Research and
analysis
Creutzfeldt-Jakob disease (CJD) biannual update (August 2014), with updated guidance on decontamination of gastrointestinal endoscopy equipment
Published 8 August 2014
This six-monthly report provides an update on
the enhanced surveillance of potential iatrogenic (healthcare-acquired)
exposures to Creutzfeldt-Jakob Disease (CJD). The data is correct as at 30 June
2014. For numbers of CJD case
reports, readers should consult data provided by the National CJD Research and Surveillance Unit
(NCJDRSU).
Following the enhanced surveillance report, an update on the guidance for the decontamination of equipment for gastrointestinal endoscopy is presented.
Public health follow-up activities include clinical monitoring, general practitioner (GP) updates, and post mortem investigations to determine whether asymptomatic individuals in these groups have been infected with the CJD agent. Some individuals also provide blood or tissue specimens for research purposes. A number of different organisations are involved in these activities: Public Health England (formerly the Health Protection Agency), Health Protection Scotland (HPS), UCL Institute of Child Health/Great Ormond Street Hospital (ICH), NHS Blood and Transplant (NHSBT), National CJD Research and Surveillance Unit (NCJDRSU), National Prion Clinic (NPC), and the UK Haemophilia Centre Doctors’ Organisation (UKHCDO).
The PHE CJD Section coordinates the collation of data on individuals identified as at increased risk of CJD, and who have been informed of this. These individuals are followed up through public health monitoring and research activities by different organisations.
The PHE CJD Section currently holds data on the following groups of ‘at risk’ patients:
The data on ‘at risk’ patients who received human-derived human growth hormone held by the ICH is a slight underestimate of the total as a small number of these patients are not included in the ICH follow-up.
Table 1. Summary of all ‘at risk’ groups on which data are collected (data correct as at 30 June 2014)
a. These are minimum figures. Central reporting
for bleeding disorder patients is incomplete, and a small number of patients
have opted out of the central UKHCDO database. A
small number of ‘at risk’ growth hormone recipients are not included in the
Institute of Child Health study. Not all of ‘at risk’ growth hormone recipients
have been notified. There is no central record of who has been
informed.
b. An asymptomatic infection is when an individual does not exhibit any of the signs and symptoms of CJD in life but abnormal prion protein indicative of CJD infection has been found in tissue obtained from them. In these cases the abnormal prion protein was identified at post mortem.
c. One patient was notified by proxy.
d. Five of these notified by proxy.
e. Three of these were notified by proxy.
f. Includes patients notified by proxy.
The ACDP TSE specific guidance on endoscopy, Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Annex F [3], which builds on the recommendations from the BSG guidance has been updated.
Following the enhanced surveillance report, an update on the guidance for the decontamination of equipment for gastrointestinal endoscopy is presented.
1. Monitoring of patients ‘at increased risk’ of CJD
Individuals who have been identified as at increased risk of CJD as a consequence of their medical care are informed of their exposure and asked to follow public health precautions to avoid potentially transmitting the infection to others. They are also followed-up to help determine the risks of CJD transmission to patients through different routes and to ascertain whether any people who may have been exposed to increased CJD risks go on to develop CJD.Public health follow-up activities include clinical monitoring, general practitioner (GP) updates, and post mortem investigations to determine whether asymptomatic individuals in these groups have been infected with the CJD agent. Some individuals also provide blood or tissue specimens for research purposes. A number of different organisations are involved in these activities: Public Health England (formerly the Health Protection Agency), Health Protection Scotland (HPS), UCL Institute of Child Health/Great Ormond Street Hospital (ICH), NHS Blood and Transplant (NHSBT), National CJD Research and Surveillance Unit (NCJDRSU), National Prion Clinic (NPC), and the UK Haemophilia Centre Doctors’ Organisation (UKHCDO).
The PHE CJD Section coordinates the collation of data on individuals identified as at increased risk of CJD, and who have been informed of this. These individuals are followed up through public health monitoring and research activities by different organisations.
The PHE CJD Section currently holds data on the following groups of ‘at risk’ patients:
- recipients of blood components from donors who subsequently developed vCJD
- blood donors to individuals who later developed vCJD
- other recipients of blood components from these blood donors
- recipients of certain plasma products between 1990 and 2001 (non-bleeding disorder patients)
- certain surgical contacts of patients diagnosed with CJD
- highly transfused recipients.
