Probable variant Creutzfeldt–Jakob disease in Asia: A case report from Taiwan and review of two prior cases
Chih-Wen Yang MD1,3, Jong-Ling Fuh MD1,3, Shuu-Jiun Wang MD1,3,*, Jiing-Feng Lirng MD2,3, Chih-Chao Yang MD4, Shih-Jung Cheng MD5 Article first published online: 25 NOV 2010
Keywords: magnetic resonance imaging; prion; pulvinar sign; variant Creutzfeldt–Jakob disease
New variant Creutzfeldt–Jakob disease (vCJD) was first identified in the UK in 1996, and was causally linked to bovine spongiform encephalopathy. Herein we report the first case of vCJD in Taiwan: a 34-year-old man who had lived in the UK between 1989 and 1997. The patient presented with depression, irritability, personality change, painful feet and allodynia, followed by gait ataxia and cognitive impairment. Electroencephalograms did not show the typical appearance of sporadic CJD. The cerebrospinal fluid 14-3-3 protein immunoassay was negative. Brain magnetic resonance imaging revealed high signal lesions involving bilateral caudate nuclei, left lentiform nucleus, bilateral dorsomedial thalami and pulvinar on fluid-attenuation inversion recovery, T2- and diffusion-weighted imaging. Prion protein gene analysis showed homozygous for methionine at codon 129. The patient developed akinetic mutism at 16 months and died at 28 months after onset. The clinical presentation and neuroimaging findings were compatible with the vCJD cases reported since 1996, and met the World Health Organization Case Definition for probable vCJD. In this communication, we also review two other cases of vCJD in Asia. All three cases were assumed as imported cases from the UK because of the residential or travel history of the patients.
European Journal of Epidemiology Volume 25, Number 5, 341-347, DOI: 10.1007/s10654-010-9446-4
Incidence of Creutzfeldt-Jakob disease in Taiwan: a prospective 10-year surveillance
Chien-Jung Lu, Yu Sun and Shun-Sheng Chen
Abstract This study was performed to estimate the incidence of Creutzfeldt-Jakob Disease (CJD) in Taiwan from 1998 to 2007. Suspected cases of CJD were reported to the Taiwan Creutzfeldt-Jakob Disease Surveillance Unit, a nationwide, hospital-based case report system initiated since 1996 to prospectively conduct a CJD epidemiological study. Consecutive patients who met the diagnostic criteria recommended by the World Health Organization were enrolled. The clinical information of each suspected case was collected and case ascertainment was performed by an expert committee. A total of 123 sporadic CJD were identified without any iatrogenic or new variant CJD cases. The overall annual incidence rate (95% CI) was 0.55 (0.46–0.65) cases per million person-year. There was no statistically significant difference between the calendar year of disease onset (P = 0.97). The incidence rates were not significantly different between women and men (P = 0.63). Age was the main factor for the risk of CJD (P < 0.0001). Age-specific incidence rate increased after the age of 40 years with the peak being in the 70–79 years age group. Our data showed low annual incidence rate and high frequency of methionine homozygous prion protein genotype of sCJD in Taiwan. This report provided important epidemiological data on ethnic Chinese. Keywords Creutzfeldt-Jakob disease - Epidemiology - Incidence - Genotype - Ethnic Chinese
Taiwan advises against import of U.S. beef tongues
AIT Director defends tongues as without risk
Taiwan News, Staff Writer 2010-04-20 02:53 PM Fonts Size:
TAIPEI (Taiwan News) – In a surprise reversal of policy, the government told meat traders Tuesday it advised them against importing beef tongues, diaphragms and testicles from the United States, despite a claim by Washington’s top representative in Taiwan that they posed no threat to health. The government said inspectors would check each case of beef including tongues, diaphragms and testicles, instead of just the first case of each batch, as it had announced earlier.
“Consumers still have doubts about the safety of tongues and testicles, so it’s best not to import them,” said Kang Jaw-jou, director-general of Taiwan’s Food and Drug Administration.
The U.S. Department of Agriculture announced last week it would allow the export to Taiwan of hanging tenders, tongues, tails, penises, testicles, tendons, and diaphragms from cattle younger than 30 months or slaughtered since the beginning of the month.
While Taiwan agreed the imports were legal under a protocol both countries signed last October, there was still widespread doubt about the new products. Tongues could still pose a risk for bovine spongiform encephalopathy or mad cow disease, consumers groups and lawmakers said.
After first approving of the new products, government officials held a news conference Tuesday to announce they advised traders against importing the products for the time being, even though they would not impose a ban.
