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From: dbriars@world.std.com Subject: McLibel: 2. BSE-CJD items
Subject: 2. BSE-CJD facts Date: Mar 26, 1996 From: Bob Horn
* 1990: GUMMER'S STUNT AND THE 'REMOTE RISK' MYTH
The chief thing to understand about Dr Narang is that he never lets up. He spent the last weekend of November, for example, collecting urine samples from a number of cattle on two dairy farms in the Midlands. Pig-sick of the official BSE policy, the two farmers had heard he was developing a fast test for BSE and decided to let him have a crack at their animals. The urine he collected, however, is still sitting in his office fridge, untested, for lack of access to an electron microscope. He used to use one at Manchester University (which has six), but last May the university authorities, having become aware of his pariah status, told him he wouldn't be welcome to do so again.
But does he stop? Six weeks ago, the family of Jean Wake, who was dying of CJD in Sunderland General Hospital, agreed to let Narang take a urine sample from her. In its selflessness, the family understood that the sooner a simple diagnostic test could be perfected, the sooner a cure might be discovered. But while the hospital agreed to provide the urine sample, it refused Narang permission to use their on-site facilities to test it. He recalls: 'They asked me why I couldn't go and do it in my garage.'
In the event, and not for the first time, Ken Bell paid for Narang to fly to America where he is free to use the facilities at the National Institute of Health's Bethesda Hospital, Washington, any time he likes. Narang's chief admirer there is Daniel Carleton Gajdusek, Nobel prize winner for his discovery-through his original work on Kuru-that spongiform dementia is a transmissible disease. To save on commuting time in and out of Washington, Narang keeps a sleeping bag at the Bethesda laboratories-such is his sense of urgency. As well as being a loose political cannon, Narang's other chief problem is that he represents a dire threat to the prevailing scientific orthodoxy. The story starts with his own illustrious beginnings, back in 1972. That year, Narang was the first scientist to identify the microscopic tell-tale filaments which characterise spongiform brain disease-the 'tubulofilamentous particles', now known as the 'nemavirus'. The nemavirus is not the disease agent itself. Nobody anywhere has yet managed to identify that. It remains invisible. But the presence of the nemavirus, as Narang discovered, is a positive: it tells you that the disease is there. In this, Narang is backed by Gajdusek. At first, he thought Narang had been looking at a contamination accident, a glitch-until one American team, then another, reproduced the nemavirus particles, after which Gajdusek wrote a handsome letter congratulating Narang's public health bosses on their brilliant scientist.
Since the late Seventies, however, orthodox thinking has largely swung the other way-to so-called prion theory, the brain child of American scientist and considerable self-publicist, Dr Stanley Prusiner. According to Prusiner, spongiform disease agent- alone of all diseases-requires no DNA whatsoever to form or to reproduce itself. The true culprit, Prusiner insists, is a rogue protein-the so-called prion. As is clear from scientific writings, most MAFF and MoH scientists are ardent prionists.
Trouble is, and few dare admit it, BSE has recently blown prion theory clean out of the water. If the theory was right, BSE, when transmitted to other animals, would be converted into a whole variety of species-specific spongiform brain diseases. Mice would have one type, sheep another, and so on. But with BSE, uniquely, it doesn't happen. As with the cats experimentally inoculated with BSE, they died of BSE. Ditto mice, sheep, goats, mink, pigs, kudu antelopes, cheetahs and, our cousin, the monkey. Killed by BSE, every one. In other words, for 20 years, prion theory has been a case of the Emperor's New White Boffin Coat. What happens now to all those glittering prionic careers and prospects, heaven only knows. Bar the shouting, what we are left with is Narang, with his precious nemavirus, no bloody microscope, and a vicious hardnut in BSE-a unique superstrain of disease that is quite immutable, species to species.
