Early identification of variant Creutzfeldt-Jakob diseaseBMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7131.563 (Published 14 February 1998) Cite this as: BMJ 1998;316:563
Some promising approaches but no clear answers yet
- Maurizio Pocchiari, Professor of virology
- Istituto Superiore di Sanita, 00161 Rome, Italy
See pp 577, 593
Unequivocal evidence now exists that the variant form of Creutzfeldt-Jakob disease is caused by the same strain of agent as bovine spongiform encephalopathy and that this strain differs from other strains isolated from cases of classic sporadic Creutzfeldt-Jakob disease. 1 2 At present definitive diagnosis of either form of the disease is possible only after death, but clinicians are under great pressure to distinguish between the two forms and in particular to be able to identify cases of variant Creutzfeldt-Jakob disease as early as possible.
Exposure of the human population in Britain to the agent causing variant Creutzfeldt-Jakob disease is likely to have occurred in the 1980s through beef products affected by bovine spongiform encephalopathy. Although it is reassuring that there have been only 24 cases of variant Creutzfeldt-Jakob disease (23 in Britain and 1 in France) and that the number of new cases did not increase in the last year, it is impossible to predict how many people are now incubating the variant form of disease. As well as concern over the size of any possible “epidemic” there is also the remote possibility that the level of infectivity outside the nervous system is …