TRANSMISSION STUDIES DO NOT LIE;
EUROPEAN COMMISSION
HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL
Scientific Steering Committee
OPINION ON
ORGANOPHOSPHATE (OP) POISONING AND
HYPOTHETICAL INVOLVEMENT IN THE ORIGIN OF BSE
Background
In its opinion on possible links between BSE and Organophosphates adopted on 25-26 June
1998 and in its opinion on Hypotheses on the origin and transmission of BSE adopted on 29-
30 November 2001 the SSC concluded that there is no scientific evidence in support of the
hypothesis of an OP origin of BSE.
The issue of organophosphate poisoning has not been dealt with by the SSC so far. The
concerns expressed in the enquiries cover mainly intoxication by occupational exposure of
shepherds and farmers to OPs upon use against ecto-parasites, especially in sheep dipping and
treatment of cattle against Warble Fly infestation. Risks from residues are addressed to a
lesser extend.
In early 2003, a large number of additional enquiries on the issue have been addressed to
European Commission's Health and Consumer Directorate General. Four of these with
substantial enclosures were by one person. Most of them are addressing both issues: chronic
organophosphate (OP) poisoning and the origin of BSE.
Information provided with the enquiries
In addition to numerous newspaper and magazine articles the enclosures to the enquiries
provide the Material Safety Data Sheet on diazinon, the OHSA Occupational Safety and
Health Guideline for Tetraethylpyrophosphate (TEPP), an US agency Hazardous Substances
Fact Sheet on crufomate, company safety information sheets, some correspondence with UK
authorities including their activities to improve safe use of these chemicals. The information
regarding claimed OP chronic poisoning of cases presented does not provide evidence, neither
for OPs being the cause for diseases nor for their exclusion (i.e., "very low" bloodcholinesterase
levels, provided without data or comparison with the normal distribution of
values; successful treatment of a patient for OP clearance without giving any OP data). It
C:\WINNT\Temporary Internet Files\SSC_Last_OP_Final.doc 2
seems however, that due to insufficient, non-prudent use of the safety requirements undue
exposures of shepherds and farmers have occurred.
There is no additional information on the claimed involvement of OPs in the origin of BSE.
This applies for both, the hypotheses on the direct effect of OPs as well as on their
hypothetical role for Cu-deficiency to be involved in the origin of BSE (Cu binding of prion
protein is known). New publications are mentioned in one enquiry but they have not yet been
provided. In an Internet search no recent scientifically valid publications were traceable. The
SSC had been informed that research would be launched on this hypothesis, but no
information has been provided so far on its status or on results.
Conclusions
a) As regards the involvement of organophosphates in the origin of BSE, no new scientific
information providing evidence or supporting the hypothesis by valid data became
available after the adoption of the last opinion of the SSC on this issue. Consequently
there is no reason for modifying the existing opinions.
b) Regarding the possibility of OP poisoning, the European legislation for registration of
plant protection products and veterinary medicines – addressed in the enquiries – provide
the basis for safe use of registered compounds and their formulations. Regarding the
alleged intoxication cases reported and OP exposure it must be concluded that safety
measures may not have been strictly followed.
References
Brown, D.R., Qin, K., Herms, J.W., Madlung, A., Manson, J., Strome, R., Fraser, P.E., Kruck, T., von
Bohlen, A., Schulz- Schaeffer, W., Giese, A., Westaway, D. and Kretzschmar, H. (1997) The Cellular
Prion Protein Binds Copper In Vivo, Nature, 390, 684-7.
Purdey, M. (2000) Ecosystems Supporting Clusters of Sporadic TSEs Demonstrate Excesses of the Radical-
Generating Divalent Cation Manganese and Deficiencies of Antioxidant Co-Factors Cu, Se, Fe, Zn Medical
Hypotheses, 54, 278-306.
