Who Infection Control Guidelines for Transmissible Spongiform Encephalopathies

An authoritative guide to procedures and precautions needed to prevent iatrogenic and nosocomial exposure to transmissible spongiform encephalopathies (TSEs) in hospitals, health care facilities, and laboratories. Prepared by an international group of 32 leading experts, the guidelines respond to the unusual resistance of TSE agents to conventional chemical and physical methods of decontamination and the corresponding need for special precautions. Areas of patient care and categories of interventions, tissues, instruments, and wastes that do not require special precautions are also clearly indicated.

In issuing these guidelines, WHO aims to help medical officers, specialists in infection control, care-givers, and laboratory workers reduce the risks of TSE transmission to negligible levels. With this goal in mind, the guidelines provide a logical framework for determining levels of risk and knowing when departures from standard procedures for infection control are required. Specific recommendations are set out in tables and explanatory text covering patient care, occupational injury, laboratory investigations, decontamination procedures, waste disposal, and precautions after death. Adherence to these procedures should ensure a high level of safety. As the document repeatedly emphasizes, no TSE patient should be denied admission to a health facility, kept in isolation, or deprived of any procedure.

Further practical advice is provided in a series of annexes, which give exact instructions for recommended decontamination methods and discuss the management of healthy "at risk" individuals and individuals with confirmed or suspected variant Creutzfeldt-Jakob disease.