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Lyodura use and the risk of iatrogenic Creutzfeldt–Jakob disease in Australia

Fiona J Brooke, Alison Boyd, Genevieve M Klug, Colin L Masters and Steven J Collins
Med J Aust 2004; 180 (4): 177-181.

Summary

  • Although infectiousness is a feature of Creutzfeldt–Jakob disease (CJD), only a small proportion of cases are linked to transmission through healthcare provision.

  • As of January 2003, over 120 cases of CJD associated with use of human cadaveric dura mater had been recognised worldwide; almost all were associated with the commercial product Lyodura.

  • Most cases (97) have occurred in Japan, giving an overall risk estimate of around 1 per 2268 patients treated with Lyodura (0.04%) in that country.

  • In Australia, five cases of CJD have so far been linked to Lyodura, but, given the protracted tails of previous epidemics of transmissible spongiform encephalopathies, further cases are possible.

  • Results of surveys of Lyodura use in Australia are incomplete, but information from the manufacturer suggests that 2208–2478 sheets of Lyodura may have been used here.

  • This use translates to a relatively high incidence of Lyodura-associated CJD, with current overall rates appearing around five times higher than those reported in Japan; reasons for this difference are unclear.

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  • Fiona J Brooke1
  • Alison Boyd2
  • Genevieve M Klug3
  • Colin L Masters4
  • Steven J Collins5

  • 1 Communicable Diseases Branch, Department of Health and Ageing, Canberra, ACT.
  • 2 Australian National Creutzfeldt–Jakob Disease Registry, Department of Pathology, University of Melbourne, Melbourne, VIC.

Correspondence: 

Acknowledgements: 

The Australian National Creutzfeldt–Jakob Disease Registry is funded by the Australian Department of Health and Ageing. The authors thank Associate Professor Peter Reilly (University of Adelaide) for many details of the Neurosurgical Society of Australasia survey of neurosurgeons, Dr L Schonberger (Centers for Disease Control and Prevention, USA) for estimated percentages for non-neurosurgical use of Lyodura, and Professor Emeritus Donald Simpson, Department of Neurosurgery, Royal Adelaide Hospital, SA, for assistance in reporting and evaluating patients with Lyodura-related CJD.

Competing interests:

None identified.

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