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HHS Teleconference Press Briefing
Likely case of vCJD in UK citizen in Florida
April 18, 2002
AT&T OPERATOR: [In progress] -- for today's conference and inform them
that I would like to turn the call over to Mr. Bill Pierce. Sir, please
begin.
MR. PIERCE: Thank you. I just am going to simply, you know, welcome you to
call, introduce who is on the call, and they're going to take it from there.
I do want to remind everybody since we're--we're going to try to get through
all your questions. Therefore if you can refrain in your questions to one if
possible or a very quick follow up, we'll be able to get through everybody.
And with that I want to introduce--and we're going to kind of go in this
order--we have on the line with us this evening, Dr. Steve Ostroff, who's
the Acting Director for the National Center for Infectious Diseases at the
CDC; Dr. Larry Shonberger, who is the CDC's CJD expert. We have from the
FDA, Dr. Mack Lumpkin, who's a Senior Associate Commissioner at FDA. We have
on the phone from the USDA, Ron DeHaven, who's the Acting Director of the
Animal and Plant Health Inspection Service, and we have Dr. Elsa Murano, the
Under Secretary for Food Safety at USDA.
With that, I'd like the talk turned over to Dr. Ostroff to begin.
DR. OSTROFF: Yeah. Let me just start by saying in terms of the spelling of
my name, the last name is O as in Oscar, S as in Sam, T as in Tom, R as in
Ralph, O as in Oscar, f-f, as in Frank Frank.
I hope all of you have seen the press release that came out from CDC about
an hour ago. Let me say before I go over the contents of the press release,
that our thoughts and hearts go out to both the patient and her family. The
press release basically indicates that both we and the Florida Department of
Health are announcing a likely case of the new variant of Creutzfeldt-Jacob
disease, CJD, in a 22-year-old individual who is a resident of Florida, but
was born and raised in the United Kingdom, and in recent years has lived
within the United States.
I think the important thing is that she resided and was raised in the UK
during the period when the BSE epidemic was at its peak in the United
Kingdom, and there is every reason to believe, and both we and the Florida
Department of Health believe that her exposure and her illness occurred
within the United Kingdom and not in the United States. However, it's
important, and the reason that we're reporting this case, is that she
represents the first recognized resident of the United States in which this
particular diagnosis has been made. She sought medical care in the United
Kingdom and the diagnosis was made in the United Kingdom. And the diagnosis
at this point is not absolutely definitive because the
information is still being reviewed by the National Surveillance Center in
the UK, but so far all evidence points to this particular diagnosis.
Although experience with the disease is pretty limited, there is no evidence
to suggest that the cases are transmitted from person to person. Illness is
thought to be acquired from the consumption of cattle products which are
contaminated with an agent that causes the disease, BSE, also known as mad
cow.
I think one of the important messages here is that this particular finding
is not unexpected. We have been anticipating for quite some time that we
would find such a case within the United States. There are large numbers of
persons who resided in Great Britain, were born and raised in Great Britain,
who live in the United States. There are large numbers of Americans who had
lived for extended periods of time in the United Kingdom that would
potentially have been exposed to the agent during the time period when
disease was being transmitted. So this is not an unexpected finding, but we
are reporting it, and we're holding this teleconference because of the fact
that this is the first case.
CDC, in terms of its role in CJD is responsible for monitoring for cases of
both the new variant form of the disease, as well as for the other forms of
Creutzfeldt-Jakob disease. This case shows that that system is working. And
I'll turn it over to Bill.
MR. PIERCE: Thank you, Dr. Ostroff.
Now, Mack, do you want to go ahead and talk a little bit about what FDA does
and its role in this?
DR. LUMPKIN: I'll be happy to. Thank you all for being with us this evening.
From the FDA's perspective there really are 3 major things that we're
involved in as far as trying to keep our country healthy as far as mad cow
is concerned, both in animals and people.
