How was the French BSE epidemic underestimated?

In a previous study, we showed that estimates of the BSE epidemic in France were censored by cattle mortality and by a lack of diagnosis. Indeed, we estimated that 51 300 cattle were infected by the BSE agent between 1987 and 1997, whereas only 103 clinical BSE cases were detected by the passive surveillance system up to June 2000. The question thus arises as to the part played by each form of censorship in this underestimation. Here, using an updated cattle survival distribution, we estimated that 44 800 cattle were infected by the BSE agent between 1987 and 1997, and that 7100 of them showed clinical signs of BSE up to June 2000, showing the low efficiency of the surveillance system. Moreover, between 2087 and 5980 'infectious' cattle, with clinical or preclinical BSE, entered the human food chain before July 1996, the date of the ban on specified bovine offal.