- bleeding disorder patients who received plasma products between 1990 and 2001 (UKHCDO)
- recipients of human derived growth hormone before 1985 (ICH)
- patients who could have received a dura mater graft before August 1992 (data not currently collected)
- people who have been treated with gonadotrophin sourced from humans before 1973 (data not currently collected)
- family risk of inherent prion disease (NPC).
The data on ‘at risk’ patients who received human-derived human growth hormone held by the ICH is a slight underestimate of the total as a small number of these patients are not included in the ICH follow-up.
Table 1. Summary of all ‘at risk’ groups on which data are collected (data correct as at 30 June 2014)
| At risk Group | Identified as ‘at risk’ | Number notified as being ‘at risk’ | Cases | Asymptomatic infections [b] | |
|---|---|---|---|---|---|
| All | Alive | ||||
| Recipients of blood from donors who later developed vCJD | 67 | 27 | 14 | 3 | 1 |
| Blood donors to individuals who later developed vCJD | 112 | 108 | 104 | – | – |
| Other recipients of blood components from these donors | 34 | 32 [c] | 19 [c] | – | – |
| Plasma product recipients (non-bleeding disorders) who received UK sourced plasma products 1980-2001 | 11 | 10 | 4 | – | – |
| Certain surgical contacts of patients diagnosed with CJD | 196 | 161 [d] | 140 [e] | – | – |
| Highly transfused patients | 11 | 10 | 5 | – | – |
| Total for ‘at risk’ groups where PHE holds data | 431 | 348 [f] | 286 [f] | 3 | 1 |
| Patients with bleeding disorders who received UK-sourced plasma products 1980-2001 [a] | 3,977 | National information incomplete | National information incomplete | – | 1 |
| Recipients of human-derived growth hormone [a] | 1,883 | 1,883 | 1,503 | 75 | – |
| Total for all ‘at risk’ groups [a] | 6,291 | At least 2,231 | At least 1,789 | 78 | 2 |
b. An asymptomatic infection is when an individual does not exhibit any of the signs and symptoms of CJD in life but abnormal prion protein indicative of CJD infection has been found in tissue obtained from them. In these cases the abnormal prion protein was identified at post mortem.
c. One patient was notified by proxy.
d. Five of these notified by proxy.
e. Three of these were notified by proxy.
f. Includes patients notified by proxy.
2. Updated guidance on decontamination of equipment for gastrointestinal endoscopy
The British Society of Gastroenterology have updated their guidance on decontamination of equipment for gastrointestinal endoscopy [1]. The update includes revised advice for management and decontamination of endoscopes after they have been used for procedures on individuals at risk of variant CJD. This aligns with Department of Health guidance, CFPP 01-06, published in April 2013 [2], which recommended that: There is no longer a requirement to quarantine endoscopes following an “invasive” procedure on patients at risk of vCJD (with very few exceptions); a single quality assured decontamination cycle following recommended guidelines is considered sufficient, but the endoscope should be decontaminated separately from others with a single-use disinfectant; routine traceability data should be available to demonstrate thorough reprocessing; ‘Single use’ accessories should always be used in preference to reusable accessories.The ACDP TSE specific guidance on endoscopy, Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Annex F [3], which builds on the recommendations from the BSG guidance has been updated.
2.1 References
- SG Guidance on Decontamination of Equipment for Gastrointestinal Endoscopy (2014).
- Management and decontamination of flexible endoscopes (CFPP 01-06) (2013): Policy and Management.
- Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection: Annex F (2014).
This report was published in Health Protection
Report volume 8 issue 31.
https://www.gov.uk/government/publications/creutzfeldt-jakob-disease-cjd-surveillance-biannual-updates/creutzfeldt-jakob-disease-cjd-biannual-update-august-2014-with-updated-guidance-on-decontamination-of-gastrointestinal-endoscopy-equipment
https://www.gov.uk/government/publications/creutzfeldt-jakob-disease-cjd-surveillance-biannual-updates/creutzfeldt-jakob-disease-cjd-biannual-update-august-2014-with-updated-guidance-on-decontamination-of-gastrointestinal-endoscopy-equipment
see steady rise in sporadic CJD cases, from 33 cases in 1990, to 115 cases
in 2013...and please NOTE ;
‘’1 There are in addition a total of 9 cases of VPSPr (death in 1997(1
case), 2004(1), 2006(1), 2008(2), 2012(4)) not included in the above
figures.’’
