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"The risk of exposure is extremely low, but it's not zero," he said.
In fewer than 1% of the cases, the disease is transmitted by exposure to brain or nervous system tissue, state public health director Dr. Jose Montero said. Only four cases of transmission via surgical instruments have been recorded, none in the United States, he said. Another 10% to 15% of the cases of Creutzfeldt-Jakob involve a genetic mutation that is passed down among families.
The disease can be verified only through a brain biopsy or autopsy. New Hampshire officials are still awaiting those results.
Meanwhile, the hospital has notified eight of its patients who may have been exposed, and hospitals in other states are working to do the same because some of the surgical equipment was rented and used elsewhere after being used in Manchester, Montero said. He would not identify the other states but said no more than five additional patients were potentially exposed.
Catholic Medical Center also has assigned a staffer to work with the potentially exposed patients, whom Pepe said range in age from mid-30s to mid-80s.
"They took it very well. I don't believe that people were angry or extremely emotionally upset," he said. "We did the best job we could in trying to alleviate their fear."
Worldwide, Creutzfeldt-Jakob affects about one person in every one million each year; in the United States, about 200 cases are recorded annually, according to the National Institutes of Health.
In South Carolina, Greenville Hospital System last year began increasing the temperature used to sterilize its surgical instruments after a patient was discovered to have Creutzfeldt-Jakob. Eleven patients there were notified that they might have been exposed.
But Pepe said the measures required to eliminate all traces of the proteins would effectively render the equipment unusable. He said the New Hampshire equipment has been quarantined pending the autopsy results.
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