Australian hospital warns of possible CJD exposure  

More than 1,000 patients contacted 

A hospital in Melbourne, Australia has contacted 1,056 patients who underwent brain or spinal surgery in the past 18 months after a patient died of Creutzfeldt-Jakob disease (CJD), according to published reports.

Australian health authorities said in a statement there was an "extremely remote" risk that the disease could be spread by surgical equipment.

The hospital stressed that the disease was not the variant type of CJD commonly referred to as the human version of mad cow disease. Rare but recurrent, the traditional so-called sporadic form of CJD occurs throughout the world. It is a rapidly progressive, invariably fatal neurodegenerative disorder that is assumed to be caused by abnormal prion proteins. The estimated annual incidence in the United States is about one case per million people. The vast majority of CJD patients usually die within one year of illness onset, but the incubation period prior to that may be as long as 20 years.

Though rare, sporadic CJD raises major infection control questions — including possibly notifying exposed patients — because nosocomial transmission has occurred via surgical instruments and other means. A case similar to the one at Royal Melbourne Hospital occurred in 2001 at a Colorado hospital, which notified patients after a patient with undiagnosed CJD underwent a brain biopsy.

Though properly sterilized and disinfected, the instruments had been reused on six subsequent patients in the interim between the biopsy and the diagnosis. Those had to be considered possible exposures because traditional sterilization methods may not effectively kill CJD in brain and dura mater left on instruments.