Risk of transmission of bovine spongiform encephalopathy to humans in the United States - Report of the Council on Scientific Affairs

Context The risk of possible transmission of bovine spongiform encephalopat hy (BSE) in the United States is a substantial public health concern. Objective To systematically review the current scientific literature and di scuss legislation and regulations that have been implemented to prevent the disease. Methods Literature review using the MEDLINE, EMBASE, and Lexis/Nexis databa ses for 1975 through 1997 on the terms bovine spongiform encephalopathy, pr ion diseases, prions, and Creutzfeldt-Jakob syndrome. The Internet was used to identify regulatory actions and health surveillance. Data Extraction MEDLINE, EMBASE, and Lexis/Nexis databases were searched fr om 1975 through 1997 for English-language articles that provided informatio n on assessment of transmission risk. Results Unique circumstances in the United Kingdom caused the emergence and propagation of BSE in cattle, including widespread use of meat and bonemea l cattle feed derived from scrapie-infected sheep and the adoption of a new type of processing that did not reduce the amount of infectious prions pri or to feeding. Many of these circumstances do not exist in the United State s. In the United Kingdom, new variant Creutzfeldt-Jakob disease probably re sulted from the ingestion of BSE-contaminated processed beef. The United Ki ngdom and the European Union now have strong regulations in place to stop t he spread of BSE, While BSE has not been observed in the United States, the US government has surveillance and response plans in effect. Conclusions Current risk of transmission of BSE in the United States is min imal because (1) BSE has not been shown to exist in this country; (2) adequ ate regulations exist to prevent entry of foreign sources of BSE into the U nited States; (3) adequate regulations exist to prevent undetected cases of BSE from uncontrolled amplification within the US cattle population; and ( 4) adequate preventive guidelines exist to prevent high-risk bovine materia ls from contaminating products intended for human consumption.