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Volume 18, Number 6—June 2012

CME ACTIVITY

Iatrogenic Creutzfeldt-Jakob Disease, Final Assessment

Paul BrownComments to Author , Jean-Philippe Brandel, Takeshi Sato, Yosikazu Nakamura, Jan MacKenzie, Robert G. Will, Anna Ladogana, Maurizio Pocchiari, Ellen W. Leschek, and Lawrence B. Schonberger
Author affiliations: Centre à l’Energie Atomique, Fontenay-aux-Roses, France (P. Brown); Institut National de la Santé et de la Recherche Médicale, Paris, France (J.-P. Brandel); Nanohana Clinic, Tokyo, Japan (T. Sato); Jichi Medical University, Yakushiji, Japan (Y. Nakamura); Western General Hospital, Edinburgh, Scotland, UK (J. MacKenzie, R.G. Will); Istituto Superiore de Sanità, Rome, Italy (A. Ladogana, M. Pocchiari); National Institutes of Health, Bethesda, Maryland, USA (E.W. Leschek); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (L.B. Schonberger)

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Table 2

Incubation periods and clinical presentations of iatrogenic Creutzfeldt-Jakob disease, according to source of infection*

Source of Infection No. cases Mean incubation period, y (range) Clinical signs†
Dura mater graft 228 12 (1.3–30) Cerebellar, visual, dementia
Neurosurgical instruments 4 1.4 (1–2.3) Visual, dementia, cerebellar
Stereotactic EEG needles 2 1.3, 1.7 Dementia, cerebellar
Corneal transplant 2 1.5, 27 Dementia, cerebellar
Growth hormone 226 17 (5–42)‡ Cerebellar
Gonadotropin 4 13.5 (12–16) Cerebellar
Packed red blood cells§ 3 6.5, 7.8, 8.3 Psychiatric, sensory, dementia, cerebellar

*EEG, electroencephalogram.
†In order of decreasing frequency.
‡Averages and ranges were 13 (5–24) y in France; 20 (7–39) y in the United Kingdom; and 22 (10–42) y in the United States.
§An additional asymptomatic but infected red-cell recipient died of an unrelated illness; another asymptomatic infected hemophilia patient who had been exposed to potentially contaminated factor VIII also died of an unrelated illness (neither is included in the table).

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