NR AFME
AU Holman,R.C.; Khan,A.S.; Kent,J.; Strine,T.W.; Schonberger,L.B.
TI Epidemiology of Creutzfeldt-Jakob disease in the United States, 1979-1990: analysis of national mortality data.
QU Neuroepidemiology 1995 Jul-Aug; 14(4): 174-81
PT journal article
AB The trends and current incidence of Creutzfeldt-Jakob disease (CJD) was examined by using a unique and potentially high sensitive source for case ascertainment. We analyzed death certificate information for 1979-1990 from US multiple-cause-of-death mortality data, compiled by the National Center for Health Statistics, Centers for Disease Control and Prevention. We evaluated death certificate data for US residents for whom CJD was listed as one of the multiple causes of death on the death certificate (046.1) from the International Statistical Classification of Diseases, Injuries, and Causes of Death (9th revision). Age-adjusted and age-specific CJD death rates by gender, race, and region were calculated to measure the disease incidence because of the rapidly fatal course of the disease for most patients with CJD. We identified 2,614 deaths with CJD listed on the death certificates. The average annual age-adjusted mortality rate was 0.9 deaths per million persons (range 0.8-1.1). The mean age at death was 67 years. CJD-related deaths were uncommon among persons younger than 50 years of age (4.3% of all deaths). The highest average annual mortality rate was for those persons aged 70-74 years (5.9 deaths per million persons). A slight majority (53.0%) of the deaths was in females, but the age-adjusted mortality rate was 1.2 times higher for males. Most deaths (94.8%) were in whites; the mortality rate for blacks was only 40% of that for whites. The age-adjusted CJD mortality rate in the United States is similar to published estimates of the crude incidence of CJD worldwide. Annual review of national multiple-cause-of-death data may provide an efficient and cost-effective method to monitor the incidence of CJD in the United States. The relative paucity of cases among blacks requires further study to rule out detection biases, but may reflect, in part, differences in genetic and/or environmental factors.
IN Eine statistische Nachuntersuchung von 2614 Amerikanern, deren Totenschein die Creutzfeldt-Jakob-Krankheit als eine der möglichen Todesursache nennt ergab, dass dort etwa 0,9 (0,8-1,1) von 1 Million Menschen an der Krankheit zu sterben scheinen. Bei den 70-74-jährigen betrug die Häufigkeit 5,9 CJD-Tote von 1 Million Menschen. Das durchschnittliche Todesalter war 67 Jahre. Nur 4,3% der Toten waren weniger als 50 Jahre alt. 53% der Toten waren Frauen. Nach einer Korrektur um das jeweilige Todesalter ergab sich jedoch eine 1,2-fach höhere Rate bei den Männern. 94,6% der Toten waren Weiße. Bei Schwarzen betrug die Rate diagnostizierter Creutzfeldt-Jakob-Erkrankungen nur 40% von der bei Weißen. Sollten Schwarze eine gewisse Immunität gegen die Creutzfeldt-Jakob-Krankheit besitzen, oder werden sie nur vor deren Ausbruch erschossen oder einer gründlichen Diagnose für unwert erachtet? Da nicht alle Creutzfeldt-Jakob-Erkrankungen als solche diagnostiziert werden, unterschätzt die Studie die Häufigkeit der Krankheit.
ZR 37
MH Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Creutzfeldt-Jakob Syndrome/*mortality; Female; Human; Infant; Infant, Newborn; Male; Middle Age; Racial Stocks; Retrospective Studies; Sex Factors; United States/epidemiology
AD Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
SP englisch
PO Schweiz