ORIGINAL RESEARCH article
Front. Public Health, 12 June 2024 Sec. Infectious Diseases: Epidemiology and Prevention Volume 12 - 2024 | https://doi.org/10.3389/fpubh.2024.1411489
Updated global epidemiology atlas of human prion diseases
Li-Ping GaoLi-Ping Gao1Ting-Ting TianTing-Ting Tian1Kang XiaoKang Xiao1Cao ChenCao Chen1Wei ZhouWei Zhou1Dong-Lin LiangDong-Lin Liang1Run-Dong CaoRun-Dong Cao1Qi Shi Qi Shi1*Xiao-Ping Dong,,, Xiao-Ping Dong1,2,3,4*
1National Key-Laboratory of Intelligent Tracking and Forecasting for Infectious Disease, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China 2Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China 3China Academy of Chinese Medical Sciences, Beijing, China 4Shanghai Institute of Infectious Disease and Biosafety, Shanghai, China
Introduction: Human prion disease (PrD), a group of fatal and transmissible neurodegenerative diseases, consists of Creutzfeldt–Jakob disease (CJD), kuru, fatal familial insomnia (FFI), Gerstmann-Sträussler-Scheinker disease (GSS), and variably protease-sensitive prionopathy (VPSPr). The emergence of bovine spongiform encephalopathy (BSE) in cattle and variant CJD (vCJD) has greatly threatened public health, both in humans and animals. Since the 1990's, dozens of countries and territories have conducted PrD surveillance programs.
Methods: In this study, the case numbers and alternative trends of different types of PrD globally and in various countries or territories from 1993 to 2020 were collected and analyzed based on the data from the websites of the international and national PrD surveillance programs, as well as from relevant publications.
Results: The total numbers of the reported PrD and sporadic CJD (sCJD) cases in 34 countries with accessible annual case numbers were 27,872 and 24,623, respectively. The top seven countries in PrD cases were the USA (n = 5,156), France (n = 3,276), Germany (n = 3,212), Italy (n = 2,995), China (n = 2,662), the UK (n = 2,521), Spain (n = 1,657), and Canada (n = 1,311). The annual PrD case numbers and mortalities, either globally or in the countries, showed an increased trend in the past 27 years. Genetic PrD cases accounted for 10.83% of all reported PrD cases; however, the trend varied largely among the different countries and territories. There have been 485 iatrogenic CJD (iCJD) cases and 232 vCJD cases reported worldwide.
Discussion: The majority of the countries with PrD surveillance programs were high- and upper-middle-income countries. However, most low- and lower-middle-income countries in the world did not conduct PrD surveillance or even report PrD cases, indicating that the number of human PrD cases worldwide is markedly undervalued. Active international PrD surveillance for both humans and animals is still vital to eliminate the threat of prion disease from a public health perspective.
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Results
Spatiotemporal distribution of all PrD and sCJD cases
The case numbers of all PrD and sCJD from 32 countries with accessible surveillance data between 1993 and 2020 were collected. In total, 27,872 PrD cases and 24,623 sCJD cases were reported, of which sCJD cases occupied 88.3% of all PrDs. As shown in Figure 1A, the reported case numbers showed an increasing trend from 1993 to 2020. The average case numbers of all PrDs and sCJD per year were 508.4 and 431.4 in the initial 8 surveillance years (1993–2000), 1,042.3 and 915.8 in the second 10 years (2001–2010), 1,338.2 and 1,201.4 in the last 10 years (2011–2020), respectively.
Among the selected countries, Australia, Austria, France, Canada, Germany, Italy, the Netherlands, Slovakia, Slovenia, Spain, Switzerland, and the UK had continuous surveillance data from 1993 to 2020. Belgium, Denmark, Finland, Hungary, Ireland, Norway, Portugal, and Sweden had the data from 1996 or 1997 to 2020. Czech Republic, Korea, and China had the data from 2000, 2001, and 2006, respectively. Israel had the data from 1993 to 2012, while Green and Argentina had the data from 1997 to 2008. Due to the inaccessibility of the data from 2019 and 2020 for several countries, the PrD case numbers of PrDs and the reporting countries in the last 2 years were relatively fewer compared to those of 2016 and 2017 (Figure 1A).
