In France, despite the ban of meat-and-bone meal (MBM) in cattle feed, bovine spongiform encephalopathy (BSE) was detected in hundreds of cattle born after the ban. To study the role of MBM, animal fat, and dicalcium phosphate on the risk for BSE after the feed ban, we conducted a spatial analysis of the feed industry. We used data from 629 BSE cases as well as data on use of each byproduct and market area of the feed factories. We mapped risk for BSE in 951 areas supplied by the same factories and connection with use of byproducts. A disease map of BSE with covariates was built with the hierarchical Bayesian modeling methods, based on Poisson distribution with spatial smoothing. Only use of MBM was spatially linked to risk for BSE, which highlights cross-contamination as the most probable source of infection after the feed ban.
In France, meat-and-bone meal (MBM) has been banned from cattle feed since July 30, 1990. However, through January 1, 2007, 957 cases of bovine spongiform encephalopathy (BSE) have been detected in cattle born after the ban. These cases provide evidence that BSE control has not been entirely effective, which poses a concern because BSE is a zoonotic disease, a source of variant CreutzfeldtJakob disease (vCJD). Until now, 158 defi nite or probable cases of vCJD in humans have been detected in the United Kingdom (www.cjd.ed.ac.uk/fi gures.htm, consulted March 12, 2007) and 21 in France (www.invs.sante.fr/recherche, consulted March 12, 2007). The risk for humans is controlled by removing specifi ed risk materials from human consumption (since 1996 in France, later in other European countries) and testing all cattle at the abattoir with a rapid test (since 2001 in continental European Union). However, these measures are expensive. Achieving 100% control of the spread of BSE is a major challenge, important for human health but limited by economic constraints.The main hypothesis concerning the source of infection in cattle born after the MBM ban still involves MBM; the BSE agent may have entered cattle feed by cross-contamination with feed for monogastric species (pigs and poultry) in which MBM was still authorized until November 2000. Cross-contamination could have occurred within factories, during feed delivery to the farm, or on mixed farms that have cattle and pigs or poultry. This hypothesis is supported by the fi nding of MBM traces in cattle feed (1) as well as by epidemiologic studies that showed a spatial link between density of monogastric species and risk for BSE (2-7).Another hypothesis, however, suggests the role of other animal byproducts such as fat and dicalcium phosphate (DCP) derived from bones, which were not prohibited in cattle feed before 2000. Such components might have been contaminated by the BSE agent during cattle slaughter (1). Clauss et al. (5) found a statistically higher use of milk replacers (which contain animal fat) for calves on BSE-affected farms in Germany, and the same type of association was observed in France for scrapie in sheep (8).More knowledge about...