Scientific Steering Committee, 1998. Opinion on possible links between BSE and Organophosphates. Adopted
on 25-26 June 1998
Scientific Steering Committee, 2001. Opinion on Hypotheses on the origin and transmission of BSE. Adopted
on 29-30 November 2001.
http://europa.eu.int/comm/food/fs/sc/ssc/out356_en.pdf
transmission studies do not lie, amplification and transmission!!!
1: J Infect Dis 1980 Aug;142(2):205-8
Oral transmission of kuru, Creutzfeldt-Jakob disease, and scrapie to
nonhuman primates.
Gibbs CJ Jr, Amyx HL, Bacote A, Masters CL, Gajdusek DC.
Kuru and Creutzfeldt-Jakob disease of humans and scrapie disease of
sheep and goats were transmitted to squirrel monkeys (Saimiri
sciureus) that were exposed to the infectious agents only by their
nonforced consumption of known infectious tissues. The asymptomatic
incubation period in the one monkey exposed to the virus of kuru was
36 months; that in the two monkeys exposed to the virus of
Creutzfeldt-Jakob disease was 23 and 27 months, respectively; and
that in the two monkeys exposed to the virus of scrapie was 25 and
32 months, respectively. Careful physical examination of the buccal
cavities of all of the monkeys failed to reveal signs or oral
lesions. One additional monkey similarly exposed to kuru has
remained asymptomatic during the 39 months that it has been under
observation.
PMID: 6997404
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6997404&dopt=Abstract
##################### Bovine Spongiform Encephalopathy #####################
From: TSS ()
Subject: Re: Abnormal PrP in the retina of the most commonly subtype sCJD
Date: August 22, 2005 at 6:59 am PST
1: Rev Neurol (Paris). 2005 May;161(5):578-81.
[Heidenhain's variant of Creutzfeldt-Jakob's disease]
[Article in French]
Fauquembergue M, Tilikete C, Perret-Liaudet A, Kopp N, Krolak-Salmon P,
Vighetto A.
Unite de Neuro-ophtalmologie et service de Neurologie D, Hospices Civils de
Lyon, Hopital Neurologique Pierre-Wertheimer, Bron.
INTRODUCTION: Creutzfeldt-Jakob's disease has various anatomoclinical
presentations including a rare form with preponderant visual signs described
by Heidenhain. In this form, the visual symptoms may be isolated for a few
weeks, leading to multiple ophthalmological examinations. OBSERVATION: We
report the case of a 75-year-old woman who developed isolated visual
disorders which rapidly increased over a period of two months. Addition of
neurological symptoms, abnormalities of EEG and positivity of 14-3-3 protein
led to the diagnosis of Creutzfeldt-Jakob's disease. The patient died 14
months after the first neuroophthalmologic signs. The diagnosis was
established by post-mortem examination and immuno-electrophoretic
demonstration of type 1 prion protein. CONCLUSION: Heidenhain's form of
Creutzfeldt-Jakob's disease highlights the importance of general rules for
prevention of iatrogenic hazard during ophthalmological examinations.
PMID: 16106810 [PubMed - in process]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Ab
stract&list_uids=16106810&query_hl=10
TSS
----- Original Message -----
From: "Terry S. Singeltary Sr." <
[email protected]>
To: <
[email protected]>
Sent: Friday, August 19, 2005 10:00 PM
Subject: Abnormal prion protein in the retina of the most commonly occurring
subtype of sporadic Creutzfeldt-Jakob disease
##################### Bovine Spongiform Encephalopathy
#####################
CJD WATCH MESSAGE BOARD
TSS
Abnormal PrP in the retina of the most commonly subtype sCJD
Fri Aug 19, 2005 22:00
68.238.104.92
SCIENTIFIC REPORT
Abnormal prion protein in the retina of the most commonly occurring subtype
of sporadic Creutzfeldt-Jakob disease
M W Head1, A H Peden1, H M Yull1, D L Ritchie1, R E Bonshek2, A B Tullo2 and
J W Ironside1
1 National CJD Surveillance Unit, University of Edinburgh, Western General
Hospital, Edinburgh EH4 2XU, UK
2 Academic Department of Ophthalmology, Manchester Royal Eye Hospital,
Manchester M13 9WH, UK
Correspondence to:
Dr M W Head
National CJD Surveillance Unit, Bryan Matthews Building, Western General
Hospital, Edinburgh EH4 2XU, UK;
[email protected].
