At Least 31 American Patients Possibly Exposed to Fatal Prion Disease in Hospital

They all had neurosurgery - in North Carolina, New Hamshire, and Massachusetts. Let's hear it for disclosure. May the truth keep coming out. Recently, a teen boy from North Carolina died died of a fatal prion disease; and a young mom from Maine is dying now, also from a prion disease. Time to get the public up to speed.

N.C. Hospital: 18 patients may have been exposed to brain infection

Eighteen neurosurgery patients at a North Carolina hospital may have been exposed to the deadly Creutzfeldt-Jakob disease (CJD) brain infection.

…Last September, a similar medical scare occurred at Catholic Medical Center in Manchester, N.H., where at least eight patients who had brain surgery were exposed to CJD. Health officials informed the public after a patient underwent surgery in May and died in August of the disease.

Health officials also notified five patients in the Massachusetts area that they too may have been exposed to the tools.

Is it just me or are prion diseases suddenly becoming the disease du jour?

reply to post by soficrow

I seem to remember a scare a few years ago involving children that were given human growth hormone that was contaminated with prions from a donor that had CJD.
Does that ring any bells for you?
I remember a case involving prions passed through dental equipment too.

reply to post by soficrow


Hi Sofe. I have come to think of you as the ATS gatekeeper for anything prion-related.

I applaud and am grateful for your interest to keep us informed.

Cross-contamination in hospitals has been creeping up in some places and while I don't know where the situation stands south of the border, I know we are generally raising awareness concerning record-keeping efforts, but we still have a lot of monitoring improvements to take hold in that regard.

reply to post by soficrow

Wow how interesting S&F! The prion diseases have fascinated me since Vet Tech school &
they are scary. The incubation period for the onset if I recall correctly was 15 to 20 yrs for
Mad Cow & Alzheimer. I remember during that time, people who died of Alzheimer & possible CJD
rarely had an autopsy due to possibilities of CJD, Mad Cow & other prion diseases & officials
didn't want to risk contamination of the instruments. The incubation period for the onset
if I remember correctly was 15 to 20 yrs for Mad Cow & Alzheimer. Now I don't know if that was true
or some tale to scare people. Eating squirrel brains (CJD?) & deer meat (CWD)were also mentioned at that
time.
I thought your report was going to be related to that beef recall we saw yesterday. But
from hospital surgeries is very scary. Do you think it was from contaminated instruments?
I wonder how often these situations are hidden from the public?

Thanks for the post & especially ALL of prion issues.

Cheers
Ektar

Good thread Soficrow. Can they even sterilize hospital equipment to stop this from spreading?

reply to post by rickymouse


Hospitals used to do it all, but I visited a factory in an industrial park where they prepare specialized surgical packages for hospitals, a niche market. It gives one the impression of a highly specialized infection-preventing outfit even though the people running it were clearly commerce driven and oriented. The only question I asked myself afterwards (and duh why didn't I think of it sooner?) was whether they recycled anything such as tubing, and how exactly do they disinfect and clean the instruments?

Sorry I should have been more clear in my post. We were taught that the prions cannot be
killed by any means not heat, not cold & not by radiation or sterilization. So once an
instrument is contaminated it was contaminated for life. That was one of the reasons given
in the past to why some of those patients were not given autopsies. However that was in 1999
& things may have changed by now.
Thanks for asking that question out right as that's what I was insinuating &
also waiting to hear.

Cheers
Ektar

rickymouse
Can they even sterilize hospital equipment to stop this from spreading?

Formaldehyde, alcohol and hydrogen peroxide have been tried and shown ineffective.
As of now, medical instruments contaminated with prions are usually put into an autoclave usually with sodium hydroxide (chlorine, since It's a pretty effective enzymatic alkali). It's not always fully effective at denaturing the proteins (denaturing in this context meaning to disrupt their structures and refrain them from folding, which is what the goal is that we want to achieve), but It's shown be be effective enough to sterilize the equipment down to what is considered a safe level of infectious prions per unit.

reply to post by Ektar

We were taught that the prions cannot be killed by any means not heat, not cold & not by radiation or sterilization.

