Fichet et al. 2004, Novel methods for disinfection of prion-contaminated medical devices (Lancet)

This is a laboratory paper from a French CEA group with two STERIS co-authors, published in The Lancet on 7 August 2004, that tested how well several chemical and physical treatments inactivate prions on instruments. The team contaminated small stainless steel wires with brain material from hamsters infected with scrapie strain 263K, treated them, then placed the wires in animal brains to measure remaining infectivity. Sodium hydroxide, sodium hypochlorite and autoclaving at 134 C in water cut infectivity by more than 5.6 log10, while milder routes (a phenolic disinfectant, an alkaline cleaner, an enzymatic cleaner followed by vaporised hydrogen peroxide) also worked, and the authors proposed them for equipment that cannot take harsh methods. STERIS announced a prion detergent for the UK the day before publication and tied it to this work. Only the abstract was read, so detailed numbers are unchecked. Information only, not infection control advice.

Key facts

  • Bibliographic record: Lancet 2004;364(9433):521-526, issue dated 7 to 13 August 2004, DOI 10.1016/s0140-6736(04)16810-4, PMID 15302195; no grant is listed.
  • Ten authors: Fichet, Comoy, Duval, Antloga, Dehen, Charbonnier, McDonnell, Brown, Lasmezas and Deslys. The record gives an affiliation only for the first author, the CEA site at Fontenay-aux-Roses.
  • Model: stainless steel wires contaminated with hamster-adapted scrapie 263K, with an animal implantation readout, plus a laboratory surface-contamination protocol built to study how decontamination works.
  • Standard methods (sodium hydroxide, sodium hypochlorite, autoclaving at 134 C in water) reduced infectivity by more than 5.6 log10; autoclaving without water immersion gave about 4 to 4.5 log.
  • Three gentler treatments were also effective: a phenolic disinfectant, an alkaline cleaner, and an enzymatic cleaner followed by vaporised hydrogen peroxide. Vaporised hydrogen peroxide alone gave about 4.5 log and suits electronics.
  • The authors proposed new procedures for surgical instruments and for surfaces that tolerate neither strong alkali, chlorine nor repeated high-temperature cycles.
  • STERIS said on 6 August 2004 that research it took part in showed several of its technologies inactivate prions, published in the Lancet of 7 August, and launched Hamo 100 PID in the UK. The release names no researchers and gives no numbers.
  • Europe PMC counted 125 citing records when read, including 2020 to 2026 work on vaporized hydrogen peroxide, newer disinfectants and sterilization kinetics.
  • The same STERIS and CEA SEPIA team (Fichet, Antloga, Comoy, Deslys, McDonnell) published a 2007 follow-up on gaseous hydrogen peroxide in the Journal of Hospital Infection, reporting activity in vitro and in vivo.
  • Later reviews treat the wire model as a standard tool but question how far it predicts safety for specific devices such as flexible endoscopes.

Timeline

  1. 2004STERIS press release announces the UK launch of Hamo 100 PID and cites the forthcoming Lancet paper.
  2. 2004Paper appears in The Lancet 364(9433).
  3. 2007Follow-up on gaseous hydrogen peroxide sterilisation by Fichet and colleagues, J Hosp Infect 67(3):278-286.
  4. 2020Kampf and colleagues review endoscope reprocessing policies and discuss the wire model; Stevenson and colleagues publish a UK modelling review of interventions against surgical CJD transmission.
  5. 2023Schwenke and colleagues (Robert Koch Institute) report that 5 minutes at 134 C substantially lowers CJD seeding activity under stated conditions.
  6. 2026Paper still appears among newly published citing records, for example a J Gen Virol study of a two-step method for sporadic prions.

Last checked 1 November 2026

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