on the risk assessment in its qualitative
modality, it is considered like low-risk, the risk of introduction of the BSE to
the national herd, whereas the quantitative study locates it in values of
5.268908E-08.
Recommendations:
We ought:
to reinforce the inspection and supervision activities by the sanitary
authority of the SAGARPA over all of those involved in the cattle production
chain, in respect to the fulfillment and application of the established
technical regulations expressed on the official norms on the monitoring of BSE,
specially the NOM-060-ZOO-1999, Zoo-sanitary specifications for the
transformation of animals offal and its use in animal feeding and the
NOM-061-ZOO-1999, Zoo-sanitary specifications of nutritional products for animal
consumption;
to increase the number of inspectors (Vet Doctors) as much as governmental
as private, with a vision of having a better supervision of the rendering plants
and feed factories. It is recommendable that such inspectors have a veterinary
doctor’s degree.
to reinforce the active epidemiology surveillance subsystem, having special
attention to aim at target animals and the size of the statistical test, as well
as its stratification at national level;
to review, to update and to homologate the criteria and definitions of the
Mexican official norms related to the monitoring of the BSE and the requirements
of import, according to norms NOM-008, NOM-030 and NOM-060;
to provide technical and legal elements in the official norms, that may
allow to optimize the use of financial and human resources (federal, state and
private), with the purpose of that the material and human infrastructure, the
installed diagnoses and the potential, can be used with greater efficiency, in
the prevention activities, diagnosis and surveillance of the BSE in
Mexico;
to homologate the mechanism of training in the obtaining of the samples for
the BSE, using the technique of the teaspoon, by means of a national
program;
to have a certified pathologist for the high security laboratory of the
CPA, because this situation of not having one, causes the delay in the
processing of samples, as well as the loss of economic resources by requiring
the support of the CENASA;
to plan the taking of samples at a national level and to coordinate its
shipment to the CPA for its processing in the laboratory of high security or its
re-expedition to the CENASA, with the purpose of optimizing the diagnosis;
to obtain funds and allocate them at each state, in order to compensate
cattle dealers affected by the animal culling at risk by BSE, in case of BSE
showing up in Mexico, the same or similar mechanism are to established for the
handling of monetary compensation, like the one used on the Alliance for the
Country or to extend the already existing state government faculties, by means
of an exclusive and specific account for the implementation of BSE comp
payment.
to implement a national animal identification and traceability system, its
products and by-products, that it may allow us to apply prevention measures and
control of diseases, as it would be the case of the BSE.
With foundation in Article 14, fraction VI, of the Federal Law of
Transparency and Access to the Governmental Public Information, the following
paragraphs have been blocked:
Justification of the blockade (p. 6, paragraph 1):
Gallinaza and pollinaza- feather meal (hay bed or substrate on which birds
grow up, constituted by rice husk, straw or another type of hay, agriculturist,
that at the end of the raising cycle of young hens or chicken, contains the
feces of the animals that were bred on it, as well as rest of non-consumed food
by the birds), it has been considered in multiple occasions, like an element of
potential risk in the transmission of the bovine spongiform encephalopathy
(BSE), when it is used to feed ruminants. The risk is generated, as it is
common, the bird feed, contains flours of meat and bone of ruminant like source
of protein. In this way, in theory, if some of the bovines with which the meat
and bone flour was prepared as bird feed were infected with the BSE prion and
given the high resistance of the agent (prion) to high temperatures, in the
industrial process as the making of the flour, like the making of the
nutritional concentrated feed for birds, and even the passage by digestive-tract
of the bird, it would not guarantee the destruction of the BSE prion, reason why
the possibility would exist, when gallinaza or pollinaza is used in the feeding
of ruminants, this could infect susceptible ruminants.
With foundation in Article 14, fraction VI, of the Federal Law of
Transparency and Access to the Governmental Public Information, the following
paragraphs have been blocked:
Justification of the blockade (p. 6, paragraph 2):
As much gallinaza as pollinaza, they can contain up to a 3% of wasted food,
independently of bird feces that could also contain the prion, all implying that
the flours of meat and bone of bovine origin, can be consumed by other bovines
and by doing this, constituting a possible situation of BSE risk.
