Brain Surgery Patient Dies, Others Alerted (CJD)

http://news.yahoo.com/s/ap/20060518/ap_on_he_me/creutzfeldt_jakob_disease

LITTLETON, Colo. - Officials at a suburban Denver hospital were alerting brain surgery patients after another patient died of a rare degenerative brain ailment called classic Creutzfeldt-Jakob Disease, the hospital said Thursday.


Six people who had neurosurgery at Littleton Adventist Hospital after an operation on the Creutzfeldt-Jakob patient and were alerted because of the remote possibility that the disease could be transmitted by surgical instruments, even after they are sterilized, the hospital said.

It was not immediately clear whether the instruments used on the victim were also used on any of the other six patients.

Classic Creutzfeldt-Jakob Disease is not related to mad cow disease, unlike variant Creutzfeldt-Jakob Disease. Classic CJD occurs sporadically, appearing in about one in 1 million people in the United States each year, according to the Centers for Disease Control and Prevention Web site. It progresses quickly and is always fatal.

I'm a firm believer that if something doesn't make sense, it's probably wrong, and that statement doesn't make sense!

Sterilization is meant to take care of virii and bacteria. They may have such limited knowledge of anything *not* limited to those two categories that the data is insufficient to rule certain things out.

Sometimes incineration is not enough.

An Autoclave is essentially a pressure cooker. Incineration means it actually combusts. A prion won't survive combustion, but then neither will glassware and tools and other things that need autoclaving.

Apparently there are some supped-up autoclaves that scientists who actually work with Mad Cow can use for their equipment.

Imagine yarn that you twist until it starts to ball up and tangle. That's kind of how proteins form. A malformed protein, a prion, is kinky in its own way and it kinks up other proteins that it comes into contact with. This causes them to malfunction - because proteins are supposed to twist in a particular way and fit into receptors on other proteins in our bodies. Kinking them makes a round peg into a square one, essentially, and so then the kinked protein won't fit into its round hole anymore. It's not just useless, it's poisonous. Like living freezerburn.

Sorry for mixing metaphors. Anyway,

This is wonky in the way that bacteria (which eats us) and viruses (which hijack our cells to make more virus) isn't. The malformed proteins don't break down by cooking or sterilization. They're not destroyed by sterilization or cooking! They go into the ground and the water, and they don't neccessarily wash off of surgical implements. It's literally a Midas Touch. We are defenseless against prions.

And it's a bigger problem than you think - a few years ago Michigan warned hunters that 25% of its wild deer and elk were suffering CJD. I am three to four degrees away from a person who died from eating vennison.

Cows get a similar brain disease, vCJD or Mad Cow disease, by eating other cows. That means that somehow, prions go from the GUT to the BRAIN. The RED CROSS won't let people who lived in ENGLAND during the 80s donate BLOOD.

So BLOOD, GUTS, SPINE, MARROW and BRAIN are dangerous to eat. Then, consider that blood serves muscle - when I researched this problem a couple of years ago I'd just stand in front of the meat counter and cry. And the USDA will NOT allow us to test EVERY COW for vCJD - Mad Cow disease, caused by prions.

vCJD and CJD is often misdiagnosed as Alzheimer's Disease. Symptoms are similar. There is no cure for either.

Disclaimer: I am not vegetarian. I am having hamburgers for dinner tonight. I have decided that so much of my food is poisoned that I can't avoid it and lead a happy life. I can't afford grass-fed beef and the US doesn't require the kind of labeling on prepared foods (even produce) that would make me feel informed. So, I live as well as I can, and work for change.

I hope you all do too.

CJD is the result of a misfolded protein, and the proteins can't be "killed"--only chemically disassembled in one way or another. It is really easier to think of it as a poison that makes more of itself once inside your body than like a disease in the ordinary sense.

Tucker

C-J is not a disease in a classical sense.
I't not a virus.
It's not bacteria.
It's not a fungus.

It is a protein.
A mutated form of a protein, folded the wrong way around.
You can't "kill" it because it doesn't "live" in the first place.

Normally proteins don't withstand high temperatures (see you breakfast egg when it becomes solid and was liquid before).
But I hear this protein is quite resistant.
Cooking the meat of a C-J cow doesn't seem help against it, so sterilizing surgical instruments probably won't either.

But then again, nobody really knows yet how consuming such a bad protein can trigger the disease and make your body producing more bad proteins yourself.

So, "Remote possibility" is a very good term for it in my opinion.

It takes temps above 700 degrees for an hour or more and a lye bath to kill CJD prions. That's supposed to be standard protocol on brain surgery instruments that will be reused for precisely this reason.

Every hospital I have ever worked in or dealt with have an emergency set of instruments for any patient that might need emergency surgery and have been diagnosed with CJD. The instruments, if used, are destroyed after.

Wow, this is incredible.

I would think EVERY hospital would handle things that same way.

water system could survive full strength bleach.

some 'bugs' are not normal.

this is scary and makes a person wonder how many go unreported. :(

The man had CJD and was in bad shape. There were orders not to feed him anything because he could no longer swallow. The nurse on the night shift decided to feed him anyway. Cause of death was from suffocation, so there is no official record of this patient also having CJD.

