Volume 3: The Early Years, 1986-88
5. Human health implications, notification, and slaughter and compensation
Chronology
December 1986
May 1987
June 1987
July 1987
September 1987
October 1987
November 1987
December 1987

December 1986

5.4 In his seminal minute to Drs Watson and Shreeve of 19 December 1986 (see paragraph 1.37), Mr Bradley commented:

If the disease turned out to be bovine scrapie it would have severe repercussions to the export trade and possibly also for humans if for example it was discovered that humans with spongiform encephalopathies had close association with the cattle. ¹

5.5 Mr Bradley explained to us that although no association had been shown between scrapie and CJD, he considered that if a new species was affected this might pose a different risk. He flagged up the possibility that there might be a risk for human health that should be considered. ²

5.6 Mr Bradley went on to say that it remained his view that:

It was inappropriate for veterinarians to be responsible for advising or doing anything in regard to public health in that particular context. It was for medical doctors to decide. ³

5.7 At the back of his mind was the requirement that, at some stage in the future, the medical authorities should be informed about BSE. ⁴

5.8 Mr Rees told us that in early 1987 he reached the provisional conclusion, on the basis of the information known about BSE at the time, that it was unlikely that the disease posed a risk to human health. ⁵ The outcome of his discussions with senior veterinary staff was that it was unlikely that BSE would affect humans, as no existing animal spongiform encephalopathies had been linked to human disease. That possibility could not, however, be ruled out. ⁶

5.9 Dr Watson's evidence indicated that, in the early days, he was principally concerned with what he considered to be:

. . . the most serious problem in the livestock industry we were likely to encounter since foot and mouth disease in 1967. ⁷

5.10 Mr Cruickshank's view of the risk to human health was based upon conversations with Mr Rees and, initially at least, they held similar views. ⁸

5.11 Mr Wells told us that in the early days none of those that he talked to discussed the question of risk to human health. The veterinary viewpoint was that BSE would behave very much like scrapie in sheep. ⁹

5.12 The contemporary documentation suggests that in the first half of 1987, Mr Rees, Dr Watson and his staff at the CVL were principally concerned with the animal health risk posed by BSE and the commercial implications that this might have. Accordingly, it is possible to move some months forward in the story to the first occasion on which there was communication about BSE to members of the medical profession.

May 1987

5.13 Mr Wells made his impromptu presentation to the joint meeting of the Medical and Veterinary Research Clubs on 29 May (see paragraph 2.46). Mr Rees observed to us that while this did not amount to formal notification to DH about BSE, it was one of the ways of making the new condition known. ¹⁰

June 1987

5.14 The note addressed by Mr Rees to the Parliamentary Secretary (Mr Donald Thompson) on 5 June (see paragraph 2.52) stated: 'There is no evidence that the bovine disorder is transmissible to humans.' ¹¹ In his oral evidence, Mr Rees said that the CVL had not at that stage concluded that there were possible implications for humans; nor was there any evidence of any potential effect on humans. When asked if he thought it important for the Minister to know that implications for humans could not be ruled out absolutely, Mr Rees replied that the Minister would have been able to infer that from what was written and from the subsequent discussions. ¹²

5.15 At the meeting held by the MAFF Permanent Secretary (Sir Michael Franklin) a few days later (see paragraph 2.57), Mr Rees advised that it was not yet known how the disease was transmitted nor whether there was any evidence connecting BSE to similar conditions in humans. Sir Michael agreed that MAFF should ensure that investigations were under way into the possibility of any link between BSE and human disorders. ¹³

5.16 In his oral evidence Sir Michael stated that the possibility of any link with human disorders was a paramount concern. However:

The prevailing impression was that, because this disease bore such close similarities to scrapie, and because scrapie had been around for a long time and had not been known to cause any ill health to humans, BSE was similarly unlikely to be a risk to human health. ¹⁴

5.17 On 30 June Mr Bradley sent Dr Watson a note that read:

May I formally draw attention to the need to acquaint the medical profession with our discovery without alarm. I gather this is being done by John Bell to staff at Colindale. ¹⁵

Mr Bradley told us he understood that Mr Bell had been communicating information to the Communicable Disease Surveillance Centre (CDSC) but that he had no detail of this. He considered that it might be necessary to go further than just the one localised contact. ¹⁶

5.18 Mr John Bell was a Senior Veterinary Officer working at the State Veterinary Service headquarters at Tolworth. His duties included liaising with the CDSC, part of the Public Health Laboratory Service (PHLS) at Colindale, about the surveillance and investigation of communicable diseases reported by the PHLS to the CDSC and thought to be associated with animals. Accordingly, Mr Bell made weekly visits to the CDSC to confer with medical epidemiologists, scrutinise PHLS reports, and consider whether farm investigations by the Veterinary Investigation Service (VI Service) were appropriate. It was Mr Bell's practice to give brief oral reports on incidents which had been reported by the VI Service and were likely to be of interest to medical epidemiologists. The meetings were attended by Dr Bartlett, Director of the CDSC, and his medical staff. ¹⁷

