Defra

Section 5: Public Health Issues (i) - General

5.1 SUMMARY OF MEASURES TO PROTECT PUBLIC HEALTH

Q.1. What measures are in place to safeguard public health?
Q.2. Do these measures work?

5.2 SAFETY

Mechanically Recovered Meat (MRM)

Q.3. What is MRM?
Q.4. Could MRM have included BSE infective material in the past?
Q.5. Was MRM included in baby food?
Q.6. What about school meals?

Milk

Q.7. Is there any risk from drinking cows milk?

Medicines

Q.8. What about medicinal products containing bovine material - are they safe?

5.3 THE BSE TESTING SYSTEM

Q.9.  What is the BSE testing system?
Q.10. Why was the system introduced?
Q.11. How many BSE positives are expected from OTM cattle tested for human consumption?

Number of animals slaughtered under the Over Thirty Month Scheme

Q.12. How many have been slaughtered under the OTMS so far?

5.4 GUIDANCE TO OCCUPATIONAL GROUPS

Q.13. What advice is there for workers who may be exposed to BSE?

5.5 NEW VARIANT OF CJD - STATISTICS

Q.14. How many cases of the new variant of CJD (vCJD) have there been in the UK?
Q.15. In which other EU countries has vCJD occurred?
Q.16. How many cases of vCJD will there be?
Q.17. How can further information on CJD be obtained?

[return to Q&A index]

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5.1 SUMMARY OF MEASURES TO PROTECT PUBLIC HEALTH

Q.1 What measures are in place to safeguard public health?
A. The measures now in place are as follows:

Q.2 Do these measures work ?
A. These measures have significantly reduced the risk of human exposure to BSE infectivity.

5.2 SAFETY http://www.food.gov.uk/bse/what/bseandgoats/

Mechanically Recovered Meat (MRM)

Q.3 What is MRM?
A. A. MRM is the product resulting from the mechanical separation of meat left on the bones after boning. All residual meat mechanically harvested from flesh bearing bones after boning should be considered MRM without prejudice to the methods used to harvest it or the structure of the end product. The production of MRM from ruminant bones is prohibited throughout the European Union.

Q.4 Could MRM have included BSE infective material in the past?
A. A. Yes, MRM was thought to be a source of BSE infectivity entering the food chain before stricter BSE controls were introduced. A report published in October 2002, commissioned by the FSA, at the request of the Spongiform Encephalopathy Advisory Committee (SEAC), specifically looked at historic uses of MRM. The report revealed that the main products containing MRM were cheaper brands of beef-burgers, fresh/chilled frozen and dried mince, pre- processed beef used in meat pies and other processed products. Until it was banned in 1995, some beef MRM came from vertebral column, which may have contained traces of spinal cord and hence BSE infectivity. The ban on production of MRM was extended in 2001 to all ruminant bones (bovine, ovine and caprine).

Q.5 Was MRM included in baby food?
A. A. In 2002 an FSA Commissioned survey on the historic uses of bovine MRM between 1980 and 1995 concluded that some baby food may have contained MRM, but information was not conclusive. The major producers claim not to have used MRM due to concerns about bone fragments.

Q.6 What about school meals?
A. A report commissioned by the FSA at the request of the Spongiform Encephalopathy Advisory Committee into the historic uses of mechanically recovered meat (MRM) from cattle between 1980 and 1995 was published on 10 October 2002. It concluded that the main products containing MRM were cheaper brands of beef-burgers, fresh/chilled frozen and dried mince, pre- processed beef used in meat pies and other processed products. It is possible some of these products containing MRM may have been used in school meals prior to 1995.

MILK

Q.7 Is there any risk from drinking cows milk?
A. To date a number of studies have looked for BSE infectivity in milk and related tissue. No BSE infectivity has been found in milk. SEAC has considered the results of the research on milk at regular intervals since 1990. On each occasion it has said that there was no reason to change its advice ‘that there is no evidence to suggest that milk is a hazard to animals or man and that no further measures are necessary to protect human or animal.” In June 2005 SEAC considered the results of the most recent research from experimentally infected cows and concluded that there was ‘no evidence for the presence of the BSE prion protein in, or for transmission of BSE via, milk’. (see para 2.1. Q.1 for information on goat and sheep milk)

MEDICINES

Q.8 What about medicinal products containing bovine material - are they safe?
A. Any human and veterinary medicinal product that uses bovine material in its manufacture is required to comply with the guidelines on safe selection, sourcing and processing of animal material used in the manufacture of medicines.

The European guideline, 'Minimising the Risk of Transmitting Agents Causing Spongiform Encephalopathy Via Medicinal Products', has been in place since 1992 and was given legal force for all products in March 2001. Manufacturers of all currently authorised medicinal products have submitted data to the Medicines and Healthcare products Regulatory Agency (MHRA) or the Veterinary Medicines Directorate to demonstrate how their products comply with the guidelines.

[Return to Questions]

5.3 THE BSE TESTING SYSTEM (Last updated:February 2006)

Q.9 What is the BSE testing system?
A. All cattle aged over 30 months at slaughter and born after 1 August 1996 must receive a negative test result for BSE before they can enter the food chain. A brain stem sample is taken in the abattoir from the animal being tested and this is then sent to an approved laboratory for testing. Any cattle testing positive or where the laboratory is unable to test the sample for whatever reason, will be banned from the food chain and destroyed by incineration. All cattle born before the introduction of the re-inforced feed ban in August 1996 are permanently excluded from the food chain. The new testing system took effect on 7 November 2005. It replaced the Over Thirty Months rule which was introduced in 1996 and which banned all cattle aged over 30 months from the food chain.

