Hospital fears brain disease
transmitted through surgery
Tuesday, 14
September 2004
A Melbourne hospital warned more than 1000 former patients
yesterday they may have contracted a rare and fatal brain disease
from surgical instruments.
Although doctors say the risk of transmission is extremely small,
the Royal Melbourne Hospital couriered letters to 1056 brain or
spinal patients yesterday after confirmation of the rare
Creutzfeldt-Jakob disease at the hospital.
The hospital stressed that the disease was not the type of CJD
known as variant CJD (vCJD) and commonly referred to as mad cow
disease.
Concerns arose after a middle- aged Victorian man died earlier this
year of CJD, which is one of the only diseases to withstand normal
sterilisation processes.
The man underwent brain surgery at the hospital twice in 2003, but
was diagnosed with the disease only last week.
The hospital has withdrawn its stock of 15,000 neurosurgical
instruments pending their replacement and has begun sterilising its
entire stock of 300,000 surgical instruments on the advice of the
National CJD Incidents Committee.
Director of Neurosurgery Professor Andrew Kaye said patients who
had undergone brain or spinal surgery during the past 18 months
were being contacted as a precaution.
"There has not been a proven case of transmission of CJD between
patients via surgical instruments in the past 30 years," he
said.
"Expert advice is that there is only an extremely remote risk of
transmission in this case." The last known case of probable
transmission of the disease through neurosurgical instruments in
Australia was during the 1970s.
There have been five reported cases world-wide of CJD being
transmitted via contaminated neurosurgical equipment.
Professor Kaye said CJD was one of the few diseases which "can
withstand normal sterilisation processes". If a patient was known
to have or have had symptoms of CJD, then disposable surgical
instruments were used.
The man who died of the disease was originally admitted to the
hospital for treatment for malignant brain tumours, a condition not
associated with CJD.
The last operation performed on the man at the hospital was six
months before the symptoms of the disease became apparent.
"This has not arisen because of any breach of protocol or
guidelines," Professor Kaye said.
Diagnosis of CJD was only possible during an autopsy via a test
which took two months to complete.
