Showing posts with label cjd. Show all posts
Showing posts with label cjd. Show all posts

Friday 12 June 2015

Prion diseases can be passed on by eating infected tissue

Thursday June 11 2015
The practice of brain eating lead to an epidemic of kuru – a CJD-like disease
CJD is caused by prions (abnormally folded proteins)
“Eating brains helped Papua New Guinea tribe become disease resistant,” The Daily Telegraph reports.
Some of the Fore people, who used to eat the brains of dead relatives as a mark of respect, may have developed resistance to prion diseases such as Creutzfeldt Jacob disease (CJD).
Prion diseases occur in humans and animals, and are caused by a build-up of abnormally folded proteins in the brain. Prion diseases can be passed on by eating infected tissue, such as beef that has been exposed to prions. This is known as bovine spongiform encephalopathy (BSE, or “mad cow disease”). There is currently no cure for prion diseases.
A tribe in Papua New Guinea were nearly wiped out by a prion disease called kuru. The infection was spread as a result of their tradition of eating the brains of deceased relatives at their mortuary feasts. Some people were resistant to the infection, and this was thought to be due to a mutation called V127 in the gene encoding the prion protein.
This study used genetically modified mice to test whether this genetic mutation was protective against kuru and CJD. The tests showed that mice with this genetic mutation were indeed resistant to these prion diseases.
The results suggest that this mutation could be responsible for the kuru resistance seen in the survivors. It is hoped this finding may eventually help to develop effective treatments for prion diseases, but much more research will be needed to get to that point.

Prions

Prions are abnormally folded proteins, which, like viruses, bacteria and fungi, can cause infections, which are (to the best of our knowledge) universally fatal.
Unlike viral, bacterial, fungi or human cells, prions do not contain a nucleus (a core of genetic material). This had led to some debate as to whether we can actually classify a prion as a living organism.
Prions are extremely tough and can withstand extreme heat and cold, and are resistant to all antimicrobial medications. They can also survive in dead tissue. 

Where did the story come from?

The study was carried out by researchers from UCL Institute of Neurology and the Papua New Guinea Institute of Medical Research. It was funded by the UK Medical Research Council.
The study was published in thepeer-reviewed medical journal Nature.
As you would expect, talk of brain-eating cannibals caught most of the media’s attention (and ours as well), but some of the headlines gave a misleading impression.
For example, The Telegraph’s headline that “Eating brains helped Papua New Guinea tribe become disease resistant” is inaccurate. Brain eating did not cause the mutation in the gene that then provided resistance to the disease. In fact eating brains nearly wiped out the tribe as Kuru mainly affected women of childbearing age and children. The tribe was saved by stopping the cannibalism in the late 1950s.
The actual beneficial effect was due to what is called “selection pressure”. This is where people with certain characteristics help them to resist the disease, such as the mutation discussed in the study, as are more likely to survive and have children themselves, leading to more people carrying the mutation.

What kind of research was this?

This was an animal study involving mice. The researchers aimed to further their understanding of prion diseases, such as CJD.
Prion diseases occur in humans and animals, and are caused by an abnormal form of a naturally occurring protein called a prion. The faulty prions replicate and convert other proteins, in a chain reaction. The abnormal prions have a different shape to the normal protein; this makes them more difficult for the body to break down, so they accumulate in the brain. The prions cause progressive brain and nervous problems with communication, behaviour, memory, movement and swallowing. These problems eventually lead to death, and there is currently no cure.
There are different types of prion diseases. Some can be inherited, while others occur by chance through a genetic mutation, and others are passed on to other people during medical procedures using contaminated equipment or body parts, or through eating contaminated food. The disease can take years to develop.
One of these prion diseases is called kuru, and occurred in a remote area in Papua New Guinea. The disease was spread by the custom of eating the brain tissue of relatives after death. Previously, the researchers discovered that some of the people who survived had a genetic variation, which led to the production of a slightly different version of the prion protein. They thought this might be what was protecting these people from the kuru infection. People (and mice) carry two copies of every gene, one inherited from each parent. In these people, one of the copies of the gene carrying instructions for making the prion protein changed, which led to the protein having one of its building blocks (amino acids) altered from guanine (G) to valine (V). This change was called V127.
In this study, the authors wanted to test whether V127 stopped mice from getting prion diseases.

