The Crohnie

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.”

When I attended the U.S. Animal Health Association meeting in Minnesota, October 1998, there was a lecture on the legal perspectives in the paratuberculosis/Crohn’s situation.

The most important point made for sellers of cattle was that if they make a statement “This cow does not have Johne’s disease”, then they are legally liable if the cow does actually turn out to have JD, a strongly possible occurrence due to the inaccuracy of current testing methods for JD. The only statement they can make is that “This cow has tested negative for Johne’s disease, by methods X, Y, and Z”.

It is possible that this principle might be extended to “Mycobacterium paratuberculosis does not cause Crohn’s disease”, which is the current position of the dairy and beef industries around the world. If/when proof that paratuberculosis causes Crohn’s is revealed, then they might be liable, since evidence is becoming much stronger that live Mycobacterium paratuberculosis are present in cattle derived foods.

With 1.5 million people with clinical Crohn’s disease around the world, and at least 400,000 people with clinical Crohn’s disease in the USA, it could result in a class-action lawsuit on a Big Tobacco Scale.

If I were in the cattle industry, I would be moving to eradicate Johne’s disease from herds of food animals now. Instead, the US Animal Health Association advocates a “Voluntary Certification” program, whereby volunteer farmers test their herd for Johne’s disease, and there is no obligation if they test positive. Such animals currently go into the food chain to make hamburgers.

More info on the USAHA meeting available from

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

Info on the finding of Mycobacterium paratuberculosis in British retail milk available from

http://www.crohns.org/governments/uk.htm

Check out the abstracts below about Sarcoidosis, Mycobacterium avium and Mycobacterium paratuberculosis. Paratuberculosis is a subspecies of avium, i.e. it’s fulll classification is “Mycobacterium avium subspecies paratuberculosis”.

And of course, for a wealth of information about paratuberculosis and Crohn’s, visit

http://crohn.ie/archive/welcome.htm

__________________________________________________________________
Title
Identification of Mycobacterium avium complex in sarcoidosis.

Author
el-Zaatari FA; Naser SA; Markesich DC; Kalter DC; Engstand L; Graham DY
Address Inflammatory Bowel Disease Laboratory, Veterans Affairs Medical
Center, Houston, Texas 77030, USA.

Source
J Clin Microbiol, 34(9):2240-5 1996 Sep

Abstract
Cell wall-defective bacteria which later reverted to acid-fast bacilli have been isolated from sarcoid tissue. These have not been conclusively shown to be mycobacteria. Specific PCR assays were applied to identify mycobacterial nucleic acids in these cultured isolates and in fresh specimens obtained from patients with sarcoidosis. Positive amplification and hybridization were observed with Mycobacterium avium complex- and/or Mycobacterium paratuberculosis-specific probes in five of the six cultured isolates and two fresh skin biopsy samples and one cerebrospinal fluid specimen. There was no amplification or hybridization with Mycobacterium tuberculosis or M. avium subsp. silvaticum probes, respectively. Patients’ sera were also tested for antibody reactivities by immunoblotting with M. paratuberculosis recombinant clones expressing the 36,000-molecular-weight antigen (36K antigen) (p36) and the 65K heat shock protein (PTB65K). All seven sarcoidosis, four of six tuberculosis, and all six leprosy patient serum specimens showed strong reactivity with p36 antigen. In contrast, 13 of 38 controls showed only weak reactivity with p36 (P = 0.002 for controls versus sarcoidosis samples). Similarly, PTB65K reacted with high intensity with sera from 5 of 5 sarcoidosis, 5 of 6 tuberculosis, and 5 of 6 leprosy patients, compared with its low-intensity reaction with 5 of 22 controls (P = 0.001 for controls versus sarcoidosis samples). This study demonstrates the isolation and/or identification of M. paratuberculosis or a closely related M. avium complex strain from sarcoid skin lesions and cerebrospinal fluid. Furthermore, the reactivity of antibodies in sarcoid patient sera against p36 and PTB65K antigens was comparable to the reactivity of sera obtained from patients with known mycobacterial disease. Collectively, these data provide further support for the theory of the mycobacterial etiology of sarcoidosis.

____________________________________________________________________
Title
Serologic reactivity against Mycobacterium paratuberculosis antigens in patients with sarcoidosis.

Author
Reid JD; Chiodini RJ
Address
Robinson Memorial Hospital, Ravenna, Ohio.