CREUTZFELDT-JAKOB DISEASE IN THE UK (By Calendar Year)
REFERRALS OF SUSPECT CJD
DEATHS OF DEFINITE AND PROBABLE CJD
Year
Referrals
Year
Sporadic1
Iatrogenic
Genetic2
vCJD
Total Deaths
1990 [53]† 1990 28 5 0 - 33
1991 75 1991 31 1 4 - 36
1992 96 1992 45 2 6 - 53
1993 79 1993 36 4 7 - 47
1994 119 1994 54 1 8 - 63
1995 87 1995 35 4 5 3 47
1996 133 1996 40 4 6 10 60
1997 163 1997 59 6 6 10 81
1998 155 1998 64 3 5 18 90
1999 170 1999 62 6 2 15 85
2000 178 2000 50 1 3 28 82
2001 179 2001 58 4 6 20 88
2002 164 2002 73 0 5 17 95
2003 162 2003 79 5 6 18 108
2004 114 2004 50 2 6 9 67
2005 124 2005 67 4 13 5 89
2006 112 2006 68 1 9 5 83
2007 119 2007 64 2 10 5 81
2008 150 2008 86 5 5 2 98
2009 153 2009 80 2 8 3 93
2010 150 2010 85 3 7 3 98
2011 158 2011 90 4 14 5 113
2012 127 2012 93 5 11 0 109
2013 149 2013 104 2 8 1 115
2014* 76 2014 51 1 5 0 57
Total Referrals 3245 Total Deaths 1552 77 165 177 1971
† Referral figure for 1990 is from 1 May onwards * As at 1st September
2014
Summary of vCJD cases
Deaths
Deaths from definite vCJD (confirmed): 122
Deaths from probable vCJD (without neuropathological confirmation):
55
Deaths from probable vCJD (neuropathological confirmation pending): 0
Number of deaths from definite or probable vCJD (as above): 177
Alive
Number of definite/probable vCJD cases still alive: 0
Total number of definite or probable vCJD (dead and alive): 177
1 There are in addition a total of 9 cases of VPSPr (death in 1997(1 case),
2004(1), 2006(1), 2008(2), 2012(4)) not included in the above figures.
2 includes all genetic prion disease, including GSS.
archive of annual reports
Annex F – Endoscopy
Transmissible Spongiform Encephalopathy Agents: Safe Working and the
Prevention of Infection: Annex F
Published: September 2004
Revised and updated: January 2014
Annex F
ENDOSCOPY
Summary of advice
Annex F provides the definitive UK guidance on decontamination of flexible
endoscopes for TSE infection prevention and control.
The specific recommendations in this guidance are complementary to national
guidance on all aspects of endoscope decontamination such as Choice Framework
for local Policy and Procedures 01-06 and the British Society of
Gastroenterology (BSG) Guidelines for Decontamination of Equipment for
Gastrointestinal Endoscopy.
Annex F provides specific advice for the management of instruments used in
all types of endoscopic procedures. This advice differs depending on the type of
CJD that a patient has been diagnosed with, or for which symptoms are being
investigated, and for those who are asymptomatic but for whom an increased risk
of developing disease has been identified.
Paragraphs F4 to F27 set out the guidance for each circumstance in detail,
while summary advice is provided in table F1 and table F2a.
Endoscopes currently in quarantine
Advice is given below regarding endoscopes that have been held in
quarantine following previous use on patients who are at increased risk of
vCJD.
Endoscopes that have been placed into quarantine on or after 1 January
2010, assuming not used to treat one of the patient categories described at
paragraphs F20 to F23 should be reviewed as follows:
1) Was the endoscope properly decontaminated using a validated process
prior to quarantine?
2) Is there tracking to demonstrate the above?
3) Has the scope been stored properly whilst in quarantine (in a drying
cabinet or at least positioned vertically, not coiled up in a case)?
If all the above are met, the endoscope can be returned to use. If the
endoscope has been out of use for more than a few months it is recommended that
it is returned to the manufacturer for service and a check of handling
characteristics before returning to use.
Previous revision date: December 2012
Changes new to this edition:
Date
Change
Notes
January 2014
Slightly modified text to reflect the wording of Table F1 and F2a
This change affects paragraphs: F8, F17, F18, F22 and F26
January 2014
Changes to table F1 and F2a to align with policy
January 2014
Changes to notes of table F2a to align with policy
January 2014
Change of terminology from “infection control” to “infection prevention and
control”
Changed throughout the document as appropriate
Transmissible Spongiform Encephalopathy Agents: Safe Working and the
Prevention of Infection: Annex F
Annex J - Assessment to be carried out before surgery and/or endoscopy to
identify patients with, or at increased risk of, CJD or vCJD
Transmissible Spongiform Encephalopathy Agents: Safe Working and the
Prevention of Infection: Annex J
Published: 31 July 2006
Revised and updated: January 2014
ANNEX J
Assessment to be carried out before surgery and/or endoscopy to identify
patients with, or at increased risk of, CJD or vCJD
Summary of advice (revised January 2014)
Annex J provides a clear and pragmatic way of assessing CJD and vCJD risk
prior to surgery or endoscopy. Certain groups of patients have been informed
that they are at increased risk of CJD or vCJD.