5.19 Mr Bell could not recall when or how he first became aware of BSE. He told us he would have received the circular to Senior Veterinary Investigation Officers of 8 June 1987 (see paragraph 2.45) but did not think that he discussed this at the CDSC. He did not remember reading Mr Wells's article published in the Veterinary Record of 31 October 1987 but had he done so, he would have been unlikely to discuss it at the CDSC as the final paragraph stated that no link with other encephalopathies had been established. He said that he reported to the CDSC what he knew from reading and occasional conversations with Mr Wilesmith and Mr Bradley at the CVL. ¹⁸ This must we think have been at a later stage of the story, when the presumed link with scrapie had been accepted.

July 1987

5.20 Mr Cruickshank, Mr Suich, Mr Kevin Taylor, Dr Watson, and Mrs Susan Cunningham met with Mr Donald Thompson and Sir Michael Franklin and discussed BSE on 22 July. Mr Thompson asked whether BSE could be transmitted to humans. Dr Watson replied that he could not give a categorical answer, but that there was no evidence to suggest that it could. Mr Thompson asked that a paper be prepared for the Minister (Mr John MacGregor) outlining the steps taken and the research necessary to assess the dangers of BSE for both cattle and humans. Sir Michael observed that 'the establishment of any risk to human health was the highest priority'. ¹⁹ Mr Thompson said that he was particularly concerned about this and wanted work to be done to rule it out. ²⁰

5.21 On 29 July Mr Rees sent Mr Thompson a paper prepared by Dr Watson pursuant to his request at the 22 July meeting. The paper stated:

The occurrence of a disease of this nature in milking animals could give rise to concern about any human health risks, although there is no reason at all to believe that such risks exist. Any possible relationship between BSE and similar diseases in humans could only be demonstrated by analysis of clusters of cases in the respective populations. Experimental work to prove animal to human transmission is impossible, although material could be inoculated into laboratory primates. ²¹

This paper was subsequently placed before the Minister. ²²

September 1987

5.22 Dr Tony Little, then Deputy Director of the CVL, had responsibility for veterinary medicines. On 9 September 1987 he attended a meeting of the Biologicals Sub-Committee of the Committee on Safety of Medicines. Present at that meeting was Mr John Sloggem, a principal pharmaceutical officer in the Biologicals Unit of DH's Medicines Division. Mr Sloggem was, at the time, considering an application for a clinical trial certificate for a drug which consisted of a bovine brain extract containing phospholipids. ²³

5.23 After the formal meeting was over, we believe Dr Little had a conversation with Mr Sloggem and other colleagues about this application in the course of which he discussed BSE (for more detail see vol. 7: Medicines and Cosmetics). Dr Little told us that:

Although the minutes of the meeting make no reference to it, I made a mention at the meeting of the occurrence of BSE in cattle. I believe (although I cannot now be sure) that I mentioned BSE during the course of the formal meeting. I can remember that a discussion of scrapie resulted from my mention of BSE. ²⁴

5.24 Dr Watson was aware that Mr Rees was in the course of preparing a progress report about BSE for Ministers. On 10 September he sent him a minute suggesting that he include the following additional information:

DHSS are aware of the problem. Concern is being expressed about the possible human health risks due to products for human use which contain an emulsion of bovine brain.

By way of explanation he added:

This matter was discussed by Dr Little with DHSS colleagues attending the Committee on Safety of Medicines Sub-Committee on Biological Products on Wednesday 9 September, and I understand that they will be writing to us. ²⁵

5.25 On 11 September Mr Bradley sent Dr Watson a note suggesting that it would be worthwhile considering publication of information about the disease in the medical literature, such as the British Medical Journal or The Lancet. He added: 'There are of course pros and cons. What do you think please?' Dr Watson replied:

Not at present. It would over emphasise the possible link to human spongiform encephalopathies. ²⁶

5.26 On 16 September Mr Rees sent his progress report (see paragraph 2.105) to Mr Thompson and Mr MacGregor. He accepted Dr Watson's suggestion and included this information:

DHSS are aware of the problem and have informally expressed some concern about any possible human health risks due to products for human use which contain an emulsion of bovine brain. However, there would be no risk provided the brains are from clinically healthy cattle. ²⁷

Mr Rees said that he believed the last sentence must have represented advice that he had been given by Dr Watson. ²⁸

October 1987

5.27 On 15 October Mr Suich circulated information in Question and Answer form to enable press officers and others to answer queries about BSE. This included:

Q. Can it be transmitted to humans?

A. There is no evidence that it is transmissible to humans. ²⁹

This is the first appearance in a Q&A briefing of what became a familiar refrain.

