Tuesday, April 13, 2010

Mad cow disease death scare after Australian woman dies

Mad cow disease death scare after woman dies

By Richar Noone

From: The Daily Telegraph April 14, 2010 12:00AM

Died from CJD in 2006 ... Carol Willesee. Source: The Daily Telegraph

MAD cow disease may have claimed the life of a NSW woman. Health officials are testing her body for the illness that sparked a global scare in the 1990s.

However, experts believe it is more likely that she died from a degenerative form of Creutzfeldt-Jakob disease (CJD) because she had not travelled overseas in several years.

North Sydney Central Coast Area Health confirmed yesterday that the remains of the woman, who died at Gosford Hospital last week, had been sent to Sydney University to test for CJD. There are two main types of the untreatable disease - classic CJD and variant CJD, commonly referred to as the human equivalent of the mad cow disease.

Because the woman had not travelled overseas in recent years, health officials believe it is more likely she died from classic CJD.

Start of sidebar. Skip to end of sidebar. .End of sidebar. Return to start of sidebar. Classic CJD is a rare degenerative disease triggered by mutations within a person's brain and is not spread by people. It can be genetic and in most countries, including Australia, descendants of CJD victims are prohibited from donating blood.

Variant CJD emerged in the UK in the 1990s and is linked to the consumption of meat products from cattle infected with bovine spongiform encephalopathy (BSE), more commonly known as mad cow disease.

It is a separate disease even though many of the symptoms, including the early and rapid onset of dementia, blindness, loss of balance and muscle spasm, are similar.

According to the National CJD Registry in Melbourne, there have been 395 confirmed cases of classic CJD in the past 40 years. There have been no confirmed cases of variant CJD or human mad cow in Australia.

"Central Coast Health Service has confirmed that testing for Creutzfeldt-Jakob Disease is being conducted on a patient who recently died in Gosford Hospital," an area health spokeswoman said.

"The results of the tests are not yet known."

The results are expected to take some time because of the process involved with removing the brain and preparing it for various tests.

Carol Willesee, the ex-wife of television journalist Mike Willesee, died from classic CJD in 2006 after medical staff at Nepean Hospital failed to diagnose the condition.

In four months the accomplished stage actress went from a healthy, active woman to not being able to walk unassisted. She died aged 59.

Daughters Amy and Jo Willesee told a special commission of inquiry into acute care services in NSW they suspected she had the disease after researching her symptoms on the internet. But it was not until weeks after she was admitted that the doctors said they were investigating the possibility of CJD - despite medical notes later revealing it had been initially raised in emergency.


http://www.dailytelegraph.com.au/news/nsw-act/mad-cow-disease-death-scare-after-woman-dies/story-e6freuzi-1225853373176



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:

In total, the country imported over the period 1980 to 2003, 1,248 live cattle from BSE-risk countries, of which 204 came from the UK according to the CD or 2,238 live cattle from BSE-risk countries, of which 194 came from the UK according to other sources. 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 different aspects discussed above that allow us to assume that certain imported cattle did not enter the domestic BSE/cattle system, i.e. were not rendered into feed. Following a review of the Australian data, it was decided to exclude all animals imported from the UK that were born before June 1976 or were still alive. Imported animals that died on farm were also excluded on the basis of an assurance from the Australian authorities that these animals were placed in lifetime quarantine and, consequently, did not enter the feed chain. A trace back by the Australian authorities showed that some of the animals that were imported from the UK were over 10 years of age at the time of slaughter or death. The Australians considered that the likelihood of these animals contaminating the feed chain with the BSE agent was very low. However, such animals were not excluded from the current assessment because of the fact that many BSE cases have been confirmed in animals over ten years of age in Europe. The Australian risk analysis also took into account the history of the UK farm of origin. Animals from herds of origin in which no cases of BSE were recorded were considered to present no risk. For many of the animals from farms in the UK that did subsequently disclose cases of BSE, the Australian authorities considered that the risk was low because there was a long interval between the data of birth of the imported animals and the date of birth of the cases in the herds of origin. However, such animals were not excluded from the current risk assessment, as per the general procedure of this process, because of the possibility of unreported cases in the herds of origin and the fact that the imported animals could have been the only animals infected with the BSE agent in the herd of origin.

The level of the external challenge as a result of animals imported to Australia from the USA was changed from 1,441 to 493 on the basis of data received from the pre- US export quarantine station. In addition, animals that were still alive or that had been slaughtered but not rendered were removed from the external challenge. Sixteen of the twenty-one animals imported from Canada in 1996 to 2001 were excluded from the external challenge on the basis of information received from the Australian authorities that they were still alive in early 2004. Likewise, the animals imported from Austria in 2001 were excluded from the external challenge on the basis of the explanation from the Austrian authorities that these animals were, in fact, exported to the Ukraine rather than Australia.

snip...

MBM imports:

In total the country imported, over the period 1980-2003, 37 tons under the import code 230110 from BSE-risk countries, of which 21 tons came from the UK according to the CD. Other sources, such as EUROSTAT, indicate that the total import of MBM was 2,844 tons none of which 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-year periods the resulting external challenge is as given in table 3. This assessment takes into account the different aspects discussed above that allow us to assume that certain imported MBM did not enter the domestic BSE/cattle system or did not represent an external challenge for other reasons. Following a review of the Australian data, the 22 tons said to have been exported from Germany in 2002 was excluded from the external challenge because the export of processed animal proteins was prohibited from European Union countries from 2001 unless a letter agreement was signed by both countries and the Australians claim (letter dated 21 April 2004) that this was not the case. The 21 tons said to have been exported from the UK in 1988 and 1994 were excluded from the external challenge on the basis of evidence from the Australian authorities that these consignments consisted of fishmeal or dog food. The 143 tons said to have been exported from Ireland in 1994 were excluded from the external challenge on the basis of an assurance from the Irish Chief Veterinary Officer that there was no trade of MBM between Ireland and Australia during the relevant period. All of the imports from Canada, France and the USA were also excluded on the basis of similar assurances from the Chief Veterinary Officer from those countries.

snip...please see full text ;

http://www.efsa.europa.eu/en/scdocs/doc/37rax1.pdf



please see full text here ;

http://efsaopinionbseanimalprotein.blogspot.com/2010/04/scientific-report-of-european-food.html



Thursday, April 8, 2010 Scientific Report of the European Food Safety Authority on the Assessment of the Geographical BSE-Risk (GBR) of AUSTRALIA Scientific Report of the European Food Safety Authority on the Assessment of the Geographical BSE Risk (GBR) of Australia Question number: EFSA-Q-2003-083

Adopted: 1 July 2004

http://efsaopinionbseanimalprotein.blogspot.com/2010/04/scientific-report-of-european-food.html



The future public health threat of vCJD in the UK, Europe and potentially the rest of the world, is of concern and currently unquantifiable. However, the possibility of a significant and geographically diverse vCJD epidemic occurring over the next few decades cannot be dismissed. ...

http://whqlibdoc.who.int/publications/2003/9241545887.pdf



KEY WORK HERE IS 'DIVERSE'.

what does diverse mean ?

adjective

1.of a different kind, form, character, etc.; unlike: a wide range of diverse opinions.

2. of various kinds or forms; multiform.

