ROME — Nothing kills the appetite for a thick juicy T-bone steak like the mention of mad cow disease. So it’s little wonder that in the southern Italian region of Puglia, medical and veterinary officials are quickly playing down the fact that two people have died in the last 10 days from confirmed cases of Creutzfeldt-Jacob disease, a neurological disorder with strains that were associated with mad cow disease in the 1980s and ’90s.

The cases occurred in an area known as the Salento, in the southernmost section of the heel of Italy’s boot. What is known is that the victims, a 49-year-old woman and a 67-year-old man, lived just 21 kilometers apart and frequented the same areas for groceries and food markets. They both fell ill in mid-July with classic neurological symptoms and they both succumbed to the disease at the same area hospital where they were being treated last week.

What is not known is whether or not they contracted Creutzfeldt-Jacob from beef infected with the bovine spongiform encephalopathy known as mad cow disease, or mucca pazza in Italy, or whether it was the result of coincidental genetic predispositions or some other factor. On Monday, local officials announced that they had definitively ruled out the contraction of the disease from blood transfusions because neither victim had been given blood recently (nor had either donated blood to local blood banks). They have not yet ruled out whether the disease came from eating infected beef.

Those results could come in two weeks’ time when analyses from brain tissue from each victim are complete, but Canio Buonavoglia, director general of the Institute of Experimental Zoo Prophylactics in Puglia and Basilicata, says there is nothing to worry about. “I think I can say that the meat in Italy are hyper-controlled,” Buonavoglia told the Gazzetta di Mezzogiorno in Lecce. “The industry in Italy, thanks to the ministry and the veterinary epidemiology, is very, very controlled.”

Still, the local health authority is concerned about what appears to be a higher incidence of Creutzfeldt-Jacob in the Salento than in other areas of Italy and Europe. Not all victims die from the disease, and the brain tissue test that defines the root cause can only be conducted post-mortem so it is not always easy to definitively test all sufferers, says Giovanni Gorgoni, head of the ASL (local health authority) in Lecce. He says while he will wait for the definitive results from the latest victims, he believes that tainted meat is not the culprit. “The thing that most concerns us instead is the high incidence of cases—much higher than the national and regional average,” he says, noting that there are four confirmed cases per million people in the Salento this year so far.

There were nearly 10 cases per million in 2013 (the average for all of Puglia is 1.7 cases per million). There were no reported cases in 2014. “The data that suggest the presence of a particular cluster in the Salento merit investigation,” he says. “Especially with the negligible share of cases linked to genetic causes. The unknown factors call for a targeted analysis and urgent consultation with the national health ministry.”

The fear of the return of mad cow comes just as Coldiretti, Italy’s main agricultural union, won a crucial battle with the nation’s minister of health and the European Union to allow many banned beef products back on the table. This summer, for example, veal pajata (cooked intestines of baby calves) is back on the menu in traditional beef restaurants for the first time in 14 years. In 2001, acting out of an abundance of caution, Italy’s health and agricultural ministries outlawed the dish, which was replaced with an inferior pajata made from lamb intestines. Italian beef is not widely exported, though its cured ham and pork products are commonly found in North America.

It will likely take a direct link between the Creutzfeldt-Jacob deaths and the beef industry to instigate further studies, especially into what many fear could be widespread corruption when it comes to the controls meant to keep beef safe. Even with the recent deaths, Buonavoglia says cattle yards’ records are not always checked for incidences of spontaneous deaths among the herds. One family member of a recent victim accused the local trade authorities of allowing importing of cheaper, banned beef from the nearby Balkans, where EU controls aren’t in place.

And while two deaths is not an epidemic, it is still worrying for beef eaters and cattle farmers. When asked if he would eat beef in Puglia, Buonavoglio admitted he is a vegetarian. “The beef is safe, though,” he says. “Nothing bad will happen if you eat it.”