Iatrogenic Creutzfeldt–Jakob disease in Australia: time to amend infection control measures for pituitary hormone recipients?
Authors: Alison Boyd, Genevieve M J A Klug, Colin L Masters and Steven J Collins
Published online: 21 February 2011
In reply: We thank Solvyns and Ralston for their thoughtful and heartfelt comments and their assistance in ensuring historical accuracy regarding the issues surrounding iatrogenic Creutzfeldt–Jakob disease (CJD) risk and recipients of the Australian Human Pituitary Hormone Program (AHPHP).
Whether there is a need for ongoing support of AHPHP recipients for the foreseeable future was not considered in the scope of our report,1 but we unequivocally support provision of optimal health care services for them, which we believe relaxation of infection control measures will assist.
The delays and manner in which many AHPHP recipients learned of their risk of CJD is certainly regrettable, but this was not the universal experience of recipients. Some were made aware of the risk by their treating practitioner in 1985,2 with their heightened personal anxiety commencing from that time.
As stated in our report, we agree that the close temporal development of CJD in the four Australian human pituitary gonadotrophin recipients appears consistent with a single, significant contamination event,1 such as from tainting of a limited number of treatment batches — an observation broadly in keeping with the existence of a higher-risk treatment window. However, despite assertions to the contrary, data acquired from various sources by the Australian National Creutzfeldt–Jakob Disease Registry for analysis did not permit confident and consistent delineation of a higher-risk treatment group. This is not synonymous with saying that a higher-risk period was unknown to us.
Competing interests
References
- Boyd A, Klug GMJA, Schonberger LB, et al. Iatrogenic Creutzfeldt–Jakob disease in Australia: time to amend infection control measures for pituitary hormone recipients? Med J Aust 2010; 193: 366-369. <eMJA full text>
- Allars M. Report of the inquiry into the use of pituitary derived hormones in Australia and Creutzfeldt-Jakob disease. Canberra: AGPS, 1994: 630. 0_i1095843
Hospital-Admitted Injection-Related Infections Among Incarcerated People Who Inject Drugs in Australia: A Retrospective Cohort Study
Andrew Palmer, Matthew Carter, Jeremy Yeo, Cecilia Shim, Jason Connor, Jeremy Hayllar, Gerald Holtmann, Naomi Moy, Elliott G. Playford, Naomi Runnegar, Paul J. Clark
The Live Attenuated Influenza Vaccine in Australia: An Additional Tool for Influenza Prevention
Cyra Patel, Alexis Pillsbury, Tran Nguyen, Xia Wang, Helen E. Quinn, Clayton K. Chiu, Allen C. Cheng, Katie L. Flanagan, Zhicheng Wang
Reflex Testing for Hepatitis D Infection: A Unique Opportunity to Reduce Hepatitis D-Related Chronic Liver Disease Deaths in Australia
Jessica Howell, Lauren Andersson, Miriam T. Levy, James O'Beirne, Leon Adams, Katharine Irvine, Avik Majumdar, Golo Ahlenstiel, Kathy Jackson, Krispin Hajkowicz, Joseph Doyle, Jane Davies, Sarah Cherian, Wayne Dimech, Alexander J. Thompson
Localised Herpes Simplex Following Midline Laparotomy
Jessica S. Bulluss, Paul Chee, Matthew J. Verheyden
West Nile virus Kunjin subtype in rural NSW
Emily Gibson, Megan Whitley, Peter Murray, Linda Hueston, Jane Bennett, Raguharan Kathiresu, David N Durrheim
Differentiated and simplified oral HIV pre‐exposure prophylaxis (PrEP) models hold the key to virtually eliminating HIV transmission in Australia by 2030
Tyson Arapali, Sarah Warzywoda, Anthony K J Smith, Curtis Chan, Timothy R Broady, Erin Sullivan, Catherine MacPhail, Mohamed A Hammoud, Alexander Dowell‐Day, Benjamin R Bavinton