Creutzfeldt-Jakob disease cluster in the health area of Meixoeiro Hospital
M. J. Moreno1,*, D. Escriche1, J. Romero, J. L. Maciñeiras1, E. Corredera1,
M. D. Castro1, P. Orizaola2, C. Navarro3, V. del Campo4
Article first published online: 17 MAY 2012
DOI: 10.1111/j.1600-0404.2012.01678.x
© 2012 John Wiley & Sons A/S
Keywords: bovine spongiform encephalopathy; Creutzfeldt-Jakob disease;
epidemiology; prion disease; surgery
Objective Galicia is the Spanish region in which most bovine spongiform
encephalopathy cases have been registered. Meixoeiro Hospital is included in the
Galician Health Service (SERGAS). The aim of the study was to analyze the
clinical and epidemiological characteristics of Creutzfeldt-Jakob disease (CJD)
in the health area of Meixoeiro Hospital and to identify possible specific risk
factors to the general public.
Methods All incident cases of CJD were identified in the health area of
Meixoeiro Hospital (187,877 inhabitants) over a 14-year period, 1997–2010, and
classified according to WHO diagnostic criteria. We obtained clinical detail and
epidemiological information on all cases. Crude and age-specific incidence rates
were calculated. A review of surgical or invasive medical procedures was
undertaken.
Results We diagnosed 12 patients with CJD, 10 sporadic CJD (sCJD), and two
genetic CJD (gCJD). No iatrogenic or variant CJD was detected. According to
Poisson distribution, 3.9 CJD cases would be expected for our area over the 14
years researched. The average yearly mortality rate from CJD was 4.6 cases per
million (3.8 from sCJD and 0.8 from gCJD). Eight patients (67%) underwent at
least one surgical or invasive medical procedure. Sixteen of twenty-seven (59%)
of these procedures were undertaken in 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.
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
=======================================
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,
REPORT ON MEASURES RELATING TO BOVINE SPONGIFORM ENCEPHALOPATHY (BSE) IN
THE UNITED STATES
snip...
• While the removal of SRM will significantly reduce risk, it must be
recognised that contamination of the carcass with SRM (specifically CNS) also
should be avoided. The subcommittee recommends that slaughter and carcass
dressing procedures, including currently used stunning procedures and mechanical
deboning processes which increase the risk of contaminating meat and meat
products with CNS tissue (including associated ganglia) be brought into line
with international standards. Specifically, processing of skulls and vertebral
columns of cattle over 30 months by mechanically recovered meat (MRM) and
advanced meat recovery (AMR) systems should be banned. The complete separation
of these tissues may be very difficult to implement, therefore the banning of
all mechanical tissue processing methods should be considered.
Non-ambulatory (downer) cows
• The subcommittee considered both the merits and the unintended
consequences of the ban prohibiting non-ambulatory cattle (downers) from
entering the food supply. It is true that non-ambulatory cattle are more likely
to be BSE infected than are healthy slaughter cattle and therefore may pose a
greater risk to public and animal health. The goals for measures related to
these cattle must be to (1) test them for surveillance purposes and (2) prevent
potentially infective tissues from entering the food and feed chains. Given
their exclusion from supervised slaughter at inspected slaughterhouses, this
important subpopulation may no longer be available for the BSE surveillance
programme at these locations. Therefore it is imperative that the USDA take
additional steps to assure that facilitated pathways exist for dead and
non-ambulatory cattle to allow for collection of samples and proper disposal of
carcasses. This most likely would involve expending resources to assist with
costs associated with sampling, transport and disposal..
snip...
Control of the implementation of measures taken:
• The experience in Europe shows that control measures prescribed by law
are not al ways implemented as intended. Regional officials are often
responsible for implementation, however the quality and effectiveness of the
controls may vary greatly between regions. Therefore, quality assurance systems
need to be implemented at all levels under the overall supervision of national
authorities.
Lessons learned
• The subcommittee appreciates the intent of the US government to follow a
science based approach to policy formulation.
• The North American cases demonstrate again that exporting countries feel
significant national social and financial impacts when importing countries fail
to comply with inter national rules regarding trade.
• Therefore, the subcommittee recommends that the US should demonstrate
leadership in trade matters by adopting import/export policy in accordance with
international standards, and thus encourage the discontinuation of irrational
trade barriers when countries identify their first case of BSE.
11
• In addition, the subcommittee hopes that the US will continue to act
responsibly when considering export of potentially contaminated materials such
as live cattle, MBM and feed. Risk materials must be destroyed or safely
utilized to protect human health, animal health, and the environment in the USA
and worldwide.
2 February 2004
Thursday, May 17, 2012
Iatrogenic Creutzfeldt-Jakob Disease, Final Assessment
Volume 18, Number 6—June 2012
Friday, May 18, 2012
Update from APHIS Regarding a Detection of Bovine Spongiform Encephalopathy
(BSE) in the United States Friday May 18, 2012
TSS