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From: Terry S. Singeltary Sr. (216-119-132-82.ipset12.wt.net)
Subject: A case-control study of sporadic Creutzfeldt-Jakob disease in the United Kingdom Analysis of clustering
Date: December 13, 2004 at 2:48 pm PST

-------- Original Message --------
Subject: A case-control study of sporadic Creutzfeldt-Jakob disease in the United Kingdom Analysis of clustering
Date: Mon, 13 Dec 2004 16:36:40 -0600
From: "Terry S. Singeltary Sr."
Reply-To: Bovine Spongiform Encephalopathy
To: BSE-L@LISTSERV.KALIV.UNI-KARLSRUHE.DE


##################### Bovine Spongiform Encephalopathy #####################

NEUROLOGY 2004;63:2077-2083
© 2004 American Academy of Neurology

A case-control study of sporadic Creutzfeldt-Jakob disease in the
United Kingdom


Analysis of clustering

L. Linsell, MSc, S. N. Cousens, MA, P. G. Smith, DSc, R. S.G. Knight,
FRCPE, M. Zeidler, MRCP, G. Stewart, MRCP, R. de Silva, MRCP, T. F.G.
Esmonde, MD, FRCP, H. J.T. Ward, MFPHM and R. G. Will, FRCP

From the Department of Infectious and Tropical Diseases (Dr. Smith, L.
Linsell and S.N. Cousens), London School of Hygiene and Tropical
Medicine, London, and National CJD Surveillance Unit (Drs. Knight,
Zeidler, Stewart, de Silva, Esmonde, Ward, and Will), Western General
Hospital, Edinburgh, UK.

Address correspondence and reprint requests to S.N. Cousens, London
School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT,
UK; e-mail: simon.cousens@lshtm.ac.uk

Background: The authors investigated whether cases of sporadic
Creutzfeldt-Jakob disease (CJD) had lived closer to one another at some
time in life than individuals without sporadic CJD. Such a phenomenon
would be compatible with some cases resulting from transmission.

Methods: UK sporadic CJD cases occurring from 1990 to 1998 were
identified. Age-, sex- and hospital-matched controls were recruited.
Lifetime residential histories were obtained by interview, usually with
a proxy respondent. With use of Monte Carlo simulation, the residential
proximity of cases during various time periods was compared with that
expected in the absence of any clustering, using the information
collected on the controls.

Results: Two hundred twenty sporadic CJD disease cases and 220 controls
were included. Cases lived closer together than might be expected in the
absence of any disease-clustering mechanism. This evidence became
stronger as the critical period during which residential proximity was
required to have occurred extended further into the past.

Conclusions: These findings are consistent with some sporadic
Creutzfeldt-Jakob disease (CJD) cases resulting from exposure to a
common external factor. The rarity of sporadic CJD suggests that
repeated point-source outbreaks of infection are more likely to explain
our observations than direct case-to-case transmission. Identifying
sources of such outbreaks many years after the event will be extremely
difficult.

------------------------------------------------------------------------

Received March 17, 2004. Accepted in final form August 12, 2004.

The views expressed in this publication are those of the authors and not
necessarily those of the Department of Health.


http://www.neurology.org/cgi/content/abstract/63/11/2077?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=prion&searchid=1102976800949_6600&stored_search=&FIRSTINDEX=0&volume=63&issue=11&journalcode=neurology

TSS

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