What did the research involve?

Mice were genetically engineered to have the human prion protein. The mice were generated to have the following versions of the prion protein genes:
  • two copies of the V127 prion protein gene
  • one copy of V127 and one normal copy (G127)
  • two copies of the normal G127 form of the gene
Each group of mice were individually injected into the brain with infectious tissue from different sources. The tissue used came from four people who had kuru, two people with variant CJD and 12 people with classical CJD.
The researchers then looked at which mice went on to develop the prion diseases.

Types of CJD

Different types of CJD include:
  • Sporadic CJD – this is the most common type of CJD, accounting for around 8 in every 10 cases, although it is still very rare; it is unknown what causes sporadic CJD.
  • Variant CJD – this is the type of CJD associated with bovine spongiform encephalopathy (BSE or “mad cow disease”), though not everyone exposed to BSE-infected meat will go on to develop vCJD.
  • Familial or inherited CJD – This very rare form of CJD is caused by an inherited mutation (abnormality) in the gene that produces the prion protein.

What were the basic results?

Mice with two copies of V127 were completely resistant to infection from all 18 human prion disease cases tested. Mice with one copy of V127 were resistant to kuru and classical CJD, but not variant CJD. Mice with both copies of the normal G127 gene were infected by all of the prion diseases tested.
Variant CJD is the form thought to be caused by consuming meat infected with bovine spongiform encephalopathy (BSE), while sporadic and familial CJD is not. These last two types are often grouped together as “classic CJD”.

How did the researchers interpret the results?

The researchers concluded that the V127 gene appears to give resistance to prion disease. They say that “understanding the structural basis of this effect may therefore provide critical insight into the molecular mechanism of mammalian prion propagation”. This could then lead to the development of treatments against such diseases.

Conclusion

This interesting piece of research has found that a mutation in the gene carrying the instructions for making the normal prion protein can prevent infection with prion diseases such as CJD and kuru in a mouse model.
This mutation had been initially found in survivors of the kuru prion disease in Papua New Guinea, so this supports the theory that this mutation could be why these people survived. The presence of the disease would have “naturally selected” people who carried any genetic variations or other characteristics that protected them from the disease. This means these people would be more likely to have children and pass on this resistance.
As this research was done on mice, the usual caveats apply: that the results may not be found in humans. However, it does support the findings we have from a natural disease epidemic in humans, and it would be unethical to carry out human experiments to test the theory.
This is not the first genetic variation linked to resistance to prion diseases, but adds to what is known about them. It is hoped this greater understanding may enable future research to develop effective treatments for prion diseases, as there are none at present.
If you or a relative have been affected by a prion disease, counselling is available at the National Prion Clinic. This can be in person or over the phone.
Analysis by Bazian. Edited by NHS ChoicesFollow Behind the Headlines on TwitterJoin the Healthy Evidence forum.

Sunday 6 May 2012

MRSA and C. difficile infections in hospitals fell


Hospital hygiene drive 'saved 10,000 lives'

