New Moves Are Afoot To Manage Beef Imports

New Zealand will be taking a similar approach to Australia over ways to manage the risk of variant Creutzfeldt Jakob Disease (vCJD) in beef and beef food products imported from Europe that may have been contaminated.

Australia is expected to announce its risk management measures for imported beef and beef products today, said Ministry of Health Chief Medical Advisor Dr Colin Feek.

"The Ministry of Health has been working co-operatively with Australian officials over the last six months over the certification process each country will use.

"New Zealand is still fine-tuning a long term solution and Cabinet is due to consider the issue of what beef products should be permitted for importation, from which countries and under which circumstances on July 30."

With Australia, we are planning to extend our formal certification process to all the countries in the world to assess future imports to ensure they are from bovine spongiform encephalopathy (BSE)-free cows, Dr Feek said.

Meanwhile, New Zealand's current import suspension has been rolled over until a permanent measure is in place.

The proposed import controls cover beef and foods containing beef from Britain, Europe, EU countries and all other countries.

The Ministry in 1996 suspended the import of British beef and beef products because consumption of beef from cows that are not BSE-free has been implicated in the development of vCJD in humans.

All EU member countries started mandatory testing of cattle for BSE from 1 January 2001 to determine the prevalence of BSE in European cattle herds.

New Zealand suspended imports from 8 January, 2001 following the discovery of cases of BSE outside the United Kingdom, raising concerns about consistency of adherence to EU policies within the EU and poor information about practices in other European countries.

The Ministry of Health, Ministry of Foreign Affairs and Trade and Ministry of Agriculture and Forestry all believe the best way to approach the issue of BSE is to take practical steps to reduce risks where possible. A BSE expert scientific panel has been providing advice to the Ministry on the issue since 1996.

"The potential risk posed by European beef and beef food products was extremely low, but there remains much to know about variant CJD and the way it is transmitted."

There are only very small quantities of beef products imported to New Zealand from Europe. The United States Centers for Disease Control has estimated the likelihood of getting vCJD from eating European beef and beef products at less than one case per 10 billion servings of beef.

"New Zealand and Australia have been working closely on this issue and both are BSE free. People can be confident about the safety of beef and beef products from the two countries."

Recent testing of cattle herds in European Union (EU) countries has identified a number of cases of BSE in European cattle, although at a much lower level than in British cattle.

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Background Information

Creutzfeldt-Jakob Disease (CJD) is a rare fatal brain disorder which was first recognised more than 70 years ago. There is no effective treatment and no reliable test to predict the disease. Approximately 85 percent of classic Creutzfeldt-Jakob Disease illnesses occur spontaneously without any known cause. Other causes include certain medical treatments that are no longer used such as injections of human growth hormone, and dural grafts (brain membrane). The symptoms may take 30 years to develop.

Variant Creutzfeldt-Jakob Disease is a new and more aggressive strain of CJD which was identified in the United Kingdom in 1996. It produces similar symptoms to CJD but develops more rapidly. Variant CJD is thought to be contracted by eating meat infected with bovine spongiform encephalitis (BSE) which has been described as "mad cow disease". It historically has affected people in the 16 to 52 year age group. The mean age is 28 years. Classic CJD tends to affect people aged from 60 or above and develops more slowly, whereas vCJD has been found in teenagers and young adults and develops more rapidly . A striking early feature of vCJD is prominent psychiatric disturbance.

Since 1980 approximately two to three cases of Creutzfeldt-Jakob Disease have been identified in New Zealand each year. This figure represents approximately one case per million people per year - the expected rate seen internationally. There have been no cases of vCJD in New Zealand.

In 1996 CJD was made a notifiable disease and a case register for CJD established. The register is similar to those already operating in Australia and the United Kingdom. This means all cases of CJD are notified so that cases can be reviewed and investigated to ensure consistent diagnosis and risk factor identification.

Leucodepletion is a filtering process which removes white blood cells prior to transfusion. "Prions", the infective agents of vCJD, are closely linked with white blood cells. Removing them will further reduce the "theoretical" risk of vCJD transmission. Leucodepletion will cost approximately $9-million per year. Introducing it has been a gradually staged process but all New Zealand blood has been leucodepleted from 1 July 2001.

Leucodepletion removes certain viruses, is likely to reduce the risk of bacterial infections such as Yersinia, and reduces the likelihood of adverse reactions to transfusion. Some evidence suggests leucodepletion will reduce the rate of post-operative infection.

QUESTIONS AND ANSWERS

What is Creutzfeldt-Jakob Disease (CJD)?

Creutzfeldt-Jakob Disease is a rare fatal brain disorder which was first recognised more than 70 years ago. There is no effective treatment and no reliable test to predict the disease. Approximately 85 percent of Creutzfeldt-Jakob Disease illnesses occur spontaneously without any known cause. Other causes include certain medical treatments that are no longer used such as human growth hormone injections, dural grafts (brain membrane). The symptoms may take 30 years to develop. Since the disease was identified by Dr Alfons Maria Jakob in the 1920's, over 3000 cases have been reported world-wide.

What is variant Creutzfeldt-Jakob Disease (vCJD)?

