Projections of the future course of the primary vCJD epidemic in the UK: inclusion of subclinical infection and the possibility of wider genetic susceptibility
Open Access
- 11 January 2005
- journal article
- Published by The Royal Society in Journal of The Royal Society Interface
- Vol. 2 (2), 19-31
- https://doi.org/10.1098/rsif.2004.0017
Abstract
The incidence of variant Creutzfeldt–Jakob disease (vCJD) in the United Kingdom appears to be in decline, with only four deaths reported this year (to 6 September 2004). However, results of a survey of lymphoreticular tissues have suggested a substantially higher prevalence of vCJD than expected from the clinical data alone. There are two plausible explanations for this discrepancy: first, a proportion of those infected will not develop clinical disease (subclinical infection); and second, the genetic group in which no clinical cases of vCJD have yet occurred is susceptible. Using mathematical models for the primary transmission of bovine spongiform encephalopathy to humans, we explore the impact of these hypotheses on case predictions. Under the first hypothesis, the results suggest relatively few future cases will arise via primary transmission, but that these cases are a small proportion of those infected, with most having subclinical infection. Under the second hypothesis, results suggest a maximum fivefold increase in cases, but this hypothesis is unable to account for the discrepancy between clinical cases and the estimated prevalence. Predictions of future cases of vCJD therefore remain uncertain, particularly given the recent identification of additional cases infected via blood transfusion.Keywords
This publication has 39 references indexed in Scilit:
- Preclinical vCJD after blood transfusion in a PRNP codon 129 heterozygous patientThe Lancet, 2004
- Prevalence of lymphoreticular prion protein accumulation in UK tissue samplesThe Journal of Pathology, 2004
- Factors determining the pattern of the variant Creutzfeldt-Jakob disease (vCJD) epidemic in the UKProceedings Of The Royal Society B-Biological Sciences, 2003
- Active Surveillance for Scrapie by Third Eyelid Biopsy and Genetic Susceptibility Testing of Flocks of Sheep in WyomingClinical and Vaccine Immunology, 2002
- The Incubation Period of KuruEpidemiology, 2002
- Predictability of the UK Variant Creutzfeldt-Jakob Disease EpidemicScience, 2001
- Classification of sporadic Creutzfeldt-Jakob disease based on molecular and phenotypic analysis of 300 subjectsAnnals of Neurology, 1999
- Codon 129 prion protein genotype and sporadic Creutzfeldt-Jakob diseaseThe Lancet, 1999
- A new variant of Creutzfeldt-Jakob disease in the UKThe Lancet, 1996
- A Probability Distribution and its Uses in Fitting DataTechnometrics, 1979