Iatrogenic Creutzfeldt-Jakob disease, final assessment.
Iatrogenic Creutzfeldt-Jakob disease, final assessment.
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DOI：
10.3201/eid1806.120116
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发表时间：
2012-06
影响因子：
11.8
通讯作者：
Schonberger LB
中科院分区：
文献类型：
--
作者：
Brown P;Brandel JP;Sato T;Nakamura Y;MacKenzie J;Will RG;Ladogana A;Pocchiari M;Leschek EW;Schonberger LB
关于人类医源性克雅氏病（CJD）的书几乎已经结束了。这种通过医疗事故传播的CJD形式于1974年首次发现。今天，只有极个别潜伏期特别长的克雅氏症病例仍然出现。最大规模疫情的主要来源是来自患有未被怀疑的克雅氏病的人类尸体的组织，这些组织用于硬脑膜移植和生长激素提取物。另外一些病例是由神经外科器械污染、角膜移植、促性腺激素和输血继发感染引起的。虽然医源性克雅氏病的最终解决方案仍然没有（实验室测试，以确定潜在的捐赠者谁窝藏传染性病原体），某些其他措施已经奏效：应用特殊消毒的穿透手术器械，减少捐赠者的血液和组织的感染潜力，并排除捐赠者已知有高于正常风险的克雅氏病。医源性克雅氏病（CJD）的时代已经接近尾声;只有潜伏期特别长的偶尔病例仍在出现。这些疾病暴发的主要来源是从患有未确诊的克雅氏病感染的人尸体中提取的受污染的生长激素（226例）和硬脑膜移植物（228例）;少数其他病例是由神经外科器械污染、角膜移植、促性腺激素和通过输血传播的变异型克雅氏病继发感染引起的。没有发现新的疾病来源，目前的做法，结合联合收割机提高识别潜在感染者与新的消毒方法，为脆弱的外科手术器械和生物制品，应继续尽量减少医源性疾病的风险，直到血液筛查试验检测临床前感染是有效的人类使用。
The book on iatrogenic Creutzfeldt-Jakob disease (CJD) in humans is almost closed. This form of CJD transmission via medical misadventures was first detected in 1974. Today, only occasional CJD cases with exceptionally long incubation periods still appear. The main sources of the largest outbreaks were tissues from human cadavers with unsuspected CJD that were used for dura mater grafts and growth hormone extracts. A few additional cases resulted from neurosurgical instrument contamination, corneal grafts, gonadotrophic hormone, and secondary infections from blood transfusions. Although the final solution to the problem of iatrogenic CJD is still not available (a laboratory test to identify potential donors who harbor the infectious agent), certain other measures have worked well: applying special sterilization of penetrating surgical instruments, reducing the infectious potential of donor blood and tissue, and excluding donors known to have higher than normal risk for CJD. The era of iatrogenic Creutzfeldt-Jakob disease (CJD) has nearly closed; only occasional cases with exceptionally long incubation periods are still appearing. The principal sources of these outbreaks are contaminated growth hormone (226 cases) and dura mater grafts (228 cases) derived from human cadavers with undiagnosed CJD infections; a small number of additional cases are caused by neurosurgical instrument contamination, corneal grafts, gonadotrophic hormone, and secondary infection with variant CJD transmitted by transfusion of blood products. No new sources of disease have been identified, and current practices, which combine improved recognition of potentially infected persons with new disinfection methods for fragile surgical instruments and biological products, should continue to minimize the risk for iatrogenic disease until a blood screening test for the detection of preclinical infection is validated for human use.
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影响因子：
6.4
作者：
Orrú CD;Wilham JM;Raymond LD;Kuhn F;Schroeder B;Raeber AJ;Caughey B
通讯作者：
Caughey B
DOI：
10.1186/1476-069x-7-31
发表时间：
2008-06-24
期刊：
Environmental health : a global access science source
影响因子：
--
作者：
Garruto RM;Reiber C;Alfonso MP;Gastrich H;Needham K;Sunderman S;Walker S;Weeks J;Derosa N;Faisst E;Dunn J;Fanelli K;Shilkret K
通讯作者：
Shilkret K
影响因子：
168.9
作者：
Gregori, Luisa;Gurgel, Patrick V.;Rohwer, Robert G.
通讯作者：
Rohwer, Robert G.
影响因子：
2.3
作者：
Yamada, Masahito;Noguchi-Shinohara, Moeko;Mizusawa, Hidehiro
通讯作者：
Mizusawa, Hidehiro
影响因子：
9.9
作者：
Ladogana, A;Puopolo, M;Zerr, I
通讯作者：
Zerr, I