The importance of ongoing international surveillance for Creutzfeldt-Jakob disease

Nat Rev Neurol. 2021 Jun;17(6):362-379. doi: 10.1038/s41582-021-00488-7. Epub 2021 May 10.


Creutzfeldt-Jakob disease (CJD) is a rapidly progressive, fatal and transmissible neurodegenerative disease associated with the accumulation of misfolded prion protein in the CNS. International CJD surveillance programmes have been active since the emergence, in the mid-1990s, of variant CJD (vCJD), a disease linked to bovine spongiform encephalopathy. Control measures have now successfully contained bovine spongiform encephalopathy and the incidence of vCJD has declined, leading to questions about the requirement for ongoing surveillance. However, several lines of evidence have raised concerns that further cases of vCJD could emerge as a result of prolonged incubation and/or secondary transmission. Emerging evidence from peripheral tissue distribution studies employing high-sensitivity assays suggests that all forms of human prion disease carry a theoretical risk of iatrogenic transmission. Finally, emerging diseases, such as chronic wasting disease and camel prion disease, pose further risks to public health. In this Review, we provide an up-to-date overview of the transmission of prion diseases in human populations and argue that CJD surveillance remains vital both from a public health perspective and to support essential research into disease pathophysiology, enhanced diagnostic tests and much-needed treatments.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cattle
  • Creutzfeldt-Jakob Syndrome / diagnostic imaging*
  • Creutzfeldt-Jakob Syndrome / epidemiology*
  • Creutzfeldt-Jakob Syndrome / genetics
  • Humans
  • Internationality*
  • Population Surveillance* / methods
  • Prion Diseases / diagnostic imaging
  • Prion Diseases / epidemiology
  • Prion Diseases / genetics
  • Prions / genetics


  • Prions