Just a slight clarification. Prions are not alive.

Can't help it. It's a flaw of mine and I admit it.
Is there a Pedants Anonymous?

reply to post by Phage

I don't think it is a flaw.
I think it would be wrong to let someone go on believing that they are correct when they are not.

Prions are not alive. To render them ineffective at replication, one must either dissolve the chemical bonds of the protein or incinerate them, AFAIK.

reply to post by unb3k44n7


Would bromelain or papain destroy the prions? Both of these would be inexpensive.

reply to post by butcherguy

I seem to remember a scare a few years ago involving children that were given human growth hormone that was contaminated with prions from a donor that had CJD.
Does that ring any bells for you?
I remember a case involving prions passed through dental equipment too.

My memories of those cases and details are vague but yeah, I'd imagine we're already dealing with the fallout. My best advice: deal with any inflammation in your body - prions use the immune system to spread, and just race to sites of inflammation. I'm actually surprised we're not seeing more cases where secondary infections affecting the brain result in prion disease - but they're probably just not diagnosed. Never mind the fibromyalgia epidemic. Am remembering a case here in Winnipeg -friend of a friend- who was told she had a herpes infection in her brain, then apparently, the hammer came down and her doctor retracted his diagnosis, said he was mistaken and gave her some general don't-panic bs. Hmmm.

reply to post by aboutface


Thanks. ...Seems to me the situation was out-of-control half a century ago - now we're playing catch-up. And facing a chronic disease pandemic I strongly believe is related. Conundrum on conundrum, and much resistance - mostly cost-related methinks. But even wikipedia is back to saying the "prion hypothesis" is still "controversial." Total bs.

reply to post by Ektar

But from hospital surgeries is very scary. Do you think it was from contaminated instruments?
I wonder how often these situations are hidden from the public?

The biggest source of "acquired" infections seems to be contaminated instruments in hospitals. The biggest problem there is things like scopes - can't go in the autoclave, aren't disposable, and available chemical agents for decontamination might not work that well. ...I think these "situations" are hidden from medical professionals, not just the public.

The unfortunate reality is that no authority in any agency (business, government or otherwise) every wants to admit any problem might exist until they can offer a solution.

btw - my thinking on the beef recall - I posted on that thread saying I thought the problem probably was prion-related, mainly because the contaminating agent was not identified by name (which it usually is).

reply to post by rickymouse

Would bromelain or papain destroy the prions? Both of these would be inexpensive.

No.

They have no sterilization properties.
They're enzymes. They're good for digestion purposes and GI tract discomfort.

Chlorine is a highly corrosive element with sterilization and oxidation properties.

Two completely different uses and properties

unb3k44n7
reply to post by rickymouse

 

Would bromelain or papain destroy the prions? Both of these would be inexpensive.

No.

They have no sterilization properties.
They're enzymes. They're good for digestion purposes and GI tract discomfort.

Chlorine is a highly corrosive element with sterilization and oxidation properties.

Two completely different uses and properties

Actually, chlorine is not that reliable - rickymouse is not that far off the mark - the best agents found for prion inactivation are enzymes. And unfortunately, using chemicals and heat on prion-contaminated surfaces tends simply to create new prion strains. Like I said, conundrum on conundrum.

Enzyme Fully Degrades Mad Cow Disease Prion

Inactivation of prions by physical and chemical means.