The first is a responsibility we share with or colleagues from USDA, and
you'll be hearing more about that when our colleagues from APHIS talk, and
that is trying to stop the entry of products into this country that might be
contaminated or might in some way spread the agent of BSE into our own
country. APHIS obviously does this with live animals and other animal
products. We do it with FDA-regulated products that have ingredients that
are of bovine origin from countries that are known to be positive for BSE or
to be at high risk for BSE.
The other thing that we do is the animal feed, which as people were talking
about a little bit earlier, seems to be the major vector, as it were, for
allowing the agent of BSE to amplify throughout a herd if it gets into a
herd, because animals who could potentially be harboring this agent could
end up, through a process by which some of the protein from the animal gets
into animal feed, that then goes back to other animals, and by doing this
propagates the agent of BSE throughout the herd.
We have since 1997 had regulations in place to prohibit that kind of feeding
in this country. Even though we have no evidence of BSE in the country
because of the realities of this disease and the technology of around this
disease at this point, we obviously want to have in place a process and a
rule such that if the agent were ever to get into the country, in the animal
form, we would not have it amplifying through our herd as happened in
Europe.
And last but not least, the area we're involved in has to do with the blood
supply here in the United States. And there's no hard evidence that this is
a disease that can be transmitted from person to person by blood. There is
some theoretical concern about this, and obviously as we continue to learn
about this disease, we do not want to wait and put regulations into place
relative to blood at a time where we might be too late. So we have had, for
several years, regulations regarding people being blood donors who have
traveled or lived in areas of the world where we are concerned about BSE and
variant Creutzfeldt-Jakob.
So those are really the three areas that we're primarily involved in at this
point.
MR. PIERCE: If you--Ron, if you want to go ahead now?
DR. DeHAVEN: Sure. This is Dr. Ron DeHaven. I'm the acting Administrator of
the Animal and Plant Health Inspection Service with USDA. As has been
mentioned, the disease in cattle is called bovine spongiform encephalopathy
or BSE, and the disease causes a progressive neurological disease that
eventually leads to death in those animals that are affected.
Our primary role within APHIS or the Animal and Plant Health Inspection
Service, has been that of active surveillance. In fact, we've had an active
surveillance program ongoing looking for the disease since 1990. By
international trade standards, an active surveillance program would require
us to look at about 440 cattle brains a year, and if all of those were
negative, again by international standards, we could satisfy the trade
community that the U.S. was free. In fact, we have been looking at
substantially higher numbers than that.
Last year, for example, we looked at 5,200 cattle brains, all of them
negative, and we've increased that surveillance this year with a target of
12,500 cattle brains being examined for the presence of BSE and we're well
on that mark, and again, all of those tests have been negative.
In 1998 we commissioned the School of Public Health at Harvard University to
conduct a risk assessment of the relative likelihood that we would have BSE
in the United States, and we released their final report in November of last
year. Their conclusions were that the risk of having BSE in the United
States is very low, but in fact if it had been introduced, the procedures
that we have in place would very quickly eliminate it. Those procedures
specifically are the fact that we have, since 1997, banned the importation
of live ruminants or cattle from Europe, as well as we banned the
importation of ruminant products from the U.S., as well as was mentioned,
the ban imposed by FDA to prohibit the feeding of ruminant proteins to
cattle in the U.S.
So we have a very active surveillance program. We're increasing that. We're
looking at further tightening the controls and procedures that might improve
that surveillance and further minimize the risk, but we're confident at this
point that we don't have it in the U.S., and those procedures are effective
in eliminating it if in fact it were to be introduced.
DR. MURANO: This is Dr. Elsa Murano. I'm the Under Secretary for Food Safety
at USDA. And I would like to say very briefly that, as my colleague from
APHIS just stated, the Harvard University School of Public Health Risk
Assessment was an effort that we collaborated on, and which provided us with
a comprehensive look at the relative risk, as he mentioned, of BSE being in
this country. And as he said very well, the risk assessment, which took 3
years to complete, very, very extensive, very comprehensive, showed that the
risk is very, very low, and it is due to all those firewalls, preventive
systems, if you will.
