Brain disease may be transmittable through surgery, study suggests
Spanish scientists have discovered that Creutzfeldt-Jakob disease (CJD) could be transmitted through general surgery. The EU-funded team believes that the fatal brain disorder may remain latent for several decades before symptoms become apparent. The findings, which are published in the Journal of Neurology, Neurosurgery & Psychiatry, suggest that surgery could be to blame for the contraction of other neurological diseases. The study was part of the NEUROPRION ('Prevention, control and management of prion diseases') project, which was funded EUR 14.4 million under the Food Quality and Safety Thematic area of the Sixth Framework Programme (FP6). Transmissible spongiform encephalopathies (TSEs) are diseases that impact the brain and nervous system of both humans and animals. CJD, the most common of all TSEs, is a rare, fatal neurodegenerative disease. It exists in various forms (e.g. genetic) but most cases are classified as sporadic. Lead author of the study Dr Jesús de Pedro-Cuesta from the Instituto de Salud Carlos III (ISCIII) and his team used TSE monitoring records from hospitals in Denmark and Sweden to study the possibility that the sporadic form of CJD could be transmitted through general surgery. Dr de Pedro-Cuesta said that the existence of the records (some dating back to the 1970s) afforded 'an extraordinary quality to the information and more credibility to the findings given the almost total absence of memory bias.' The team's findings indicate that a link does indeed exist between the sporadic form of CJD and surgery, with the risk of having contracted the disease becoming noticeable (with some exceptions) at least 20 years after having undergone an operation. Based on their study, Dr de Pedro-Cuesta explained that the disease is likely to enter and spread much more quickly within the central or peripheral nervous system. He added that they do not, however, rule out the possibility that intraoperational transfusions play a secondary part in transmission of the disease. 'Suggesting that a disease could have been acquired during healthcare is a very delicate affirmation, as some relatives of patients with sporadic CJD may be tempted to seek compensation from health authorities for the alleged intraoperational transmission years previously, which would be impossible to prove in individual cases,' said Dr de Pedro-Cuesta. As well as indicating that contraction of the disease could be prevented, Dr de Pedro-Cuesta added that it represents a shift in the way we understand Alzheimer's, Parkinson's and neurodegenerative diseases. More than 40 European institutes collaborated on the 6-year NEUROPRION project that ended in 2009. The aim of the project was to improve the way research into prion diseases is structured and integrated in Europe. NEUROPRION's joint programme of research activities focused on prevention, control, treatment and risk management of TSEs.
Countries
Denmark, Spain, Sweden