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ZERO Doubt CJD Spread Via
Blood And Blood Products

From Patricia Doyle, PhD
dr_p_doyle@hotmail.com
9-10-4
 
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
 
[2]
 
From: ProMED-mail <promed@promedmail.org>
 
Patients To Be Alerted To Variant Creutzfeldt-Jakob disease risk
 
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 [2003], 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."
 
http://news.bbc.co.uk/1/hi/health/3610096.stm
 
 
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 [2004], 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 [1] 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 samples.
 
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."
 
http://www.sundayherald.com/44447
 
 
--
ProMED-mail
promed@promedmail.org
 
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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Cat=&Board=emergingdiseases
Zhan le Devlesa tai sastimasa
Go with God and in Good Health
 

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