At the Food Safety and Inspection Service, one of the things that we do is
in addition to all those firewalls that are present already, is we
automatically condemn any animal that has central nervous system disorders,
so that it does not enter the food supply, it does not get into the
slaughter plant.
And secondly, we certainly want to remain very vigilant in terms of
preventing this disease from, if it should ever happen to be in this
country, which of course there has never been any cases of BSE in the United
States, so we have published a current thinking paper that outlines some
additional actions that we're considering that we may take in order to
really be as vigilant and to have as strong a system as possible in order to
prevent this disease from entering the food chain.
MR. PIERCE: Thank you. Before I open it up, I just want to say a few things.
First of all, along with Dr. Ostroff, at the HHS, our thoughts here go out
to the family and to the individual. I also want to just remind folks that
CDC, FDA, USDA, lots of good information on this subject is on the website
and covers a huge amount of ground. So there's a great deal of detail out
there.
With that, let's open it up for questions.
AT&T OPERATOR: Thank you. At this time if there are any question or
comments, press star 1 on your touchtone phones. Star 1 for any questions or
comments, and all questions will be taken in the order they are received.
Your first question comes from Denise Grady. Please state your company name.
QUESTION: New York Times. Can you tell us anything about the status of the
patient now? Is she hospitalized? Has she ever been a blood donor? And do
the people taking care of her, are they taking any special precautions?
DR. OSTROFF: Yeah. Thank you for that question. This is Steve Ostroff. The
patient recently returned home from the United Kingdom. The diagnosis is
quite recent. We feel, and the Florida Department of Health also feels, that
we don't want to divulge any information about her current status. So I will
defer in terms of answering the first question.
In terms of the second question about as she ever a blood donor, to the best
of our knowledge--and she and the family have been interviewed--the answer
to that question is no. And so that's not a concern.
The third question concerning what sorts of precautions the care givers are
taking, I also don't know the circumstances of that, but there are none in
particular.
AT&T OPERATOR: Your next question comes from Seth Borenstein. Please state
your company name.
QUESTION: Yes. This is Seth Borenstein with Knight-Ridder Newspapers. What
I'm wondering about, I want to make sure that this isn't just another case
of getting it from the stream. How are you certain that the woman got it in
the United Kingdom? When was she in the United--you said she was in there
during the time period when BSE was running rampant. But what are the
incubation times for BSE? When did she get to the United States and how do
you know she did not contract it in the United States?
DR. : Thank you for those questions. This is a, you know, relatively
recently recognized disease. So the incubation periods aren't entirely
clear, but it's likely that with the other forms of CJD in which we have
longer term information, incubation periods for this illness are long, and
you're talking years and not months, but we can't place a definitive figure
on that.
The strongest piece of information is that she clearly had the exposure that
essentially all of the other recognized cases of the new variant CJD have
had, which is that she was a resident of the United Kingdom for the better
part of her life, and was certainly there during the time period where she
was--she had an opportunity to be exposed to the agent. She hasn't lived in
this country for a number of years, but again, there's no--there's been no
evidence that this disease is present within the United States. She's the
first recognized human case, and as our colleagues from the USDA have
stated, there has been no evidence of this disease being present in animals
in this country either.
So, based on the fact that she had the known exposures and the fact that
there has been no evidence of disease in this country, one would have to
conclude that the overwhelming likelihood is that she acquired it while she
was living in the United Kingdom.
MR. PIERCE: Next question?
AT&T OPERATOR: The next question comes from Robert Bezelle [ph]. Please
state your company name, sir.
QUESTION: NBC News for Dr. Ostroff.
Could you give us a bit more on the timing. I know you don't want to
identify the individual, but when did she go to the United Kingdom and why
was she there now? It's a bit confusing in terms of the time line of where
she was and when. When did she become a United States citizen--or resident,
rather, excuse me.
