Friday, March 11, 2022

Prevalence of Surgical Procedures at Symptomatic Onset of Prion Disease

Prevalence of Surgical Procedures at Symptomatic Onset of Prion Disease

Research Letter Surgery

March 9, 2022

Prevalence of Surgical Procedures at Symptomatic Onset of Prion Disease

Amanda L. Porter, MD1; Christian C. Prusinski, DO1; Evelyn Lazar, MD1; et alClara Yuh, DO2; Robert C. Bucelli, MD, PhD3; Brian S. Appleby, MD4; Gregory S. Day, MD, MSc, MSCI1

Author Affiliations Article Information

JAMA Netw Open. 2022;5(3):e221556. doi:10.1001/jamanetworkopen.2022.1556

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive fatal prion disease. Although most cases are sporadic or inherited, prions may be transmitted via contaminated tissues or durable medical equipment.1,2 The risk of iatrogenic transmission is highest following procedures involving the central nervous system, where prion burden is highest.2,3 However, experimental models suggest that transmission may occur following contact with other tissues (eg, nasal mucosa, lung, lymph nodes, and spleen).4 If these models are accurate, surgical procedures involving these tissues may pose a risk to future patients. To evaluate the potential scope of this problem, we determined the frequency of invasive procedures performed in patients with CJD at multiple tertiary care centers.

Methods

Protocols for this case-control study were approved by the Mayo Clinic institutional review board. A waiver of consent was granted for the use of retrospective, deidentified data. This study follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. An automated search of Mayo Clinic records identified 252 of 1 843 675 patients with diagnostic evaluation including “CJD” or “prion disease” evaluated from January 2014 (the time at which specific biomarkers of prion disease were incorporated within clinical practice) to February 2021 at Mayo Clinic locations in Rochester, Minnesota; Jacksonville, Florida; and Phoenix, Arizona. Fourteen patients at Washington University (Saint Louis, Missouri) were enrolled from February 2016 to December 2019 within prospective studies of rapid progressive dementia. Available records were dual-reviewed (April 2021) to identify patients who met criteria for probable CJD (neuropsychiatric disorder with positive cerebrospinal fluid real-time quaking-induced recovery assays; or rapidly progressive dementia with 1 or more of the following signs and symptoms: myoclonus, visual or cerebellar signs, pyramidal or extrapyramidal signs, akinetic mutism, and consistent brain magnetic resonance imaging; 71 patients) or definite CJD (pathologically or genetically confirmed, 50 patients)5 and to capture surgical procedures. Procedures performed within 1 year of the onset of symptoms attributed to CJD were counted to include the presymptomatic period associated with latent prion accumulation. Procedures were stratified by risk of prion contamination of instruments.3,4 Statistical analysis was performed using SPSS statistical software version 28.0 (IBM), using Pearson χ2 tests for categorical variables and Mann-Whitney U tests for continuous variables to evaluate the association between patient-specific factors and procedures. Significance was set at P < .10 due to the exploratory nature of this analysis. Data were analyzed from March 2021 to June 2021.

Results

In total, 26 of 121 patients (21%) (63 female patients [52%]; median [range] age, 65.4 [21.9 to 81.5] years) with CJD underwent 55 procedures, including high-risk procedures in 2 patients with neuropathologically proven CJD (Table 1). Procedures were more frequent in patients with a history of arthritis (odds ratio [CI] 5.58 [1.16-26.7], P = .02) and possibly less frequent in patients with behavioral symptoms or signs at presentation (odds ratio [CI] 0.43 [0.16-1.17]. P = .093) (Table 2). Median times from symptom onset to brain magnetic resonance imaging and electroencephalogram were greater in patients who underwent procedures, suggesting that diagnostic delays were associated with procedures. Seventeen of 32 procedures (53%) were performed in the months prior to symptomatic onset (median [range,] −5.4 [−0.2 to −10.8] months). Appropriate procedural precautions were observed in 1 patient.

Discussion

Invasive procedures were frequently performed in patients with CJD included in this case-control study. Actual numbers of procedures may have been even greater, recognizing that procedures performed at outside hospitals may have been overlooked or excluded from records. Replication of study methods within additional hospitals—including community-based centers—is required to confirm these findings and establish the generalizability of results.

Features of sporadic CJD typically manifest in the sixth through eighth decades of life (median age, 68 years),5 a time when gait abnormalities, sensorimotor complaints and visual changes may be mistaken for common age-related surgically responsive conditions, leading to surgical procedures in this cohort and others.6 Thus, it is essential to accurately decipher the cause of symptoms and signs in clinical practice (eg, distinguishing between difficulty walking due to joint pain vs ataxia due to CJD). Preoperative risk assessment tools may identify patients at risk of CJD, for whom elective surgical procedures should be deferred and emergent procedures completed under precautions.2 However, prescreening cannot prevent invasive procedures in presymptomatic patients. National registries may address this problem. In the US, The National Prion Disease Pathology and Surveillance Center systematically collects data from patients with suspected CJD. Incorporating questions on recent invasive procedures would allow early notification of surgeons or facilities when a diagnosis of CJD is confirmed, permitting quarantine, decontamination, or decommissioning of affected instruments. This would also allow for prospective surveillance in larger numbers of patients, providing data needed to replicate our findings and quantify the scope of the potential problem posed by surgical procedures in patients with CJD.


***> In the US, The National Prion Disease Pathology and Surveillance Center systematically collects data from patients with suspected CJD. Incorporating questions on recent invasive procedures would allow early notification of surgeons or facilities when a diagnosis of CJD is confirmed, permitting quarantine, decontamination, or decommissioning of affected instruments. This would also allow for prospective surveillance in larger numbers of patients, providing data needed to replicate our findings and quantify the scope of the potential problem posed by surgical procedures in patients with CJD.

Subject: [CJDVoice] CJD FOUNDATION QUESTIONNAIRE ???(what will they find out with this ??? )

Date: Thu, 07 Nov 2002 10:10:53 -0600

From: "Terry S. Singeltary Sr."

