Abstract
Estimates of the final size of the variant Creuzfeldt-Jakob Disease epidemic have been made by fitting theoretical curves of the incubation period distribution to the histogram of observed annual deaths to 2002, using various assumptions of the mean and standard deviation of this distribution, and also of the efficacy of the Specified Bovine Offals ban of 1989. Unless the mean incubation time is greater than 15 to 20 years the estimates lie in the low hundreds to about a thousand, and the most likely situation, of a mean between 11 and 15 years, gives estimates of about 150 to 500 deaths. Numbers above a few thousands would only occur if the mean incubation period is of the order of 25 to 30 years and reasons are adduced to indicate this is very unlikely. These numbers are not greatly increased if the ban was poorly observed. This method of analysis may be applicable to other situations where a cause that is limited in space and time is expected to have late effects.
Similar content being viewed by others
References
Anderson R.M., Donnelly C.A., Ferguson N.M., Woolhouse M.E.J., MaWhinney S., Dunstan S.P., Southwood T.R.E., Wilesmith J.E., Ryan J.B.M., Hoinville L.J., Hillerton J.E., Austin A.R. and Wells G.A.H. 1996. Transmission dynamics and epidemiology of BSE in British cattle. Nature 382: 779–788.
Baier M., Norley S., Schultz J., Burwinkel M., Schwarz A. and Riemer C. 2003. Prion diseases: infectious and lethal doses following oral challenge. J. Gen. Virol. 84:1927–1929.
Brown P., Will R.G., Bradley R., Asher D.M. and Detwiller L. 2001. Bovine spongiform encephalopathy and variant Creutzfeldt-Jakob Disease: background, evolution and current concerns. Emerg. Inf. Dis.7: 6–16.
Bruce M.E., Will R.G., Ironside J.W., McConnell J., Drummond D., Suttie A., McCardle L., Chree A., Hope J., Birkett C., Cousens S., Fraser H. and Bostock C.J. 1997. Transmissions to mice indicate that the 'new variant' CJD is caused by the BSE agent.Nature 389: 498–501.
Bryant G. and Monk P. 2001. Final report of the investigations into the North Leicestershire cluster of variant Creutzfeldt-Jakob disease.Leicestershire Health Authority, Leicester, UK
Collinge J., Sidle K.C.L., Meads J., Ironside J. and Hill A. F. 1996.Molecular analysis of prion strain variation and the aetiology of new variant CJD. Nature383:685–690.
Cooper J.D. and Bird S.M. 2002a. UK bovine carcass meat consumed as burgers, sausages and other meat products: by birth cohort and gender. J. Cancer Epidemiol. Prevention7:49–57.
Cooper J.D. and Bird S.M. 2002b. UK dietary exposure to BSE in beef mechanically recovered meat: by birth cohort and genderJ. Cancer Epidemiol. Prevention7:59–70.
Cooper J.D. and Bird S.M. 2002c. UK dietary exposure to BSE in head meat: by birth cohort and gender. J. Cancer Epidemiol.Prevention7:71–83.
Cooper J.D. and Bird S.M. 2003. Predicting incidence of variant Creutzfeldt-Jakob disease from UK dietary exposure to bovine spongiform encephalopathy for the 1940 to 1969 and post-1969 birth cohorts. Int. J. Epidemiol.32:784–791.
Cousens S.N., Vynnycky E. Zeidler M., Will R.G. and Smith P.G. 1997. Predicting the vCJD epidemic in humans. Nature 385: 197–198.
Diringer H., Roehmel J. and Beekes M. 1998. Effect of repeated oral infection of hamsters with scrapie. J. Gen. Virol. 79: 609–612.
Ferguson N.M., Ghani A.C., Donnelly C.A., Hagenaars T.J. and Anderson R.M. 2002. Estimating the human health risk from possible BSE infection of the British sheep flock.Nature415:420–424.
Foster J.D., Parnham D.W., Hunter N. and Bruce M.E. 2001. Distribution of the prion protein in sheep terminally affected with BSE following experimental oral transmission.J. Gen. Virol. 82: 2319–2326.
Gale P., Young C., Stanfield G. and Oakes D. 1998. Development of a risk assessment for BSE in the aquatic environment. J. Appl.Microbiol.84:467–477.