The total reported case numbers of all PrDs and sCJDs in the selected countries are shown in Figure 1B. The countries with PrD case numbers over 1,000 were the USA (n = 5,156), France (n = 3,276), Germany (n = 3,212), Italy (n = 2,995), China (n = 2,662), the UK (n = 2,521), Spain (n = 1,657), and Canada (n = 1,311). The countries that reported more than 500 PrD cases were Australia (n = 886), the Netherlands (n = 620), and South Korea (n = 579). Eight other countries reported more than 300 cases, including Austria, Belgium, Czech Republic, Israel, Sweden, Switzerland, Slovakia, and Hungary. Furthermore, the annual diagnosed PrD cases in 24 countries were separately calculated. Except for Belgium, all countries showed increased tendencies for the annual diagnosed PrD cases in the surveillance years (Figure 1C). The case numbers varied largely among the countries but were generally associated positively with the national population sizes.
Proportions of genetic PrD (gCJD, FFI, and GSS)
The case numbers of genetic PrD, including gCJD, FFI, and GSS, in dozens of countries were counted, and the percentages of genetic PrD out of all PrD were calculated (Figure 2). Among the 24 counties or territories, a total of 3,010 genetic PrD cases were reported according to the official websites and literature pieces (19, 20), which accounted for 10.83% of all reported PrD cases. The genetic PrD percentage of Japan was cited from a 10-year surveillance report (16, 21). Overall, the genetic PrD percentages of 11 countries were in the range of 5–10%, i.e., China, the USA, the UK, Spain, Australia, Austria, France, Canada, Germany, South Korea, and Slovenia. Seven countries or territories showed relatively low (below 5%) genetic PrD percentages, such as Sweden, Belgium, Ireland, the Netherlands, Norway, Portugal, and Taiwan-China. The genetic PrD percentages of Japan, Italy, and the Czech Republic were in the ranges of 10–20%. Israel, Slovakia, and Hungary had much higher genetic PrD percentages of 69.57, 60.30, and 36.31%, respectively.
AMRs of sCJD worldwide
Based on the surveillance or reported case numbers of sCJD, the sCJD incidences in various countries were estimated. The average AMRs of sCJD from 1993 to 2020 are shown in Figure 3A. Among the 34 selected countries, Slovakia and Israel showed the highest AMRs, which were 2.57 and 2.41/million, respectively. The AMRs of 21 countries were higher than 1.0/million; among them, eight countries (France, Italy, Austria, Switzerland, Canada, Hungary, Slovenia, and Sweden) showed AMRs higher than 1.5/million. The alterations of the AMRs of 24 countries with consecutive surveillance data over 10 years from 1993 to 2020 were selected and are illustrated in Figure 3B. Most of the countries revealed an increased trend in the reported incidences.
Distribution of acquired PrD (Kuru, vCJD, and iCJD) cases
To date, Kuru has only been detected in the Fore tribe in Papua New Guinea because of ritualistic mortuary cannibalism (22, 23). The Kuru epidemic peaked in the late 1950's (23) and subsided following the prohibition of cannibalism in the mid-1950's (24). However, Kuru did not manifest until several decades after exposure, due to the heterozygous mutation at codon 129 (23).
Another form of acquired prion disease is iCJD. There have been at least 485 iCJD cases reported worldwide; 96.7% of them were identified before 2012 (25). In addition to a small number of iCJD cases being caused by neurosurgical instrument contamination (four cases), contaminated electroencephalogram (EEG) needles (two cases), corneal grafts (two cases), and gonadotrophic hormone (four cases), the majority of the iCJD cases were caused by administrations of growth hormone (226 cases) and dura mater grafts (228 cases) derived from human cadavers with undiagnosed CJD contaminations (25). As shown in Figure 4A, 18 countries have reported iCJD cases associated with dura mater grafts; the top five countries were Japan (n = 142), Spain (n = 14), and France (n = 13). Nine countries have reported iCJD cases caused by growth hormones; the top three countries were France (n = 119), the UK (n = 65), and the USA (n = 29). Since 2013, there have been 16 iCJD cases reported: 11 in the UK, 4 in the USA, and 2 in Canada.
