Volume 194 - Issue 4
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
Med J Aust 2011; 194 (4): 214-215. || doi: 10.5694/j.1326-5377.2011.tb03794.x
Published online: 21 February 2011
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
The Australian National Creutzfeldt–Jakob Disease Registry is funded by the Australian Government Department of Health and Ageing. Steven Collins is the Medical Director of the CJD Support Group Network. He receives Fellowship and program grant funding from the National Health and Medical Research Council.
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