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Tougher Guidelines Needed To Prevent Variant Creutzfeldt-Jakob Disease

Scientist want tougher guidelines to be imposed on re-use of surgical instruments to prevent the spread of variant Creutzfeldt-Jakob disease// (vCJD), the human form of Bovine Spongiform Encephalopathy (BSE) or mad cow disease.

Even though most of the 161 cases of vCJD are linked to patients eating beef infected with BSE, scientists believe vCJD could also spread by infected surgical tools as the protein which triggers the disease sticks firmly to the stainless steel tools used for surgery and is not effectively removed by sterilization. Also, recent cases of vCJD have been reported following blood transplants raising concerns about iatrogenic transmission through instrumentation.

Scientist want a log on the number of times surgical instruments are used and also a log on the patient on whom they were used to ensure that instruments could be discarded appropriately in case they were found to be used on patients with vCJD.

Scientists at the National Creutzfeldt-Jakob Disease Surveillance Unit in Edinburgh and the London School of Hygiene and Tropical Medicine fear that hundreds could die in the next 20 years as a result of vCJD contracted during surgery as the hospitals do not keep a log on how often surgical tools are used in operations.

Tini Garske at the London School of Hygiene and Tropical Medicine has asked for the Department of Health to fund an audit to get the number of times instruments are used. "Just knowing how many times instruments are used would be a huge help, but if the instruments were tracked, we could link them to patients and make sure they are not used again," said Dr Garske.

Even though no case of vCJD has so far been linked to surgical instruments, there is a theoretical possibility that hundreds of death could occur as a result of infection with vCJD via surgery. As a precautionary measure the UK government has allocated £200 million for tracking of reusable surgical equipment.
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