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What infection control measures should be implemented in cases of suspected or confirmed CJD?
Answer
In cases of suspected or confirmed Creutzfeldt-Jakob disease (CJD), standard infection control precautions should be implemented as the primary measure, since routine care is unlikely to involve contact with high or medium risk tissues that require special handling. This includes strict adherence to hand hygiene using liquid soap and warm running water or alcohol hand rub before and after direct contact with the patient. Personal protective equipment (PPE) such as disposable gloves and aprons should be worn when contact with body fluids is anticipated, and long-sleeved fluid-repellent gowns should be used if there is a risk of extensive splashing. Procedures involving potential contamination, such as wound dressings, should be scheduled at the end of clinical sessions to allow thorough environmental cleaning afterwards. Environmental surfaces, including treatment couches, should be cleaned with detergent and warm water followed by a hypochlorite solution at 1000 ppm concentration. Waste contaminated with body fluids must be disposed of as infectious waste. No additional special measures beyond these standard precautions are generally required in primary care settings for CJD due to the low risk of transmission through routine contact 1.
However, literature on transmissible spongiform encephalopathies, including CJD, highlights the exceptional resistance of prions to conventional disinfection and sterilization methods, suggesting that in settings where surgical instruments contact high-risk tissues (e.g., brain or nervous tissue), enhanced decontamination protocols or single-use instruments may be necessary to prevent iatrogenic transmission (Papacchini et al., 2003). While this is more relevant to hospital or surgical environments, it underscores the importance of strict adherence to infection control protocols and awareness of prion inactivation challenges in healthcare settings.
In summary, for general practice and community care, follow standard infection control precautions with appropriate PPE, hand hygiene, environmental cleaning, and waste disposal. For invasive procedures involving high-risk tissues, consult specialist infection control guidance due to prion resistance to standard sterilization (Papacchini et al., 2003) 1.
Key References
- CKS - Healthcare-associated infections
- CG139 - Healthcare-associated infections: prevention and control in primary and community care
- NG78 - Cystic fibrosis: diagnosis and management
- NG33 - Tuberculosis
- (Papacchini et al., 2003): [Prevention of transmissible spongiform encephalopathy and methods for prion inactivation].
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