Twenty-four surgery patients treated at a hospital in the northeast of England are being told that they could have been infected with Creutzfeldt-Jakob disease (CJD).
The risk, thought to be very small, has arisen because instruments used to operate on a patient with sporadic CJD were re-used. The UK Department of 91色情片 (DoH) described the incident as 鈥渁ppalling鈥� and said the hospital had apparently 鈥渇ailed to prevent avoidable and unnecessary exposure鈥�. The government鈥檚 chief medical officer has now ordered an inquiry.
Instruments used to conduct a brain biopsy on a female patient at Middlesbrough General Hospital were later used on other patients. But two weeks after the biopsy on 29 July, the woman was confirmed to be infected with the deadly brain disease. Only then were the instruments removed from use. There are five recorded cases of CJD transmission following neurosurgical operations.
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The hospital maintains that prior to the biopsy, she was examined by five neurologists, none of whom suspected she had the disease. However, Paul Lawler, medical director of the NHS trust that runs the hospital has admitted that 鈥渋n hindsight鈥� it may have been better to have removed the instruments immediately, rather than waiting until the CJD diagnosis had been confirmed.
Mutated protein
Safety procedures issued by DoH in 1999 require surgical instruments used on patients with suspected CJD to be quarantined until diagnosis is confirmed or discounted. This is because the mutated prion protein though to be responsible for CJD may survive standard decontamination techniques.
The precautions were introduced because an unknown number of people in the UK are carrying variant CJD, following the BSE fiasco of the 1980s and 1990s. But the incident in Middlesbrough will raise serious questions about how well the precautions are being complied with.
鈥淧atients are potentially at risk from people who are carrying vCJD, but don鈥檛 know it. It鈥檚 an unknown quantity,鈥� says a spokesperson from the National Prion Clinic at St Mary鈥檚 Hospital, London.
Sporadic CJD is a prion disease that occurs randomly in the population and has no known cause. The other form of the disease, vCJD, is believed to be transmitted by eating meat from BSE-infected cattle. Both forms lead to brain deterioration and eventual death, and there is no treatment or cure.
Since 1990, 577 people have died of sporadic CJD in the UK, with 117 succumbing to vCJD. The number of people infected with vCJD remains unknown and recent data shows the epidemic is still growing. The maximum estimates of the ultimate extent of the epidemic suggest vCJD will afflict thousands of people.