Reply-To: cjdvoice@yahoogroups.com

To: cjdvoice@yahoogroups.com

CC: bloodcjd@yahoogroups.com 

Greetings Voice, 

i send this 'CJD Foundation Questionnaire' and ask the group, what they suppose will be found out with this ???

with this questionnaire, in my opinion, they don't want to know what/where the routes and sources of CJDs in theUSA are coming from. NO WONDER they said i was interfering with there research, there research consist of _not_ finding out anything other than how it was diagnosed.

you folksjudge for yourself. maybe i'm just being an extremist as some say???

then again, maybe not...TSS 

CJD FOUNDATION QUESTIONNAIRE

REPORT FOR DATA BASE OF PATIENTS WITH CREUTZFELDT--JAKOB DISEASE (CJD) OR OTHER TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES (TSE's) 

Name of Patient*:(not required; if provided, must be with express consent of family member) 

Date form filled out: / / (mm/dd/yy) 

Person filling out form: 

Relationship of person filling out form to patient: 

Location where patient died: State: County: City: 

Location where patient resided: State: County: City: 

Sex of patient: male female unknown 

Race of patient: white African-American -- Asian/Pacific IslanderAmerican-Indian/Alaskan Native Other (please identify:Unknown 

Patient's date of birth: (mm/dd/yy) 

Age of patient at onset of symptoms: 

Date of patient's initial symptoms: (mm/dd/yy) 

Age of patient at time of death: 

Patient's date of death: (mm/dd/yy) 

Duration of illness: months 

Was this case referred to the National Prion Disease Pathology Surveillance Center at Case Western Reserve University in Cleveland, Ohio? yes no unknown 

 If yes, by whom was this case referred? Pathologist -- Neuropathologist -- Neurologist Other Physician (please identify which kind:Unknown 

Who made initial diagnosis of CJD or other TSE? 

Pathologist - Neuropathologist - Neurologist Other Physician (please identify which kind: )Unknown 

Please describe the clinical neurological presentation of the illness (list the symptoms or signs): 

at onset of the illness: 

during the course of illness: 

Was an EEG (electroencephalogram) performed? yes -- no -- unknown 

If yes, 

how long after onset was the EEG performed? 

how many times was the EEG performed? 

can you indicate the results? 

- slow periodic sharp waves (PSW) 

- unilateral periodic sharp waves (LSW) 

- not reported 

- other 

Was the cerebrospinal fluid tested for the 14-3-3 protein? yes - no -unknown 

If yes, what was the result? positive - negative - unknown 

Was a brain biopsy performed? - yes - no - unknown 

If yes, what was the result?_____ 

positive for__________ 

negative for CJD and other TSE's ______ 

unknown 

Was an autopsy performed? yes - no - unknown 

If yes, what was the result? _____ 

positive for__________ 

negative for CJD and other TSE's______ 

unknown 

Was the neuropathology of this case consistent with new variant CJD? yes - no - unknown 

What was the final diagnosis of this case? 

___CJD, probably sporadic 

___Familial (hereditary) CJD 

___Iatrogenic (by infection) CJD; 

please specify_______________ 

___Gerstmann-Strausster-Scheinker Syndrome (GSS) 

___Fatal Familial Insomnia (FFI) 

___Other 

___Unknown 

* I hereby give consent to the Creutzfeldt-Jakob Disease Foundation, Inc. to use the above information, including name of patient if supplied, in connection with activities to promote the research, education and awareness of Creutzfeldt-Jakob Disease and related transmissible spongiform encephalopathies. 

-4- 

END 

================================================== 

 Greetings again CJD Voice,

NOW, compare to the CJD questionnaire i sent through, and ask yourself why they ask me to remove this from internet? better yet, ask yourself why the CJD Foundationin fact did remove my questionnaire from their message board? what is it they are so afraid of that we may find out? 

Subject: [CJDVoice] CJD QUESTIONNAIRE... updated version II...TSS

Date: Tue, 05 Nov 2002 12:52:52 -0600

From: "Terry S. Singeltary Sr."

Reply-To: cjdvoice@yahoogroups.com

To: cjdvoice@yahoogroups.com

CC: bloodcjd@yahoogroups.com 

 CJD VICTIM 

1. 

 NAME______________________________________ 

 STREET___________________________________ 

 TOWN_____________________________________ 

phone____________________________________ 

 A. What is the subjects SURNAME____________________________ 

B. What is the subjects status? ___________________________

(1=suspect/confirmed CJD, 2=hospital control (specifydiagnosis), 3=GP control).C. If the subject is a (suspect) case, are they alive on theday of interview?_____(yes or no or not applicable) 

D. What is your (respondent's) name?_______________________ 

 (first name, and surname)What is the relationship to (subject)? ________________ 

address__________________ 

phone____________________ 

E. DATE OF INTERVIEW__________________________ 

LOCATION OF INTERVIEW_____________________ 

F. NAME OF INTERVIEWER________________________ 

2. SUBJECT INFORMATION 

A. SEX___________________ 

B. BIRTH DATE____________ 

C. BIRTH PLACE___________ (country, state, county, city) 

D. ETHNIC ORIGIN_________ 

E. MARITAL*DOMESTIC STATUS__________________ 

(If the subject is female and is/has been married) record the subjects maiden name if different

from current surname. 

F. PRESENT HOME ADDRESS_________________________ 

(ALSO, If deceased, last home address, before subjectbecame ill?) 

G. Is/was subject right or left handed?__________________ 

 F. How many years of full-time education?________________ 

3. PAST MEDICAL HISTORY 

A. Has the Subject had dental treatment other than fillings:

e.g. extractions or root canal work?_________________ 

If yes, record a description of treatment; with dates; 

Dentists name and address____________________________ 

 B. Has the Subject ever had any operations, including eyeoperations or stitching of

wounds?___________________ 

 (If yes, record the year, hospital and type of operation). _______________ 

(record total number of operations) 

 For each type of operation record the number of such operationsundergone, the year of the first such operation and the year of the lastsuch operation. When no such operations were undergone record 0 for thenumber of operations. 

NEUROLOGIC (brain)_____________________________ 

EYE____________________________________________ 

ABDOMINAL______________________________________ 

ORTHOPEDIC_____________________________________ 

OTHER__________________________________________ 

TONSILS OUT?___________________________________ 

APPENDIX OUT?__________________________________ 

ever received an ORGAN TRANSPLANT, including corneal or bone marrow

transplant?_____________________________________ 

 kidney, liver, and other_______________________ 

C. BLOOD TRANSFUSION__________________________ 

TRANSFUSION OF ALBUMIN OR IMUNOGLOBULIN________ 

BLOOD DONOR____________________________________ 

D. Has Subject ever been admitted to aHospital_______________________ 

E. Has Subject ever been to see psychiatrist

(reason andtreatment) _____________________ 


F. MEDICATIONS, has Subject taken any medications regularly, (if yes, record the date, name of the medication, the reason for taking it, and route of administration) prompt for prescription drugs, including insulin and type. 

__________________________________________________ 

__________________________________________________ 

__________________________________________________ 


Prompt for hormone therapy or nutritional supplements including oral contraceptives and hormone replacement therapy: 

 __________________________________________________ 

__________________________________________________ 

__________________________________________________ 



Prompt for homeopathic/herbal therapy: 

__________________________________________________ 

__________________________________________________ 

__________________________________________________ 

 Prompt for eye drops 

__________________________________________________ 


SUMMARY OF ABOVE RESPONSES; HAS THE SUBJECT BEEN EXPOSED TO ONE OF THE MEDICATIONS OF BOVINE OR OVINE ORIGIN, AND OR ANY DESICCATED ANIMAL ORIGIN? 

