nvCJD To Cost Patients Billions
To Insure Safer Invasive Instruments
James Meikle - Health Correspondent,3604,413721,00.html

The NHS (UK) faces the prospect of paying billions of pounds for throwaway surgical instruments as part of the spiralling costs to cut the theoretical risk of patients catching the human form of BSE.
All tonsil operations in Britain - about 85,000 a year - are soon likely to be performed using £400 sets of once only instruments, and this switch to fully disposable equipment in mainstream surgery is likely to be just the forerunner of a change in surgery procedures at NHS and private and military hospitals.
Surgeons and government officials are investigating the use of more disposable instruments in complicated operations including brain and eye surgery where the risks rise for contamination of instruments with rogue prions - the proteins thought to be responsible for variant CJD. Tonsillectomies, not performed as often these days, are usually carried out only on children with frequent tonsilitis.
Dentists and opticians have already been told to buy more single-use equipment and there are tougher measures for decontaminating non-disposable instruments. Government advisers on BSE and vCJD have said that proper sterilisation can substantially reduce levels of infectivity.
A decision about the surgical changes will be made next month.
Some of the 88 victims of vCJD in Britain, five of whom are still alive, have been teenagers but it is not certain either how they were infected or how long the disease was incubating before they displayed the symptoms, which include depression, anxiety and loss of bodily control.
Cheap beef products are still prime suspects behind the disease. Government advisers have said the risk of transmitting the disease via surgical instruments was still "theoretical and unquantifiable". None of the vCJD cases so far has been linked to surgical contamination and it is understood a risk assessment has suggested that disposable instruments for tonsil surgery may only prevent one extra case of vCJD. But the Phillips inquiry into BSE and vCJD called for a "precautionary approach". Advisers have recognised that some precision equipment for single use could be unaffordable. There could also be problems storing disposables before safely destroyiing them.
The costs of the medical consequences of vCJD are mounting. Measures to cut the risk of vCJD contamination through blood donations are costing £83m a year in England and north Wales alone; the change in tonsil operations would cost another £35m yearly. The treatment of vCJD patients costs beween £6,500 and £40,000. Instruments used on vCJD patients are already destroyed, including medical equipment costing nearly £30,000. Yesterday, France became the latest among countries to ban blood donors who have been to Britain between 1980 and 1996.
The news of the measures coincided with new concerns that loopholes in food regulations allowed manufacturers to get round rules making it illegal to import and sell meat from cattle over 30 months old. Harriet Kimbell, a member of Seac, the spongiform encephalopathy advisory committee, said: "It is not illegal for an English manufacturer to go to Europe, buy meat and make it into products like frozen beefburgers, and sell it in Britain."
A person in the UK whose blood was used in the production of a polio vaccine administered in Ireland, has been diagnosed with vCJD, the Irish government said yesterday. Between January 1998 and January 1999, 83,500 doses of the oral vaccine were distributed, mostly to the young.
The Irish health minister, Micheal Martin, insisted there was no risk of the recipients getting the disease."This person's donation was one of 22,353 [in] a pool. The final dilution was 1 to 63,866."
People are being advised to contact their GPs to find out about affected batches.
Steven Lunt, 33, a victim of vCJD who died in April, seldom ate beef, an inquest heard yesterday. John Pollard, the south Manchester coroner, said Mr Lunt, of Stockport, died of variant CJD. Health officials are investigating a possible link between the deaths of Mr Lunt and Paul Dickens, 28, who lived near him.

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