HSE unsure of CJD risk to surgery patients at Beaumont Hospital

US expert describes risk of transmission as ‘pretty high’

Minister for Health, James Reilly: will be seeking reassurances that protocols to prevent a recurrence are sufficient. Photographer: Dara Mac Dónaill

Minister for Health, James Reilly: will be seeking reassurances that protocols to prevent a recurrence are sufficient. Photographer: Dara Mac Dónaill

Sat, Jul 20, 2013, 01:00

PAUL CULLEN

The Health Service Executive has said it doesn’t know the exact risk faced by patients who were operated on with instruments used on a patient who has been diagnosed with CJD at Beaumont Hospital in Dublin.

Having previously estimated the risk of the other patients getting the disease as slightly above one in a million, officials last night revised their estimate down to one in 400,000. Dr Kevin Kelleher, head of health protection at the HSE, admitted it was impossible to know the exact risk faced by up to 20 affected patients.

One US expert described the risk of transmission as “pretty high”. Michael Payne, research operations manager at the National Prion Disease Pathology Surveillance Centre in Cleveland, Ohio, pointed out that the prion proteins which cause the disease survive normal sterilisation processes and pose a risk to both patients and staff exposed to them.

Not contagious

However, CJD is not contagious and prions must come into contact with an open wound for the disease to be transmitted.

At least 1,300 people contacted a helpline set up yesterday to provide information to patients concerned about the issue. The HSE said last night it had contacted “virtually all” patients, or their family members, who were operated on using the instruments.

The patients have been told they have a “slightly higher risk” of getting CJD and will need to take precautions to prevent any further transmission of the disease “in the unlikely event they have been infected”.

A review has identified up to 20 patients who are at risk as a result of being operated on with the same instruments that were used on the patient later diagnosed with CJD. The HSE defended the hospital’s handling of the situation by pointing out that the instruments were withdrawn once CJD was suspected and before a full diagnosis was made.

It said the affected patients were contacted yesterday as soon as the review identified who was at risk. The timing of these contacts had “nothing to do” with news coverage.

Diagnosis

The period under review is between June 1st last and mid-July, and follows the diagnosis late last week of CJD in a patient who had undergone surgery in Beaumont.

The HSE says the diagnosis was discovered later during a “routine” examination of tissue in the laboratory. The disease was spotted through a microscopic examination of “suspicious” tissue by pathologists.

As soon as the diagnosis was made, the patient was quarantined and international experts consulted.

Mr Payne said the only way to decontaminate equipment exposed to CJD was to use powerful solutions of bleach or sodium hydroxide and then to sterilise it at high temperatures for over four hours. Beaumont says it has traced all of the surgical instruments involved in the current case.

Minister for Health James Reilly said he would be seeking reassurances from the HSE and the hospital that the protocols in place to prevent a recurrence were sufficient. He said there was no “clinical suspicion” to suggest a case of CJD was involved at the time the patient was operated on.