1 : differing from one another : unlike

2 : composed of distinct or unlike elements or qualities

URGENT DATA ON ATYPICAL BSE RISK FACTORS TO HUMANS AND ANIMALS OIE REFUSE TO ACKNOWLEDGE $

position: Post Doctoral Fellow Atypical BSE in Cattle

Closing date: December 24, 2009

Anticipated start date: January/February 2010

Employer: Canadian and OIE Reference Laboratories for BSE CFIA Lethbridge Laboratory, Lethbridge/Alberta

snip...

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.

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



Sunday, April 4, 2010

USDA AND OIE OUT OF TOUCH WITH RISK FACTOR ON ATYPICAL TSE

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



14th International Congress on Infectious Diseases H-type and L-type Atypical BSE January 2010 (special pre-congress edition)

18.173 page 189

Experimental Challenge of Cattle with H-type and L-type Atypical BSE

A. Buschmann1, U. Ziegler1, M. Keller1, R. Rogers2, B. Hills3, M.H. Groschup1. 1Friedrich-Loeffler-Institut, Greifswald-Insel Riems, Germany, 2Health Canada, Bureau of Microbial Hazards, Health Products & Food Branch, Ottawa, Canada, 3Health Canada, Transmissible Spongiform Encephalopathy Secretariat, Ottawa, Canada

Background: After the detection of two novel BSE forms designated H-type and L-type atypical BSE the question of the pathogenesis and the agent distribution of these two types in cattle was fully open. From initial studies of the brain pathology, it was already known that the anatomical distribution of L-type BSE differs from that of the classical type where the obex region in the brainstem always displays the highest PrPSc concentrations. In contrast in L-type BSE cases, the thalamus and frontal cortex regions showed the highest levels of the pathological prion protein, while the obex region was only weakly involved.

Methods:We performed intracranial inoculations of cattle (five and six per group) using 10%brainstemhomogenates of the two German H- and L-type atypical BSE isolates. The animals were inoculated under narcosis and then kept in a free-ranging stable under appropriate biosafety conditions.At least one animal per group was killed and sectioned in the preclinical stage and the remaining animals were kept until they developed clinical symptoms. The animals were examined for behavioural changes every four weeks throughout the experiment following a protocol that had been established during earlier BSE pathogenesis studies with classical BSE.

Results and Discussion: All animals of both groups developed clinical symptoms and had to be euthanized within 16 months. The clinical picture differed from that of classical BSE, as the earliest signs of illness were loss of body weight and depression. However, the animals later developed hind limb ataxia and hyperesthesia predominantly and the head. Analysis of brain samples from these animals confirmed the BSE infection and the atypical Western blot profile was maintained in all animals. Samples from these animals are now being examined in order to be able to describe the pathogenesis and agent distribution for these novel BSE types. Conclusions: A pilot study using a commercially avaialble BSE rapid test ELISA revealed an essential restriction of PrPSc to the central nervous system for both atypical BSE forms. A much more detailed analysis for PrPSc and infectivity is still ongoing.

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


http://ww2.isid.org/Downloads/IMED2009_AbstrAuth.pdf


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



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


Wednesday, February 24, 2010

Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America 14th

ICID International Scientific Exchange Brochure -

http://transmissiblespongiformencephalopathy.blogspot.com/2010/02/transmissible-spongiform-encephalopathy.html



TSE


http://transmissiblespongiformencephalopathy.blogspot.com/



Atypical BSE, BSE, and other human and animal TSE in North America Update October 19, 2009

snip...

I ask Professor Kong ;

Thursday, December 04, 2008 3:37 PM Subject: RE: re--Chronic Wating Disease (CWD) and Bovine Spongiform Encephalopathies (BSE): Public Health Risk Assessment

''IS the h-BSE more virulent than typical BSE as well, or the same as cBSE, or less virulent than cBSE? just curious.....''

Professor Kong reply ;

.....snip

''As to the H-BSE, we do not have sufficient data to say one way or another, but we have found that H-BSE can infect humans. I hope we could publish these data once the study is complete.

Thanks for your interest.''

Best regards,

Qingzhong Kong, PhD Associate Professor Department of Pathology Case Western Reserve University Cleveland, OH 44106 USA

END...TSS

I look forward to further transmission studies, and a true ENHANCED BSE/atypical BSE surveillance program put forth testing all cattle for human and animal consumption for 5 years. a surveillance program that uses the most sensitive TSE testing, and has the personnel that knows how to use them, and can be trusted. I look forward to a stringent mad cow feed ban being put forth, and then strictly enforced. we need a forced, not voluntary feed ban, an enhanced feed ban at that, especially excluding blood. we need some sort of animal traceability. no more excuses about privacy. if somebody is putting out a product that is killing folks and or has the potential to kill you, then everybody needs to know who they are, and where that product came from. same with hospitals, i think medical incidents in all states should be recorded, and made public, when it comes to something like a potential accidental transmission exposure event. so if someone is out there looking at a place to go have surgery done, if you have several hospitals having these type 'accidental exposure events', than you can go some place else. it only makes sense. somewhere along the road, the consumer lost control, and just had to take whatever they were given, and then charged these astronomical prices. some where along the line the consumer just lost interest, especially on a long incubating disease such as mad cow disease i.e. Transmissible Spongiform Encephalopathy. like i said before, there is much more to the mad cow story than bovines and eating a hamburger, we must start focusing on all TSE in all species. ...TSS

http://bse-atypical.blogspot.com/2009/10/atypical-bse-bse-and-other-human-and.html




P26 TRANSMISSION OF ATYPICAL BOVINE SPONGIFORM ENCEPHALOPATHY (BSE) IN HUMANIZED MOUSE MODELS

Liuting Qing1, Fusong Chen1, Michael Payne1, Wenquan Zou1, Cristina Casalone2, Martin Groschup3, Miroslaw Polak4, Maria Caramelli2, Pierluigi Gambetti1, Juergen Richt5*, and Qingzhong Kong1 1Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA; 2CEA, Istituto Zooprofilattico Sperimentale, Italy; 3Friedrich-Loeffler-Institut, Germany; 4National Veterinary Research Institute, Poland; 5Kansas State University, Diagnostic Medicine/Pathobiology Department, Manhattan, KS 66506, USA. *Previous address: USDA National Animal Disease Center, Ames, IA 50010, USA

Classical BSE is a world-wide prion disease in cattle, and the classical BSE strain (BSE-C) has led to over 200 cases of clinical human infection (variant CJD). Two atypical BSE strains, BSE-L (also named BASE) and BSE-H, have been discovered in three continents since 2004. The first case of naturally occurring BSE with mutated bovine PrP gene (termed BSE-M) was also found in 2006 in the USA. The transmissibility and phenotypes of these atypical BSE strains/isolates in humans were unknown. We have inoculated humanized transgenic mice with classical and atypical BSE strains (BSE-C, BSE-L, BSE-H) and the BSE-M isolate. We have found that the atypical BSE-L strain is much more virulent than the classical BSE-C. The atypical BSE-H strain is also transmissible in the humanized transgenic mice with distinct phenotype, but no transmission has been observed for the BSE-M isolate so far.

