Infection control: preventing iatrogenic transmission of spongiform encephalopathy in Danish hospitals

The Danish infection control guidelines dealing with transmissible spongiform encephalopathy (TSE) recognise that preventive measures to avoid iatrogenic transmission must be taken, though the risk for patients in Danish hospitals can be characterised as minimal. A minimal risk situation cannot meanwhile be maintained unless hospitals and other healthcare institutions are prepared and have effective and well-functioning decontamination procedures in place suited for the purpose. The guidelines recommend that staff both in the operating theatre and in the Central Sterile Supply Department (CSSD) must be able to apply the procedures needed for safe handling and decontamination of used instruments. These include cleaning and effective sterilisation, as well as quarantine procedures and ways to discard and incinerate certain used instruments. The guidelines also address occupational safety, and single-use instruments are recommended where these are available and can be safely used. Effective procedures for decontamination of instruments and other medical devices are identified as the key to prevention of iatrogenic spread of TSE. Hospitals are advised to have their sterilisers and other equipment professionally checked in order to make sure that specific procedures for safe handling and decontamination of used surgical instruments and other medical equipment are available in case of suspected or confirmed TSE.