Volume 3: The Early Years, 1986-88
1. The identification of a new disease in cattle
Discussion

1.26 Conflicts of evidence are bound to occur when witnesses are asked about events that took place some 15 years ago. Contemporary documents provide a valuable aid to solving such conflicts. Having carefully considered all the evidence, we have concluded that Ms Richardson is mistaken in her recollection that, in September 1985, she and her colleagues at the CVL identified the disease affecting Cow 142 as a scrapie-like disease in cattle. While we think that she may well have noticed a pathological similarity to scrapie, we do not believe that she can have concluded that Cow 142 was suffering from a transmissible spongiform encephalopathy.

1.27 The following are our reasons for reaching this conclusion:

1. The suggestion in Ms Richardson's Pathology Report that the spongiform encephalopathy was an acute condition attributable to 'a toxicity of some description' is incompatible with a conclusion that Cow 142 was suffering from a transmissible spongiform encephalopathy (TSE).
2. It is plain that Ms Richardson had a discussion about Cow 142 with Mr Watkin-Jones in which she commented that the pathological changes were consistent with bacterial toxin. Her memory must be at fault when she says: (a) that the conversation never took place and (b) that she would not have ascribed the condition to a bacterial toxin. The suggestion that a bacterial toxin was the cause is incompatible with a conclusion that Cow 142 was suffering from a TSE.
3. The suggestion made by Ms Richardson that a bacterial toxin might be the cause echoes the manuscript note added to the foot of her Report by Mr Wells. We believe that he must have raised the possibility of bacteraemia on his first review and that Ms Richardson accepted this as a possible cause.
4. We are satisfied that Dr Jeffrey cannot, in September 1985, have identified Cow 142 as 'bovine scrapie' and said that Mr Wells had had two such cases and was expecting two more. Had this been the case both he and Mr Wells would surely have remembered this, and records of the cases in question would have been preserved. Neither Dr Jeffrey nor Mr Wells has any such recollection and no such records exist.

1.28 We believe that in the years that have passed, Ms Richardson's memory mayhave attributed to September 1985 events that took place at the end of 1986, when early cases of BSE were identified at the CVL.

1.29 We do not consider that Mr Wells, or anyone else who studied the brain sections of Cow 142 in September 1985, is to be criticised for failing to diagnose that the cow was suffering from a TSE. In his statement Mr Wells drew attention to the fact that samples from previous cases had not included brain sections and that the main post-mortem finding in relation to those cases had been that of internal bleeding. ¹

1.30 There were no indications from the tissues provided that it might be desirable to investigate further into the nervous tissues of these, or possible future cases. ² As Mr Wells said in his statement to the Inquiry:

Taken in isolation and in the light of these factors, the case in September 1985 did not at that time suggest that a new disease had been identified. Vacuolar changes in the brain of that particular animal were not severe and there was previous, and current, evidence of other disease problems . . . It was not, therefore, immediately apparent from the post-mortem histopathological examination of the brain of one animal in this herd that it was the first and unprecedented case of a new disease. ³

1.31 There could have been a number of causes of the degeneration of the cerebral tissue in Cow 142. By the time that Mr Wells diagnosed the true cause in June 1987, he was much more familiar with the signs of BSE and was specifically searching for them.

1.32 The CVL received samples of nervous tissues and other organs from a further Stent cow on 10 September 1986. The histological examination by Dr S Done, dated 22 September 1986, revealed a mild spongiform change in the medulla (hindbrain). ⁴

1.33 At the time this case appears to have made no impact on Mr Wells, if he indeed was told about it. When he came to review it in June 1987 he found that there was insufficient information to make a conclusive retrospective diagnosis of BSE. We are left with a strong suspicion that all nine cows which appeared to manifest the 'Stent Farm Syndrome' may have been cases of BSE.