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From: TSS ()
Subject: Mortality from Human Transmissible Spongiform Encephalopathies: A Record Linkage Study
Date: April 25, 2005 at 1:00 pm PST

-------- Original Message --------
Subject: Mortality from Human Transmissible Spongiform Encephalopathies: A Record Linkage Study
Date: Mon, 25 Apr 2005 15:03:51 -0500
From: "Terry S. Singeltary Sr."
To: Bovine Spongiform Encephalopathy


Original Paper

Mortality from Human Transmissible Spongiform Encephalopathies: A Record
Linkage Study
Susanna Contia, Maria Masoccoa, Virgilia Toccacelia, Monica Vichia, Anna
Ladoganab, Susanna Almontib, Maria Puopolob, Maurizio Pocchiarib

aNational Center of Epidemiology, Surveillance and Health Promotion, and
bDepartment of Cell Biology and Neurosciences, Istituto Superiore di
Sanità, Rome, Italy

Address of Corresponding Author


Neuroepidemiology 2005;24:214-220 (DOI: 10.1159/000085139)

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Key
Words

* Creutzfeldt-Jakob disease
* Mortality
* Record linkage

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Abstract

To evaluate the ability of the Italian Creutzfeldt-Jakob (CJD) register
to detect human transmissible spongiform encephalopathy (TSE) cases we
compared mortality data from the CJD register with those obtained from
death certificates collected by the Italian National Census Bureau
(ISTAT) between 1993 and 1999. We used the method of record linkage to
compare and integrate data from these two sources. The integrated
estimate of TSE deaths was 457: 183 deaths recorded by the CJD register
and ISTAT, 210 cases only by the CJD register, and 64 cases only by
ISTAT. The average integrated estimated mortality rate was 1.58 deaths
per million people per year over the study period and peaked in 1999 at
2.13. This figure is similar to that obtained from data from the CJD
register alone in the years 2000-2002. The increase in mortality rates
is likely due to an improvement in case ascertainment. The
misclassification of cases by ISTAT was above 50% from 1996 onward,
suggesting that using only death certificates is not a reliable way to
monitor TSE cases in Italy.

Copyright © 2005 S. Karger AG, Basel

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Author
Contacts

Maurizio Pocchiari, MD
Department of Cell Biology and Neurosciences
Istituto Superiore di Sanità
Viale Regina Elena 299, IT-00161 Rome (Italy)
Tel. +39 06 49903202, Fax +39 06 49903012, E-Mail pocchia@iss.it


http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=NED2005024004214

> The misclassification of cases by ISTAT was above 50% from 1996
> onward, suggesting that using only death certificates is not a
> reliable way to monitor TSE cases in Italy.


Italy is not the only country that states this ;

THE EPIDEMIOLOGY OF CJD RG WILL 1984 (182 PAGES)

snip...

One reason for this was the _inaccuracy_ in coding of cases correctly
certified as CJD Coding is carried out by staff who are not medically
qualified and it is not surprising that coding errors occur in the
processing of large numbers of certificates. In 1982, 12,000
certificates per week were processed at the office of population
censuses and surveys bu 15 coders and 6 checkers (Alderson et al.,
1983). The occurrence of both inter- and intra-observer coding errors
has been described (Curb et al., 1983) and the _inaccuracies_ of BOTH
certification and coding discovered in this study _support_ the
introduction of a more accurate system of death certificates and a more
detailed and specific coding system...

snip...

http://www.bseinquiry.gov.uk/files/mb/m26/tab01.pdf

AS implied in the Inset 25 we must not _ASSUME_ that transmission of BSE
to other species will invariably present pathology typical of a
scrapie-like disease.

snip...

http://www.bseinquiry.gov.uk/files/yb/1991/01/04004001.pdf


SADLY, in the USA, the federal gov. does not want to find
any TSE in humans or animals, so they simply dont look. CJD
not mandatory reportable of all ages in all states, dont test all cattle
for human and animal consumption. in fact, if you count the
3 positive, positive, inconclusives (without western blot), and
the one that got away in TEXAS, the stumbling and staggering one
they ordered to go directly to be rendered, the one that showed
all the signs of a clinical BSE cow, the one Austin officials ordered
NOT to be BSE tested, if you count all these mad cows, in
reallity, there should be 5 documened mad cows in the USA
counting the one old Dave capped in the wrong place, the healthy
walker, sub-clinical cow. Any country out there trying to keep
BSE/TSE from there country would be foolish under present
circumstance to import anything from North America in relations
to BSE/TSE. This includes a wide variaty of products too, not just
a slab of meat...

> The increase in mortality rates is likely due to an improvement in
> case ascertainment. The misclassification of cases by ISTAT was above
> 50% from 1996 onward, suggesting that using only death certificates is
> not a reliable way to monitor TSE cases in Italy.


ONE other thing, the statement above seems to contradict itself.
how in the hell can they claim on the one hand that they misclassified
over 50% of the cases from 1996 onward, but yet claim mortality
rates is likely due to an improvement in case ascertainment. that's
a load of BSe if i ever heard it. Every time a country finds an
increase in CJD, famous last words are ;

> likely due to an improvement in case ascertainment


IT could also very well mean that CJD is rising...

TSS






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