DR. OSTROFF: Right. Again, we just learned of this case so we don't have all
of that information. There has been active investigation underway both by
CDC, as well as by the Florida Department of Health. I can tell you the
diagnosis was just made, and as far as why she was in the United Kingdom, in
terms of the diagnosis, she basically again was born and raised in the
United Kingdom and went there for health care purposes.
QUESTION: Can you give me more of the timing, though? How long was she in
the United Kingdom before she came to the United States? That sort of thing.
DR. OSTROFF: I've been asked not to do that.
MR. PIERCE: They should, I would just, this is Bill Pierce, you probably
want to try to check in with the Florida Health Department on that to see
whether they might be able to do it. Because, again, we do have some
confidentiality issues that we have to try to deal with, but Florida might
be best to answer those very specific cases about the--
QUESTION: When you say "born and raised," though, what does that mean? I
mean, raised is--give me a range for "raised"--five years or ten years? I
mean, she's only 22.
MR. PIERCE: Right. She spent the majority of her life in the United Kingdom.
QUESTION: Okay. Thank you.
AT&T OPERATOR: The next question comes from Kristin Reed. Please state your
company name.
QUESTION: I'm from Bloomberg News, and my first question is just--I might
have missed this at the beginning of the call--but is there someone in
particular in Florida that we should be contacting with these other
questions?
Secondly, in terms of agriculture policies, I know that there was quite a
bit of news floating around a couple of years ago about policies on downed
cattle that weren't confirmed to have CNS problems, and I just wonder if you
could update us with what the current policies are on the slaughter of
downed cows?
MR. PIERCE: I can answer your first question. The contact at the Florida
Department of Health is Rob Hayes, and the phone number is 850-245-4111.
QUESTION: Thank you.
DR. DeHAVEN: This is Ron DeHaven from Animal and Plant Health Inspection
Service of USDAs. Clearly, when we have an active surveillance program, we
are doing our best to target those animals that are showing symptoms that
would be consistent with a case of BSE. And so, in fact, we are actively at
live stock markets and at slaughter seeking out downed animals for our
surveillance program.
So we would have routine samples submitted just from slaughter animals, but
then we are actively targeting downed animals for our surveillance program.
And, in fact, so far this year, we have collected samples from over 400
downed animals, again, all negative so far.
QUESTION: And just, if you can refresh me, if I run a slaughter house, am I
still allowed to slaughter a downed animal for meat?
DR. MURANO: A downed animal--this is Dr. Elsa Murano Under Secretary for
Food Safety--a downed animal, you have to remember, it could be an animal
that broke its leg. So what we do is we look at animals that, if they are
showing any kind of sign of illness, those animals, of course, are
absolutely immediately condemned and are not allowed to come into the food
supply. The "downed animals" that we allow would be an animal that simply
broke its leg, and it's down because it cannot walk for the broken leg
reason, not because of disease. Diseased animals are not allowed into the
food supply.
QUESTION: Okay. Thank you very much.
AT&T OPERATOR: Your next question comes from Leslie Clark. Please state your
company name.
QUESTION: The Miami Herald.
Could you give us a little more details on some of the epidemiological
surveys you are doing in Florida? I mean, are you going to any, you sound
confident that she contracted it in the U.K., but are you checking food
sources in Florida?
MR. : I think that you would be best served to address that question with
the State of Florida, but from our perspective, there wouldn't be any reason
to do that based on our current understanding of this case.
QUESTION: So you are that sure.
MR. : Yes.
MR. PIERCE: Next question?
AT&T OPERATOR: Next question comes from Sandy Antonio. Please state your
company name.
QUESTION: Hi, NBC 6 in Miami.
Basically, all of my questions were pretty much answered, but are you guys
allowed to let us know like what part of Florida she is from?
MR. PIERCE: Again, the people at the state have simply elected to say that
she is a resident of the State of Florida.
QUESTION: Okay.
MR. PIERCE: Next question?
AT&T OPERATOR: Your next question comes from Marion Falco. Please state your
company name.
QUESTION: Hi, I'm with CNN.
