Surgical instruments

Creutzfeldt-Jakob Disease Can Surface Years After Surgery

With a few exceptions, the risk of having contracted the sporadic form of Creutzfeldt-Jakob disease (CJD) manifests itself at least 20 years after having undergone surgery, according to new research published recently in the Journal of Neurology, Neurosurgery & Psychiatry.

With a few exceptions, the risk of having contracted the sporadic form of Creutzfeldt-Jakob disease (CJD) manifests itself at least 10 years after having undergone surgery, according to new research published recently in the Journal of Neurology, Neurosurgery & Psychiatry.

Jesús de Pedro, the head of prion monitoring at the National Epidemiology Centre of the Carlos III Health Institute, explains, "Based on the monitoring records of spongiform encephalopathy in two Nordic countries, we studied the possibility of transmission of the sporadic form of CJD through general surgery. While we are not ruling out the idea that intraoperational transfusions may play a secondary part, the data suggest that the disease enters and spreads much more quickly within the central or peripheral nervous system."

According to the authors, the fact that computer records of surgeries have been in place since the early seventies in hospitals in Sweden and Denmark enables operations on residents of those countries to be linked to cases of CJD, which "extends an extraordinary quality to the information and more credibility to the findings given the almost total absence of memory bias".

Why is the idea of transmission through surgery important? The most interesting thing about this finding, which points to an external cause that could be prevented, is that "it may signify a shift in our understanding of the nature of neurodegenerative diseases, such as Alzheimer's or Parkinson's," de Pedro says.

We might, therefore, ask ourselves if other types of motor neurone diseases can be transmitted through surgery and be latent for decades, such as those where risk factors, particularly physical professions and activities or certain sporting activities, for example, which are more likely to lead to surgery, have already been indicated.

"Suggesting that a disease could have been acquired during healthcare is a very delicate affirmation, as some relatives of patients with sporadic CJD may be tempted to seek compensation from health authorities for the alleged intraoperational transmission years previously, which would be impossible to prove in individual cases," de Pedro adds.

Nonetheless, the most conclusive pattern that the study presents, albeit based on few cases and one that must be replicated in future studies, is that the onset of CJD occurs approximately 10 years after an operation on the retina with reused equipment.

Reference: Jesús de Pedro-Cuesta, Ignacio Mahillo-Fernández, Alberto Rábano, Miguel Calero, Mabel Cruz, Ake Siden, Henning Laursen, Gerhard Falkenhorst, Kare Mølbak y el Grupo de Investigación EUROSURGYCJD. "Nosocomial transmission of sporadic Creutzfeldt-Jakob disease: results from a risk-based assessment of surgical interventions". J Neurol Neurosurg Psychiatry (2010).

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