Prion infection & SINGLE-USE needles, lancets, etc.

[Guest guest]

Hi Hank & Matt,

 

I wrote:

> IMO it is gross malpractice to reuse AP needles [or any blood-

> touching instrument] on another human patient! Never attempt to

> clean and resterilise a used needle!

 

Matt Bauer replied:

> If you feel this way you [must avoid] dentists. Their practices

> are a re-sterilizing nightmare. Unlike the simple, solid shaft AP

> needle, dental equipment has a host of factors making proper

> sterilization most difficult. Their equipment is expensive which

> makes them want to sterilize to a minimum to reduce wear, this

> equipment often has porous surfaces in which contaminants can get

> trapped greatly complicating sterilization procedures, and many

> dental offices are under great pressure to see a high volume of

> patients.

 

Matt, I have not been to a dentist for years! I SHUDDER at the

thought of the high risks of cross-infection in routine dentistry -

probes, elevators, forceps, etc are so easily contaminated by

blood/bloody saliva. I cringe at the thought after reading the article

by Paul Brown et al, March 2002 (see below). Last year, I had a

rocking molar [following several recurrences of an abscess at its

root] I extracted it myself in a variant of the old method of tying line

around it and whipping it out in one powerful pull. I used a triple-

strand of 10kg nylon fishing line as the " lassoo " . It worked fine, and

first-time!

 

Hank Barru wrote:

> To Phil and group: Some months back on the list there was mention

> of prion infection and the possibility of transmitting prions via

> reusable acupuncture needles. Can anyone recommend a good source

> of information about this hazard, and about prion infections

> generally? We are updating the medical asepsis guidelines at my

> school, and this is one area we have not yet looked at. Thanks,

> Hank Barru

 

Following public concern over the risks of transmission of CJD by

hospital equipment [clamps, saws, knives, retractors, etc], I

understand that the UK Government appointed a Committee to

advise on best practices to be adopted. I understand that the report

was not released publicly, but that it recommended destruction

after single use of all instruments that contacted brain or nerve

tissue of any patient with ANY central encephalopathy/neuropathy.

I also understand that the government did NOT act on that report

because it would cost many millions of pounds annually to

implement the policy.

 

Many countries ban blood donations from donors with neurological

symptoms because there is research evidence that prion diseases

may be transmitted via blood in animals.

 

Here are copies of earlier mails on the difficulties of sterilising

instruments possibly infected with prions. Please forward this to

relevant colleagues.

 

Paper 1, below (by Paul Brown et al, March 2002), showed that

prion infectivity could withstand ashing at 600 DegC. That

suggested the horrific possibility of an INORGANIC template for

prion diseases, and the impossibility of disinfecting infected

material by practical methods of heating.

 

A new paper by Paul Brown et al (Paper 2, below) suggests a

practical way to reduce prion infectivity in meat products. This

paper has enormous implications for the meat/food industry. Note

that the heaviest treatment (short pressure pulses of 1,200 MPa at

running temperatures of 121-137°C) reduced infectivity drastically

but it did not remove it completely. Research is still needed to find

a way to reduce infectivity of prion-contaminated meat products to

zero.

 

Paper 1: New studies on the heat resistance of hamster-adapted

scrapie agent: threshold survival after ashing at 600°C suggests an

inorganic template of replication. Brown P, Rau EH, Johnson BK,

Bacote AE, Gibbs CJ Jr, Gajdusek DC. Proc Natl Acad Sci U S A

2000 Mar 28;97(7):3418-21. Laboratory of Central Nervous System

Studies, National Institute of Neurological Disorders and Stroke,

National Institutes of Health, Bethesda, MD 20892, USA.

brownp One-gram samples from a pool of crude

brain tissue from hamsters infected with the 263K strain of hamster-

adapted scrapie agent were placed in covered quartz-glass

crucibles and exposed for either 5 or 15 min to dry heat at

temperatures ranging from 150 to 1000°C. Residual infectivity in the

treated samples was assayed by the intracerebral inoculation of

dilution series into healthy weanling hamsters, which were

observed for 10 months; disease transmissions were verified by

Western blot testing for proteinase-resistant protein in brains from

clinically positive hamsters. Unheated control tissue contained 9.9

log(10)LD(50)/g tissue; after exposure to 150°C, titers equaled or

exceeded 6 log(10)LD(50)/g, and after exposure to 300°C, titers

equaled or exceeded 4 log(10)LD(50)/g. Exposure to 600°C

completely ashed the brain samples, which, when reconstituted

with saline to their original weights, transmitted disease to 5 of 35

inoculated hamsters. No transmissions occurred after exposure to

1000°C. These results suggest that an INORGANIC molecular

template with a decomposition point near 600°C can nucleate the

biological replication of the scrapie agent.

