A bug present in retail pasteurised milk in the UK causes Crohn’s disease, a leading medical researcher at St George’s Medical School, London claims today.
The bug, an organism known as MAP (Mycobacterium avium subspecies paratuberculosis), is not completely killed by normal milk pasteurisation methods and is present in people with Crohn’s disease.
Professor John Hermon-Taylor, who has been funded by medical research charity Action Research, states “The problems currently caused by MAP in the milk supply constitute a public health disaster of tragic proportions for which a range of remedial measures are urgently needed, and for which the government must take responsibility”.
He added “Both through our own work and new research evidence from the USA I am absolutely certain that MAP causes a substantial proportion of Crohn’s disease”.
Professor Hermon-Taylor will detail his evidence at Action Research’s annual presentation to the Medical Journalists Association at The Royal Society of Medicine, London on 24 January 2000.
MAP is a specific member of the class of organism known as Mycobacteria, of which the tuberculosis and leprosy organisms are the most notorious members. MAP contains fragments of foreign DNA that has converted it from a harmless organism into a pathogen.
Crohn’s disease severely affects an unknown number of people, believed to be up to 80,000 people in the UK. It is thought that there are 4000 - 8000 new cases every year. These figures will remain uncertain until the government makes the disease notifiable (i.e. collects statistics upon diagnosis).
It is estimated to cost the nation as much as £240 million each year in direct health care costs alone.
The evidence is as follows:
1. The organism can live in cattle and other animals for years without causing visible disease.
2. The dairy herd prevalence of sub-clinical infection (i.e. where the disease is present but not apparent) with MAP in Western Europe and North America is reported to be in the range of 21-54%.
3. Sub-clinically infected dairy cows (i.e. those cows that do not appear diseased) secrete MAP into their milk and onto pastures.
4. MAP is tougher than tuberculosis and is not completely inactivated by pasteurisation (i.e. 72 degrees for fifteen seconds).
5. Residual MAP is present in retail pasteurised milk in the UK.
6. MAP is probably present in some areas, in water supplies.
7. MAP is a specific cause of chronic infection of the intestines in very many animals including, so far, four types of primates.
8. MAP can be detected by improved culture systems and DNA tests in the inflamed gut of a high proportion of people with Crohn’s disease. This is confirmed from recent work from St. George’s Hospital, London and the University of Central Florida.
9. Preliminary studies in the US have isolated MAP from the breast milk of women with Crohn’s who have recently given birth but not from women who do not have Crohn’s. (The American Journal of Gastroenterology, 2000)
10. Recent evidence from a top research group in Los Angeles led by Dr Jonathan Braun has shown that nine out of ten people with Crohn's disease have antibodies in their blood which recognise a specific mycobacterial (MYCO) protein in MAP. (Infection and Immunity 1999; 67:6510-6517)
11. MAP is difficult to kill with antibiotic drugs but a new treatment developed at St George's Hospital, London using antibiotics active against MAP has shown that a substantial proportion of Crohn’s disease patients get better, some lastingly. A randomised controlled trial of this treatment throughout Australia began in September 1999.
The following remedial measures need to be considered and implemented:
1. To reverse the decision to allow the sale of unpasteurised milk in the UK.
2. To increase the stringency of milk pasteurisation.
3. To test dairy herds for MAP using an up-to-date molecular techniques.
4. To carry out detailed research for MAP in the environment and water supplies.
5. To make Crohn’s disease a notifiable condition.
6. To sequence the DNA Genome of MAP of both the cattle and human strain.
7. To develop therapeutic vaccines for humans, and preventative vaccines for animals.
Action Research has funded Professor John Hermon-Taylor’s pioneering research into the disease for over 20 years at St George’s Hospital Medical School, London. Action Research has funded four research projects into Crohn’s disease since 1979, a total spend of over £ ¾ million.
The research developed new methods for testing for the bug and indicated its presence both in milk and in humans.
Crohn’s disease is not a killer but it does ruin the lives of sufferers. Symptoms include chronic diarrhoea, daily abdominal pain, weight loss, extreme tiredness and psychological problems.
Anne Luther, director general of Action Research, said “The extent of this problem appears far greater than CJD and Aids in the UK, yet previous calls for government action appear to have gone unheeded”.
For further help please contact Mike Deyes at Action Research on 01403 327429.
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