Creutzfeldt-Jakob disease primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

There is no vaccine against Creutzfeldt-Jakob disease. Preventive measures to reduce Creutzfeldt-Jakob disease have not been studied and may or may not be helpful. Preventive measures may include sterilizing medical equipment before use, avoiding the use of infected patients as cornea donors, managing infected animals (e.g. cows), and not accepting transfusions from individuals with certain travel histories (e.g. travel to UK for > 6 months between 1980-1996).

Primary Prevention

• There is no vaccine against Creutzfeldt-Jakob disease.
• Preventive measures to reduce Creutzfeldt-Jakob disease have not been studied and may or may not be helpful.
• In general, the following measures are thought to reduce the risk of transmission of Creutzfeldt-Jakob disease:

• Sterilizing medical equipment before use
• Avoiding the use of infected patients as cornea donors

• Managing infected animals (e.g. cows)

• Not accepting transfusions from individuals with certain travel histories (e.g. Travel to UK for > 6 months between 1980-1996).

Prevention of Variant CJD

• To reduce any risk of acquiring vCJD from food, travelers to Europe or other areas with indigenous cases of bovine spongiform encephalopathy (BSE) may consider either avoiding beef and beef products altogether or selecting beef or beef products, such as solid pieces of muscle meat (rather than brains or beef products like burgers and sausages), that might have a reduced opportunity for contamination with tissues that may harbor the BSE agent.
• Milk and milk products from cows are not believed to pose any risk for transmitting the BSE agent.

Prevention of Bovine Songiform Encephalopathies

• Public health control measures, such as surveillance, culling sick animals, or banning specified risk materials, have been instituted in many countries, particularly in those with indigenous cases of confirmed BSE, in order to prevent potentially BSE-infected tissues from entering the human food supply.
• The most stringent control measures include a UK program that excludes all animals more than 30 months of age from the human food and animal feed supplies. The program appears to be highly effective.
• In June 2000, the European Union Commission on Food Safety and Animal Welfare strengthened the European Union's BSE control measures by requiring all member states to remove specified risk materials from animal feed and human food chains as of October 1, 2000; such bans had already been instituted in most member states. Other control measures include banning the use of mechanically recovered meat from the vertebral column of cattle, sheep, and goats for human food and BSE testing of all cattle more than 30 months of age destined for human consumption.

Blood Donor Restrictions

• It is thought that variant Creutzfeldt-Jakob disease may be transmitted by blood transfusion.
• Restrictions on blood donations may be helpful (unknown level of effectiveness). There is currently no test to determine if a blood donor is infected and in the latent phase of variant Creutzfeldt-Jakob disease.

• On May 28, 2002, the United States Food and Drug Administration instituted a policy that excludes from donation anyone who spent at least 6 months in certain Western European countries (or 3 months in the United Kingdom) from 1980 to 1996.
• A similar policy applies to potential donors to the Australian Red Cross' Blood Service, precluding people who have spent a cumulative time of six months or more in the United Kingdom between 1980 and 1996.
• The Singapore Red Cross precludes potential donors who have spent a cumulative time of three months or more in the United Kingdom between 1980 and 1996.
• As of 1999, Health Canada announced a policy to defer individuals from donating blood if they have lived within the United Kingdom for one month or more from Jan. 1, 1980 to Dec. 31, 1996. :*In 2000, the same policy was applied to people who have resided in France, for at least three months from Jan. 1980 to Dec. 1996. Canada will not accept blood from a person who has spent more than 6 months in a Western European country since January 1, 1980.
• The Association of Blood donors of Denmark precludes potential donors who have spent a cumulative time of at least twelve months in the United Kingdom between 1 January 1980 and 31 December 1996.
• The Swiss Blutspendedienst SRK precludes potential donors who have spent a cumulative time of at least six months in the United Kingdom between 1 January 1980 and 31 December 1996.

References

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