Ghani A.C., Ferguson N.M., Donnelly C.A., Hagenaars T.J. and Anderson R.M. 1998. Epidemiological determinants of the pattern and magnitude of the vCJD epidemic in Great Britain. Proc.Roy. Soc. Lond. B 265: 2443–2452.
Ghani A.C., Donnelly C.A., Ferguson N.M. and Anderson R.M. 2000. Assessment of the prevalence of vCJD through testing tonsils and appendices for abnormal prion protein. Proc. Roy. Soc. Lond. B 267: 23–29.
Ghani A.C., Ferguson N.M., Donnelly C.A. and Anderson R.M. 2003a. Factors determining the pattern of the variant Creutzfeldt-Jacob disease (vCJD) epidemic in the UK. Proc. Roy. Soc. Lond.B 270: 689–698.
Ghani A.C., Donnelly C.A., Ferguson N.M. and Anderson R.M. 2003b. Updated projections of future vCJD deaths in the United Kingdom. BMC Infectious Diseases3:4–15.
Hagenaars T.J., Ferguson N.M., Donnelly C.A., Ghani A.C. and Anderson R.M. 2000. Feed-borne transmission and case clustering of BSE. Proc. Roy. Soc. Lond. B 267: 205–215.
Hill A.F., Desbruslais M., Joiner S., Sidle K.C.L., Gowland I., Collinge J., Doey L.J. and Lantos P. 1997. The same prion strain causes vCJD and BSE. Nature 389:448–450.
Hilton D.A., Ghani A.C., Conyers L., Edwards P., McCardle L., Penney M., Ritchie D. and Ironside J.W. 2002. Accumulation of prion protein in tonsil and appendix: review of tissue samples.Brit. Med. J. 325: 633–634.
Huillard d'Aignaux J.N., Cousens S.N., and Smith P.G. 2001. Predictability of the UK variant Creutzfeldt-Jakob disease epidemic.Science 294: 1729–1731.
Medley G.F. 2001.Predicting the unpredictable.Science294: 1663–1664.
O'Rourke K.I., Holyoak G.R., Clark W.W., Mickelson J.R., Wang S., Melco R.P., Besser T.E. and Foote W.C. 1997. PrP genotypes and experimental scrapie in orally inoculated Suffolk sheep in the United States. J. Gen. Virol. 78: 975–978.
Phillips N., Bridgeman J. and Ferguson-Smith M. 2000. The BSE Inquiry. The Stationery Office, London, UK, 16 vols.
Ricketts M.N., Cashman N.R., Stratton E.E. and El Saadany S. 1997. Is Creutzfeldt-Jakob Disease transmitted in blood? Emerg.Inf. Dis. 3: 155–163.
Ridley R.M. and Baker H.F. 1996. Variation on a theme of Creutzfeldt-Jakob disease: implications of new cases with a young age at onset. J. Gen. Virol. 77: 2895–2904.
Robinson M.M., Hadlow W.J., Huff T.P., Wells G.A.H., Dowson M., Marsh R.F. and Gorham J.R. 1994. Experimental infection of mink with bovine spongiform encephalopathy. J. Gen. Virol.75: 2151–2155.
Scott D.W. 1992. Multivariate density estimation. JohnWiley, New York, USA, pp. 48, 78.
Sokal R.R. and Rohlf F.J. 1981. Biometry. W.H. Freeman, New York, USA.
Thomas P. and Newby M. 1999. Estimating the size of the outbreak of new-variant CJD. Brit. Food J. 101: 44–57.
Valleron A.-J., Boelle P.-Y., Will R. and Cesbron J.-Y. 2001. Estimation of epidemic size and incubation time based on age characteristics of vCJD in the United Kingdom. Science 294: 1726–1728.
Venters G.A. 2001. New variant Creutzfeldt-Jakob disease: the epidemic that never was. Brit. Med. J.232:858–561.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sneath, P. Estimation of the size of the vCJD epidemic. Antonie Van Leeuwenhoek 86, 93–103 (2004). https://doi.org/10.1023/B:ANTO.0000036145.53052.3b
Issue Date:
DOI: https://doi.org/10.1023/B:ANTO.0000036145.53052.3b