VARIANT CREUTZFELDT-JAKOB DISEASE (vCJD) AND ...

PAT/IC 4 v.3
ix)
Dental treatment of patients with,or at risk of CJD or vCJD
The risks of transmission of infection from dental instruments, used for routine dental
treatment, are thought to be very low provided optimal standards of infection control and
decontamination are maintained. Instruments labelled by manufacturers as “single use”
should not be re-used under any circumstances.
See advice from the Chief Dental Officer in 2007 for further guidance
Dentists are advised to ensure that:
• Endodontic reamers and files are treated as single use.
• Highest standards of decontamination are observed for all dental instruments.
• Manufacturers’ decontamination instructions are followed for all instruments and
where instruments are difficult to clean, single use instruments should be used
where possible.
x) List of workers exposed to TSE agents
Control of Substances Hazardous to Health (COSHH) regulations require employers to
keep a list of employees who work with TSE agents, such as:
• Staff performing invasive clinical procedures on patients suspected to be suffering
from CJD of any type, particularly where there is a risk of exposure to central
nervous tissue, eye tissue or other tissues known to contain CJD infectivity.
• Laboratory staff handling tissue specimens from patients with CJD.
• Staff undertaking post-mortem examinations of patients who have died of
CJD/vCJD or where CJD/vCJD is suspected.
The infromation recorded should include the type of work done and, where known, any
specific exposure, accident or incident. The list must be kept for 40 years after the last
known exposure and may be kept with the individual’s occupational health record.
11. AFTER DEATH
On the death of a patient defined in Table 1, the removal of the body from the ward to the
mortuary should be carried out using standard infection control measures. A body bag is
recommended for transportation to the mortuary, in line with normal procedures where
there is a known infection risk, and mortuary staff notified of this risk.
Post-mortem examination may be required to confirm a clinical diagnosis and cause of
death in patients with suspected CJD or vCJD. Such procedures have the potential to
expose mortuary staff to tissues containing high levels of infectivity and must be discussed
with the Consultant Histopathologist and Infection Prevention and Control Team. Detailed
guidance is available in “Transmissible spongiform encephalopathy agents : Safe working
and the prevention of infection” – Annex H. Department of Health; June 2003.
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