Early identification of variant Creutzfeldt-Jakob disease. Some promising approaches but no clear answers yet
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The medical world has long been calling for a method of early identification of cases variant Creutzfeldt-Jakob Disease, says Pocchiari in this week's BMJ. Exposure of the human population in Britain to the agent causing variant is likely to have occurred in the 1980s through beef products affected by bovine spongiform encephalopathy (BSE), suggests the author. He notes that even though it is reassuring that there have only been 24 cases of variant CJD and that the number of new cases did not increase last year, he fears that it is impossible to predict how many people are now incubating the variant form of the disease.
Pocchiari fears that the disease may be accidentally transmitted by medical procedures and in particular, cites concern about plasma derived products because they are prepared in huge pools, with the chance of including blood from potentially infected donors. If we were able to detect variant CJD at an early stage, batches of plasma suspected of contamination with the disease could be withdrawn.
Definite diagnosis of all forms of Creutzfeldt-Jakob disease is still possible only by examination of the brain, one the patient has died, says Pocchiari and a simple but specific blood test is badly needed.
Professor Maurizio Pocchiari, Professor of Virology, Istituto Superiore di Sanita, Rome
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