Brain, Vol. 125, No. 6, 1414-1416,
June 2002
© 2002 Guarantors of Brain
Book Review |
PRINCIPLES OF NEUROEPIDEMIOLOGY
MRC Environmental Epidemiology Unit, University of Southampton, Southampton, UK
PRINCIPLES OF NEUROEPIDEMIOLOGY
Edited by Tracy Batchelor and Merit E. Cudkowicz
2001. Oxford: Butterworth-Heinemann
Price £65. Pp. 400. ISBN 0750670428.
Pots and pans but no pudding
Rinyaszentkirály is a small village in the south west of Hungary with a population of less than 500 souls. Eleven of the 15 babies born there in 1989 and 1990 had serious congenital abnormalities. The first reaction, when news of this apparent epidemic reached official ears, was to put it down to misdiagnosis by a country doctor. But when a team of geneticists and paediatricians was sent to examine the babies, the outbreak proved to be real enough. Epidemiologists know from bitter experience that most clusters of disease are chance events but, even allowing for the likelihood of inbreeding in an isolated community, this explanation wouldn’t wash. The probability of 11 affected births out of 15, when the expected rate of congenital abnormalities is 
6%, is less than one in a billion.
The investigating epidemiologists found no evidence of unusually high rates of congenital abnormality in nearby towns and villages.