Uncertainty in the Tail of the Variant Creutzfeldt-Jakob Disease Epidemic in the UK

被引:44
作者
Garske, Tini [1 ]
Ghani, Azra C. [1 ]
机构
[1] Univ London Imperial Coll Sci Technol & Med, Dept Infect Dis Epidemiol, Med Res Council, Ctr Outbreak Anal & Modelling, London, England
基金
英国医学研究理事会;
关键词
TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES; BLOOD-TRANSFUSION; VCJD EPIDEMIC; PROJECTIONS; INFECTIVITY; RISK; CJD;
D O I
10.1371/journal.pone.0015626
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Despite low case numbers the variant Creutzfeldt-Jakob disease epidemic poses many challenges for public health planning due to remaining uncertainties in disease biology and transmission routes. We develop a stochastic model for variant CJD transmission, taking into account the known transmission routes (food and red-cell transfusion) to assess the remaining uncertainty in the epidemic. We use Bayesian methods to obtain scenarios consistent with current data. Our results show a potentially long but uncertain tail in the epidemic, with a peak annual incidence of around 11 cases, but the 95% credibility interval between 1 and 65 cases. These cases are predicted to be due to past food-borne transmissions occurring in previously mostly unaffected genotypes and to transmissions via blood transfusion in all genotypes. However, we also show that the latter are unlikely to be identifiable as transfusion-associated cases by case-linking. Regardless of the numbers of future cases, even in the absence of any further control measures, we do not find any self-sustaining epidemics.
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页数:12
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