PATIENTS undergoing surgery or endoscopic tests are to be screened for their risk of having the deadly human form of mad cow disease following a series of infection scares last year.
The Chief Medical Officer for Scotland Dr Harry Burns has written to all health boards ordering doctors to identify patients who may have previously been exposed to Creutzfeldt-Jakob Disease (CJD).
Surgeons must now carry out a strict assessment
before patients undergo surgical procedures on tissues such as the brain, spinal cord, eye, spleen and tonsils.
The new guidelines come after a series of incidents last year that saw patients who potentially carried CJD undergoing surgery without the proper infection control precautions.
Doctors must now ensure they identify whether patients are at risk of carrying the deadly disease through family contacts, previous surgery or from receiving infected tissues, organs and hormone products.
All patients undergoing procedures on tissues considered to be susceptible to CJD will be asked a series of questions about their potential exposure before elective and emergency surgery.
If they are found to be "at risk" of CJD, extra infection control measures including decontamination of surgical instruments and their disposal will be put in place.
Burns said: "The need for additional advice on pre-procedure assessment was identified by the CJD Incidents Panel following a number of CJD cases in 2005 in which patients underwent surgery without prior knowledge of the need for infection control precautions relating to their special CJD status."
The new guidelines come amid fears that vCJD can be transmitted to patients via infected surgical instruments.
Researchers have called for better logging of the number of times equipment is used and on whom to ensure instruments used on patients later diagnosed with CJD could be taken out of use.
The latest figures show that so far in 2006 there have been 62 suspected cases of CJD in the UK and three people have died from the form caused by eating BSE-infected beef, vCJD.
Since 1995, 156 people have died of vCJD, with 28 dying at the height of the epidemic in 2000. There are currently six living individuals who are suffering from vCJD.
But experts at the National CJD Surveillance Unit at the Western General Hospital in Edinburgh have warned that hundreds more people could die in the next 20 years as a result of contracting vCJD during surgery. Of the 161 people diagnosed with vCJD by the end of 2005, 130 had undergone surgery in the years preceding the start of symptoms.
The government has now allocated £200m to improve sterilisation and tracking of reusable surgical equipment.
Scientists also hope to develop better tests for CJD - which currently requires a tissue sample for analysis - to screen patients when they arrive in hospital.
Dr Ian Stansfield, a CJD researcher at Aberdeen University, said: "Recent research has suggested there may be different types of vCJD that have different incubation times.
"This means we could see waves of epidemics as the other types begin to harm people. As the moment we can only identify patients with CJD if their tissue is found to have the misfolded protein responsible. The trouble is this misfolded protein acts as a catalyst and causes healthy forms of the protein to misfold also, which is what allows the disease to be infectious."
