The Chief Medical Officers of England, Scotland, Wales and Northern Ireland have asked NICE to develop guidance on the prevention of transmission of Creutzfeldt-Jacob Disease (CJD).

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on patient safety and reduction of risk of transmission of Creutzfeld-Jakob disease (CJD) via interventional procedures.


CJD is a progressive, fatal neurological disease that belongs to a wider group of neurodegenerative disorders known as transmissable spongiform encephalopathies (TSEs) or prion diseases. Traditionally there are three categories of CJD; sporadic CJD (the most common), inherited CJD and iatrogenic CJD.

A novel form of human prion disease, vCJD was first recognised in the UK in 1996 and is believed to result from consumption of food derived from cattle infected with BSE. Like BSE, vCJD is a fatal neurodegenerative disease that causes sponge-like changes in the brain.

This guidance covers management of all patients undergoing procedures involving instruments and endoscopes that might pose a risk of transmission of CJD. It does not cover dental procedures.

Coding recommendations

This procedure is outside the scope of the OPCS-4 classification.