Commission Decision of 19 March 2002 laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (notified under document number C(2002) 1043) (2002/253/EC) (repealed)

[F1 VARIANT CREUTZFELDT-JAKOB DISEASE (VCJD) U.K.

Preconditions U.K.

• Any person with a progressive neuropsychiatric disorder with a duration of illness of at least six months

• Routine investigations do not suggest an alternative diagnosis

• No history of exposure to human pituitary hormones or human dura mater graft

• No evidence of a genetic form of transmissible spongiform encephalopathy

Clinical criteria U.K.

Any person with at least four of the following five:

• Early psychiatric symptoms (1)

• Persistent painful sensory symptoms (2)

• Ataxia

• Myoclonus or chorea or dystonia

• Dementia

Diagnostic criteria U.K.

Diagnostic criteria for case confirmation: U.K.

• Neuropathological confirmation: spongiform change and extensive prion protein deposition with florid plaques throughout the cerebrum and cerebellum

Diagnostic criteria for a probable or a possible case: U.K.

• EEG does not show the typical appearance (3) of sporadic CJD (3) in the early stages of the illness

• Bilateral pulvinar high signal on MRI brain scan

• A positive tonsil biopsy (4)

Epidemiological criteria U.K.

An epidemiological link by human to human transmission (e.g. blood transfusion)

Case classification U.K.

A. Possible case U.K.

Any person fulfilling the preconditions

AND

• meeting the clinical criteria

  AND

• a negative EEG for sporadic CJD (3)

B. Probable case U.K.

Any person fulfilling the preconditions

AND

• meeting the clinical criteria

  AND

• a negative EEG for sporadic CJD (3)

  AND

• a positive MRI brain scan

  OR

Any person fulfilling the preconditions

AND

• a positive tonsil biopsy

C. Confirmed case U.K.

Any person fulfilling the preconditions

AND

• meeting the diagnostic criteria for case confirmation]

Textual Amendments

F1 Substituted by Commission Decision of 28 April 2008 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (notified under document number C(2008) 1589) (Text with EEA relevance) (2008/426/EC).

(1)

[F1 Depression, anxiety, apathy, withdrawal, delusions.

(2)

This includes both frank pain and/or dysaesthesia.

(3)

The typical appearance of the EEG in sporadic CJD consists of generalised periodic complexes at approximately one per second. These may occasionally be seen in the late stages of VCJD.

(4)

Tonsil biopsy is not recommended routinely nor in cases with EEG appearances typical of sporadic CJD, but may be useful in suspect cases in which the clinical features are compatible with VCJD and MRI does not show pulvinar high signal.]

Textual Amendments

F1 Substituted by Commission Decision of 28 April 2008 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (notified under document number C(2008) 1589) (Text with EEA relevance) (2008/426/EC).