Prions are very resistant to inactivation, and accidental transmission has occurred through the use of inadequate decontamination procedures. Strong sodium hypochiorite solutions achieve inactivation but other chlorine-releasing compounds are less effective. 2M sodium hydroxide leads to substantial but incomplete inactivation; other chemical procedures such as the use of proprietary phenolic disinfectants are much less less effective. Infectivity can survive autoclaving at 132-138 degrees C, and under certain conditions the effectiveness of autoclaving actually declines as the temperature is increased. The small resistant subpopulations that survive autoclaving are not inactivated by simply re-autoclaving, and they acquire biological characteristics that differentiate them from the main population. Despite the limitations of autoclaving, combining autoclaving (even at 121 degrees C) with a sodium hydroxide treatment is extremely effective. Protein-fixation (e.g., by ethanol or formalin) substantially enhances the thermostability of these agents. This suggests that future successful inactivation strategies might best be developed by studying procedures that avoid protein-fixation.

reply to post by soficrow


Do you want to wash your dishes with pineapple and papayas? Would you trust they would be clean (sterilized?) for you family? No.

Do you want to "sterilize" anything in your digestive tract. No. That would be harmful, for the same reason why you don't ingest chlorine or sodium hydroxide internally - this would clearly be detrimental. Would you sterilize objects "externally" with them. Yes.

You're confusing enzymes with enzymatic properties.

using chemicals and heat on prion-contaminated surfaces tends simply to create new prion strains.

a) Prions treated with chlorine and/or sodium hydroxide so far are proven most effective.
No, these chemicals do not create "new protein strains", that's ridiculous.

b) We're not discussing temperature.
But if you really want to yes, heat of any intensity is ineffective. This is why we're not discussing temperature in the denaturation of prions because It has no effect, so I don't even know why you brought it up.


He is far off the mark, as are you.

reply to post by unb3k44n7

Do you want to wash your dishes with pineapple and papayas? Would you trust they would be clean (sterilized?) for you family? No.

Do you want to "sterilize" anything in your digestive tract. No. That would be harmful, for the same reason why you don't ingest chlorine or sodium hydroxide internally - this would clearly be detrimental. Would you sterilize objects "externally" with them. Yes.

He is far off the mark.

The nature and strength of any chlorine compound used to "sterilize" for prions would render it dangerous to ingest even 2nd hand off treated objects. I wouldn't do it.

In fact, natural agents like turmeric and tea DO inhibit prion propagation in the body. Papain and bromelin both digest protein - and have been used for prion decontamination in medical research settings. As well, papain and bromelin are being used in patents for treating prion disease symptoms in living patients. So rickymouse is NOT " far off the mark."

* An enzyme–detergent method for effective prion decontamination of surgical steel

* Patent application title: METHODS AND COMPOSITIONS FOR THE TREATMENT OF SYMPTOMS OF PRION DISEASES

* Methods and compositions for the treatment of symptoms of prion diseases. US 20100092447 A1






Note: Gawd I hate dial-up.

I'm not familiar with the prion thing (heard about it right here on ATS) But that heat resistant trait is something that perks my interest. What about it makes it's bonds impervious to heat? Even the toughest metals can be smelted back down, how is this protein stronger in that it can't be incinerated? Or is it that autoclaves aren't hot enough? If it's just the latter, and the medical professionals have half a brain (absolutely no pun intended) then smelt the stuff down already. Specialized tools for a single use in known cases is a far better way to control spreading than to leave it unchecked via "We can't get our sterilization machines hot enough".

reply to post by soficrow


reply to post by soficrow


Oh Ok, you want to do the online internet "source" thing. I don't usually link sources because there's no need to if you already know what you're talking about, but OK, I'll play. Give me a minute to gather some online links for proof that will be to your approval


Keep in mind the discussion now is about what is currently being used to sterilize prion-contaminated medical equipment

Anything from this PDF should do
www.shea-online.org...

There is good evidence to suggest that the most effective method for prion decontamination involves autoclaving in the presence of high concentrations of sodium hydroxide

cid.oxfordjournals.org...


...I can even go as far as to wiki it for you.
Look under sterilization
en.wikipedia.org...

"Source" for the wiki "source"
www.cdc.gov...

Ill stop for now. Do you want more sources? I can do this all day Yay? Nay?