Estimation of the size of the iatrogenic Creutzfeldt-Jakob disease outbreak associated with cadaveric dura mater grafts in Korea

• Published in: Epidemiology and health 2016, 38(0), , pp.1-7
• Main Authors: Jeon, Byoug-Hak, Kim, Jinseob, Kim, GangHyun Kim, Park, Soo Chul, Kim, SangYun, Cheong, Hae-Kwan
• Format: Article
• Language: English
• Subjects: Creutzfeldt-Jakob disease; Dura mater; Incubation period; Modeling; Prediction; Prion diseases; Surveillance; 예방의학
• ISSN: 2092-7193; 2092-7193
• DOI: 10.4178/epih.e2016059

This study estimated the overall magnitude of Creutzfeldt-Jakob disease (iCJD) based on dura graft cases in Korea using a mathematical model. We estimated the number of annual cases of dura grafts performed between 1980 and 1995 by applying the proportion of dura grafts recorded by the Health Insurance Review Agency claim dataset in Korea to the number of nationwide neurosurgery cases. The distribution of the incubation period was assumed to fall under a Weibull distribution with density function or a log-logistic distribution with density function. The total number of neurosurgeries performed from 1980 to 1995 was estimated to be 263,945, and among these surgeries, 37% used dura graft products. Between the years of 1980 and 2020, our model predicts that the total number of iCJD cases was between 14.9 and 33.2 (95% CI: 13.4-50.9). Notably, we estimated that the cumulative number of iCJD cases caused by dura grafts between 1980 and 2011 was approximately 13.3 to 27.3 (95% CI: 12.2-40.6). Estimations made using this model are consistent with the actual development of cases, indicating that this model is valid for future projection. Based on our model, we postulate that iCJD will undergo a sharp decline from 2012 to 2020.