In total, 232 vCJD cases have been reported worldwide since 1995. The case numbers of vCJD reached its peak during the period from 1998 to 2003 and have decreased markedly since 2004 (Figure 4B). Globally, 12 countries or regions have reported definite and probable vCJD cases: 96.12% of vCJD cases in Europe, 2.59% in North America, and 1.29% in Asia. Overwhelmingly, more vCJD cases (n = 178) were identified in the UK, which accounted for 76.72% of all vCJD cases in the world, followed by France (12.07%, n = 28). Remarkably few cases were identified in the other countries or regions, including Spain (n = 5), the USA and Ireland (n = 4), Italy and the Netherlands (n = 3), Canada and Portugal (n = 2), Japan, Taiwan-China, and Saudi Arabia (n = 1). Moreover, the secondary infections with variant CJD transmitted by transfusion of blood products were verified in the UK (n = 3) in 2003 (26), 2004 (27), and 2006 (28). Compared to the period of the vCJD peak in the UK (1998–2003), the vCJD peak period for the remaining 11 countries or regions was late (2003–2008). Up to 28 cases were reported in the UK in 2000 and 21 in 2001 (Figure 4C).
CJD cases reported in Africa
An early study described 23 CJD cases of North African immigrants to France (12 came from Tunisia and 11 from Algeria) from 1968 to 1982 (29). Another report briefly described 13 CJD cases (four definite, seven probable, and two possible sCJD cases) in Kenya from 1990 to 2004 based on a hospital (30). There were several case reports of CJD in African countries, e.g., the first sCJD case in Morocco in 2005, which was confirmed by postmortem histology (31), a probable CJD in Egypt in 2019 (32), and the first Heidenhain variant of sCJD from East Africa in 2021 (33). In 2006, South Africa reported the first dura mater graft-associated iCJD cases (34). A few gCJD cases, such as V201I in a Moroccan patient and a 5-octapeptide repeat insertion (5-OPRI) in a South African family, were reported (35, 36).
Discussion
In this present study, we have reviewed the accessible surveillance data of PrD cases from more than 30 countries worldwide from 1993 to 2020. The majority of the surveillance data comes from countries in Europe, North America, and Eastern Asia. Although CJD has been described for a long time, the global surveillance for CJD/PrD has been implemented since the 1990's under the framework of the WHO, along with the emergence of BSE in cattle and vCJD in human (2). The EuroCJD program started in 1993 and consisted of seven countries (Austria, France, Germany, Italy, the Netherlands, Slovakia, and the UK) initially and expanded to other European (Spain) and non-European (Australia and Canada) countries later. In 2007, another broader surveillance program, NeuroCJD, was initiated, covering almost all European countries. Meanwhile, Argentina, Australia, Japan, Canada, Mexico, China, Israel, and the USA, among other countries, conducted their national surveillance programs and joined the global network.
The annual identified PrD case numbers and PrD-reported mortality, either worldwide or in the country or territory, increased from 1993 to 2020, with there being an almost 2-fold increase. One of the most important reasons for such increases is the implementation of ~30 years-long surveillance for CJD globally, which remarkably improves the awareness of PrD both in the professional field and the public community. Along with the progression of the overall diagnosis, the development and progression of new and specific techniques help greatly to recognize and diagnose the PrD cases, such as brain MRI, RT-QuIC, and the detection tools for some cerebral spinal fluid (CSF) proteins. The new techniques have led to a revision of the WHO-accepted diagnostic criteria on more than one occasion, so case classification has altered, with some cases (previously in possible or doubtful categories) currently being reported as probable. Additionally, the aging of the population worldwide in the past three decades may also influence the PrD annual incidence.