I have a couple of questions. First of all, do you know how many cases
worldwide have been found of new variant CJD in people obviously? And, also,
you said that she was tested in England or in the U.K. Obviously, if you
could give some details on how that test is--and why you're so
obviously--you think it's so conclusive because the only way to truly
identify it is if you do an autopsy, and obviously she is still alive.
MR. PIERCE: I'll let Dr. Schonberger give you that information.
DR. SCHONBERGER: Yes, this is Dr. Schonberger.
It's my understanding that at the beginning of this month there was 125
total cases in the world--117 of those cases were reported from the United
Kingdom, 6 of those cases were reported from France, and there was 1 each
reported from Ireland and Italy.
Now these cases have a very unique, in a sense, clinical presentation and
quite different from that of regular classic CJD. In addition, there are
several types of tests that we are aware of that were conducted on the
particular patients that we are talking about that are strongly indicative
of the new variant CJD.
Those tests need to be assessed, however, further, the results of them, in
the U.K. for a final determination. The results that we have seen from a
paper report, as I say, are very strongly indicative of this disease, and
that is why we are calling it, given the clinical picture, given these
reports, that it is very likely a case.
QUESTION: Do you have a--if I can have a quick follow-up--what is the
prognosis of this patient?
DR. SCHONBERGER: Well, we can't say absolutely because it's, again, you're
talking about 125 diagnosed case. But, in general, the disease is
degenerative, and there currently is no specific therapy or intervention
that can be given. So the prognosis is, in general, not good.
QUESTION: But is she gravely ill right now or is she--I know you can't
reveal any details, but is she going to drop--not to be callous--but is she
going to drop dead tomorrow or is she, I mean, she was able to travel back
from the U.K.
DR. SCHONBERGER: Right.
QUESTION: Is she in robust shape?
DR. SCHONBERGER: I think it's safe to say that if she had a clinically
compatible illness that she wouldn't be in robust shape, but, again, to
respect her privacy and confidentiality, I don't think we can go any further
than that. But, again, I think the fact that she was able to travel home
certainly is suggestive that she is certainly not at the end stage.
MR. PIERCE: Next question?
AT&T OPERATOR: Your next question comes from David Brown. Please state your
company name, sir.
QUESTION: The Washington Post.
A couple of things. First of all, does she eat meat? And if she's a
vegetarian, how long has she been a vegetarian?
Can you tell us was she in England for all of the '80s, for 7 years of the
'80s, all of the '90s, just something perhaps a little bit more specific?
And the third thing is I got on after the introductions, and it is Dr.
Schonberger. Could you give his full name, and identification, and perhaps
spell his last name. I would appreciate it.
DR. OSTROFF: Sure. This is Steve Ostroff. I actually don't know what her
food preferences are. Again, we just learned about this case and are in the
process of investigating it. In terms of whether she was in Great Britain
during the entire period of the '80s, as I mentioned at the beginning, sort
of the peak period of the epidemic in animals was in the late '80s and the
early '90s, and she was there during the peak of the epidemic, so I think,
based on that, I would have to say that she was, indeed, there during the
entire period of the 1980s.
DR. SCHONBERGER: Schonberger is S-c-h-o-n-b-e-r-g-e-r.
And as you heard from Dr. Ostroff, she's 22 years old, so you know when she
was born, and she spent the majority of her life in the U.K. before coming
to the United States. So you can calculate where she was during the '80s.
QUESTION: Can you tell me your first name and your identification, and it's
S-c-h-o-n-b-e-r-g-e-r; is that right?
DR. SCHONBERGER: That's right, Lawrence or Larry is the first name, either
one, and I'm Chief of the CJD Surveillance Unit.
QUESTION: Okay. Thank you.
AT&T OPERATOR: Your next question comes from Stacy Singer. Please state your
company name.
QUESTION: I'm with Sun Sentinel in South Florida.
Since this is a disease that hasn't been seen in the United States before, I
wonder if you are communicating with health care providers to look for any
types of symptoms, et cetera? What kind of communications going on, and how
are Florida health departments and health officials getting involved or are
they?