November 1987

5.28 In the light of increased media interest in BSE, Mr Thompson had on 30 October requested a strong defensive briefing on both action taken by MAFF up to that point and action being contemplated. ³⁰

5.29 Mr Suich's response included a statement that there was no evidence that BSE was transmissible to humans. He added that because direct research could not be carried out, it would take many years to build up sufficient data to establish whether or not it was transmissible. Mr Suich drew an analogy with scrapie, which had been present in British sheep for many decades and had shown no correlation with the incidence of spongiform encephalopathies in humans. ³¹

December 1987

5.30 We referred in Chapter 2 (see paragraph 2.125) to the query made in November 1987 by Mr Coultous, an Environmental Health Officer, as to the appropriate approach at the slaughterhouse to the carcass of a BSE suspect. At that point Mr Bradley did not consider that this had become an issue that justified circulating information to EHOs. ³² The first written expression of concern about animals affected by BSE entering the human food chain appears to have come not from MAFF officials but from Lord Montagu of Beaulieu. On 4 December he wrote to Mr MacGregor, having had his attention drawn to BSE by one of his tenants:

My concern in writing to you, and indeed the concern of my tenant, is that in present legislation there is nothing which prevents veterinary officers from certifying the carcass of an animal infected with this disease as fit for human consumption. Indeed, it is my understanding that many such cattle may already be sold through abattoirs for this purpose.

At the present time I understand little or no research has been done on whether this disease can be transmitted to humans through the consumption of beef from infected animals, and, until this is known, it seems quite wrong to me that it is possible to sell infected carcasses for this purpose. As you will appreciate, there is a substantial financial incentive on farmers to sell a carcass for human consumption, as I understand it is worth approximately £300, as against a price of £50 if sold for pet food. Perhaps this is an area where the Ministry should make the disease notifiable and pay compensation at the full value for animals infected?

I wonder if this is something which should be taken up urgently through your Ministry, at least until a clearance is placed on any possibility of risk arising from the consumption of carcasses affected with this disease. ³³

5.31 Mr Cruickshank told us that he felt that a slaughter and compensation scheme would have been mentioned in informal discussions a lot earlier, but that MAFF only really focused on the point formally at the time of Lord Montagu's letter. ³⁴

5.32 Mr Alan Lawrence, of MAFF's Animal Health Division, told us that he was not aware of any detailed consideration being given to making the disease notifiable or to a slaughter and compensation policy prior to receipt of Lord Montagu's letter in early December. ³⁵

5.33 On 11 December Dr C E C Wells, a retired neurologist with considerable experience of cases of CJD, wrote to Dr Watson raising concerns about BSE. He asked whether BSE had been discussed with clinical neurologists and neuropathologists individually or through their professional bodies. He went on to ask a number of questions about the disease. ³⁶

5.34 Dr Watson sent his draft letter to Mr Suich for clearance. ³⁷ Mr Suich approved the letter, ³⁸ and Dr Watson then sent his response to Mr Wells. In this letter he stated:

Whilst we share your concern about BSE and also your desire not to cause alarm I wish to reassure you that medical colleagues have been kept informed and indeed we are collaborating in our research programme with the Neuropathogenesis Unit Edinburgh. All the points raised in your letter and a number of others are being investigated although, as you appreciate, this type of work is expensive, difficult and long-term. ³⁹

5.35 At a meeting of MAFF officials on 15 December, chaired by Mr Rees, it was agreed that an options paper should be prepared and considered at a further meeting, on 8 January, prior to making a submission to Ministers. This would look at a number of options including making the disease notifiable with or without slaughter and compensation. ⁴⁰

5.36 In a note the day after the 15 December meeting, Dr Watson asked Mr Bradley to consider further research into the risk of transmission of BSE by placenta, milk and heat-treated tissue. The sooner the information on possible modes of transmission was available the better, particularly if the policy to be adopted was notification and the slaughter with compensation of affected cattle. ⁴¹

5.37 On 20 December Mr Bradley sent a minute to Dr Watson, attaching his thoughts on a logical approach to research and the BSE infection network. He felt MAFF needed to know 'Is BSE transmissible to primates (& by inference to man)?', and suggested experiments to transmit BSE and scrapie to marmosets. Mr Bradley also suggested experiments to establish which tissues contained the BSE agent, and in what concentrations, and experiments to establish the minimum infective dose for a) a primate and b) a calf.

5.38 Mr Bradley's minute went on to recommend that consideration be given to a number of methods of interrupting the potential chain of transmission. These included:

1. Incinerating all positive BSE carcasses.
2. Sending the head to MAFF and the carcass to the abattoir.
3. Condemning all offals and spinal cord and passing the carcass on its merits. ⁴²

5.39 On 29 December an article on BSE in The Times raised the question of whether it might be a zoonosis. ⁴³

Mystery Disease Strikes at Cattle

The arrival of an unknown disease is inevitably a subject of curiosity and concern. When that disease appears to be confined to a single country - Britain - there are bound to be calls for urgent investigations and for more information to be made public . . .

There is no indication of whether it can infect other animal species or whether it is zoonotic, namely transferable to humans.

There have been suggestions that it could be linked to a sheep disease called scrapie.