|A national laboratory in Cleveland, Ohio, has confirmed the CDC's preliminary diagnosis of an extremely rare condition known as Creutzfeldt-Jakob disease (CJD) following the September 10 brain biopsy of a patient at Emory University Hospital.
Emory officials emphasized the extreme unlikelihood of any other patients being affected by this rare case. In the medical literature, there has not been a single reported case of CJD transmitted by surgical instruments in the nearly three decades since 1976 and the widespread adoption of modern surgical sterilization techniques. Those sterilization techniques have been standard procedure at Emory for all operations for three decades and were followed after the original brain biopsy in this case.
CJD, a degenerative brain disease, occurs in the population worldwide at the rate of about one person per million per year for reasons that are usually unknown. The illness is not the variant condition known popularly as "mad cow disease."
The hospital said it shared the laboratory findings with surgical patients first before making them public.
In the wake of the initial preliminary CDC finding, the Hospital re-sterilized all of its neurosurgical instruments to an enhanced standard recommended by some national and international authorities for cases of CJD. Later, after a continuing review of the situation, the Hospital re-sterilized all of its surgical instruments to the same enhanced standard. Hospital officials say the re-sterilization of all surgical instruments appears to exceed what other hospitals have done in the same situation.
Emory officials have advised 98 brain and spine surgery patients who were operated on following the biopsy that the Hospital is seeking written guidance from an advisory committee of the Department of Health and Human Services on whether they should be blood donors in the future. If HHS advises against donation, the surgical patients would fall in the same extremely low-risk deferred-donor pool as persons who spent three months or more in the United Kingdom between 1980 and 1996, or members of the Armed Services who resided at U.S. military bases in Northern Europe for six months or more between 1980 and 1996.
"We continue to seek the best available guidance and information from experts at other medical centers and from agencies such as CDC and HHS," said William Bornstein, MD, PhD, chief quality officer for Emory Healthcare. "The extreme rarity of this disease and the nature of the potential exposure, which is so small that it cannot be quantified, make it challenging to find published guidelines which are applicable to our situation. Nevertheless, we are fully committed to finding and sharing with our patients the best available information."
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