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    Emerging Diseases, Infection Control & California Dental Practice Act TSE and MRSA

    SATURDAY, SEPTEMBER 22, 2018

    Emerging Diseases, Infection Control & California Dental Practice Act TSE PRION AND MRSA

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    kind regards, terry

    #2
    I would like to know more about diseases transmitted in the dentist's office. Thanks for the interesting information.

    Comment


      #3
      Tell me, which specialties in the field of dentistry are more at risk of spreading diseases?

      Comment


      • flatfish
        flatfish commented
        Editing a comment
        I have not addressed this issue in a long time, and investigation into TSE PrP and iatrogenic transmission of nvcjd and scjd, really has not been addressed much, especially with the different typical and atypical TSE PrP. BUT, recent science with CWD, represents a risk factor for iatrogenic transmission (see in my next post), and the recent deaths of lab workers in France working with TSE PrP, and other iatrogenic cases, should bring much concern with dental practices and the TSE PrP, especially with the amount of cwd across the USA, exposure to CWD, and then surgical or dental procedures are a present risk factor of further iatrogenic transmission, imo.

        i believe that there is substantial risk factors for iatrogenic transmission via some dentistry practices, imo...kind regards, terry

        WHO tse prp tissue table, dental pulp NOT TESTED

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        Low risk 18 (33) Endoscopy, gastrointestinal Screening with or without polypectomy 9 (50) Oral and maxillofacial surgery Dental grafting 4 (22)

        CWD in humans might remain subclinical but with PrPSc deposits in the brain with an unusual morphology that does not resemble the patterns usually seen in different prion diseases (e.g., mouse #328; Fig. 3), clinical with untraceable abnormal PrP (e.g., mouse #327) but still transmissible and uncovered upon subsequent passage (e.g., mouse #3063; Fig. 4), or prions have other reservoirs than the usual ones, hence the presence of infectivity in feces (e.g., mouse #327) suggesting a potential for human-to-human transmission and a real iatrogenic risk that might be unrecognizable.

        Supplementary Information The online version contains supplementary material available at

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        snip...see full text;

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        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 al

        Table 1. Surgical Procedures Performed in Patients With Creutzfeldt-Jakob Disease Using Durable Instruments,
        Stratified by Risk of Contamination of Instruments With Prions

        Low risk 18 (33)

        Endoscopy, gastrointestinal Screening with or without polypectomy 9 (50)

        Oral and maxillofacial surgery Dental grafting 4 (22)

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        Bioassay Studies Support the Potential for Iatrogenic Transmission of Variant Creutzfeldt Jakob Disease through Dental Procedures

        Elizabeth Kirby ,Joanne Dickinson ,Matthew Vassey,Mike Dennis,Mark Cornwall,Neil McLeod,Andrew Smith,Philip D. Marsh,James T. Walker,J. Mark Sutton ,Neil D. H. Raven

        Published: November 30, 2012

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        Findings
        Challenge via the small intestine gave a transmission rate of 100% (mean incubation 157±17 days). Infectivity was found in both dental pulp and the gingival margin within 3 weeks of challenge and was observed in all tissues tested within the oral cavity before the appearance of clinical symptoms. Following exposure to deliberately contaminated dental files, 97% of mice developed clinical disease (mean incubation 234±33 days).

        Interpretation
        Infectivity was higher than expected, in a wider range of oral tissues, than was allowed for in previous risk assessments. Disease was transmitted following transient exposure of the gingiva to a contaminated dental file. These observations provide evidence that dental procedures could be a route of cross-infection for vCJD and support the enforcement of single-use for certain dental instruments.

        snip...

        As a worse case study, the incubation periods described here would be expected to be the most rapid giving rise to prion-disease symptoms in this model, and as a novel low-dose, peripheral model of infection, the incubation periods might be expected to be considerably longer than those observed for blood transfusion cases. Given the difficulties in linking dental procedure case histories to vCJD, such cases may not yet be evident.

