SEAC response to the SEAC epidemiology subgroup position statement on the vCJD epidemic
SEAC welcomed and endorsed the SEAC Epidemiology Subgroup’s position statement on the vCJD epidemic1.
A substantial number of subclinical carriers of vCJD infection may exist in the UK population who cannot, at present, be identified. As a result a secondary, possibly self-sustaining, vCJD epidemic could arise due to human-to-human transmission via medical interventions such as blood transfusion and surgery. In order to implement the most appropriate precautionary measures, there is an urgent need to ascertain better the prevalence, age and genotype distribution of subclinical vCJD infection in the UK population. These data will inform assessment and subsequent management of the risks of secondary transmission.
New information on the prevalence, age and genotype distribution of vCJD infection will be provided by the planned testing of samples under collection for the National Anonymous Tonsil Archive (NATA). This testing should be progressed with urgency. However a large proportion of tonsils will be collected from young individuals with relatively low dietary exposures to BSE, and there is uncertainty about the sensitivity of tonsil tests to detect subclinical vCJD infection. It is, therefore, very important that additional programmes to test a range of tissues collected from other age groups in the population are considered.
Testing of tissues collected from autopsies could, potentially, provide substantial data on the prevalence, age and genotype distribution of infection which would complement data from NATA. However, there are practical, ethical and legal issues around post mortem testing. The committee recommends that an expert group is convened with some urgency by the Department of Health to consider and advise how such post mortem testing, or other testing designed to ascertain the prevalence, age and genotype distribution of vCJD in the UK population, might best be undertaken.
1SEAC Epidemiology Subgroup. Position statement on the vCJD epidemic. November 2005.
Page updated: 26 January 2006