Norma NOM-060-ZOO-1999 Zoo-sanitary specifications for the transformation
of animal’s offal and its use in animal feeding and the NOM-061-ZOO-1999
Zoo-sanitary Specifications of nutritional products for animal consumption, they
clearly indicate the prohibition to feed ruminants with flours of meat and bone
of ruminant origin, however, the prohibition to feed ruminants with gallinaza or
pollinaza, is not contemplated in these norms.
With foundation in Article 14, fraction VI, of the Federal Law of
Transparency and Access to the Governmental Public Information, the following
paragraphs have been blocked:
Justification of the blockade (p. 6, paragraph 3):
Other elements to consider are the production cycles of the farms of birds
in Mexico, a common practice is that when a cycle is reached (ended) “all
inside, all outside”, and the pollinaza and gallinaza are destined to feed the
cattle. Depending on the type and the characteristics of the bed, it is possible
to calculate an approximated weight of 13,9 kg. by square meter of bird farm
surface.
With foundation in Article 14, fraction VI, of the Federal Law of
Transparency and Access to the Governmental Public Information, the following
paragraphs have been blocked:
Justification of the blockade (p. 6, paragraph 4):
In the Mexican market, two types of products are accepted: pollinaza and
gallinaza, which has been consolidated as a production system, considering that
near 90% of the feces are used as ruminant’s feed, with prices reaching near
those of cereal grains, the rest is used in agriculture.
With foundation in Article 14, fraction VI, of the Federal Law of
Transparency and Access to the Governmental Public Information, the following
paragraphs have been blocked:
Justification of the blockade (p. 6, paragraph 5):
The use of the animal feces like source of high nutrients supply, it obeys
mainly to its high content of mineral matter and non-protein nitrogen. In
general, nitrogen is concentrated in greater amount in bird feces. What is
doubtless, it is that the feces are raw material available all the year long for
animal feeding, especially bovines.
The FAO (1980) made a description of the physical composition of pollinaza
as it is detailed next:
Feces 62%
Bed 31%
Wasted Feed 3%
Feathers 2%
Unknown ingredients related to fresh matter 2%
Source: The FAO. Feed from Wastes Animal: State of knowledge, Production
animal and Health, to paper 18. Rome, Italy 1980.
Conclusion:
Making public the information that has been eliminated of the report, it
would open the door for those in the grain business to use it for their benefit
and by pressing the government/the authority to establish a NOM banning such
products as ruminant feed. This would bring/cause an important alteration in the
commercialization of these products nationwide, which in turn would remarkably
increase the production costs of the cattle in feed lots. Today, we foresee
escalating grains prices at medium term, originated by its use in the ethanol
production; this would aggravate the situation and force a NOM as described
before, which in addition, if our sanitary status with respect to the BSE is
considered low, it would be obviously excessive cost and highly harmful for the
producer of birds and cattle. It is why, that it was decided to block the
reference information.
With foundation in Article 14, fraction VI, of the Federal Law of
Transparency and Access to the Governmental Public Information, the following
paragraphs have been blocked:
Justification of the blockade (p. 12, paragraph 3):
During the period between 1996 to 2003 years in which, considering the long
period of incubation of the BSE, the disease was already present in the United
States of America and Canada, Mexico as usual, imported considerable amounts of
calves destined for dairy production. In the same term “bullfight” bulls from
Spain were imported once Europe reached a free status from FMD, same that
allowed the import of some cattle for reproduction from other European
countries, with exception of the United Kingdom and Ireland, countries in which
BSE already existed.
In all the cases these imports were immediately stopped even before the
confirmation of BSE in those countries, nevertheless, as already indicated, the
ample period of incubation of the disease, those imports are looked as of
certain risk, even though in that moment they were not.
The nonexistence of a national animal identification and traceability
system at that time made it impossible to establish the destiny of most of those
animals and to even know if they have been eliminated at the end of its
productive life. It is possible to indicate that the recent imports of heifers
coming from the United States of America and in the near future from Canada, new
requirements and actions that guarantee their traceability and other measures to
mitigate the BSE risk, are in place.
Even though during the administration of the Lic. Vicente Fox, the SAGARPA
made a concerted effort to establish the National System of Individual Cattle
Identification (SINIIGA), the magnitude, cost and coverage of the project, its
conclusion in the short and medium term are way far distant, what implies that
it will be long time before Mexico can count on a suitable (working) national
system of identification and traceability of animals and products of origin
animal.