 G. Has Subject ever been tested for allergy using needles?________________ 

 H. Has Subject ever received a treatment involving a course ofinjections? 

_______________________________________ 

 (If yes, record year, name of therapy, frequency, reason) 

 I. Has Subject been VACCINATED? _______________________________ 

 (If yes, give name of vaccine, and route.) 

 J. Has Subject ever undergone lumbar puncture or electrical tests involving needles? 

__________________________________________ 

 K. Has Subject ever undergone acupuncture? ____________________ 

 L. Has Subject ever used drugs by needle? _____________________ 

 M. Has Subject ever been tattooed, ear or body piercing of any kind?____ 

 4. FAMILY HISTORY PEDIGREE 

 (indicating years of birth and death) Subjects grandparents,Subjects parents and parents siblings, Subject and siblings Subjects children. 

 A. From the genealogy, record whether the Subject has been married more than once? 

________________________________________ 

 B. Have any of the BLOOD relatives of the Subject included inthe Pedigree above died with dementia (or remain alive with dementia)? 

________________________________________ 

 C. Have any of these individuals been diagnosed as having Creutzfeldt-Jakob disease, and or any 

other T.S.E.?_______________________________ 

 (if so, give name, address, and apprx. date of illness) 

D. CONFIRMATION OF FAMILY HISTORY OF CJD OR OTHER TSE'S 

(1=definite 2=probable 3=possible 4=unable to confirm 5=not a case) 

_________________________________________________ 

 E. Has Subject had social contact, through family, friends or work, with someone else who developed CJD?_____________________________ 

(record the persons name and the apprx. date of illness.) 

F. Confirmation of social contact with case of CJD?____________ 

 G. FOR NON-U.K. cases only, Has Subject lived in or visited theUnited Kingdom during the period 1980-1999?________________________ 

 (if yes, record dat and duration of visits) 

 DIETARY HISTORY 

 A. Has Subject ever been a vegetarian for a period of 1 year or more? 

 (if yes), during what period was Subject vegetarian, and did the Subject eat any meat or fish at all during this time? ______________ 

 B. Does Subject have a history of any other dietary restrictions or eccentricities? (record apprx. dates and details of restrictions; 

__________________________________________________ 

 C. How many years did Subject eat school dinners?__________________ 

(give dates) 

 D. Has the Subject ever eaten animal food or petfood? 

_____________________________________________ 

(If yes, record the types of food and dates) 

E. How did/does the Subject like their steak cooked?________________ 

 (1=well done 2=medium 3=medium-rare 4=rare 5=did not eat steak) 

 F. How often does/did Subject cut or chop up raw red meat or bones, in their work or in their home?_______________________________ 

 G. (For each of the following food items) How often did Subject eat (food item)? 

BRAIN_________________ (specify animal which organ came from) 

EYE___________________ 

TRIPE_________________ 

LIVER_________________ 

KIDNEY_______________ 

SWEETBREADS_________

(pancreas) 

ROAST LAMB, 

LAMB COPS, 

LAMB STEW, 

ROAST PORK, 

HAM, 

BACON, 

ROAST BEEF, 

STEAK, 

BEEF STEW, 

MINCED BEEF, 

VEAL, 

VENISON, 

CHICKEN, 

BURGERS, 

MEAT PIES SUCH AS PORK, VEAL, AND HAM, STEAK AND KIDNEY, CHICKEN AND MUSHROOM,*** 

GOTS, 

MEAT SAUSAGES, 

BLACK PUDDING, 

HAGGAS, 

LIVER SAUSAGE OR PATE', 

STEAK TARTARE (raw minced steak with raw egg) carpaccio, 

CHEESE, COWS MILK (1=drinks milk/eats breakfast cereal with milk, 2=only in tea/coffee, 3=NO) 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 


5. EXPOSURE TO ANIMALS: 

 A. Did the Subject every HUNT, DRESS, AND EAT DEER? ____________________ 

 ELK_____________________ 

 SQUIRREL_______________ 

 OTHER__________________ 

 (if so, list location, and year, and list any specific organs that the Subject may have considered to be a delicacy). 

B. Did the Subject share a home with: 

CATS________________ 

DOGS________________ 

FERRETS_____________ 

C. Has the Subject worked or stayed for more than one week on a farm? (1=lived or worked, 2=stayed, 3=NO) If YES, did Subject work or help with; 

CATTLE______________ 

SHEEP________________ 

GOATS_______________ 

PIGS__________________ 

CHICKENS____________ 

MINK_________________ 

(If yes), did Subject participate in: Treating cattle for Warble fly?______________ 

Dipping sheep?_________________________ 

Crop Spraying?________________________ 

(If the Subject took part in any of these activities), recorddates, places and details of the activity

including agentsused; 

__________________________________________________ 

__________________________________________________ 

__________________________________________________ 

 D. Has the Subject used any of the following; 

BONE MEAL__________________ 

HOOF AND HORN____________ 

DRIED BLOOD________________ 

MANURE____________________ (if yes, record the item used and dates) 

E. Has Subject ever DISSECTED ANIMAL EYES, for example at school?

__________________________________________________ 

 6. RESIDENTIAL HISTORY (begin with the most recent residence and work backwards) From(dd/mm/yy) TO(dd/mm/yy) STREET TOWN COUNTY STATE (include zip code). 

__________________________________________________ 

__________________________________________________ 

__________________________________________________ 

 7. OCCUPATIONAL HISTORY OF SUBJECT; (begin with most recent occupation and work backwards) FROM (dd/mm/yy) TO(dd/mm/yy) NAME OF EMPLOYER TOWNDESCRIPTION OF WORK; 

__________________________________________________

__________________________________________________

__________________________________________________ 

 A. Has the Subject ever worked in farming, the meat industry,the pharmaceutical industry, or in a hospital? 

B. Has the SUBJECT, their PARTNERS or PARENTS ever worked in thefollowing areas; 

medical/pharmaceutical/nursing/dentistry_____________________________ 

animal laboratories______________________________________________ 

pharmaceutical laboratories________________________________________ 

other research laboratories________________________________________ 

animal farming________________________________________________ 

veterinary medicine_____________________________________________ 

meat industry_________________________________________________ 

(BUTCHER'S/ABATTOIRS/RENDERING PLANTS, ETC) and or (catering other occupation involving animal products, including leather)? 

