Choice

The BMJ, BSE, and vCJD

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7269.0 (Published 04 November 2000) Cite this as: BMJ 2000;321:0

Usually the BMJ avoids blowing its own trumpet, just as it avoids exclamation marks. An exclamation mark is unnecessary at the end of a startling sentence and embarrassing at the end of one that is not startling. Similarly readers will either like us because we do well or squirm if we praise ourselves when we are doing poorly. Not all readers, however, may be aware of the creditable record of the BMJ on bovine spongiform encephalopathy (BSE) passing to humans.

Last week Lord Phillips reported on Britain's failure to act more quickly in response to this major public health issue (p 1091 and p 1097). Early in 1988 a middle level civil servant raised the possibility that BSE might pass to humans, but for the next eight years ministers, civil servants, and two chief medical officers insisted that there was no risk. They adopted a paternalistic approach. The Phillips report condemns this approach and calls for greater honesty.

It was in March 1996 that the government accepted that BSE might pass to humans, but in June 1988 the BMJ published a piece by Tim Holt, a junior doctor, and Julie Phillips, a dietitian, in which they argued for passage from cows to humans. “Press announcements released last year about an outbreak of a brain disease, spongiform encephalopathy, in the cattle of south west Britain were received with alarming indifference by the medical profession as well as by the general public … It has generally been accepted that the slaughter of animals showing characteristic signs of infection … as well as the usual processes of sterilisation and pasteurisation, are enough to remove any risk to the consumer. Unfortunately, this is a view that is naive, uninformed, and potentially disastrous.” Ten years later Dr Holt told the BMJ: “People now treat me as some sort of prophet and ask if I received divine inspiration. The answer is no. But it wasn't luck either. It was evidence based. The evidence was all there at the time, and all it needed was a good working knowledge of the literature and common sense. It's extraordinary that more people didn't reach the same conclusion.”

A BMJ editorial from February 1990 accepted the view of an expert committee that beef was probably safe, but added that “such claims are scarcely scientific when the question has not been tested and is, perhaps, untestable.” An editorial in April 1992 concluded that the risk to humans remained uncertain. In November 1995 we published a cluster of articles on the subject, one of which concluded that it could not be just chance that cases of Creutzfeldt-Jakob disease were occurring in farmers and young adults. (All of these articles and more can be read on www.bmj.com/cgi/collection/mad_cow.)

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