The blockade of the above paragraph obeys to the convenience of not
exposing to the Federal Government to unnecessarily critics that even though
funded, it would not contribute to the solution of a problem that, although is
of urgent attention, by its magnitude and cost, it exceeds in much, the present
capacities as much of the Government, like of the National Cattlemen Sector. The
critic would sustain in that what it is said in such paragraph is purely
speculative, without possibility of corroborating it documentarily.
END...
Hola Amigo Terry,
Finally, here is a translation - if you can call it that - i'm not happy
with it but guess that some paragraphs are very literally translated (poorest
job i have ever done translating a document), please read it and if something is
not clear enough or not right just let me know it and i'll correct it...
If you don't find anything of importance; if it is to vague and shows that
they have done nothing about it; if somehow it gives you the impresion that they
don't know a thing and are trying to cover their butts in a very stupid
way;...yea! you got the right impression!!
All they are saying it's a "mea culpa" and we ought to do this and that; we
don't know how they came in or where they are; we are looking into it; we
screwed up all the BSE testing and we don't know how to do it right; it is too
costly and we don't have the money; we didn't do it, past administration did it;
we are trying to fix it; etc.,
All of the above and more, but we are following OIE rules, we have NO BSE
anywhere and risk is extremely low or null, but CATTLEMEN WIL BE
COMPENSATED!!
Conclusion- they are a bunch of murderers and me a national security threat
for having them to admit it!! .....Oh my Lord!
snip...end (tss)
Have a wonderful weekend and our best regards,
xxxxxxxxxxxxxxxxxxxxxxx
=======================================
BSE MAD COW IN MEXICO ???
El proyecto más grande de la Fundación CJD es su proyecto continuo con su
Línea de Ayuda gratuita (1800-659-1991). La línea de ayuda está disponible para
familias que están lidiando con diagnosis sospechado de CJD de sus personas
amadas y necesitan apoyo e información, y para personas que tienen preguntas
referentes a la enfermedad de Prion como son: médicos, profesionales, directores
de funerales, embalsamadotes, público en general, prensa y medios de
comunicación.
En la parte posterior, podrá encontrar las estadísticas de la Línea de
Ayuda de Enero 1, 2010 – Febrero 28, 2010.
La Fundación de CJD no es una agencia de reporte y no se requiere que las
familias nos reporten la enfermedad o muerte de sus seres queridos La intención
de estas estadísticas no es de naturaleza científica, sino por lo contrario, son
para ayudar a validar el trabajo que realizamos diariamente.
2010 NUEVOS CASOS REPORTADOS TOTAL DE MUERTOS REPORTADOS EN EUA
LINE DE AYUDA
(LLAMADAS DE FAMILIA)
LINE DE AYUDA
(E-MAILS DE FAMILIA)
SITIOWEB VISITANTES
UNICOS
Enero 28 19 62 52 3,996
Febrero 23 20 75 29 4,313
Total = 51 39 137 81 8,309
Nota: No todos los nuevos casos y muertes reportados son confirmados por
autopsia.
Ganadores de Fondos de la Fundación CJD 2009
ATTEMPTED CJD SURVEILLANCE MEXICO
105 MILLION
4 BASIC
WORKER
NON WORKER
GOV
PRIVATE
PROB
PATIENT SURVEILLANCE AND HEALTH INSTITUTIONS TO COOPERATE.
VERY DIFFICULT TO GO INTO NEUROLOGY
PRIONS IN MEXICO LAST YEAR
REVIEW DEATH CERTIFICATES GUADALOHARO NO MENTION OF CJD IN THE LAST 12
YEARS...2 CASES...SEARCH THROUGH DEATH CERTIFICATES AT HIS HOSPITAL. DATA NOT
COMPLETE TO CALCULATE PREVALENCE. MOST PATIENT BY INTERNET, FEW BY NEUROLOGIST.
OFFERS TO NEUROLOGIST TO GET INFORMATION FROM USA PRION UNIT.
no prion studies by this institution or surveillance being done by this
institution.
BASICALLY, Mexico has no CJD surveillance program, as with the BSE
surveillance policy. ...
Geographical BSE risk assessment and its impact on disease detection and
dissemination
Original Research Article
Preventive Veterinary Medicine, Available online 1 February 2012,
Mo Salman, Vittorio Silano, Dagmar Heim, Joachim Kreysa
Preventive Veterinary Medicine
1 February 2012
Geographical BSE risk assessment and its impact on disease detection and
dissemination
Salman M, Silano V, Heim D, Kreysa J.