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In 1987, after MAFF had managed to keep the new cattle disease quiet for almost two years, Narang remembers the chill that overtook him when the news broke. Would it be harmful to man? Could it mutate and jump the species barrier? Gajdusek had been badgering him to come and work in America, but there was no way he would leave, not now. His first difficulty, however, was that he worked for the PHSL in Newcastle while responsibility for handling the BSE outbreak was given to the Central Veterinary Laboratory (CVL) at Weybridge, directly under MAFF in London. But Narang had his own laboratory-custom-built by the PHSL, such was his status back then-and he began liaising actively with MAFF from there.
Head down over his microscope, he hardly noticed how swiftly the politics of BSE moved in, mob-handed, to ambush the science. In April 1988, for example, the Government set up the Southwood Committee to assess the significance of the BSE epidemic, and to consider its possible danger to man. The committee contained not a single expert on spongiform brain disease.
MAFF, which is essentially a trade ministry, has no brief whatsoever for human health. 'And thank God for it!' said the Chief Veterinary Officer, Keith Meldrum, when explaining this point to me. But surely the Ministry of Health would put human well-being first? Come the political crunch, no. In February 1989, for example, on publication of the Southwood report, MAFF and the MoH put out a joint media release which omitted Southwood's warning about the possible dangers of BSE, and majored instead on the one phrase 'remote risk'. The fix was in.
Narang, meanwhile, had been developing a brain-tissue test for diagnosing BSE in sub-clinical animals. His idea was to carry out random tests on animals in abattoirs, just after slaughter, to assess the true extent of sub-clinical infection. Did it only exist in herds which had had BSE cases already? Or would it be found in apparently BSE-free herds? By August 1988, already satisfied that his test worked, he wrote offering it to the newly set-up Spongiform Encephalopathy Advisory Committee (SEAC). MAFF already had its own test, but each one could take several days to complete. In his letter to the SEAC, Narang claimed that his test could be done in under an hour. He got no reply, however, and not for another 11 months did MAFF contact him. By way of getting him to prove his claims, he was invited to the CVL at Weybridge and presented with three cattle brains. Taking less than an hour each, all his diagnoses were correct. This was in August 1989.
Next, nothing happened until November, when Narang was invited to apply for a MAFF grant to develop his test, which he did. But in January 1990, MAFF wrote to inform him that his application had been turned down. According to Narang, Ray Bradley, then the Government's official BSE co-ordinator, told him separately by phone: "Everyone appreciates how sensitive your test is but John MacGregor [then Minister of Agriculture] doesn't want your rubber stamp." Meanwhile, there'd been a very disturbing development on the CJD front. A colleague of Narang's, Dr Robert Perry, of the Newcastle General Hospital, had recorded four cases of CJD in the Northern Region Health Area. Normally, he would have expected two cases in any one year, not four. Narang's analyses of the brains yielded another chilling oddity. Two were not typical CJD at all. Specifically, they showed 'atypical spongiform encephalopathy accompanied by focal neurofibrillary tangles formation'-the same tangles you find in BSE and in Kuru, and in the same places, the central grey matter and cerebellum. When Narang and Perry published their findings in The Lancet in March 1990, they didn't mention BSE. If only to scientific insiders, however, here was a big clue that BSE might be linked with CJD.
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1990: GUMMER'S STUNT AND THE 'REMOTE RISK' MYTH
In the whole BSE saga to date, 1990 was a make-or-break year politically. At its opening, the BSE epidemic curve looked as if a gentle Pennine slope had suddenly become an Alp. Lulled by official assurances of 'remote risk', however, the public remained calm-until April, when news broke of the first case of a cat dying from spongiform disease. As if in dress rehearsal for what happened again all over Britain last week, local councils banned beef from the menus of 2,000 schools. In May, France, Germany and Italy banned British beef imports. Heavily deploying the 'remote risk' gambit, the new Minister for Agriculture, John Gummer, tried to feed his four-year old daughter a beefburger in front of the world's media in order to demonstrate that beef was safe. Had Gummer not been told about the apparently BSE-like strain of CJD? If not, why not? But even if he hadn't known, his claim about the safety of beef was baseless anyway: his own scientists at MAFF didn't complete their infectivity tests on beef for another two years and five months.
