Cruetzfeldt-Jakob Disease (CJD)

Cruetzfeldt-Jakob Disease (CJD)

• 14-3-3 Protein Assay
•  Abnormal Prion
• Bovine spongiform Encephalopathy

CJD

Cerebral Spinal Fluid (2-3 ml)

Sterile CSF conical tubes

• Tube 1- Chemistry
• Tube 2- Cytology
• Tube 3- Microbiology (Microbiology is x4 tubes collected)
• Tube 4- Hematology
• The last tube collected will be processed for the cell count

Lumbar Puncture

Clean the puncture site with antiseptic solution and alcohol before needle insertion. Insert a needle with stylet at the L3-L4, L4-L5 or L5-LS interspace. When subarachnoid space is reached, remove stylet and spinal fluid will appear in the needle hub. Slowly drain CSF into sterile tubes.

Shunt Fluid

Clean the reservoir site with antiseptic solution and alcohol. Collect fluid through the reservoir unit and place it in a sterile tube.
Indicate method of collection on requisition.

Suggested Volumes:

• Routine Culture (C&S) - 2 mL
• Fungus Culture - 2 mL
• Mycobacterium Culture - 2 mL
• Virus Culture - 2 mL

CJD-clear atraumatic CSF taken from a living patient 2-3 ml minimum. Please provide the waybill # at the time of notification.

• Prior to submission of specimen, Notify Public Health Laboratory of an incoming CJD specimen by contacting at 416-235-6556.
• Always send the most turbid tube to Microbiology.
• Specimen description and total quantity will be recorded for the CSF
• The supernatant/extra specimen will be frozen in the -70'C freezer for approximately 6 months after processing for all required tests.
• CSF specimen with visible blood , hemolysis or xanthochromia may impact validity of test results and will not be processed without consultation with the National Microbiology Laboratory's Section Chief.
• CSF specimens collected post-mortem will impact the validity of test results and as such are not processed.

• Freeze directly after the lumbar puncture at -20 to -80°C until assay is run for optimum integrity.
• Do not treat with formaldehyde or formic acid. The specimen will need to be considered as 'Hazardous Material'.
• Specimen should be shipped out as "Category B, UN 3373 ". Certified UN3373 outer container must be used to ship specimen for CJD.
• Inner container must consist of primary and secondary leak-proof containers with enough absorbent material between the primary and secondary container to absorb the entire contents in the case of damage to the package.
• Clearly label the outer package with "CJD" for laboratory processing, decontamination and disposal.
• Ship only Monday to Wednesday on frozen dry ice to Public Health Laboratory 
• PHL will forward specimen to National Microbiology Laboratory (NML) for testing.
• Please provide the waybill# at the time of notification
• The specimen should be delivered to the laboratory STAT, with no delay
• The specimen should not be transported through the automated delivery system.
• If after hours and no call-back is initiated the specimen should be stored at room temperature in the STAT container.

Offsite, Referral Laboratory