______________________________________________________

______________________________________________________

______________________________________________________ 

 *** NOTE *** 

please include venison/sheep/lamb and the bovine to any of the above questions. 

example=brain tanning deer/elk hide or any other topics that pertain to transmission of TSEs 

_________________________________________________ 

 example=antler velvet nutritional supplements 

_________________________________________________ 

_any_ nutritional supplements??? name/ingredients 

_________________________________________________ 

example=elk/deer brains ie/scrambled, sandwich or otherwise 

_________________________________________________ 

 COSMETICS-ie facial creams, eye make-up etc. name/brand/ingredients 

__________________________________________________ 

MEDICAL-ENDOSCOPY WORK OF ANY TYPE

__________________________________________________ 

Terry S. Singeltary Sr. Bacliff, Texas USA 77518


July 9, 1991

Loma Linda University

A Seventh-day Adventist Institution

xxxxxxx

Dear xxxx:

Creutzfeldt-Jakob Disease Study Neuroepidemiology Section Department of Neurology, Rm 1580 School of Medicine Loma Linda, California 92350

July 9, 1991

The Department of Neurology of Loma Linda University is conducting a multi-state study of Creutzfeldt-Jakob disease to identify risk factors for this disease. This study is federally funded by a grant from the National Institute of Neuroiogic Disorders and Stroke (NINDS) of the National Institutes of Health (NIH).

We recently contacted the Texas Department of Health in Austin and according to their records xxxxx xxxxxx had Creutzfeldt-Jakob disease.

We would like for you to participate in this study of Creutzfeldt-Jakob disease. This research project may be of great benefit in preventing this disease. The success of this study depends upon your participation, which will involve signing a consent form (see enclosed consent form) to release the medical records of xxxx xxxxx and participating in an interview about xxxxx xxxxxx. This interview will be arranged at your convenience. Participation in this study is at no cost to you. If you agree to participate in this study, you are still free to refuse to answer any specific question.

In order to release the medical records of xxxx xxxxx, we need to know the name(s) of the hospital (s) where xxxx xxxxx was examined/diagnosed for Creutzfeldt-Jakob disease. Please fill out the enclosed hospital form indicating where xxxx xxxxx was examined/diagnosed for Creutzfeldt-Jakob disease.

All information supplied will be held in strictest confidence. All information will be pooled and no one person's answers will be identifiable, since code numbers and not names will be used in all analyses.

If you agree to participate in this study, please sign and complete the attached consent form and hospital form and return them to us. A self-addressed, stamped envelope is enclosed for your convenience.

If you have any questions about this study, please feel free to call us collect at (714) 799-2146.

Sincerely,

Carey G. Smoak, MSPH Project Coordinator 

===================== 

Loma Linda University

A Seventh-day Adventist Institution

xxxx xxxx 

Dear xxxxx:

Creutzfeldt-Jakob Disease Study Neuroepidemiology Section Department of Neurology, Rm 1580 School of Medicine Loma Linda, California 92350

October 21, 1991

Thank you for agreeing to participate in the Creutzfeldt-Jakob, disease study. Your participation in this important research project is greatly appreciated.

In the next few months we will be contacting you to arrange an interview about xxxx xxxxx. In order to prepare for the interview we need some information regarding xxxx xxxxx.

Please fill out the enclosed form and return it to us. A self-addressed, stamped envelope is enclosed for your convenience. It is very important that you return al1 of this information to us as soon as possible.

If you have any questions, please feel free to call us collect at (714) 799-2146.

Sincerely,

Zoreh Davanipour, DVM, PhD Principal Investigator Associate Professor & Director, Neuroepidemiology Section

Carey G. Smoak, MSPH Project Coordinator

======================

Loma Linda University

A Seventh-day Adventist Institution

xxxx xxxxx

Dear xxxx xxxxx: 

Creutzfeldt-Jakob Disease Study Neuroepidemiology Section Department of Neurology, Rm 1580 School of Medicine Loma Linda, California 92350

(714) 799-2146 October 30, 1991

Thank you for agreeing to participate in the Creutzfeldt-Jakob disease study. We are enclosing a summary of the questions that we will be asking you about xxxx xxxxx. All information will be kept confidential. Please think carefully about these questions. This list is provided so that you will have some time to compose your thoughts. Please keep this list for yourself; do not mail it back to us.

Please note that the interviewers are only performing the task of asking questions and do not have any knowledge about study methodology or the disease. In order to maintain high scientific quality of the data and to keep the interviewers unbiased during the interview session, it is absolutely necessary that you _do not use_ the word Creutzfeldt-Jakob disease. You may describe the illness that xxxx xxxxx had, but please _do not use_ the word Creutzfeldt-Jakob disease.

Should you wish to discuss with someone about Creutzfeldt-Jakob disease, please feel free to call us collect at (714) 799-2146 or (714) 799-2152. Thank you.

Sincerely, Zoreh Davanipour, DVM, PhD Principal Investigator Associate Professor & Director, Neuroepidemiology Section

Carey G. Smoak, MSPH Project Coordinator 

====================

Loma Linda University

A Seventh-day Adventist Institution

xxxx xxxxxx

Dear xxxxx:

Creutzfeldt-Jakob Disease Study Neuroepidemiology Section Department of Neurology, Rm 1580 School of Medicine Loma Linda, California 92350

November 11, 1991

Thank you for agreeing to participate in the Creutzfeldt-Jakob disease study. Your participation in this important research project is greatly appreciated.

I just wanted to remind you that I have re-scheduled your interview for xxxx xxx.

If you have any questions, please feel free to call me collect at (714) 799-2152.

Sincerely,

Carey G. Smoak, MSPH Project Coordinator

====================

Loma Linda University A Seventh-day Adventist Institution

Creutzfeldt-Jakob Disease Study Neuroepidemiology Section Department of Neurology, Rm 1580 School of Medicine Loma Linda, California 92350

SUMMARY OF QUESTIONS

1. Ethnic, religious and educational background.

2. Lifetime occupational history (specific jobs? when? for how long?)

3. Animal contacts (animals, animal products and sick animals):

a. at work

b. during hobbies or sports (for example hunting, fishing...)

c. as pets

Any contacts with animals: such as sheep, goats, cows, pigs, horses, birds, fish, rodents, rabbits, deer, mink, monkeys, dogs, cats, etc. (types of animals? when? how often?).

Any contacts with animal products: such as brains, eye balls, livers, kidneys, hearts, lungs, spinal cords, skin, wools, furs, stomachs, intestines, meats, muscles, spleens, lymphatics, etc. (types of animal products? when? how often?).

Any contacts with sick animals (including dogs, cats, laboratory animals, birds, large animals) with neurological problems or illnesses (types of sick animals? when? how often?).

Lifetime diet history, until July, 1988: Frequency of meat consumption? How often? Types of meat consumed: such as lamb; beef; sea food; processed meats like sausage, hot dogs, salami...; deer, rabbit; organ meats, etc. Any major changes in diet, such as becoming a vegetarian or being on weight loss programs. How was meat prepared/cooked (such as barbecued/grilled, smoked, fried, broiled, roasted/baked, raw, simmered, etc.)?