Re-enter Dr Narang. In June 1990, the House of Commons Agriculture Committee invited a range of scientific experts to present their views of the situation, and how best to proceed. Twice they sent written invitations to Dr Narang through the PHSL and his administrative seniors twice neglected to inform him. Meanwhile, the committee was given plenty else to think about. Dr Gerald Forbes, Director of Environmental Health for Scotland, said that 'statements being made about the safety of beef are quite unacceptable because they have no scientific basis in fact'. Afterwards, Forbes experienced considerable phone harassment, pressuring him to toe the party line. When neuropathologist Dr Gareth Roberts was giving evidence, there arose the issue of human exposure to BSE-tainted foodstuffs from 1985 up to the belated 'offal ban' of November 1989. "It was noted", Roberts recalled. "There was silence. And then we moved on to discuss other topics." Microbiologist Professor Richard Lacey described the abattoir policy of roughly sawing out potentially infective spinal tissue-which sprays the stuff over the rest of the carcass-as a "dangerous attempt to manipulate a disease" about which there was 'a complete absence of knowledge'. He argued that all herds with BSE cases should be destroyed, and that new herds be bred from BSE-free ones on uncontaminated pastures. Afterwards, protected by parliamentary privilege, farming MPs called Lacey a 'bogus professor' and 'in need of psychiatric treatment'.
Eventually, the Agricultural Committee got through to Narang by phone, and invited him to submit written evidence. His main points remain chilling to read. First, he addressed the need for urgency. At that time, MAFF scientists were carrying out series after series of scrapie and BSE infectivity tests using mice, each series taking between one and three years to complete. But, as Narang pointed out, if you knew what to look for-those tell-tale nemavirus filaments-you could get a good indication in just 20 days.
At that time, too, MAFF was still taking weeks to confirm BSE cases. Narang, not mentioning that he'd demonstrated it to MAFF the year before, cited his own quick diagnosis technique. Next, addressing the claim that BSE posed only a 'remote risk' to man, he pointed out that BSE was a unique superstrain with an unusually short incubation time, and killed test mice almost twice as fast as scrapie. He also cited experiments with 23 different species of animals, all of which-whether inoculated or fed with spongiform agent-had died. 'Therefore,' he wrote, 'humans are not likely to be totally resistant.' Lastly, Narang proposed that CJD cases in the population should be monitored for any new, atypical patterns in symptoms and pathology. In concluding his paper, he offered his experience and speedy techniques to whomsoever could use them best and quickest. Again, there were no takers- not from MAFF or the MoH anyway. Was Narang, the dedicated scientist, too naive for his own good? Still trying, as he was, to get development funding for his diagnostic test, he was clearly kicking against the political pricks. The real trouble started in March 1991. He'd been doing experiments involving genetic manipulation when, out of the blue, he was accused of failing to register the work under new health and safety rules. Registration with the Health and Safety Executive (HSE) is compulsory if genetic manipulations pose a direct danger to man. The fact was, Narang knew his work wasn't in that category. But the mud stuck: here's a scientist who can't be trusted with dangerous materials.
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With the mud still sticking, in July 1992 an even muckier lot was hurled. As ever, when not peering down a microscope, Narang was doing his own brand of rushing-about research-some with farmers, some with the families of CJD victims, most of them desperate for solutions or answers, and many of them willing to help with his work in any way they could. Families wrote to him, and he contacted others through medical colleagues.
Then, wham: Narang was suspended from the PHSL, following complaints of alleged professional misconduct, filed mostly by other professionals. According to the PHSL letter informing him of his misdeeds, dated July 29 1992, all complaints had come from outside the PHSL.
