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Novant Health officials apologized this week to 18 patients and their families for exposing those patients to surgical instruments that had been used on a CJD patient ….
In the past 30 years, only four patients have been infected in this way, none in the United States.
….procedures involving retina and optic nerve were associated with an increased risk at a latency of ≥1 year OR (95% CI) 5.53 (1.08 to 28.0). At latencies of 10 to 19 years, interventions on peripheral nerves 4.41 (1.17 to 16.6) and skeletal muscle 1.58 (1.01 to 2.48) were directly associated. Interventions on blood vessels 4.54 (1.01 to 20.0), peritoneum 2.38 (1.14 to 4.96) and skeletal muscle 2.04 (1.06 to 3.92), interventions conducted by vaginal approach 2.26 (1.14 to 4.47) and a pooled category of lower-risk procedures 2.81 (1.62 to 4.88) had an increased risk after ≥20 years.
Surgery Linked to Creutzfeldt-Jakob Disease
A new study spearheaded by Spanish scientists demonstrates a causal relationship between the onset of Creutzfeldt-Jakob disease (CJD), caused by a protein called a prion, and general surgery.
…The finding, published recently in the Journal of Neurology, Neurosurgery & Psychiatry, reveals that, with a few exceptions, the risk of having contracted the sporadic form of CJD manifests itself at least 20 years after having undergone an operation.
...We might, therefore, ask ourselves if other types of motor neuron diseases can be transmitted through surgery and be latent for decades, such as those where risk factors, particularly physical professions and activities or certain sporting activities, for example, which are more likely to lead to surgery, have already been indicated.
…the most conclusive pattern that the study presents, ….is that the onset of CJD occurs approximately 10 years after an operation on the retina with reused equipment.
Now that medical instruments can be decontaminated
& prions can be deactivated, it seems this should be
mandatory practice in hospitals. Maybe it's very expensive?
It will be interesting to follow & see where all this new prion
information leads to & if people will try to sue, or there will
be more testing. I just had a major surgery at the end of Aug 2013.
How should heat-sensitive instruments or materials that come in contact with suspected or confirmed CJD patients be decontaminated?
All disposable instruments, materials, and wastes that come in contact with high infectivity tissues (brain, spinal cord, and eyes) and low infectivity tissues (cerebrospinal fluid, kidneys, liver, lungs, lymph nodes, spleen, and placenta) of suspected or confirmed TSE patients should be disposed of by incineration. Surfaces and heat-sensitive re-usable instruments that come in contact with high infectivity and low infectivity tissues should be decontaminated by flooding with or soaking in 2N NaOH or undiluted sodium hypochlorite for 1 hour and rinsed with water.
[CDC NOTE: Sodium hypochlorite may be corrosive to some instruments.]
I am glad to see they can finally test for prions.