PMID: 10716712 [PubMed - indexed for MEDLINE]

 

Paper 2: Ultra-high-pressure inactivation of prion infectivity in

processed meat: A practical method to prevent human infection

(food processing | scrapie | bovine spongiform encephalopathy |

new variant Creutzfeldt-Jakob disease | prion disease). Paul

Brown*, Richard Meyer , Franco Cardone & Maurizio Pocchiari*

(2003) Preprint, May 5, Proc. Natl. Acad. Sci. USA,

http://www.pnas.org/cgi/content/abstract/1031826100v1 National

Institutes of Health, Bethesda, MD 20892; Washington Farms,

Tacoma, WA 98443; and Istituto Superiore di Sanità, 00161 Rome,

Italy. Bovine spongiform encephalopathy contamination of the

human food chain most likely resulted from nervous system tissue

in mechanically recovered meat used in the manufacture of

processed meats. We spiked hot dogs with 263K hamster-

adapted scrapie brain (10% wt/wt) to produce an infectivity level of

9 log10 mean lethal doses (LD50)/g paste homogenate. Aliquots

were subjected to short pressure pulses of 690, 1000, and 1200

MPa at running temperatures of 121-137°C. Western blots of

PrPres were found to be useful indicators of infectivity levels, which

at all tested pressures were significantly reduced as compared with

untreated controls: from 103 LD50/g at 690 MPa to 106 LD50/g at

1200 MPa. The application of commercially practical conditions of

temperature and pressure could ensure the safety of processed

meats from bovine spongiform encephalopathy contamination, and

could also be used to study phase transitions of the prion

misfolded state.

 

See also the Medline Preprint of the same abstract at:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve & db=pub

med & list_ui ds=12732724 & dopt=Abstract

 

On 29 Jan 2003 Mangala wrote:

> ... The NCCAOM book of 'Clean Needle Technique', says : " While

> disposable needles are not essential for Clean Needle Technique,

> they are recommended The protocol of sterilization is clearly

> defined. Autoclave is the method of choice. 'It is critical that a

> pressurized steam bath, as provided by an autoclave, be maintained

> at 250 degrees Farenheit, 15 pounds of pressure for 30 minutes. The

> pressure must be released quickly at the end of the sterilization

> cycle.' Dry heat sterilizers : 2 hrs of exposure to 338 degrees

> Farenheit. In case of rebbers and plastics instruments that can

> melt under this temperature :, it is acceptable to use high level

> disinfectants, in a correct concentration and for a specified

> immertion time. Amongst the 'Unacceptable' procedures are : Glass

> Bead Devices, Boiling Water, Alcohol and Pressure Cookers. Thanks.

> Mangala

 

In reply to this, I wrote:

 

This is a plea to ALL medical professionals with political clout.

Please try to have a National Ban in your country on the

sterilisation and re-use of all needles for human use (including

spinal and biopsy needles).

 

Autoclaving and dry heat, and the usually accepted ways of

sterilising instruments simply CANNOT guarantee freedom from

prion-infectivity. The evidence is that PRIONS have an INORGANIC

template. Prion infectivity REMAINS after ASHING of infective

material at 600 DegC

 

This is recent evidence and the implications for doctors, nurses,

dentists, acupuncturists, etc are horrific.

 

Human prion diseases range far wider than CJD and Kuru! There

are MANY others known in humans. Some papers even suggest a

prion-link in Alzheimer's Disease.

 

Needles cost very little. Why run the risk of transmitting an

INCURABLE disease for the sake of a few cents?

 

Need I say more?

 

Because of risks of transmitting AIDS, hepatitis, CJD, etc, one

should ALWAYS use disposable single-use needles and NOT

attempt to resterilise them. The same applies to 7-star (hammer-

type) needles, lancets, etc. An exception is if patients are given

their OWN needles for their OWN use only.

 

 

Best regards,

 

 

WORK : Teagasc Staff Development Unit, Sandymount Ave., Dublin 4, Ireland

WWW :

Email: <

Tel : 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

WWW : http://homepage.eircom.net/~progers/searchap.htm

Email: <

Tel : 353-; [in the Republic: 0]

[Guest guest]

Ouchhhhhhhhhhhhhhhhhhhhhhhhhhhh )

 

Thanks for the article it is impressive.

 

Vanessa

 

>>Last year, I had a

rocking molar [following several recurrences of an abscess at its

root] I extracted it myself in a variant of the old method of tying line

around it and whipping it out in one powerful pull. I used a triple-

strand of 10kg nylon fishing line as the " lassoo " . It worked fine, and

first-time! >>

 

 

 

 

 

 

 

 

[Guest guest]

Wow Phil! You really are concerned about sterility. Not to freak you out any

more but, the most difficult piece of equipment to keep clean in a dental

practice are the suction tubes that draw out bloody saliva. These tubes are now

fitted with back-flow valves to help prevent back-flow of contaminated waste,

but are prone to failures and must be carefully and regularly flushed.

