CJD threat forces NHS into £200m clean-up

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The Government is to spend £200m on sterilising surgical instruments to minimise the risk of hospitals passing on variant Creutzfeldt-Jakob disease during certain operations.

The Government is to spend £200m on sterilising surgical instruments to minimise the risk of hospitals passing on variant Creutzfeldt-Jakob disease during certain operations.

The money will be spent on cleaning and decontaminating equipment to the "highest standards possible".

It will also pay for expensive disposable surgical instruments for the removal of tonsils. Reusable instruments have been shown to harbour the infective agent involved in vCJD, the human form of "mad cow" disease.

Scientists have found that the agent capable of transmitting bovine spongiform encephalopathy (BSE) and related brain diseases can survive the high temperatures and pressures normally used to sterilise surgical instruments.

All hospitals were requested last year to review their sterilisation procedures, and the money will be used to ensure these plans are implemented, the Department of Health said.

Advisers to the Government warned there was a risk of vCJD being passed between patients who shared surgical instruments, even when they were sterilised. For tonsil surgery, hospitals will ensure "single-use instruments" are introduced this year "to further minimise the theoretical risk of transmission of variant CJD in hospital", the department said.

John Denham, a Health minister, said: "We have no evidence of any patient being infected with vCJD in hospital. But while we are still learning about the progress of vCJD we should take precautions to reduce theoretical risk of transmission to patients.

"Scientists tell us that the most effective way to prevent the potential spread of this disease in hospitals is by cleaning and sterilising to the highest standards."

So far, 88 people are known to have contracted vCJD, probably from eating infected beef, but scientists have little idea of how many people are incubating the disease and are capable of passing on the infection.

Pat Troop, the deputy chief medical officer, said: "There is a theoretical risk that it could be passed on through surgical operations from those who have yet to show symptoms of the disease."

The Government is following the advice of its Spongiform Encephalopathy Advisory Committee (Seac), which said last year that instruments used in tonsillectomies should be disposable, partly because the operation is usually performed on children.

Dr Troop said the measure "will allow us to learn valuable lessons should we decided ultimately to extend the use of single-use instruments to other procedures". Using disposable instruments for tonsil operations alone will cost the NHS £25m a year.

Scientists at St Mary's Hospital in London have estimated that if there are 10,000 people in Britain incubating the human variant of BSE, about half the sets of tonsillectomy instruments in the country could be contaminated.

Four types of surgery are thought to pose most risk: tonsil removal, appendix removal, operations at the back of the eye, and brain surgery, where already many instruments are disposed of after an operation.

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