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focus of public interest because of the occurrence of bovine spongiform encephalopathy
(BSE) in cattle in the United Kingdom and the probability of transmission through foodstuffs
to people.
3.1.2 Incidence
In general CJD occurs sporadically, i.e. without any demonstrable cause; the average age for
onset of disease is 64 years, and the average duration of disease is 4 months. Among the
acquired forms of this disease is kuru, which is a neurodegenerative disease found in a
group of people with a specific language in Papua-New Guinea following consumption of
human brain during cannibalistic rituals. There is also the possibility of unintentional
transmission when performing medical procedures. The new variant of Creutzfeldt-Jakob
disease (vCJD), which is associated with BSE in cattle, has occurred mainly in the United
Kingdom and France.
3.1.3 Transmission route
The disease can be transmitted through administration of human hypophyseal hormones,
corneal eye transplants or through neurosurgical instruments. The interval between exposure
and onset of the first clinical symptoms is between 1 and 30 years.
3.1.4 Diagnosis
With onset of disease, patients have concentration and attention disorders, progressing later
to impaired movements, personality changes, impaired vision and gait. After, in general rapid
progression of symptoms, the disease inevitably leads to death. Apart from clinical
symptoms, the diagnostic methods used include electroencephalogram (EEG), cerebrospinal
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Level 2 Script of the wfhss education group Special Microbiology
fluid (CSF) tap test and magnetic resonance imaging (MRI). CJD can be definitively
diagnosed only through post mortem examination.
At present there is no treatment.
3.1.5 Precautionary measures
Today in industrialised countries hypophyseal hormones can be safely produced using
recombinant technologies, and there are also strict safety regulations and restrictions in
place for transplantations.
There is no evidence of a risk of transmission in routine nursing and when dealing with
infected persons, and conventional hygiene measures suffice.
3.1.6 Instrument reprocessing
See  CJD chapter in Instrument Reprocessing
4 Authors
Mag. Dr. Tillo Miorini, Institute for Applied Hygiene, Graz
Prof. Duygu Percin, Department of Clinical Microbiology, Erciyes University Faculty of
Medicine, Kayseri, Turkey.
The script has been proof read and authorized by the wfhss education group
5 References
1) Steirischer Seuchenplan (O. Feenstra Hrsg.), 2002
(http://www.verwaltung.steiermark.at/cms/ziel/2651878/DE/)
2) RKI Mitteilung: Die Variante der Creutzfeldt-Jakob-Krankheit (vCJK): Epidemiologie,
Erkennung, Diagnostik und Prävention unter besonderer Berücksichtigung der
Risikominimierung einer iatrogenen Übertragung durch Medizinprodukte, insbesondere
chirurgische Instrumente  Abschlussbericht der Task Force vCJK zu diesem Thema.
Bundesgesundheitsbl -Gesundheitsforsch  Gesundheitsschutz 2002, 45:376 394,
Springer-Verlag 2002. (www.rki.de)
6 Learning Objectives
Understand and be able to cite the mentioned special microorganisms of particular
importance in medical device reprocessing or occupational safety their most important
characteristics
Be able to tell, which of the pathogens require special treatment of MDs and why
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