Not that the PHSL didn't actively seek out other complaints. On October 1, for example, its Newcastle Director, Dr N F Lightfoot, questioned Robert Perry - who'd not been a complainant - as to whether Narang had ever obtained patients' case notes improperly. The written record of that meeting capitalises Perry's unequivocal 'NO'.
The last paragraph of that record, however, is testimony that the PHSL knew that an apparently BSE-like strain of CJD was on the loose. 'After this interview was completed,' Lightfoot wrote, 'and I was standing at the door of Dr Perry's office, Dr Perry freely informed me that there had been four cases of CJD in the Northern Region this year and that he would only expect one or two cases per year.'
No, not the four cases Perry and Narang had encountered in 1989. Another four, here in 1992. Lightfoot continued: 'He [Perry] added interestingly that in two of these cases the histological appearance of the lesions was unusual' -that is, unusual in the area of brain the disease had attacked- 'in that they involved the cerebellum and that this was the appearance that is seen in BSE in cows.' With the charges still hanging over him, the PHSL had not yet done its worst by Narang. Come August 1993, he was directed by the PHSL to leave his Newcastle laboratory and, for the next 12 months, to carry on his work in London, at the London Hospital. An ex-MAFF employee was put in as his assistant. 'It was ridiculous,' says Narang. 'I could only work in the lab when she was there. Otherwise, it was locked. I came in through another entrance once and, after that, the lab was padlocked.' Also, when preparing a long series of animal experiments for Narang to work on, she prepared them for RNA analysis, not DNA. In August 1994, came the coup de grace: because of cutbacks, the PHSL informed Narang there was no longer any place for him back at Newcastle. His work had already been redistributed there among other scientists, and he would either have to accept another kind of post or take redundancy. The PHSL had also destroyed a number of his precious spongiform samples. Narang still feels profoundly abused. 'God is hard but not cruel,' he says.
The PHSL claims that it was a legitimate redundancy and, when Narang recently appealed on the grounds of wrongful dismissal, the tribunal found for the PHSL. But consider the triumphalist glee with which the PHSL set about Narang's redundancy- the following internal memo, for example, from J H Phipps, Head of Human Resources, PHSL, to its Deputy Director, K M Saunders. About an upcoming meeting with Narang on October 11,1994, Phipps wrote: 'It would be splendid if we could have approval to finalise separation on that date.' And elsewhere: 'Now is the ideal and most defensible time to address the problem. Prolonged delay could provide even more media fodder.' And further: 'I have been advised on numerous occasions about the "PR repercussions" which I must obviously respect. My experience in such instances, endorsed by Christine Murphy [Chief Press Officer, PHSL] is that such repercussions have a comparatively short shelf-life.'
All along and still, the PHSL insists that Narang's redundancy was unconnected with the charges laid against him. Quite so. But what about those charges? Remember those HSE registration forms he was accused of neglecting to fill in, the ones concerning dangerous genetic materials? Fully three years on, the HSE determined that he had had no case to answer. Stranger still, it emerged at the tribunal that the HSE had sent the forms to Dr Lightfoot... who'd then thrown them away. 'Administrative error,' said the tribunal. And the charges of professional misconduct? At the outset, the PHSL had warned Narang that, if proved, they could constitute grounds for dismissal. Fair enough. So why wasn't he fired? Why did the PHSL' internal enquiry drag on for over two years? Couldn't the charges be substantiated? Or would firing him have generated even more 'media fodder'? Actually, it's all academic: the PHSL's internal enquiry petered out and then, with his redundancy, was abandoned altogether.
The appalling treatment of Narang actually dates back to that key moment in 1989 when MAFF and the MoH chose to major on the public message of 'remote risk'. Exactly there, the Government gave up its right to public confidence on the BSE issue. We couldn't be trusted to be told the possible risks and to make up our own minds. From that moment, the Government has been fighting the kind of rearguard action that made the likes of Gummer's calculated lie a political necessity. Official BSE policy is a 'rotten borough', as Narang discovered when he attempted to address the risks head on. And how rotten is the borough that would even throw away the man and the possible means of ending the BSE threat?
