2008년 05월 05일
미국 vCJD 사망자 3명에 대해서
출처 - 미 질병통제센터 (CDC)
Have any cases of variant CJD (vCJD) been reported in the United States?
Yes, three cases of vCJD have been reported from the United States. By convention, variant CJD cases are ascribed to the country of initial symptom onset, regardless of where the exposure occurred. There is strong evidence that suggests that two of the three cases were exposed to the BSE agent in the United Kingdom and that the third was exposed while living in Saudi Arabia.
The first patient was born in the United Kingdom in the late 1970's and lived there until a move to Florida in 1992. The patient had onset of symptoms in November 2001 and died in June of 2004. The patient never donated or received blood, plasma, or organs, never received human growth hormone, nor did the patient ever have major surgery other than having wisdom teeth extracted in 2001. Additionally, there was no family history of CJD.
The second patient resided in Texas during 2001-2005. Symptoms began in early 2005 while the patient was in Texas. He then returned to the United Kingdom, where his illness progressed, and a diagnosis of variant CJD was made. The diagnosis was confirmed neuropathologically in early 2006 at the time of the patient's death. While living in the United States, the patient had no history of hospitalization, of having invasive medical procedures, or of donation or receipt of blood and blood products. The patient almost certainly acquired the disease in the United Kingdom. He was born in the United Kingdom and lived there throughout the defined period of risk (1980-1996) for human exposure to the agent of bovine spongiform encephalopathy (BSE, commonly known as "mad cow" disease). His stay in the United States was too brief relative to what is known about the incubation period for variant CJD.
The third patient was born and raised in Saudi Arabia and has lived in the United States since late 2005. The patient occasionally stayed in the United States for up to 3 months at a time since 2001 and there was a shorter visit in 1989. The patient's onset of symptoms occurred in Spring 2006. In late November 2006, the Clinical Prion Research Team at the University of California San Francisco Memory and Aging Center confirmed the vCJD clinical diagnosis by pathologic study of adenoid and brain biopsy tissues. The patient has no history of receipt of blood, a past neurosurgical procedure, or residing in or visiting countries of Europe. Based on the patient's history, the occurrence of a previously reported Saudi case of vCJD attributed to likely consumption of BSE-contaminated cattle products in Saudi Arabia, and the expected greater than 7 year incubation period for food-related vCJD, this U.S. case-patient was most likely infected from contaminated cattle products consumed as a child when living in Saudi Arabia (1). The patient has no history of donating blood and the public health investigation has identified no known risk of transmission to U.S. residents from this patient.
정리
1. 영국에서 1970년대 후반에 태어나서 1992년 플로리다로 건너옴. 2001년 11월 발병해서 2004년 6월 사망
- 환자 발병 2001년. 미국에서 광우병 소가 처음으로 발견된게 2003년(1마리) 영국에서는 89년대 조사시작할때부터 무려 18만마리 확인. 그리고 그전에(조사 시작 전) 광우병 걸린소 40만마리가 식탁으로 갔다는 사실(영국 발표)을 종합해 보건데 92년도 이전부터 이미 걸려서 들어왔을 가능성이 있음
2. 영국에서 태어나서 2001~2005년간 텍사스에 거주. 2005년초 vCJD 증상을 보임
- 광우병 잠복기는 최소 8년 이상으로 보는 것이 정설. 게다가 미국 오기 전까지 영국에서 태어나 살아왔으므로 영국에서 걸렸을 가능성이 큼
3. 사우디 태생이며 2005년말에 미국 정착. 2006년 봄에 증상을 보였고 2006년 11월말에 vCJD로 확진
- 2005년에 미국와서 1년만에 걸렸으므로 잠복기 감안하면 역시 사우디에서 걸렸다는것이 확실 (당시 사우디에 영국 소고기가 수입이 됐었기 떄문에 이를 유력한 감염요인으로 보고있음)
추가
4. 버지니아 22세 여성 케이스에 대해서는 예비조사 결과 vCJD가 아니라고 USDA에서 밝힘
“One last point that I would like to address is regarding a human health issue. I am certain that many of you are aware that an investigation was being conducted to determine the cause of death from a young patient in Virginia who was recently reported in the in the media to have died of variant Creutzfeldt-Jacob disease (vCJD). The epidemiologic characteristics of the illness and preliminary results of the neuropathologic testing of brain tissue obtained at autopsy indicate that the patient did not die of vCJD. The U.S. Centers for Disease Control and Prevention has just provided us with that information, and I felt it was important to share that with you today. An official release once all testing is completed and confirmed is expected soon, but the CDC has allowed me to offer you this preliminary information today.
