The Challenge of Prion Decontamination
Iatrogenic transmission of these diseases via contaminated medical devices is considered rare, but it has been documented. In an experimental case, transmission of the disease was observed despite cleaning and decontamination of the medical device with formaldehyde. Clinically, 2 cases of TSEs have been confirmed in which transmission of the disease was due to the use of implanted depth electrodes that had been previously used on a patient with CJD and were inadequately decontaminated by cleaning with benzene and disinfecting with 70% alcohol and formaldehyde. Other cases have been linked to the use of neurosurgical instruments. These reports highlight the need for safe and effective prion decontamination methods.
The World Health Organization and the US Centers for Disease Control and Prevention recommend that instrumentation used in cases likely to have high infectivity be immediately destroyed after use; short of destruction, it is recommended that heat and chemical decontamination be used in combination to process instruments that come in contact with high-infectivity tissues.
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