The Crohnie

In 2007, the United States Department of Agriculture’s (USDA) National Animal Health Monitoring Service (NAHMS) surveyed US Dairy Herds on a nationwide basis.

They found that 68.1% of US Dairy Herds are infected with Mycobacterium avium subspecies paratuberculosis (MAP), an obligate pathogen which causes Inflammatory Bowel Disease (Johne’s Disease) in cattle, sheep, goats and other food animals. Paratuberculosis is present in milk from infected animals, and is known to survive commercial pasteurization. Live MAP has been cultured from US retail milk supplies.

Mycobacterum avium subspecies paratuberculosis is suspected of causing the human Inflammatory Bowel Disease known as Crohn’s Disease, and there is mounting scientific and medical evidence that at least some proportion of Crohn’s Disease is caused by MAP. If MAP does cause Crohn’s Disease, then it is certain that the primary route of transmission of MAP to humans is through contaminated dairy and meat products.

The NAHMS study also found evidence for MAP in 95% of large dairy herds, an unprecedented figure which shows that MAP is spreading rapidly and unchecked through US herds of food animals. Not only is the milk from these cattle infected with MAP, but their carcasses, which are used to make ground beef, contain billions of MAP organisms.

The testing method used to detect paratuberculosis is known to underestimate the true prevalence. To quote the NAHMS report: “Although environmental sampling is an effective method of detecting operations infected with MAP, it will not detect all infected operations. Thus, reported percentages will be less than the true prevalences.”

The full report is available from the USDA Animal and Plant Inspection Service (APHIS) website.

Johne’s Disease on U.S. Dairies, 1991–2007.

Live Mycobacterium avium subspecies paratuberculosis (MAP) has been cultured from retail milk purchased from stores in California, Minnesota and Wisconsin.

This means that American consumers are being exposed to live bacteria that are known to cause Inflammatory Bowel Disease (Johne’s Disease) in a wide range of animals, including dairy and beef cattle, and is suspected of being a cause of human Crohn’s Disease.

The most important points are

1. From May 2002 through April 2003, milk was purchased from stores in California, Minnesota and Wisconsin – three of the USA’s top 5 milk-producing states. (The other two are New York and Pennsylvania.)

2. Milk was tested for presence of viable MAP, using methodologies created in the 1990’s by British researchers, to study the presence of MAP in retail milk in the UK. It has been known since 1998 that United Kingdom dairy products are contaminated with live MAP.

3. Of 702 US samples tested, 2.8 percent contained viable MAP – that is, MAP bacteria that was alive, capable of multiplying and establishing infection, and capable of causing Inflammatory Bowel Disease in susceptible species.

4. Rate of positives was similar among states, but there was a seasonal effect. More positive samples were found during July, August and September.

This study confirms what we in the Paratuberculosis Awareness and Research Association have long believed: that American consumers are eating and drinking food that contains a live and dangerous bacterium, through the medium of MAP-contaminated dairy products.

On average 2.8% of milk cartons were found to be contaminated. Assuming that the average milk consumer drinks from a single carton of milk per day, this means that the average milk consumer is exposed to live paratuberculosis on average ten times a year. Consuming from 2 different milk cartons per day, 20 times a year, etc. This applies particularly to children, who are encouraged to consume milk, for the calcium and protein content. An average American child living in Minnesota, California or Wisconsin, if they consume from one milk carton per day, will have been exposed to live paratuberculosis up to 100 times by their tenth birthday.

The published results apply only to milk. Although research has shown that the food treatment methodologies used to manufacture other dairy products, such as cheese, chocolate, whey, etc, are incapable of destroying MAP, no US research has sought to determine the percentage of these retail dairy products also contaminated with live MAP. The majority of Wisconsin milk is used for cheese manufacture. Recent scientific results have shown that the methods to manufacture cheddar cheese do not kill paratuberculosis.

To this date, the food safety regulators in the United States, the Food & Drug Admninistration (FDA), have taken no action on the presence of live paratuberculosis in milk, dairy and beef products. The time has now come for the FDA to revise its policy of inaction, and to act immediately to protect American consumers from this dangerous bacterium.

If you believe that the US Government should put the interests of the American public before the interests of American Dairy and Beef Industries, and act to eradicate MAP from human food, please visit the PARA web site for steps you can take to help.