Double-gloved. With positive-pressure micron masks. Two gowns. Two of everything. And after the test, it was all incinerated, right down to the electrodes. And one of the doctors supervising the test wanted me to surrender every stitch of my clothing for incineration. The whole wing of the hospital was put on notice. It was seriously paranoid.

I was still in my 20s, and didn't fear anything. But nobody even had a clue about CJD back then, only that it was transmissible, rare, and incurable.

The day that we discover a non-toxic denaturant for the prions, is a day that will lift my spirits considerably.

--p!

defensive pronouncement to its relationship to Mad Cow?

You can not get any other disease any closer to CJD than Mad Cow.
And the next closest disease next to Mad Cow is Ahlzimers!

and what US Gov't agency is going to inform its citizens about
the meat industry poisoning its people?
Certainly not the CDC or the EPA or the AMA.

Hell no!!!
Hurt the profits of Bush's goat roping Texas Cowboys?

anyone who's paid any attention to the mad cow outbreak in Britain knows of a link between CJD and mad cow. However, they may NOT understand the difference between CLASSIC and VARIANT CJD...as you seem not to.

Sporadic CJD) and "variant" CJD, IMHO, is that in sCJD nobody has figured out how the heck the person got it, so it MUST be sCJD, RIGHT???

I happen to think they are THE SAME DISEASE. But what do I know. I'm just a veterinarian with a microbiology degree and a longstanding interest in veterinary public health and zoonoses.

Prions are dirived from a certain class of brain protiens, cCJD being a result of a spontaneous misfolding while vCJD is from ingesting protiens that are already misfolded.

I think your just trying to find a reason to call eating meat bad.

find a reason to call eating meat bad. I am NOT a vegetarian, lol. I gladly eat venison and elk and oryx harvested by my DBF, fish cauht by him, some chicken from the grocery, occasional turkey from same, and even beef once or twice a year. I LOVE eggs. I eat at McDonalds once or twice a year (spartanism is not my thing).

I have a serious problem with factory farming and the problems it causes. I have no problem with eating meat, per se.

Run along now and make your gross overgeneralisms somewhere else.........

And about the idea of "spontaneous folding" - I give that about as much creedence as "spontaneous generation".

between 'vegetarian' and 'veterinarian'

but I've never looked at the literature.

Therw was a cluster of cases in Kentucky about 10 years ago that was traced back to squirrel brains (no Clampet music, please). What was the difference there? How do they identify the clinical markers?

And what about people who eat deer & elk with "chronic wasting disease?"

eating venison and elk at some gathering, IIRC..............

the classic version might come from scrapie... but thats just my guess.

and I didn't even play a Doctor on tv!

identical to how Alzheimer's looks in people.

My theory is that this whole mess is a lot more widespread than anyone will admit. They are NOT looking for it - I hear they don't ever bother to do autopsies on people who have "Alzheimer's". Why bother - we "know" what they had, RIGHT???

and this has been a fascinating and informative thread. I love meat (elk etc too) and as a nurse that has work in nursing home with alzheimer's...I figure I am already pretty screwed over. I try to know my food source if at all possible. Nice to know I don't have to eat charcoal-since that doesn't protect.
So how about lasers and prions? Not practical for cleaning but maybe destroying.

that involves nasty things like lye baths (hell on surgical instruments - WINCE!!!) or some such impractical measures.

if neurosurgery is performed on a patient with no evidence of CJD, they steralize and reuse instruments. If patient later develops CJD, its an indication that he may have had it all along, and any other patients that had the equipment used on them are in danger.

If you want completely new instruments for your surgery I imagine you could arrange for it. However, its thousands of dollars as most hospitals no longer re-use any instruments under a certain dollar value anyway. In addition, CJD is not transmited via normal means (even blood borne)-- it requires brain tissue contact to instrument, and intrument to brain tissue for transmission.

or patients that have had neurosurgical dura mater (brain tissue) graft.

But there's no need to panic, the Bush govt. has it all under control. :mad:

I wonder why instrumentation can't be cleaned with that first, maybe even routinely? Dunno what it might do to the metal, if anything. And then autoclave afterwards.

Also, don't ants make formic acid?

I once had a crazy notion that ants could be the clue to a cure for prion diseases, and possibly even AD.

that feeling of bugs/ants crawling on your skin. formica (Latin)=ants. wonder if formica (as in counter tops) is related to ants?

So -- yes. It's related to the Latin formica = ant.

Of course, it could be one of those Urban Legends that debunkers love, but I acquired that factoid before the Internet.

--p!

Formic acid is easy to produce and obtain. There's nothing really special about it. It's a fairly simple acid that ants and stinging insects produce in their bodies. It's usually delivered by stinging.

There is currently no known way to destroy prions, but since they are proteins, there must be some kind of way to denature them enough to render them inactive. Acids are just as good at denaturing most proteins as anything else. But since prions -- as well as CJD itself -- are so difficult to work with, work has been slow.

--p!

but did hear conc. sulphuric would do the trick.