5. Major illnesses and causes of death among blood relatives.

6. Medical history:

We are interested in the following medical history for three time periods:

1) birth through age 14,

2) age 15 up to January, 1987, and

3) since January, 1987.

a. major diseases (such as cancer, heart disease, stroke, diabetes, neurological problems, mental problems, infections, etc.)

b. allergies (drug allergies, food allergies, hay fever, hives)

c. accidents and injuries

d. head trauma (when?, age?, how often?, nature of trauma, affected part, severity of trauma, x-rays taken,? CT scan done,? MRI/NMR done,? did loss of consciousness occur?, did loss of memory occur?)

e. other trauma besides head trauma (when?, age?, how often?, nature of trauma, affected part, severity of trauma, x-rays taken,? CT scan done,? MRI/NMR done,? did loss of consciousness occur?, did loss of memory occur?)

f. hospitalizations (reason for hospitalizations), surgeries (types of anesthesia used), sutures (stitches)

g. insects or animal bites or stings

h. eye examinations

i. glaucoma tests (frequency of tests; types of tests, such as: contact tonometry versus non-contact tonomerty/air puff method)

j. childhood illnesses, vaccinations

k. dental work (oral operations & root canal, types of anesthesia used)

7. Medical products:

We are interested in the following medical products for three time periods:

1) birth through age 14,

2) age 15 up to January, 1987, and

3) since January, 1987.

a. heart valve products if undergone heart surgery

b. eye products (contact lenses)

c. eye surgeries (cornea transplant)

d. suture material and collagen used in surgeries

e. hormones: thyroid, pancreatic (insulin and glucagon), human growth hormone, other pituitary hormones (oxytocin, vasopressin, gonadotropins, corticotropin, ACTH), adrenal and ovarian hormones (cortisone, epinephrine, estrogen), specific estrogen hormones called Premarin, Estrace or Estraderm (women only)

f. head, face, neck, brain or pituitary gland operation (when? how often?)

g. blood thinning (anticoagulant) and blood clot dissolving products (heparin, urokinase, alteplase, tissue plasminogen activator/TPA)

h. pancreatic enzymes (pancreatin, trypsin, chymotrypsin)

i. blood transfusions and red blood cell products, transfusions of platelet/plasma products

j. active & passive immunizations (vaccinations)

k. nutritional supplements (vitamins, minerals)

8. Lifetime residential history: where? when? how long? name of cities? zip codes? At each residence identify the source of drinking water: such as city water supply, private well, community well, bottled water. Identify pest control measures at each residence: such as ants, roaches, earwigs, spiders, termites, bees, yellow jackets, mice, rats, etc.

9. Lifetime travel history OUTSIDE of the U.S.A. (where? when? for how long?).

Thank for agreeing to participate in this interview. This page is enclosed for you to make any notes.

=====================

Loma Linda University

A Seventh-day Adventist Institution

Creutzfeldt-Jakob Disease Study Neuroepidemiology Section Department of Neurology, Rm 1580 School of Medicine Loma Linda, California 92350

Neurology Research Center 11175 Mt View Ave, Suite O Loma Linda, CA 92354 909-799-2152 909-799-2149 (fax)

March 21, 1994

xxxx xxxxx

Dear xxxx,

Thank you for participating in the Creutzfeldt-Jakob disease study. Your participation and interest in this important research project are greatly appreciated.

The research project on Creutzfeldt-Jakob disease is progressing very well. We have met and even exceeded our goal of interviewing 100 families who had a relative with Creutzfeldt-Jakob disease. In fact, we have interviewed 119 families who had a relative with Creutzfeldt-Jakob disease. Moreover, we have interviewed 105 control subjects (i.e., non-demented subjects) and are in the process of finding additional control subjects and interviewing them to compare the data with the individuals who had Creutzfeldt-Jakob disease. We expect to complete this research project in a couple of years and then we will analyze all of the information that we have collected. Once research results become available we will share the information with you and your family, if you so indicate on the enclosed form. Of course, no identifying information on any subject will be released.

In the near future we may be contacting you to gather more information on just a few items about your relative who had Creutzfeldt-Jakob disease. For completeness of the data and the success of this scientific research we need you to verify the information on the following page and return it to us in the enclosed self-addressed, stamped envelope.

If you have any questions please feel free to call us collect at (909) 799-2152. Thank you.

Sincerely Yours,

Zoreh Davanipour, DVM, PhD Principal Investigator & Director, Neuroepidemiology Section

Carey G. Smoak, MSPH Project Coordinator

TSS

############ http://mailhost.rz.uni-karlsruhe.de/warc/bse-l.html ############


HISTORY OF USA QUESTIONNAIRE ;


Monitoring the occurrence of emerging forms of Creutzfeldt-Jakob disease in the United States 2003 revisited 2009 

Saturday, July, 18, 2009 

Greetings, 

I would like to submit a review of past CJD surveillance in the USA, and the urgent need to make all human TSE in the USA a reportable disease, in every state, of every age group, and to make this mandatory immediately without further delay. The ramifications of not doing so will only allow this agent to spread further in the medical, dental, surgical arena’s. North America seems to have the most species with documented Transmissible Spongiform Encephalopathy's, most all of which have been rendered and fed back to food producing animals and to humans for years. If you look at the statistics, sporadic CJD seems to be rising in the USA, and has been, with atypical cases of the sCJD. I find deeply disturbing in the year of 2009, that Human Transmissible Spongiform Encephalopathy of any strain and or phenotype, of all age groups, and I stress all age groups, because human TSE's do not know age, and they do not know borders. someone 56 years old, that has a human TSE, that has surgery, can pass this TSE agent on i.e. friendly fire, and or passing it forward, and there have been documented nvCJD in a 74 year old. Remembering also that only sporadic CJD has been documented to transmit via iatrogenic routes, until recently with the 4 cases of blood related transmission, of which the origin is thought to be nvCJD donors. However most Iatrogenic CJD cases are nothing more than sporadic CJD, until the source is proven, then it becomes Iatrogenic. An oxymoron of sorts, because all sporadic CJD is, are multiple forms, or strains, or phenotypes of Creutzfeldt Jakob Disease, that the route and source and species have not been confirmed and or documented. When will the myth of the UKBSEnvCJD only theory be put to bed for good. This theory in my opinion, and the following there from, as the GOLD STANDARD, has done nothing more than help spread this agent around the globe. Politics and money have caused the terrible consequences to date, and the fact that TSEs are a slow incubating death, but a death that is 100% certain for those that are exposed and live long enough to go clinical. once clinical, there is no recourse, to date. But, while sub-clinical, how many can one exposed human infect? Can humans exposed to CWD and scrapie strains pass it forward as some form of sporadic CJD in the surgical and medical arenas? why must we wait decades and decades to prove this point, only to expose millions needlessly, only for the sake of the industries involved? would it not have been prudent from the beginning to just include all TSE's, and rule them out from there with transmission studies and change policies there from, as opposed to doing just the opposite? The science of TSE's have been nothing more than a political circus since the beginning, and for anyone to still believe in this one strain, one group of bovines, in one geographical location, with only one age group of human TSE i.e. nvCJD myth, for anyone to believe this today only enhances to spreading of these human and animal TSE's. This is exactly why we have been in this quagmire. 