Source
Campus Stop 1644, Animal Population Health Institute, College of Veterinary
Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
80523-1644, USA.
Abstract
Bovine Spongiform Encephalopathy (BSE) rapidly evolved into an issue of
major public concern particularly when, in 1996, evidence was provided that this
disease had crossed the species barrier and infected humans in the UK with what
has become known as "variant Creutzfeldt Jakob Disease" (vCJD). The aim of this
paper is to describe the European Geographical BSE risk assessment (GBR) that
was successfully used for assessing the qualitative likelihood that BSE could be
present in a country where it was not yet officially recognized. It also
discusses how this can lead to risk-based and therefore preventive management of
BSE at national and international levels. The basic assumption of the GBR method
is that the BSE agent is initially introduced into a country's domestic cattle
production system through the importation of contaminated feedstuffs or live
cattle. This is referred to as an "external challenge". The ability of the
system to cope with such a challenge is, in turn, referred to as its
"stability": a stable system will not allow the BSE agent to propagate and
amplify following its introduction, while an unstable system will. The
BSE-status of a country assessed by this system was used by the European
Commission as the basis for trade legislation rules for cattle and their
products. The GBR was an invaluable tool in evaluating the potential global
spread of BSE as it demonstrated how a disease could be transferred through
international trade. This was shown to be a critical factor to address in
reducing the spread and amplification of BSE throughout the world. Furthermore,
GBR resulted in the implementation of additional measures and management
activities both to improve surveillance and to prevent transmission within the
cattle population.
Copyright © 2012 Elsevier B.V. All rights reserved.
see more here ;
IN SHORT, AND IN A NUT SHELL ;
(Adopted by the International Committee of the OIE on 23 May 2006)
11. Information published by the OIE is derived from appropriate
declarations made by the official Veterinary Services of Member Countries. The
OIE is not responsible for inaccurate publication of country disease status
based on inaccurate information or changes in epidemiological status or other
significant events that were not promptly reported to the Central Bureau,
PO-028: Oral transmission of L-type bovine spongiform encephalopathy
(L-BSE) in primate model Microcebus murinus
Nadine Mestre-Frances,1 Simon Nicot,2 Sylvie Rouland,1 Anne-Gaëlle
Biacabe,2 Isabelle Quadrio,3 Armand Perret-Liaudet,3 Thierry Baron,2 Jean-Michel
Verdier1 1IN SER M UM2; Montpellier, France; 2Anses; Lyon, France; 3Hopitaux
Civils de Lyon; Lyon, France
An atypical form of bovine spongiform encephalopathy has been identified in
cattle in Europe, North America and Japan and was designed as L-type BSE (L-BSE)
due to the lower apparent molecular mass of the unglycosylated,
protease-resistant prion protein (PrPres) detected by western blot compared with
classical BSE. Experimental evidences from studies in transgenic mice expressing
human PrP and in primate models suggest a higher risk of transmission to humans
of the L-BSE form than for classical BSE agent. However, a major unresolved
issue concerns the potential transmissibility of the L-BSE agent by oral route.
To address this question, we infected mouse lemurs (Microcebus murinus), a
non-human primate model, with L-BSE by intracerebral or oral route.
Four adult lemurs were intracerebrally (IC) inoculated with 5mg of L-BSE
infected brain homogenate of an atypical French BSE case (02-2528). Four young
and four adult animals were fed with 5 mg or 50 mg of infected brain. After
sacrifice, the brain tissues were biochemically and immunocytochemically
investigated for PrPres.
The 4 animals IC inoculated died at 19 and 22 months postinoculation (mpi).
They developed blindness, tremor, abnormal posture, incoordinated movements,
balance loss. Symptoms get worse according to the disease progression, until
severe ataxia. Severe spongiosis was evidenced into the thalamus, the striatum,
the mesencephalon, and the brainstem, whereas into the cortex the vacuolisation
was weaker. Strong deposits of PrPres were detected into the thalamus, the
striatum, and the hippocampus whereas in the cerebral cortex, PrPres was
prominently accumulated in plaques.