*** Therefore it is recommended that all patients about to undergo any
surgery or endoscopy should be asked if they have ever been notified as at
increased risk of CJD or vCJD. This recommendation is outlined in paragraphs J1
and J2.
In addition, patients undergoing surgery or neuro-endoscopy which may
involve contact with tissues of potentially high level TSE infectivity (“high
risk tissues”) should, through a set of detailed questions, be assessed for
their possible CJD/vCJD risk exposure. These questions are outlined in Table J1
and paragraphs J3 to J6.
Previous revision date: January 2013
Changes new to this edition:
Date
Change
Notes
January 2014
Alignment of the list of people considered at increased risk of vCJD with
that contained in Part 4.
This change affects paragraph J14.
January 2014
Change of terminology from “infection control” to “infection prevention and
control”
Changed throughout the document as appropriate
These annexes have table at the start setting out the changes that have
been included in the new version.
FAQs – a new question has been added regarding blood transfusion
My patient has a history of blood transfusion. Should my patient be
considered at increased risk of CJD and/or vCJD?
Wednesday, January 15, 2014
*** INFECTION PREVENTION AND CONTROL OF CJD, VCJD AND OTHER HUMAN PRION
DISEASES IN HEALTHCARE AND COMMUNITY SETTINGS Variably Protease-Sensitive
Prionopathy (VPSPr) January 15, 2014
Thursday, January 23, 2014
Medical Devices Containing Materials Derived from Animal Sources (Except
for In Vitro Diagnostic Devices) [Docket No. FDA–2013–D–1574]
Monday, January 13, 2014
*** Prions in Variably Protease-Sensitive Prionopathy: An Update Pathogens
2013 Pathogens 2013, 2, 457-471; doi:10.3390/pathogens2030457
Friday, January 10, 2014
*** vpspr, sgss, sffi, TSE, an iatrogenic by-product of gss, ffi, familial
type prion disease, what it ???
*** The discovery of previously unrecognized prion diseases in both humans
and animals (i.e., Nor98 in small ruminants) demonstrates that the range of
prion diseases might be wider than expected and raises crucial questions about
the epidemiology and strain properties of these new forms. We are investigating
this latter issue by molecular and biological comparison of VPSPr, GSS and
Nor98.
Wednesday, March 28, 2012
VARIABLY PROTEASE-SENSITVE PRIONOPATHY IS TRANSMISSIBLE, price of prion
poker goes up again $
Saturday, August 14, 2010
BSE Case Associated with Prion Protein Gene Mutation (g-h-BSEalabama) and
VPSPr PRIONPATHY
(see mad cow feed in COMMERCE IN ALABAMA...TSS)
Monday, January 14, 2013
Gambetti et al USA Prion Unit change another highly suspect USA mad cow
victim to another fake name i.e. sporadic FFI at age 16 CJD Foundation goes
along with this BSe
VARIABLY PROTEASE-SENSITVE PRIONOPATHY IS TRANSMISSIBLE ...price of prion
poker goes up again $
OR-10 15:25 - 15:40 VARIABLY PROTEASE-SENSITIVE PRIONOPATHY IS
TRANSMISSIBLE IN BANK VOLES Nonno
OR-10: Variably protease-sensitive prionopathy is transmissible in bank
voles
Romolo Nonno,1 Michele Di Bari,1 Laura Pirisinu,1 Claudia D’Agostino,1
Stefano Marcon,1 Geraldina Riccardi,1 Gabriele Vaccari,1 Piero Parchi,2 Wenquan
Zou,3 Pierluigi Gambetti,3 Umberto Agrimi1 1Istituto Superiore di Sanità; Rome,
Italy; 2Dipartimento di Scienze Neurologiche, Università di Bologna; Bologna,
Italy; 3Case Western Reserve University; Cleveland, OH USA
Background. Variably protease-sensitive prionopathy (VPSPr) is a recently
described “sporadic”neurodegenerative disease involving prion protein
aggregation, which has clinical similarities with non-Alzheimer dementias, such
as fronto-temporal dementia. Currently, 30 cases of VPSPr have been reported in
Europe and USA, of which 19 cases were homozygous for valine at codon 129 of the
prion protein (VV), 8 were MV and 3 were MM. A distinctive feature of VPSPr is
the electrophoretic pattern of PrPSc after digestion with proteinase K (PK).