The ones that believe that there is a spontaneous CJD in 85%+ of all cases of human TSE, and the ones that do not believe that cattle can have this same phenomenon, are two of the same, the industry, and so goes the political science aspect of this tobacco and or asbestos scenario i.e. follow the money. I could go into all angles of this man made nightmare, the real facts and science, for instance, the continuing rendering technology and slow cooking with low temps that brewed this stew up, and the fact that THE USA HAD THIS TECHNOLOGY FIRST AND SHIPPED IT TO THE U.K. SOME 5 YEARS BEFORE THE U.S. STARTED USING THE SAME TECHNOLOGY, to save on fuel cost. This is what supposedly amplified the TSE agent via sheep scrapie, and spread via feed in the U.K. bovine, and other countries exporting the tainted product. BUT most everyone ignores this fact, and the fact that the U.S. has been recycling more TSE, from more species with TSEs, than any other country documented, but yet, it's all spontaneous, and the rise in sporadic CJD in the U.S. is a happenstance of bad luck ??? I respectfully disagree. To top that all off, the infamous BSE-FIREWALL that the USDA always brags about was nothing more than ink on paper, and I can prove this. YOU can ignore it, but this is FACT (see source, as late as 2007, in one recall alone, some 10,000,000 MILLION POUNDS OF BANNED MAD COW FEED WENT OUT INTO COMMERCE TO BE FED OUT, and most was never recovered. This was banned blood laced, meat and bone meal. 2006 was a banner year for banned mad cow protein going into commerce in the U.S. (see source of FDA feed ban warning letter below). I stress that the August 4, 1997 USA mad cow feed ban and this infamous BSE firewall, was nothing more than ink on paper, it was never enforceable. 

I propose that the current diagnostic criteria for human TSEs only enhances and helps the spreading of human TSE from the continued belief of the UKBSEnvCJD only theory in 2009. With all the science to date refuting it, to continue to validate this old myth, will only spread this TSE agent through a multitude of potential routes and sources i.e. consumption, medical i.e., surgical, blood, dental, endoscopy, optical, nutritional supplements, cosmetics etc. I propose as with Aguzzi, Asante, Collinge, Caughey, Deslys, Dormont, Gibbs, Gajdusek, Ironside, Manuelidis, Marsh, et al and many more, that the world of TSE Transmissible Spongiform Encephalopathy is far from an exact science, but there is enough proven science to date that this myth should be put to rest once and for all, and that we move forward with a new classification for human and animal TSE that would properly identify the infected species, the source species, and then the route. This would further have to be broken down to strain of species and then the route of transmission would further have to be broken down. Accumulation and Transmission are key to the threshold from sub-clinical to clinical disease, and key to all this, is to stop the amplification and transmission of this agent, the spreading of, no matter what strain. In my opinion, to continue with this myth that the U.K. strain of BSE one strain TSE in cows, and the nv/v CJD one strain TSE humans, and the one geographical location source i.e. U.K., and that all the rest of human TSE are just one single strain i.e. sporadic CJD, a happenstance of bad luck that just happens due to a twisted protein that just twisted the wrong way, IN 85%+ OF ALL HUMAN TSEs, when to date there are 6 different phenotypes of sCJD, and growing per Gambetti et al, and that no other animal TSE transmits to humans ??? With all due respect to all Scientist that believe this, I beg to differ. To continue with this masquerade will only continue to spread, expose, and kill, who knows how many more in the years and decades to come. ONE was enough for me, My Mom, hvCJD i.e. Heidenhain Variant CJD, DOD 12/14/97 confirmed, which is nothing more than another mans name added to CJD, like CJD itself, Jakob and Creutzfeldt, or Gerstmann-Straussler-Scheinker syndrome, just another CJD or human TSE, named after another human. WE are only kidding ourselves with the current diagnostic criteria for human and animal TSE, especially differentiating between the nvCJD vs the sporadic CJD strains and then the GSS strains and also the FFI fatal familial insomnia strains or the ones that mimics one or the other of those TSE? Tissue infectivity and strain typing of the many variants of the human and animal TSEs are paramount in all variants of all TSE. There must be a proper classification that will differentiate between all these human TSE in order to do this. With the CDI and other more sensitive testing coming about, I only hope that my proposal will some day be taken seriously. ... 

please see history, and the ever evolving TSE science to date ; 




RE-Monitoring the occurrence of emerging forms of Creutzfeldt-Jakob disease in the United States

Terry S. Singeltary, retired (medically), CJD WATCH

Submitted March 26, 2003

I lost my mother to hvCJD (Heidenhain Variant CJD). I would like to comment on the CDC's attempts to monitor the occurrence of emerging forms of CJD. Asante, Collinge et al [1] have reported that BSE transmission to the 129-methionine genotype can lead to an alternate phenotype that is indistinguishable from type 2 PrPSc, the commonest sporadic CJD. However, CJD and all human TSEs are not reportable nationally. CJD and all human TSEs must be made reportable in every state and internationally. I hope that the CDC does not continue to expect us to still believe that the 85%+ of all CJD cases which are sporadic are all spontaneous, without route/source. We have many TSEs in the USA in both animal and man. CWD in deer/elk is spreading rapidly and CWD does transmit to mink, ferret, cattle, and squirrel monkey by intracerebral inoculation. With the known incubation periods in other TSEs, oral transmission studies of CWD may take much longer. Every victim/family of CJD/TSEs should be asked about route and source of this agent. To prolong this will only spread the agent and needlessly expose others. In light of the findings of Asante and Collinge et al, there should be drastic measures to safeguard the medical and surgical arena from sporadic CJDs and all human TSEs. I only ponder how many sporadic CJDs in the USA are type 2 PrPSc?