The orally inoculated animals showed similar clinical symptoms occurring
between 27 and 34 mpi. Disease was characterized by progressive prostration,
loss of appetite and poor appearance of the fur. Only one adult animal showed
disequilibrium. PrPres was strongly accumulated only in the striatum and
thalamus and weakly into the cortex. No plaques were evidenced. Two animals that
were orally challenged at the age of two years are still alive and healthy 34
months after inoculation. The western blot analysis showed uniform molecular
profiles, irrespective of the route or dose of infection, and included notably a
PrPres form with low apparent molecular mass (~19 kDa) similar to the PrPres in
the original cattle brain. However, the PrPres profile in lemurs was
characterized by a higher proportion of di- and mono-glycosylated species (up to
95% of the total signal) than in the bovine L-BSE inoculum (~80%). In addition,
small amounts of PrPres were detected by western blotting in the spleen of three
animals (one intra-cerebrally inoculated and two fed with 5 mg of cattle
brain).
Here, we demonstrate that the L-BSE agent can be transmitted by oral route
from cattle to young and adult mouse lemurs. In comparison to IC inoculated
animals, orally challenged lemurs were characterized by longer survival periods
as expected with this route of infection.
Friday, May 25, 2012
R-CALF USDA’s New BSE Rule Eliminates Important Protections Needed to
Prevent BSE Spread
Saturday, May 26, 2012
Are USDA assurances on mad cow case 'gross oversimplification'?
SNIP...
What irks many scientists is the USDA’s April 25 statement that the rare
disease is “not generally associated with an animal consuming infected
feed.”
The USDA’s conclusion is a “gross oversimplification,” said Dr. Paul Brown,
one of the world’s experts on this type of disease who retired recently from the
National Institutes of Health. "(The agency) has no foundation on which to base
that statement.”
“We can’t say it’s not feed related,” agreed Dr. Linda Detwiler, an
official with the USDA during the Clinton Administration now at Mississippi
State.
In the May 1 email to me, USDA’s Cole backed off a bit. “No one knows the
origins of atypical cases of BSE,” she said
The argument about feed is critical because if feed is the cause, not a
spontaneous mutation, the California cow could be part of a larger outbreak.
SNIP...
Sunday, May 27, 2012
CANADA PLANS TO IMPRISON ANYONE SPEAKING ABOUT MAD COW or ANY OTHER DISEASE
OUTBREAK
CENSORSHIP IS A TERRIBLE THING
Sunday, May 27, 2012
GAIN REPORT BSE Case in United States Will Not Affect Trade, States
Canadian Food Inspection Agency
Subject: Bovine Spongiform Encephalopathy; Importation of Bovines and
Bovine Products APHIS-2008-0010-0008 RIN:0579-AC68
Comment from Terry Singeltary Document ID: APHIS-2008-0010-0008 Document
Type: Public Submission This is comment on Proposed Rule: Bovine Spongiform
Encephalopathy; Importation of Bovines and Bovine Products Docket ID:
APHIS-2008-0010 RIN:0579-AC68
Topics: No Topics associated with this document View Document: More
Document Subtype: Public Comment Status: Posted Received Date: March 22 2012, at
12:00 AM Eastern Daylight Time Date Posted: March 22 2012, at 12:00 AM Eastern
Daylight Time Comment Start Date: March 16 2012, at 12:00 AM Eastern Daylight
Time Comment Due Date: May 15 2012, at 11:59 PM Eastern Daylight Time Tracking
Number: 80fdd617 First Name: Terry Middle Name: S. Last Name: Singeltary City:
Bacliff Country: United States State or Province: TX Organization Name: CJD TSE
PRION Submitter's Representative: CONSUMERS
Comment: comment submission Document ID APHIS-2008-0010-0001
Greetings USDA,
OIE et al, what a difference it makes with science, from one day to the
next. i.e. that mad cow gold card the USA once held. up until that fateful day
in December of 2003, the science of BSE was NO IMPORTS TO USA FROM BSE COUNTRY.
what a difference a day makes$ now that the shoe is on the other foot, the USDA
via the OIE, wants to change science again, just for trade $ I implore the OIE
decision and policy makers, for the sake of the world, to refuse any status quo
of the USA BSE risk assessment. if at al, the USA BSE GBR should be raise to BSE
GBR IV, for the following reasons. North America is awash with many different
TSE Prion strains, in many different species, and they are mutating and
spreading. IF the OIE, and whatever policy makers, do anything but raise the
risk factor for BSE in North America, they I would regard that to be highly
suspicious. IN fact, it would be criminal in my opinion, because the OIE knows
this, and to knowingly expose the rest of the world to this dangerous pathogen,
would be ‘knowingly’ and ‘willfully’, just for the almighty dollar, once again.