After PK-treatment, PrP from VPSPr forms a ladder-like electrophoretic pattern
similar to that described in GSS cases. The clinical and pathological features
of VPSPr raised the question of the correct classification of VPSPr among prion
diseases or other forms of neurodegenerative disorders. Here we report
preliminary data on the transmissibility and pathological features of VPSPr
cases in bank voles.
Materials and Methods. Seven VPSPr cases were inoculated in two genetic
lines of bank voles, carrying either methionine or isoleucine at codon 109 of
the prion protein (named BvM109 and BvI109, respectively). Among the VPSPr cases
selected, 2 were VV at PrP codon 129, 3 were MV and 2 were MM. Clinical
diagnosis in voles was confirmed by brain pathological assessment and western
blot for PK-resistant PrPSc (PrPres) with mAbs SAF32, SAF84, 12B2 and 9A2.
Results. To date, 2 VPSPr cases (1 MV and 1 MM) gave positive transmission
in BvM109. Overall, 3 voles were positive with survival time between 290 and 588
d post inoculation (d.p.i.). All positive voles accumulated PrPres in the form
of the typical PrP27–30, which was indistinguishable to that previously observed
in BvM109 inoculated with sCJDMM1 cases. In BvI109, 3 VPSPr cases (2 VV and 1
MM) showed positive transmission until now. Overall, 5 voles were positive with
survival time between 281 and 596 d.p.i.. In contrast to what observed in
BvM109, all BvI109 showed a GSS-like PrPSc electrophoretic pattern,
characterized by low molecular weight PrPres. These PrPres fragments were
positive with mAb 9A2 and 12B2, while being negative with SAF32 and SAF84,
suggesting that they are cleaved at both the C-terminus and the N-terminus.
Second passages are in progress from these first successful transmissions.
Conclusions. Preliminary results from transmission studies in bank voles
strongly support the notion that VPSPr is a transmissible prion disease.
Interestingly, VPSPr undergoes divergent evolution in the two genetic lines of
voles, with sCJD-like features in BvM109 and GSS-like properties in BvI109. The
discovery of previously unrecognized prion diseases in both humans and animals
(i.e., Nor98 in small ruminants) demonstrates that the range of prion diseases
might be wider than expected and raises crucial questions about the epidemiology
and strain properties of these new forms. We are investigating this latter issue
by molecular and biological comparison of VPSPr, GSS and Nor98.
SOURCE PRION2012
I believe it was Gambetti et al that coined this term sporadic FFI, from
some conspicuous sub-type of sporadic CJD possibly?
seems they could not tie it to a true FFI by diagnostic standards to date,
so it was then termed a sFFI, confusing matters even worse. ...
A subtype of sporadic prion disease mimicking fatal familial insomnia
THIS seems to raise more questions than answers, confusing the TSEs even
worse.
WHAT is sporadic CJD, and how many sub-types and atypical strains,
phenotypes etc. will there be, arising from nothing. a spontaneous happening of
sorts???
i think not. ...tss
Wednesday, October 27, 2010
A novel variant of human disease with a protease-sensitive prion protein
and heterozygosity methionine/valine at codon 129: Case report
snip...
Genetic findings
No mutations were found in the open reading frame after sequencing the
prion protein gene (PRNP). A heterozygosis methionine valine (MV) was observed
in codon 129.
snip...
Thursday, July 10, 2008
A Novel Human Disease with Abnormal Prion Protein Sensitive to Protease
update July 10, 2008
Although several subjects had family histories of dementia, no mutations
were found in the PrP gene open reading frame.
Thursday, July 10, 2008
A New Prionopathy update July 10, 2008
***+++***
Thursday, July 10, 2008
A Novel Human Disease with Abnormal Prion Protein Sensitive to Protease
update July 10, 2008 Friday, June 20, 2008
Here we go folks. AS predicted. THIS JUST OUT !
