Handling of endoscopic equipment after use in the case of a patient with suspected prion disease

Abstract

Introduction. Prion diseases are slow-acting, neurodegenerative diseases found in humans and many species of animals. Although they occur very rarely in humans, currently, an increase in this type of disease is being observed, probably as a result of exposure to infectious prions causing BSE disease in cows. Objective. The aim of the procedures described in the article is to minimize the risk of human-to-human transfer of all forms of transmissible spongiform encephalopathy, including variant CJD (vCJD) by contaminated medical equipment. Brief description of the state of knowledge. All diseases caused by prions, referred to as transmissible spongiform encephalopathies, are fatal. They are characterized by a long development period (up to several decades). Enormous problems are connected with the risk of transferring prions from patient to patient on the surface of instruments used in medical procedures. Laboratory tests indicate that standard disinfection and sterilization procedures may be insufficient to completely remove infectious proteins from contaminated instruments. One of the methods of infection prevention involves taking equipment used for surgery within the brain, tonsils or appendix, into quarantine until biopsy results of these organs have been received that exclude, as far as possible, asymptomatic carriage of prions. Conclusions. Whenever possible and justified, disposable-use instruments should be used for invasive surgery in patients with definite, clinically probable cases of CJD (vCJD). After use, these instruments should be incinerated.