I warned the OIE about all this, including the risk factors for CWD, and the
fact that the zoonosis potential was great, way back in 2002. THE OIE in
collaboration with the USDA, made the legal trading of the atypical Nor-98
Scrapie a legal global commodity. yes, thanks to the OIE and the USDA et al,
it’s now legal to trade the atypical Nor-98 Scrapie strain all around the globe.
IF you let them, they will do the same thing with atypical BSE and CWD (both
strains to date). This with science showing that indeed these TSE prion strains
are transmissible. I strenuously urge the OIE et al to refuse any weakening to
the USA trade protocols for the BSE TSE prion disease (all strains), and urge
them to reclassify the USA with BSE GBR IV risk factor.
SEE REFERENCE SOURCES IN ATTACHMENTS
PLEASE SEE Terry S. Singeltary Sr. _Attachment_ WORD FILE ;
***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...
MAD COW USDA ATYPICAL L-TYPE BASE BSE, the rest of the story...
***Oral Transmission of L-type Bovine Spongiform Encephalopathy in Primate
Model
***Infectivity in skeletal muscle of BASE-infected cattle
***feedstuffs- It also suggests a similar cause or source for atypical BSE
in these countries.
***Also, a link is suspected between atypical BSE and some apparently
sporadic cases of Creutzfeldt-Jakob disease in humans.
The present study demonstrated successful intraspecies transmission of
H-type BSE to cattle and the distribution and immunolabeling patterns of PrPSc
in the brain of the H-type BSE-challenged cattle. TSE agent virulence can be
minimally defined by oral transmission of different TSE agents (C-type, L-type,
and H-type BSE agents) [59]. Oral transmission studies with H-type BSEinfected
cattle have been initiated and are underway to provide information regarding the
extent of similarity in the immunohistochemical and molecular features before
and after transmission.
In addition, the present data will support risk assessments in some
peripheral tissues derived from cattle affected with H-type BSE.
in the url that follows, I have posted
SRM breaches first, as late as 2011.
then
MAD COW FEED BAN BREACHES AND TONNAGES OF MAD COW FEED IN COMMERCE up until
2007, when they ceased posting them.
then,
MAD COW SURVEILLANCE BREACHES.
Friday, May 18, 2012
Update from APHIS Regarding a Detection of Bovine Spongiform Encephalopathy
(BSE) in the United States Friday May 18, 2012
TSS
Wednesday, May 30, 2012
PO-028: Oral transmission of L-type bovine spongiform encephalopathy
(L-BSE) in primate model Microcebus murinus
Tuesday, June 05, 2012
Captive Deer Breeding Legislation Overwhelmingly Defeated During 2012
Legislative Session
Saturday, June 09, 2012
USDA Establishes a Herd Certification Program for Chronic Wasting Disease
in the United States
Monday, June 11, 2012
another atypical Nor-98 Scrapie case documented in Canada for 2012
too bad Canada’s policy on BSE aka mad cow type disease, and the reporting
there from of completed cases, have ceased to exist on the CFIA site for the
public to follow.
you have to request a copy. CFIA ceased giving those copies out to me. ...
•Request a copy of a completed BSE investigation report for a case after
January 2009
Sunday, May 27, 2012
CANADA PLANS TO IMPRISON ANYONE SPEAKING ABOUT MAD COW or ANY OTHER DISEASE
OUTBREAK, CENSORSHIP IS A TERRIBLE THING
Thursday, March 29, 2012
atypical Nor-98 Scrapie has spread from coast to coast in the USA 2012
NIAA Annual Conference April 11-14, 2011San Antonio, Texas
Monday, November 30, 2009
USDA AND OIE COLLABORATE TO EXCLUDE ATYPICAL SCRAPIE NOR-98 ANIMAL HEALTH
CODE
price of prion poker goes up again $$$
Monday, June 11, 2012
Guidance for Industry Draft Guidance for Industry: Amendment to “Guidance
for Industry: Revised Preventive Measures to Reduce the Possible Risk of
Transmission of Creutzfeldt-Jakob Disease and Variant Creutzfeldt-Jakob Disease
by Blood and Blood Products”
layperson
kind regards, terry
posted by Terry S. Singeltary Sr. at
12:32 PM
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