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Dr. Narang is not nearly the only individual to fall foul of official BSE policy. Consider what happened to Finnish-trained veterinarian Marja Hovi merely for trying to do her job properly. In early 1994, when a member of a group practice in Bristol, Hovi took over as Official Veterinary Surgeon (OVS) in a local export specialist abattoir. One of her responsibilities was to verify that slaughtered animals going for export had come from BSE-free herds. The Germans are particularly hot on this point, not least because, periodically, their own domestic beef sales have been more adversely affected by Britain's BSE crisis than have British domestic beef sales. Which is one measure of how effective the Government's 'remote risk' campaign has been here at home.
At slaughterhouses, owner-farmers are required to produce written declarations that their animals have come from BSE-free herds. "But as soon as I started the job," Hovi explains, "it was clear that some previous vets hadn't demanded any owners' declarations." What, animals had been going through on the nod? "Yes."
"Being the one who had to certify, on my signature, that they were BSE-free, I was horrified. So I started asking for owner's declarations. And these turned out to be useless because they only declared the owner's opinion about where the animals had come from. There was no requirement for records of where they'd been born or which herds they'd been moved to and sold from since, nothing. But I assumed the declarations would be easily checkable against MAFF's own records. It was possible, just, to cross-check, but very difficult and time consuming. There was no on-line MAFF access you could just punch up. First, when I started demanding declarations, the abattoir management said it would jeopardise their customer relations, and put them at a disadvantage in relation to other abattoirs. So I did my own phone-poll, asking other vets what they did. Some said, "Oh, is there a problem with this now? Are the inspectors coming round?" Some said they didn't bother with owners' declarations. Some said they collected them. But none of them were matching declarations with MAFF records. MAFF certainly wasn't enforcing the regulations, either, which made it very difficult for me to stand my ground."
"After just a month in the job, with the local council threatening to withdraw the OVS contract because I was still refusing to sign certificates, the veterinary practice said they could no longer afford to keep me on, and fired me." Hovi went public only after her former employers had started to tell journalists that she'd been relieved of her job because she'd been 'difficult'. Six weeks ago, 19 months after Hovi was fired, David King, one of the largest cattle breeders in the West of England, was found guilty of falsifying cattle documents, claiming that animals had come from BSE-free herds when they hadn't. He was fined u30,000 and ordered to pay u18,500 costs. According to the prosecutor, King had 'betrayed the farming community and put a substantial industry in jeopardy'.
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As of last month, evidence emerged that another aspect of MAFF's BSE leaky containment policy has again burst open- namely, that an increasing number of farmers are illegally burying BSE carcasses rather than face economic ruin. At the beginning of the outbreak, while incinerating some BSE carcasses, MAFF itself interred large numbers of others in mass graves-until informed of the dangers. Not for nothing is spongiform disease agent known as the 'smallest and most lethal living thing' or, with no less awe, 'kryptonite'. For as well as being able to survive domestic bleach, ultra-violet light and ordinary cooking, it can also thrive for up to three years when buried-opening up the possibility of the disease being spread by scavenging animals, birds and insects, and via underground seepage into water tables. Hence one reason for Sir Richard Southwood's anger back in 1988, when John MacGregor set compensation to farmers for BSE-stricken animals at a measly 50 per cent of market value. It took MacGregor another 18 months to change his mind, upping it to 100 per cent, with MAFF following in swiftly afterwards to make their Minister look good. Since the setting of compensation at 100 per cent, MAFF insisted, there hadn't been a new surge in declared BSE cases, thus proving that farmers hadn't been burying BSE carcasses illegally after all. In March 1994, Night & Day promptly discovered some farmers who owned up to doing just that.
