Sent: Monday, March 15, 2010 12:19 PM Subject: Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Part 4 REVISED FEB. 2010
Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Part 4
PART 4
Infection control of CJD, vCJD and other human prion diseases in healthcare and community settings Part 4 has been redrafted (February 2010) to clarify how best to manage patients in healthcare and community settings. A number of recent policy decisions have been incorporated into this guidance including:
Standard infection control precautions should be used to clear up spillages as quickly as possible of all material from patients with, or “at increased risk” of, CJD/vCJD in a healthcare setting. 10,000ppm rather than 20,000ppm sodium hypochlorite is recommended for practical purposes.
High or medium risk tissues from patients with, or “at increased risk” of, CJD or vCJD, should be incinerated, and low risk tissues or body fluids should follow normal clinical waste disposal.
Instruments used in high or medium risk procedures on patients with, or “at increased risk” of, CJD/vCJD can be quarantined and re-used exclusively on the same patient, subject to tracking of instruments throughout the decontamination cycle, and ensuring that under no circumstances should quarantined instrument sets be reprocessed for use on other patients unless the diagnosis of CJD or vCJD has been positively excluded.
Individuals who have been identified prior to high risk surgery as having received blood or blood components from 80 or more donors since January 1980 are now designated as “at increased risk” of vCJD and have been added to Table 4a.
The anterior eye has been reclassified as low risk with regards to tissue infectivity. In addition, updated information on other guidance, including dentistry, anaesthesia and intensive care, has been incorporated.
Published: 2 June 2003
Revised and updated: 25 February 2010
Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Part 4
CONTENTS
Introduction
Other relevant guidance
Caring for patients with, or “at increased risk“ of, CJD or vCJD
Management arrangements for infection control
Tissue infectivity
Iatrogenic transmission
CJD
vCJD
Patient categorisation
Patients “at increased risk” of CJD or vCJD
Hospital care of patients
Taking samples and other invasive medical procedures
Spillages
Clinical waste
Childbirth
Bed linen
Occupational exposure
Surgical procedures and instrument management
Single use instruments
Handling of instruments that are not designated as single-use
Quarantining instruments
Decontamination of instruments
Storage of instruments for research purposes
Incineration of instruments
Complex instruments
Use of laser for tonsillectomy – smoke plumes
Anaesthesia and intensive care
Endoscopy
Ophthalmology
Community healthcare
Caring for symptomatic patients at home
Spillages
Published: 2 June 2003
Clinical waste
Revised and updated: 25 February 2010
Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Part 4
Bed linen
Pregnancy
Dentistry
After death
Published: 2 June 2003
Revised and updated: 25 February 2010
Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Part 4
Introduction
snip...
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@ab/documents/digitalasset/dh_113959.pdf
Saturday, January 23, 2010
Experimental Verification of a Traceback Phenomenon in Prion Infection
http://creutzfeldt-jakob-disease.blogspot.com/2010/01/experimental-verification-of-traceback.html
Sunday, January 17, 2010
CJD Following up: Patients never contracted brain disorder UW Hospital patients
http://creutzfeldt-jakob-disease.blogspot.com/2010/01/cjd-following-up-patients-never.html
Sunday, January 17, 2010
Human tissue, recovered from a donor history indicated increased risk factors for Creutzfeldt-Jacob disease Lions Eye Bank
http://creutzfeldt-jakob-disease.blogspot.com/2010/01/human-tissue-recovered-from-donor.html
Saturday, January 16, 2010
Evidence For CJD TSE Transmission Via Endoscopes 1-24-3 re-Singeltary to Bramble et al
http://creutzfeldt-jakob-disease.blogspot.com/2010/01/evidence-for-cjd-tse-transmission-via.html
Thursday, January 28, 2010
Multiorgan Detection and Characterization of Protease-Resistant Prion Protein in a Case of Variant CJD Examined in the United States
http://creutzfeldt-jakob-disease.blogspot.com/2010/01/multiorgan-detection-and.html
Friday, January 22, 2010
nvCJD Clause 2 : Blood donations
http://vcjdtransfusion.blogspot.com/2010/01/nvcjd-clause-2-blood-donations.html
Friday, November 20, 2009
SaBTO Advisory Committee on the Safety of Blood, Tissues and Organs Summary of the Eighth Meeting, 27 October 2009
http://vcjdtransfusion.blogspot.com/2009/11/sabto-advisory-committee-on-safety-of.html
