Day 107 - 24 Mar 95 - Page 60


     
     1        identified.  The speculations which have emerged from some
     2        papers on E.coli suggest that the appearance of these
     3        highly distinctive, very severe cases may be the exception
     4        rather than the rule, and that there may be a background
     5        level of low level infection which is indistinguishable
     6        from -- it may be mild, it may be slightly more serious or
     7        the same -- from normal gastroenteritis or normal
     8        dysentery-type diseases which are never identified because
     9        nobody is looking for them.
    10
    11        I draw your attention to the phenomenon we saw with
    12        campylobacter which was quite remarkable at the time,
    13        because if you look at the graph from one year when people
    14        were learning how to look for campylobacter and developing
    15        the tests, we would have a few hundred one year and the
    16        next year we had several thousand that you might they had
    17        seen an explosive growth; all it was a change and an
    18        improvement in the development of testing which suddenly
    19        recognised the burden of disease that hitherto had escaped
    20        attention.  I am trying to be fair and consistent by saying
    21        I do not know that E.coli is a rare disease, E.coli 0157.
    22        The scenario which you put to me could be true, but on the
    23        evidence available it could also not be true.
    24
    25   Q.   I am not asking -- I am sorry, have you finished?
    26        A.  Yes.
    27
    28   Q.   I am very careful if I can be never to interrupt.  I am not
    29        asking for certainties.  I am not asking you to make the
    30        sort of statement on which you might be prosecuted under
    31        the Trade Descriptions Act, Mr. North.  I am asking for
    32        your best estimate as a professional man of the incidence
    33        of E.coli 0157: H7 poisoning in this country as compared
    34        with the incidence of salmonellosis?
    35        A.  Sir, I think the jury is out.  In a few years time we
    36        will begin to know the answers to those questions.
    37
    38   Q.   Leave it then.
    39
    40   MR. JUSTICE BELL:  It has been put in very general terms just
    41        that it is much less.
    42        A.  The acute, sir, serious illness is clearly less than
    43        salmonella, indisputable.  Whether or not the burden of
    44        E.coli illness right across the spectrum in the community
    45        is less than salmonella, I do not know.
    46
    47   MR. RAMPTON:  Can we return, please, to page 116 which really
    48        more or less is the end of the book but I would not swear
    49        to that, under the heading "Keeping things in proportion",
    50        it says: "At the end of all this we should keep in 
    51        perspective the number of food poisoning cases as a 
    52        percentage of the number of meals eaten."  Are you speaking 
    53        there of food poisoning cases generally, I mean you
    54        jointly, or are you speaking merely about salmonellosis?
    55        A.  I think you can have application to both.
    56
    57   Q.   "It is so small as to be statistically insignificant and a
    58        number of deaths even more so."  Does that hold good today?
    59        A.  Yes, it still applies.
    60

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