Cousens Simon, Everington Dawn, Ward Hester J T, Huillard Jerome, Will Robert G, Smith Peter G
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Stat Methods Med Res. 2003 Jun;12(3):235-46. doi: 10.1191/0962280203sm332ra.
The causative agents of variant Creutzfeldt-Jakob disease (vCJD) and of bovine spongiform encephalopathy (BSE) are currently indistinguishable. However, the route(s) by which humans became infected remain unknown. The path by which humans were infected with the BSE agent might impact on the geographical distribution of cases and we therefore sought evidence of regional variation and local clustering of vCJD cases. With the notable exception of a group of five cases in Leicestershire, the absence of local clustering of vCJD cases is compatible with most human exposure to the vCJD agent arising through routes that result in the risk of infection being similar over wide geographical areas, rather than through small-scale local events. Infection through the consumption of mechanically recovered meat (MRM) contaminated with the BSE agent was a potential route for such widespread exposure. An ecological analysis relating the regional incidence of vCJD to historical dietary data does not provide a dear evidence that humans became infected through consumption of MRM.
变异型克雅氏病（vCJD）和牛海绵状脑病（BSE）的病原体目前无法区分。然而，人类感染的途径仍然未知。人类感染BSE病原体的途径可能会影响病例的地理分布，因此我们寻找vCJD病例区域差异和局部聚集的证据。除了莱斯特郡的一组五例病例外，vCJD病例不存在局部聚集现象，这与大多数人类通过导致感染风险在广泛地理区域相似的途径接触vCJD病原体相一致，而不是通过小规模的局部事件。食用受BSE病原体污染的机械回收肉（MRM）而感染是这种广泛接触的潜在途径。一项将vCJD区域发病率与历史饮食数据相关联的生态分析并未提供确凿证据表明人类是通过食用MRM而感染的。
