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Emerging Infectious Diseases
Volume 2, Number 2, April-June 1996

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News and Notes

BSE Meeting at CDC

The recent report of a new variant of Creutzfeldt-Jakob disease (V-CJD) in
Great Britain and the possible link between the disease and bovine
spongiform encephalopathy (BSE) has raised a number of health and safety
concerns (1,2). On April 8, 1996, CDC organized a meeting of U.S. agency
representatives to review information about the report of U.K. cases and
about efforts to identify the existence of BSE and V-CJD in the United
States. The meeting covered the scientific evidence for the report of
V-CJD; recommendations from a meeting of international experts organized by
the World Health Organization on April 2-3; and the current and proposed
activities of U.S. agencies with regard to BSE and V-CJD.

Among the observations made during the meeting were the following:

   * There is no evidence from U.S. surveillance activities or from
     scientific studies to indicate that BSE exists in the United States.
   * Active surveillance for BSE is conducted by the U.S. Department of
     Agriculture (USDA). All cattle presented for slaughter in the United
     States are observed for signs of central nervous system (CNS)
     disorders. Livestock showing CNS signs are condemned and not allowed
     to enter the slaughter plant or to become part of the human food
     supply. Since 1990, laboratory testing of nearly 2,800 brain specimens
     from cattle with CNS signs has shown no evidence of BSE.
   * No U.K. cattle or ruminant-based feed has been imported into the
     United States since July 1989, when USDA banned the importation of
     cattle and cattle products from the United Kingdom. U.K. cattle
     imported before the ban will be destroyed as a precaution to ensure
     that these animals do not enter the food chain (human or animal).
   * The Food and Drug Administration plans to issue a ban on
     ruminant-to-ruminant feeding in the United States.
   * Additional research is needed on the characterization of the causative
     agent of BSE and on the epidemiology, rapid laboratory diagnosis, and
     pathogenesis of BSE and CJD.
   * The Centers for Disease Control and Prevention (CDC) monitors the
     occurrence of CJD in the United States through surveillance and
     special epidemiologic studies (3). On the basis of mortality
     surveillance from 1979 to 1993, the annual incidence of CJD remained
     stable at approximately one case per million persons. In the United
     Kingdom, five of eight patients who died of V-CJD since May 1995 were
     younger than 30 years of age; by comparison, in the United States, CJD
     deaths among persons younger than 30 years are extremely rare (fewer
     than 5 per billion per year). CDC’s efforts will be expanded to
     include active surveillance studies at four Emerging Infections
     Program sites (Connecticut, Minnesota, Oregon, and the San Francisco
     area) and in Atlanta to provide more up-to-date information on the
     occurrence of CJD and to verify the absence or presence of V-CJD.

     Future cooperative efforts among U.S. agencies, industry, and other
     interested parties in response to the report of V-CJD are planned. The
     report of the April 8 meeting at CDC can be accessed on the CDC NCID
     Web site (connect to http://www.cdc. gov/ncidod/ncid.htm; the report
     is under New, Reemerging, and Drug-Resistant Infections).

     References
       1. Will RG, Ironside JW, Zeibler M, et al. A new variant of
          Creutzfeldt-Jakob disease in the UK. Lancet 1996;347:921-5.
       2. CDC. World Health Organization consultation on public health
          issues related to bovine spongiform encephalopathy and the
          emergence of a new variant of Creutzfeldt-Jakob disease.MMWR
          1996;45:295-6, 303.
       3. Holman RC, Khan AS, Kent J, Strine TW, Schonberger LB.
          Epidemiology of Creutzfeldt-Jakob disease in the United States,
          1979-1990: analysis of national mortality data. Neuroepidemiology
          1995;14:174-81.