New rules to reduce the risk of patients being infected with the human form of BSE from surgical instruments were introduced in England yesterday.
Within the next few months disposable instruments will be used for all tonsil surgery after the British government's advisory body on BSE, the Spongiform Encephalopathy Advisory Committee (SEAC), concluded there was a "theoretical risk" that vCJD could be passed to patients through surgical instruments.
The government will follow up SEAC's advice, given last November, by spending £200 million (sterling) to implement the new procedures and conduct a review of decontamination and sterilisation units in hospitals. Hospitals in Scotland plan to introduce changes in tonsil surgery by the end of the year, and a review of sterilisation units in Welsh hospitals is being conducted. In Northern Ireland the Minister for Health, Ms Bairbre de Brun, said she wanted to introduce similar protective measures on the use of surgical instruments and hoped additional money would be made available to fund the changes.
vCJD can be caused by naturally occurring proteins in the body mutating into a new form called a "prion" which then converts good protein into infected protein.
But the prion protein is resistant to many of the substances scientists have used to try to destroy it. Sterilisation and even blasting the protein with radioactivity have proved unsuccessful.
Changes to tonsil surgery have been made because in its advice to the British government SEAC identified tonsils as a high-risk area for infection.
The Health Minister, Mr John Denham, said the changes were being introduced as a "precautionary move" to minimise the risk of infection. "We have no evidence of any patient being infected with variant CJD in hospital," he said. Prof Peter Smith, head of SEAC, said tonsillectomy was being used as a "pilot study" to assess any problems or further changes, and consideration would then be given to extending the programme to other types of surgery.
Eye surgery and brain surgery are also an area of concern because of the high concentration of the prion protein in those areas.