title: Can mortality data provide reliable indicators for Creutzfeldt-Jakob disease surveillance? A study in France from 2000 to 2008.
abstract: BACKGROUND
  Surveillance of Creutzfeldt-Jakob disease (CJD) is still an important issue because of the variant CJD epidemic, which is in decline and also because of the emergence of novel forms of animal transmissible spongiform encephalopathy with zoonotic potential and the risk of nosocomial and blood transfusion-related transmission. Active surveillance has been implemented in most European countries and requires important human resources and funding. Here, we studied whether national mortality and morbidity statistics can be used as reliable indicators.
  
  
  METHODS
  CJD data collected by the French national CJD surveillance centre were compared with data registered in the national mortality statistics.
  
  
  RESULTS
  From 2000 to 2008, the two sources reported fairly similar numbers of CJD deaths. However, analysis of individual data showed important between-sources disagreement. Nearly 24% of CJD reported by the mortality register were false-positive diagnoses and 21.6% of the CJD cases diagnosed by the surveillance centre were not registered as CJD in the national mortality statistics. One out of 22 variant CJD cases was not reported as having any type of CJD in the mortality statistics.
  
  
  CONCLUSIONS
  These findings raise doubt about the possibility of a reliable CJD surveillance only based on mortality data.
authors: AP-HP, Cellule Nationale de Référence des Maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. jean-philippe.brandel@psl.aphp.fr
authors: Jean-Philippe
authors: JP
authors: Brandel
authors: Arlette
authors: A
authors: Welaratne
authors: Dominique
authors: D
authors: Salomon
authors: Isabelle
authors: I
authors: Capek
authors: Véronique
authors: V
authors: Vaillant
authors: Albertine
authors: A
authors: Aouba
authors: Albertine
authors: A
authors: Aouaba
authors: Stéphane
authors: S
authors: Haïk
authors: Annick
authors: A
authors: Alpérovitch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D007562:Creutzfeldt-Jakob Syndrome / Q000175:diagnosis / Q000401:mortality*; D003951:Diagnostic Errors; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012042:Registries / Q000592:standards*; D015203:Reproducibility of Results