III International Symposium on THE NEW PRION BIOLOGY: BASIC SCIENCE, DIAGNOSIS AND THERAPY 2 - 4 APRIL 2009, VENEZIA (ITALY)

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



Originally published as JGV in Press, 10.1099/vir.0.010801-0 on July 22, 2009 Originally published as JGV in Press, 10.1099/vir.0.010801-0 on June 17, 2009 J Gen Virol 90 (2009), 2563-2568; DOI 10.1099/vir.0.010801-0


Short Communication

PrPTSE in muscle-associated lymphatic tissue during the preclinical stage of mice infected orally with bovine spongiform encephalopathy


Franco Cardone1,, Achim Thomzig2,, Walter Schulz-Schaeffer3, Angelina Valanzano1, Marco Sbriccoli1, Hanin Abdel-Haq1, Silvia Graziano1, Sandra Pritzkow2, Maria Puopolo1, Paul Brown4, Michael Beekes2 and Maurizio Pocchiari1

1 Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy 2 Robert Koch-Institut (P24 – Transmissible Spongiform Encephalopathies), Nordufer 20, 13353 Berlin, Germany 3 Prion and Dementia Research Unit, Department of Neuropathology, University Medical Center, Georg-August University Goettingen, Robert-Koch-Str. 40, 37075 Goettingen, Germany 4 7815 Exeter Road, Bethesda, MD 20814, USA

Correspondence Franco Cardone franco.cardone@iss.it

The involvement of muscles in the pathogenesis of transmissible spongiform encephalopathies (TSEs) is irregular and unpredictable. We show that the TSE-specific protein (PrPTSE) is present in muscles of mice fed with a mouse-adapted strain of bovine spongiform encephalopathy as early as 100 days post-infection, corresponding to about one-third of the incubation period. The proportion of mice with PrPTSE-positive muscles and the number of muscles involved increased as infection progressed, but never attained more than a limited distribution, even at the clinical stage of disease. The appearance of PrPTSE in muscles during the preclinical stage of disease was probably due to the haematogenous/lymphatic spread of infectivity from the gastrointestinal tract to lymphatic tissues associated with muscles, whereas in symptomatic animals, the presence of PrPTSE in the nervous system, in neuromuscular junctions and in muscle fibres suggests a centrifugal spread from the central nervous system, as already observed in other TSE models.

These authors contributed equally to this work.

http://vir.sgmjournals.org/cgi/content/abstract/90/10/2563



Atypical BSE (BASE) Transmitted from Asymptomatic Aging Cattle to a Primate

Emmanuel E. Comoy1*, Cristina Casalone2, Nathalie Lescoutra-Etchegaray1, Gianluigi Zanusso3, Sophie Freire1, Dominique Marcé1, Frédéric Auvré1, Marie-Magdeleine Ruchoux1, Sergio Ferrari3, Salvatore Monaco3, Nicole Salès4, Maria Caramelli2, Philippe Leboulch1,5, Paul Brown1, Corinne I. Lasmézas4, Jean-Philippe Deslys1

1 Institute of Emerging Diseases and Innovative Therapies, CEA, Fontenay-aux-Roses, France, 2 Istituto Zooprofilattico Sperimentale del Piemonte, Turin, Italy, 3 Policlinico G.B. Rossi, Verona, Italy, 4 Scripps Florida, Jupiter, Florida, United States of America, 5 Genetics Division, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America

Abstract Top Background Human variant Creutzfeldt-Jakob Disease (vCJD) results from foodborne transmission of prions from slaughtered cattle with classical Bovine Spongiform Encephalopathy (cBSE). Atypical forms of BSE, which remain mostly asymptomatic in aging cattle, were recently identified at slaughterhouses throughout Europe and North America, raising a question about human susceptibility to these new prion strains.

Methodology/Principal Findings Brain homogenates from cattle with classical BSE and atypical (BASE) infections were inoculated intracerebrally into cynomolgus monkeys (Macacca fascicularis), a non-human primate model previously demonstrated to be susceptible to the original strain of cBSE. The resulting diseases were compared in terms of clinical signs, histology and biochemistry of the abnormal prion protein (PrPres). The single monkey infected with BASE had a shorter survival, and a different clinical evolution, histopathology, and prion protein (PrPres) pattern than was observed for either classical BSE or vCJD-inoculated animals. Also, the biochemical signature of PrPres in the BASE-inoculated animal was found to have a higher proteinase K sensitivity of the octa-repeat region. We found the same biochemical signature in three of four human patients with sporadic CJD and an MM type 2 PrP genotype who lived in the same country as the infected bovine.

Conclusion/Significance Our results point to a possibly higher degree of pathogenicity of BASE than classical BSE in primates and also raise a question about a possible link to one uncommon subset of cases of apparently sporadic CJD. Thus, despite the waning epidemic of classical BSE, the occurrence of atypical strains should temper the urge to relax measures currently in place to protect public health from accidental contamination by BSE-contaminated products.

Citation: Comoy EE, Casalone C, Lescoutra-Etchegaray N, Zanusso G, Freire S, et al. (2008) Atypical BSE (BASE) Transmitted from Asymptomatic Aging Cattle to a Primate. PLoS ONE 3(8): e3017. doi:10.1371/journal.pone.0003017

Editor: Neil Mabbott, University of Edinburgh, United Kingdom

Received: April 24, 2008; Accepted: August 1, 2008; Published: August 20, 2008

Copyright: © 2008 Comoy et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: This work has been supported by the Network of Excellence NeuroPrion.

Competing interests: CEA owns a patent covering the BSE diagnostic tests commercialized by the company Bio-Rad.

* E-mail: mhtml:%7B33B38F65-8D2E-434D-8F9B-8BDCD77D3066%7Dmid://00000110/!x-usc:mailto:emmanuel.comoy@cea.fr

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0003017


Saturday, December 01, 2007

Phenotypic Similarity of Transmissible Mink Encephalopathy in Cattle and L-type Bovine Spongiform Encephalopathy in a Mouse Model

Volume 13, Number 12–December 2007 Research

Phenotypic Similarity of Transmissible Mink Encephalopathy in Cattle and L-type Bovine Spongiform Encephalopathy in a Mouse Model

Thierry Baron,* Anna Bencsik,* Anne-Gaëlle Biacabe,* Eric Morignat,* andRichard A. Bessen†*Agence Française de Sécurité Sanitaire des Aliments–Lyon, Lyon, France; and†Montana State University, Bozeman, Montana, USA

Abstract

Transmissible mink encepholapathy (TME) is a foodborne transmissible spongiform encephalopathy (TSE) of ranch-raised mink; infection with a ruminant TSE has been proposed as the cause, but the precise origin of TME is unknown. To compare the phenotypes of each TSE, bovine-passaged TME isolate and 3 distinct natural bovine spongiform encephalopathy (BSE) agents (typical BSE, H-type BSE, and L-type BSE) were inoculated into an ovine transgenic mouse line (TgOvPrP4). Transgenic mice were susceptible to infection with bovine-passaged TME, typical BSE, and L-type BSE but not to H-type BSE. Based on survival periods, brain lesions profiles, disease-associated prion protein brain distribution, and biochemical properties of protease-resistant prion protein, typical BSE had a distint phenotype in ovine transgenic mice compared to L-type BSE and bovine TME.The similar phenotypic properties of L-type BSE and bovine TME in TgOvPrP4 mice suggest that L-type BSE is a much more likely candidate for the origin of TME than is typical BSE.

snip...

