MAP: Where We’ve Been & Where We’re Going Part 1

My research into MAP (mycobacterium avium paratuberculosis) has proven worthy to get a grasp of what this bacterium entails, coupled with the enormity of what this could mean for Ulcerative Colitis/Crohn’s Disease, MS, Hashimoto’s,T1D patients and others. Let me reiterate, however, that MAP may be one cause for Crohn’s and/or Ulcerative Colitis development; microbiologists, researchers, and physicians are painstakingly working to further prove this.

In a 2003 published article by NCBI (National Center for Biotechnology Information), the notion of a correlation between MAP, Johne’s Disease and Crohn’s was presented. 3 years prior, the USDA requested that the Board on Agriculture and Natural Resources of the National Academies form a committee to research their concerns. The council extensively viewed evidence, domestically and globally, and made “recommendations for a national control program,” going so far as to recommend that further emphasis be put into funding, research, and awareness. [1]

The council recommended specific and controlled testing of individuals with Crohn’s Disease to determine if they were MAP positive, and drew the following two conclusions: “The possibility that Map infection could be a cause of some cases of Crohn’s disease in humans, combined with concern that Map is becoming widespread in the environment and the food chain, could transform JD into a serious public health problem.” [1]

“Several approaches have been taken to begin addressing growing concern over JD. The National Johne’s Disease Working Group (NJWG) of the United States Animal Health Association has implemented an educational program to increase awareness among livestock producers, developed a voluntary herd status program to encourage producers to rear JD-free herds, and has developed minimum standards for state JD control programs. All of these efforts are yielding positive results, but the lack of a nationally coordinated control effort has limited progress and the sense of urgency continues to grow.” [1]

The National Research Council named 9 specific, evidenced conclusions, and outlined recommendations (25 to be exact), of methods, protocol and prevention, based on their findings and what other countries do who face the same problems. These easy to understand, and follow, recommendations included input from NJWG, who educate farmers and veterinarians on how to handle this MAP, Johne’s threat. [1]

These conclusions were geared towards producers, state and federal authorities. As for MAP causing Crohn’s Disease, the committee had these to say: “After evaluating all of the available evidence for and against a causal role for Map in Crohn’s disease, the committee was of the unanimous opinion that the evidence was insufficient either to establish or to refute a causal connection.” [1]

“If a causal relationship is established between human Map infection and even a subset of Crohn’s disease cases, the above research recommendations will be essential for implementation of new control programs aimed at protecting public health by minimizing exposure to Map. Additional research would then be needed to develop methods for routine screening of dairy products, meat, and meat products for Map,” according to the committee. [1]
Out of the list of 25 recommendations, concluded by the Board on Agriculture and Natural Resources of the National Academies and the NJWG, consider this one:

RECOMMENDATION 21. The National Institutes of Health or a similar body should convene a panel with experts in gastroenterology, Crohn’s disease, infectious disease, mycobacteriology, biostatistics, epidemiology, etc., to define the precise study designs and to rank order the various studies to be done.” [1]

Based on their own merit – global experts representing all of these fields, led by Dr. J. Todd Kuenster, primary author and conference organizer, accomplished this recommendation, on their own. In the 2017 MAP conference held at Temple University in Philadelphia, attendees and consensus contributors (including my GI, Dr. Ira Shafran), agreed on this: “In a blind study, three independent laboratories using” (Prof. UCF) “Naser’s method have confirmed that viable MAP is found at a higher prevalence in CD patients than in controls”, “…MAP present in dairy products and meat causes disease in some humans and thus poses a public health threat…” [2] [3] You can’t get simpler than that.

1. National Research Council (US) Committee on Diagnosis and Control of Johne’s Disease. Diagnosis and Control of Johne’s Disease. Washington (DC): National Academies Press (US); 2003. Executive Summary. Executive Summary Diagnosis and Control of Johne’s Disease

2. Human Para Foundation

3. 2017 MAP Conference

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