 

Some on the list may be interested to learn there was a study done in the late

1970's-early 1980's in Hong Kong in which the rates of hepatitis for those who

had acupuncture, tattoos, and electrolysis were followed. The authors concluded

those who had tattoos and electrolysis had slightly higher rates of hepatitis

while acupuncture patients showed no higher rates than the general population.

 

Matt Bauer

-

Acupuncture research in the UK and beyond.

Cc: traditional_Chinese_Medicine

Thursday, September 11, 2003 11:23 AM

Re: Prion infection & SINGLE-USE needles, lancets, etc.

 

 

Hi Hank & Matt,

 

I wrote:

> IMO it is gross malpractice to reuse AP needles [or any blood-

> touching instrument] on another human patient! Never attempt to

> clean and resterilise a used needle!

 

Matt Bauer replied:

> If you feel this way you [must avoid] dentists. Their practices

> are a re-sterilizing nightmare. Unlike the simple, solid shaft AP

> needle, dental equipment has a host of factors making proper

> sterilization most difficult. Their equipment is expensive which

> makes them want to sterilize to a minimum to reduce wear, this

> equipment often has porous surfaces in which contaminants can get

> trapped greatly complicating sterilization procedures, and many

> dental offices are under great pressure to see a high volume of

> patients.

 

Matt, I have not been to a dentist for years! I SHUDDER at the

thought of the high risks of cross-infection in routine dentistry -

probes, elevators, forceps, etc are so easily contaminated by

blood/bloody saliva. I cringe at the thought after reading the article

by Paul Brown et al, March 2002 (see below). Last year, I had a

rocking molar [following several recurrences of an abscess at its

root] I extracted it myself in a variant of the old method of tying line

around it and whipping it out in one powerful pull. I used a triple-

strand of 10kg nylon fishing line as the " lassoo " . It worked fine, and

first-time!

 

Hank Barru wrote:

> To Phil and group: Some months back on the list there was mention

> of prion infection and the possibility of transmitting prions via

> reusable acupuncture needles. Can anyone recommend a good source

> of information about this hazard, and about prion infections

> generally? We are updating the medical asepsis guidelines at my

> school, and this is one area we have not yet looked at. Thanks,

> Hank Barru

 

Following public concern over the risks of transmission of CJD by

hospital equipment [clamps, saws, knives, retractors, etc], I

understand that the UK Government appointed a Committee to

advise on best practices to be adopted. I understand that the report

was not released publicly, but that it recommended destruction

after single use of all instruments that contacted brain or nerve

tissue of any patient with ANY central encephalopathy/neuropathy.

I also understand that the government did NOT act on that report

because it would cost many millions of pounds annually to

implement the policy.

 

Many countries ban blood donations from donors with neurological

symptoms because there is research evidence that prion diseases

may be transmitted via blood in animals.

 

Here are copies of earlier mails on the difficulties of sterilising

instruments possibly infected with prions. Please forward this to

relevant colleagues.

 

Paper 1, below (by Paul Brown et al, March 2002), showed that

prion infectivity could withstand ashing at 600 DegC. That

suggested the horrific possibility of an INORGANIC template for

prion diseases, and the impossibility of disinfecting infected

material by practical methods of heating.

 

A new paper by Paul Brown et al (Paper 2, below) suggests a

practical way to reduce prion infectivity in meat products. This

paper has enormous implications for the meat/food industry. Note

that the heaviest treatment (short pressure pulses of 1,200 MPa at

running temperatures of 121-137°C) reduced infectivity drastically

but it did not remove it completely. Research is still needed to find

a way to reduce infectivity of prion-contaminated meat products to

zero.

 

Paper 1: New studies on the heat resistance of hamster-adapted

scrapie agent: threshold survival after ashing at 600°C suggests an

inorganic template of replication. Brown P, Rau EH, Johnson BK,

Bacote AE, Gibbs CJ Jr, Gajdusek DC. Proc Natl Acad Sci U S A

2000 Mar 28;97(7):3418-21. Laboratory of Central Nervous System

Studies, National Institute of Neurological Disorders and Stroke,

National Institutes of Health, Bethesda, MD 20892, USA.

brownp One-gram samples from a pool of crude

brain tissue from hamsters infected with the 263K strain of hamster-

adapted scrapie agent were placed in covered quartz-glass

crucibles and exposed for either 5 or 15 min to dry heat at

temperatures ranging from 150 to 1000°C. Residual infectivity in the

treated samples was assayed by the intracerebral inoculation of

dilution series into healthy weanling hamsters, which were

observed for 10 months; disease transmissions were verified by

Western blot testing for proteinase-resistant protein in brains from

clinically positive hamsters. Unheated control tissue contained 9.9

log(10)LD(50)/g tissue; after exposure to 150°C, titers equaled or

exceeded 6 log(10)LD(50)/g, and after exposure to 300°C, titers

equaled or exceeded 4 log(10)LD(50)/g. Exposure to 600°C

completely ashed the brain samples, which, when reconstituted

with saline to their original weights, transmitted disease to 5 of 35

inoculated hamsters. No transmissions occurred after exposure to

1000°C. These results suggest that an INORGANIC molecular

template with a decomposition point near 600°C can nucleate the

biological replication of the scrapie agent.

