Statement of Principles
concerning
 
CREUTZFELDT-JAKOB DISEASE
No. 77 of 2014
 
for the purposes of the
 
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
Title
1.         This Instrument may be cited as Statement of Principles concerning Creutzfeldt-Jakob disease No. 77 of 2014.
Determination
2.         The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)        revokes Instrument No. 35 of 2004 concerning Creutzfeldt-Jakob disease; and
(b)        determines in its place this Statement of Principles.
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about Creutzfeldt-Jakob disease and death from Creutzfeldt-Jakob disease.
(b)               For the purposes of this Statement of Principles, "Creutzfeldt-Jakob disease", also known as CJD, means a spongiform encephalopathy characterised by an accumulation of abnormal prion protein in the brain.  This definition includes classical and variant Creutzfeldt-Jakob disease.
(c)                Creutzfeldt-Jakob disease attracts ICD-10-AM code A81.0.
(d)       In the application of this Statement of Principles, the definition of "Creutzfeldt-Jakob disease" is that given at paragraph 3(b) above.
Basis for determining the factors
4.         On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that Creutzfeldt-Jakob disease and death from Creutzfeldt-Jakob disease can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
Factors that must be related to service
5.         Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.
Factors
6.         The factor that must exist before it can be said that, on the balance of probabilities, Creutzfeldt-Jakob disease or death from Creutzfeldt-Jakob disease is connected with the circumstances of a person’s relevant service is:
(a)               receiving treatment involving a specified human tissue or product at least six months before the clinical onset of Creutzfeldt-Jakob disease; or
(b)               undergoing neurosurgery at least six months before the clinical onset of Creutzfeldt-Jakob disease; or
(c)               for variant Creutzfeldt-Jakob disease only,
(i)                 receiving blood or blood products from a person infected with variant Creutzfeldt-Jakob disease at least three years before the clinical onset of Creutzfeldt-Jakob disease; or
(ii)               consuming beef or a beef product from an area or country with evidence of bovine spongiform encephalopathy infection in cattle at the time of consumption, where the beef or beef product was consumed at least three years before the clinical onset of Creutzfeldt-Jakob disease.
Inclusion of Statements of Principles
7.                  In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.
Other definitions
8.                  For the purposes of this Statement of Principles:
"a beef product" means food prepared from or containing beef;
"a specified human tissue or product" means:
(a)               a corneal transplant;
(b)               cadaveric human pituitary hormones; or
(c)               human dura mater as a graft or in radiographic embolisation procedures;
"blood products" means biopharmaceutical products made from human blood;
"bovine spongiform encephalopathy", also known as mad cow disease, means a neurodegenerative disease of cattle caused by consumption of prion-contaminated meat or bone meal;
"death from Creutzfeldt-Jakob disease" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s Creutzfeldt-Jakob disease;
"ICD-10-AM code" means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), Eighth Edition, effective date of 1 July 2013, copyrighted by the Independent Hospital Pricing Authority, and having ISBN 978-1-74128-213-9;
"relevant service" means:
(a)        eligible war service (other than operational service) under the VEA;
(b)        defence service (other than hazardous service and British nuclear test defence service) under the VEA; or
(c)        peacetime service under the MRCA;
"terminal event" means the proximate or ultimate cause of death and includes:
(a)                pneumonia;
(b)               respiratory failure;
(c)                cardiac arrest;
(d)               circulatory failure; or
(e)                cessation of brain function;
"variant Creutzfeldt-Jakob disease" means a form of Creutzfeldt-Jakob disease which is characterised by a younger age at onset, a more protracted clinical course, more sensory disturbances and more psychiatric symptoms than classical Creutzfeldt-Jakob disease, as well as a marked accumulation of abnormal prion protein and florid amyloid plaques in the brain tissue.
Application
9.         This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.
Date of effect
10.       This Instrument takes effect from 22 September 2014.
Dated this   twenty-second   day of   August   2014
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed at the direction of:          )
PROFESSOR NICHOLAS SAUNDERS AO
CHAIRPERSON