ABSTRACT
Background: Involvement of the eye has been reported in patients with
variant Creutzfeldt-Jakob disease (vCJD), but there is disagreement on
whether retinal involvement occurs in sporadic Creutzfeldt-Jakob disease
(sCJD).
Methods: Western blotting, paraffin embedded tissue blotting, and
immunohistochemistry were used to test whether the abnormal form of the
prion protein (PrPSc) accumulates to detectable levels in the eye in a case
of the most common subtype of sCJD (MM1).
Results: Low levels of PrPSc were detectable in the retina, localised to the
plexiform layers of the central retina. PrPSc was not detectable in other
ocular tissues.
Conclusions: The abnormal form of the prion protein is present in the retina
in the most common sCJD subtype (MM1), albeit at levels lower than those
found previously in vCJD and in sCJD of the VV2 subtype.
----------------------------------------------------------------------------
----
Abbreviations: sCJD, sporadic Creutzfeldt-Jakob disease; vCJD, variant
Creutzfeldt-Jakob disease
Keywords: Creutzfeldt-Jakob disease; prion protein; PRNP codon 129 genotype;
retina
http://bjo.bmjjournals.com/cgi/content/abstract/89/9/1131?maxtoshow=&HITS=10
&hits=10&RESULTFORMAT=&fulltext=prion&searchid=1124503447145_1536&stored_sea
rch=&FIRSTINDEX=0&volume=89&issue=9&journalcode=bjophthalmol
Eye procedure raises CJD concerns
By Steve Mitchell
Medical Correspondent
Washington, DC, Nov. 18 (UPI) -- A New York man who died from a rare brain
disorder similar to mad cow disease in May underwent an eye procedure prior
to his death that raises concerns about the possibility of transmitting the
fatal disease to others, United Press International has learned.
The development comes on the heels of the announcement Thursday by U.S.
Department of Agriculture officials of a possible second case of mad cow
disease in U.S. herds.
Richard Da Silva, 58, of Orange County, N.Y., died from Creutzfeldt Jakob
disease, an incurable brain-wasting illness that strikes about one person
per million.
Richard's wife Ann Marie Da Silva told UPI he underwent a check for the eye
disease glaucoma in 2003, approximately a year before his death. The
procedure involves the use of a tonometer, which contacts the cornea -- an
eye tissue that can contain prions, the infectious agent thought to cause
CJD.
Ann Marie's concern is that others who had the tonometer used on them could
have gotten infected.
A 2003 study by British researchers suggests her concerns may be justified.
A team led by J.W. Ironside from the National Creutzfeldt-Jakob Disease
Surveillance Unit at the University of Edinburgh examined tonometer heads
and found they can retain cornea tissue that could infect other people --
even after cleaning and decontaminating the instrument.
"Retained corneal epithelial cells, following the standard decontamination
routine of tonometer prisms, may represent potential prion infectivity," the
researchers wrote in the British Journal of Ophthalmology last year. "Once
the infectious agent is on the cornea, it could theoretically infect the
brain."
Prions, misfolded proteins thought to be the cause of mad cow, CJD and
similar diseases, are notoriously difficult to destroy and are capable of
withstanding most sterilization procedures.
Laura Manuelidis, an expert on these diseases and section chief of surgery
in the neuropathology department at Yale University, agreed with the British
researchers that tonometers represent a potential risk of passing CJD to
other people.
Manuelidis told UPI she has been voicing her concern about the risks of
corneas since 1977 when her own study, published in the New England Journal
of Medicine, showed the eye tissue, if infected, could transmit CJD.
