- Jeff - We've been warning your listeners and readers
for years about the risk of CJD in blood.
- Meanwhile, we've seen article after article in which
'scientists' would have us believe that infective prions are not in the
blood and that there might only be a chance for theoretical risk of transmission.
- After reading the following, there should be no doubt
that CJD/Mad Cow spreads vis blood.
- Patricia Doyle
- From: ProMED-mail <firstname.lastname@example.org>
- Patients To Be Alerted To Variant Creutzfeldt-Jakob disease
- BBC News Online
- Sun 29 Aug 2004
- Patients who received blood products from donors who
subsequently died from variant Creutzfeldt-Jakob disease [abbreviated as
CJD (new var.) or vCJD in ProMED-mail] are to be warned that they could
be carrying the brain wasting disease. The measures are being taken after
it emerged, last year , that a patient had died following a transfusion
from someone with the human form of mad cow disease. The case was thought
to be the 1st person-to-person vCJD transmission. Only patients who received
blood products before 1999, when new rules and procedures were introduced,
are at risk.
- Since 1997, all cases of vCJD that are reported to the
National CJD Surveillance Unit, and diagnosed as having "probable"
vCJD, are passed on to the National Blood Service, which searches its blood
donor records. If the patient has given blood, any stocks of that blood
are immediately destroyed. White blood cells, which it is thought may carry
the greatest risk of transmitting the disease, have been removed from all
blood used for transfusion since 1999. And, blood products, such as clotting
factors, have been prepared from plasma imported from the US since 1998.
- Health Secretary Dr. John Reid said that the new measures
to prevent the possible spread of vCJD would include an assessment of blood
products used before 1999, and, informing anyone who received blood products
from donors who later died of vCJD. He said: "Many more patients of
course, including hemophiliacs, will have received plasma products before
plasma was sourced from the US. They will have received products derived
from large pools of plasma donated from many thousands of people and thus
heavily diluted. The UK-wide CJD Incidents Panel considers the risks for
this group to be even lower than for those who received whole blood.
- It is very difficult to trace all individual recipients
of products made from these plasma pools. However, the CJD Incidents Panel
will be advising, on a case-by-case basis, which recipients will need to
be contacted, as the necessary information becomes available."
- Patients will be informed in September 2004, after the
Health Protection Agency has carried out the risk assessment. It is understood
that letters will be sent urging each patient to contact a specialist.
But, the Department of Health expressed concern that the results of the
risk assessment exercise be communicated to patients in a sensitive and
appropriate manner directly by the doctors, and other clinicians, who care
for them. A spokesman added: "It would be grossly unfair on the patients
involved to discuss the results of the risk assessment exercise in the
media before patients are informed of the outcome. A full public statement
will be made at the appropriate time."
- Thousands May Have Gotten vCJD Through Blood Transfusions
- The Sunday Herald online
- Sun 29 Aug 2004 [edited]
- Thousands of people who received blood products prior
to 1999, are to be warned that they may be incubating variant Creutzfeldt-Jakob
Disease [abbreviated as CJD (new var.) or vCJD in ProMED-mail], the human
form of mad cow disease [bovine spongiform encephalopathy].
- Health chiefs are to take the unprecedented step of writing
to all those patients who received blood from donors who subsequently died
from the brain- wasting disease. The move, ordered by the Department of
Health in England, is the strongest sign yet that ministers are preparing
for a new epidemic of the disease spread through blood. Until now, they
have always maintained that infection through a transfusion is a "theoretical
risk." The letters are to be sent out to patients, including hundreds
of Scots, at the end of September 2004, after the Health Protection Agency
carried out a risk assessment on UK patients who received blood, or plasma
products, prior to all plasma being sourced from the US in 1999 [1998 according
to the BBC report above. - Mod.JW].
- It is understood that the letters will urge each patient
to contact a specialist. The vCJD risk assessment, 1st announced by Westminster
Health Secretary John Reid in December 2003, was ordered at the time as
a precautionary measure, after a patient, who had received a transfusion
from someone with vCJD, also died of the disease. Although the donor showed
no signs of the condition when giving blood in 1996, the disease developed
in 1999, and, the donor subsequently, died from vCJD. The recipient of
the blood died in the autumn of 2003, and at a post-mortem, vCJD was found
in the brain.
- On 17 Dec 2003, the Health Minister told the Commons
that the case was "not a proven causal connection," but that
"the possibility of this being transfusion-related cannot be discounted."
It was the 1st report in the world to warn of the possible transmission
of vCJD from person to person via blood. In March , he banned blood
donations from anyone who had received a transfusion since 1980 to prevent
vCJD being spread. The Department of Health last night [Sat 28 Aug 2004]
refused to reveal the outcome of the risk assessment, but it is understood
that behind-the-scenes talks have been ongoing with senior health officials
and groups, such as the Haemophilia Society, about the potential outcome
of the exercise. Other categories of patients, such as those with leukemia,
burn victims, and pregnant women, can all be treated with blood products.
But, those most exposed are likely to be hemophiliacs, who use the products
to help their blood to clot.
- The latest figures from the National CJD Surveillance
Unit in Edinburgh show that the number of deaths in the UK definitely or
probably caused by vCJD now stands at 147 (see part  above). However,
news of the Department of Health move has fueled fears of a new epidemic
of vCJD, the human form of BSE, from blood. Scientists have estimated that
almost 4000 people could be harboring vCJD, based on studies of appendix
- A Department of Health spokeswoman said: "We have
asked the HPA to lead on preparations for notifying patients who have received
plasma products, and we have been working with the agency, clinicians'
representatives, and patient groups."
- Dr. Janet Corry (<Janet.Corry@bristol.ac.uk>) has
pointed out, in relation to previous reports of the transmission of vCJD
by blood donation, that it was not mentioned in ProMED-mail, or elsewhere,
that the blood donated to the patient may not have been leucoreduced. White
blood cells are now routinely removed before blood in the UK is transfused,
and leuoreduction would have substantially lowered the risk of infection
in the recipient. The effectiveness of this procedure is described by Greene
et al. in the journal Lancet vol. 364, pp.529-531, 2004).
- Professor Ironside, Director of the UK National CJD Surveillance
Unit in Edinburgh, has commented, in a recent Medscape interview, <http://www.medscape.com/viewarticle/488201>
that leucoreduction was implemented in the U.K. around 1999 because of
concerns about potential infectivity of vCJD in blood, or in blood components.
Leucoreduction has been used in other countries for other purposes, as
it does eliminate other cells associated with infections (e.g. cytomegalovirus),
and so it has other benefits. The effectiveness of this step was not known
at the time it was introduced. A number of recent studies have suggested
that, although leucoreduction basically may have some benefit in reducing
prion infectivity, it will not necessarily remove infectivity completely,
indicating that there is a need to look at other potential measures which
might help achieve this result. - Mod.CP
- Patricia A. Doyle, PhD
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