Laprevotte Ivan, Hénaut Alain
Laboratoire Génome et Informatique, UMR CNRS 8116, Tour Evry 2, 523 Place des Terrasses, 91034 Evry Cedex, France.
BMC Public Health. 2003 Aug 6;3:25. doi: 10.1186/1471-2458-3-25.
A new variant of Creutzfeldt-Jakob disease was described in the United Kingdom. It is often claimed that it is caused by consumption of food infected with the agent of bovine spongiform encephalopathy. However, this remains open to question because the number of cases of the variant is, at the present time, less than would be expected from a major food-borne source.
The EUROCJD cooperative study presents currently available epidemiological data of Creutzfeldt-Jakob disease and its new variant, for nine European countries plus Australia and Canada. Unexpectedly, for the United Kingdom where all but a few cases of the new variant have been reported, these cases have to be included in the incidence curve of the sporadic forms of the disease in order to obtain the best fit with the median curve from all the countries. This variant could be merely a rare clinical phenotype within the sporadic disease. The published clinical and experimental data which suggest that it is linked with bovine spongiform encephalopathy, lead us to propose that this link could be a common etiological origin other than consumption of bovine infected food. In any case, public health recommendations hold and further investigation is required.
The lack of a relative increase of the Creutzfeldt-Jakob-disease mortality rate in the United Kingdom, does not fit well with the new variant being the consequence of consumption of food infected with the agent of bovine spongiform encephalopthy.
英国发现了一种新型克雅氏病。人们常称其由食用感染牛海绵状脑病病原体的食物所致。然而,这一点仍存在疑问,因为目前该变体病例数少于主要食源性来源所预期的数量。
欧洲克雅氏病协作研究提供了九个欧洲国家以及澳大利亚和加拿大目前可得的克雅氏病及其新变体的流行病学数据。出人意料的是,在除少数几例新变体病例外所有病例均已上报的英国,为了使其发病率曲线与所有国家的中位数曲线达到最佳拟合,这些病例必须纳入散发性疾病的发病率曲线中。该变体可能仅仅是散发性疾病中一种罕见的临床表型。已发表的临床和实验数据表明它与牛海绵状脑病有关,这使我们提出这种关联可能源于除食用感染牛的食物之外的共同病因。无论如何,公共卫生建议仍然适用,需要进一步调查。
英国克雅氏病死亡率没有相对上升,这与新变体是食用感染牛海绵状脑病病原体的食物所致的观点不太相符。