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 and clinical classification codes for this guidance.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.