***> Every victim/family of CJD/TSEs should be asked about route and source of this agent. 

***> To prolong this will only spread the agent and needlessly expose others.

Letters

February 14, 2001

Diagnosis and Reporting of Creutzfeldt-Jakob Disease

Terry S. Singeltary, Sr

Author Affiliations

JAMA. 2001;285(6):733-734. doi:10-1001/pubs.JAMA-ISSN-0098-7484-285-6-jlt0214 To the Editor: In their Research Letter, Dr Gibbons and colleagues1 reported that the annual US death rate due to Creutzfeldt-Jakob disease (CJD) has been stable since 1985. These estimates, however, are based only on reported cases, and do not include misdiagnosed or preclinical cases. It seems to me that misdiagnosis alone would drastically change these figures. An unknown number of persons with a diagnosis of Alzheimer disease in fact may have CJD, although only a small number of these patients receive the postmortem examination necessary to make this diagnosis. Furthermore, only a few states have made CJD reportable. Human and animal transmissible spongiform encephalopathies should be reportable nationwide and internationally.


Alzheimer’s disease and Transmissible Spongiform Encephalopathy prion disease, Iatrogenic, what if ?

Posted by flounder on 05 Nov 2014 at 21:27 GMT

Background

Alzheimer’s disease and Transmissible Spongiform Encephalopathy disease have both been around a long time, and was discovered in or around the same time frame, early 1900’s. Both diseases are incurable and debilitating brain disease, that are in the end, 100% fatal, with the incubation/clinical period of the Alzheimer’s disease being longer (most of the time) than the TSE prion disease. Symptoms are very similar, and pathology is very similar.

Methods

Through years of research, as a layperson, of peer review journals, transmission studies, and observations of loved ones and friends that have died from both Alzheimer’s and the TSE prion disease i.e. Heidenhain Variant Creutzfelt Jakob Disease CJD.

Results

I propose that Alzheimer’s is a TSE disease of low dose, slow, and long incubation disease, and that Alzheimer’s is Transmissible, and is a threat to the public via the many Iatrogenic routes and sources. It was said long ago that the only thing that disputes this, is Alzheimer’s disease transmissibility, or the lack of. The likelihood of many victims of Alzheimer’s disease from the many different Iatrogenic routes and modes of transmission as with the TSE prion disease.

Conclusions

There should be a Global Congressional Science round table event set up immediately to address these concerns from the many potential routes and sources of the TSE prion disease, including Alzheimer’s disease, and a emergency global doctrine put into effect to help combat the spread of Alzheimer’s disease via the medical, surgical, dental, tissue, and blood arena’s. All human and animal TSE prion disease, including Alzheimer’s should be made reportable in every state, and Internationally, WITH NO age restrictions. Until a proven method of decontamination and autoclaving is proven, and put forth in use universally, in all hospitals and medical, surgical arena’s, or the TSE prion agent will continue to spread. IF we wait until science and corporate politicians wait until politics lets science _prove_ this once and for all, and set forth regulations there from, we will all be exposed to the TSE Prion agents, if that has not happened already.

end...tss


***> There should be a Global Congressional Science round table event set up immediately to address these concerns from the many potential routes and sources of the TSE prion disease, including Alzheimer’s disease, and a emergency global doctrine put into effect to help combat the spread of Alzheimer’s disease via the medical, surgical, dental, tissue, and blood arena’s. 

iatrogenic CJD TSE PrP

least we forget...

*** Transmission of Creutzfeldt-Jakob disease to a chimpanzee by electrodes contaminated during neurosurgery *** 

Gibbs CJ Jr, Asher DM, Kobrine A, Amyx HL, Sulima MP, Gajdusek DC. 

Laboratory of Central Nervous System Studies, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892. Stereotactic multicontact electrodes used to probe the cerebral cortex of a middle aged woman with progressive dementia were previously implicated in the accidental transmission of Creutzfeldt-Jakob disease (CJD) to two younger patients. The diagnoses of CJD have been confirmed for all three cases. More than two years after their last use in humans, after three cleanings and repeated sterilisation in ethanol and formaldehyde vapour, the electrodes were implanted in the cortex of a chimpanzee. Eighteen months later the animal became ill with CJD. This finding serves to re-emphasise the potential danger posed by reuse of instruments contaminated with the agents of spongiform encephalopathies, even after scrupulous attempts to clean them. 


MONDAY, JANUARY 31, 2022 

Validation of Revised International Creutzfeldt-Jakob Disease Surveillance Network Diagnostic Criteria for Sporadic Creutzfeldt-Jakob Disease Singeltary Comment Submission


WEDNESDAY, FEBRUARY 02, 2022 

Understanding the nature of PrP found in Appendix tissues in the UK population 


FRIDAY, DECEMBER 24, 2021 

Creutzfeldt Jakob Disease CJD TSE Prion Update December 25, 2021


Saturday, December 18, 2021 

Direct neural transmission of vCJD/BSE in macaque after finger incision 


Tuesday, November 30, 2021 

Second death in France in a laboratory working on prions


Second lab worker with deadly prion disease prompts research pause in France

A lab worker died of prion disease in 2019, nine years after a lab accident.

BETH MOLE - 7/29/2021, 5:16 PM

https://arstechnica.com/science/2021/07/second-lab-worker-with-deadly-prion-disease-prompts-research-pause-in-france/

A 2020 paper published in the New England Journal of Medicine left little doubt that Jaumain had been infected on the job. She had variant CJD, but since Europe’s ‘mad cow’ outbreak ended after 2000 and the disease virtually disappeared, the paper said it was virtually impossible for someone her age in France to contract food-borne vCJD.

Science also said two independent reports – one by government inspectors – had found no safety violations at the lab where Jaumain worked. The press release also noted that the inspectors concluded there was “the presence of a risk control culture within the research teams”. The Jaumain family’s lawyer called the neutrality of the reports into question, however.

At the same time, the government inspectors’ report also revealed that there had been at least 17 accidents among the 100 or so scientists and technicians in France working with prions in the previous decade, raising concerns about how effective this risk control culture is. Five of these occurred when workers “stabbed or cut themselves with contaminated syringes or blades”.


Wednesday, July 28, 2021 

France issues moratorium on prion research after fatal brain disease strikes two lab workers


Wednesday, July 28, 2021 

France issues moratorium on prion research after fatal brain disease strikes two lab workers


Friendly fire, pass it forward, they call it iatrogenic cjd, or what i call 'tse prion poker', are you all in $$$

all iatrogenic cjd is, is sporadic cjd, before the iatrogenic event is discovered, traced back, proven, documented, put into the academic domain, and then finally the public domain, this very seldom happens, thus problem solved, it's all sporadic cjd...

SATURDAY, AUGUST 01, 2020

Sporadic Creutzfeldt-Jakob Disease among Physicians, Germany, 1993–2018 high proportion of physicians with sCJD were surgeons


SUNDAY, JULY 19, 2020 

Joseph J. Zubak Orthopaedic surgeon passed away Monday, July 6, 2020, Creutzfeldt-Jakob Disease (CJD)


Variant Creutzfeldt–Jakob Disease Diagnosed 7.5 Years after Occupational Exposure

Variant Creutzfeldt–Jakob disease was identified in a technician who had cut her thumb while handling brain sections of mice infected with adapted BSE 7.5 years earlier. The long incubation period was similar to that of the transfusion-transmitted form of the disease.



