CJD death toll of 48 may be `just the tip of the iceberg'

THE INQUIRY into BSE closed yesterday, the same day that the ban on beef on the bone was finally lifted, with a warning that the 48 people who have died of the human version of the disease so far in Britain may be "just the tip of an iceberg".

Lord Phillips, the chairman of the public inquiry into bovine spongiform encephalopathy, said in his closing statement that the number of victims had doubled since he began taking evidence nearly two years ago. "No one can say whether or not those victims are just the tip of an iceberg of infection that is still concealed from sight," he said. "This is an unusual inquiry in that, while we are investigating events which led to the disaster, the full extent of that disaster may not be clear for years to come."

Outside Britain there have been three more confirmed deaths from Creutzfeldt- Jakob disease (CJD), one in Ireland and two in France, where doctors are investigating a third suspected case. The discovery of France's latest victim - a woman of 36 - was made public this week. There were suggestions yesterday that Lionel Jospin, the French Prime Minister, may have known about the case when he resolved to maintain the ban on British beef.

Yesterday, Britain's problems with its European Union partners over beef looked set to deepen, when the European Commission said that the German parliament appeared not to have moved towards lifting its ban and that it could take legal action against Germany as early as next Wednesday.

Professor Peter Smith, acting chairman of the Government's Spongiform Encephalopathy Advisory Committee, emphasised yesterday that it would take at least two more years before scientists could judge whether the human epidemic will remain small or spiral out of control, with tens of thousands of cases over the coming decades. The crucial unknown, he said, was the length of the incubation period between exposure to BSE material and the onset of the variant form of CJD, the human brain disease. "If the average incubation period is 10 years, then we are well into the epidemic and it could remain relatively low. If it is 20 years, then we may face a much bigger problem," he said.

Lord Phillips said that the inquiry - which is due to report in March - would be unable to resolve all the scientific issues, such as the final scale of the epidemic, but might help to dispel some misconceptions, such as whether BSE is the true cause of v-CJD.

The inquiry was set up to establish the early history of the BSE epidemic and v-CJD, assess the measures introduced to tackle the problem and reach conclusions about the adequacy of that response. More than 560 witnesses gave evidence.

Lord Phillips said that the public had made many value judgements as the BSE epidemic unfolded, culminating in the announcement in March 1996 by the Tory government of the link between BSE and the new variant form of CJD. "What is important at the end of the day is to identify whether there are any improvements that can be made to the way our national systems operate when faced with a challenge such as that posed by the emergence of BSE," he said.

David Body, solicitor to the families of CJD victims, said the inquiry had been meticulous and thorough.