Prion disease and medical devices

Prions are novel proteinaceous-infectious agents that have been implicated in transmissible spongiform encephalopathies. It is now generally accepted that noninfectious prion proteins are normally produced by the host and may undergo a conformational change to an abnormal, pathologic form, which app ears to be responsible for disease symptoms. Many methods of decontaminatio n and sterilization are claimed to be ineffective against prion proteins. I ncidences of iatrogenic transmission of prions due to medical devices have been reported, and the recommended clinical practices when handling suspect ed cases are reviewed. Recent results with a peracetic acid based sterilant indicate that it may be a safe and effective means of prion inactivation o n medical devices.