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Volume 10, Number 9—September 2004

Dispatch

Barriers to Creutzfeldt-Jakob Disease Autopsies, California

Janice K. Louie*†Comments to Author , Shilpa S. Gavali*, Ermias D. Belay‡, Rosalie Trevejo†, Lucinda H. Hammond*, Lawrence B. Schonberger‡, and Duc J. Vugia*†
Author affiliations: *California Emerging Infections Program, Richmond, California, USA; †California Department of Health Services, Berkeley, California, USA; ‡Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Table 2

Perceptions of California neurologists, pathologists, and neuropathologists regarding performance of autopsy in Creutzfeldt-Jakob disease (CJD)

Characteristic Neurologists 
n/N (%) Pathologists 
n/N (%) Neuropathologists 
n/N (%)
Important reasons to obtain autopsy for CJD patients
  Autopsy is needed to confirm CJD diagnosis 92/197 (47) 11/21 (52)
  Autopsy is needed to rule out variant CJD or other TSEa forms 168/231 (73) 87/193 (45) 12/20 (60)
Barriers to performing autopsy and histopathologic analysis for CJD
  Clinicians do not feel autopsy is required for diagnosis 94/221 (43) 72/198 (36) 7/21 (33)
  Facilities not able/willing to perform autopsies on CJD patients 75/234 (32) 111/210 (53) 8/22 (36)
  Families are reluctant to give consent for autopsy 192/242 (79) 57/202 (28) 6/22 (27)
  Cost of autopsy is a concern to patient’s family 113/234 (48) 34/202 (17) 8/20 (40)
  Cost of autopsy is a concern to hospital/institution 78/234 (34) 40/199 (20) 8/21 (38)
  Infection control is a concern regarding autopsy 102/235 (44) 143/185 (77) 9/11 (82)
  Facilities are inadequate to perform autopsy 24/185 (13) 5/11 (45)
  Infection control is a concern regarding histopathologic evaluation 62/111 (56) 4/8 (50)
  No available pathologists experienced in recognizing histopathologic features of CJD 69/111 (62) 1/8 (13)

aTSE, transmissible spongiform encephalopathy.

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