Infection Control Concerns Regarding CJD

  1. It sounds like the additional form of infection control they are doing is identifying the patients at risk, if they can, and then disposing of the surgical instruments afterwards. I wonder how much of risk there is to contract this surgically. They did say that quite a few of the patients with the disease had had prior surgery or am I misunderstanding this.

    http://news.scotsman.com/health.cfm?id=1221872006
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  2. 8 Comments

  3. by   Marie_LPN, RN
    Since one of our spine instruments is $2800 for just ONE, that would get extremely expensive.

    The article seemed to mean that mad cow cannot be cleared off of instruments throuogh decontam and autoclaving.

    Quoted from http://news.scotsman.com/topics.cfm?...&id=1118012006 :

    No case of vCJD has so far been linked to surgical instruments.
    Graham Steel, of the CJD Alliance, said many unknowns remained over the issue of surgical transmission of vCJD.
    Which kinda makes me wonder how great is the sterilization process. If it's possibly not good enough to get rid of mad cow, then what about the other diseases that could possibly be lingering?
    Last edit by Marie_LPN, RN on Aug 21, '06
  4. by   pickledpepperRN
    http://www.cdc.gov/ncidod/EID/vol7no1/brown.htm

    http://www.cdc.gov/ncidod/dvrd/cjd/

    How should surgical instruments used on suspected or confirmed CJD patients be reprocessed?
    http://www.cdc.gov/ncidod/dvrd/cjd/i...tm#reprocessed
  5. by   indigo girl
    Quote from http://news.scotsman.com/topics.cfm?tid=671&id=1118012006
    No case of vCJD has so far been linked to surgical instruments. But Dr Garske said theoretical models found it was possible that hundreds of deaths could occur between 2006 and 2021 as a result of infection with vCJD via surgery. It was also possible that there would be no cases, due to uncertainties about the risks of transmission on reused instruments and the lack of data on how often they are reused.
    I read this as meaning that they are not certain, because of the lack of data, and that MAY be why they can not prove cause and effect. They are concerned about the theoretical models, at least, that is what I think they are saying.
    They are certainly proceeding as if they are concerned.


    And then, this seems like a lot of people who had surgery, happened to develop this disease. Is really not higher than the rest of the population?

    [QUOTE=http://news.scotsman.com/topics.cfm?tid=671&id=1118012006]

    Of 161 people diagnosed with vCJD by the end of 2005, 130 had had surgery in the years preceding the start of symptoms. But there was no evidence to suggest this was higher than the rest of the population, the report said.
  6. by   indigo girl
    [QUOTE=spacenurse]http://www.cdc.gov/ncidod/EID/vol7no1/brown.htm

    This article is from 2001, and says there have been no cases of BSE in the US, which is no longer the case. There have been three, THAT WE KNOW ABOUT, which is why we have this economic consequence:

    http://www.presstelegram.com/business/ci_4216657

    The FDA has a testing program, and it may work very well. They do not test every cow. You have to wonder, however, about the three cases. Did these cases occur in a vacuum? Just how did they get infected anyway? If it was from their feed, what about the other cows that ate that feed, and where are they? These were old cows, I think, so what have they been used for prior to diagnosis?
  7. by   indigo girl
    Dairy cattle feed recalled due to contamination with animal tissue this year:

    http://depts.washington.edu/einet/?a...cle&print=2316
  8. by   indigo girl
    In the Texas case, an admirable job was done trying to trace the origin of the index animal, but they could not:

    Quote from http://www.aphis.usda.gov/newsroom/hot_issues/bse/content/printable_version/EPI_Final.pdf
    Summary:
    Despite a thorough investigation of two farms that were known to contain the index cow,
    and 35 other farms that might have supplied the index cow to the farms where the index
    case was known to have resided, the investigators were unable to locate the herd of
    origin. The index case did not have unique or permanent identification, plus, the size and
    color of the cow being traced is very common in the Southern United States. Due to the
    unremarkable appearance of solid red cows, it is not easy for owners to remember
    individual animals. In the Southern United States, it is common business practice to buy
    breeding age cows and keep them for several years while they produce calves. Most
    calves produced are sold the year they are born, whereas breeding cows are sold when
    there is a lapse in breeding, which can occur multiple times in cows' lives. For all of
    these reasons, USDA was unable to locate the herd of origin.
  9. by   indigo girl
    This is the result of the more recent Alabama case:



    Quote from http://www.aphis.usda.gov/newsroom/hot_issues/bse/content/printable_version/EPI_Final.pdf#search=%22USDA%20Alabama%20BSE%20Inv estigation%22
    Summary:
    Despite a thorough investigation of two farms that were known to contain the index cow,
    and 35 other farms that might have supplied the index cow to the farms where the index
    case was known to have resided, the investigators were unable to locate the herd of
    origin. The index case did not have unique or permanent identification, plus, the size and
    color of the cow being traced is very common in the Southern United States. Due to the
    unremarkable appearance of solid red cows, it is not easy for owners to remember
    individual animals. In the Southern United States, it is common business practice to buy
    breeding age cows and keep them for several years while they produce calves. Most
    calves produced are sold the year they are born, whereas breeding cows are sold when
    there is a lapse in breeding, which can occur multiple times in cows' lives. For all of
    these reasons, USDA was unable to locate the herd of origin.
  10. by   indigo girl
    And this link is on the original case in Washington state, note the last paragraph:

    http://www.usda.gov/wps/portal/!ut/p...4TQ/.d/0/_th/J

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