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. 2003 Apr 27:3:4.
doi: 10.1186/1471-2334-3-4.

Updated projections of future vCJD deaths in the UK

Azra C Ghani  1 , Christl A Donnelly, Neil M Ferguson, Roy M Anderson
Affiliations

Updated projections of future vCJD deaths in the UK

Azra C Ghani et al. BMC Infect Dis. .

Abstract

Background: Past projections of the future course of the vCJD epidemic in the UK have shown considerable uncertainty, with wide confidence bounds. However, recent vCJD case data have indicated a decrease in the annual incidence of deaths over the past two years.

Methods: A detailed survival model is fitted to the 121 vCJD deaths reported by the end of 2002 stratified by age and calendar time to obtain projections of future incidence. The model is additionally fitted to recent results from a survey of appendix tissues.

Results: Our results show a substantial decrease in the uncertainty of the future course of the primary epidemic in the susceptible genotype (MM-homozygous at codon 129 of the prion protein gene), with a best estimate of 40 future deaths (95% prediction interval 9-540) based on fitting to the vCJD case data alone. Additional fitting of the appendix data increases these estimates (best estimate 100, 95% prediction interval 10-2,600) but remains lower than previous projections.

Conclusions: The primary vCJD epidemic in the known susceptible genotype in the UK appears to be in decline.

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Figures

Figure 1
Figure 1
Time series of 121 deaths from vCJD to the end of 2002 and 95% Poisson confidence intervals.
Figure 2
Figure 2
Likelihood profile for long-term (to 2080) projections of future vCJD cases fitting to a) the vCJD case data alone and b) to the vCJD case data and prevalence data. The bold line shows the cut-off corresponding to the 95% confidence limit (based on the maximized log likelihood and one degree of freedom). For b), the blue and red lines show the contribution to the likelihood from the vCJD case data and prevalence data respectively.
Figure 3
Figure 3
MLE of the probability density function (PDF) of the incubation period distribution obtained from fitting to the vCJD case data alone and to the vCJD case and prevalence data simultaneously.
Figure 4
Figure 4
MLE of the probability density function (PDF) of the age-dependent susceptibility/exposure function obtained from fitting to the vCJD case data alone and to the vCJD case and prevalence data simultaneously.
Figure 5
Figure 5
Likelihood profile for the mean incubation period. The bold lines show the cut-offs corresponding to the 95% confidence limits (based on the maximized log likelihood and one degree of freedom).
See this image and copyright information in PMC

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