SEAC: Q & A on their recommendations

2002

February

Q. What was SEAC's view on holding further open meetings?

A. Generally the Committee agreed that it would be beneficial if the public were given an opportunity to hear the full range of views expressed during discussions, and hence from September 2002, every SEAC meeting would be largely held in open session with a closed session to cover any confidential issues.

Q. What was SEAC's view on progress to develop western blot techniques to discriminate BSE from scrapie in sheep ?

A. Members were generally encouraged by the continuing development of the Western blot technique. However there was concern that the researchers did not have access to adequate amounts of control material from sheep experimentally infected with BSE. Members agreed that every effort should be made to provide suitable control material from sheep experimentally infected with BSE. They considered this was a particularly high priority.

Q. What was SEAC's view of the Autoimmune Theory of BSE?

A. Professor Ebringer gave a presentation to Members outlining both the autoimmune hypothesis for the cause of BSE and the diagnostic test that had been developed on the basis of the proposed aetiology. Overall the Committee considered that Professor Ebringer supported his theory by using a rather selective and limited choice of publications, and had disregarded much of the published literature. They concluded that the theory was not a good postulate for the origin of BSE and that it did not seriously challenge the prion hypothesis.

Q. What was SEAC's opinion of the M.A.N. assay developed by Professor Ebringer as a test for BSE?

A. The Committee agreed that, although the data presented on the M.A.N. assay was of some interest, a sensitivity of 70% was not sufficient to give confidence that BSE positive animals could be correctly identified. There was too much overlap between the antibody levels seen in individual control animals, and those seen in the BSE infected animals. Members also agreed that the specificity of the test also appeared to be poor compared to existing tests. The Committee concluded that on the basis of the results presented, there was little justification at this time for carrying out additional work to develop the test for use in pre-clinical animals.

Q. What was the Committees view on the Matrix of Sheep breeds and genotypes using in DEFRA's research programme?

A. Members expressed some concern that the animals used in the current research programme may not directly match the genetic make-up of the majority of cross-bred sheep that enter the food chain. However, Members agreed that using a large number of sheep breeds would result in such a wide range of combinations of breed and genotype that the data would be very difficult to interpret. The Committee considered that in the first instance, it was important to refine further the role that specific alleles play in susceptibility to, and development of TSE infection, and that this was best done in a limited number of key breeds.

Q. What was SEAC's view on the results form the embryo transfer experiment?

A. Members reviewed an experiment to examine if embryos removed from clinically positive BSE cattle were infected with the BSE agent, or able to transmit infection to recipient surrogate mothers. Both the calves produced from the embryos and the surrogate mothers were kept for up to seven years and examined for evidence of BSE infection at post mortem. No evidence was seen in either case. The Committee concluded that although the results had not shown that BSE could be transmitted by this route, it was impossible to prove a negative. Although no risk had been demonstrated the results were not incompatible with a small risk of transmission.

Q. What recommendations were made to aid the investigation of the BSE cases born after August 1996?

A. Members suggested that all BSE cases born after the implementation of addition feed security measures in August 1996 should have their prion protein gene sequenced to assess if these animals have an unusual genetic make-up that could be associated with the occurrence of BSE.

Q. Members received an update on decontamination procedures for surgical instruments. What was the outcome?

A. The Committee was informed that initial reviews had found that decontamination services in 109 hospitals did not meet acceptable standards. By implementing urgent action plans and improving the management of decontamination services, NHS Estates now rated decontamination in all 249 hospitals with central sterile services as either acceptable or better. The Committee requested information on how standards of decontamination were monitored in the independent sector.

Q. What was SEAC's view on the re-introduction of re-usable surgical instruments for tonsillectomy and adenoidectomy surgery?

A. The Committee was informed that the Department of Health had announced the reintroduction of re-usable surgical instruments for tonsillectomy and adenoidectomy surgery. This was because of concerns raised by some hospital trusts using single use instruments. Some Members were concerned that the decision to re-introduce re-usable instruments for tonsil surgery was based on limited evidence from a small number of centres prior to a full audit. The Committee requested an update on the audit of single use tonsillectomy kits at the next SEAC meeting.

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