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vCJD spread in blood transfusions



Transfer of vCJD by blood transfusion is being taken seriously in UK. In
spite of the evidence of spread in blood USDA still allows use of blood
meal in cattle feed. That threatens cows with BSE and farm hands with
vCJD through exposure to blood in cuts and lesions along with breathing
dust from cattle feed. USDA's crazed indifference is perplexing. Do they
patent blood meal diets along with GM crops?
Patient's death from vCJD may be linked to blood transfusion

Committee to discuss need for further precautions to prevent possible
vCJD transmission through blood

Stephen Pincock

The Lancet
Volume 363, Issue 9402 , 31 December 2003, Page 43


News that a UK patient died from variant Creutzfeldt-Jakob disease
(vCJD) after receiving blood from a donor who later died from the
condition has raised concerns that vCJD could be transmitted via
transfusion.

UK health minister John Reid told parliament on Dec 17 that the patient
died in autumn this year and a post-mortem in December confirmed the
diagnosis of vCJD.

In 1996, the patient had received a transfusion of blood from a donor
who was, at the time, free of signs of vCJD but developed the condition
in 1999 and later died.

"It is therefore possible that the disease was transmitted from donor to
recipient by blood transfusion", Reid said. "This is a possibility, not
a proven causal connection."

It is also possible that both individuals separately acquired vCJD by
eating meat or meat products that were infected with bovine spongiform
encephalopathy, he said.

This is the first report of possible vCJD transmission through blood.
Nevertheless, health agencies in the UK and elsewhere have long
considered this eventuality.

In the USA and other countries, for example, there are restrictions on
blood donation by people who have spent time in the UK since the disease
first surfaced.

Since 1999, leucodepletion of donated blood has been practised in the
UK, and all blood products have been made using plasma imported from the
USA. In December last year, the UK government spent nearly £50 million
(US$88 million) buying Life Resources Incorporated––the largest
remaining independent US plasma collector––to ensure plasma and
plasma-related products were derived from sources outside the UK.

As recently as October this year, the UK government's Advisory Committee
on the Microbiological Safety of Blood and Tissues for Transplantation
said it was not necessary to stop people who have received a blood
transfusion from giving blood.

"However, in the light of today's statement, we have asked that
committee to look comprehensively at whether further precautionary
measures could be taken that would not adversely impact on the safety or
availability of blood", Reid said. This further investigation is being
overseen by the Chief Medical Officer, Liam Donaldson.

At this early stage it is not clear exactly what precautions the
committee will focus on, a Department of Health spokesman told The Lancet.

Stephen Dealler, a microbiologist at Lancaster Royal Infirmary,
suggested the possibilities could include offering self-transfusion,
considering prophylaxis with pentosan polysulphate, using techniques to
clean prions from plasma, and developing tests to detect prions in blood.

"I think within a few years we'll get somewhere with that", he said of
such tests. There are many companies involved in that field, and with
the right support, "it's possible we'll get there much sooner", he told
The Lancet.

Donaldson distributed Reid's speech to doctors across the country on the
day it was made, noting "you may get patients coming to you with
questions relating to this".

The UK is generally regarded internationally as having a "very safe"
blood service, Reid stressed. The National Blood Service responded to
the health minister's statement by reiterating how vital it was that
donors continue to come forward to donate blood, which is already in
short supply.

"It is important to balance the unknown risk of contracting vCJD through
a blood transfusion against the risk of a patient not receiving the
blood transfusion they require", the blood service said in a statement.

The spread of vCJD in the UK has not reached the scale that some had
feared it might: as of Dec 1, there have been 143 cases of definite or
probable vCJD (see also p 51–61), and over the past 3 years, the number
of new cases has fallen year on year.

15 patients in the UK are known to have received blood donated by people
who later developed vCJD. They are being contacted and will be told
about the circumstances of their case and have the opportunity for
counselling, Reid said.

Thousands of patients who received blood products from donors before
plasma was imported from the USA are also likely to be contacted.
However, Reid said the CJD incidents panel considered the risk for these
patients was "even lower than for those who received whole blood".

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