vCJD Passed In Oz Hospital -
1,000 Former Patients Warned
15,000 Instruments Thrown Out

The - Australia
More than 1,000 former patients of a major Melbourne hospital have been contacted amid concerns they may have contracted a rare brain disease via surgical instruments.
The Royal Melbourne Hospital couriered letters to 1,056 brain or spinal patients after confirmation of the rare Creutzfeldt-Jakob disease (CJD) at the hospital, although doctors say the risks of transmission are extremely small.
Concerns arose after a middle-aged Victorian man died of the disease earlier this year.
The man underwent 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The hospital has withdrawn its stock of 15,000 neurosurgical instruments pending their replacement and has begun sterilising its entire stock of 300,000 surgical instruments on the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 worldwide of CJD being transmitted via contaminated neurosurgical equipment.
Professor Kaye said CJD is one of the few diseases which "can withstand normal sterilisation processes".
He said if a patient is known to have or has symptoms of CJD then disposable surgical instruments are 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.
There are about 20 cases of CJD reported within Australia each year.
This type of CJD, known as Sporadic CJD, is not communicable and occurs randomly.
It is a fatal disease with the average survival rate of four months after symptoms appear.
It is related to Variant CJD, or Mad Cow disease, but has very different characteristics.
There has never been a diagnosed case of Mad Cow disease in Australia.
Professor Kaye said diagnosis of CJD was only possible when the brain is examined under a microscope.
There are no screening tests for healthy people to determine whether they have the risk of carrying the disease.



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