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

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