At present most Mycoplasma Avium Paratuberculosis (MAP) research takes place in Europe, even though Rhode Island surgeon Dr Rodrick Chiodini was the first to culture MAP from children with Crohn's in the mid-nineties. MAP research is extremely controversial in the US owing, in part, to a US Department of Agriculture Survey (USDA) revealing that 68 percent of US dairy herds test positive for MAP infection (which can be asymptomatic).
Does MAP "Cause" Crohn's Disease?
There seems to be universal agreement among researchers that Mycobacterium Avium Paratuberculosis (MAP), on its own, doesn't "cause" Crohn's Disease. This is based on strong genetic and immunological evidence suggesting the children and young adults who develop the illness have either an inherited or acquired susceptibility to develop an abnormal immune reaction to MAP infection. However there is also overwhelming evidence that preventing MAP infection in the first place reduces a children's chances of developing an incurable and often fatal illness. Owing to the federal government's refusal to implement public health measures to effectively limit exposure, the US presently enjoys the distinction of having the highest incidence of Crohn's in the world.
While the issue remains controversial, twenty years of research strongly suggests MAP plays some role in the etiology of Crohn's:
1. While MAP is a common soil organism found nearly everywhere in the world, Crohn's Disease is only found in cultures that drink milk and is found in all cultures that drink milk, except for India (where milk is boiled).
2. Crohn's was virtually unknown prior to the early 1900s, when there was a transition from buying milk from a local dairy to a system of mass distribution, involving the pooling of milk from many different sources.
3. MAP is found in the breast milk of nursing mothers with Crohn's.
4. MAP is found in the intestines of 80-90% of patients with Crohn's Disease and only 4% of patients with other serious intestinal diseases.
5. Asian countries previously free of Crohn's are experiencing an increased incidence as they begin drinking milk and keeping dairy herds.
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