1. Original datasheet from American retail milk study
http://www.johnes.org/newsfiles/109216471862392.html

2. Articles about live paratuberculosis contamination in human food
http://www.crohns.org/map_food

3. Articles about the relationship between Mycobacterium avium subspecies paratuberculosis and Crohn’s Disease.
http://www.crohns.org/articles
http://www.crohns.org/research
http://www.crohns.org/treatment

4. Government agencies with responsibility for regulating Food Safety.
http://www.crohns.org/governments

5. PARA’s work to get the US Congress to help address this problem.
http://www.crohns.org/congress

6. What you can do to help.
http://www.crohns.org/help

I’d like to draw your attention to a major success in PARA’s drive to find a cure for Crohn’s Disease.

Since the National Institute of Allergy and Infectious Diseases (NIAID) hosted a workshop on possible infectious causes of Crohn’s Disease in 1998, attended by all of the PARA Board of Directors, including myself, PARA directors Cheryl Miller and Karen Meyer have worked tirelessly with both NIAID staff and with Crohn’s Disease researchers to obtain funding for those researchers who wish to investigate infectious causes of Crohn’s Disease.

The first spectacular success in this ongoing campaign to find a cure for Crohn’s Disease is the provision of US$1.8 million in funding for researchers who are investigating a infectious cause for Crohn’s Disease, with a strong emphasis on research into Mycobacterium avium subspecies paratuberculosis (MAP).

Further information from the PARA web site

http://www.crohns.org/

Among the researchers who have received research funding in this round are two members of PARA’s Scientific Advisory Council, Dr. Saleh Naser and Dr. Norman Pace.

http://www.crohns.org/council/naser.htm
http://www.crohns.org/council/pace.htm

The NIH funding involves not only the National Institute of Allergy and Infectious Diseases (NIAID), but also involves the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), the National Institute of Health that has more traditionally been associated with Crohn’s Disease research.

Specifically, the NIDDK has funded another member of the PARA Scientific Advisory Council, Dr. Fouad El-Zaatari, to continue his long and detailed research program on the role of paratuberculosis in Crohn’s Disease. Dr. El-Zaatari has received funding to continue, among other research, his pioneering work on “In-Situ Hybridization”.

The latter is a technique whereby paratuberculosis bacteria which are present in gut tissue can be labelled and made detectable by attaching, for example, x-ray opaque metal atoms to them. This technique has potential for use as a clinical diagnostic technique, particularly because it can detect the cell-wall-deficient forms of MAP which are believed to be involved in the pathogenesis of Crohn’s Disease.

More details on Dr. El-Zaatari and his work from the following URLs

http://www.crohns.org/para/el-zaatari.htm
http://www.paratuberculosis.org/members/el-zaatari.htm

More information on In-Situ Hybridization from

http://www.paratuberculosis.org/proc6/abst5_2.htm
http://www.paratuberculosis.org/proc7/abst6_p7.htm

You can read more from the following links
NIAID: Crohn’s Disease: Is There a Microbial Etiology? Recommendations for a Research Agenda
NIAID: Recommendations for a Research Agenda
PARA’s efforts benefit Crohn’s sufferers – NIH allocates $1.8 million to study infectious cause of Crohn’s

Momentous developments are afoot!!

I attended the UK Government meeting on MAP in milk last Wednesday, and wrote the following report.

====================================================
London, 5th Dec 2001.
UK Government adopts comprehensive strategy for eliminating MAP from milk.

The UK government today adopted a comprehensive strategy to prevent human exposure to the bacterium Mycobacterium avium subspecies paratuberculosis (MAP). MAP is believed by a growing number of scientists to be a cause of Crohn’s Disease, a lifelong, debiliating and incurable bowel disease suffered mainly by the young.

The Advisory Committee on the Microbiological Safety of Food (ACMSF), which advises the UK Government Food Standards Agency, today approved a comprehensive program of measures aimed at eliminating MAP from retail milk, as purchased by consumers. Previous research commissioned by the ACMSF showed that live MAP could be cultured from approximately 2% of retail milk on sale in the United Kingdom.

The strategy adopted by the ACMSF shows that the UK Government is taking the issue of MAP and Crohn’s Disease extremely seriously. As the ACMSF says in its strategy document: “…. the Agency has put to one side the question of whether or not there is a link between MAP and Crohn’s Disease. The Agency believes that precautionary action to reduce human exposure to MAP should start now and should not be dependent on waiting for the link to be proven.”

Among the raft of measures approved by the ACMSF are:

– Increasing pasteurisation times from 15 seconds to 25 seconds. Although some dairies had voluntarily adopted this extended pasteurisation time in 1998, the more stringent conditions will now become standard government recommendation.