At the time the procedure was done on Richard Da Silva, about a year before
he died, she said it was "absolutely" possible he was infectious.
The CJD Incidents Panel, a body of experts set up by the U.K. Department of
Health, noted in a 2001 report that procedures involving the cornea are
considered medium risk for transmitting CJD. The first two patients who have
a contaminated eye instrument used on them have the highest risk of
contracting the disease, the panel said.
In 1999, the U.K. Department of Health banned opticians from reusing
equipment that came in contact with patients' eyes out of concern it could
result in the transmission of variant CJD, the form of the disease humans
can contract from consuming infected beef products.
Richard Da Silva was associated with a cluster of five other cases of CJD in
southern New York that raised concerns about vCJD.
None of the cases have been determined to stem from mad cow disease, but
concerns about the cattle illness in the United States could increase in
light of the USDA announcement Thursday that a cow tested positive on
initial tests for the disease. If confirmed, this would be the second U.S.
case of the illness; the first was detected in a Washington cow last
December. The USDA said the suspect animal disclosed Thursday did not enter
the food chain. The USDA did not release further details about the cow, but
said results from further lab tests to confirm the initial tests were
expected within seven days.
Ann Marie Da Silva said she informed the New York Health Department and
later the eye doctor who performed the procedure about her husband's illness
and her concerns about the risk of transmitting CJD via the tonometer.
The optometrist -- whom she declined to name because she did not want to
jeopardize his career -- "didn't even know what this disease was," she said.
"He said the health department never called him and I called them (the
health department) back and they didn't seem concerned about it," she added.
"I just kept getting angrier and angrier when I felt I was being dismissed."
She said the state health department "seems to have an attitude of don't
ask, don't tell" about CJD.
"There's a stigma attached to it," she said. "Is it because they're so
afraid the public will panic? I don't know, but I don't think that the
answer is to push things under the rug."
New York State Department of Health spokeswoman Claire Pospisil told UPI she
would look into whether the agency was concerned about the possibility of
transmitting CJD via tonometers, but she had not called back prior to story
publication.
Disposable tonometers are readily available and could avoid the risk of
transmitting the disease, Ironside and colleagues noted in their study. Ann
Marie Da Silva said she asked the optometrist whether he used disposable
tonometers and "he said 'No, it's a reusable one.'"
Ironside's team also noted other ophthalmic instruments come into contact
with the cornea and could represent a source of infection as they are either
difficult to decontaminate or cannot withstand the harsh procedures
necessary to inactivate prions. These include corneal burrs, diagnostic and
therapeutic contact lenses and other coated lenses.
Terry Singletary, whose mother died from a type of CJD called Heidenhain
Variant, told UPI health officials were not doing enough to prevent people
from being infected by contaminated medical equipment.
"They've got to start taking this disease seriously and they simply aren't
doing it," said Singletary, who is a member of CJD Watch and CJD Voice --
advocacy groups for CJD patients and their families.
U.S. Centers for Disease Control and Prevention spokeswoman Christine
Pearson did not return a phone call from UPI seeking comment. The agency's
Web site states the eye is one of three tissues, along with the brain and
spinal cord, that are considered to have "high infectivity."
The Web site said more than 250 people worldwide have contracted CJD through
contaminated surgical instruments and tissue transplants. This includes as
many as four who were infected by corneal grafts. The agency noted no such
cases have been reported since 1976, when sterilization procedures were
instituted in healthcare facilities.
Ironside and colleagues noted in their study, however, many disinfection
procedures used on optical instruments, such as tonometers, fail. They wrote
their finding of cornea tissue on tonometers indicates that "no current
cleaning and disinfection strategy is fully effective."
Singletary said CDC's assertion that no CJD cases from infected equipment or
tissues have been detected since 1976 is misleading.
"They have absolutely no idea" whether any cases have occurred in this
manner, he said, because CJD cases often aren't investigated and the agency
has not required physicians nationwide report all cases of CJD.