'CleanYourHands' campaign has led to significant fall in MRSA and other superbug infections, says BMJ report
  • guardian.co.uk, 
  • Article history
A doctor scrubbing up in hospital
MRSA rates in hospitals fell by more than half between July 2004 and June 2008, according to the BMJ study. Photograph: Getty Images
The government-funded campaign to improve hand hygiene at hospitals across England and Wales led to a significant fall in the rates of superbug infections, a report has revealed.
After the "CleanYourHands" campaign was rolled out in 2004, the amount of soap and alcoholic hand rub bought by NHS trusts almost tripled, according to a study published in the British Medical Journal (BMJ).
Over the same period, MRSA rates in hospitals were slashed by more than half, while there was a significant drop in the number of Clostridium difficile infections.
The campaign, backed by the Department of Health, was introduced across the 187 acute NHS trusts in England and Wales between December 2004 and June 2005.
It encouraged hospital visitors, patients and staff to wash their hands with soap or an alcohol gel when entering or leaving wards. People were also encouraged to clean their hands before touching patients or eating food and after going to the toilet.
As part of the drive, alcohol gels were put by bedsides, posters reminded staff to wash their hands and regular checks were made to ensure hands were kept clean.
The BMJ study, which analysed statistics between July 2004 and June 2008, found that the number of patients infected with MRSA fell from 1.88 cases per 10,000 bed days to 0.91 over the four-year period.
Rates of C difficile infection dropped from 16.75 to 9.49 cases, while the number of cases of MSSA – a bacterium found on the skin – did not fall.
The study also found that hospital trust procurement of soap and alcohol hand rub rose from a combined 21.8ml to 59.8ml per patient bed day over the period.
The increased use of soap in hospitals was linked to reduced rates of C difficile infection, while rising use of alcohol hand rub was associated with a reduction in MRSA cases.
The report concludes: "The CleanYourHands campaign was associated with sustained increases in hospital procurement of alcohol rub and soap, which the results suggest has an important role in reducing rates of some healthcare associated infections.
"National interventions for infection control undertaken in the context of a high profile political drive can reduce selected healthcare associated infections."
Sheldon Paul Stone, senior lecturer at UCL medical school, who led the study, estimated that around 10,000 lives were saved because of the campaign, which ended in 2010.
He told the Independent: "Without a doubt, lives were saved by the campaign. I would say 10,000 lives over the four-year period of the study was a reasonable estimate.
"If hand hygiene were a new drug, pharmaceutical companies would be out selling it for all they were worth."
Stone added: "It is obvious the campaign should be continued. Independent groups have suggested it should. It needs a new focus on staff who use gloves. They deal with the most infectious patients but they are much less likely to use soap."
A spokesman from the Department of Health was quoted as saying: "The CleanYourHands campaign was successful in its aim to highlight the importance of good hand hygiene practice across the NHS. We know this has been successful.
"The challenge now is to ensure the NHS embeds the good practice highlighted in the campaign to achieve our ambition to wipe out avoidable healthcare-associated infection."

Hand hygiene campaign 'cut superbug infections'the campaign to improve hand 


hygiene in hospitals in England and Wales contributed to a significant fall in the rates of superbug infections, according to a report.

The study published on the BMJ website showed the amount of soap and hand gel being used tripled during the campaign.
At the same time, levels of MRSA and C. difficile infections in hospitals fell.
The government has since dropped the campaign, but said its ambition was to "wipe out" such infections.
Hospital superbugs were once a real fear for many patients. In response the Clean Your Hands campaign, funded by the Department of Health, was introduced in all hospitals by June 2005.
Alcohol gels were put by bedsides, posters reminded staff to wash their hands and there were regular checks to ensure hands were kept clean.
By 2008, the total amount of soap and alcohol gel being purchased by hospitals trebled, going from 22ml per patient per day to 60ml per patient per day.
Rates of MRSA more than halved in the same time period and C. diff infections fell by more than 40%.
'Success story'
One of the report's authors, Dr Sheldon Stone from the Royal Free University College London Medical School, estimated that around 10,000 lives were saved because of the campaign.
He told the BBC: "It's been a real British success story, we've gone from being the dirty man of Europe to being world leaders.
"What we need to do is keep up the momentum and stay at the forefront of world hand hygiene."
A spokesman from the Department of Health said: "The Clean Your Hands campaign was successful in its aim to highlight the importance of good hand hygiene practice across the NHS. We know this has been successful.
"The challenge now is to ensure the NHS embeds the good practice highlighted in the campaign to achieve our ambition to wipe out avoidable healthcare-associated infection.
"We know real progress has been made in this area as MRSA bloodstream infections have dropped by 41% and C. difficile by 30% across the NHS in England since 2009/10.

Friday 23 September 2011

cjd deaths up year on year !

CJD Statistics


CJD Figures

These figures show the number of suspect cases referred to the NCJDRSU in Edinburgh, and the number of deaths of definite and probable cases in the UK, from 1 January 1990 up to 5th September 2011

REFERRALS OF SUSPECT CJD

DEATHS OF DEFINITE AND PROBABLE CJD

Year

Referrals

Year

Sporadic

Iatrogenic

Familial

GSS

vCJD

Total Deaths

1990

[53]

