As this is the last week of the month, you can expect to see ubiquitous end-of-the-year roundups, highlighting the biggest stories of the past 12 months. Ever the contrarian (hence the name of this blog!), I’ve decided instead to focus on arguably the biggest non-story of the past decade, certainly where food production meets public health: the emergence – and rapid disappearance – of mad cow disease.
It will be 10 years ago in March that Newsweek magazine ran this cover story about mad cow disease, which had broken out in the United Kingdom about five years prior. Mad cow was a new and scary disorder caused by infected neurological tissues that were being spread through the meat supply. It mimicked an existing brain disorder called Creutzfeld-Jakob Disease, which occurs spontaneously in one out of every one million people, usually in their senior years. But this was not your father’s CJD; the new, variant CJD was aggressive, singling out young people, and just like in a bad zombie movie, it literally was eating through the brains of its victims, all of whom themselves seemed to have eaten infected meat products at some point in the 1990s. [And a technical footnote: vCJD is the name of the disease once humans contract it; the Bossy-borne version is called bovine spongiform encephalopathy).
So Newsweek predicted it was just a matter of time that the same plague could descend upon the U.S. Many other media outlets also began jumping on the bandwagon in early 2001, from 20/20, to 60 Minutes, all proclaiming that the “deadly spread” of mad cow, after it had ravaged merry old England, was about to follow the path of the Spice Girls and cross to our shores, exacting an even more lethal toll.
Except, it didn’t. It hasn’t. And it won’t. Here’s a quick quiz for you: How many people across the world would you estimate to have died from mad cow disease in the past 15 years?:
Anytime there is a new and unknown disease threat, there is a natural human inclination to circle the wagons and fear the worst (do the words “swine flu” sound familiar? How about “bird flu”? What they have in common: neither was worse than the same ol’ garden variety flu we’ve always had to deal with, despite dire initial predictions, including yet another Newsweek magazine cover story).
Back in 2000, it didn’t help that the British government itself was already pushing the panic buttons. Look at this statement from 10 years ago: they were predicting that up to 250,000 British residents could die from mad cow, which is one in every 250 people there. Extrapolate those numbers to the U.S., and the death toll forecast might have been 1 million. That’s twice the number of Americans who have died of HIV/AIDs in the past 30 years.
And yet, and yet…the facts ultimately vanquish the scary things we see, or think we see, lurking in the shadows. This chart from the U.K.’s repository for epidemiological data on all forms of CJD, lists the cumulative total of vCJD cases since the malady was first identified in the mid-1990s. AND HERE IS THE ANSWER TO THE QUIZ: A = 170. It includes “probable” cases of mad cow infection that weren’t, or haven’t, actually been confirmed by pathological tests. So it’s an upward estimate.
That’s how many people have died from mad cow disease. The mortality incidence peaked with the onslaught of news coverage in 2000, with 28 deaths. But rather than escalating into the thousands, or even hundreds of thousands, the death rate rapidly dropped (and yes, everyone who gets infected dies). This year, knock on wood, there will only be three deaths, same as last year, and following the general trend toward less than a handful of deaths annually. All tragic for those families, to be certain, but also vanishingly rare, far rarer than other garden variety foodborne illnesses, or deaths cause by dog bites, or insect stings, or other freakish acts of nature. Rare enough to still sometimes be news, unlike other causes of death.
This has been an all-England scrum: as far as we know, not a single American, that is, nobody who wasn’t a part- or full-time resident of the U.K. during the period that mad cow disease was spread in England in the 1990s, has succumbed. Not one. So much for that deadly spread in America. This is due to preventions our government put in place back in the late 1990s, but it’s also due to the fact that livestock production practices, from the farm to the slaughterhouse, are different here than they were back in Britain. And it appears likely that it’s also due to the fact that vCJD is not all that easy to contract. Otherwise, the death toll in England would probably have been much higher than 170 cases out of about 62 million total residents.
So that’s my candidate for this year-end election: one of the biggest non-events in medical history. Except that mad cow disease, in England and America, was big, big news. And created lots of concern. And generated a significant amount of public policy efforts to go along with those headlines and eyewitness news coverage. All to combat something that by any reasonable measure, has been an absolutely negligible health threat in every country other than Great Britain, where it’s now essentially extinct. Have a great 2011!