title: Unexpected and unexplained increase in death due to neurological disorders in 2012 in England and Wales: is cytomegalovirus implicated?
abstract: In early 2012 deaths (all-cause mortality) in England and Wales showed an unexpected and unexplained increase which continued for 18 months before abating. The highest percentage increase in deaths was noted to be for neurological degenerations (mainly dementia, Alzheimer's, Parkinson's). This study seeks to understand why increased deaths should focus on these conditions and if an unrecognized infectious outbreak could be implicated. Cause of death statistics for England and Wales were compared for 2012 versus 2011 as was the diagnosis for first outpatient appointment and inpatient admissions for these conditions. Deaths for dementia, Alzheimer's and Parkinson's showed a 15% increase with associated age specificity. The increase could not be explained by changes in the coding relating to cause of death. The increase coincided with increased GP referral (as first outpatient attendance) and inpatient admission for a range of neurological conditions. These increases were also observed on previous occasions of a similar event where deaths peaked in 2003 and 2008. A cascade of debility leading to immobility and institutionalization along with specific immune impairments appears to render those suffering from neurological degenerations sensitive to infectious outbreaks and more specifically to the particular agent behind these events. These and other studies point to outbreaks of a previously uncharacterized agent with the outbreak peaking in 2003, 2008 and 2012 (and in other years prior to these dates). Cytomegalovirus is a potential candidate and the necessary research to test this hypothesis is outlined.
authors.affiliation: Healthcare Analysis & Forecasting, Honister Walk, Camberley GU15 1RQ, UK. Electronic address: hcaf_rod@yahoo.co.uk.
authors.forename: R P
authors.initials: RP
authors.lastname: Jones
authors.affiliation: Tuebingen Ageing & Tumor Immunology Group, Department of Internal Medicine, University of Tuebingen Medical School, Waldhoernlestr.22, D 72072 Tuebingen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Goldeck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003586:Cytomegalovirus Infections / Q000150:complications*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology / Q000401:mortality*; D014852:Wales / Q000453:epidemiology