THURSDAY, JULY 02, 2020 

Variant Creutzfeldt–Jakob Disease Diagnosed 7.5 Years after Occupational Exposure


MONDAY, JANUARY 14, 2019 

Evaluation of iatrogenic risk of CJD transmission associated with Chronic Wasting Disease TSE Prion in Texas TAHC TPWD


FRIDAY, JANUARY 31, 2020 

CJD TSE Prion Blood Products, iatrogenic transmission, Confucius is confused again, WHAT IF? Docket Number: FDA-2012-D-0307


Friday, February 4, 2022 

Different α-synuclein prion strains cause dementia with Lewy bodies and multiple system atrophy, iatrogenic transmission, what if?


Thursday, October 28, 2021 

Chronic Wasting Disease (CWD) TSE Prion Zoonosis, friendly fire, iatrogenic transmission, blood products, sporadic CJD, what if?


Thursday, July 29, 2021 

TSE PRION OCCUPATIONAL EXPOSURE VIA ANIMAL OR HUMAN, iatrogenic transmission, nvCJD or sCJD, what if? 


Chronic Wasting Disease CWD TSE Prion aka mad cow type disease in cervid Zoonosis Update

***> ''In particular the US data do not clearly exclude the possibility of human (sporadic or familial) TSE development due to consumption of venison. The Working Group thus recognizes a potential risk to consumers if a TSE would be present in European cervids.'' Scientific opinion on chronic wasting disease (II) <***

What if?


Friday, January 29, 2021 
Scientists identify locations of early prion protein deposition in retina, what if?
Saturday, January 23, 2021

Improved surveillance of surgical instruments reprocessing following the variant Creutzfeldt-Jakob disease crisis in England: findings from a 3-year survey


FRIDAY, SEPTEMBER 06, 2019 

Disinfection of Multi-Use Ocular Equipment for Ophthalmological Procedures: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines


vpspr, sgss, sffi, TSE, an iatrogenic by-product of gss, ffi, familial type prion disease, what if ???

Greetings Friends, Neighbors, and Colleagues,



Saturday, February 2, 2019 

CWD GSS TSE PRION SPINAL CORD, Confucius Ponders, What if?

snip... 

 ***> In particular the US data do not clearly exclude the possibility of human (sporadic or familial) TSE development due to consumption of venison. The Working Group thus recognizes a potential risk to consumers if a TSE would be present in European cervids.'' Scientific opinion on chronic wasting disease (II) <*** 

REVIEW 

***> In conclusion, sensory symptoms and loss of reflexes in Gerstmann-Sträussler-Scheinker syndrome can be explained by neuropathological changes in the spinal cord. We conclude that the sensory symptoms and loss of lower limb reflexes in Gerstmann-Sträussler-Scheinker syndrome is due to pathology in the caudal spinal cord. <***

***> The clinical and pathological presentation in macaques was mostly atypical, with a strong emphasis on spinal cord pathology.<*** 

***> The notion that CWD can be transmitted orally into both new-world and old-world non-human primates asks for a careful reevaluation of the zoonotic risk of CWD. <***

***> All animals have variable signs of prion neuropathology in spinal cords and brains and by supersensitive IHC, reaction was detected in spinal cord segments of all animals.<*** 

***> In particular the US data do not clearly exclude the possibility of human (sporadic or familial) TSE development due to consumption of venison. The Working Group thus recognizes a potential risk to consumers if a TSE would be present in European cervids.'' Scientific opinion on chronic wasting disease (II) <***

Thursday, March 8, 2018 

Familial human prion diseases associated with prion protein mutations Y226X and G131V are transmissible to transgenic mice expressing human prion protein


MONDAY, NOVEMBER 26, 2018 

Sporadic Creutzfeldt-Jakob Disease in a Woman Married Into a Gerstmann-Sträussler-Scheinker Family: An Investigation of Prions Transmission via Microchimerism 


THURSDAY, FEBRUARY 15, 2018 

Iatrogenic Creutzfeldt-Jakob disease with Amyloid-β pathology: an international study

http://creutzfeldt-jakob-disease.blogspot.com/2018/02/iatrogenic-creutzfeldt-jakob-disease.html

FRIDAY, JANUARY 10, 2014

vpspr, sgss, sffi, TSE, an iatrogenic by-product of gss, ffi, familial type prion disease, what it ???

Greetings Friends, Neighbors, and Colleagues,

vpspr, sgss, sffi, TSE, an iatrogenic by-product of gss, ffi, familial type prion disease, what it ???

Confucius is confused again.

I was just sitting and thinking about why there is no genetic link to some of these TSE prion sGSS, sFFi, and it’s really been working on my brain, and then it hit me today.

what if, vpspr, sgss, sffi, TSE prion disease, was a by-product from iatrogenic gss, ffi, familial type prion disease ???

it could explain the cases of no genetic link to the gss, ffi, familial type prion disease, to the family.

sporadic and familial is a red herring, in my opinion, and underestimation is spot on, due to the crude prehistoric diagnostic procedures and criteria and definition of a prion disease.

I say again, what if, iatrogenic, what if, with all these neurological disorders, with a common denominator that is increasingly showing up in the picture, called the prion.

I urge all scientist to come together here, with this as the utmost of importance about all these neurological disease that are increasingly showing up as a prion mechanism, to put on the front burners, the IATROGENIC aspect and the potential of transmission there from, with diseases/disease??? 

in question, by definition, could they be a Transmissible Spongiform Encephalopathy TSE prion type disease, and if so, what are the iatrogenic chances of transmission?

this is very important, and should be at the forefront of research, and if proven, could be a monumental breakthrough in science and battle against the spreading of these disease/diseases.


Friday, January 10, 2014 

vpspr, sgss, sffi, TSE, an iatrogenic by-product of gss, ffi, familial type prion disease, what it ??? 

Greetings Friends, Neighbors, and Colleagues, 



Sunday, October 27, 2013 

A Kiss of a Prion: New Implications for Oral Transmissibility 



***The occurrence of contact cases raises the possibility that transmission in families may be effected by an unusually virulent strain of the agent.

snip...see full text here;


snip...see full text;


MONDAY, FEBRUARY 14, 2022 

Atypical Nor98 Scrapie, Atypical BSE, CWD, Can Emerge As Different TSE PrP In Cross Species Transmission, A Volatile Situation For Human and Animal Health




















Insanity: doing the same thing over and over again and expecting different results. 

Any man can make mistakes, but only an idiot persists in his error. 

All men make mistakes, but only wise men learn from their mistakes.

Terry S. Singeltary Sr.