Re: CJD
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From: | "Tim Morken" <timcdc@hotmail.com> |
To: | histonet@Pathology.swmed.edu |
Reply-To: | |
Date: | Thu, 22 Jul 1999 08:36:06 EDT |
Content-Type: | text/plain; format=flowed |
Karla,
Below are some sites I got together from CDC and other sources.
Journal article:
Handling Creutzveldt-Jakcob disease Tissues in the Histology Laboratory,
Titford, M. and Bastian, F.O., J Histotech, V12, No.3 Sept 1989
If you have access to the internet you can go to these sites:
Search Altavista for "CJD" at http://www.altavista.digital.com
there are many articles concerning CJD and V-CJD from Britain.
CAP: Detailed information on handling CJD in the autopsy suite and the lab,
with references.
http://www.cap.org/html/publications/cjd.html#menu
For all CDC information on CJD, go to to the main CDC web page and search
for "CJD" :
http://www.cdc.gov
CJD Epidemiology, risk factors and decontamination:
http://www.cdc.gov/ncidod/diseases/hip/cjd.htm
Media facts:
http://www.cdc.gov/od/oc/media/fact/cjd.htm
Udatated info at (reproduced below)
http://www.cdc.gov/od/ohs/biosfty/bmbl/sect7e.htm#Trans
AGENT: Transmissible Spongiform Encephalopathies (Creutzfeldt-Jakob, kuru
and related agents)
Laboratory-associated infections with the transmissible spongiform
encephalopathies (prion
diseases) have not been documented. However, there is evidence that
Creutzfeldt-Jakob
disease (CJD) has been transmitted iatrogenically to patients by
corneal transplants, dura
mater grafts and growth hormone extracted from human pituitary glands,
and by exposure
to contaminated electroencephalographic electrodes (99). Infection is
always fatal. There is
no known nonhuman reservoir for CJD or kuru. Nonhuman primates and
other laboratory
animals have been infected by inoculation, but there is no evidence of
secondary
transmission. Scrapie of sheep and goats, bovine spongiform
encephalopathy and mink
encephalopathy are transmissible spongiform encephalopathies of animals
that are similar to
the human transmissible diseases. However, there is no evidence that
the animal diseases
can be transmitted to man.
LABORATORY HAZARDS: High titers of a transmissible agent have been
demonstrated in
the brain and spinal cord of persons with kuru. In persons with
Creutzfeldt-Jakob disease
and its Gerstmann-Straussler-Schenker Syndrome variants, a similar
transmissible agent has
been demonstrated in the brain, spleen, liver, lymph nodes, lungs,
spinal cord, kidneys,
cornea and lens, and in spinal fluid and blood. Accidental parenteral
inoculation, especially
of nerve tissues, including formalin-fixed specimens, is extremely
hazardous. Although
non-nerve tissues are less often infectious, all tissues of humans and
animals infected with
these agents should be considered potentially hazardous. The risk of
infection from aerosols,
droplets, and exposure to intact skin, gastric and mucous membranes is
not known;
however, there is no evidence of contact or aerosol transmission. These
agents are
characterized by extreme resistance to conventional inactivation
procedures including
irradiation, boiling, dry heat and chemicals (formalin,
betapropiolactone, alcohols);
however, they are inactivated by 1 N NaOH, sodium hypochlorite (>2%
free chlorine
concentration) and steam autoclaving at 134 degrees C for 1 hour.
RECOMMENDED PRECAUTIONS: Biosafety Level 2 practices and facilities are
recommended
for all activities utilizing known or potentially infectious tissues
and fluids from
naturally-infected humans and from experimentally infected animals.
Extreme care must be
taken to avoid accidental autoinoculation, or other traumatic
parenteral inoculations of
infectious tissues and fluids (76). Although there is no evidence to
suggest that aerosol
transmission occurs in the natural disease, it is prudent to avoid the
generation of aerosols
or droplets during the manipulation of tissues or fluids, and during
the necropsy of
experimental animals. It is further strongly recommended that gloves be
worn for activities
that provide the opportunity for skin contact with infectious tissues
and fluids.
Formaldehyde-fixed and paraffin-embedded tissues, especially of the
brain, remain
infectious. It is recommended that formalin-fixed tissues from
suspected cases of
transmissible encephalopathy be immersed in 96% formic acid for 30
minutes before
histopathologic processing (15). Vaccines are not available for use in
humans (51).
----Original Message Follows----
From: "Carson, Karla" <KCarson@chw.edu>
To: "'Histonet'" <histonet@Pathology.swmed.edu>
Subject: CJD
Date: Wed, 21 Jul 1999 13:32:51 -0700
We are doing a brain biopsy tomorrow morning... just now got the word for
possible Creutzfeldt-Jacob Disease. How are you handling the
fixation/processing of surgical cases involving CJD?
Karla Carson HT/HTL(ASCP)
Regional Pathology Supervisor
Mercy Healthcare Sacramento
916-453-4494
kcarson@chw.edu <mailto:kcarson@chw.edu>
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