Tuesday, August 03, 2010
Variably protease-sensitive prionopathy: A new sporadic disease of the
prion protein
Monday, August 9, 2010
Variably protease-sensitive prionopathy: A new sporadic disease of the
prion protein or just more PRIONBALONEY ?
snip...see full text ;
O.K. let's compare some recent cases of this prionpathy in other countries
besides Gambetti's first 10 recently, that he claims is a spontaneous event,
from a genetic disorder, that is not genetic, but sporadic, that is related to
no animal TSE in North America, or the world. ...
Wednesday, October 27, 2010
A novel variant of human disease with a protease-sensitive prion protein
and heterozygosity methionine/valine at codon 129: Case report
Sunday, August 09, 2009
CJD...Straight talk with...James Ironside...and...Terry Singeltary... 2009
Tuesday, August 18, 2009
BSE-The Untold Story - joe gibbs and singeltary 1999 – 2009
====================================
The familial mutations, Gajdusek proposed, lowered the barrier to such
accidental conversion. "Thus," he wrote in 1996, "with these mutations, this
ordinarily rare event becomes a ... dominant inherited trait." But Weissmann's
qualification still remained to be refuted: the mutations might simply allow
easier entry to a lurking virus. ...page 202 Deadly Feast
===================================
something to think about for sure.
but i interpret this as (1st not the gold standard, just my opinion;-), as
because of certain gene mutations, one or a family, would be more susceptible to
the many different strains of TSE, and the many different proven routes and
sources, (which will cause different symptoms, different incubation periods from
onset of clinical symptoms to death, different parts of the brain infected,
etc.). in other words, it's NOT the gene mutation that CAUSES the disease, but
the fact that it makes you more SUSCEPTIBLE, to the TSEs from the surrounding
environment, and PLUS accumulation, i think this plays a critical role. maybe
there is a one dose scenario, but i think there is more of the 'accumulators'
that go clinical, than the 'one dose'. and what is the threshold to sub-clinical
to clinical ?
anyway, just pondering out loud here.
also, for anyone interested, there are some studies with links to follow
here ;
Sunday, August 11, 2013
Creutzfeldt-Jakob Disease CJD cases rising North America updated report
August 2013
*** Creutzfeldt-Jakob Disease CJD cases rising North America with Canada
seeing an extreme increase of 48% between 2008 and 2010 ***
Tuesday, May 28, 2013
Late-in-life surgery associated with Creutzfeldt-Jakob disease: a
methodological outline for evidence-based guidance
Saturday, November 16, 2013
Management of neurosurgical instruments and patients exposed to
creutzfeldt-jakob disease 2013 December
Infect Control Hosp Epidemiol.
Wednesday, December 11, 2013
*** Detection of Infectivity in Blood of Persons with Variant and Sporadic
Creutzfeldt-Jakob Disease
Tuesday, March 5, 2013
Use of Materials Derived From Cattle in Human Food and Cosmetics; Reopening
of the Comment Period FDA-2004-N-0188-0051 (TSS SUBMISSION)
FDA believes current regulation protects the public from BSE but reopens
comment period due to new studies
what’s the big secret about the age and history of this poor gentleman ???
MAD COW COVER UP USA, THE EVIDENCE MOUNTS $$$
Monday, June 02, 2014
Confirmed Human BSE aka mad cow Variant CJD vCJD or nvCJD Case in Texas
Thursday, January 17, 2013
TSE guidance, surgical, dental, blood risk factors, Part 4 Infection
control of CJD, vCJD and other human prion diseases in healthcare and community
settings (updated January 2013)
Wednesday, July 23, 2014
After the storm? UK blood safety and the risk of variant Creutzfeldt-Jakob
Disease
Thursday, July 24, 2014
Government must do more to reduce risk of vCJD infection
Friday, February 14, 2014
Creutzfeldt-Jakob disease (CJD) biannual update (February 2014), with
briefing on novel human prion disease National CJD Research and Surveillance
Unit NCJDRSU
U.S.A. 50 STATE BSE MAD COW CONFERENCE CALL Jan. 9, 2001
Transmissible Spongiform Encephalopathy TSE Prion Disease North America
2014
Transmissible Spongiform Encephalopathy TSE Prion Disease have now been
discovered in a wide verity of species across North America. typical C-BSE,
atypical L-type BASE BSE, atypical H-type BSE, atypical H-G BSE, of the bovine,
typical and atypical Scrapie strains, in sheep and goats, with atypical Nor-98
Scrapie spreading coast to coast in about 5 years. Chronic Wasting Disease CWD
in cervid is slowly spreading without any stopping it in Canada and the USA and
now has mutated into many different strains. Transmissible Mink Encephalopathy
TME outbreaks. These Transmissible Spongiform Encephalopathy TSE Prion Disease
have been silently mutating and spreading in different species in North America
for decades.