– Stricter quality monitoring of pasteurisation plants. Due to the potential for MAP to survive pasteurisation because of defective or improperly operated pasteurisation machinery, dairies and farms will be closely monitored to ensure that they are complying with regulations.

– Improvement of on-farm milking practices. Because a likely route for MAP to infect milk is faecal contamination, on-farm milking practices are to be closely studied to find the most effective method to prevent this contamination.

– Elimination of MAP infection from herds. The ACMSF is initiating a multi-pronged effort to eliminate MAP from herds of food animals, including improvement of existing diagnostics, a national survey to determine the prevalence of MAP infection in UK dairy herds, and development of a improved vaccination methods to protect animals from the infection.

– Alternative pasteurisation technologies. The ACMSF is coordinating several research projects which are assessing the effectiveness of several novel pasteurisation methods against MAP. The methods being studied include high-pressure homogenisation, double pasteurisation, microfiltration and bactofugation.

The timetable by which these measures will be implemented will be finalised in another ACMSF meeting, to be held in London in January
2002.

PARA greatly welcomes these developments, and commends the UK Government on its willingness to act in the best interests of its citizens and the best interests of the public health. However, there are some further measures which PARA would like to see the UK Government undertake.

o Labelling of extended pasteurisation. Since it is not possible for the UK Government to mandate 25 second pasteurisation for all UK milk, for reasons of European regulation, there will still be some 15 second pasteurised milk for sale in the UK. In order that Crohn’s Disease patients and their families be able to differentiate between 25 second and 15 second pasteurised milk, it is vital that the pasteurisation time be labelled on retail milk containers.

o Elimination of MAP from beef. Milk is not the only route for transmission of MAP to the human population. MAP can also be transmitted through beef from infected cows, and there is evidence to believe that the standard temperatures used for cooking of beef will not effectively kill the organism. Although the comprehensive strategy to deal with MAP in milk is a welcome start, it does not deal with the whole MAP problem.

Paratuberculosis Awareness & Research Association is non-profit organisation of Crohn’s Disease patients, their families and friends who are dedicated to the following goals

1. To promote awareness of the disease-causing potential of the bacterium Mycobacterium paratuberculosis in the national community of sufferers of Crohn’s Disease and Inflammatory Bowel Disease; in medical, veterinary and food research communities; in governmental agencies and in the public in general.

2. To promote clinical trials of therapy effective against MAP as treatment for Crohn’s Disease.

3. To promote mandated national testing programs to ensure that the milk/dairy, beef and other products on our grocery shelves are free of contamination with Mycobacterium avium subspecies paratuberculosis.

For further information, please visit the PARA web site at

http://www.crohns.org/

As promised a few months back, I’ve managed to digitize the the BBC TV programs about Mycobacterium avium subspecies paratuberculosis (MAP), Crohn’s Disease and MAP contamination of milk and water. Apologies for the delay, there’s been quite a few technical hitches along the way. You can access them from

http://www.crohns.org/media/

Also on that page, you will find a U.K. government interim report on the MAP contamination of retail milk in the UK. The results are definitive and beyond all doubt: MAP bacteria are alive and growing in our retail milk.

MAP is in the milk supply, and it’s in the water supply. Antibiotics effective against MAP make Crohn’s Disease better. When will the US and other Governments wake up to the suffering of Crohn’s Disease, and how it could be prevented?

If you want to do something about this terrible situation, please join PARA and add your voice to the growing chorus calling for change.

As some of you may be aware, there is a wealth of evidence which suggests that some cases, and possibly a majority of cases, of Crohn’s Disease are caused by infection with Mycobacterium avium subspecies paratuberculosis.

To date, research in this field has been severely hampered by chronic lack of funding.

In order to address this funding shortfall, Paratuberculosis Awareness & Research Association (PARA) has assembled a proposal for the U.S. Government. The premise is simple: We want funding for research to develop better diagnostics and treatments for Crohn’s Disease!

We intend to raise awareness of this promising but neglected research avenue. In order for our efforts to succeed, we need as much support as possible.

We are asking you (yes, you!) to please join us in this most important endeavour. It is only by raising awareness of this issue on Capitol Hill that we can hope to achieve our goals.

Please (please, please, please) visit the following page, where you will find

o The contents of PARA’s submission to the U.S. Government.
o Instructions on how to contact the members of the U.S. Government committees responsible for funding allocation
o Instructions on how to contact your elected representatives, if you are a U.S. citizen.

http://www.crohns.org/congress/support.htm

Many of you reading this message have suffered for many years because of Crohn’s Disease. We ask you to please consider spending 30 minutes to join with us in helping to bring an end to Crohn’s Disease. It’s in your own best interest, and the interest of all of our relatives, friends and family.

