NR AFCF
AU Hansen,M.
TI Creutzfeldt-Jakob disease
QU The New England Journal of Medicine 1999 May 27; 340(21): 1687-8; discussion 1689
IA http://www.nejm.org/content/1999/0340/0021/1687b.asp
KZ N Engl J Med. 1998 Dec 31;339(27):1994-2004. PMID: 9869672
PT comment; letter
VT
The article on Creutzfeldt-Jakob disease by Johnson and Gibbs (Dec. 31 issue) (1) gives the impression that case-control epidemiologic studies have been numerous and have found no link to "dietary eccentricities." We are aware of only a small number of case-control studies, but several of these found a link between consumption of meat products and an increased risk of Creutzfeldt-Jakob disease. One study from the United States that involved 26 patients with the disease found that nine individual food items were statistically linked to an increased risk of Creutzfeldt-Jakob disease. (2) Of these foods, six came from pigs. Furthermore, with four of the pork products there was a positive association between increased consumption of the products and increased risk of Creutzfeldt-Jakob disease.
A second study that is by far the largest case-control study to date, involving over 400 European patients and published just last year, found a significantly increased risk of Creutzfeldt-Jakob disease associated with the consumption of raw meat or brains. (3) The same study also found a significant increase in the risk of Creutzfeldt-Jakob disease with increasing consumption of pork.
A third case-control study of sporadic Creutzfeldt-Jakob disease in the United Kingdom, involving 206 cases, found a significant increase in the risk of Creutzfeldt-Jakob disease associated with increasing consumption of beef, veal, venison, or brains. (4)
Finally, Johnson and Gibbs point out that laboratory studies provide strong evidence that bovine spongiform encephalopathy and new-variant Creutzfeldt-Jakob disease have a common origin but conclude that the mode of transmission is not necessarily consumption of meat from cattle infected with the agent responsible for bovine spongiform encephalopathy. But many scientists would disagree with them. The fact that the same studies show that various exotic ungulate species in zoos, as well as domestic house cats, all in the United Kingdom, have died of a transmissible spongiform encephalopathy caused by an agent that appears identical to the agent that causes bovine spongiform encephalopathy strongly suggests that these animals, as well as the persons with new-variant Creutzfeldt-Jakob disease, contracted the disease from something they ate. Given these findings, and given the fact that all three case-control studies of sporadic Creutzfeldt-Jakob disease show a significant correlation between the disease and consumption of various animal products, it would make sense to conduct more detailed studies to pursue this connection.
Michael Hansen, Ph.D., Consumers Union, Yonkers, NY 10703
References
1. Johnson RT, Gibbs CJ Jr. Creutzfeldt-Jakob disease and related transmissible spongiform encephalopathies. N Engl J Med 1998;339:1994-2004.
2. Davanipour Z, Alter M, Sobel E, Asher DM, Gajdusek DC. A case-control study of Creutzfeldt-Jakob disease: dietary risk factors. Am J Epidemiol 1985;122:433-51.
3. van Duijn CM, Delasnerie-Laupretre N, Masullo C, et al. Case-control study of risk factors of Creutzfeldt-Jakob disease in Europe during 1993-95. Lancet 1998;351:1081-5.
4. Creutzfeldt-Jakob disease surveillance in the UK: sixth annual report 1997. Edinburgh, Scotland: National CJD Surveillance Unit, 1998.
ZR 4
MH Animal; Case-Control Studies; Cattle; Creutzfeldt-Jakob Syndrome/epidemiology/*transmission; Diet/*adverse effects; Encephalopathy, Bovine Spongiform/transmission; Human; Meat; Prion Diseases/transmission/veterinary; Prions; Swine
AD Michael Hansen, Ph.D., Consumers Union, Yonkers, NY 10703
SP englisch
PO USA