NR APAF
AU Ward,H.J.T.; Sanchez-Jaun,P.; Smith,A.J.; Everington,D.; Cooper,S.A.; Heath,C.; Knight,R.S.G.; Will,R.G.
TI Secondary transmission of variant Creutzfeldt-Jakob Disease (vCJD)?
QU International Conference - Prion diseases: from basic research to intervention concepts - TSE-Forum, 08.10.-10.10.2003, Gasteig, München - Poster session - BR-61
PT Konferenz-Poster
AB
The most likely cause of variant CJD (vCJD) is dietary transmission of abnormal prion protein. However, the possibility of secondary iatrogenic transmission must be considered. This paper evaluates the evidence for secondary transmission via surgery, ophthalmic surgery, dentistry and blood transfusion.
Data of medical interventions were obtained from relatives, hospital and general practice records of 136 cases of vCJD referred to the UK CJD Surveillance Unit, and hospital and community controls. Recipients of blood transfusions were traced via the relevant blood transfusion service.
There were no statistical differences between the frequencies of ophthalmic surgery between cases and controls. 8 patients with vCJD (6%) had a history of eye surgery and all, except one carried out 15 months prior to onset, were performed in childhood. 5 (3%) community controls of and 10 (15%) hospital controls had a history of ophthalmic surgery. There was no geographic or temporal link between cases. The frequency of neurological, ear, nose and throat, abdominal, orthopaedic, transplant and thoracic surgery in 100 vCJD cases were not statistically different from control groups.
Root canal treatment, extractions and crowns/bridges were identified a priori as the highest risk treatments. There was no significant difference between the frequency of dental treatment of 116 cases, 137 community and 61 hospital controls.
33 recipients of blood products were identified from 126 vCJD cases eligible to donate blood. The mean age of recipients was 62 years (17-99 years); 20 of whom had died, (median time between transfusion and death: 144 days (0 days-18 years), none with a progressive neurological illness.
In spite of the presence of abnormal prion protein and the demonstration of infectivity in the lymphoreticular system, there is no evidence to date of secondary transmission of vCJD.
Although these data are reassuring, the possibility of secondary transmission cannot be excluded.
AD H.J.T. Ward, P. Sanchez-Jaun, D. Everington, S. Cooper, C. Heath, R.S.G. Knight, R.G. Will, National CJD Surveillance Unit, UK; A. Smith, University of Glasgow Dental School, UK
SP englisch
PO Deutschland