CJD fears put watchdog under strain

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AN INCREASE in the number of people suspected of suffering from Creutzfeldt Jakob disease is straining the national surveillance system for the human version of "mad cow" disease.

Bob Will, head of the National CJD Surveillance Unit in Edinburgh, has consulted the Department of Health about the need to increase the unit's resources to cope with the extra workload.

Dr Will, a clinical neurologist, said the past few months had seen a higher number of people being referred to the unit by doctors concerned that their patients were suffering from CJD, some of whom may be suffering from the human form of bovine spongiform encephalopathy (BSE).

The unit, which was set up in 1990, was designed to cope with a maximum of 150 referrals a year. However, if present trends continue, the unit will have to deal with up to 200 referrals in 1999.

"If it gets higher than 150 referrals we will need extra staff and if it gets higher again we'd have to consider the way the whole system works," Dr Will said. He has resigned from the government's Spongiform Encephalopathy Advisory Committee, on which he has served since 1990, to concentrate on the surveillance programme.

There have been 34 deaths from new variant CJD - human BSE - and scientists have not seen a significant increase in cases to indicate an epidemic. However, the first indication of an epidemic would be an increase in referrals to the unit.

"It's significant in terms of the workload. In terms of meaning something in relation to CJD I think that is impossible to say," Dr Will said.

"We have been quite busy in the past few months but I don't think you can conclude that means something definite epidemiologically at the moment."

For every five patients with suspected new variant CJD, only one proves definitely tohave it - cases are usually confirmed by post-mortem tests on the patient's brain.

"We've had a few more referrals than our previous experience in the past few months," Dr Will said. He added that the unit looks particularly carefully at suspected cases of CJD in the under-50s, who are at greater risk of the new variant of the disease.

Scientists believe it is too early to say whether there will be an epidemic of "human BSE" because of the uncertainty over both the time it takes for the disease to incubate and the amount of infected material that entered the human food chain.