출처 - 미 농무부(USDA) : pdf 파일임
Have any cases of variant CJD (vCJD) been reported in the United States?
Yes, three cases of vCJD have been reported from the United States. By convention, variant CJD cases are ascribed to the country of initial symptom onset, regardless of where the exposure occurred. There is strong evidence that suggests that two of the three cases were exposed to the BSE agent in the United Kingdom and that the third was exposed while living in Saudi Arabia.
The first patient was born in the United Kingdom in the late 1970's and lived there until a move to Florida in 1992. The patient had onset of symptoms in November 2001 and died in June of 2004. The patient never donated or received blood, plasma, or organs, never received human growth hormone, nor did the patient ever have major surgery other than having wisdom teeth extracted in 2001. Additionally, there was no family history of CJD.
The second patient resided in Texas during 2001-2005. Symptoms began in early 2005 while the patient was in Texas. He then returned to the United Kingdom, where his illness progressed, and a diagnosis of variant CJD was made. The diagnosis was confirmed neuropathologically in early 2006 at the time of the patient's death. While living in the United States, the patient had no history of hospitalization, of having invasive medical procedures, or of donation or receipt of blood and blood products. The patient almost certainly acquired the disease in the United Kingdom. He was born in the United Kingdom and lived there throughout the defined period of risk (1980-1996) for human exposure to the agent of bovine spongiform encephalopathy (BSE, commonly known as "mad cow" disease). His stay in the United States was too brief relative to what is known about the incubation period for variant CJD.
The third patient was born and raised in Saudi Arabia and has lived in the United States since late 2005. The patient occasionally stayed in the United States for up to 3 months at a time since 2001 and there was a shorter visit in 1989. The patient's onset of symptoms occurred in Spring 2006. In late November 2006, the Clinical Prion Research Team at the University of California San Francisco Memory and Aging Center confirmed the vCJD clinical diagnosis by pathologic study of adenoid and brain biopsy tissues. The patient has no history of receipt of blood, a past neurosurgical procedure, or residing in or visiting countries of Europe. Based on the patient's history, the occurrence of a previously reported Saudi case of vCJD attributed to likely consumption of BSE-contaminated cattle products in Saudi Arabia, and the expected greater than 7 year incubation period for food-related vCJD, this U.S. case-patient was most likely infected from contaminated cattle products consumed as a child when living in Saudi Arabia (1). The patient has no history of donating blood and the public health investigation has identified no known risk of transmission to U.S. residents from this patient.
정리
1. 영국에서 1970년대 후반에 태어나서 1992년 플로리다로 건너옴. 2001년 11월 발병해서 2004년 6월 사망
- 환자 발병 2001년. 미국에서 광우병 소가 처음으로 발견된게 2003년(1마리) 영국에서는 89년대 조사시작할때부터 무려 18만마리 확인. 그리고 그전에(조사 시작 전) 광우병 걸린소 40만마리가 식탁으로 갔다는 사실(영국 발표)을 종합해 보건데 92년도 이전부터 이미 걸려서 들어왔을 가능성이 있음
2. 영국에서 태어나서 2001~2005년간 텍사스에 거주. 2005년초 vCJD 증상을 보임
- 광우병 잠복기는 최소 8년 이상으로 보는 것이 정설. 게다가 미국 오기 전까지 영국에서 태어나 살아왔으므로 영국에서 걸렸을 가능성이 큼
3. 사우디 태생이며 2005년말에 미국 정착. 2006년 봄에 증상을 보였고 2006년 11월말에 vCJD로 확진
- 2005년에 미국와서 1년만에 걸렸으므로 잠복기 감안하면 역시 사우디에서 걸렸다는것이 확실 (당시 사우디에 영국 소고기가 수입이 됐었기 떄문에 이를 유력한 감염요인으로 보고있음)
추가
4. 버지니아 22세 여성 케이스에 대해서는 예비조사 결과 vCJD가 아니라고 USDA에서 밝힘
“One last point that I would like to address is regarding a human health issue. I am certain that many of you are aware that an investigation was being conducted to determine the cause of death from a young patient in Virginia who was recently reported in the in the media to have died of variant Creutzfeldt-Jacob disease (vCJD). The epidemiologic characteristics of the illness and preliminary results of the neuropathologic testing of brain tissue obtained at autopsy indicate that the patient did not die of vCJD. The U.S. Centers for Disease Control and Prevention has just provided us with that information, and I felt it was important to share that with you today. An official release once all testing is completed and confirmed is expected soon, but the CDC has allowed me to offer you this preliminary information today.
출처 - 미 농무부(USDA) : pdf 파일임
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