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        Published online 2012 Nov 30. doi: 10.1371/journal.pone.0049850
        PMCID: PMC3511499
        PMID: 23226225

        Bioassay Studies Support the Potential for Iatrogenic Transmission of Variant Creutzfeldt Jakob Disease through Dental Procedures

        Elizabeth Kirby,# 1 Joanne Dickinson,# 1 Matthew Vassey, 1 Mike Dennis, 1 Mark Cornwall, 1 Neil McLeod, 1 Andrew Smith, 2 Philip D. Marsh, 1 , 3 James T. Walker, 1 J. Mark Sutton, 1 , * and Neil D. H. Raven 1
        Noriyuki Nishida, Editor

        snip...

        Findings
        Challenge via the small intestine gave a transmission rate of 100% (mean incubation 157±17 days). Infectivity was found in both dental pulp and the gingival margin within 3 weeks of challenge and was observed in all tissues tested within the oral cavity before the appearance of clinical symptoms. Following exposure to deliberately contaminated dental files, 97% of mice developed clinical disease (mean incubation 234±33 days).

        Interpretation
        Infectivity was higher than expected, in a wider range of oral tissues, than was allowed for in previous risk assessments. Disease was transmitted following transient exposure of the gingiva to a contaminated dental file. These observations provide evidence that dental procedures could be a route of cross-infection for vCJD and support the enforcement of single-use for certain dental instruments.

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        Transmission of the 263K scrapie strain by the dental route

        Loredana lngrosso1, Flavio Pisani1, Maurizio Pocchiari1

        Published: 01 November 1999 Only registered and activated users can see links., Click Here To Register...

        Although these findings may not apply to humans affected by TSEs, they do raise concerns about the possible risk of transmitting these disorders through dental procedures. Particular consideration should be taken in regard to new variant CJD patients because they may harbour more infectivity in peripheral tissues than sporadic CJD patients.

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        Published: 27 September 2003

        Investigation of PrPres in dental tissues in variant CJD

        M W Head, D Ritchie, V McLoughlin & J W Ironside British Dental Journal volume 195, pages339–343 (2003)

        Key Points Previous studies have indicated that dental surgery is not a risk factor for sporadic CJD, but in variant CJD the tissue distribution of infectivity is much wider, raising concerns over transmission via dental surgical instruments.

        A range of dental tissues were studied for the presence of the abnormal form of the prion protein, using a combination of immunohistochemistry and a sensitive Western blot assay.

        Abnormal prion protein was detected in the trigeminal ganglia, tonsil and lymph nodes in variant CJD but not in sporadic CJD cases. Alveolar nerves, gingiva, dental pulp, tongue and salivary gland tissue were negative in all cases. Lymphoid tissues (including tonsil) were negative in sporadic CJD.

        Since the presence of the abnormal form of the prion protein is associated with infectivity, these findings indicate that the highest levels of infectivity in dental tissues are likely to be found in the tonsil and associated lymphoid tissues. This does not exclude the presence of lower levels of infectivity in the negative tissues in our study.

        These new findings will be of use to inform the risk assessment on dental tissues and variant CJD.

        Abstract Objective To study the distribution of disease-associated prion protein (PrP) in oral and dental tissues in variant CJD.

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        doi: 10.18502/ijps.v16i1.5385 2021 Jan; 16(1): 106–110.
        PMCID: PMC8140296
        PMID: 34054989

        Creutzfeldt-Jakob Disease after Dental Procedure along with the Initial Manifestations of Psychiatric Disorder: A Case Report

        Rahim Badrfam,1 Ahmad Ali Noorbala,2 Zahra Vahabi,3 and Atefeh Zandifar4,*

        Introduction: Creutzfeldt-Jakob disease (CJD) as a prion disease is an untreatable type of progressive neurodegenerative encephalopathy. Although no definitive case has been reported yet, here we report a case that given the history, course of symptoms, and recent dental practice, it is highly probable that it was caused by dental procedures.

