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July 1979

Safety Precautions With Spongiform Encephalopathy

Arch Neurol. 1979;36(7):451. doi:10.1001/archneur.1979.00500430081018

To the Editor.—  The article of Cook and Austin in the Archives (35:697-698, 1978) contains disturbing implications, which may have far-reaching results that were obviously not the intention of the authors. The proved transmissible nature of spongiform encephalopathy (SE) led to the proposal of guidelines by Gajdusek et al.1 We should keep in mind that the majority of cases of SE are sporadic and, therefore, clinically unsuspected, and only 10% of them are familial. Considering the likelihood that the incubation period is five times longer than that of a clinically recognizable disease, the proposed safety rules will protect us from less than 20% of all potentially infectious material. Of course, in familial cases of SE, the extension of precautions to potential victims prior to the onset of clinical symptoms will increase the margin of safety.The extension of the safety guidelines to familial Alzheimer's disease (AD) proposed by Cook and