1990

28

5

0

0

-

33

1991

75

1991

32

1

3

0

-

36

1992

96

1992

45

2

5

1

-

53

1993

79

1993

36

4

5

2

-

47

1994

119

1994

54

1

5

3

-

63

1995

87

1995

35

4

2

3

3

47

1996

133

1996

40

4

2

4

10

60

1997

163

1997

60

6

4

2

10

82

1998

155

1998

64

3

3

2

18

90

1999

170

1999

62

6

2

0

15

85

2000

178

2000

50

1

2

1

28

82

2001

179

2001

58

4

4

2

20

88

2002

163

2002

72

0

4

1

17

94

2003

162

2003

79

5

4

2

18

108

2004

114

2004

50

2

4

2

9

67

2005124200567485589
2006112200669163584

2007

119200764291581

2008

150200888523199
2009153200978235391
2010149201084361397
2011*108201149261260

Total Referrals

2841

Total Deaths

1264

67

89

44

172

1636

*As at 5th September 2011

Summary of vCJD cases

Deaths

Deaths from definite vCJD (confirmed):

Deaths from probable vCJD (without neuropathological confirmation):

Number of deaths from definite or probable vCJD:

119

53

172

Alive

Number of definite/probable vCJD cases still alive:

3

Total number of definite or probable vCJD cases (dead and alive):

175

(Table updated 9th September 2011)

The National Creutzfeldt-Jakob Disease Research & Surveillance Unit (NCJDRSU)


The incidence of Creutzfeldt-Jakob disease (CJD) is monitored in the UK by the National CJD Research & Surveillance Unit (NCJDRSU) based at the Western General Hospital in Edinburgh, Scotland. The Unit brings together a team of clinical neurologists, neuropathologists and scientists specialising in the investigation of this disease. This document is intended to summarise the research in progress at the NCJDRSU and also provide some background information about CJD and other human spongiform encephalopathies. We have also provided some links to other resources and contrary points of view available on the Web.


Creutzfeldt-Jakob Disease Surveillance.

  • Figures for the number of CJD cases and referrals of suspected cases of CJD to the NCJDRSU since 1990.
  • NCJDRSU protocol for CJD surveillance across the UK.
  • National Referral System. From July 2004, a new national reporting system was announced by the Chief Medical Officer. This is centred on the National CJD Reporting Form to be faxed, by the notifying clinician, to the National Creutzfeldt-Jakob Disease Research & Surveillance Unit (NCJDRSU), the National Prion Clinic (NPC) and the local CCDC.
  • Interim guidance on incidents involving inherited prion disease - this document sets out how inherited prion disease incidents should be reported to the CJD Incidents Panel and complements the guidance on local reporting by clinicians of CJD cases to public health departments (above).
  • Text and figures of the latest annual report of the NCJDRSU covering the period 1990-2009 (published 11th March 2011).
  • Archive of previous NCJDRSU annual reports (1992-2008).
  • National CJD Research & Surveillance Unit Scientific Report 2007/08 (published 13th November 2008).
  • Reporting CJD cases to public health departments - Guidance Document. - (updated November 2006)
  • Potential treatments for Creutzfeldt-Jakob disease (updated July 2006).

Information on variant CJD.

  • Reproduction of the complete Lancet article published by the NCJDRSU in April 1996.
  • Text of a letter written by Dr Robert Will to every Neurologist in the UK. This letter describes in some detail the clinical and pathological variants observed between sporadic CJD and the new variant of the disease which has been identified here at the NCJDRSU.
  • The original statement issued by SEAC, the government's advisory committee on spongiform encephalopathies, about these ten cases of the new variant of CJD.
  • Protocol for the investigation of geographically associated cases of variant CJD
  • Incidence of variant Creutzfeldt-Jakob disease diagnoses and deaths in the UK compiled by N J Andrews at the Statistics Unit, Centre for Infections, Health Protection Agency.(updated 18th May 2011)
  • Figures for the number of vCJD cases worldwide [data courtesy of the European and Allied Countries Study Group of CJD (EUROCJD/NEUROCJD)]

Care and Support.


Practical information about CJD.


Creutzfeldt-Jakob Disease research.

    .....SECTION UNDER DEVELOPMENT .........

  • Complete reference list of scientific research articles produced by the NCJDRSU since 1990.

Other links


About ourselves

  • The people involved in the research being undertaken at the CJD unit.
  • The setup, details of the funding of the CJD and the collaborative projects we are involved in.
  • Our address should you wish further contact.

For enquiries contact:

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