The USDA, FDA, et al have assured us of a robust Triple BSE TSE prion
Firewall, of which we now know without a doubt, that it was nothing but ink on
paper. Since the 1997 mad cow feed ban in the USA, literally tons and tons of
banned mad cow feed has been put out into commerce, never to return, as late as
December of 2013, serious, serious breaches in the FDA mad cow feed ban have
been documented. The 2004 enhanced BSE surveillance program was so flawed, that
one of the top TSE prion Scientist for the CDC, Dr. Paul Brown stated ; Brown,
who is preparing a scientific paper based on the latest two mad cow cases to
estimate the maximum number of infected cows that occurred in the United States,
said he has "absolutely no confidence in USDA tests before one year ago" because
of the agency's reluctance to retest the Texas cow that initially tested
positive.
see ;
The BSE surveillance and testing have also been proven to be flawed, and
the GAO and OIG have both raised serious question as to just how flawed it has
been (see GAO and OIG reports). North America has more documented TSE prion
disease, in different documented species (excluding the Zoo BSE animals in the
EU), then any other place on the Globe. This does not include the very
likelihood that TSE prion disease in the domestic feline and canine have been
exposed to high doses of the TSE prion disease vid pet food. To date, it’s still
legal to include deer from cwd zone into pet food or deer food. Specified Risk
Material i.e. SRM bans still being breach, as recently as just last month.
nvCJD or what they now call vCJD, another case documented in Texas last
month, with very little information being released to the public on about this
case? with still the same line of thought from federal officials, ‘it can’t
happen here’, so another vCJD blamed on travel of a foreign animal disease from
another country, while ignoring all the BSE TSE Prion risk factors we have here
in the USA and Canada, and the time that this victim and others, do spend in the
USA, and exposed to these risk factors, apparently do not count in any way with
regard to risk factor. a flawed process of risk assessment.
sporadic CJD, along with new TSE prion disease in humans, of which the
young are dying, of which long duration of illness from onset of symptoms to
death have been documented, only to have a new name added to the pot of prion
disease i.e. sporadic GSS, sporadic FFI, and or VPSPR. I only ponder how a
familial type disease could be sporadic with no genetic link to any family
member? when the USA is the only documented Country in the world to have
documented two different cases of atypical H-type BSE, with one case being
called atypical H-G BSE with the G meaning Genetic, with new science now showing
that indeed atypical H-type BSE is very possible transmitted to cattle via oral
transmission (Prion2014). sporadic CJD and VPSPR have been rising in Canada,
USA, and the UK, with the same old excuse, better surveillance. You can only use
that excuse for so many years, for so many decades, until one must conclude that
CJD TSE prion cases are rising. a 48% incease in CJD in Canada is not just a
blip or a reason of better surveillance, it is a mathematical rise in numbers.
More and more we are seeing more humans exposed in various circumstance in the
Hospital, Medical, Surgical arenas to the TSE Prion disease, and at the same
time in North America, more and more humans are becoming exposed to the TSE
prion disease via consumption of the TSE prion via deer and elk, cattle, sheep
and goats, and for those that are exposed via or consumption, go on to further
expose many others via the iatrogenic modes of transmission of the TSE prion
disease i.e. friendly fire. I pondered this mode of transmission via the victims
of sporadic FFI, sporadic GSS, could this be a iatrogenic event from someone
sub-clinical with sFFI or sGSS ? what if?
