New variant of Creutzfeldt-Jakob (vCJD) disease and other human prion diseases under epidemiological surveillance in Brazil

Abstract

To increase the timeliness of detection of human cases of the new variant of Creutzfeldt-Jakob disease (vCJD) and to reduce the risk of transmission, the Brazilian Ministry of Health has established and standardized rules and control measures. These include the definition of criteria for suspect cases, reporting, monitoring, and control measures for illness prevention and transmission. Guidelines to be used by the team of health care staff were published and distributed to health workers. A detailed proposal for a simplified system of surveillance for prion diseases was developed and mandatory reporting introduced. Additional effort is necessary to increase vCJD case detection, thus making it necessary to establish a partnership with health care services for best identification of suspected cases and dissemination of information to all involved in the service dealing with vCJD investigation.

Prion diseases are under compulsory notification in Brazil: Surveillance of cases evaluated by biochemical and/or genetic markers from 2005 to 2007

“…Presence of periodic sharp wave complexes in EEG and abnormal high signal in the cortex, caudate nucleus, putamen and thalamus on FLAIR, T2 and/or diffusion-weighted in MRI were considered as suspicious. A notification form was filled out with all possible data while cerebrospinal fluid and blood samples were collected and sent to specialized centers following a pre standardized chronogram 26 to evaluate 14.3.3 protein levels and for PRNP sequencing respectively.…”

“…In 2001, the Brazilian Ministry of Health devised special actions aimed at reducing risks of CJD transmission within the country, and in July 2005 CJD was included amongst the diseases under mandatory notification and investigation. 26 To date, 35 cases have been notified and analyzed by biochemical and genetic markers where 51% of these were classified as probable sCJD. Genetic forms of prion diseases due to recognized pathogenic PRNP mutations were not found.…”

Viral and Prion Infections Associated with Central Nervous System Syndromes in Brazil

“…CJD and its variants have been included on the list of compulsorily reported diseases in Brazil since 2005. The notification organization chart progresses from the identification of the suspected case by the health care services, through its confirmation, until its notification to the local epidemiological surveillance system and registration in the Notifiable Diseases Information System (Sinan) [ 236 ]. From 2005 to 2020, 1273 suspected cases of CJD were reported, resulting in the confirmation of 408 cases, with an average age at onset of 62 years of age ( Figure 3 ).…”

Compulsory Notification of Prion Diseases in Brazil: What Has Changed Since 2005?

“…Nevertheless, in 2005, the Health Ministry included PD in the compulsory notification list, which requires health care professionals to notify all suspected cases to public departments of health in order to establish groups of epidemiological surveillance, reinforcing the PD epidemiology. 5 …”