As a rare neurological disease, the recognition and diagnosis of PrD/CJD are still difficult in many low- and lower-middle-income countries. A few CJD cases have been reported in the literature in some African countries. In Asia, only Japan, South Korea, Mailand-China, and Taiwan-China conducted long-term PrD surveillance programs. A total of about 30 CJD cases have been reported in India over the past 30 years (37); since then, only a few studies have reported CJD (38–40). Sporadic cases of PrD have been reported in several other Asian countries, such as Pakistan, Thailand, Omen, and Singapore (41–43). A few sCJD cases have been reported in Malaysia (44). Among the countries of Middle and South America, some such as Argentina, Chile, Mexico, Brazil, and Peru have reported their data of PrD surveillance or studies. For example, in Argentina, 211 cases have been reported from 1996 to 2007; in Chile, 230 cases from 2001 to 2007 (45); in Mexico, 29 cases from seven individual studies from 1990 to 2020 (46) and 24 cases in a referral center during 2014–2019 (47); in Brazil, 35 cases during the period 2005–2007 (48), 408 sCJD cases, and several gCJD cases during the period 2005–2020 (48); and in Peru, 11 and six sCJD cases and several gCJD cases from various literatures (49, 50). It is apparent that the PrD or CJD case numbers globally are markedly undervalued, which may pose a potential biosafety risk.
The ratios of genetic PrD cases, including gCJD, FFI, and GSS, in the large portions of the counties recruited in this study are in the expected range (5–15%). Israel and Slovakia show extremely high ratios (over 60%) of genetic PrD. Early studies have already addressed the fact that the incidence of a kind of gCJD, E200K, is frequent among Jews of Libyan origin, which was estimated to be 100 times higher than that in the general population (51–53). Recently, E200K gCJD patients of Turkish ancestry were analyzed, and it was found to display similar demographic and clinical features to those of Libyan descent (54). E200K gCJD is also frequent in Slovakia. A previous study identified the familial clusters among 78 definite CJD cases in Slovakia and an adjacent part of Hungary from 1972 to 1991 (55). Another study has shown that 74.2% (95/136) of Slovakian CJD cases contain the E200K mutation (56). Surveillance of PrD cases in Eastern Slovakia from 2004 to 2016 has identified 21 E200K gCJD and six sCJD cases, with E200K gCJD accounting for 77.78% of the total number of cases (57). The ratio of genetic PrD in Hungary is also much higher (36.35%). Similar to the neighboring country of Slovakia, E200K gCJD is the predominant subtype, which is presumed to relate to the historical migration of the Slovakian population or to being geographically close to Slovakia (58). Japan and Italy also show relatively high ratios of genetic PrD, ~17–18%. More frequent CJD cases with the V180I variant in Japanese (59) and the V210I variant in Italian (60) are possibly associated with those phenomena. On the other hand, the ratios of genetic PrD are very low in several European countries, such as Belgium, the Netherlands, and the Scandinavian countries, such as, Switzerland and Poland, where even fewer genetic PrD cases are reported. In addition to the accessibility of PRNP sequencing, the ethnic-associated distribution of genetic PrD and its subtypes among various countries is apparent.
Acquired CJD has dropped dramatically in the recent decades worldwide. Kuru has been almost eradicated in Papua New Guinea after the prohibition of cannibalism. The two most predominant forms of iCJD, administrations of growth hormone and dura mater grafts, have diminished significantly after the prohibition of their use. It is noteworthy the number of vCJD cases both in the UK and globally has been almost undetected in the past 3 years after the successful implementation of prevention and control measures to remove BSE prions from the animal and human food chains. It is clear that the removal of prion sources successfully contains and eliminates the occurrence and outbreak of human-acquired PrD.