Conclusion

These studies provide experimental evidence that the Stetsonville TME agent is distinct from typical BSE but has phenotypic similarities to L-type BSE in TgOvPrP4 mice. Our conclusion is that L-type BSE is a more likely candidate for a bovine source of TME infection than typical BSE. In the scenario that a ruminant TSE is the source for TME infection in mink, this would be a second example of transmission of a TSE from ruminants to non-ruminants under natural conditions or farming practices in addition to transmission of typical BSE to humans, domestic cats, and exotic zoo animals(37). The potential importance of this finding is relevant to L-type BSE, which based on experimental transmission into humanized PrP transgenic mice and macaques, suggests that L-type BSE is more pathogenic for humans than typical BSE (24,38).

http://www.cdc.gov/eid/content/13/12/1887.htm?s_cid=eid1887_e



P02.35

Molecular Features of the Protease-resistant Prion Protein (PrPres) in H-type BSE

Biacabe, A-G1; Jacobs, JG2; Gavier-Widén, D3; Vulin, J1; Langeveld, JPM2; Baron, TGM1 1AFSSA, France; 2CIDC-Lelystad, Netherlands; 3SVA, Sweden

Western blot analyses of PrPres accumulating in the brain of BSE-infected cattle have demonstrated 3 different molecular phenotypes regarding to the apparent molecular masses and glycoform ratios of PrPres bands. We initially described isolates (H-type BSE) essentially characterized by higher PrPres molecular mass and decreased levels of the diglycosylated PrPres band, in contrast to the classical type of BSE. This type is also distinct from another BSE phenotype named L-type BSE, or also BASE (for Bovine Amyloid Spongiform Encephalopathy), mainly characterized by a low representation of the diglycosylated PrPres band as well as a lower PrPres molecular mass. Retrospective molecular studies in France of all available BSE cases older than 8 years old and of part of the other cases identified since the beginning of the exhaustive surveillance of the disease in 20001 allowed to identify 7 H-type BSE cases, among 594 BSE cases that could be classified as classical, L- or H-type BSE. By Western blot analysis of H-type PrPres, we described a remarkable specific feature with antibodies raised against the C-terminal region of PrP that demonstrated the existence of a more C-terminal cleaved form of PrPres (named PrPres#2 ), in addition to the usual PrPres form (PrPres #1). In the unglycosylated form, PrPres #2 migrates at about 14 kDa, compared to 20 kDa for PrPres #1. The proportion of the PrPres#2 in cattle seems to by higher compared to the PrPres#1. Furthermore another PK-resistant fragment at about 7 kDa was detected by some more N-terminal antibodies and presumed to be the result of cleavages of both N- and C-terminal parts of PrP. These singular features were maintained after transmission of the disease to C57Bl/6 mice. The identification of these two additional PrPres fragments (PrPres #2 and 7kDa band) reminds features reported respectively in sporadic Creutzfeldt-Jakob disease and in Gerstmann-Sträussler-Scheinker (GSS) syndrome in humans.

http://www.neuroprion.com/pdf_docs/conferences/prion2007/abstract_book.pdf



FC5.5.1

BASE Transmitted to Primates and MV2 sCJD Subtype Share PrP27-30 and PrPSc C-terminal Truncated Fragments

Zanusso, G1; Commoy, E2; Fasoli, E3; Fiorini, M3; Lescoutra, N4; Ruchoux, MM4; Casalone, C5; Caramelli, M5; Ferrari, S3; Lasmezas, C6; Deslys, J-P4; Monaco, S3 1University of Verona, of Neurological and Visual Sciences, Italy; 2CEA, IMETI/SEPIA, France; 3University of Verona, Neurological and Visual Sciences, Italy; 4IMETI/SEPIA, France; 5IZSPLVA, Italy; 6The Scripps Research Insitute, USA

The etiology of sporadic Creutzfeldt-Jakob disease (sCJD), the most frequent human prion disease, remains still unknown. The marked disease phenotype heterogeneity observed in sCJD is thought to be influenced by the type of proteinase K-resistant prion protein, or PrPSc (type 1 or type 2 according to the electrophoretic mobility of the unglycosylated backbone), and by the host polymorphic Methionine/Valine (M/V) codon 129 of the PRNP. By using a two-dimensional gel electrophoresis (2D-PAGE) and imunoblotting we previously showed that in sCJD, in addition to the PrPSc type, distinct PrPSc C-terminal truncated fragments (CTFs) correlated with different sCJD subtypes. Based on the combination of CTFs and PrPSc type, we distinguished three PrPSc patterns: (i) the first was observed in sCJD with PrPSc type 1 of all genotypes,; (ii) the second was found in M/M-2 (cortical form); (iii) the third in amyloidogenic M/V- 2 and V/V-2 subtypes (Zanusso et al., JBC 2004) . Recently, we showed that sCJD subtype M/V-2 shared molecular and pathological features with an atypical form of BSE, named BASE, thus suggesting a potential link between the two conditions. This connection was further confirmed after 2D-PAGE analysis, which showed an identical PrPSc signature, including the biochemical pattern of CTFs. To pursue this issue, we obtained brain homogenates from Cynomolgus macaques intracerebrally inoculated with brain homogenates from BASE. Samples were separated by using a twodimensional electrophoresis (2D-PAGE) followed by immunoblotting. We here show that the PrPSc pattern obtained in infected primates is identical to BASE and sCJD MV-2 subtype. These data strongly support the link, or at least a common ancestry, between a sCJD subtype and BASE. This work was supported by Neuroprion (FOOD-CT-2004-506579)



FC5.5.2

Transmission of Italian BSE and BASE Isolates in Cattle Results into a Typical BSE Phenotype and a Muscle Wasting Disease

Zanusso, G1; Lombardi, G2; Casalone, C3; D’Angelo, A4; Gelmetti, D2; Torcoli, G2; Barbieri, I2; Corona, C3; Fasoli, E1; Farinazzo, A1; Fiorini, M1; Gelati, M1; Iulini, B3; Tagliavini, F5; Ferrari, S1; Monaco, S1; Caramelli, M3; Capucci, L2 1University of Verona, Neurological and Visual Sciences, Italy; 2IZSLER, Italy; 3IZSPLVA, Italy; 4University of Turin, Animal Pathology, Italy; 5Isituto Carlo Besta, Italy

