Releases Saturday 13 October 2001
No 7317 Volume 323
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(1) BSE LINK TO NEW VARIANT CJD IS OPEN TO
QUESTION
(2) IS
EUROPE PREPARED FOR AN
INTERNATIONAL
DISEASE OUTBREAK?
(3) HEALTHCARE
PROFESSIONALS NEED
TRAINING TO
HELP THEM TALK MORE
COMFORTABLY
ABOUT SEXUAL ISSUES
(4) OBITUARIES SIGNAL A TIME FOR WOMEN
(1) BSE LINK TO
NEW VARIANT CJD IS OPEN TO
QUESTION
(New variant Creutzfeldt-Jakob disease:
the epidemic
that never was)
http://bmj.com/cgi/content/full/323/7317/858
The link between the bovine spongiform
encephalopathy (BSE) prion and new variant
Creutzfeldt-Jakob disease is open to question,
argues
George Venters, Consultant in Public Health
Medicine,
in this week's BMJ.
He applied standard criteria - used to
establish links
between cause and disease - to the case
for the BSE
prion being the cause of new variant Creutzfeldt-Jakob
disease.
He found no direct evidence that this prion
was
infectious to humans. Other inconsistencies,
including
the small rate of growth in the number
of cases and
suspect or weak evidence directed at confirming
the
hypothesis rather than testing it, also
suggest that the
variant is not caused by the prion and
is not new, he
explains.
Despite improved detection and reporting
of all prion
encephalopathies after the establishment
of the UK
Creutzfeldt-Jakob disease Surveillance
Unit in 1990,
this does not seem to have been adequately
considered
as an explanation for the appearance of
what was
claimed to be a new disease, he adds.
"I believe that the evidence now available
casts serious
doubts on the case for a causal link between
bovine
spongiform encephalopathy and "new" variant
Creutzfeldt-Jakob disease," he writes.
"The medical
profession should, at least, be publicly
debating this as
an issue. The purpose of this paper is
to start that
process."
Contact:
George Venters, Consultant in Public Health
Medicine,
Lanarkshire Health Board, Hamilton, Scotland.
Email: george.venters{at}lanarkshirehb.scot.nhs.uk
(2) IS EUROPE
PREPARED FOR AN
INTERNATIONAL DISEASE OUTBREAK?
(Communicable disease outbreaks involving
more than
one country: systems approach to
evaluating the
response)
http://bmj.com/cgi/content/full/323/7317/861
(Editorial: Surveillance for infectious
diseases in the
European Union)
http://bmj.com/cgi/content/full/323/7317/818
Networks of national surveillance organisations
in
Europe need to be improved to ensure effective
control
of disease outbreaks, concludes a study
in this week's
BMJ.
These findings have important implications,
not only for
potential outbreaks such as salmonella
or influenza, but
also in the light of current concerns
about future terrorist
attacks involving biological weapons.
Researchers studied how these national
networks
responded in five international outbreaks.
Although the
networking approach was successful, they
identified
critical weaknesses in detection, coordination,
funding
and reporting. There were delays in informing
other
countries about important events, a lack
of clarity over
how outbreaks that involved several countries
should be
investigated, and how the investigation
should be
resourced.
Previous research has shown weaknesses
in national
surveillance systems. In one member state
the system
failed to ascertain 60% of community acquired
legionnaires' disease and it is likely
that the coverage
achieved in other surveillance systems
is similar or
lower, say the authors. There is a clear
requirement for
enhancement of many national surveillance
systems.
Increasing globalisation is likely to lead
to further
international outbreaks, add the authors.
Responding
effectively to these requires coordination
of national
surveillance and response systems within
the European
Union and support for enhanced surveillance
and
control activities in developing countries,
they conclude.
Contact:
Julius Weinberg, City University, London,
UK
Email: j.r.weinberg{at}city.ac.uk
(3) HEALTHCARE
PROFESSIONALS NEED
TRAINING TO HELP THEM TALK MORE
COMFORTABLY ABOUT SEXUAL ISSUES
(Communication about sexual problems
and sexual
concerns in ovarian cancer: qualitative
study)
http://bmj.com/cgi/content/full/323/7317/836
Ovarian cancer affects sexual functioning,
but healthcare
professionals' knowledge about this is
inadequate, as is
their communication with patients about
sexual issues,
concludes a study in this week's BMJ.
Interviews were conducted with 15 women
with
ovarian cancer and 43 clinicians and nurses
in Leeds to
determine their attitudes about, and experiences
of,
communication about sex.
Some women felt uncomfortable discussing
sex, but
they felt that the benefits would outweigh
any
embarrassment. Women felt that time available
to
discuss psychosexual concerns was limited,
but they did
not seek extensive information ? reassurance
of the
safety of sex, reassurance that their
problems were not
unique, and permission to discuss concerns
was often
all that was needed.
All but one of the healthcare professionals
thought that
medical staff should discuss psychosexual
issues.
However, only four clinicians (25%) and
five nurses
(19%) did so. Knowledge about the impact
of ovarian
cancer on sexual functioning was lacking,
with few
healthcare professionals being aware of
the problems
that can occur.
Healthcare professionals need training
to help them
communicate more comfortably about sexual
issues, say
the authors. Detailed discussion may be
unnecessary ?
just a few reassuring words may be enough
to relieve
some of the fears and problems provoked
by ovarian
cancer and its treatment, they conclude.
Contact:
Maxine Stead, Northern and Yorkshire Clinical
Trials
and Research Unit, Leeds, UK
Email: m.stead{at}cancermed.leeds.ac.uk
(4) OBITUARIES SIGNAL A TIME FOR WOMEN
(Obituaries)
http://bmj.com/cgi/content/full/323/7317/871
This week, for the first time in 160 years
of the BMJ,
every obituary is of a woman. Are women
finally
becoming equal with men in medicine?
Editor, Richard Smith, believes so. He
comments:
"Does it mean anything that every one
of the suicidal
terrorists of September 11 was a man and
that all the
major figures in our current "war" seem
to be men? I
think it does. Once we have a world where
women
have a much greater say we may hope for
both less war
and better medicine."
Contact:
Richard Smith, Editor, British Medical
Journal, London,
UK
Email: rsmith{at}bmj.com
FOR ACCREDITED JOURNALISTS
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London WC1H 9JR
(contact: pressoffice{at}bma.org.uk)
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Association for the
Advancement of Science
(http://www.eurekalert.org)
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