- The NHS (UK) faces the prospect of paying billions of
pounds for throwaway surgical instruments as part of the spiralling costs
to cut the theoretical risk of patients catching the human form of BSE.
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- All tonsil operations in Britain - about 85,000 a year
- are soon likely to be performed using £400 sets of once only instruments,
and this switch to fully disposable equipment in mainstream surgery is
likely to be just the forerunner of a change in surgery procedures at NHS
and private and military hospitals.
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- Surgeons and government officials are investigating the
use of more disposable instruments in complicated operations including
brain and eye surgery where the risks rise for contamination of instruments
with rogue prions - the proteins thought to be responsible for variant
CJD. Tonsillectomies, not performed as often these days, are usually carried
out only on children with frequent tonsilitis.
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- Dentists and opticians have already been told to buy
more single-use equipment and there are tougher measures for decontaminating
non-disposable instruments. Government advisers on BSE and vCJD have said
that proper sterilisation can substantially reduce levels of infectivity.
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- A decision about the surgical changes will be made next
month.
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- Some of the 88 victims of vCJD in Britain, five of whom
are still alive, have been teenagers but it is not certain either how they
were infected or how long the disease was incubating before they displayed
the symptoms, which include depression, anxiety and loss of bodily control.
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- Cheap beef products are still prime suspects behind the
disease. Government advisers have said the risk of transmitting the disease
via surgical instruments was still "theoretical and unquantifiable".
None of the vCJD cases so far has been linked to surgical contamination
and it is understood a risk assessment has suggested that disposable instruments
for tonsil surgery may only prevent one extra case of vCJD. But the Phillips
inquiry into BSE and vCJD called for a "precautionary approach".
Advisers have recognised that some precision equipment for single use could
be unaffordable. There could also be problems storing disposables before
safely destroyiing them.
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- The costs of the medical consequences of vCJD are mounting.
Measures to cut the risk of vCJD contamination through blood donations
are costing £83m a year in England and north Wales alone; the change
in tonsil operations would cost another £35m yearly. The treatment
of vCJD patients costs beween £6,500 and £40,000. Instruments
used on vCJD patients are already destroyed, including medical equipment
costing nearly £30,000. Yesterday, France became the latest among
countries to ban blood donors who have been to Britain between 1980 and
1996.
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- The news of the measures coincided with new concerns
that loopholes in food regulations allowed manufacturers to get round rules
making it illegal to import and sell meat from cattle over 30 months old.
Harriet Kimbell, a member of Seac, the spongiform encephalopathy advisory
committee, said: "It is not illegal for an English manufacturer to
go to Europe, buy meat and make it into products like frozen beefburgers,
and sell it in Britain."
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- A person in the UK whose blood was used in the production
of a polio vaccine administered in Ireland, has been diagnosed with vCJD,
the Irish government said yesterday. Between January 1998 and January 1999,
83,500 doses of the oral vaccine were distributed, mostly to the young.
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- The Irish health minister, Micheal Martin, insisted there
was no risk of the recipients getting the disease."This person's donation
was one of 22,353 [in] a pool. The final dilution was 1 to 63,866."
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- People are being advised to contact their GPs to find
out about affected batches.
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- Steven Lunt, 33, a victim of vCJD who died in April,
seldom ate beef, an inquest heard yesterday. John Pollard, the south Manchester
coroner, said Mr Lunt, of Stockport, died of variant CJD. Health officials
are investigating a possible link between the deaths of Mr Lunt and Paul
Dickens, 28, who lived near him.
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