Reinterpreting Chronic Wasting Disease Emergence in the USA in Light of Historical Surveillance Limitations.

We estimated the probabilities of detecting one or more chronic wasting disease (CWD) cases (Pdet) in free-ranging cervids in the continental US during 1997 - 2001. Based on sample sizes reported by respective state authorities at the time and a target for detectable apparent prevalence (i.e., a design prevalence) of 0.001 (one positive per 1,000 animals statewide), estimated Pdet were <50% for 39/46 states where CWD had not been detected in the wild prior to 1997 and were <5% in 20/26 states located east of the Mississippi River. The survey designs and sample sizes reported by most states prior to 2002 would have yielded exceedingly small detection probabilities for focal CWD outbreaks. Although most CWD foci in the US were first detected in 2002 or after, the data presented here and elsewhere suggest it is plausible that an unknown number of these-some established perhaps decades earlier-were already present but had simply eluded detection. These data highlight uncertainty regarding timelines for CWD emergence in the US. Accepting-and to the extent possible quantifying-uncertainty in the historical distribution of CWD throughout the US seems a necessary foundation for better understanding its emergence, its drivers and patterns of spread, and its response to various interventions-past, present, and future.