The clinical phenotype of bovine spongiform encephalopathy has been extensively reported in early accounts of the disorder. Following the introduction of statutory active surveillance, almost all BSE cases have been diagnosed on a pathological/molecular basis, in a pre-symptomatic clinical stage. In recent years, the active surveillance system has uncovered atypical BSE cases, which are characterized by distinct conformers of the PrPSc, named high-type (BSE-H) and low-type (BSE-L), whose clinicopathological phenotypes remain unknown. We recently reported two Italian atypical cases with a PrPSc type similar to BSE-L, pathologically characterized by PrP amyloid plaques. Experimental transmission to TgBov mice has recently disclosed that BASE is caused by a distinct prion strain which is extremely virulent. A major limitation of transmission studies to mice is the lack of reliable information on clinical phenotype of BASE in its natural host. In the present study, we experimentally infected Fresian/Holstein and Alpine/Brown cattle with Italian BSE and BASE isolates by i.c. route. BASE infected cattle showed survival times significantly shorter than BSE, a finding more readily evident in Fresian/Holstein, and in keeping with previous observations in TgBov mice. Clinically, BSE-infected cattle developed a disease phenotype highly comparable with that described in field BSE cases and in experimentally challenged cattle. On the contrary, BASE-inoculated cattle developed an amyotrophic disorder accompanied by mental dullness. The molecular and neuropathological profiles, including PrP deposition pattern, closely matched those observed in the original cases. This study further confirms that BASE is caused by a distinct prion isolate and discloses a novel disease phenotype in cattle, closely resembling the phenotype previous reported in scrapie-inoculated cattle and in some subtypes of inherited and sporadic Creutzfeldt-Jakob disease.



http://www.neuroprion.com/pdf_docs/conferences/prion2007/abstract_book.pdf





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

Emmanuel A. Asante1, Jacqueline M. Linehan1, Melanie Desbruslais1, Susan Joiner1, Ian Gowland1, Andrew L. Wood1, Julie Welch1, Andrew F. Hill1, Sarah E. Lloyd1, Jonathan D.F. Wadsworth1 and John Collinge1

1.MRC Prion Unit and Department of Neurodegenerative Disease, Institute of Neurology, University College, Queen Square, London WC1N 3BG, UK Correspondence to:

John Collinge, E-mail: j.collinge@prion.ucl.ac.uk

Received 1 August 2002; Accepted 17 October 2002; Revised 24 September 2002

--------------------------------------------------------------------------------

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 PrPSc 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.

Keywords:BSE, Creutzfeldt–Jakob disease, prion, transgenic

http://www.nature.com/emboj/journal/v21/n23/abs/7594869a.html




Research Project: Study of Atypical Bse Location: Virus and Prion Diseases of Livestock

Project Number: 3625-32000-086-05 Project Type: Specific Cooperative Agreement

Start Date: Sep 15, 2004 End Date: Sep 14, 2009

Objective: The objective of this cooperative research project with Dr. Maria Caramelli from the Italian BSE Reference Laboratory in Turin, Italy, is to conduct comparative studies with the U.S. bovine spongiform encephalopathy (BSE) isolate and the atypical BSE isolates identified in Italy. The studies will cover the following areas: 1. Evaluation of present diagnostics tools used in the U.S. for the detection of atypical BSE cases. 2. Molecular comparison of the U.S. BSE isolate and other typical BSE isolates with atypical BSE cases. 3. Studies on transmissibility and tissue distribution of atypical BSE isolates in cattle and other species.

Approach: This project will be done as a Specific Cooperative Agreement with the Italian BSE Reference Laboratory, Istituto Zooprofilattico Sperimentale del Piemonte, in Turin, Italy. It is essential for the U.S. BSE surveillance program to analyze the effectiveness of the U.S diagnostic tools for detection of atypical cases of BSE. Molecular comparisons of the U.S. BSE isolate with atypical BSE isolates will provide further characterization of the U.S. BSE isolate. Transmission studies are already underway using brain homogenates from atypical BSE cases into mice, cattle and sheep. It will be critical to see whether the atypical BSE isolates behave similarly to typical BSE isolates in terms of transmissibility and disease pathogenesis. If transmission occurs, tissue distribution comparisons will be made between cattle infected with the atypical BSE isolate and the U.S. BSE isolate. Differences in tissue distribution could require new regulations regarding specific risk material (SRM) removal.

http://www.ars.usda.gov/research/projects/projects.htm?ACCN_NO=408490




North Dakota Firm Recalls Whole Beef Head Products That Contain Prohibited Materials

Recall Release CLASS II RECALL FSIS-RC-023-2010 HEALTH RISK: LOW

Congressional and Public Affairs (202) 720-9113 Catherine Cochran

WASHINGTON, April 5, 2010 - North American Bison Co-Op, a New Rockford, N.D., establishment is recalling approximately 25,000 pounds of whole beef heads containing tongues that may not have had the tonsils completely removed, which is not compliant with regulations that require the removal of tonsils from cattle of all ages, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.

Tonsils are considered a specified risk material (SRM) and must be removed from cattle of all ages in accordance with FSIS regulations. SRMs are tissues that are known to contain the infective agent in cattle infected with Bovine Spongiform Encephalopathy (BSE), as well as materials that are closely associated with these potentially infective tissues. Therefore, FSIS prohibits SRMs from use as human food to minimize potential human exposure to the BSE agent.

The product subject to recall includes: Various weight cases of "Beef Heads KEEP FROZEN." Each case bears the establishment number "EST. 18859" inside the USDA mark of inspection and a case code number "16999." "North Dakota Natural Beef" is printed in the bottom left-hand corner of each label.

The recalled products were produced between June 25, 2009, and February 19, 2010. These products were shipped to distribution centers in Md., Mich., and Minn. for further sale.

The problem was discovered during FSIS inspection activities at the establishment. FSIS routinely conducts recall effectiveness checks to verify recalling firms notify their customers of the recall and that steps are taken to make certain that the product is no longer available to consumers.

Media with questions about the recall should contact Philip Wicke, Vice President of Operations, at (701) 356-7723. Consumers with questions about the recall should contact Jeremy Anderson, Director of Customer Service, at (952) 545-2495.

Consumers with food safety questions can "Ask Karen," the FSIS virtual representative available 24 hours a day at AskKaren.gov. The toll-free USDA Meat and Poultry Hotline 1-888-MPHotline (1-888-674-6854) is available in English and Spanish and can be reached from l0 a.m. to 4 p.m. (Eastern Time) Monday through Friday. Recorded food safety messages are available 24 hours a day. #



http://www.fsis.usda.gov/News_&_Events/Recall_023_2010_Release/index.asp




Monday, April 5, 2010

Update on Feed Enforcement Activities to Limit the Spread of BSE April 5, 2010


http://madcowfeed.blogspot.com/2010/04/update-on-feed-enforcement-activities.html



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



>>> 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


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




>>> 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. <<<


Friday, April 02, 2010

Mad cow march on parliament Australia, JUST SAY NO TO USDA AND OIE

http://bse-atypical.blogspot.com/2010/04/mad-cow-march-on-parliament-australia.html



Sunday, April 4, 2010

USDA AND OIE OUT OF TOUCH WITH RISK FACTOR ON ATYPICAL TSE

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




TSS

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Friday, November 06, 2009

Surveillance of Creutzfeldt-Jakob disease in Australia: 2009 update

Communicable Diseases Intelligence Volume 33 No 2 - June 2009

Surveillance of Creutzfeldt-Jakob disease in Australia: 2009 update

This report provides a snapshot of Creutzfeldt-Jakob disease (CJD) in Australia for the period 1 April 2008 to 31 March 2009. In this short report, the Australian National CJD Registry provides undated Australian human transmissible spongiform encephalopathies (TSE) figures and discuss a recently published investigation of geographical TSE clustering in regional New South Wales.