Q.10 Why was the system introduced?
A. As a result of the marked decline in BSE cases and the introduction of rapid tests for the disease, the Food Standards Agency in 2002 began a review to decide whether the Over Thirty Months rule could be replaced by BSE testing. A scientific risk assessment carried out for the review indicated that the additional risk from moving to testing OTM cattle, rather than banning them completely, would result in a range of between 0 and 2.5 additional cases of vCJD, over the next 60 years, with a central estimate of 0.5. On the FSA’s advice, the Government agreed that, subject to a robust system for testing for BSE being put in place, it would be proportionate to the level of risk to replace the OTM rule by testing for cattle born on or after 1 August 1996.

Q.11 How many BSE positives are expected from OTM cattle tested for human consumption?
A. Based on testing results to date, we expect a maximum of about 10 cattle to test positive at abattoirs in the first year of testing. Only cattle for which there is a negative result are allowed into the food chain.

Number of animals slaughtered under the Over Thirty Month Scheme

Q.12 How many have been slaughtered under the OTMS so far?
A. From May 1996 until September 2005, a total of 8,076,400 animals have been slaughtered in the UK under the OTMS. The total figure for the 2005/06 scheme year from 01 April 2005 up to the week ending 30 September 2005 is provisionally 314, 535 animals.

 

5.4 GUIDANCE TO OCCUPATIONAL GROUPS

Q.13 What advice is there for workers who may be exposed to BSE?
A. Prevention or control of exposure to BSE is required under the Control of Substances Hazardous to Health Regulations 2002 and subsequent amendments.

Occupational groups such as farmers, veterinary surgeons, slaughterhouse workers, etc. who may be exposed to BSE in the course of their work should follow the advice given by the Advisory Committee on Dangerous Pathogens (ACDP) in their current guidance. Information on how to obtain the must up-to-date advice can be found on the ACDP website. The ACDP guidance recommends sensible and prudent precautions including general principles of good occupational hygiene and methods for slaughtering.

Laboratory researchers working with BSE should follow the same precautions as for all TSE agents. Guidance is given in “Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection”.

5.5 NEW VARIANT OF CJD - STATISTICS

Q.14 How many cases of the new variant of CJD (vCJD) have there been in the UK?
A. To 04 October 2005 there has been a total of 151 definite and probable cases of vCJD [SEE ' NOTE' BELOW]. The following table provides details of confirmed and probable cases:

Year	vCJD probable: still alive	vCJD probable: awaiting post-mortem results	vCJD confirmed	Other types of CJD*	Total
1985	-	-	-	28	28
1986	-	-	-	26	26
1987	-	-	-	24	24
1988	-	-	-	24	24
1989	-	-	-	32	32
1990	-	-	-	33	33
1991	-	-	-	36	36
1992	-	-	-	53	53
1993	-	-	-	46	46
1994	-	-	-	61	61
1995	-	-	3	44	47
1996	-	-	10	50	60
1997	-	-	10	71	81
1998	-	-	18	71	89
1999	-	-	15	70	85
2000	-	-	28	54	82
2001	-	-	20	67	87
2002	-	-	17	77	94
2003	-	-	18	88	106
2004	-	-	9	58	67
2005	6	1	3	45	55
Totals	6	1	151	1058	1216

This table now includes the number of living patients known to be suffering from 'probable' vCJD. This is because recently agreed criteria for diagnosing vCJD in living sufferers has been confirmed by SEAC, the scientific advisory body which advises the Government on CJD issues, as being reliable enough to enable such information to be published.

Deaths: Apart from the 'still alive' column, all columns show the number of deaths which have occurred in definite and probable cases of all types of CJD and GSS in the year shown. The figures include both cases referred to the Unit for investigation while the patient was still alive and those where CJD was only discovered post mortem (including a few cases picked up by the Unit from death certificates). The figures will be subject to retrospective adjustment as diagnoses are confirmed.

Definite cases: This refers to the diagnostic status of cases. In definite cases the diagnosis will have been pathologically confirmed, in most cases by post mortem examination of brain tissue (rarely it may be possible to establish a definite diagnosis by brain biopsy while the patient is still alive).

vCJD: Variant CJD, the hitherto unrecognised variant of CJD discovered by the National CJD Surveillance Unit and reported in The Lancet on 6 April 1996. This is characterised clinically by a progressive neuropsychiatric disorder leading to ataxia, dementia and myoclonus (or chorea) without the typical EEG appearance of CJD. Neuropathology shows marked spongiform change and extensive florid plaques throughout the brain.

Probable vCJD cases: are those who fulfil the’ probable’ criteria set out in the Annex on the Department of Health website and and are either still alive, or have died and await post mortem pathological confirmation. Those still alive will always be shown within the current year's figures, until they ultimately transfer across into the 'awaiting p.m.' or the 'vCJD confirmed' column. It follows therefore that the figures in these columns will be subject to retrospective adjustment, for example as and when post mortem confirms diagnosis. After death, some cases* are never confirmed pathologically because a post mortem examination does not take place (for instance where the relatives of the patient refuse consent) and these cases remain permanently in the probable category.

Other types: this column includes cases of sporadic, iatrogenic, familial CJD and Gertsmann-Straùssler-Scheinker syndrome (GSS).

Q.15 In which other EU countries has vCJD occurred?
A. Monthly updates of definite and probable cases of vCJD are available from the Department of Health website.

Q.16 How many cases of vCJD will there be?
A. There are still many uncertainties about vCJD, including the route of infection, the infectious dose, the incubation period and the role of genetic susceptibility. In the absence of accurate information it is not possible yet to make any firm predictions about the evolution of the epidemic. It is likely to be some years before we will be able to do so with any certainty.

Q.17 How can further information on CJD be obtained?
A. Contact the Department of Health website.

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