Please feel free to post copies of this message on other Crohn’s Disease boards/forums/chats.

Source: The London Times, 25th January 2000.
http://www.the-times.co.uk/news/pages/tim/2000/01/25/timnwsnws02030.html?999

Crohn’s linked to bacteria in milk

BY IAN MURRAY, MEDICAL CORRESPONDENT

CROHN’S disease is almost certainly caused by bacteria found in milk – even if pasteurised – and drinking water supplies, according to research by a world expert on the chronic illness. John Hermon-Taylor of St George’s Medical School in Tooting, South London, says that up to 55 per cent of dairy herds in Western Europe and America are infected with the bacteria, which can survive the pasteurisation process. Water supplies become infected as the droppings from herds seep into the soil, down into natural aquifers.

The organism is called MAP (Mycobacterium avium subspecies paratuberculosis), which is difficult to detect and destroy. The normal pasteurisation process involves heating milk to 72C for 15 seconds, but to be sure of killing MAP it would need to be heated to that level for twice as long.

Crohn’s disease is not fatal but causes chronic diarrhoea, persistent abdominal pain, weight loss, tiredness and mental problems. Because it is not notifiable, the number of people affected can only be estimated but it is thought that up to 80,000 suffer from it in Britain, with between 4,000 and 8,000 new cases every year. The cost to the nation of sufferers’ medical care is estimated to be GBP 240 million a year.

Professor Hermon-Taylor, who has researched the illness for 20 years, said: “If there were no MAP I believe there would be almost no Crohn’s disease. It is certainly responsible for between 60 per cent and 90 per cent of all cases and I would think that it is more likely to be 90 per cent.”

His study, funded by Action Research, the medical charity, shows that MAP can live undetected in cattle for years. Infected cows secrete the bacteria into their milk and on to their pastures. Tests have proved that MAP causes chronic infection of the intestines of many animals, including four types of primates. American studies have isolated MAP from the breast milk of women with Crohn’s disease but not in women who do not have the illness.

“The problems 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,” Professor Hermon-Taylor said.

He wants to see the Government reverse its decision to allow the sale of unpasteurised milk and to increase the stringency of the pasteurising process. Dairy herds ought to be tested for the infection and the illness ought to notifiable, he said.

Professor Hermon-Taylor said that anybody worried about catching the disease from milk could be certain of killing any MAP by heating it to 80C and then allowing it to cool before drinking it.

Source: The Guardian, 25th January 2000.
http://www.newsunlimited.co.uk/uk_news/story/0,3604,128597,00.html

Crohn’s disease ‘disaster’ blamed on pasteurised milk

What’s wrong with our food? – special report

Julia Hartley-Brewer
Tuesday January 25, 2000

Pasteurised milk infected with dangerous bacteria is responsible for a “public health disaster”, a leading medical specialist warned last night.

John Hermon-Taylor, head of the surgical department at St George’s medical school in Tooting, south London, claimed that a bacterium believed to cause Crohn’s disease, the inflammatory bowel disorder, was not killed by pasteurisation.

The bacterium, mycobacterium avium subspecies paratuberculosis (or MAP), was thought to be destroyed by pasteurisation, but Professor Hermon-Taylor claimed that his 20 years of research had proved that Crohn’s disease in humans was linked with Johne’s disease in cattle and passed on in pasteurised milk.

He called on the government to take urgent action to prevent the spread of the disease through unsafe milk. In pasteurisation milk and other foods are heated to destroy disease-causing micro-organisms and protect against putrefaction.

A ministry of agriculture spokesman said: “The government is carrying out its own research, and the advice from the department of health is that, on the basis of what is currently known, there is no need for anyone to change their dietary habits.”

A National Dairy Council spokeswoman said: “The dairy industry has already taken voluntary steps to increase the pasteurisation time, purely as a precautionary measure. This is only one of a series of hypotheses, and what is needed is further research.”

Crohn’s disease, which afflicts about 80,000 people in the UK, is a severe inflammation of the small intestine and the colon, sometimes requiring surgery. Symptoms include chronic diarrhoea, abdominal pain, weight loss, extreme tiredness and psychological problems, and it can produce ulcers and tumours in the bowel.

Government scientists researching a possible link between milk and Crohn’s disease are due to report this year. However, at present medical specialists assess the risk of infection from drinking a glass of pasteurised milk at one in 5m.

