Mad Cow Disease: Dealing Sensibly with a New Concern
JFP_08.04_PracticeAlert.final 7/20/04 9:19 AM Page 645 Practice Alert P UBLIC H EALTH I SSUES I NFLUENCING Y OUR P RACTICE Mad Cow disease: Dealing sensibly with a new concern Eric Henley, MD, MPH University of Illinois College of Medicine at Rockford; School of Public Health, University of Illinois at Chicago Jack Herrmann, DVM, MPH AVMA/AAAS Congressional Science Fellow, Washington, DC fter a period out of the spotlight, Mad vCJD had been reported worldwide, most in the Cow disease is again causing a stir. UK. Confirmation of either the classic or variant Following the first documented case in form requires pathology examination of brain A 1 this country on December 23, 2003, the US gov- tissue collected by biopsy or, if a patient has died, ernment is instituting new preventive measures, at autopsy.2 and patients may be asking for assurances of safe- ty (see “What to advise patients,” page 565). Uniqueness of vCJD In medical school, family physicians learned Mad Cow’s connection to humans: vCJD about classic CJD, which is endemic throughout Mad Cow disease is the bovine form of transmis- the world and, in the US, causes an average of sible spongiform encephalopathy (TSE), a disease 1 death per million people per year. The epidemi- that can also affect sheep, deer, goats, and ology of vCJD and CJD are quite different (Table humans (Table 1). The causative agent is thought 2). Because vCJD is a new disease, its incubation to be an infective protein called a prion, discov- period is unknown, but it is likely to be years or ered in 1997.
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