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PL CMO (2004)2: Reducing the risk of exposure of patients to the agent of CJD through brain biopsy procedures

  • Document type:
    Professional letter - Chief Medical Officer
  • Author:
    Department of Health
  • Published date:
    17 May 2004
  • Primary audience:
    Professionals
  • Gateway reference:
    3105
  • Series number:
    PL CMO (2004)2
  • Pages:
    4
  • Copyright holder:
    Crown

A brain biopsy can reveal a diagnosis of CJD that was not suspected prior to the biopsy because CJD can present in atypical ways with a differential diagnosis that includes conditions such as cerebral vasculitis. The biopsy could result in inadvertent exposure of subsequent patients to CJD agent via the instruments used. The Department of Health has taken expert advice on the need for additional guidance for the quarantine of surgical instruments following brain biopsies in such circumstances.

The attached protocol has been prepared in conjunction with neurosurgeons, neurologists, neuropathologists and the National CJD Surveillance Unit.

I strongly urge that this protocol be implemented within your NHS Trust with immediate effect.

National guidance 'Transmissible Spongiform Encephalopathy Agents: Safe Working and the Prevention of Infection'1 on the prevention of infection arising from the agents that cause Creutzfeldt-Jakob Disease (CJD) and other spongiform encephalopathies was last revised and issued in December 2003.

I would be grateful if Medical Directors would also review present policies, procedures and practices within your NHS Trusts to ensure that this guidance is being fully complied with and that all staff in key roles are aware of it and fully understand how to apply it. The protocol for brain biopsy developed by the Department of Health has been added as an Annex to this Guidance.

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