Two decades have passed since Dr. Ironside first confirmed his first ten
nvCJD victims in 1995. Ten years later, 2005, we had Dr. Gambetti and his first
ten i.e. VPSPR in younger victims. now we know that indeed VPSPR is
transmissible. yet all these TSE prion disease and victims in the USA and Canada
are being pawned off as a spontaneous event, yet science has shown, the
spontaneous theory has never been proven in any natural case of TSE prion
disease, and scientist have warned, that they have now linked some sporadic CJD
cases to atypical BSE, to atypical Scrapie, and to CWD, yet we don’t here about
this in the public domain. We must make all human and animal TSE prion disease
reportable in every age group, in ever state and internationally, we must have a
serious re-evaluation and testing of the USA cattle herds, and we must ban
interstate movement of all cervids. Any voluntary effort to do any of this will
fail. Folks, we have let the industry run science far too long with regards to
the TSE prion disease. While the industry and their lobbyist continues to funnel
junk science to our decision policy makers, Rome burns. ...end
REFERENCES
Sunday, June 29, 2014
Transmissible Spongiform Encephalopathy TSE Prion Disease North America
2014
Tuesday, August 12, 2014
MAD COW USDA TSE PRION COVER UP or JUST IGNORANCE, for the record AUGUST
2014
Monday, July 28, 2014
Mitigating the Risk of Transmission and Environmental Contamination of
Transmissible Spongiform Encephalopathies 2013 Annual Report
Thursday, October 25, 2012
Current limitations about the cleaning of luminal endoscopes and TSE prion
risk factors there from
Article in Press
Saturday, January 16, 2010
Evidence For CJD TSE Transmission Via Endoscopes 1-24-3 re-Singeltary to
Bramble et al
Evidence For CJD/TSE Transmission Via Endoscopes
From Terry S. Singletary, Sr flounder@wt.net 1-24-3
Terry S. Singeltary Sr., P.O. BOX 42, Bacliff, Texas 77518 USA
Professor Michael Farthing wrote:
Louise Send this to Bramble (author) for a comment before we post. Michael
snip...
Evidence For CJD/TSE Transmission Via Endoscopes
From Terry S. Singletary, Sr flounder@wt.net 1-24-3
I have researched human/animal TSEs now for over 5 years due to the death
of my Mother from the Heidenhain Variant Creutzfeldt Jakob disease, one of six -
known - variants of the infamous 'sporadic' CJD.
I did a little survey several years ago about CJD and ENDOSCOPY in 2001,
and then went there again when another article was released recently. However,
they seemed to only be concerned with the vCJD strain and risk from endoscopy
equipment.
My concerns are if vCJD can be transmitted by blood, and there are now 6
variants of the infamous sporadic CJDs that they are documenting to date, how do
they know that none of these 6 variants will not transmit the agent (prion) via
blood?...especially since the sporadic CJDs are the only ones documented to date
to transmit via the surgical arena and now that the CWD is spreading more and
more, who knows about the cattle?
I would always read this study and it would bring me back to reality as to
how serious/dangerous this agent is in the surgical/medical arena. You might
want to read this short abstract from the late, great Dr. Gibbs twice, and let
it really sink in. And please remember while reading some of these transmission
studies, that most all, if not ALL these agents transmit freely to primates.
Humans, of course, are primates.
Regarding claims that:
'Well, it has never been documented to transmit to humans."
There are two critical factors to think about:
A. CJD/TSEs in the USA are NOT reportable in most states and there is NO
CJD/TSE questionnaire for most victims and their families, and the one they are
now issuing asks absolutely nothing about route and source of the (prion) agent,
only how the disease was diagnosed. Furthermore, the elderly are only very
rarely autopsied, ie looking for Alzheimer's or 'FAST Alzheimer's' OR prion
disease-related factors and phenomena, such as heart failure caused by
disease.
B. It is unethical and against the law to do transmission studies of TSEs
to humans, they are 100% FATAL.
I suggest you read these case studies about medical arena CJD transmission
very carefully:
1: J Neurol Neurosurg Psychiatry 1994 Jun;57(6):757-8
Transmission of Creutzfeldt-Jakob disease to a chimpanzee by electrodes
contaminated during neurosurgery.
Gibbs CJ Jr, Asher DM, Kobrine A, Amyx HL, Sulima MP, Gajdusek DC.
Laboratory of Central Nervous System Studies, National Institute of
Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD
20892.
Stereotactic multicontact electrodes used to probe the cerebral cortex of a
middle aged woman with progressive dementia were previously implicated in the
accidental transmission of Creutzfeldt-Jakob disease (CJD) to two younger
patients. The diagnoses of CJD have been confirmed for all three cases. More
than two years after their last use in humans, after three cleanings and
repeated sterilisation in ethanol and formaldehyde vapour, the electrodes were
implanted in the cortex of a chimpanzee. Eighteen months later the animal became
ill with CJD. This finding serves to re-emphasise the potential danger posed by
reuse of instruments contaminated with the agents of spongiform
encephalopathies, even after scrupulous attempts to clean them.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8006664&dopt=Abstract
Tissue Infectivity and TSEs (brain = high / rectum = medium)
snip...see full text ;
Evidence For CJD TSE Transmission Via Endoscopes 1-24-3
re-Singeltary to Bramble et al
Evidence For CJD/TSE Transmission Via Endoscopes
From Terry S. Singletary, Sr flounder@wt.net 1-24-3
TSS