PMID: 10716712 [PubMed - indexed for MEDLINE]

 

Paper 2: Ultra-high-pressure inactivation of prion infectivity in

processed meat: A practical method to prevent human infection

(food processing | scrapie | bovine spongiform encephalopathy |

new variant Creutzfeldt-Jakob disease | prion disease). Paul

Brown*, Richard Meyer , Franco Cardone & Maurizio Pocchiari*

(2003) Preprint, May 5, Proc. Natl. Acad. Sci. USA,

http://www.pnas.org/cgi/content/abstract/1031826100v1 National

Institutes of Health, Bethesda, MD 20892; Washington Farms,

Tacoma, WA 98443; and Istituto Superiore di Sanità, 00161 Rome,

Italy. Bovine spongiform encephalopathy contamination of the

human food chain most likely resulted from nervous system tissue

in mechanically recovered meat used in the manufacture of

processed meats. We spiked hot dogs with 263K hamster-

adapted scrapie brain (10% wt/wt) to produce an infectivity level of

9 log10 mean lethal doses (LD50)/g paste homogenate. Aliquots

were subjected to short pressure pulses of 690, 1000, and 1200

MPa at running temperatures of 121-137°C. Western blots of

PrPres were found to be useful indicators of infectivity levels, which

at all tested pressures were significantly reduced as compared with

untreated controls: from 103 LD50/g at 690 MPa to 106 LD50/g at

1200 MPa. The application of commercially practical conditions of

temperature and pressure could ensure the safety of processed

meats from bovine spongiform encephalopathy contamination, and

could also be used to study phase transitions of the prion

misfolded state.

 

See also the Medline Preprint of the same abstract at:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve & db=pub

med & list_ui ds=12732724 & dopt=Abstract

 

On 29 Jan 2003 Mangala wrote:

> ... The NCCAOM book of 'Clean Needle Technique', says : " While

> disposable needles are not essential for Clean Needle Technique,

> they are recommended The protocol of sterilization is clearly

> defined. Autoclave is the method of choice. 'It is critical that a

> pressurized steam bath, as provided by an autoclave, be maintained

> at 250 degrees Farenheit, 15 pounds of pressure for 30 minutes. The

> pressure must be released quickly at the end of the sterilization

> cycle.' Dry heat sterilizers : 2 hrs of exposure to 338 degrees

> Farenheit. In case of rebbers and plastics instruments that can

> melt under this temperature :, it is acceptable to use high level

> disinfectants, in a correct concentration and for a specified

> immertion time. Amongst the 'Unacceptable' procedures are : Glass

> Bead Devices, Boiling Water, Alcohol and Pressure Cookers. Thanks.

> Mangala

 

In reply to this, I wrote:

 

This is a plea to ALL medical professionals with political clout.

Please try to have a National Ban in your country on the

sterilisation and re-use of all needles for human use (including

spinal and biopsy needles).

 

Autoclaving and dry heat, and the usually accepted ways of

sterilising instruments simply CANNOT guarantee freedom from

prion-infectivity. The evidence is that PRIONS have an INORGANIC

template. Prion infectivity REMAINS after ASHING of infective

material at 600 DegC

 

This is recent evidence and the implications for doctors, nurses,

dentists, acupuncturists, etc are horrific.

 

Human prion diseases range far wider than CJD and Kuru! There

are MANY others known in humans. Some papers even suggest a

prion-link in Alzheimer's Disease.

 

Needles cost very little. Why run the risk of transmitting an

INCURABLE disease for the sake of a few cents?

 

Need I say more?

 

Because of risks of transmitting AIDS, hepatitis, CJD, etc, one

should ALWAYS use disposable single-use needles and NOT

attempt to resterilise them. The same applies to 7-star (hammer-

type) needles, lancets, etc. An exception is if patients are given

their OWN needles for their OWN use only.

 

 

Best regards,

 

WORK : Teagasc Staff Development Unit, Sandymount Ave., Dublin 4, Ireland

WWW :

Email: <

Tel : 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

WWW : http://homepage.eircom.net/~progers/searchap.htm

Email: <

Tel : 353-; [in the Republic: 0]