As many as eight neurosurgery patients may have been exposed to Creutzfeldt-Jakob disease (CJD) from surgical equipment that was previously used on a patient who likely had the incurable prion disease, according to New Hampshire health officials.

The patients underwent neurosurgery at Catholic Medical Center in Manchester between May and August and have been notified of their potential exposure, the hospital stated in a press release, adding that the risk to patients believed to be exposed is “extremely low.” 

The initial patient underwent surgery in May and died in August. The only way to confirm a CJD diagnosis is through autopsy, which is currently underway at the National Prion Disease Pathology Surveillance Center.

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Surgical instruments used on the patient a with tentative sporadic CJD diagnosis were later used on at least eight other patients after ordinary sterilization — a procedure that does not adequately eradicate the prion proteins responsible for CJD. Some of the equipment was later rented and taken to hospitals in other states, health officials said.

Sporadic CJD occurs when normal prion proteins spontaneously refold eventually causing encephalopathy, It differs from variant CJD, also known as “mad cow disease,” which is transmitted via ingestion of misfolded prion proteins from animal products, such as beef cattle. Approximately 350 cases of sporadic CJD were diagnosed in the United States in 2009.

The incubation period from when patients are first exposed to CJD to when they start experiencing symptoms varies from one year to several decades.

In the early stages of CJD, the patient may have rapidly failing memory and other cognitive difficulties. These symptoms become worse much faster than with other more common types of dementia, such as Alzheimer’s disease. Other symptoms can include personality changes including anxiety and depression, lack of coordination and visual disturbances.

As the illness progresses, mental deterioration becomes pronounced and involuntary movements such as sudden jerky movements, blindness, weakness of extremities and coma may occur. There is no treatment or cure.