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CJD Fact Sheet (Mad Cow Disease) |
Why are Transonic Neuro Flowprobes Single Use? |
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Transonic Systems offers single-use disposable Flowprobes for neurosurgery in order to protect against the possibility of inadvertent transmission of sterilization-resistant Creutzfeldt-Jakob Disease (CJD). Why Does CJD present such a critical concern for neurosurgeons and what is the rationale behind Transonic Systems single-use disposable flowprobe offering for neurosurgeons?
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What is Creutzfeldt-Jakob Disease? |
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Creutzfeldt Jakob Disease (CJD) is a fatal neurological disorder. Symptoms, similar to those of Alzheimer’s Disease, typically begin to appear about age 60, but progression of the disease is then rapid and most patients die within one year. Initial symptoms include memory lapses, behavioral changes, lack of coordination and visual disturbances. As the disease progresses, mental deterioration continues and involuntary movements, blindness, weakness of extremities, and coma may occur. There is no treatment or cure for CJD. Human CJD includes: sporadic CJD in which the person has no known risk factors and symptoms appear spontaneously; acquired CJD in which the disease is transmitted by exposure to infected brain or nervous system tissue, usually through certain medical procedure involving the brain, spinal cord or eyes; and hereditary CJD.
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Pathogenesis |
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CJD belongs to the transmissible spongiform encephalopathies (TSE) disease family. Its name refers to the sponge-like appearance of infected brain cells under the microscope. It is thought to be caused by protein isomer (prion) which is very infective when inoculated directly into nervous tissue. CJD’s virulence, combined with its remarkable resistance to conventional sterilizing procedures,1,2,3 has resulted in transmission between neurosurgical patients.4
Other TSEs are found in animals such as cows (bovine encephalopathy [BSE] or “Mad Cow Disease”) scrapie, which affects sheep and goats; mink encephalopathy; and feline encephalopathy. Similar disease are endemic in elk, deer (Chronic Wasting Disease) and zoo animals.
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Resistance to Sterilization |
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TSE prions are resistant to steam sterilization, dry heat, ethylene oxide gas and chemical disinfection. No consensus exists on sterilization methods for surgical instruments adequate to prevent the spread of CJD, but autoclaving at 134-138C for 60 min is inadequate.1 Steam autoclaving and even ashing at 360C is not effective.3 Solutions of sodium hypochloride1 and quanidine thiocyanate5 offer promise to disrupt the infectious agent.
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Preventing CJD Transmission during Neurosurgery |
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It is recommended that “all instruments used for patients with CJD must be destroyed” and re-use of surgical instruments in neurological cases is also not advised.6 The virulence of TSE demands that medical professionals adopt the same prophylactic philosophy used for rabies after an animal bite, and HIV when there is a risk of blood exposure: WHEN IN DOUBT, PROCEED AS IF THE AGENT IS PRESENT. Sensitive to this need, Transonic Systems is pleased to offer single-use disposable flowprobes for neurosurgery.
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References
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(http://www.ninds.nih.gov/disorders/cjd/detail–cjd.html)
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1
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Taylor DM, Fraser H, McConnell I, Brown DA, Brown KL, Lamza KA, Smith GR, Decontamination studies with the agents of bovine spongiform encephalopathy and scrapie. Arch Virol 1994;139(3-4):313-326.
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2
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Burger D, Gorham JR, Observation on the remarkable stability of transmissible mink encephalopathy virus. Res Vet Sci 1977 Jan;22(1):131-2.
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3
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Brown P, Liberski PP, Wolff, A, Gajdusek, DC, Resistance of scrapie infectivity to steam autoclaving after formaldehyde fixation and limited survival after ashing at 360 degrees C: practical and theoretical implications. J Infect Dis 1990 Mar;161(3):467-72.
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4
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el Hachimi KH, Chaunu MP, Cervenakova, L, Brown, P, Foncin, JF, Putative neurosurgical transmission of Creutzfeldt-Jakob disease with analysis of donor and recipient: agent strains. C R Acad Sci III 1997 Apr;320(4):319-28.
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5
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Manuelidis, L, “Decontamination of Creutzfeldt-Jakob Disease and Other Transmissible Agnets,” Neuroviro 1997;3(1):62-65.
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6
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Estebe JP, Anesthesia and non-conventional transmissible agents. Ann Fr Anesth Reanim 1997;16(8):955-63.
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More Background References >
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Last Updated 7/2005
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