http://www.washingtonpost.com/wp-srv/aponline/20010510/aponline222808_000.htm

Rare Disease Closes Canada Hospital

By David Goodman, Associated Press Writer

Thursday, May 10, 2001; 10:28 p.m. EDT

WINDSOR, Ontario –– The chief trauma hospital in this Canadian border city will keep its operating rooms closed at least through Friday after possible infection with a rare brain-wasting illness.

Surgeons at Hotel-Dieu Grace Hospital operated March 11 on a woman who later tested positive for possible infection with Creutzfeldt-Jakob Disease.

The disease, known as CJD, is extremely rare and usually fatal, hospital neurosurgeon Dr. Srinivas Chakravarthi said Thursday. CJD occurs worldwide, typically in those over the age of 50, with about one case per million people each year.

A variant of the disease has been linked directly to eating meat from cattle infected with bovine spongiform encephalopathy, known as mad cow disease. Nearly 100 people in Europe have died of new variant CJD since 1995.

Chakravarthi said he learned of the test result, which is about 85 percen accurate, on Monday. As a precaution, the hospital halted all surgery and began disinfecting its operating rooms and surgical equipment Tuesday.

Patients who have had neurosurgery at the hospital since March were being contacted, said chief executive Frank Bagatto. However, "the odds of anyone getting this particular disease is almost close to zero," Chakravarthi said at a news conference.

One good sign is that the woman who tested positive seems to be doing well, which could indicate the test is a false positive, the surgeon said.

Meanwhile, Ontario's health minister warned Thursday that patients may have been exposed to the disease at Windsor Regional Hospital because of shared medical instruments.

Hotel-Dieu frequently shares medical equipment with other hospitals but seldom shares neurological equipment, Chakravarthi said. He did not say if there had been any such sharing since March 11.

On the Net: http://www.cjdfoundation.org

© Copyright 2001 The Associated Press

-- Swissrose (cellier3@mindspring.com), May 11, 2001

Answers

Just to make clear, the disease of concern in this article is "classic" CJD, with a distinct histopathology under the microscope and distinct epidemiology, in comparison to the "new variant" CJD that has affected as I recall a couple hundred people -- so far -- in Europe.

The *classic* CJD being mentioned in this article was first described a long time ago, affects roughly one person per million population *worldwide* every year (mostly older persons: 99% of cases occur in persons older than 35 years, and most of those are aged 50 or older) and is only rarely thought to occur as a result of neurosurgical instruments contaminated from a previous patient-- a risk that has been well known and discussed for a couple decades at least. There are a few familial instances of classic CJD (i.e., it is passed by genetic inheritance in those few families), but maybe 95% of classic CJD cases worldwide are classified as "sporadic."

-- Andre Weltman, M.D. (aweltman@state.pa.us), May 11, 2001.