Letter from the Publisher

Townsend Letter for Doctors and Patients, Oct, 2001

Mad Cow Disease is not new to the readers of this publication and is no longer news to most of the public. But two headlines in the August 14th New York Times should raise eyebrows in both groups. "Doctors Test Therapy for a Brain Malady: 2 People with Disease Related to Mad Cow Disease Take Malaria Drug." Quinacrine, an antimalarial drug used widely in World War II, has been shown to kill mouse cells infected with prions, the agent thought to cause Mad Cow Disease and the human form, Creutzfeldt-Jakob disease. Researchers at the University of California at San Francisco immediately decided to initiate a clinical trial this fall of quinacrine in Creutzfeldt-Jakob disease patients. News of this proposed trial spread quickly to patient families; 2 patients requested immediate treatment under so-called "compassionate use." In the very short time period the drug has been in use, one patient has shown after 19 days of use, some improvement in ability to walk and perform coordination tests; the other patient has w orsened. In addition to quinacrine, the old schizophrenia drug, chlorpromazine, also shows some promise to control prions. A news report elsewhere in this issue speculates about the use of certain anti-cancer agents in the treatment of C-J disease.

The other headline which underlies much of the concern expressed in articles throughout this issue is "Prohibited Meat Entered US, a Report Finds." The US Department of Agriculture reported that 750,000 pounds of prohibited meat has "found its way into inspection warehouses in the US." As there is no central clearinghouse for information and because multiple agencies are involved in the paperwork of these inspections, the so-called safety claimed by USDA-inspected meat and poultry is called into question. For the ranchers and feed-lot operators, this report must be anxiety-producing; the beef industry in the US has only been spared Britain's outbreak of foot and mouth disease by stringent measures to prevent contaminated beef products from entering the US. The USDA freely admits that there have been instances where uninspected or prohibited meat has made its way into the marketplace. The only solution to date: the USDA intends to computerize inspection reports in the near future and is planning to add more i nspections.

Of course the readers of the Townsend Letter are faced with additional concerns. As manufacturers, distributors and consumers of food supplements, we are concerned with the safety of such products. Many food supplements contain "glandulars," freeze-dried or desiccated preparations of liver, kidney, pancreas, heart, thyroid, and brain from cow and pig and perhaps other animals. As there has been incidence of Mad Cow Disease or scrapie in both the cow and sheep, but no known incidence of a related disorder in the pig, there is concern that "glandular" supplementation may inadvertently include diseased parts from infected animals. When questioned about this possibility, supplement manufacturers denied any possibility that their product could be adulterated with materials from animals having Mad Cow Disease. They assert that glandular products are derived from sources known to be free of disease. In particular, beef, pig, sheep and lamb products from New Zealand were thought to be pristine, free of pesticides an d hormones as well as disease. Other manufacturers were certain that their supplements were uncontaminated because the raw materials came only from USDA inspected cows and pigs. No one indicated that they had done any testing for Mad Cow Disease (as none can be done) or any independent inspection for contaminated meat-products prior to manufacturing. One major change has taken place in supplement manufacturing this year: Many supplement manufacturers are switching from beef gelatin capsules to vegetable-derived capsules. We are pleased that Lily G. Casura who has previously written for us about Mad Cow Disease, has interviewed several parties to explore this timely question as to the safety of glandulars in our supplements.

We look forward to your comments on this difficult question.

Jonathan Collin, MD