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Prospective 25-year surveillance of prion diseases in France, 1992 to 2016: a slow waning of epidemics and an increase in observed sporadic forms
- Angéline Denouel1 , Jean-Philippe Brandel1,2 , Laurène Peckeu-Abboud3 , Danielle Seilhean1 , Elodie Bouaziz-Amar4,5 , Isabelle Quadrio6,7 , Jean-Baptiste Oudart8,9,10 , Sylvain Lehmann11 , Pantxika Bellecave12 , Jean-Louis Laplanche4,5 , Stéphane Haik1,2
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View Affiliations Hide AffiliationsAffiliations: 1 Paris Brain Institute (Institut du Cerveau, ICM), INSERM, CNRS, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France 2 Assistance Publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des Maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France 3 Department of Clinical Sciences, Clinical Immunology Unit, Institute of Tropical Medicine, Antwerp, Belgium 4 Département de Biochimie et Biologie Moléculaire, Hôpitaux Lariboisière-Fernand Widal, Paris, France 5 INSERM, UMR 1144, ‘Optimisation Thérapeutique en Neuropsychopharmacologie’, Paris, France 6 Neurochemistry and Neurogenetics Unit, Department of Biochemistry and Molecular Biology, Lyon University Hospital, Bron, France 7 CNRS UMR5292, INSERM U1028, University of Lyon 1, BioRan, Lyon, Paris 8 Université de Reims Champagne-Ardenne, SFR CAP-Santé (FED 4231), Laboratoire de Biochimie Médicale et Biologie Moléculaire, Reims, France 9 CNRS UMR 7369, Matrice Extracellulaire et Dynamique Cellulaire – MEDyC, Reims, France 10 CHU Reims, Pôle de Biologie, Service de Biochimie – Pharmacologie – Toxicologie, Reims, France 11 Université de Montpellier, IRMB, INM, INSERM, CHU de Montpellier, Laboratoire Biochimie-Protéomique clinique, Montpellier, France 12 CHU Bordeaux, Virology Laboratory, Bordeaux, FranceAngéline Denouelangeline.denouel gmail.com
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Citation style for this article: Denouel Angéline, Brandel Jean-Philippe, Peckeu-Abboud Laurène, Seilhean Danielle, Bouaziz-Amar Elodie, Quadrio Isabelle, Oudart Jean-Baptiste, Lehmann Sylvain, Bellecave Pantxika, Laplanche Jean-Louis, Haik Stéphane. Prospective 25-year surveillance of prion diseases in France, 1992 to 2016: a slow waning of epidemics and an increase in observed sporadic forms. Euro Surveill. 2023;28(50):pii=2300101. https://doi.org/10.2807/1560-7917.ES.2023.28.50.2300101 Received: 09 Feb 2023; Accepted: 01 Jun 2023
Abstract
Prion diseases are rare, fatal disorders that have repeatedly raised public health concerns since the early 1990s. An active prion disease surveillance network providing national level data was implemented in France in 1992.
We aimed to describe the epidemiology of sporadic, genetic and infectious forms of prion diseases in France since surveillance implementation.
We included all suspected cases notified from January 1992 to December 2016, and cases who died during the period with a definite or probable prion disease diagnosis according to EuroCJD criteria. Demographic, clinical, genetic, neuropathological and biochemical data were collected.
In total, 25,676 suspected cases were notified and 2,907 were diagnosed as prion diseases, including 2,510 (86%) with sporadic Creutzfeldt–Jakob disease (sCJD), 240 (8%) genetic and 157 (6%) with infectious prion disease. Suspected cases and sCJD cases increased over time. Younger sCJD patients (≤ 50 years) showed phenotypes related to a distinct molecular subtype distribution vs those above 50 years. Compared to other European countries, France has had a higher number of cases with iatrogenic CJD after growth hormone treatment and variant CJD (vCJD) linked to bovine spongiform encephalopathy (second after the United Kingdom), but numbers slowly decreased over time.
We observed a decrease of CJD infectious forms, demonstrating the effectiveness of measures to limit human exposure to exogenous prions. However, active surveillance is needed regarding uncertainties about future occurrences of vCJD, possible zoonotic potential of chronic wasting diseases in cervids and increasing trends of sCJD observed in France and other countries.
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