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A Practical Approach to Avoiding Iatrogenic Creutzfeldt-Jakob Disease (CJD) from Invasive Instruments

Published online by Cambridge University Press:  08 April 2015

Paul Brown  and
Michael Farrell
Paul Brown*
Affiliation:
National Institutes of Health (retired), Bethesda, Maryland, USA
Michael Farrell
Affiliation:
Neuropathology, Beaumont Hospital, Dublin, Ireland
*
Address all correspondence to Paul Brown, MD, 7815 Exeter Road, Bethesda, MD. ([email protected]).
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Abstract

Potential Creutzfeldt-Jakob disease instrument-contamination events continue to occur, causing widespread hospital and patient concern. We propose the use of a combination of diagnostic tests (ie, spinal fluid for 14-3-3 protein or nasal brushing for misfolded prion protein) and instrument handling procedures (ie, using a regional set of dedicated instruments), which if applied to all patients admitted with symptoms of either dementia or cerebellar disease, should eliminate the risk of iatrogenic instrument infection.

Infect Control Hosp Epidemiol 2015;36(7):844–848

Type
Review Article
Information
Infection Control & Hospital Epidemiology , Volume 36 , Supplement 7 , July 2015 , pp. 844 - 848
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

1. Brown, P, Gibbs, CJ Jr, Rodgers-Johnson, P, et al. Human spongiform encephalopathy: the National Institutes of Health series of 300 cases of experimentally transmitted disease. Ann Neurol 1994;35:513–529.Google Scholar
2. Jones, DP, Nevin, S. Rapidly progressive cerebral degeneration (subacute vascular encephalopathy) with mental disorder, focal disturbances, and myoclonic epilepsy. J Neurol Neurosurg Psychiatr 1954;17:148–159.Google Scholar
3. Nevin, S, McMenemey, WH, Behrman, S, Jones, DP. Subacute spongiform encephalopathy – a subacute form of encephalopathy attributable to vascular dysfunction (spongiform cerebral atrophy). Brain 1960;83:519–570.CrossRefGoogle ScholarPubMed
4. Will, RG, Matthews, WB. Evidence for case-to-case transmission of Creutzfeldt-Jakob disease. J Neurol Neurosurg Psychiatr 1982;45:235–238.Google Scholar
5. Bernoulli, C, Siegfried, J, Baumgartner, G, et al. Danger of accidental person-to-person transmission of Creutzfeldt-Jakob disease by surgery. Lancet 1977;1:478–479.Google Scholar
6. El Hachimi, KH, Chaunu, M-P, Cervenakova, L, Brown, P, Foncin, J-F. Putative neurosurgical transmission of Creutzfeldt-Jakob disease with analysis of donor and recipient: agent strains. C.R. Acad Sci Paris 1997;320:319–328.Google Scholar
7. Xiao, X, Yuan, J, Qing, L, et al. Comparative study of prions in iatrogenic and sporadic Creutzfeldt-Jakob disease. J Clin Cell Immunol 2014;5:240–249.Google Scholar
8. Kobayashi, A, Parchi, P, Yamada, M, et al. Reliable criteria to identify Creutzfeldt-Jakob disease among presumed spontaneous cases. J Virol 2015;Jan 21. pii: JVI.03183-14 [Epub ahead of print].Google Scholar
9. Belay, ED, Blase, J, Sehulster, LM, Maddox, RA, Schonberger, LB. Management of neurosurgical instruments and patients exposed to Creutzfeldt-Jakob disease. Infect Control Hosp Epidemiol 2013;34:1271–1280.CrossRefGoogle ScholarPubMed
10. CJD Guideline: Classic Creutzfeldt-Jakob Disease in Canada, Quick Reference Guide. Ottawa, Canada: Health Canada; 2007. Pp. 1–15.Google Scholar
11. Smyth, EG, Farrell, M, Healy, DB, et al. Managing the consequences of neurosurgical intervention in a patient with previously undiagnosed Creutzfeldt-Jakob disease. Infect Control Hosp Epidemiol 2014;35:907–908.Google Scholar
12. Stoeck, K, Sanchez-Juan, P, Gawinecka, J, et al. Cerebrospinal fluid biomarker supported diagnosis of Creutzfeldt-Jakob disease and rapid dementias: a longitudinal multicenter study over 10 years. Brain 2012;135:3051–3061.Google Scholar
13. Orrú, CD, Bongianni, M, Tonoli, G, et al. A test for Creutzfeldt-Jakob disease using nasal brushings. New Engl J Med 2014;371:519–529.CrossRefGoogle ScholarPubMed
14. Fichet, G, Comoy, E, Duval, C, et al. Novel methods for disinfection of prion-contaminated medical devices. Lancet 2000;364:521–526.Google Scholar
15. Hewitt, PE, Llewelyn, CA, Mackenzie, J, Will, RG. Creutzfeldt-Jakob disease and blood transfusion: results of the UK Transfusion Medicine Epidemiological Review study. Vox Sang 2006;91:1–10.Google Scholar