About ten years or so ago, it was found that heat sterilization didn't kill prions, therefore it could still be present on surgical instruments after heat sterilization. There is a combination of chemical and heat that is termed "somewhat effective," that is how most facilities sterilize now I think, there is radiation sterilization too (don't know if it is used commonly). Last I read, prions were somewhat an anomaly in that they are not technically alive.

Kurt Vonnegut's fictional substance "Ice 9" is used as a model to show how prions unfold and seed other cells.