Published Date: 2002-08-06 23:50:00
Subject: PRO/AH/EDR> CJD (new var.) - UK: update Aug 2002
Archive Number: 20020806.4963
CJD (NEW VAR.) - UK: UPDATE AUG 2002
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[1]
Date: Mon 5 Aug 2002
From: ProMED-mail <promed@promedmail.org>
Source: UK Department of Health, press release 2002/0341, Mon 5 Aug
2002 [edited]
<http://www.doh.gov.uk/cjd/stats/aug02.htm>
Monthly Creutzfeldt-Jakob Disease Statistics; Mon 5 Aug 2002
------------------------------------------------------------
The [UK] Department of Health issued on Mon 5 Aug 2002 the latest
information about the numbers of known cases of Creutzfeldt-Jakob
disease. This includes cases of variant Creutzfeldt-Jakob disease
[abbreviated in ProMED-mail as (vCJD) or CJD (new var.)] -- the form
of the disease thought to be linked to bovine spongiform
encephalopathy (BSE). The position is as follows:
Definite and probable CJD cases in the UK:
Year/ Referrals/ Sporadic/ Iatrogenic/ Familial/ GSS/ vCJD/ Total deaths
[vCJD is the last column but one -- negative until 1995 - Mod.JW]
1990/ 53/ 28/ 5/ 0/ 0/ -/ 33
1991/ 75/ 32/ 1/ 3/ 0/ -/ 36
1992/ 96/ 44/ 2/ 5/ 1/ -/ 52
1993/ 78/ 37/ 4/ 3/ 2/ -/ 46
1994/ 116/ 51/ 1/ 4/ 3/ -/ 59
1995/ 87/ 35/ 4/ 2/ 3/ 3/ 47
1996/ 134/ 40/ 4/ 2/ 4/ 10/ 60
1997/ 161/ 59/ 6/ 4/ 1/ 10/ 80
1998/ 154/ 63/ 3/ 4/ 1/ 18/ 89
1999/ 169/ 61/ 6/ 2/ 0/ 15/ 84
2000/ 178/ 48/ 1/ 2/ 1/ 28/ 80
2001/ 172/ 51/ 3/ 2/ 2/ 20/ 78
2002*/ 67/ 12/ 0/ 1/ 0/ 11/ 24
*As of Mon 5 Aug 2002
Summary of vCJD cases
Deaths:
-------
Deaths from definite vCJD (confirmed): 92
Deaths from probable vCJD (without neuropathological confirmation):
22
Deaths from probable vCJD (neuropathological confirmation pending):
1
Number of deaths from definite or probable vCJD (as above): 115
Alive:
------
Number of probable vCJD cases still alive: 10
Total number of definite or probable vCJD (dead and alive): 125
The precise definitions of the terms: Referrals, Deaths, Definite cases,
Probable vCJD cases, Sporadic, Probable sporadic, Iatrogenic,
Familial, GSS, variant CJD, and the case definitions can be found by
accessing the Department of Health web-site or by reference to a
preceding ProMED-mail post in this thread [CJD (new var.) - UK:
update Mar 2002 20020305.3693].
The next monthly statistics will be published on Mon 2 Sep 2002.
--
ProMED-mail
<promed@promedmail.org>
[Since the previous monthly statistics released by the Department of
Health on Wed 5 2002, the number of referrals has risen by 13. -
Mod.CP]
******
[2]
Date: Thu 25 Jul 2002
From: ProMED-mail <promed@promedmail.org>
Source: Eurosurveillance Weekly, Issue 30/25, Thu 25 Jul 2002 [edited]
<http://www.eurosurv.org/update/>
Incidence trends and short term predictions for variant Creutzfeldt-
Jakob disease in the United Kingdom update
----------------------------------------
Introduction
By the end of June 2002, a total of 124 cases of variant Creutzfeldt-
Jakob disease (vCJD) had been reported in the United Kingdom:
<http://www.doh.gov.uk/cjd/stats/jul02.htm>
In order to monitor the underlying trend in vCJD incidence, quarterly
analyses that estimate the underlying trend are performed. The models
fitted to the data enable short-term predictions for the expected number
of deaths in the next year, as well as an estimate of the total number of
individuals with symptom onset who are yet to be identified.
The quarterly analyses are available on the CJD surveillance unit
website:
is now available.