DR. OSTROFF: I think that question would best be addressed to the State of
Florida.
Again, both we and the state have just learned about this case and are still
in the process of investigating it. I'm sure that in the same way that we're
holding this telebriefing, the state is taking steps, as we speak, to
appropriately notify the county health departments around the state. But,
again, it's much better to speak to them and find out specifically what they
are doing.
QUESTION: Is there going to be any education effort for health care
providers related to this?
DR. OSTROFF: We definitely have been working with our colleagues in the
clinical community to make them aware of the signs and symptoms of this
disease. We have information that is on our website, and I think that the
information is readily available. Because of this particular case, I think
we will be making it more readily available on the website so that it is
more easily accessible.
MR. PIERCE: This is Bill Pierce, and I would just add, I mean, literally by
holding this press conference and the news getting out, we'll certainly get
the attention of the clinical community who will then probably get back to
the CDC and the FDA to learn more if they have questions. So we appreciate
you guys being on the phone call.
MR. : I would like to maybe add something. If you really want to be helpful
in terms of informing people about what services are available, the CDC has
established, in collaboration with the neuropathology group, a National
Prion Disease Pathology Center which provides free of charge two patients
and physicians the latest and most up-to-date, state-of-the-art prion
disease diagnostic tools, and so they could call.
If they have any patients where they are suspicious of either the regular
Creutzfeldt-Jakob disease that we have in the United States routinely or
even a variant CJD that we are highly suspicious of in this case, they can
send tissues to that National Prion Disease Pathology Surveillance Center.
It is located in Cleveland, Ohio, at Case Western Reserve University.
DR. DeHAVEN: This is Ron DeHaven from USDA. Let me just take a moment to put
a plug in for our website at USDA. It is www.usda.gov. And you can click on
the BSE button. It will tell you everything you need to know about the
disease itself, as well as the Harvard risk assessment that we had conducted
to evaluate the likelihood of having BSE in cattle in the United States.
MR. PIERCE: Next question?
AT&T OPERATOR: Your next question comes from Marin McKenna. Please state
your company name.
QUESTION: Hi. This is Marin McKenna from the Atlanta Journal Constitution.
Thanks for doing this.
I have two questions. First, Dr. Ostroff or Dr. Schonberger, could you talk
a little bit about the prevalence of classic CJD in the U.S. Do you have
numbers for the U.S. as a whole or for Florida?
And, second, over the course of the discovery of the new variant CJD
epidemic in the United Kingdom, there was some discussion over whether
standard practices for sterilizing medical and dental instruments were
adequate in the setting of a prion disease, and there was some discussion
also of changing to disposable instruments.
Can you talk about that, and the obvious question, of course, is are you
aware of whether this patient had any surgery or dental work in the U.S.?
DR. SCHONBERGER: Let me answer your first question about what's the normal
observations we have in terms of the incidence of classic CJD in the United
States.
We are finding that through the various methods that we use to monitor the
disease that we are observing about one case per million population per
year--roughly, just under 300 cases every year. And when you calculate the
incidence by year for the period 1985 through to the present, we find that
the incidences remain relatively stable. Now the specific numbers are
available on our website, but again it will be around 275/300 cases a year.
DR. OSTROFF: The other thing that I will just note, in terms of that, is
that the classic forms of CJD are much more common in older individuals, and
so that rate of one per million is for the population as a whole. Obviously,
the state of Florida has a large elderly population and so you might
anticipate that if you see a rate that is a little bit higher, it is not
necessarily because there is a higher risk in Florida, it's because there's
a large population of people who are at the highest risk of getting the
classic form of the disease.
As far as your question about sterilization, I don't know if Dr. Lumpkin
from FDA would want to comment on that.
DR. LUMPKIN: What I would comment on that is, as we've been talking about
with the classic form of Creutzfeldt-Jakob, we have had, along with CDC,
recommendations for dealing with instruments and tissues from individuals
who were known to have this kind of disease or who were suspected of having
this kind of disease. I don't think we know of any reason that you would
treat variant Creutzfeldt-Jakob differently than classical
Creutzfeldt-Jakob, as far as instrumentation is concerned.