Communicable Diseases Surveillance

Genevieve M Klug, Alison Boyd, Victoria Lewis, Amelia McGlade, Christiane Stehmann, Colin L Masters, Steven J Collins Abstract

In Australia, the occurrence of all human transmissible spongiform encephalopathies (TSEs) is surveyed by the Australian National Creutzfeldt-Jakob Disease Registry (ANCJDR). While prospective surveillance commenced in October 1993, the ANCJDR also retrospectively ascertained cases that occurred between 1970 and 1993. During the surveillance period of 1 April 2008 to 31 March 2009, the ANCJDR received 90 suspect TSE case notifications, which is slightly increased from previous annual surveillance periods. Based on the total number of probable and definite CJD cases, ascertained between 1993 and 2009, the Australian age-adjusted mortality rate is 1.18 deaths per million per year. In this short report, we provide updated Australian human TSE figures and discuss a recently published investigation of geographical TSE clustering in regional New South Wales. Commun Dis Intell 2009;33:188–191.

snip...

Australian National Creutzfeldt-Jakob Disease Registry surveillance update Since 1 October 1993, the ANCJDR has been notified of 1,345 suspected cases of CJD, arising in both the prospective and retrospective ascertainment periods. For the prospective period, the average annual rate of suspect cases notified to the ANCJDR was 3.1 per million per year. Fluctuations in these annual notification rates have been observed (Figure 1) and the reasons for these have been discussed previously.3 More recently, the rate of notifications from 2006 to 2008 has been sustained at a higher level in comparison to the longer term average observed for 1993–2008. The increased number of notifications is most likely underpinned by increased referrals to the ANCJDR of cerebrospinal fluid for 14-3-3 protein testing, particularly for the 2007–2008 period where CSF referrals have increased by 43% in comparison with the previous 6 year average. This sustained increased level of CSF referrals has given the ANCJDR confidence that the introduction of 'fee-for-service' from 1 January 2007 has not detrimentally affected CSF referrals and consequently rates of suspect case notification, as initially speculated.

Figure 1: Annual age-standardised Creutzfeldt-Jakob disease mortality rates and suspect case* notification rates, 1993 to 2008

During the 2008–2009 reporting period to 31 March 2009, 90 suspect cases were added to the Register, which is a 17% increase from the previous surveillance year. Of these 90 suspect case notifications, 20 have been reclassified as definite TSE cases. A further 15 cases that were notified prior to 1 April 2008 have also been confirmed as definite (11) or probable (4) TSE since the last update. The Register has a large group of cases still under investigation (184), with the majority of these still alive as at 31 March 2009. Despite active investigation of all suspect cases, the number of incomplete cases continues to expand, although final outcomes for the large majority of all suspect cases have been obtained through detailed investigation. The number of incomplete cases is of concern to the ANCJDR as for many of these cases, a conclusive outcome may not be achievable. Follow-up can be difficult for cases that have been notified several years previously. In 541 cases, CJD has been excluded while 608 cases have been classified as definite (395) or probable (213) CJD and a further 12 cases fulfil the possible case definition (Table 1). A sustained elevation of the annual CJD incidence and the proportions of autopsy-confirmed cases for the surveillance years of 2005–2008 has been observed (Figure 2). As previously discussed, this relates to the growing number of notifications and pro-active approach of the ANCJDR of seeking autopsy in all clinically suspect cases.3

Table 1: Classification of cases by the Australian National Creutzfeldt-Jakob Disease Registry, 1 January 1970 to 31 March 2009

snip...

Age-standardised mortality rates were calculated using the Australian Bureau of Statistics 2000 estimated resident population for Australia.

The aetiologic proportions of all Australian TSE cases are consistent with previous observations.3 Cases classified as sporadic CJD comprise 90.5% of all Australian cases, while 8.2% of cases are genetic and the remaining 1.3% are iatrogenic. During the 2008–2009 surveillance period, 4 new cases of familial TSE were classified, while no further iatrogenic CJD and no cases of vCJD were identified in Australia.

Based on the 608 definite and probable cases, TSE incidence peaks at 4.9 cases per million per year in the 65–69 year age group, an incidence almost 5 times the reported global incidence. As sporadic cases comprise the majority of cases, the peak incidence in this group closely aligns with overall TSE rates. Since the last surveillance period, the median age at death for sporadic cases has remained unchanged; 66 years (males, 65 years; females, 67 years), the proportion of female sporadic cases has remained consistent at 53% and their median duration of disease similar at 4 months. A slightly shorter disease duration is observed in males (median, 3 months). Genetically determined TSEs have a younger age at death (medians, overall 59 years; males, 51 years; females, 62 years) and longer illness duration (medians, overall 6 months; males, 4 months; females, 7.5 months) when compared to sporadic cases. The sex ratio for familial cases is slightly biased towards females with 58% of the cases being female.

Based on all definite and probable TSE cases, the average, age-adjusted mortality rate in Australia for the 1970–2009 period is 0.88 deaths per million per year. A restriction of the timeframe to the prospective surveillance period of 1993–2009 provides a more reliable representation of the true national figures with a mortality rate of 1.18 deaths per million per year. By individual state and territory, the TSE mortality rates (Table 2) in some jurisdictions have altered since the previous update.3 Notably, the average age-standardised mortality rates during 1993–2009 have increased in Western Australia, the Australian Capital Territory and the Northern Territory, while in Tasmania, the rate has continued to decline and is currently around half the rate observed in Victoria and Western Australia (Table 2). This strongly suggests case under-ascertainment in Tasmania for this specific period. In the remaining states and territories, no significant changes in the longer-term mortality rate average (1993–2009) have occurred since last reported.

Analysis of incidence rates by state and territory over the last decade highlights the strengths and weaknesses of surveillance in the various regions (Table 2). In Victoria, case numbers have remained constant over this period and have resulted in the highest mortality rate in Australia. In contrast, a lower than expected mortality rate in Queensland, South Australia and Tasmania was observed. This decline was concerning as the 10-year timeframe provided us with a recent snapshot of confirmed cases, excluding the diluting influence of the earlier prospective surveillance years. Broadened surveillance and diagnostic responsibilities, changes to privacy legislation around 2000 and less accessible autopsy services in various regions may have contributed to the lower mortality in the specific states.

snip...

Suspect case notification between this and the previous reporting period have remained stable in the Australian Capital Territory, the Northern Territory, South Australia and Western Australia (Figure 3). In contrast, a 70% increase in notifications has been observed in Victoria. While the total number of CSF referrals arising in Victoria has remained unchanged, there has been an increase in the number of clinically suspect TSE cases added to the Register, derived from CSF referrals. Marked declines in notifications in the large populations of New South Wales and Queensland, and to a lesser degree in Tasmania, were observed in 2008. The impact of these lower notifications may be reflected in a reduced number of confirmed CJD cases for this period. A contractual agreement between the ANCJDR and Queensland Health Department was established in May 2008 to evaluate all cases of suspect TSE. The impact of this agreement on TSE incidence in Queensland will be of particular interest.

snip...

Analysis of a potential Creutzfeldt-Jakob disease cluster During 2008, the ANCJDR published findings from an investigation conducted assessing an increased number of sporadic CJD cases within a coastal region of New South Wales during the period 1993–2006.4 Statistical analysis identified a spatially significant cluster in 3 contiguous statistical local areas, consisting of 13 definite and 1 probable CJD case. An epidemiological review of ANCJDR case data for the 14 cases did not reveal a plausible cross-over or point source transmission event to explain the cluster of cases.

