Positive result of CJD Case

[ej1104]

So about a week ago, I was chosen to be a circulator in a brain biopsy case in which the patient was possibly infected with CJD(Creutzfeldt-Jakob disease) for those of you not familiar, CJD is similar to mad cow in which it is formed by prions in the brain which cannot be destroyed in sterilization and causes rapid mental dysfunction and deterioration in those infected. Symptoms are similar to dementia and Alzheimer's. I was just informed that results of the biopsy came back positive, in which case the one pan of instruments that were quarantined since have to be completely destroyed and incinerated. Now I was told before hand that transmission is extremely rare and can be done only by direct contact or basically ingesting brain tissue of the infected. Now During the case I wore gown, gloves, mask, hood, etc. so my direct contact with the biopsy was very low besides having it handed off by the scrub nurse and into a biohazard bag to pathology. I spoke with my supervisors about what The next step is to do? The scrub and I who were involved took proper pre-cautions and followed policy on how to perform the case. I felt okay about it afterwards and felt we were well prepared, but ever since hearing the positive results and knowing how rare it is and how little is known, I can't help feel in the dark about it, has anyone ever experienced a similar situation in the OR or with a patient who may have or did have CJD?

[MereSanity]

I'm sorry you have to deal with this. I would think you will be OK. However, write down details for your personal records in case something ever comes up (after all workmans comp would apply big time) and you need those details. I thought it was just contact and ingestion so I think you will be OK (eye protection too) but I have not dealt with this personally.

MereSanity BSN, RN, CNOR

[NedRN]

You have virtually no chance of developing CJD from personal contact. It is very rare except among certain populations. Cannibals that eat brains, and cows (and presumably other animals) that are fed meal made from animal parts left over from slaughter houses are susceptible (a practice now illegal in this country and most other western countries). So are surgical patients having brain surgery following brain surgery from patients from CJD. It is extraordinarily difficult to denature prions with ordinary instrument processing hence the abundance of caution by destroying the instruments to eliminate any direct infection of following patients. There is a lot that is unknown about prion disease but if you didn't eat the specimen I don't think you have a lot to worry about. You have probably already dealt with a number of non-diagnosed CJD patients outside of neuro as have we all and there is no cluster of OR nurses with CJD.