Although infectiousness is a feature of
Creutzfeldt-Jakob disease (CJD), only a small proportion of cases are linked to transmission through healthcare provision. As of January 2003, over 120 cases of CJD associated with use of human cadaveric dura mater had been recognised worldwide; almost all were associated with the commercial product
Lyodura. Most cases (97) have occurred in Japan, giving an overall risk estimate of around 1 per 2268 patients treated with
Lyodura (0.04%) in that country. In Australia, five cases of CJD have so far been linked to
Lyodura, but, given the protracted tails of previous epidemics of
transmissible spongiform encephalopathies, further cases are possible. Results of surveys of
Lyodura use in Australia are incomplete, but information from the manufacturer suggests that 2208-2478 sheets of
Lyodura may have been used here. This use translates to a relatively high incidence of
Lyodura-associated CJD, with current overall rates appearing around five times higher than those reported in Japan; reasons for this difference are unclear.