The Crohnie

The highest incidence and prevalence of Crohn’s Disease in the world were reported from Canada last year.

In the province of Manitoba, in the period 1989 to 1994, every year 14.6 people per 100,000 developed Crohn’s Disease. This rate is significantly higher than the previous record of 11 people per 100,000 per year from North Eastern Scotland, itself a very high figure.

Manitoba
http://www.ncbi.nlm.nih.gov/pubmed/10342800

Scotland
http://www.ncbi.nlm.nih.gov/pubmed/1634058

Manitoba is, of course, Canada’s dairy belt, being nestled beside the Great Lakes. The land there is very flat and wet, and the large number of lakes, streams and rivers are very interconnected.

It is becoming clear that water supplies are an important distribution route for MAP, as is evidenced by the saturation of Netherlands dairy herds with Bovine Johne’s Disease (up to 100% of herds in some areas).

If the water supply is an important vector for MAP infection in the human population, one would expect high yearly incidences of Crohn’s Disease in areas where there is a large population of cattle and where Bovine Johne’s Disease (BJD) is endemic. Among areas that fulfill these criteria are Wisconsin, Florida and the Netherlands.

However, either there are no Crohn’s Disease epidemiology figures available at all for these areas, or figures that are available are ten years out of date.

Which is why we need to make Crohn’s Disease a compulsorily reportable disease.

How else can we track the rampant progress of a disease which has spread to more people than HIV, in every country of the developed world, albeit much more slowly (Crohn’s taking 87 years instead of HIV’s 25-30 years).

Unfortunately, there is no information available on the epidemiology of either Crohn’s Disease or BJD in Saskatchewan.

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.”

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

It seems we’re getting a lot of people flaring at the moment, a lot of people with bloated abdomens, obstructions, new diagnoses, etc.

Why is this?

It has been reported that CD is seasonal, with the highest possibility of relapse in Autumn(Fall) and Winter. Read the following URL for details

http://crohn.ie/archive/research/misc/season.htm

One possible conclusion is that seasonal factors, e.g. lack of sunlight, different nutrition, are involved in causing Crohns disease.

Another explanation is bacterial. The bacterium Mycobacterium paratuberculosis, which has been postulated as the cause of Crohns disease, has been detected to be present in retail samples of milk on a seasonal basis, i.e. in the Autumn and Winter. The bacterium is not found in milk during the Spring and Summer. See the following URL for details

http://crohn.ie/archive/htmilk.htm
Does Mycobacterium paratuberculosis cause Crohn’s disease?
http://crohn.ie/archive/welcome.htm

Some information about Crohns in Asia and diet in Asia.

Crohns disease was almost unknown in most parts of Asia until very recently. If it did exist before the last few years, it is likely that it would have been confused with intestinal tuberculosis.

For a table of statistics of prevalence of Crohns disease across the world, including Hong Kong and Japan, with references to the medical studies that derived the figures, see the URLs

http://crohn.ie/archive/epidem.htm
http://crohn.ie/archive/epistats.htm

In this table you will find several studies which refer to migrants who move from countries with low CD prevalence to countries with high CD prevalance, for example Morrocans moving to Belgium, West Indians moving to England, and South Asians moving to England. In all cases, the migrants were as likely to develop CD as the people of their new home country, thus lending credence to the theory that CD is caused by an environmental agent.

A recent study in Japan searched for a correlation between diet change and development of CD. They found that CD was highly correlated with a change in diet from the traditional fish/vegetarian based diet to a more western meat/dairy based diet. A strong correlation was found between CD and Japanese people who had changed to a meat based diet, but the strongest correlation was found in Japanese people who had changed their diet to include dairy products. To see an abstract of this study, see the URL

http://crohn.ie/archive/research/misc/japprot.htm

A possible explanation for this high correlation is the fact there is a very high risk that dairy products contain bacteria of the species Mycobacterium paratuberculosis, an organism which has for years been theorized to cause Crohns disease. Recent studies have provided further evidence that CD is indeed caused by this enteric pathogen, which causes a chronic intestinal disease, identical to Crohns disease, in many species of animals, including sub-human primates, cattle, sheep, goats, dogs, deer, chickens, gerbils, horses, llamas, etc.

If you wish to read more about this topic, I have gathered together the relevent research into one web site. The URL for this site is

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

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