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The feared large scale epidemic of variant Creutzfeldt–Jakob disease (vCJD) has thankfully not materialised. The number of cases identified annually in the UK has been in decline since 1999 although there could still be a tail to the outbreak lasting for many years (figure). Internationally, the trend in the number of vCJD cases is also in decline and bovine spongiform encephalopathy (BSE) is now a rare disease, even in the UK. One explanation is that the measures introduced to control these diseases were effective; indeed, it is of interest that, to date, no case of vCJD in the UK was born after 1989 when the specified bovine offal ban was introduced whereas there have been three cases born after this date in other European countries where legislative measures to minimise human exposure to BSE were introduced some years later. However, BSE and vCJD control measures are very costly and there will be pressure in the coming years to withdraw or amend relevant legislation and guidance. An important question is whether there are continuing realistic concerns about public …
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