An importer who saw his application for 453 kilograms of U.S. beef products approved on April 15 decided to cancel his order, said Huang Chih-peng, the director-general of the Ministry of Economic Affairs’ Bureau of Foreign Trade, which reviews the applications.
Huang said he had personally talked to the company, which canceled its plan in a concrete response to health doubts.
Inspectors would also test each case or box of tongues and related products, and not just one case from each batch, the government said.
American Institute in Taiwan Director William Stanton said the beef products were completely safe. Some people would bring up the subject for political purposes, but this had nothing to do with health, he said.
Tongues had never been regarded as a risky part of cattle, and the protocol never banned the product, Stanton said. He rejected a statement by Vice Foreign Minister Shen Lyu-shun to the effect that last week’s decision by the USDA to allow the export of tongues was made unilaterally without consulting Taiwan.
The Office of the United States Trade Representative said Monday it was deeply disappointed with Taiwan’s decision to toughen up inspections because it was not consistent with the protocol.
Lawmakers accused the government of going against the Legislative Yuan’s January decision to ban the import of internal organs by agreeing to allow diaphragms and testicles.
William Lai of the Democratic Progressive Party said that the beef products were included under the section for internal organs during Taiwan-U.S. negotiations and therefore also fell under the Legislative Yuan ban.
Ruling Kuomintang lawmaker Tsai Chin-lung told reporters he did not dare eat the beef tongues and testicles because they were too risky. His KMT colleague Wu Ching-chih agreed and said the products should be banned.
----- Original Message -----
From: Terry S. Singeltary Sr.
Sent: Monday, November 02, 2009 10:20 AM
Subject: MAD COW DISEASE, CJD, AND OTHER TSE IN THE USA, THE TRUTH
Dear Honorable Chairman Hsieh Tien-jen and general of the Consumers' Foundation, Wu Jia-cheng,
A kind greetings from Bacliff, Texas !
I wish to send you urgent data on the truth about mad cow disease in the USA.
----- Original Message -----
From: Terry S. Singeltary Sr.
To: XXXXXXX@ms14.hinet.net Cc: XXXXXXX@mail-consumers.org.tw
Sent: Monday, April 19, 2010 12:55 PM
Subject: MAD COW DISEASE AND CJD USA MAMMALIAN PROTEIN FEED AND SRM
A Kind Greetings from Bacliff, Texas.
I send this information as a follow up and update...
Kindest Regards, Terry
North Dakota Firm Recalls Whole Beef Head Products That Contain Prohibited Materials
Recall Release CLASS II RECALL FSIS-RC-023-2010 HEALTH RISK: LOW
Congressional and Public Affairs (202) 720-9113 Catherine Cochran
WASHINGTON, April 5, 2010 - North American Bison Co-Op, a New Rockford, N.D., establishment is recalling approximately 25,000 pounds of whole beef heads containing tongues that may not have had the tonsils completely removed, which is not compliant with regulations that require the removal of tonsils from cattle of all ages, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today.
Tonsils are considered a specified risk material (SRM) and must be removed from cattle of all ages in accordance with FSIS regulations. SRMs are tissues that are known to contain the infective agent in cattle infected with Bovine Spongiform Encephalopathy (BSE), as well as materials that are closely associated with these potentially infective tissues. Therefore, FSIS prohibits SRMs from use as human food to minimize potential human exposure to the BSE agent.
Wednesday, April 30, 2008
Consumption of beef tongue: Human BSE risk associated with exposure to lymphoid tissue in bovine tongue in consideration of new research findings
Sunday, October 18, 2009
Wisconsin Firm Recalls Beef Tongues That Contain Prohibited Materials SRM WASHINGTON, October 17, 2009
Thursday, October 15, 2009
Nebraska Firm Recalls Beef Tongues That Contain Prohibited Materials SRM WASHINGTON, Oct 15, 2009
Tuesday, December 29, 2009
Taiwan to resume USA beef ban over mad cow disease threat
Tuesday, November 10, 2009
Surveillance On the Bovine Spongiform Encephalopathy and rabies in Taiwan and USA
Monday, November 30, 2009
Taiwan, USDA, and USA beef, what the consumer does not know, could kill them
Monday, November 22, 2010
Atypical transmissible spongiform encephalopathies in ruminants: a challenge for disease surveillance and control
Sunday, November 21, 2010
Preclinical Deposition of Pathological Prion Protein in Muscle of Experimentally Infected Primates and potential Iatrogenic TSE there from
Thursday, November 18, 2010
UNITED STATES OF AMERICA VS GALEN J. NIEHUES FAKED MAD COW FEED TEST ON 92 BSE INSPECTION REPORTS FOR APPROXIMATELY 100 CATTLE OPERATIONS