KEY POINTS:
Health authorities are investigating whether a patient with the brain-wasting disease, CJD, contracted it from a graft from a cadaver more than 20 years ago.
Forty-three patients are being warned of possible infection after the woman was diagnosed with the condition.
Health authorities have warned the patients their operations were carried out using the same instruments as the patient who has developed the disease.
The woman, who had neurosurgery at Auckland City Hospital last month, has recently developed symptoms consistent with sporadic CJD.
Attention is now turning to how she contracted the disease and suspicion has fallen on a so-called "dural graft" - or transplanted brain membrane - which she received during previous brain surgery in 1984.
Neurologist Barry Snow today described the situation after her latest surgery: "After her operation she didn't recover in the way we would have expected and that lead us to perform more investigations including brain scans which raised the possibility of CJD.
"She has had some seizures and hasn't regained awareness in the same way that we expect people to do."
Neurosurgeon Edward Mee said a dural graft was used to close the cover around the brain or spinal column.
"In the 1970s it was considered that cadaver dura would be an ideal substitute and companies produced this substitute and there was a product developed in Germany that was known as Lyodura. That product was used widely throughout the world including in the United Kingdom, Europe, America, France, Australia and New Zealand."
But there was now concern that material from a cadaver infected with CJD could have been used in the product.
The 43 other patients who have received warnings about a possible infection include adults and children who have received recent surgery.
The instruments from the operation on the infected patient were sterilised thoroughly before being reused, but doctors cannot guarantee that the rogue protein which causes CJD - Creutzfeldt-Jakob disease - has been eradicated.
The protein - known as a prion - is close to being a substance from hell. It causes the brain to waste away, killing the patient but is almost impossible to destroy.
The disease is different from "mad cow disease", which is a variant of CJD, so New Zealand's agricultural exports will not be affected.
The DHB stressed there have been no reports of contracting CJD from surgical instruments since the 1970s and said sterilisation procedures have improved since then.
It said Auckland City Hospital has a world class unit with up-to-date processes and technology for cleaning, disinfecting, sterilising and tracking of surgical instruments.
David Sage, chief medical officer for Auckland DHB, said: "I cannot emphasise too much how close to zero we believe their risk to be."
Patients have been directly contacted and anyone not in the identified 43 patients has no need to be concerned, the DHB said.
A further 11 patients were operated on during the same period but have been told the same surgical instruments were not used in their cases.
The possible causes of CJD include the use of human growth hormone, dura matter grafts used in brain surgery, corneal grafts, and exposure to contaminiated surgical instruments.
CJD kills about one person in a million and has no treatment or cure. Scientists believe the prions can lie dormant for years, then begin to cause the brain to waste, leading to mental deterioration, blindness and coma.
A helpline number has been set up - 0800 234200.
- NZHERALD STAFF
