Latest quarterly analysis of variant Creutzfeldt-Jakob disease incidence
in the UK shows continued slowdown

Nick Andrews )
Health Protection Agency Communicable Disease Surveillance Centre,
London, England.

Five new cases of variant Creutzfeldt-Jakob disease (vCJD) were
diagnosed in the United Kingdom (UK) in the first quarter of 2003,
bringing the total number of confirmed or probable cases to 134 (1).
Five deaths occurred in the first quarter, bringing the total number of
deaths to 126. The total number of onsets and deaths by year are shown
in the table.

The quarterly analysis of vCJD incidence published on the CJD
Surveillance Unit website (http://www.cjd.ed.ac.uk/vcjd.htm) shows that
five diagnoses and five deaths are consistent with the continued decline
in vCJD incidence that was first reported in the previous quarter (2,
3). The latest analysis indicates that the underlying incidence trend
may have reached a peak about the year 1999 or 2000, although the small
numbers mean that it is still possible that the incidence has merely
slowed rather than peaked. The estimated current incidence of onsets is
3.2 per quarter and deaths 3.9 per quarter. Extrapolation of the best
fitting model gives an estimate of 12 deaths in the next 12 months with
a prediction interval from 5 to 22.

Further surveillance may show the epidemic to have a long tail or more
than one peak. There is also the theoretical possibility of human to
human spread. The recent decline in incidence should therefore be
interpreted with caution.

Table: Annual cases by onset and death

Year Onset Death
1994 8 0
1995 10 3
1996 11 10
1997 14 10
1998 17 18
1999 29 15
2000 24 28
2001 16 20
2002 5* 17
2003(Q1) 0* 5
Total 134 126

[Oz: NB still too early to be sure, but looking good.]

also note:

Deaths:
Year *vCJD Total CJD
1990 - 33
1991 - 36
1992 - 53
1993 - 46
1994 - 61
1995 3 47 Note: CJD starts being properly reported in UK.
1996 10 60
1997 10 80
1998 18 89
1999 15 85
2000 28 81
2001 20 82
2002 17 86
2003* 6 16



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Oz
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