The main surveillance data in this study are derived from the CJD international surveillance network supported by the European Union (EU) CDC and some accessible national CJD surveillance websites. Some countries have only the total numbers of various subtypes of PrDs in a certain period, but without the exact annual numbers. Japan is one of the countries implementing national CJD surveillance programs worldwide. However, the precise annual numbers of PrDs, particularly the data from the last 10 years, are inaccessible. Additionally, the PrD annual data from Chile, Brazil, and Mexico are also lacking. Hence, the global annual PrD number in this context is significantly underestimated. Given the annual mortality of all PrDs of 1 case/million and the global total population of 8.032 billion in 2023 (61), the PrD annual numbers are estimated to be at more than 8,000 at least. Only less than one-fifth of the PrD cases can be recognized and handled properly worldwide, and more importantly, most diagnosed PrD cases are distributed in high- and upper-middle-income countries or territories. As a transmissible fatal neurodegenerative disease lacking prophylactic and therapeutic tools, active international PrD surveillance for both humans and animals still remains vital to eliminate the threat of prion disease from a public health perspective (62).
Conclusion
In the present study, an epidemiological retrospective analysis of PrD was conducted with the purpose of better understanding the spatiotemporal distribution of features across the globe from 1993 to 2020. The case numbers and annual incidence of all types of PrDs reveal an increasing trend, while those of vCJD and iCJD declined remarkably. The surveillance programs are still limited to high- and upper-middle-income countries or territories in Europe, North America, East Asia, and Oceania. A lack of awareness, poor clinical and laboratory capacity, and limited financial resources prohibit the comprehensive understanding of human PrD trends globally. The potential threats of both human and animal prions are far from eliminated. Thereby, the integration and expansion of human and animal PrD monitoring networks in all regions of the world are still needed and should be improved, including the development of simplified and user-friendly detection technologies, digitalized information collection and analysis systems, and easily accessible tissue banks.
Data availability statement
Publicly available datasets were analyzed in this study. This data can be found at: https://www.eurocjd.ed.ac.uk/data_tables.
Front. Public Health, 12 June 2024 Sec. Infectious Diseases: Epidemiology and Prevention Volume 12 - 2024 | https://doi.org/10.3389/fpubh.2024.1411489
Updated global epidemiology atlas of human prion diseases
The top seven countries in PrD cases were the USA (n = 5,156), France (n = 3,276), Germany (n = 3,212), Italy (n = 2,995), China (n = 2,662), the UK (n = 2,521), Spain (n = 1,657), and Canada (n = 1,311).
FRIDAY, MAY 03, 2024
National Prion Disease Pathology Surveillance Center Cases Examined1 April 8th 2024
https://creutzfeldt-jakob-disease.blogspot.com/2024/05/national-prion-disease-pathology.html
TUESDAY, DECEMBER 12, 2023
CREUTZFELDT JAKOB DISEASE TSE PRION DISEASE UPDATE USA DECEMBER 2023
https://creutzfeldt-jakob-disease.blogspot.com/2023/12/creutzfeldt-jakob-disease-tse-prion.html
SUNDAY, NOVEMBER 26, 2023
The role of environmental factors on sporadic Creutzfeldt-Jakob disease mortality: evidence from an age-period-cohort analysis
https://creutzfeldt-jakob-disease.blogspot.com/2023/11/the-role-of-environmental-factors-on.html
MONDAY, APRIL 24, 2023
2023 CDC REPORTS CJD TSE Prion 5 cases per million in persons 55 years of age or older
https://creutzfeldt-jakob-disease.blogspot.com/2023/04/2023-cdc-reports-cjd-tse-prion-5-cases.html
MONDAY, DECEMBER 18, 2023
Change in Epidemiology of Creutzfeldt-Jakob Disease in the US, 2007-2020
SUNDAY, NOVEMBER 26, 2023
The role of environmental factors on sporadic Creutzfeldt-Jakob disease mortality: evidence from an age-period-cohort analysis
https://creutzfeldt-jakob-disease.blogspot.com/2023/11/the-role-of-environmental-factors-on.html
https://creutzfeldt-jakob-disease.blogspot.com/2023/12/change-in-epidemiology-of-creutzfeldt.html
2001 Singeltary on CJD
February 14, 2001
Diagnosis and Reporting of Creutzfeldt-Jakob Disease
Terry S. Singeltary, Sr
Author Affiliations
JAMA. 2001;285(6):733-734. doi:10-1001/pubs.JAMA-ISSN-0098-7484-285-6-jlt0214
To the Editor: In their Research Letter, Dr Gibbons and colleagues1 reported that the annual US death rate due to Creutzfeldt-Jakob disease (CJD) has been stable since 1985. These estimates, however, are based only on reported cases, and do not include misdiagnosed or preclinical cases. It seems to me that misdiagnosis alone would drastically change these figures. An unknown number of persons with a diagnosis of Alzheimer disease in fact may have CJD, although only a small number of these patients receive the postmortem examination necessary to make this diagnosis. Furthermore, only a few states have made CJD reportable. Human and animal transmissible spongiform encephalopathies should be reportable nationwide and internationally.
