A HEALTH SCARE REVISITED
What is being said now about CJD reminds
Richard Pattinson of what was said about
Aids ten years ago — just as dubiously
WE HAVE been here before. It was the mid-Eighties and a terrible new disease was upon us, threatening to kill hundreds of thousands of people. No one was safe from an illness that could be caught without knowing; that lay dormant for years before destroying people's health; and that led to an inevitable and terrible death. Aids, we were told, didn't choose its victims — any- one could be carrying the fatal virus. A newspaper headline at the time was typical: `A million dead by 2000 if we don't act now' screamed the now defunct Today, in early January 1987. Later on in the article came a prediction from an American scientist: 'By the year 2014, more than 80 per cent of the United States popu- lation is either infected, sick or dead. Dismal as it may appear, this scenario errs on the conser- vative side.'
Fortunately, this terrifying prediction was wide of the mark. Ten years on, and with the bene- fit of hindsight, it has become clear that Aids is not as catas- trophic as was once feared. This is not to belittle the many who have died from the disease, but rather to state that what had had the potential to be the great plague of the 20th century did not become nearly as widespread as had been predicted.
Ten years on, and another health scare is upon us, the implications of which are at least as grave. It is almost exactly two years since Stephen Dorrell's Commons statement in which we were chillingly informed that, of the cases of CID in the young, 'the most likely cause at present is that these cases are linked to exposure to BSE'. Since that announcement — that the likeliest cause of a degenerative brain disease was the con- sumption of diseased cattle — the popular press has been full of the kind of prophecies of Armageddon only recently laid to rest by the calming of fears over Aids.
New variant Creutzfeldt-Jakob disease (nvCJD), as Britain's new Aids has come to be known, has so far killed only a suspected 23 people in Britain and one in France. And yet, just as in 1987 with Aids, it is not possible to be certain that millions will not die from the disease. Indeed, it will be years before we can be certain one way or the other.
The similarities in the coverage of the two diseases are striking and reveal much about the way in which health scares fea- ture in the popular press, following dis- cernible patterns. There is an important relationship between the conversion of sci- entific analysis into digestible news for a mass market and the media's desire to sell their product. When a paper declares that there will be 'a million dead if we don't act now', it is not simply reporting the views of some scientific 'expert', it is also titillating its readers with a horror story as salacious as it is scary. In this way newspapers take advantage of the ambiguities in scientific research. Only hundreds might actually die, but 'millions may die' makes better copy.
That scientists often cannot produce information that fits into the structures of press reporting was well intimated recently by Dr Harry Baker and Dr Rosalind Rid- ley. Speaking at the newly established BSE inquiry, the scientists — who were the first to demonstrate that bovine BSE could be transmitted to primates, evidence that raised the alarm — explained that there was a 'cultural misunderstanding' between scientists and government; that is to say, the kind of information that scientists can give, and the kind of information govern- ments need to give out in press releases and the like, are essentially incompatible. Scientists may talk of the balance of proba- bilities; governments need to explain to the public that something is or isn't safe. Hence the spectacle of Jack Cunningham banning beef on the bone, despite the one in two billion chance of infection from eat- ing it. If it wasn't banned, then technically British beef still wasn't safe.
As with government announcements, so with the popular press. A science of proba- bilities is mutated into sup- posed hard facts. Add to this incompatibility the need to sell papers and you have the per- fect formula for a health scare, and all the hysteria that accom- panies it. Cue crashing beef prices, world-wide bans, and the wholesale slaughter of mil- lions of cattle that might carry the infection.
So what do we exactly know about the new killer? Regular CJD occurs the world over, at the rate of approximately one in a million people. It is a spon- taneous degenerative brain dis- order, meaning that there appears to be no causal factor in its devel- opment. What distinguishes nvCID from regular CJD is the similarity in the compo- sition of brain deterioration in its victims, as well as the fact that regular CJD afflicts almost exclusively the oldest in a popula- tion (those over 60). NvCJD, by contrast, affects people considerably younger — the average age of victims has so far been 27. It was the combination of younger victims and the similarity of brain deterioration that led scientists to conclude that this was a new form of CJD with a common cause.
The illness itself has been described in hideous terms. Like Aids ten years ago, it is incurable and untreatable. Readers of news have been subjected to graphic descriptions of sufferers 'howling like animals' as the result of an illness that in a matter of months causes its victims to go from being anxious, to becoming unsteady on their feet, to complete physical and mental degeneration. Before-and-after pictures showed how healthy young men and women have been reduced to wrecks, eerily similar to the images of cows that so shocked those of us who watched the reports earlier this decade.
In the two years since Mr Dorrell's announcement of 1996, it has become accepted that young people are dying now because of contaminated meat, most likely from cheap burgers and pies, consumed in the late Eighties. And yet the cause, and certainly the extent, of nvC.ID are not at all certain. The link with BSE is still not proved (the process by which nvCJD occurs is not understood). As Mr Darrell, health minister at the time of the announcement that finally acknowledged the potential link between BSE and nvCJD, stated, the eat- ing of contaminated meat was only what scientists described as the 'likeliest expla- nation' for the emergence of nvCJD — no one could be certain. Dissenting voices at the moment are rare (although they are growing). But if, as happened with Aids, the predicted epidemic fails to materialise, the press will need to find answers to explain away the predictions it scared its readers with a few years back.
In the case of Aids, most papers took the majority line that increased awareness and caution were the reasons that the epidemic had failed to appear. Some blamed over- hyping by various pressure groups (the Mail, for example, laid the blame squarely at the feet of the homosexual lobby). The Sunday Times's approach was the most interesting. Having, along with everyone else, predicted a calamity in the late Eight- ies, its explanation as to why the predicted epidemic had failed to occur was unique to say the least. Disputing that there was a link between HIV and Aids — a link near- universally accepted by scientists — the paper's then science correspondent ran a succession of highly controversial articles proclaiming that a 'growing number' of sci- entists were now supporting this line. In reality, very few were, and after a change in editorial staff the Sunday Times quietly dropped its crusade. With BSE, dissenting voices are only just beginning to emerge. In the last couple of weeks, a number of alternatives to the hypothesis that nvCJD and BSE were caused by eating diseased animals have been put forward. One suggests that the high usage of organophosphate pesticides on cattle destroyed their immune systems, thus leaving them more susceptible to infection from the BSE agent. Another casts doubt on the scientific theory for the existence of BSE and nvCJD, blaming instead a bacterial infection. For the moment, though, such dissent is rare. We have only just begun to see deaths from nvCJD, and it is still several years before we will get any indications as to how many people are likely to die. As in 1987 with Aids, we are at a crossroads. In five or ten years' time, with luck, it will be with a sense of relief that we look back on the hysteria generated by this horrible new dis- ease, as the predicted millions fail to fall. For now, we can do nothing (not being sci- entists) but wait it out.
The author is a political researcher for Lon- don News Network `When you asked if I'd sleep with you, Batman, I thought...'