"There's no national surveillance unit for CJD in the United States; people
are dying who aren't autopsied, the CDC has no way of knowing" whether
people have been infected via infected equipment or tissues, he said.
Ann Marie Da Silva said she has contacted several members of her state's
congressional delegation about her concerns, including Rep. Sue Kelly,
R-N.Y., and Sen. Charles Schumer, D-N.Y.
"Basically, what I want is to be a positive force in this, but I also want
more of a dialogue going on with the public and the health department," she
said.
http://washingtontimes.com/upi-breaking/20041118-030642-2974r.htm
Cadaver corneal transplants -- without family permission
Houston, Texas channel 11 news 28 Nov 99
Reported by Terry S. Singeltary Sr.son of CJD victim
http://www.mad-cow.org/~tom/dec99_news.html#bbb
CJD and intraocular surgery
Ophthalmic surgery and Creutzfeldt-
Jakob disease
http://www.vegsource.com/talk/madcow/messages/92788.html
-------- Original Message --------
Subject: Ophthalmic surgery and Creutzfeldt-Jakob disease
Date: Fri, 19 Mar 2004 09:39:43 -0600
From: "Terry S. Singeltary Sr."
Reply-To: Bovine Spongiform Encephalopathy
To:
[email protected]
######## Bovine Spongiform Encephalopathy #########
April 2004; Vol. 88, No. 4
URL: http://www.bjophthalmol.com/content/vol88/issue4/index.shtml?etoc
Series editor: David Taylor
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
Ophthalmic surgery and Creutzfeldt-
Jakob disease
P S-Juan, H J T Ward, R De Silva, R S G Knight, R G Will
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
Although the evidence does not suggest that contaminated
ophthalmic instruments represent a risk of onward transmission of
sporadic CJD, this conclusion should be treated with caution
The occurrence of variant
Creutzfeldt-Jakob disease (vCJD)
and the probable causal link with
bovine spongiform encephalopathy
(BSE) in cattle have increased interest
in the search for possible environmental
sources of sporadic CJD (sCJD).
Presumed iatrogenic CJD is rare. Up to
the year 2000 there had been 267 cases
reported worldwide: three cases secondary
to human corneal grafting (one
confirmed, one probable, and one possible
case), 114 related to human dura
mater grafts, 139 related to human
growth hormone treatment, four related
to human pituitary gonadotrophin therapy,
and seven linked to neurosurgical
procedures or stereotactic EEG electrodes.
1 Because of the marked resistance
of the infectious agent of CJD to
conventional sterilisation techniques,
there is concern about the possibility of
transmission of infection via surgical
instruments in contact with infected
tissue, especially in neurosurgery or
ophthalmic surgery.
SNIP...
a bit of history;
The Eyes have it/CJD * and they could be stealing them from YOUR loved
one, hence the
spread of CJD (aka MADCOW DISEASE) will spread...
http://jama.ama-assn.org/issues/v282n23/full/jlt1215-5.html
http://mad-cow.org/~tom/dec99_news.html#bbb
Testimony of Bess Believeaux, Lions Eye Bank of Central Texas
(Submission to the Jan. 18/19 meeting of the
TSE Advisory Committee)
http://www.fda.gov/ohrms/dockets/ac/01/slides/3681s2_16.pdf
TSS Submission to the same Committee;
http://www.fda.gov/ohrms/dockets/ac/01/slides/3681s2_09.pdf
Tissue Banks International (TBI), Gerald J Cole
http://www.fda.gov/ohrms/dockets/ac/01/slides/3681s2_13.pdf
TSS
########### http://mailhost.rz.uni-karlsruhe.de/warc/bse-l.html ############
Cadaver corneal transplants -- without family permission
http://www.mad-cow.org/~tom/dec99_news.html#bbb
TSS
#################### https://lists.aegee.org/bse-l.html
####################
#################### https://lists.aegee.org/bse-l.html ####################
