The Crohnie

BBC Televsion has produced a program about the high prevalence of Crohns Disease in Wales, its relationship to Mycobacterium avium subspecies paratuberculosis (MAP), and the presence of MAP in Welsh rivers.

You can watch the program online here (but unfortunately in very poor video quality, although the audio is fine). On the first page below, click the link “Watch the last show”.

http://www.bbc.co.uk/wales/programmes/sites/weekinweekout/index.shtml
http://www.bbc.co.uk/wales/programmes/sites/weekinweekout/updates/080325_crohns_disease.shtml

Liverpool, UK – 10 December 2007: Scientists at the University of Liverpool have found how a bacterium, known to cause illness in cattle, may cause Crohn’s disease in humans.

http://www.liv.ac.uk/newsroom/press_releases/2007/12/crohns-disease.htm

Crohn’s is a condition that affects one in 800 people in the UK and causes chronic intestinal inflammation, leading to pain, bleeding and diarrhoea.

The team found that a bacterium called Mycobacterium paratuberculosis releases a molecule that prevents a type of white blood cell from killing E.coli bacteria found in the body. E.coli is known to be present within Crohn’s disease tissue in increased numbers.

It is thought that the Mycobacteria make their way into the body’s system via cows’ milk and other dairy products. In cattle it can cause an illness called Johne’s disease – a wasting, diarrhoeal condition. Until now, however, it has been unclear how this bacterium could trigger intestinal inflammation in humans.

Professor Jon Rhodes, from the University’s School of Clinical Sciences, explains: “Mycobacterium paratuberculosis has been found within Crohn’s disease tissue but there has been much controversy concerning its role in the disease. We have now shown that these Mycobacteria release a complex molecule containing a sugar, called mannose. This molecule prevents a type of white blood cells, called macrophages, from killing internalised E.Coli.”

Scientists have previously shown that people with Crohn’s disease have increased numbers of a ’sticky’ type of E.coli and weakened ability to fight off intestinal bacteria. The suppressive effect of the Mycobacterial molecule on this type of white blood cell suggests it is a likely mechanism for weakening the body’s defence against the bacteria.

Professor Rhodes added: “We also found that this bacterium is a likely trigger for a circulating antibody protein (ASCA) that is found in about two thirds of patients with Crohn’s disease, suggesting that these people may have been infected by the Mycobacterium.”

The team is beginning clinical trials to assess whether an antibiotic combination can be used to target the bacteria contained in white blood cells as a possible treatment for Crohn’s disease.

The research was funded by Core and the Medical Research Council and is published in Gastroenterology.

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.

The BBC ran five separate programmes on paratuberculosis and food safety over the last four days. They were

1. Thursday 30th March 2000 – Newsnight (BBC1 TV, 10 minute report)
2. Friday 31st March 2000 – Farming Today (BBC Radio 4, 12 minute report)
3. Sunday 2nd April – CountryFile (BBC1 TV, 12 minute report)
4. Sunday 2nd April – On the Record (Interview with Agriculture Minister)
5. Monday 3rd April – Farming Today (BBC Radio 4)

I have numbers 2, 3, 4, and 5 on tape, and hope to digitize them and make them available on the net, for you all to see first hand.

However, I am about to go away for at least three weeks, so it will probably be the end of this month before you get to see/hear them.

As you will understand when you see/hear the programmes themselves, this issue is far from old hat. The only reason why it keeps cropping up in the news is because STILL, despite continued warnings to the Food Safety and Health Authorities, almost nothing has been done about MAP and Crohn’s Disease. The risk of exposure to MAP and the possible resulting development of Crohn’s Disease is still born by one group alone: the consumer.

Until we get research funds to deal with this complicated problem, I’m afraid that the controversy is going to continue. What we in PARA are trying to do is to educate everyone involved on the the complexities of this situation, so that at least we can discuss the issue in common terms, rather than the rampant prejudice and polarization that characterizes this subject.

If you are at all concerned about this issue, or wish to read more, please visit the PARA web page, at

http://www.crohns.org/

For those of you living in Britain, consider yourself lucky that you have a truly free press. A combination of the large financial muscle of the Dairy Industry “Got Milk” advertising campaigns and the threat of “Oprah’s Hamburger” style SLAPP suits ensure that those on the other side of the Atlantic are denied the opportunity to see the other side of this very important story.

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.”