A STATISTICAL-MODEL TO IDENTIFY THE CONTAMINATED LOTS IMPLICATED IN IATROGENIC TRANSMISSION OF CREUTZFELDT-JAKOB-DISEASE AMONG FRENCH HUMANGROWTH-HORMONE RECIPIENTS

From 1970 to 1988, thousands of children have been treated with human growth hormone (hGH) to supply pituitary gland deficiency, In France, 51 of the 968 children treated by hGH lots produced between January 19 84 and March 1985 had developed Creutzfeldt-Jakob disease (CJD) by the end of 1996. The authors' objective was to investigate which of the 1 3 hGH lots produced during this period might be implicated in the iatr ogenic transmission of CJD, In this paper, the authors describe a mode l that was developed to compute the probability for each lot of being contaminated. The validity of the model was assessed by a simulation s tudy that showed a good agreement between the estimated and the simula ted number of contaminated lots. The model suggested that about half o f the lots distributed during this period might have been contaminated by the infectious agent that causes CJD, The risk of iatrogenic CJD f or patients exposed to contaminated hGH lots was estimated to be 0.06 (95% confidence interval 0.05-0.07).