title: Iatrogenic Creutzfeldt-Jakob disease, final assessment.
abstract: The era of iatrogenic Creutzfeldt-Jakob disease (CJD) has nearly closed; only occasional cases with exceptionally long incubation periods are still appearing. The principal sources of these outbreaks are contaminated growth hormone (226 cases) and dura mater grafts (228 cases) derived from human cadavers with undiagnosed CJD infections; a small number of additional cases are caused by neurosurgical instrument contamination, corneal grafts, gonadotrophic hormone, and secondary infection with variant CJD transmitted by transfusion of blood products. No new sources of disease have been identified, and current practices, which combine improved recognition of potentially infected persons with new disinfection methods for fragile surgical instruments and biological products, should continue to minimize the risk for iatrogenic disease until a blood screening test for the detection of preclinical infection is validated for human use.
authors.affiliation: Centre à l’Energie Atomique, Fontenay-aux-Roses, France. paulwbrown@comcast.net
authors.forename: Paul
authors.initials: P
authors.lastname: Brown
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Brandel
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sato
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Jan
authors.initials: J
authors.lastname: MacKenzie
authors.forename: Robert G
authors.initials: RG
authors.lastname: Will
authors.forename: Anna
authors.initials: A
authors.lastname: Ladogana
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pocchiari
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Leschek
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Schonberger
mesh_terms: D007562:Creutzfeldt-Jakob Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D004340:Drug Contamination / Q000517:prevention & control; D004388:Dura Mater / Q000637:transplantation; D004866:Equipment Contamination / Q000517:prevention & control; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology* / Q000517:prevention & control; D015994:Incidence; D019737:Transplants
chemical_list: D019382:Human Growth Hormone