NR AQVJ
AU Boelle,P.Y.; Cesbron,J.Y.; Valleron,A.J.
TI Epidemiological evidence of higher susceptibility to vCJD in the young
QU BMC Infectious Diseases 2004 Aug 10; 4(1): 26
IA http://www.biomedcentral.com/1471-2334/4/26
PT journal article
AB BACKGROUND: The strikingly young age of new variant Creutzfeldt-Jakob disease (vCJD) cases remains unexplained. Age dependent susceptibility to infection has been put forward, but differential dietary exposure to contaminated food products in the UK population according to age and sex during the bovine spongiform encephalopathy (BSE) epidemic may provide a simpler explanation. METHODS: Using recently published estimates of dietary exposure in mathematical models of the epidemiology of the new variant Creutzfeldt-Jakob disease (vCJD), we examine whether the age characteristics of vCJD cases may be reproduced. RESULTS: The susceptibility/exposure risk function has likely peaked in adolescents and was followed by a sharp decrease with age, evocative of the profile of exposure to bovine material consumption according to age. However, assuming that the risk of contamination was proportional to exposure, with no age dependent susceptibility, the model failed to reproduce the observed age characteristics of the vCJD cases: The predicted cumulated proportion of cases over 40 years was 48%, in strong disagreement with the observed 10%. Incorporating age dependent susceptibility led to a cumulated proportion of cases over 40 years old of 12%. CONCLUSIONS: This analysis provides evidence that differential dietary exposure alone fails to explain the pattern of age in vCJD cases. Decreasing age related susceptibility is required to reproduce the characteristics of the age distribution of vCJD cases.
IN Anhand von Computersimulationen kamen die Autoren zu dem Schluss, dass die Altersverteilung der nvCJK-Fälle kaum allein mit altersabhängiger Exposition, sondern viel besser mit der Annahme einer mit dem Alter abnehmenden Empfänglichkeit erklärt werden könne.
MH Adolescent; Adult; Age Factors; Child; Child, Preschool; Cohort Studies; Creutzfeldt-Jakob Syndrome/etiology/immunology/*mortality; *Diet/adverse effects/mortality/statistics & numerical data; Disease Susceptibility/epidemiology; Female; Humans; Infant; Male; Models, Biological; Sex Factors
AD INSERM U444, Assistance Publique Hopitaux de Paris, Universite Pierre et Marie Curie, Paris, France. boelle@u444.jussieu.fr
SP englisch
PO England
EA pdf-Datei und HTML-Version