http://bmj.com/cgi/content/full/323/7313/590
BMJ 2001;323:590 ( 15 September )
Bryan Christie
The rate of contracting variant Creutzfeldt-Jakob disease (vCJD) has been
found to be twice as high in Scotland and the north of England as
elsewhere in Britain, leading to speculation that poorer diets in
these areas may be responsible for the increased risk.
Professor James Ironside, the senior pathologist at the National CJD
Surveillance Unit in Edinburgh, said that the more frequent consumption
of cheap meat products such as pies and burgers in the north of
Britain may explain the difference. These products were more likely
to contain mechanically recovered meat that had been sluiced or
scraped off the bones of cattle before such material was banned for
human consumption. This type of meat carried the greatest risk of
infection with bovine spongiform encephalopathy (BSE).
So far, 102 people have died from vCJD in the United Kingdom, three in
France, and one in the Republic of Ireland. Professor Ironside,
speaking at the British Association's Festival of Science meeting in
Glasgow, also said that the number of cases in the United Kingdom is
showing a steady upward trend. From 1996 to 1999 the
annual number of cases of vCJD was about 14, but last year this
increased to 28, and there have been a further 17 so far
this year.
Professor Ironside said that the previous worst case scenario of
140000 deaths from vCJD in the United Kingdom may have to be
revised upwards if this continues. An analysis of the UK figures has
also shown a north-south split, with an incidence of 2.71 per
million people in Scotland and the north of England, compared with
1.47 in the south of England and Wales.
Most of the meat products infected with BSE entered the food chain in the
late 1980s and early 1990s, but Professor Ironside said that efforts
to establish whether diet is responsible had been hindered by the
food industry.
"Our investigations have not been helped by the reluctance of the food
industry to give us the information about what kind of meat went
into their products," he said. The Food Standards Agency is now
involved in trying to obtain such information.
The other possible explanation for the higher concentration of cases in the
northern half of Britain is that people in these areas have a
greater genetic susceptibility. The surveillance unit has found that
every person who has contracted vCJD shares a common genetic factor
that is present in about a third of the population.
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