As to your question about this particular patient, again, I will refer that
one back to CDC.
DR. OSTROFF: I'm sorry. Has the patient had dental work or surgery?
QUESTION: Correct.
DR. OSTROFF: I don't have that information at the current time and probably
the State of Florida would have more specific information about her medical
history.
However, again, I want to emphasize that for the purposes of respecting this
patient's confidentiality, I am not 100-percent sure that they would divulge
that information.
MR. PIERCE: Next question?
AT&T OPERATOR: Your next question comes from David Royce. Please state your
company, sir.
QUESTION: It's Dave Royce with the Associated Press. I just want to be clear
on something. Did she present symptoms in Florida and then go back to the
United Kingdom for diagnosis and follow up? That's my first question.
DR. OSTROFF: Let me answer that by saying that is our current understanding.
QUESTION: So she was--so she then had a follow-up examination in the UK and
was confirmed to have, or it came to be believed that she had
Creutzfeldt-Jakob disease and then returned to the United States?
DR. OSTROFF: Correct.
QUESTION: And can you be a little more specific about when that was, when
she returned to the United States?
DR. OSTROFF: Well, again, we just learned of this from the providers in the
UK, and so her return was recent, but I think--I can't be specific about the
exact date and time.
QUESTION: I mean recent, does that mean this year, within the last two
years, three years?
DR. OSTROFF: Oh, her diagnosis was just made.
QUESTION: And then the final question, and I understand that this isn't
transmitted from person to person, but is it normal that someone with this
disease would be allowed to leave the UK when she knew that she had the
disease, and come to the United States? And did nobody ask any questions
about that? Is that just kind of a common thing?
DR. OSTROFF: I--there's no reason that she can't come home that we're aware
of. I mean there is no--and there is not on the list of diseases that are
not permissible for entry into the United States, and essentially this is
not a communicable disease.
QUESTION: Thank you. And that was Dr. Ostroff?
DR. OSTROFF: Yes.
QUESTION: Thank you.
MR. PIERCE: We'll take two more questions. Next question? We have no more
questions?
AT&T OPERATOR: Your next question comes from Richard Knox. Please state your
company name.
QUESTION: National Public Radio. Have the cases of variant CJD in Britain
been emerging at a steady pace, or has there been a long lag since between
the last one and this one? Does anybody know whether she's kind of a late
outlier or whether this has been happening on a yearly basis in the UK?
DR. SHONBERGER: This is Dr. Shonberger. The cases in the UK are actually
increasing in their incidence. This is an analysis that was reported at a
recent conference by the CJD Surveillance Group in the United Kingdom. So at
this point in time they do not know what the final number of cases will be,
but the 125 that we know about in the world is part of an ongoing outbreak.
QUESTION: Do you know the current pace of new cases being reported in the
UK?
DR. SHONBERGER: The--we're talking--one of the numbers that I have heard
them talk about is that there is a--from the review of what has happened in
the past, there has been a doubling of the number of cases about every 3-1/2
years.
DR. : And I might add that if you want the specifics of the number of cases
reported on a quarterly basis from the UK, they do make that information
available on their website. If you punch in new variant Creutzfeldt-Jakob
disease, it will take you to the Ministry of Health website in the UK, and
they have a very nice table of the actual incidence of cases on a quarterly
basis.
DR. : And you can get to their website through the CDC website if you wish.
QUESTION: Thanks.
MR. PIERCE: This will be the last question.
AT&T OPERATOR: Your last question comes from Monica Conrad. Please state
your company name.
QUESTION: ABC News. I think we've pretty much covered it.
MR. PIERCE: Excellent, Monica, way to go.
QUESTION: The last one was the last question. Thank you.
MR. PIERCE: I want to thank everybody for joining us this evening, and if
there's anything different or new to report, we obviously will be in touch
with folks. Goodnight.