The table shows the distribution of cases by year of symptom onset,
diagnosis, and death, as well as the median age at death. The overall
median age at death was 28 (range 14-74 years). The median number of
days from onset to diagnosis was 334 days and from onset to death 411
days. Of the 124 cases, 68 (55 percent) were male.
Table: Annual cases by onset, diagnosis, and death
Year/Onset/Diagnosis/Death/Median age at death
1994/8/0/0/-
1995/10/7/3/-
1996/11/8/10/30
1997/14/12/10/26
1998/17/17/18/25.5
1999/29/17/15/29
2000/24/27/28/25.5
2001/11/25/20/28
(2002)/0/11/11/31
Total/124/124/115/-
Trends in incidence
-----------------
The recent analyses showed that the underlying incidence is increasing
by an estimated 18 percent per year based on date of symptom onset, or
20 percent per year based on date of death. These trends are lower than
the 22 and 27 percent estimated in November 2001, because only 11
cases were diagnosed in the first 2 quarters of 2002 (reference 1).
The analysis using date of symptom onset enabled all 124 cases to be
included, but also required adjustment in the model for the delay from
symptom onset to diagnosis. The figure [on the web page] shows the
incidence of onsets by quarter, with the fitted underlying trend. The
estimated current incidence is 8.1 onsets per quarter. In recent quarters,
the expected number of cases is much higher than the observed
number of cases owing to the reporting delay. The cumulative
difference between the expected number and the observed number is
27, which means that the estimated total number of cases with onsets
by the end of June 2002 is 151 (124+27, 95 percent confidence interval
142 to 166).
A separate model including a quadratic trend did not give a
significantly better fit (P=0.21), so there is no evidence of a departure
from an exponentially increasing trend. The value for the quadratic
term is, however, negative, and this model is actually consistent with an
epidemic at its peak. The data do not therefore enable an epidemic at its
peak to be distinguished from an epidemic with a continued
exponential increase. The analysis using date of death included 115
cases.
No adjustment for reporting delay was required for deaths because
most cases are diagnosed before death. The estimated current quarterly
incidence of deaths is 7.0 and, assuming the current trend continues,
the total number of deaths in the next 12 months is predicted to be 32
(18 to 48). Again, there is no evidence of a significant departure from
an exponentially increasing trend (P=0.13).
Conclusions
---------------
Although [because?] only 11 cases have been diagnosed in the first 6
months of 2002, it is not yet possible to conclude that the epidemic is
reaching or has reached its peak. A continued exponential increase at
the current underlying rate will give an estimate of approximately 32
deaths in the next 12 months. The quarterly analyses will continue to be
performed in order update short-term predictions and detect any
changes in the incidence trend which may indicate that the epidemic
has reached its peak.
[The article is illustrated by a figure of "Observed and expected
quarterly incidence of vCJD onsets".]
Reference
---------
Andrews N. Incidence trends and short term predictions for variant
Creutzfeldt-Jakob disease in the United Kingdom. Eurosurveillance
Weekly 2001: 5: 011115: <http://www.eurosurv.org/2001/011115.htm>
[Byline: Nick Andrews]
--
ProMED-mail
<promed@promedmail.org>
See Also
CJD (new var.) - UK: update Jul 2002 20020702.4652CJD (new var.) - UK: update June 2002 20020606.4418
CJD & CJD (new var.) - UK: update May 2002 20020510.4157
CJD (new var.) - UK: update Apr 2002 20020404.3877
CJD (new var.) - UK: update Mar 2002 20020305.3693
CJD (new var.) - UK: update Feb 2002 20020212.3549
CJD (new var.) - UK: update Jan 2002 20020111.3223
2001
----
CJD (new var.), incidence & trends - UK 20011115.2816
CJD (new var.), incidence & trends - UK (02) 20011124.2875
CJD (new var.), second wave of cases possible - UK 20010515.0948
CJD (new var.) - UK: 9th Annual Report 20010706.1293
CJD (new var.) - UK: reassessment 20011029.2671
CJD (new var.) - UK: regional variation 20010628.1231
CJD (new var.) - UK: regional variation (02) 20010907.2145
CJD (new var.) - UK: update 3 Jan 2001 20010104.0025
CJD (new var.) - UK: update Aug 2001 20010808.1872
CJD (new var.) - UK: update June 2001 20010622.1188
CJD (new var.) - UK: update Oct 2001 20011005.2419
CJD (new var.) - UK: update Sep 2001 20010906.2134
......................................cp/pg/jw
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