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This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Poster presentation

The management of potential exposures to Cretuzfeld-Jakob Disease (CJD) via endoscopy

A Iten1*, H Sax1, V Camus1, D Scalia1, A Hadengue2, P-Y Martin3, S Hurst3 and D Pittet1

  • * Corresponding author: A Iten

Author Affiliations

1 Infection Control Program, Genève, Switzerland

2 Service of Gastroenterology, Genève, Switzerland

3 Committee of ethics , HUG, Genève, Switzerland

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BMC Proceedings 2011, 5(Suppl 6):P312  doi:10.1186/1753-6561-5-S6-P312


The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1753-6561/5/S6/P312


Published:29 June 2011

© 2011 Iten et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

We describe the case of a 68-year-old male with autopsy-confirmed sporadic CJD (CJDs) who had undergone 2 colonoscopies prior to this diagnosis.

The involved endoscopy centre had multiple colonoscopes and gastroscopes that are cleaned and disinfected in the same automatic washers/disinfectors (AWD). There was no system in place to track the use and disinfection of individual endoscopes.

Four questions arise:

- Is it necessary to dispose of colonoscopes potentially contaminated by CJDs?

- Is it necessary to dispose of the AWD where the endoscopes were washed?

- Is it necessary to dispose gastroscopes at risk of contamination during the disinfection process in the AWD?

- Is it necessary to inform the patients who were exposed to these endoscopes ?

Results

We estimated that this situation occurs approximately 17 times each year in Switzerland. To answer these questions requires data on the presence of CJDs prions in the colon, the risk of contamination of the endoscopes, the risk of prion transmissions to other patients via the endoscopes, and the procedures of cleansing and disinfection. Finally, it is also necessary to take into account psychological, financial and ethical implications for the endoscopy centre and the patients exposed to the potentially contaminated endoscopes.

Conclusion

This complex situation highlights the need for guidance recommendations in this area.

Disclosure of interest

None declared.