Scientists have discovered that they can diagnose new variant CJD with a simple test of a patient's tonsils. This is an astonishing breakthrough.

One of the many gruesome aspects of fatal brain disease CJD was that it could only be confirmed post-mortem. The tissue test now means that doctors can diagnose the new variant of the disease long before the patient shows any symptoms.

This discovery offers an obvious benefit. At present, we have no idea as to the prevalence of CJD. Its incubation period is unknown.

So far there have been 33 confirmed cases. If its incubation period is short, the number of victims should remain relatively small.

Otherwise, we face the spectre of a CJD epidemic in a few years' time.

The ability to test thousands of people for new variant CJD will allow doctors to assess the size of the threat for the first time.

Already plans for screening patients who undergo routine operations are being drawn up.

Health authorities could analyse this information and prepare plans to cope with the outbreak accordingly.

But it is not as simple as that. Another medical breakthrough has left us with another terrible dilemma.

Once an otherwise healthy person's tonsil test proves positive, they are under a death sentence. They will know that before they die their brain will degenerate to the point where they cannot recognise their family or do anything for themselves.

What the victim will not know is when the first symptoms will develop. It may be weeks, months or years. Every time they forgets their house keys, they will be sure CJD has taken hold. It is the stuff of nightmares.

There is no question that the patient must be told he has CJD. His permission for the biopsy will have to be sought and the results passed on.

What we need to decide is whether we should do the tests at all. Do the advantages of screening for the disease outweigh the mental torment it will cause the victims?

Today's news brings fresh hope that scientists may discover a cure for CJD in time to save the newly identified victims. But we cannot rely on that.

A further consideration is the cost to the health service of a mass screening programme.

Before scientists embark on such a programme, the implications must be debated thoroughly. We only have ourselves to blame for new variant CJD. Now we must work together to find a way through this disaster. That will take time and courage.

see NEWS 'Expert welcomes new test for BSE'

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