A new and more aggressive strain of the disease which was identified in the United Kingdom in 1996. It produces similar symptoms to classical CJD though the disease develops more rapidly. Variant CJD is thought to be contracted by eating meat infected with bovine spongiform encephalitis (BSE) which has been described as "mad cow disease". It historically has affected people in the 16 to 52 year age group. The mean age is 28 years.

What are the unique differences between CJD and vCJD?

CJD tends to affect people aged from 60+ and symptoms may take 30 years to develop, whereas vCJD has been found in teenagers and young adults and it develops more rapidly. A striking early feature of vCJD is prominent psychiatric disturbance.

Have there been any cases of CJD in New Zealand?

Since 1980 approximately two to three cases of Creutzfeldt-Jakob Disease have been identified in New Zealand each year. This figure represents approximately one case per million people per year - the expected rate seen internationally. In 1996 CJD was made a notifiable disease and a case register for CJD established. The register is similar to those already operating in Australia and the United Kingdom. This means all cases of CJD are notified so that cases can be reviewed and investigated to ensure consistent diagnosis and risk factor identification.

Have there been any cases of vCJD in New Zealand?

No.

Is there a test for vCJD?

Not yet. Overseas work continues on this but a test may be years away.

Is the Ministry aware of anyone within New Zealand that has travelled to the UK and become infected with vCJD?

No. The Ministry does not believe people who have travelled to the UK should be concerned about their health. To date, there is no evidence that travellers to the UK, even those who may have eaten beef while travelling there, have become infected with vCJD.

How many people in the UK have vCJD?

Figures released in June 2001 indicated there had been 102 definite or probable cases of vCJD in the UK.

Have there been any other reports internationally of vCJD?

There has been one case reported in France and one in Ireland.

What are health authorities doing to protect New Zealanders from CJD and vCJD?

New Zealand is excluding donors from giving blood if they spent six months or more in the UK between January 1980 and December 1996. The six month period is cumulative. This new system will take effect on February 17th. New Zealand is also introducing leucodepletion - which is white blood cell filtering for all other blood donations.

Are health authorities being over-cautious?

Safety is our key priority. We are taking these steps to maintain public confidence and safety of the blood supply. The US FDA and Health Canada agree that this new policy is needed to further safeguard blood supplies.

Why did you choose the period 1980 to 1996?

The first cases of bovine spongiform encephalopathy (BSE) were identified in 1986. Because scientists believe that the incubation period for the disease is five years, it likely appeared in cattle in 1980. Variant CJD is related to BSE. It is possible that people were exposed to BSE through food when cattle were fed bovine offal. Although the UK introduced a ban on bovine offal in 1989, the ban was not fully enforced until 1996 following identification of the first cases of vCJD.

Why is six months the cut-off for deferring donors? Our approach is identical to that implemented by regulators in the US and Canada. The period of six months was chosen on the basis that it will greatly reduce the exposure of donors to BSE risk. The policy is expected to reduce the theoretical risk of vCJD without jeopardising the safety of the blood system.

Should I have a check up if I have lived in the UK?

No. There is no need to be concerned about your health, and the Ministry does not believe it is necessary to see a doctor.

What is the Ministry of Health doing to protect the public against the risk of BSE ?

We have risk minimisation strategy, rather than risk elimination. Actions the Ministry have taken include:

UK beef import suspension in 1996.

European beef import suspension 8 Jan 2001

Sought voluntary withdrawal of stock on shelves

Blood donor deferral for donors who have spent six months or more in the UK between January 1980 and December 1996

Leucodepletion - a type of blood filtering - has been introduced for all blood donations.

Which products are involved in the suspension of beef and beef product imports?

Beef products may be included in foods such as soups, canned foods, sausages, gravies and sauces, thickeners, stocks and flavourings, pates, pastes, luncheon meats etc. The potential risk is higher with processed goods made from mechanically removed meat - which can include spinal nerve and brain tissue.

What quantities of were being imported, say over a five year period, before the suspension was imposed ?

We believe it was very small quantities, based on anecdotal evidence, but for actual statistics suggest you check with Customs Service.

Why isn't gelatine included in the ban ?

We consider that the risk posed by gelatine is far lower than the risk posed by other food products and that a ban is not warranted.

How is the ban being monitored ?

Imports are processed at the border by customs. Food products that don't contain beef are let through.

Food products thought to contain beef from listed countries are checked to see if they do contain beef and, if so, that the beef is certified (to our standards) as being free of BSE. If they don't measure up, the products are re-exported to the country of origin or destroyed. The voluntary removal of products from retailers' shelves is not being "enforced" because it is voluntary. However, retailers have been very helpful in working to ensure that no suspect products are stocked on their shelves.

What process is in place for checking to ensure that vaccines, drugs, dietary supplements, cosmetics or other products that contain beef are BSE free?

We consider that the risk posed by pharmaceuticals, cosmetics, fats and oils, and dietary supplements to be substantially lower (if at all) than processed beef food products and believe there is no need for import restrictions. Milk and milk products are not included in the ban as studies conducted so far have not revealed evidence of BSE infection in milk.

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