Sunday, May 10, 2009
Meeting of the Transmissible Spongiform Encephalopathies Committee On June 12, 2009 (Singeltary submission)
http://tseac.blogspot.com/2009/05/meeting-of-transmissible-spongiform.html
Monday, August 17, 2009
Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Annex J,K, AND D Published: 2009
http://creutzfeldt-jakob-disease.blogspot.com/2009/08/transmissible-spongiform-encephalopathy.html
Friday, July 17, 2009
Revision to pre-surgical assessment of risk for vCJD in neurosurgery and eye surgery units Volume 3 No 28; 17 July 2009
http://creutzfeldt-jakob-disease.blogspot.com/2009/07/revision-to-pre-surgical-assessment-of.html
Tuesday, August 12, 2008
Biosafety in Microbiological and Biomedical Laboratories Fifth Edition 2007 (occupational exposure to prion diseases)
http://creutzfeldt-jakob-disease.blogspot.com/2008/08/biosafety-in-microbiological-and.html
14th ICID International Scientific Exchange Brochure -
Final Abstract Number: ISE.114
Session: International Scientific Exchange
Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America
update October 2009
T. Singeltary
Bacliff, TX, USA
Background:
An update on atypical BSE and other TSE in North America. Please remember, the typical U.K. c-BSE, the atypical l-BSE (BASE), and h-BSE have all been documented in North America, along with the typical scrapie's, and atypical Nor-98 Scrapie, and to date, 2 different strains of CWD, and also TME. All these TSE in different species have been rendered and fed to food producing animals for humans and animals in North America (TSE in cats and dogs ?), and that the trading of these TSEs via animals and products via the USA and Canada has been immense over the years, decades.
Methods:
12 years independent research of available data
Results:
I propose that the current diagnostic criteria for human TSEs only enhances and helps the spreading of human TSE from the continued belief of the UKBSEnvCJD only theory in 2009. With all the science to date refuting it, to continue to validate this old myth, will only spread this TSE agent through a multitude of potential routes and sources i.e. consumption, medical i.e., surgical, blood, dental, endoscopy, optical, nutritional supplements, cosmetics etc.
Conclusion:
I would like to submit a review of past CJD surveillance in the USA, and the urgent need to make all human TSE in the USA a reportable disease, in every state, of every age group, and to make this mandatory immediately without further delay. The ramifications of not doing so will only allow this agent to spread further in the medical, dental, surgical arena's. Restricting the reporting of CJD and or any human TSE is NOT scientific. Iatrogenic CJD knows NO age group, TSE knows no boundaries. I propose as with Aguzzi, Asante, Collinge, Caughey, Deslys, Dormont, Gibbs, Gajdusek, Ironside, Manuelidis, Marsh, et al and many more, that the world of TSE Transmissible Spongiform Encephalopathy is far from an exact science, but there is enough proven science to date that this myth should be put to rest once and for all, and that we move forward with a new classification for human and animal TSE that would properly identify the infected species, the source species, and then the route.
http://ww2.isid.org/Downloads/14th_ICID_ISE_Abstracts.pdf
International Society for Infectious Diseases Web: http://www.isid.org
Saturday, January 2, 2010
Human Prion Diseases in the United States January 1, 2010 ***FINAL***
http://prionunitusaupdate2008.blogspot.com/2010/01/human-prion-diseases-in-united-states.html
my comments to PLosone here ;
http://www.plosone.org/annotation/listThread.action?inReplyTo=info%3Adoi%2F10.1371%2Fannotation%2F04ce2b24-613d-46e6-9802-4131e2bfa6fd&root=info%3Adoi%2F10.1371%2Fannotation%2F04ce2b24-613d-46e6-9802-4131e2bfa6fd
Friday, February 05, 2010
New Variant Creutzfelt Jakob Disease case reports United States 2010 A Review
http://vcjd.blogspot.com/2010/02/new-variant-creutzfelt-jakob-disease.html
Sunday, February 14, 2010
[Docket No. FSIS-2006-0011] FSIS Harvard Risk Assessment of Bovine Spongiform Encephalopathy (BSE)
http://bseusa.blogspot.com/2010/02/docket-no-fsis-2006-0011-fsis-harvard.html
Wednesday, February 24, 2010
Transmissible Spongiform encephalopathy (TSE) animal and human TSE in North America 14th
ICID International Scientific Exchange Brochure -
http://transmissiblespongiformencephalopathy.blogspot.com/2010/02/transmissible-spongiform-encephalopathy.html
TSE
http://transmissiblespongiformencephalopathy.blogspot.com/
Friday, February 05, 2010
New Variant Creutzfelt Jakob Disease case reports United States 2010 A Review
http://vcjd.blogspot.com/2010/02/new-variant-creutzfelt-jakob-disease.html
TSS