        Case Report: The patient was a 52-year-old woman who has had memory problems gradually with forgetting the names of family members since 6 weeks prior to the visit and shortly after the dental procedure. She experienced progressive visual hallucinations accompanied by a sharp decline in cognitive, verbal, and motor abilities in just a few weeks. Finally, the diagnosis of Creutzfeldt-Jakob was made for her based on the clinical history and typical brain MRI.

        Discussion: Clinical evidence of this patient, along with positive brain MRI results, indicates the risk of prion transfer through dental procedures. Paying attention to the neurological aspects of psychiatric manifestations and increasing the awareness of dentists about how to deal with and act on the potential dangers of prion transfer is of paramount importance.

        Key Words: Creutzfeldt-Jakob Disease, Dental Procedures, Psychiatric Manifestation

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      #4
      Published: 27 September 2003

      Investigation of PrPres in dental tissues in variant CJD

      M W Head, D Ritchie, V McLoughlin & J W Ironside British Dental Journal volume 195, pages339–343 (2003)C

      Key Points Previous studies have indicated that dental surgery is not a risk factor for sporadic CJD, but in variant CJD the tissue distribution of infectivity is much wider, raising concerns over transmission via dental surgical instruments.

      A range of dental tissues were studied for the presence of the abnormal form of the prion protein, using a combination of immunohistochemistry and a sensitive Western blot assay.

      Abnormal prion protein was detected in the trigeminal ganglia, tonsil and lymph nodes in variant CJD but not in sporadic CJD cases. Alveolar nerves, gingiva, dental pulp, tongue and salivary gland tissue were negative in all cases. Lymphoid tissues (including tonsil) were negative in sporadic CJD.

      Since the presence of the abnormal form of the prion protein is associated with infectivity, these findings indicate that the highest levels of infectivity in dental tissues are likely to be found in the tonsil and associated lymphoid tissues. This does not exclude the presence of lower levels of infectivity in the negative tissues in our study.

      These new findings will be of use to inform the risk assessment on dental tissues and variant CJD.

      Abstract Objective To study the distribution of disease-associated prion protein (PrP) in oral and dental tissues in variant CJD.

      Design Prospective single centre autopsy based study.

      Setting Within the National CJD Surveillance Unit, UK, 2000-2002.

      Materials and methods Patients with suspected variant CJD undergoing autopsy where permission to remove tissues for research purposes had been obtained from the relatives. Fixed and frozen autopsy tissues from the brain, trigeminal ganglion, alveolar nerve, dental pulp, gingiva, salivary gland, tongue and tonsils were studied by Western blot, PET blot and immunocytochemistry to detect disease-associated PrP.

      Results Disease-associated PrP was only detected in the brain, trigeminal ganglia and tonsils.

      Conclusions The failure to detect disease-associated PrP in most dental and oral tissues will help inform ongoing risk assessments for dental surgery in relation to the possible iatrogenic transmission of variant CJD via dental instruments.

      Introduction

      see;

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      Thursday, November 14, 2013

      Prion diseases in humans: Oral and dental implications

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      Subject: CJD: update for dental staff

      Date: November 12, 2006 at 3:25 pm PST

      1: Dent Update. 2006 Oct;33(8):454-6, 458-60.

      CJD: update for dental staff.

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      Friday, March 11, 2022

      Prevalence of Surgical Procedures at Symptomatic Onset of Prion Disease

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      MONDAY, JANUARY 31, 2022

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

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      WEDNESDAY, FEBRUARY 02, 2022

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

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      FRIDAY, DECEMBER 24, 2021

      Creutzfeldt Jakob Disease CJD TSE Prion Update December 25, 2021

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      Saturday, December 18, 2021

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

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      Tuesday, November 30, 2021

      Second death in France in a laboratory working on prions

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      kind regards, terry

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