How should surgical instruments used on suspected or confirmed CJD patients be reprocessed?
Inactivation studies have not rigorously evaluated the effectiveness of actual cleaning and reprocessing methods used in health care facilities. Recommendations to reprocess instruments potentially contaminated with the CJD agent are primarily derived from in vitro inactivation studies that used either brain tissues or tissue homogenates, both of which pose enormous challenges to any sterilization process. The World Health Organization (WHO) has developed CJD infection control guidelines that can be a valuable guide to infection control personnel and other health care workers involved in the care of CJD patients. Destruction of heat-resistant surgical instruments that come in contact with high infectivity tissues, albeit the safest and most unambiguous method as described in the WHO guidelines, may not be practical or cost effective. One of the three most stringent chemical and autoclave sterilization methods outlined in Annex III of the WHO guidelines (see below) should be used to rep
