Kersseboom R, Koekoek S C, Richardus J H
Medische Faculteit, Erasmus Universiteit, Postbus 1738, 3000 DR Rotterdam.
Ned Tijdschr Geneeskd. 2002 Apr 20;146(16):754-9.
Variant Creutzfeldt-Jakob disease (vCJD) is a fatal and untreatable neurological disease, in which pathogenic prions (PrPSc) are involved. There is convincing epidemiological and experimental evidence that vCJD is a human expression of bovine spongiform encephalopathy (BSE). The risk of transmission of pathogenic prions which cause vCJD to humans is influenced by the species barrier, genetic susceptibility of the host, dose of infection and route of exposure. Transmission of pathogenic prions from bovines to humans is possible through meat products containing nerve and lymphatic tissue, and through medical products derived from bovine material. Human to human transmission is, in principle, also possible via blood and blood-derived products, human organs and tissues for transplantation, and through surgical instruments. Preventive measures to reduce transmission from bovines to humans have been introduced step by step in the Netherlands since 1989. With proper implementation, the current risk of becoming infected by Dutch meat products is small. It is very likely, however, that in the past decade BSE-infected bovines have entered the food chain. The Dutch population has also been exposed to foreign infected meat products. Measures to prevent human to human transmission are currently being improved in the Netherlands. It is expected that cases of vCJD will occur in the Netherlands in the future, but the number cannot be estimated accurately. The presence of PrPSc in both the livestock and in the human population in the Netherlands constitutes a permanent public health threat and is a reason for continued vigilance and active prevention.
变异型克雅氏病（vCJD）是一种致命且无法治疗的神经疾病，其发病涉及致病性朊病毒（PrPSc）。有令人信服的流行病学和实验证据表明，vCJD是牛海绵状脑病（BSE）在人类身上的表现形式。导致vCJD的致病性朊病毒传播给人类的风险受到物种屏障、宿主的遗传易感性、感染剂量和接触途径的影响。致病性朊病毒可通过含有神经和淋巴组织的肉类产品以及源自牛材料的医疗产品从牛传播给人类。人与人之间的传播原则上也可通过血液及血液制品、用于移植的人体器官和组织以及手术器械实现。自1989年以来，荷兰已逐步采取预防措施以减少从牛到人的传播。如果措施落实得当，目前食用荷兰肉类产品感染的风险较小。然而，在过去十年中，感染疯牛病的牛很可能已进入食物链。荷兰民众也接触过国外受感染的肉类产品。目前荷兰正在改进预防人与人之间传播的措施。预计未来荷兰会出现vCJD病例，但具体数量无法准确估计。荷兰家畜和人群中PrPSc的存在对公共卫生构成了持续威胁，也是需要继续保持警惕并积极预防的原因。
