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From: TSS ()
Subject: Risk factors for sporadic Creutzfeldt-Jakob disease
Date: December 16, 2007 at 2:31 pm PST

Sunday, December 16, 2007

Risk factors for sporadic Creutzfeldt-Jakob disease

Published Online: 11 Dec 2007

Copyright © 2007 American Neurological Association

Original Article

Risk factors for sporadic Creutzfeldt-Jakob disease

Hester J. T. Ward, FFPH 1 *, Dawn Everington, MSc 1, Simon N. Cousens, MA 2,
Blaire Smith-Bathgate, RGN 1, Michelle Gillies, MRCP 1, Katy Murray, MRCP 1,
Richard S. G. Knight, FRCPE 1, Peter G. Smith, DSc 2, Robert G. Will, FRCP 1
1National Creutzfeldt-Jakob Disease Surveillance Unit, University of
Edinburgh, Western General Hospital, Edinburgh, United Kingdom
2Department of Epidemiology and Population Health, London School of Hygiene
and Tropical Medicine, London, United Kingdom

email: Hester J. T. Ward (

*Correspondence to Hester J. T. Ward, National CJD Surveillance Unit,
Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, United Kingdom

Funded by:
Department of Health; Grant Number: 121/7400
Scottish Executive Health Department; Grant Number: R39924



Although surgical transmission of Creutzfeldt-Jakob disease (CJD) has been
demonstrated, these iatrogenic cases account for only a small proportion of
all CJD cases. The majority are sporadic CJD (sCJD) cases of un-known cause.
This study investigated whether some cases classified as sCJD might have an
unrecognized iatrogenic basis through surgical or other medical procedures


This study compared medical risk factors from 431 sCJD cases referred 1998
to 2006 with 454 population control subjects. Possible geographic and
temporal links between neurological and gynecological operations in 857 sCJD
cases referred from 1990 to 2006 were investigated


A reported history of ever having undergone surgery was associated with
increased risk for sCJD (odds ratio, 2.0; 95% confidence interval, 1.3-2.1;
p = 0.003). Increased risk was not associated with surgical categories
chosen a priori but was confined to the residual category other surgery, in
which the increase in risk appeared most marked for three subcategories:
skin stitches, nose/throat operations, and removal of growths/cysts/moles.
No convincing evidence was found of links (same hospital, within 2 years)
between cases undergoing neurosurgery or gynecological surgery


It is unlikely that a high proportion of UK sCJD cases are the result of
transmission during surgery, but we cannot exclude the possibility that such
transmission occurs occasionally. A study based on accurate surgical
histories obtained from medical records is required to determine whether the
increased risk associated with reported surgical history reflects a causal
association or recall bias. Ann Neurol 2007

Received: 24 May 2007; Revised: 5 September 2007; Accepted: 1 October 2007
Digital Object Identifier (DOI)

10.1002/ana.21294 About DOI

Additional Material


> which the increase in risk appeared most marked for three subcategories:

> skin stitches, nose/throat operations, and removal of growths/cysts/moles.

10 January 1990

Other US BSE risks: the imported products picture

24 Jul 00 Trade Statistics: UK to US

Compiled by Terry S.Singeltary Sr of Bacliff, Texas

[Opinion (webmaster): The US has focused for years on tracing, containing,
and eradicating live animal imports from the UK or other countries with
acknowledged BSE like Belgium, including some 499 cattle and the Vermont
sheep. This strategy does not acknowledge imports of rendered bovine
products from England during the BSE period nor secondary products such as
surgical catgut, which is to say surgical cowgut, or dairy cattle embryos,
vaccines for veterinarian and human medicines. What has become of these?

Mr. Singeltary, who lost his mother to CJD of unexplained origin a few years
back and went on to became a well-known TSE activist, has tracked down
voluminous pertinent import data through correspondence with UK officials
and searches of government web sites. Imports of such products are
frequently cited by Europeans in rating BSE risks in the US and in shutting
out US exports.

Many people's eyes glaze over when reviewing reams of sometimes older trade
statistics. There is no proof that any of the imported products was
contaminated with BSE nor if so, any evidence that any BSE product lead to
infection in US livestock, surgical patients, or what not. Nonetheless, the
data obtained by Mr. Singeltary establish that an appalling variety and
tonnage of products that were imported by the US from the UK and othr
BSE-affected countries during the peak of the BSE epidemic years.]

10 January 1990





2.1 At the first meeting of the Working Party on Bovine
Spongiform Encephalopathy on 6 September 1989, detailed
consideration was given to XXXXX Surgical Catgut. This
arose from the Company's response to the Letter to License
Holders, indicating that the bovine small intestine source
material was derived from UK cattle, unlike 8 other
licensed catgut sutures. In contrast XXXXX Surgical
Catgut was stated to hold over 90% share of the market for
catgut sutures, and to constitute approximately 83% of all
sutures used in U.K.


snip... see full text ;


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