title: Modelling the epidemic of variant Creutzfeldt-Jakob disease in the UK based on age characteristics: updated, detailed analysis.
abstract: Incubation period of the new variant Creutzfeldt-Jakob disease (vCJD) from infection to clinical onset and the eventual impact of the disease remain major concerns. Based on i) epidemiological conceptualization of human exposure to BSE contaminated material, ii) exponentially decreasing susceptibility after 15 years of age, and iii) typical incubation period (IP) distributions for time from infection to onset, we have previously estimated mean incubation period and projected number of vCJD cases. In this paper, we investigate the robustness of these estimates with respect to i-iii using the UK's 113 vCJD cases with clinical onset before December 2000. Mean incubation period was estimated at 16.4 years (95% CI 11.4-24.8), 15.9 years (95% CI 11.4-22.0), 14.1 years (95% CI 10.4-24.2) with the log-normal, Gamma and Weibull distributions respectively. Corresponding predictions for the total size of the epidemic ranged from 183 to 304. Maximal susceptibility to infection between 1.3 and 15.9 years and decreasing by 15% per year of age thereafter yielded the best fit. The shape of the IP distribution did not affect the predictions. In summary, within a set of reasonable assumptions, mean incubation period for vCJD ranged from 15 to 20 years, and the eventual impact of vCJD was a few hundred patients.
authors.affiliation: Epidémiologie et Sciences de l'Information, INSERM U444, Assistance Publique, Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.
authors.forename: Pierre-yves
authors.initials: PY
authors.lastname: Boëlle
authors.forename: Guy
authors.initials: G
authors.lastname: Thomas
authors.forename: Alain-Jacques
authors.initials: AJ
authors.lastname: Valleron
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Cesbron
authors.forename: Robert
authors.initials: R
authors.lastname: Will
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D007562:Creutzfeldt-Jakob Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D004198:Disease Susceptibility; D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data; D005544:Forecasting; D006801:Humans; D016013:Likelihood Functions; D015233:Models, Statistical; D009010:Monte Carlo Method; D016012:Poisson Distribution; D011159:Population Surveillance; D018570:Risk Assessment; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology