4 ms·

> She had not been trained in handling dangerous prions or responding to accidents and did not wear both metal mesh and surgical gloves, as she was supposed to,

> She had not been trained in handling dangerous prions or responding to accidents and did not wear both metal mesh and surgical gloves, as she was supposed to, says Julien Bensimhon, the family’s lawyer. The thumb should have been soaked in a bleach solution immediately, which did not happen, Bensimhon adds. Does bleach even affect proteins? Isn't that protocol for an organism you're afraid of?

roflc0ptic 5y ago
yes, bleach kills microorganisms by denaturing their proteins.
- Scoundreller 5y ago
  And by oxidizing everything else. It’s not denaturation that’s making my clothes white again.
- rcxdude 5y ago
  Yes, though prions are extremely tough by protein standards (surviving extremely high temperatures and acidity, making them difficult to clean away. Prions have been transmitted from patient to patient through sterilized instruments used in brain surgery)
meepmorp 5y ago
Hypochlorous acid denatures proteins, so yeah.
- DoingIsLearning 5y ago
  But wasn't there an issue before of prion contamination with surgical instruments used in ophtalmic surgery. I am sure those would have been autoclaved and reprocessed at some ridiculous pH value, no?
  - throwaway0a5e 5y ago
    >I am sure those would have been autoclaved and reprocessed at some ridiculous pH value, no? Probably not until they had reason to do so. "Hot acidic environment" is hell when it comes to corrosion and the engineering incentive for medical stuff is only to be as corrosion resistant as you need because there are other design considerations and the most corrosion resistant stainless steels are not the bet fit for building a super precise needle you're gonna poke around in someone's eye so you wind up wanting to pick a middle ground alloy. Picking a middle ground alloy puts a hard limit on what you can do to clean your instruments before you degrade them in unacceptably short order. I don't know how things have changed since. My medical manufacturing experience is out of date and limited.
  - persedes 5y ago
    yeah I wouldn't count on prions being as easily denatured as other proteins. E.g. mad cow disease spread because prions are not killed by simply cooking / boiling it.
    - resoluteteeth 5y ago
      Is there some specific reason to think that prions are harder to denature than other proteins? It seems like mad cow disease could also spread simply because meat is not normally cooked to ensure that 100% of the proteins in it are denatured.
      - nebopolis 5y ago
        Prions are essentially already denatured/unfolded. They are a more stable state of a normal protein that has biological function, and they interact with the "correctly" folded proteins to cause them to denature into additional prions. Often denaturing a prion means actually breaking apart the protein into fragments or amino acids, because it is already at the most stable/denatured state. This is also why they are so persistent in nature and so hard to remove from surfaces. Apparently gas plasma sterilization is a promising possibility. (this seems like an ok overview of the challenges: https://pubmed.ncbi.nlm.nih.gov/21271212/ https://pubmed.ncbi.nlm.nih.gov/21271212/). Current procedures include things like autoclaving in 121C sodium hydroxide for 30 minutes. Definitely not something that fully cooking will inactivate.
tedivm 5y ago
Yeah, bleach does affect prions. Most of the studies I could find were tested on metal, not just someone's thumb. It looks bleach doesn't do a great job of penetrating tissue so the hope is to destroy the prions before they get into the cut, which seems more hopeful than effective to me.
MisterTea 5y ago
> Does bleach even affect proteins? Isn't that protocol for an organism you're afraid of? Yes, bleach's direct action is attacking proteins: https://phys.org/news/2008-11-household-bacteria.html https://phys.org/news/2008-11-household-bacteria.html
COGlory 5y ago
>A 5-minute soak in a 40% solution of household bleach decontaminated stainless steel wires coated with chronic wasting disease (CWD) prions, according to a new study by National Institutes of Health scientists. https://www.nih.gov/news-events/news-releases/household-bleach-inactivates-chronic-wasting-disease-prions https://www.nih.gov/news-events/news-releases/household-blea...
- quenix 5y ago
  Holy shit, 5 minutes soaked? That's intense
  - sudosysgen 5y ago
    Well, that is 40% household bleach. We could probably make a solution that disinfects faster.
    - Dah00n 5y ago
      Disinfects a cut thumb faster?
      - sudosysgen 5y ago
        Yes. I wouldn't want to be the one dipping my thumb in 2x household bleach though.
ta988 5y ago
Yes it does destroy them efficiently, it unfolds them (so no more prion effect) and also aggregate them so they can't circulate.
hallway_monitor 5y ago
I was thinking what if she amputated her thumb immediately? It seems like an extreme reaction, but could it have prevented her infection and death?
- bencollier49 5y ago
  Good luck getting that research commissioned! Interesting idea though, and really it'd be a pretty sensible trade-off.
- deleted 5y ago
  [deleted]
- subroutine 5y ago
  That'd be a bold move, considering (1) it may not have helped, and (2) it is possible the thumb incident wasn't how she got infected. It's possible she got infected some other random day in the lab. Maybe she rubbed her eye while wearing a contaminated glove, or breathed in brain flecks through a poor fitting N95, while slicing a particularly dry cryosample.

roflc0ptic 5y ago

yes, bleach kills microorganisms by denaturing their proteins.

Scoundreller 5y ago
And by oxidizing everything else. It’s not denaturation that’s making my clothes white again.
rcxdude 5y ago
Yes, though prions are extremely tough by protein standards (surviving extremely high temperatures and acidity, making them difficult to clean away. Prions have been transmitted from patient to patient through sterilized instruments used in brain surgery)

meepmorp 5y ago

Hypochlorous acid denatures proteins, so yeah.

DoingIsLearning 5y ago
But wasn't there an issue before of prion contamination with surgical instruments used in ophtalmic surgery. I am sure those would have been autoclaved and reprocessed at some ridiculous pH value, no?
- throwaway0a5e 5y ago
  >I am sure those would have been autoclaved and reprocessed at some ridiculous pH value, no? Probably not until they had reason to do so. "Hot acidic environment" is hell when it comes to corrosion and the engineering incentive for medical stuff is only to be as corrosion resistant as you need because there are other design considerations and the most corrosion resistant stainless steels are not the bet fit for building a super precise needle you're gonna poke around in someone's eye so you wind up wanting to pick a middle ground alloy. Picking a middle ground alloy puts a hard limit on what you can do to clean your instruments before you degrade them in unacceptably short order. I don't know how things have changed since. My medical manufacturing experience is out of date and limited.
- persedes 5y ago
  yeah I wouldn't count on prions being as easily denatured as other proteins. E.g. mad cow disease spread because prions are not killed by simply cooking / boiling it.
  - resoluteteeth 5y ago
    Is there some specific reason to think that prions are harder to denature than other proteins? It seems like mad cow disease could also spread simply because meat is not normally cooked to ensure that 100% of the proteins in it are denatured.
    - nebopolis 5y ago
      Prions are essentially already denatured/unfolded. They are a more stable state of a normal protein that has biological function, and they interact with the "correctly" folded proteins to cause them to denature into additional prions. Often denaturing a prion means actually breaking apart the protein into fragments or amino acids, because it is already at the most stable/denatured state. This is also why they are so persistent in nature and so hard to remove from surfaces. Apparently gas plasma sterilization is a promising possibility. (this seems like an ok overview of the challenges: https://pubmed.ncbi.nlm.nih.gov/21271212/ https://pubmed.ncbi.nlm.nih.gov/21271212/). Current procedures include things like autoclaving in 121C sodium hydroxide for 30 minutes. Definitely not something that fully cooking will inactivate.

tedivm 5y ago

Yeah, bleach does affect prions. Most of the studies I could find were tested on metal, not just someone's thumb. It looks bleach doesn't do a great job of penetrating tissue so the hope is to destroy the prions before they get into the cut, which seems more hopeful than effective to me.

MisterTea 5y ago

> Does bleach even affect proteins? Isn't that protocol for an organism you're afraid of? Yes, bleach's direct action is attacking proteins: https://phys.org/news/2008-11-household-bacteria.html https://phys.org/news/2008-11-household-bacteria.html

COGlory 5y ago

>A 5-minute soak in a 40% solution of household bleach decontaminated stainless steel wires coated with chronic wasting disease (CWD) prions, according to a new study by National Institutes of Health scientists. https://www.nih.gov/news-events/news-releases/household-bleach-inactivates-chronic-wasting-disease-prions https://www.nih.gov/news-events/news-releases/household-blea...

quenix 5y ago
Holy shit, 5 minutes soaked? That's intense
- sudosysgen 5y ago
  Well, that is 40% household bleach. We could probably make a solution that disinfects faster.
  - Dah00n 5y ago
    Disinfects a cut thumb faster?
    - sudosysgen 5y ago
      Yes. I wouldn't want to be the one dipping my thumb in 2x household bleach though.

ta988 5y ago

Yes it does destroy them efficiently, it unfolds them (so no more prion effect) and also aggregate them so they can't circulate.

hallway_monitor 5y ago

I was thinking what if she amputated her thumb immediately? It seems like an extreme reaction, but could it have prevented her infection and death?

bencollier49 5y ago
Good luck getting that research commissioned! Interesting idea though, and really it'd be a pretty sensible trade-off.
deleted 5y ago
[deleted]
subroutine 5y ago
That'd be a bold move, considering (1) it may not have helped, and (2) it is possible the thumb incident wasn't how she got infected. It's possible she got infected some other random day in the lab. Maybe she rubbed her eye while wearing a contaminated glove, or breathed in brain flecks through a poor fitting N95, while slicing a particularly dry cryosample.