BSE agent hypotheses

Bovine spongiform encephalopathy (BSE) cases born after the total feed ban

Sixty bovine spongiform encephalopathy (BSE) cases of Classical or unknown type (BARB‐60 cases) were born after the date of entry into force of the EU total feed ban on 1 January 2001. The European Commission has requested EFSA to provide a scientific opinion on the most likely origin(s) of these BARB‐60 cases; whether feeding with material contaminated with the BSE agent can be excluded as the origin of any of these cases and, if so, whether there is enough scientific evidence to conclude that such cases had a spontaneous origin. The source of infection cannot be ascertained at the individual level for any BSE case, including these BARB‐60 cases, so uncertainty remains high about the origin of disease in each of these animals, but when compared with other biologically plausible sources of infection (maternal, environmental, genetic, iatrogenic), feed‐borne exposure is the most likely. This exposure was apparently excluded for only one of these BARB‐60 cases. However, there is considerable uncertainty associated with the data collected through the field investigation of these cases, due to a time span of several years between the potential exposure of the animal and the confirmation of disease, recall difficulty, and the general paucity of documented objective evidence available in the farms at the time of the investigation. Thus, feeding with material contaminated with the BSE agent cannot be excluded as the origin of any of the BARB‐60 cases, nor is it possible to definitively attribute feed as the cause of any of the BARB‐60 cases. A case of disease is classified as spontaneous by a process of elimination, excluding all other definable possibilities; with regard to the BARB‐60 cases, it is not possible to conclude that any of them had a spontaneous origin.

Prions and the human transmissible spongiform encephalopathies

The last 5 years have seen the emergence of a new disease in humans (vCJD), mainly in the United Kingdom. This emergence has been accompanied by an explosion of scientific data on a novel group of the responsible infectious agents called prions and has profound implications for infection control and transfusion policies. Also of concern is the finding of prions in neural, gingival, pulpal, and salivary tissue in animal models and significant titers of infectivity from extraneural organs (particularly, in cases of vCJD, in lymphoreticular tissues). There is limited information on the presence of prion proteins in the oral tissues from human studies. Because of the differences in patterns of disease in animal models and in strains of prion protein, it is difficult to extrapolate directly these findings to humans, but it illustrates a potential for transmission by way of the dental route. High levels of infectivity may be present in tissues early in the incubation period and before clinical signs and symptoms. The dental profession must turn its attention to the routine decontamination of dental instruments to ensure that these procedures are performed to the highest regulatory standard. Clinicians and manufacturers must work closely together to develop instruments that are either single use or can be presented in a form that can be more easily decontaminated. Clinicians must pay close attention to manufacturers' decontamination instructions and must not reuse items designated as single use, such as endodontic files. Improvements in compliance with these requirements will not only reduce the risk of transmission of TSEs but also other less tenacious infectious agents.

Transmissible spongiform encephalopathies in food animals. Human food safety and animal feed safety concerns for veterinarians

This article presents a brief overview of transmissible spongiform encephalopathies (TSEs) using examples of diseases that provide evidence supporting oral transmission of the agent. Agent theories are described briefly in general terms. Scrapie, bovine spongiform encephalopathy (BSE), chronic wasting disease, and transmissible mink encephalopathy are discussed to improve disease recognition by the food animal practitioner. Control programs for scrapie and BSE are described and the role of the veterinarian in animal feed and human food safety is related to TSEs.

BSE: a decade on--Part I

Bovine spongiform encephalopathy (BSE), popularly known as "mad cow disease", was discovered in 1986 and has accounted for the deaths of over 165,000 cattle in the UK (by the end of January, 1997) with about 34,000 (mainly dairy) herds involved. The syndrome in the cow includes changes in posture and temperament, apprehension, and loss of coordination. There are many parallels with scraple in sheep, with similar neuropathological changes in the hindbrain that give it a spongiform appearance under the microscope. The facts have been broadly reviewed in The Lancet in 1990 and 1993, and in much more detail elsewhere. In a two-part article, the first of which appears here, we now summarise recent developments.