One potential hypothesis for the significant finding related to the region's clinicians and their management of potential CJD cases. To investigate this theory, further evaluation was undertaken comparing the regional area with the entire state, emphasising rates of referrals for 14-3-3 CSF testing, rates of case notification to the ANCJDR and suspect CJD post-mortem rates. These observations were chosen to objectively quantify an intensity of surveillance and how this relates to incidence rates.

Our analyses demonstrated that the cluster area maintained a higher level of surveillance and clinical awareness compared with the entire State of New South Wales. The population-based rate of notification of all suspect cases to the ANCJDR was 68% greater in the cluster area than for New South Wales (age-adjusted RRMH: 1.68, 95% CI=1.36–2.10) and similarly, the population-based rate of request for CSF testing was 59% greater than the state referral rate (age-adjusted RRMH: 1.59, 95% CI=1.25–2.02). No difference between the likelihood of a suspect case being confirmed as probable or definite CJD (all types or sporadic only) was observed, suggesting that once CJD was questioned as a diagnosis in a clinical setting, the likelihood of a case being assessed for CJD classification was no different in the circumscribed area to the entire state. In contrast, a difference did exist in the proportion of cases that were assessed by neuropathological examination (biopsy or autopsy), with the cluster area having an almost two and half times greater neuropathological examination rate in suspect cases compared with New South Wales (age-adjusted RRMH, 2.34, 95% CI=1.56–3.51). Simply stated, approximately double the intensity of surveillance translated to a doubling of the CJD incidence rate.

One of the distinguishing features of the 14 cluster cases provided another key piece of supporting evidence for enhanced surveillance. The cohort displayed a significantly older age at death when compared with sporadic CJD cases from New South Wales and Australia overall. Analysis of autopsy data in Austria, where autopsy of all suspect CJD cases is mandatory, suggests global under-ascertainment of older age CJD cases.5 Hence, the ability to detect older and less typical cases in this cluster region suggests clinicians manifested a greater than usual suspicion of CJD and atypical presentations.

These findings have provided us with a hypothesis that intensity of surveillance for rare disorders can be quantified and this can positively correlate with higher incidence. It further suggests that the true incidence of CJD in Australia may be almost twice the currently observed average rate of 1.18 cases per million per year. A further exploration of this hypothesis is needed within and between individual nations and may give us an improved understanding of methodologies for optimal surveillance for rare conditions such as CJD.


http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3302d.htm



http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3302-pdf-cnt.htm/$FILE/cdi3302d.pdf



http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phi-index.htm



Surveillance of Creutzfeldt-Jakob disease in Australia: 2008


http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3202d.htm



http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3202-pdf-cnt.htm/$FILE/cdi3202d.pdf



Do Reports of sCJD Clusters Matter? January 13, 2004 JP Morgan North American Equity Research

There have been seven cases of human sCJD clusters identified in the US in the last 15 years, in which people in a specific location were diagnosed with sCJD, resulting in rates between 2.1 and 8.4 deaths per million people for that specific location compared with the national average of one in 1 million. · There is no proven link between sCJD and BSE, and hence it is considered a different disease from vCJD (which has been linked to BSE). However, the existence of clusters raises the question of "contamination" or "infection", and also raises the hypothesis that rather than cases of sCJD these might have been cases of vCJD. · Clusters are not spontaneous, they normally have a source. Moreover, some cases of sCJD may have been improperly diagnosed as Alzheimer's.· We continue to believe that as long as no further cases of BSE-positive cows are found in North America and the industry has respected the 1997 ban on animal feed for live cattle, beef consumption in the US will not suffer. · Moreover, due to political pressure we expect key overseas markets (Japan, South Korea, and Mexico) to open up to US beef in the next six months - the recent 20% drop in cattle prices can be attributed mainly to these import bans. · However, two concerns linger and should be kept in mind by investors, 1) Has the 1997 ban on animal feed for live cattle been honored by the beef industry? 2) Can clusters of cases of sporadic CJD (or sCJD) really be a variant of CJD and indeed be linked to BSE? In this note we focus on the issue of sCJD clusters, and the potential impact that the growing debate on clusters could have on beef consumption in the US. United States Foods

Pablo E. Zuanic(1-212) 622-6744pablo.zuanic@jpmorgan.comChristopher
M. Bledsoe(1-212) 622-6386christopher.m.bledsoe@jpmorgan.comDaniel
Ogbonna(212) 622-6382daniel.c.ogbonna@jpmorgan.com

State of Our Views Regarding BSE in the US We continue to believe that as long as no further cases of BSE-positive cows are found in North America and the industry has respected the 1997 ban on animal feed for live cattle, beef consumption in the US will not suffer. Moreover, due to political pressure we expect key overseas markets (Japan, South Korea, and Mexico) to open up to US beef in the next six months - the recent 20% drop in cattle prices can be attributed mainly to these import bans.

· However, two concerns linger and should be kept in mind by investors, 1) Has the 1997 ban on animal feed for live cattle been honored by the beef industry? The government's General Accounting Office says it has not; 2) Can clusters of cases of sporadic CJD (or sCJD as it is commonly known) really be a variant of CJD and indeed be linked to BSE (vCJD is the scientific term for the disease linked to mad cow)?

· In this note we focus on the issue of sCJD clusters.

· Do sCJD Clusters Matter?

· The media focus (and as a result, the consumer at large) since December 23, thus far, has been on the potential of new BSE-positive cows being found, and on the various initiatives the authorities are taking to prevent an outbreak of BSE. However, the apparent existence of sCJD clusters in the US has received little publicity. If sporadic (or spontaneous) CJD is really spontaneous, it should not be found in population clusters. The fact that it indeed has been found in clusters raises concerns.

· Understanding the "Difference" Between sCJD and vCJD

· Prior to 1996 there was only one known type of CJD, and it was called "sporadic" or "spontaneous" because it was unclear where it came from, or how it was generated. In 1996 scientists in England "discovered" a "variant" of CJD (vCJD), which they indicated could be linked to the animal form of the disease (BSE or Mad Cow). Experts kept vCJD separate from sCJD because unlike the new vCJD the original sCJD could not be directly linked to BSE. However, not enough is known to be fully certain that sporadic CJD is truly spontaneous and has no external catalyst. The other notable difference between vCJD and sCJD is the incubation period. Whereas sCJD has an average incubation period of 40 years and is exceedingly rare in young people, vCJD can affect people of all ages and has a much shorter incubation period of just two to five years. An even more relevant difference is that sCJD is found in 1 out of 1 million people per annum, or 5,000 cases per year on a global basis, while only 180 human cases of vCJD (the type of CJD linked to BSE) have ever been reported.

· Existence of Clusters of sCJD May Imply They Are Really Cases of vCJD There have been seven sCJD clusters identified in the US in the last 15 years, in which people in a specific location were diagnosed with sCJD, resulting in rates between 1.2 and 8.4 deaths per million people for that specific location compared with the national average of one in 1 million. The existence of clusters raises the question of "contamination" or "infection", and also raises the hypothesis that rather than cases of sCJD these might have been cases of vCJD. Clusters are not spontaneous, they normally have a source.

