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

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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. Page 20 of 22
PAT/IC 4 v.3 The undertakers should be notified of the infection control risk. When the diagnosis of CJD or vCJD is known or suspected it is advisable to avoid embalming procedures. Viewing the deceased, and superficial contact, need not be discouraged even if a post-mortem has taken place. For further information see “Funeral arrangements after a CJD death” 12. REFERENCES Transmissible spongiform encephalopathy agents : Safe working and the prevention of infection. Guidance from the Advisory Committee on Dangerous Pathogens and the Spongiform Encephalopathy Advisory Committee. Department of Health TSE guidance: Department of Health - Advisory Committee on Dangerous Pathogens (ACDP) Page 21 of 22
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VARIANT CREUTZFELDT-JAKOB DISEASE (vCJD) AND ...

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