https://jamanetwork.com/journals/jama/article-abstract/1031186
https://creutzfeldt-jakob-disease.blogspot.com/2023/09/professor-john-collinge-on-tackling.html
FRIDAY, JANUARY 15, 2021
CJD TSE Prion Questionnaire USA, UK, and the history there from, have you filled out this questionnaire?
if not, why not?
https://cjdquestionnaire.blogspot.com/2021/01/cjd-tse-prion-questionnaire-usa-uk-and.html
CJD TSE Prion Questionnaire USA, UK, Singeltary
CJD FOUNDATION Questionnaire
https://cjdfoundation.org/files/pdf/Patient%20Questionnaire%202016.pdf
UK CJD Questionnaire
http://web.archive.org/web/20090506075100/http://www.bseinquiry.gov.uk/files/mb/m26/tab04.pdf
cjd questionnaire 1979
https://webarchive.nationalarchives.gov.uk/ukgwa/20080102185730mp_/http://www.bseinquiry.gov.uk/files/yb/1980/01/31001001.pdf
RE: re-Human Prion Diseases in the United States part 2 flounder replied to flounder on 02 Jan 2010 at 21:26 GMT I would kindly like to add to my initial concerns, something I brought up years ago, and I believe that still hold true today, more so even than when I first stated these concerns in 2003 ;
***> routine passive mortality CJD surveillance USA ?
***> THIS has been proven not to be very useful in the U.K.;
THE EPIDEMIOLOGY OF CJD RG WILL 1984 (182 PAGES)
snip...
One reason for this was the _inaccuracy_ in coding of cases correctly certified as CJD Coding is carried out by staff who are not medically qualified and it is not surprising that coding errors occur in the processing of large numbers of certificates. In 1982, 12,000 certificates per week were processed at the office of population censuses and surveys by 15 coders and 6 checkers (Alderson et al., 1983). The occurrence of both inter- and intra-observer coding errors has been described (Curb et al., 1983) and the _inaccuracies_ of BOTH certification and coding discovered in this study _support_ the introduction of a more accurate system of death certificates and a more detailed and specific coding system...
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http://web.archive.org/web/20040521215716/http://www.bseinquiry.gov.uk/files/mb/m26/tab01.pdf
Draft Proposal For The Monitoring of Creutzfeldt-Kakob Disease 1989 Dr. R. Will
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IDENTIFICATION OF CASES
Cases of CJD may be identified from death certificates, but this alone is unlikely to provide adequate monitoring. ERRORS are made in certification and diagnosis; in the Oxford study death certificates were obtained on a series of known confirmed cases and CJD was mentioned in only 66% of certificates. In another series of 175 certified cases, 42 patients were judged not to have suffered from CJD after examination of case notes (7)...
