N.H. Hospital May Have Exposed Patients to CJD
http://www.medpagetoday.com/Surgery/Neurosurgery/41405

Published: Sep 5, 2013

By John Gever, Deputy Managing Editor, MedPage Today

Health officials in New Hampshire said eight neurosurgery patients at one hospital in the state may have been unwittingly exposed to Creutzfeldt-Jakob disease (CJD).

Surgical instruments used on a patient later given a tentative diagnosis of sporadic CJD were subsequently used in at least eight other patients after ordinary sterilization, which is not adequate to reliably eliminate the prion proteins responsible for CJD, the officials said Wednesday.

The first patient underwent surgery at Catholic Medical Center in Manchester, N.H., in May and died in August. The CJD diagnosis has not been confirmed, as detailed study of the patient’s brain is still underway.

Some news reports indicated that the total number of potentially exposed patients could be as high as 13. Some of the surgical equipment used on the first patient was rented and later taken to hospitals in other states, these reports said.

Officials said the eight patients exposed in the Manchester hospital had been notified, and that they had been told the risk of infection was extremely low.

Sporadic CJD is thought to arise from a spontaneous refolding of normal prion proteins into a disease-causing conformation within an individual’s brain. The abnormally folded proteins then catalyze refolding of other normal prion proteins, eventually causing a lethal sponge-like encephalopathy. About 350 cases of sporadic CJD have been diagnosed annually in the U.S. in recent years, according to the CDC.

The sporadic form differs from so-called variant CJD, transmitted via ingestion of misfolded prion proteins from food animals such as beef cattle, and popularly referred to as mad cow disease.