The bovine spongiform encephalopathy (BSE) maternal cohort study suppo
rts a role both for direct maternal transmission and for inherited gen
etic susceptiblity to the BSE agent. Additional data from the main BSE
data base do not resolve whether the risk of direct maternal transmis
sion of BSE from dam to calf is concentrated in the interval within 5
months before the onset of BSE in the dam, as data from the BSE matern
al cohort study suggest. The reason for this is that we cannot rely, a
s our analysis requires, on the survival of calves or traceability of
the dam being independent of the interval from the birth of a calf to
onset of BSE in the dam. Accordingly, for the present, we place most w
eight on evidence from the BSE maternal cohort study. Direct maternal
transmission of the BSE agent from dam to calf has not been ruled out;
vertical transmission of the new variant Creutzfeldt-Jakob disease (N
VCJD) from mother with NVCJD to baby is therefore also possible. Actio
ns to quantify, and minimize, the transmission risk, if any, from a mo
ther with NVCJD to her baby, or to delivery teams, should be taken wit
hout delay.