full text;
http://web.archive.org/web/20050526035006/http://www.bseinquiry.gov.uk/files/yb/1989/05/00005001.pdf
CJD Questionnaire
F. MEDICATIONS, has Subject taken any medications regularly, (if yes, record the date, name of the medication, the reason for taking it, and route of administration) prompt for prescription drugs, including insulin and type. Prompt for hormone therapy or nutritional supplements including oral contraceptives and hormone replacement therapy: Prompt for homeopathic/herbal therapy: Prompt for eye drops SUMMARY OF ABOVE RESPONSES; HAS THE SUBJECT BEEN EXPOSED TO ONE OF THE MEDICATIONS OF BOVINE OR OVINE ORIGIN, AND OR ANY DESICCATED ANIMAL ORIGIN? G. Has Subject ever been tested for allergy using needles? H. Has Subject ever received a treatment involving a course of injections? (If yes, record year, name of therapy, frequency, reason)
https://web.archive.org/web/20090506075100/http://www.bseinquiry.gov.uk/files/mb/m26/tab04.pdf
NOT to open up old wounds, but here is my 23 years of endeavors to get the USA to have a CJD Questionnaire for every family of a person whom died of cjd tse prion in the USA in every State, pertaining to real questions of all the potential routes of CJD in that questionnaire. seems i have failed terribly. there was great debate, much anguish, and i did take it personally, when others took credit for what i had been trying to get done. but this was long ago, and today the CJD Foundation seems to be working hard to change there old ways, and seem to be looking to find the routes of sporadic cjd as well. this is just that history, like it or not...kind regards, terry
THE MAKING OF THE USA CJD QUESTIONNAIRE
https://cjdquestionnaire.blogspot.com/2015/10/cjd-foundation-creutzfeldt-jakob.html
https://creutzfeldt-jakob-disease.blogspot.com/2012/03/cjd-foundation-cwru-gambetti-familial.html
https://cjdquestionnaire.blogspot.com/2009/
http://cjdquestionnaire.blogspot.com/2007/11/cjd-questionnaire.html
https://cjdquestionnaire.blogspot.com/2007/
http://cjdquestionnaire.blogspot.com/
MONDAY, SEPTEMBER 11, 2023
Professor John Collinge on tackling prion diseases sCJD around 1 in 5000 deaths worldwide
“The best-known human prion disease is sporadic Creutzfeldt-Jakob disease (sCJD), a rapidly progressive dementia which accounts for around 1 in 5000 deaths worldwide.”
https://www.ucl.ac.uk/brain-sciences/dementia-ucl-priority/professor-john-collinge-tackling-prion-diseases
Singeltary sCJD
https://creutzfeldt-jakob-disease.blogspot.com/2023/09/professor-john-collinge-on-tackling.html
AS implied in the Inset 25 we must not _ASSUME_ that transmission of BSE to other species will invariably present pathology typical of a scrapie-like disease.
snip...
http://web.archive.org/web/20060307063542/http://www.bseinquiry.gov.uk/files/yb/1991/01/04004001.pdf
https://journals.plos.org/plosone/article/comment?id=10.1371/annotation/04ce2b24-613d-46e6-9802-4131e2bfa6fd
MONDAY, SEPTEMBER 11, 2023
Professor John Collinge on tackling prion diseases sCJD around 1 in 5000 deaths worldwide
“The best-known human prion disease is sporadic Creutzfeldt-Jakob disease (sCJD), a rapidly progressive dementia which accounts for around 1 in 5000 deaths worldwide.”
https://www.ucl.ac.uk/brain-sciences/dementia-ucl-priority/professor-john-collinge-tackling-prion-diseases
Singeltary sCJD
https://creutzfeldt-jakob-disease.blogspot.com/2023/09/professor-john-collinge-on-tackling.html
AS implied in the Inset 25 we must not _ASSUME_ that transmission of BSE to other species will invariably present pathology typical of a scrapie-like disease.
snip...
http://web.archive.org/web/20060307063542/http://www.bseinquiry.gov.uk/files/yb/1991/01/04004001.pdf
https://journals.plos.org/plosone/article/comment?id=10.1371/annotation/04ce2b24-613d-46e6-9802-4131e2bfa6fd
Terry S. Singeltary Sr.