Source
Sarcoidosis, 10(1):32-5 1993 Mar

Abstract
Although sarcoidosis has clinical and histopathologic similarities to some forms of tuberculosis and other mycobacterial infections, attempts to establish a mycobacterial etiology have not been successful. Using cytoplasmic antigens derived from a wild strain of Mycobacterium paratuberculosis in an enzyme-linked immunosorbent assay, patients with sarcoidosis were found to have immunoglobulin levels significantly higher than those found in a control population in the IgG, but not in IgA or IgM antibody classes. Results were comparable to those reported from patients with Crohn’s disease, where M. paratuberculosis has been intensively studied as a possible etiologic agent. To elucidate these relationships, examination of DNA from sarcoid tissues for possible homology with DNA from M. paratuberculosis and closely related organisms, as well as cultural attempts with techniques and media appropriate for M. paratuberculosis may be warranted.

__________________________________________________________________

For sufferers of Crohns disease in the USA.

A mother on the USA, Karen Meyer, has a son who has Crohns disease. She is very concerned that her son may have contracted Crohns from consumption of food contaminated with the bacterium M paratuberculosis, and is concerned that many other people in the USA may contract Crohns disease, again possibly as a result of consumption of contaminated food.

She has attempted to find out what actions the US government is taking to ensure that food purchased and consumed by the public at large is indeed safe. She has been in touch with several government agencies, including the FDA, the US Department of Agriculture and the US Animal Health Association.

She is very unhappy about the replies she has received, and has determined to raise awareness of this issue among members of government, so that answers can be found to the following important questions

o Is M paratuberculosis is involved in causing Crohns disease?
o Are consumers infected with M paratuberculosis through the food chain?
o If M paratuberculosis is involved with Crohns disease, then how can sufferers of Crohns disease be medically treated to eliminate the infection?

Mrs Meyer wants you to join her in her awareness-raising campaign, and has formed the “Paratuberculosis Awareness and Research Association” (PARA) to organize this campaign.

PARA has a web page. The URL for this page is

http://www.crohns.org/

The page contains details of correspondance that Karen has had with the various agencies of the US government, and minutes of meetings of some those same agencies.

I encourage all sufferers of Crohns in the USA, and elsewhere, to visit the PARA web site.

Mycobacterium paratuberculosis has been extensively researched as a cause of Crohns disease, and much of that research indicates that Mycobacterium paratuberculosis is responsible for at least some cases of Crohns.

Mycobacterium paratuberculosis infects the milk supply. It is shed by infected cows in their milk, and it is not killed by standard pasteurization techniques. 2.9% of all dairy cattle in the USA are infected with Mycobacterium paratuberculosis.

Only the UHT (Ultra Heat Treatment) pasteurization process kills Mycobacterium paratuberculosis. Therefore, if you want to reduce your exposure to M paratuberculosis, you should switch to UHT milk. Also, you should only consume other dairy products (cream, cheese, etc) that have been made with UHT pasteurized milk.

Also, there are other pathogenic bacteria that are not killed by standard pasteurization. Some of these cause food poisoning, and would have an extremely adverse affect on people with active IBD (Inflammatory Bowel Disease) if they were infected with these bacteria. Again, only UHT pasteurization is capable of destroying these bacteria.

I have gathered together the relevant information and research about bacteria, milk and pasteurization onto a web page. The URL is

http://crohn.ie/archive/uhtmilk.htm

I strongly recommend that you visit this web page.

This is part of a larger site that contains all of the research relevant to whether or not Mycobacterium paratuberculosis causes Crohns disease. The URL is

http://crohn.ie/archive/welcome.htm

If you have Crohns disease, I recommend that you visit the site.

For anyone that is interested in whether Crohns disease could be caused by bacterial infection with Mycobacterium paratuberculosis, I have created a web site that contains all of the relevent medical research.

This organism causes a chronic intestinal disease, which is extremely similar to Crohn’s disease, in cattle, sheep, goats, chickens, monkeys, deer, dogs, horses, and rabbits, to name a few. Mycobacterium paratuberculosis is endemic to diary cattle in most countries of the western world, including most parts of the USA and Canada.

The organism is shed by infected cows in their milk, and is not killed by pasteurization. There is a high probability that Mycobacterium paratuberculosis infects the milk that you personally drink.

If you want to read about this further, see the URL

http://crohn.ie/archive/welcome.htm