Day 107 - 24 Mar 95 - Page 59
1 country at the moment?
2 A. Yes.
3
4 Q. I think Mr. Bennett gave a figure of 30,000.
5
6 MR. JUSTICE BELL: You said 30 and a half thousand?
7 A. Yes.
8
9 Q. So you were pretty near 30,000 as well.
10
11 MR. RAMPTON: Near enough 30 and a half.
12 A. Yes, call it 30.
13
14 Q. Whereas you get a figure for confirmed or identifiable
15 cases of E.coli 0157 poisoning as, I think, in the low
16 hundreds?
17 A. Yes.
18
19 Q. Annually in this country?
20 A. Yes. Mr. Rampton, we have seen this before, this sort
21 of scenario, with campylobacter. In the early stages you
22 got sometimes only dozens of campylobacters because the
23 test was not properly developed and the symptoms were not
24 properly understood. Then when the technology to test and
25 the system ground into gear to find cases, we end up with
26 more campylobacter than we have salmonella.
27
28 MR. MORRIS: Can the witness be allowed to finish?
29
30 MR. RAMPTON: I thought he had. Do not think, Mr. North, that
31 I am interested in trapping you into giving certain answers
32 about matters which quite plainly must allow a certain
33 flexibility and speculation. All I am asking you is this.
34 Do you not think it right, given that E.coli 0157 poisoning
35 is apt to show considerably more severe symptoms than
36 salmonellosis, given that the number of confirmed cases
37 annually in this country is something around the low
38 hundreds as compared with 30,000 or 30 and a half thousand
39 for salmonellosis, do you not think it likely, first, that
40 the degree of under-reporting for E.coli 0157 is a great
41 deal less than it is for salmonellosis and, second, that it
42 is, in any event, and this must follow, a much rarer
43 condition?
44 A. I really want to be careful and fair and honest. I am
45 having difficulty with this. I do not know that to be
46 true. I do know, and it is an interesting phenomenon, the
47 way you identify currently E.coli illness is by this very,
48 very specific bunch of symptoms or signs to the observer,
49 and that triggers a complicated half proven and somewhat
50 insensitive testing procedure. In food poisoning
51 investigations one does not routinely screen for 0157, and
52 laboratories successes in identifying 0157 are poor.
53
54 Now the thing that has emerged from some of the papers is
55 speculations that there may be cases, and do not forget
56 there is an enormous burden of unexplained food poisoning,
57 the actual doctor identified food poisoning as opposed to
58 the laboratory confirmed food poisoning is substantially
59 higher. That means there is an enormous amount of
60 gastroenteritis in the community which is never