· A cluster consists of two statistical improbabilities: 1) multiple cases occurring in a relatively limited geographic area, and 2) multiple cases occurring within the same time period. The most recent cluster was found in Cherry Hill, New Jersey. The others have been found in Lehigh, Pennsylvania (1986-90), Allentown, Pennsylvania (1989-92), Tampa, Florida (1996-97), Oregon (2001-02), and Nassau County, New York (1999-2000). Given that sCJD occurs randomly in one out of one million cases, it is a statistical rarity to find an sCJD cluster - let alone six. The following tables highlight known clusters in the US.

· Table 1: Clustered sCJD Deaths

· Local sCJD Deaths

· Time Span State Local Area Pop. (MM) Period (mo.) Total Ann'lized 1986-1990 PA Lehigh Valley 0.5 48 18 4.5 1989-1992 PA Allentown 2.5 36 15 5.0 1996-1997 FL Tampa 2.2 18 13 8.7 1996-1999 TX Denton .01 38 4 1.3 1999-2000 NY Nassau County 1.3 12 7 7.0 2001-2002 OR Entire State 3.4 24 14 7.0 2000-2003* NJ Cherry Hill Area 1.7 36 12 4.0 Source: JPMorgan.

The second table, below, shows what portion of the state's total expected sCJD cases (as based on a one per million occurrence) were found in the local cluster, comparing the local cluster's portion of cases with the local area's portion of the state's total population. The greater the factor between the former and the latter suggests a higher statistical improbability that the cluster is spontaneous (sCJD).

· Table 2: Clustered sCJD Deaths vs. Expected State Cases

· Annual Statewide Local Area (% of:)

· Time Span State Local Area sCJD Deaths* exp. state cases state pop. 1986-1990 PA Lehigh Valley 11.9 37.8% 4.5% 1989-1992 PA Allentown 12.0 41.7% 20.8% 1996-1997 FL Tampa 14.1 61.5% 15.7% 1996-1999 TX Denton 20.9 6.1% .02% 1999-2000 NY Nassau County 18.1 38.7% 7.4% 2001-2002 OR Entire State 3.4 205.9% 100.0% 2000-2003* NJ Cherry Hill Area 8.0 50.0% 21.6% * *State cases are extrapolated based on state population and the 1 per million national average. Source: JPMorgan.

The CDC Is Currently Investigating the New Jersey Cluster The US Center for Disease Control (CDC) has opened an investigation into a cluster of deaths in an area surrounding Cherry Hill, New Jersey. Specifically, after dismissing the case when it was first brought to their attention earlier in 2003, the agency has since reversed course and on December 31, 2003 sought out information from Janet Skarbek. Skarbek, a Cinnaminson, New Jersey CPA believes she has uncovered a common link between seven deaths in the local area and a restaurant at the now-closed Garden State Race Track. All of the deaths had first been identified as the randomly occurring (one out of one million) cases of sporadic Creutzfeldt-Jakob Disease (sCJD), and six of the deaths occurred between 2000 and 2003.

Science Expanding its Knowledge of CJDs

Have Cases of sCJD Been Overlooked?

Dr. Omar Bagasra believes that a 29 year old that died of presumably sCJD in the New Jersey cluster may have died from a new, mutated form of CJD since sCJD has a typical incubation period of 40 years and is limited to elderly patients in almost all cases. Moreover, he suspects that the link between the seven local deaths (clustered geographically and chronologically) indicates that the new form of the disease is caused by some external catalyst, unlike the randomly occurring sporadic CJD (sCJD). He adds, though, that there may actually have been other unreported CJD-related deaths in the area since the disease is often misdiagnosed as Alzheimer's.

Diagnoses of Alzheimer's Might Have Been Cases of CJD

Lawrence Schonberger, the CDC epidemiologist who contacted Janet Skarbek on December 31, is quoted separately as saying that sCJD is underreported on death certificates, and that about 14 percent of cases are missed. In fact, due to similarities between sCJD and Alzheimer's disease, a 1998 Yale study found that as many as 13 percent of Alzheimer's deaths are actually sCJD, but conservative estimates place this number closer to 1 percent. If we extrapolate this finding to the 50,000 Alzheimer's deaths each year in the US, the number of actual sCJD deaths per year is somewhere between 500 and 6500. But, for us this raises additional questions, since at a rate of one per million, the US should not experience much more than 300 sCJD deaths in a single year. Furthermore, Alzheimer cases have grown 50-fold in the last 25 years from 857 cases in 1979 to 50,000 cases in today (albeit part of the increase could very well be attributed to improvements in reporting).

Can sCJD Be Caused by External Agents?

A recent study out of Imperial College in London has led some to believe that the same prions that cause the BSE-related vCJD may also cause a disease that manifests itself in a way that more closely resembles sporadic CJD. John Collinge, the scientist that conducted the experiment, is basing this assertion on findings in the study's mice, which were injected with BSE prions. As expected, some of the mice developed symptoms from vCJD, but unexpectedly, others suffered from symptoms that more closely resembled sCJD. If true, the implications are significant, as it will force scientists to consider whether cases of sporadic CJD may actually have been caused by consumption of contaminated beef.

Does All This Matter?

For now we await the results of the CDC investigation of the New Jersey cluster. Previous investigations have found clusters to be just coincidences. While this may be the case, we believe that the media may start focusing more on the issue of clusters, and that the debate could raise consumers' concerns about beef. But even in the worst case scenario that these clusters were indeed linked to BSE, one could still make the argument that these cases were generated before the 1997 ban on animal feed for cattle was imposed, and that hence chances of contamination since then are unlikely. Still, the question lingers, has the 1997 ban been respected? Will consumers concerns increase as the discussion of CJD clusters hits the national media? Bottom Line: If no new cases of BSE-positive cows are found and the issue of CJD clusters is disregarded by consumers, then the effect on beef consumption will be negligible. On the other hand, new cases of infected cows and/or a wider debate of CJD clusters could indeed have an effect on beef sales. ...END


Subject: J.P. MORGAN INVESTORS WARNED ABOUT POTENTIAL SPORADIC CJD AND BSE RELATION From: "Terry S. Singeltary Sr." Reply-To: Bovine Spongiform Encephalopathy Date: Mon, 19 Jan 2004 08:33:38 -0600 Content-Type: text/plain

https://lists.aegee.org/cgi-bin/wa?A2=ind0401&L=BSE-L&T=0&F=&S=&P=25337&X=14C6D9515C8B05410B



BSE (Mad Cow) Update: Do Reports of sCJD Clusters Matter?

snip... see full text ;

http://cjdtexas.blogspot.com/



Thursday, November 05, 2009

Incidence and spectrum of sporadic Creutzfeldt-Jakob disease variants with mixed phenotype and co-occurrence of PrPSc types: an updated classification

http://creutzfeldt-jakob-disease.blogspot.com/2009/11/incidence-and-spectrum-of-sporadic.html



Friday, October 23, 2009

Creutzfeldt-Jakob Disease Surveillance Texas Data for Reporting Years 2000-2008

http://cjdtexas.blogspot.com/2009/10/creutzfeldt-jakob-disease-surveillance.html



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