Prof Hermon-Taylor, who is funded by the charity Action Research, said: “The problems 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.

“I am certain that MAP causes a substantial proportion of Crohn’s disease.”

Addressing the Royal Society of Medicine last night, he called for an immediate ban on the sale of unpasteurised milk and greater stringency in the pasteurisation process, including doubling sterilising time from 15 to 30 seconds.

He wanted the disease to be made notifiable, requiring doctors to report cases to the department of health, and for wide-ranging testing for MAP in dairy herds and the water supply. “I’m not scaremongering, but this disease ruins people’s lives,” he said.

“We need as a matter of urgency to carry out research to determine whether MAP is being conveyed from animals to the human population in water supplies.”

Crohn’s disease is not fatal. It is estimated there are between 4,000 and 8,000 new cases a year, costing as much as GBP 240 million a year in health care.

It has become five times more common in people aged under 26 in the past 20 years, and Anne Luther, director general of Action Research, described the problem in the UK as far greater than either the BSE-linked Creutzfeldt-Jakob disease or Aids.

Calls for a ban on unpasteurised milk – the raw cow’s milk known as “green top” favoured by 100,000 consumers, including the Queen – were rejected by the government last January.

Source: The Independent (London), 24th January 2000.
URL:
http://www.independent.co.uk/news/UK/Health/2000-01/PAmilk240100.shtml

Health scare over milk

By Karen Edwards, PA News

24 January 2000

A bug found in pasteurised milk causes Crohn’s disease, a leading medical researcher said today.

Professor John Hermon-Taylor of St George’s Medical School in London says the bug, an organism known as MAP (Mycobacterium avium subspecies paratuberculosis) is present in everyday milk.

The pasteurisation process fails to wipe out the disease, according to Professor Hermon-Taylor.

Crohn’s disease is not a killer, but causes chronic diarrhoea, daily abdominal pain, weight loss, extreme tiredness and psychological problems.

It affects an unknown number of people, believed to be up to 80,000 in the UK. It is thought there are 4,000-8,000 new cases every year. Figures are unclear because Crohn’s disease is not a notifiable condition.

But it is estimated to cost the nation as much as GBP 240 million each year in direct health care costs alone.

Professor Hermon-Taylor, who was funded by medical research charity Action Research, said: “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.

“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 said the answer is to test dairy herds for MAP and adopt more stringent milk pasteurisation processes.

Source: BBC News, London, 24th January 2000.
URL: http://news.bbc.co.uk/hi/english/health/newsid_617000/617438.stm

Critics say they need more proof that a bug found in milk could be the cause of a devastating bowel condition.

A London-based scientist, Professor John Hermon-Taylor, says he is convinced that that Mycobacterium paratuberculosis (MAP) is the cause of many cases of Crohn’s Disease.

And traditional methods of making milk safe, such as pasteurisation, may not be able to protect the public, he adds.

However, other Crohn’s experts say he has yet to prove a strong link between the bacteria and the disease, which can cause chronic diarrhoea, abdominal pain and weight loss.

Professor Hermon-Taylor said that his own work at St George’s Hospital in London has found that MAP is present in the guts of people with Crohn’s – and that the bug is well–known as a cause of intestinal illness in animals.

Residual levels of MAP exist in retail pasteurised milk in the UK, although there is controversy over whether these levels mean the organism could do any harm.

MAP is hardy enough to survive the 15 seconds of pasteurisation at 72 degrees which is enough to kill most other bacteria.

Another study suggested that MAP could be found in the breast milk of women with Crohn’s, but not in the milk of women who did not have the disease.

A spokesman for the National Association for Colitis and Crohn’s Disease said it was prepared to review any new evidence produced by Professor Hermon-Taylor.

But he said that the organisation was waiting for the results of two controlled studies before making any firm judgement.

The first of these, by the Ministry of Agriculture Fisheries and Food (MAFF) is looking at the occurrence of MAP in samples of pasteurised milk.

Another trial, in Australia, is attempting to treat Crohn’s disease with a combination of antibiotics.

Professor Hermon-Taylor said: “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.

“I am absolutely certain that MAP causes a substantial proportion of Crohn’s disease.”

He is calling for a ban on unpasteurised milk, as well as an increase in the stringency of milk pasteurisation, and the widespread testing of dairy herds for the bug.

He also wants water supplies checked for MAP, and Crohn’s made a “notifiable disease”, meaning doctors must inform the authorities of every new case.

The research has been funded by Action Research.

Its director general, Anne Luther, 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.”