This latest surge in illicit burials dates from July this year, when MAFF increased the scope of its offal ban to include cows heads. To offset the extra handling expense, the Licensed Animals Slaughterers and Salvage Association (LASSA) passed on a u15-20 collection charge to farmers. Since the measure was introduced, says LASSA Secretary Chris Ashworth, the number of BSE animals being handled by knacker businesses nation-wide has dropped by a dramatic 20-25 per cent. 'We reckon they're being put underground again,' says Ashworth. On the surface, the economics don't make sense. Why, for a saving of only u20, would a farmer forfeit his Government compensation? Many a farmer, it turns out, can get compensation from his own insurance company, provided he claims to have slaughtered the animal for something other than BSE. Of course, he risks prosecution but, if it's his first BSE case, by burying it he'd avoid the economic blighting of his whole herd, and retain the BSE-free status he needs in order to export. To bury his second, tenth or twentieth BSE animals illegally would also make economic sense.
What added to farmers' temptation was the EC's insistence last year that the time period for declaring a herd BSE-free should be extended from two years with no confirmed cases to six years. (You can understand European caution: what little BSE they have, they got from us.) But the six-year rule trebles the economic penalty to farmers. And imagine this: just as the sixth year is about to elapse, an animal goes down with BSE. What will the farmer do? Come clean and face losing money for another six years, even bankruptcy? Or bury the evidence?
The primary fault is the Government's continued refusal to compensate farmers for the economic blight which just one BSE case can inflict on their whole herds. Until it changes its mind illegal burials will doubtless continue. Is it any wonder that the Government's every rearguard action is now greeted with 'pull the other one' public cynicism? Consider the constant re-adjustments to the 'offal ban'. Calves under six months were wholly exempt until, in June 1994, their intestines were banned. In June 1995, after it was discovered that cows' eyes could be infectious, the whole head was banned except for cheek meat and tongue. Since November, as per Professor Lacey's point back in 1990, the whole of the vertebral column is now banned, except for the tail, and just last week, new restrictions on mechanically recovered meat were announced.
As to beef meat itself, MAFF established its apparent safety-after feeding it to mice for three years-in 1993. We didn't hear much about it, doubtless because any bold announcement would have drawn attention to all the previous, specious claims about beef safety. But as Narang points out, 'If you're looking for infectivity, mice don't eat very large amounts of meat. Feeding it to mink would be a better test.' Weight for weight, mink eat as much meat as humans, and they're also highly susceptible to BSE. Every scientist who's criticised BSE policy to date has been turned on by the 'rotten borough' as if they were the villains. The current rogues gallery, each with their names skilfully blackened, includes the eminent neuropathologist, now retired, Helen Grant-"too out of date"; Richard Lacey-"the bogus professor"; Stephen Dealler-"away with the fairies"; Marja Hovi-"a difficult woman"; and Narang. The newest rogue, of course, is retired neuropathologist Sir Bernard Tomlinson, who broke ranks two weeks ago by saying he'd like to see all beef offal banned, including liver, and that he'd already warned his children and grand children not to eat beefburgers. 'Now Sir Bernard'll be getting it in the neck, of course,' said Helen Grant. 'Oh, they make me spit!'
Three weekends ago, after visiting farms to collect urine samples, Narang returned to his pokey flat-cum-office in Newcastle to find that it had been expertly burgled. A large window pane had been cut out, and used for both entry and exit. The thief knew what he was looking for: Narang's tape recorded case notes, taken from farmers and the families of CJD victims. Luckily, he'd already transcribed most of them. "Oh, but it's nice to think someone is interested in my work," he smiled.
The PHSL is unhelpful about passing on Dr Narang's mail. He can be contacted c/o Ken Bell International, 22-40 Brentwood Avenue, Newcastle upon Tyne, NE2 3DH.
Central Public Health Laboratory and *Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5HT, UK
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