Re: Decontamination fo CJD tissue.
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|From:||Tim Morken <firstname.lastname@example.org>|
For really good information about the practicalities of dealing with CJD lab
Jennifer Hofecker, HT, Dept of Pathology, Univ. of Rochester Medical center,
Box 626, Rochester, NY, 14642. PH(W): 716-275-3196, email:
Jennifer has put on workshops at the NSH meetings and has a lot of printed
material on how to set up a lab for CJD work.
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,
For all CDC information on CJD, go to to the main CDC web page and search
for "CJD" :
CJD Epidemiology, risk factors and decontamination:
Udatated info at (reproduced below)
AGENT: Transmissible Spongiform Encephalopathies (Creutzfeldt-Jakob, kuru
and related agents)
Laboratory-associated infections with the transmissible spongiform
diseases) have not been documented. However, there is evidence that
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
animals have been infected by inoculation, but there is no evidence of
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
the brain and spinal cord of persons with kuru. In persons with
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
of nerve tissues, including formalin-fixed specimens, is extremely
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
however, there is no evidence of contact or aerosol transmission. These
characterized by extreme resistance to conventional inactivation
irradiation, boiling, dry heat and chemicals (formalin,
however, they are inactivated by 1 N NaOH, sodium hypochlorite (>2%
concentration) and steam autoclaving at 134 degrees C for 1 hour.
RECOMMENDED PRECAUTIONS: Biosafety Level 2 practices and facilities are
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
Formaldehyde-fixed and paraffin-embedded tissues, especially of the
infectious. It is recommended that formalin-fixed tissues from
suspected cases of
transmissible encephalopathy be immersed in 96% formic acid for 30
histopathologic processing (15). Vaccines are not available for use in
NSH just had a teleconference on this TODAY - Wed. July 21, 1999.
Contact the NSH office at 301-262-6221. Ask them for Jennifer's
phone number, the person who gave the teleconference today. I
forget her last name, and I'm at home, and that's at work.
You really need a good procedure. THIS IS NOTHING TO GOOF UP ON.
Basically, you will need to fix the tissue in 10% NBF for several
days, place it in 90% formic acid for an hour, go back into NBF,
hand process in plastic dishes, collect all the fixation and processing
solutions and dishes for special sterilization and incineration,
wear all the personal protective equipment you can, cover your
microtomes with plastic wrap or aluminum foil to collect all
the shavings (to be sterilized and incinerated), hand stain
in plastic disposable containers (and again collect all
staining solutions to be sterilized and incinerated).
I hope someone will be able to contact Jennifer early
tomorrow, or that someone will be able to email you their
procedure. (Sorry, I got a new computer at work, and literally
cannot do a thing with it. But that's another story.)
Also, maybe someone can email you the address of the
Histonet archives. I can't find my bookmark on it.
I know this has been discussed before, so you might be able
to find a procedure from previous postings.
Peggy A. Wenk, HTL(ASCP)
William Beaumont Hospital
Royal Oak, MI 48073
----Original Message Follows----
From: Sharon Allen <SAllen@exchange.hsc.mb.ca>
To: "'email@example.com'" <firstname.lastname@example.org>
Subject: Decontamination fo CJD tissue.
Date: Thu, 09 Mar 2000 13:56:01 -0600
We receive all ?Creutzfeld-Jakob cases in our area, which amount to
8 to 12/year, with 1 to 3 positives.
I would be interested in hearing of other labs protocol for handling
these cases i.e. decontamination of tissue etc.
We currently use formic acid for up to 2 hours for the tissue,
sodium hypochlorite for the glassware, microtome, countertop and
incineration for anything disposable.
Any input negative or positive would be appreciated.
Winnipeg, Manitoba Canada
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