Reducing the risk of transmission of Creutzfeldt–Jakob disease (CJD) from surgical instruments used for interventional procedures on high-risk tissues

The committee emphasised the importance of continued surveillance for all forms of Creutzfeldt–Jakob disease (CJD) to identify trends in incidence rates. It noted that there are effective systems for doing this in the UK.

The committee noted that the economic modelling suggests that keeping surgical instruments moist is the most cost-effective strategy, because it saves money and potentially increases societal health. Additional strategies aimed at reducing the future risk of surgically transmitted CJD (stCJD) do not appear to be cost effective.

The committee supported the need, as outlined in the Department of Health and Social Care's Health Technical Memorandum (HTM) 01-01: decontamination of surgical instruments (2016), for systems to be developed that allow both individual instruments and sets to be tracked and traced. This would avoid instrument migration.

The committee encouraged further research into the development of cost-effective decontamination methods that remove or destroy prions from instruments.

The committee noted that single-use instruments are the only way of completely avoiding the potential for the transmission of CJD infection by surgical instruments.

The committee emphasised that clinicians should comply with the Department of Health and Social Care's Health Technical Memorandum (HTM) 01-01: decontamination of surgical instruments (2016) and corresponding guidance in the devolved administrations' areas and other relevant guidance and standards.

The committee emphasised that this guidance applies to procedures on high-risk tissues and not to people at risk of CJD as defined in the Advisory Committee on Dangerous Pathogens' guidance on transmissible spongiform encephalopathy agents: safe working and the prevention of infection.