Following a proven (positive EBV PCR) post-viral myelitis in my own child
recently I have witnessed a bizarre "epidemic" of mild, subacute and acute
myeloradiculitis in my own patient clientele in our local area over the last
3 weeks, ranging from infant to veterans. This coincides with an outbreak of
glandular fever in many schools in the area. Most cases fortunately are
self-limiting, but can be very difficult to differentiate from acute
Guillain Barre polyneuritis. Fortunately we now have excellent tools such as
DNA amplification to assess these conditions better than we did previously,
to avoid such cases being misdiagnosed as, fort example, pesticide toxicity.
Most of the signs and symptoms of most of the pesticide "poisonings" are
frequently unable to be differentiated from mild or subacute post-viral
myelitis. We must avoid the danger of jumping on non-evidence based
bandwagons or we pose the risk of treating patients inappropiately.
Judicious and timely use of antivirals for conditions such as
post-herpetic/zoster/EBV myelitis can be crucial. I would doubt that much of
the witchcraft which is employed in treating "pesticide poisoning" here in
New Zealand would be at all likely to reduce the neurological damage by
viral infections of the CNS. I presume the same witchcraft is employed also
in the UK.
JW

Dr Jon Wilcox
General Medicine, Paediatrics and Obstetrics,
Glenfield Medical Centre,
452 Glenfield Road,
Auckland 1310, New Zealand
Phone or Fax +649-444-7656
e-mail   [log in to unmask]
-----Original Message-----
From: Chris Salter <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Wednesday, December 02, 1998 03:20
Subject: Re: Sheep dip


>In article <00ff01be1d84$8cd042e0$3802bcc3@eleanor-tom>, dated Tue, 1
>Dec 1998 at 23:31:20, John Caldwell <[log in to unmask]> writes
>>Is anyone on the list aware of any evidence for such a connection, and if
so
>>could you pass on the details?
>
>Further to my original reply I only just remembered to check BBC News
>Online.
>
>Wednesday, November 11, 1998 Published at 11:27 GMT
>
>Doctors warn on sheep dip
>
>http://news.bbc.co.uk/hi/english/sci/tech/newsid%5F211000/211513.stm
>
>By Environment Correspondent Alex Kirby
>
>People exposed to organophosphate (OP) sheep dips can suffer "genuine
>and often very severe symptoms", according to new research.
>
>A report by the Royal Colleges of Physicians and Psychiatrists says
>sufferers must be taken seriously and treated sympathetically by
>doctors.
>
>The report follows the establishment of a working party early last year
>at the request of the then Chief Medical Officer.
>
>It set its own terms of reference: to advise on the clinical management
>of patients with the symptoms of chronic OP exposure, and to review any
>new evidence about them.
>
>The group heard about symptoms including excessive tiredness, headaches,
>limb pains, disturbed sleep, poor concentration, mood changes, and
>thoughts of suicide.
>
>It was also told that patients felt strongly they had not been looked
>after properly by hospitals and doctors.
>
>Cause still unknown
>
>Crucially, though, it did not look at the way that OPs do their damage,
>saying only that "further studies will be needed to understand the cause
>of these symptoms".
>
>OPs are ferociously strong pesticides, derived from the nerve gases used
>by the Nazis in the World War II.
>
>>From 1976 until 1992, sheep farmers were obliged by law to use them to
>eradicate pests from their animals.
>
>Even those who took the precautions recommended (such as wearing
>protective clothing) say they were often ill after dipping.
>
>The report criticises the care available to sufferers with the
>conclusion: "Existing clinical services do not, in the main, provide
>satisfactory management."
>
>It urges doctors to take patients seriously and to be open-minded.
>
>GPs should usually be responsible for sufferers, according to the
>report, and it may be helpful to set up groups of specialists to form
>"centres of excellence".
>
>Professor John Newsom-Davis, chairman of the joint working party, said:
>"I hope that this report will result in greatly improved medical care
>for those unfortunate sufferers from OP sheep dip exposure and that it
>will prompt further research."
>
>Committee member Professor David London said: "We found there was a
>large group of people who were getting symptoms having been exposed to
>organophosphate sheep dip and the management of these people was really
>not very satisfactory."
>
>Chief medical officer Professor Liam Donaldson said: "The working
>party's recommendations will be of considerable interest to a number of
>government departments."
>
>He said the report would now be studied carefully by the Committee of
>Toxicity's Working Group on Organophosphates, and would be sent to
>relevant expert committees for further consideration
>
>Professor Donaldson said he had also asked the Department of Health to
>open immediate discussions with the directors of the National Poisons
>Information Service on the report's recommendations that specialist
>advice should be set up in areas where it currently does not exist.
>
>Improved support for GPs who have patients sufferng from related
>illnesses should be discussed, Professor Donaldson added.
>
>"Government funded research is already under way to establish
>scientifically whether there is a link between prolonged low-level
>exposure to OP sheep dips and ill health," he said.
>
>Critics see flaws
>
>The OP Information Network is in touch with almost 700 sufferers. It
>sent material to the working party, but decided not to give oral
>evidence.
>
>OPIN's Liz Sigmund said: "We are unhappy with this report, because it
>did not look at how the symptoms are caused.
>
>"Nor does it address the problem that many GPs just do not know the
>symptoms of chronic OP poisoning.
>
>"And some of our contacts know that several of its recommendations -
>like using antidepressants above a very low dosage and techniques to
>improve memory and speech - are not just useless. They can be positively
>harmful."
>
>OPIN is also "very concerned" that the working party did not look at
>reported cases of problems among children of farming families. It knows
>of 22 such children.
>
>Ms Sigmund said: "They have severe cognitive and behavioural problems.
>They could have been caused by direct exposure to OPs.
>
>"Or they might be the consequence of damage in the womb, or even of
>genetic damage to the father. We just do not know".
>
>OPs are no longer compulsory for dipping sheep. But they are used in
>other products such as some flypapers, flea collars for animals, and
>anti-lice shampoos for use on children's heads.
>
>OPIN says it knows of at least one sufferer from OP poisoning who was
>prescribed eyedrops containing OPs, to treat suspected glaucoma.
>
>Dr Bob Davies, a consultant psychiatrist practising in Somerset, has
>seen many OP sufferers over the last five years.
>
>Dr Davies, himself a member of the Royal College of Psychiatrists, says
>the report is "not bad, but weak".
>
>"They held their hearings behind closed doors and they did not look at
>how the damage is caused. That is a fundamental weakness.
>
>"The key to understanding OPs is to know how they hit the brain at the
>most basic level".
>
>"It is not a psychiatric problem. It is a chemical one."
>
>Although some farmers are calling for a blanket ban on OPs, Larry Cooke
>of the National Farmers Union said this would not be practical unless
>something else was available to eradicate pests from sheep flocks.
>
>He said that if pests were allowed to proliferate it would have dire
>consequences for sheep farmers and result in animals having to be put
>down.
>--
>Chris Salter (Vice Chairman)             Lincolnshire Post-Polio Network
>                    Registered Charity No. 1064177
>          <URL:http://www.zynet.co.uk/ott/polio/lincolnshire/>
>     Web Site & Vice Chairman Email: [log in to unmask]
>           Honorary Secretary Email: [log in to unmask]
>        Member of the British Healthcare Internet Association
>



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