- Hello Jeff - The last case in the below update is really
interesting. A wife and sister-in-law die within 2 years of each other
from sporadic CJD. The update also includes more on risk of transmission
of CJD via blood.
-
- Patricia Doyle
-
- In this update:
- [1] UK DOH vCJD Monthly statistics - October 2004
- [2], [3], [4] & [5] Potentially Contaminated Blood
Products
- [5] Sporadic CJD Cases
-
- ******
- [1]
- Date: Fri 8 2004
- From: ProMED-mail
- Source: UK Department of Health, monthly
Creutzfeldt-Jakob
disease
- statistics, 2004/0354, Wed 6 Oct 2004 [edited]
- http://www.dh.gov.uk/PublicationsAndStatistics/
- PressReleases/PressReleasesNotices/fs/en?
- CONTENT_ID=4090176&chk=phom3p
-
-
- [Now that the incidence in the UK of variant
Creutzfeldt-Jakob
Disease -- abbreviated as CJD (new var.) or vCJD in ProMED-mail -- shows
evidence of having peaked, or, at least of having reached a plateau, the
Department of Health's full table of definite and probable CJD deaths and
referrals will no longer be reproduced in ProMED-mail. Only the monthly
summary of variant CJD statistics will be posted, unless there is a
substantial
change in the situation. The full table, updated monthly, can be accessed
at the Department of Health website:
- http://www.dh.gov.uk/assetRoot
- /04/08/35/86/04083586.pdf.
-
- The precise definition of the terms deaths, definite
cases, probable vCJD
- cases, and, the case definitions can be found by
accessing
the Department
- of Health web-site, or by referring to a previous
ProMED-mail
post in this
- thread (for example, CJD (new var.) - UK: update Mar
2002 20020305.3693) -
- Mod.CP]
-
- Monthly variant Creutzfeldt-Jakob disease statistics
as of Mon 4 Oct 2004
- ----------------------------------------------------
- The Department of Health is today [Wed 6 Oct 2004]
issuing
the latest information about the numbers of known cases of
Creutzfeldt-Jakob
disease. This includes cases of variant Creutzfeldt-Jakob disease (vCJD),
the form of the disease thought to be linked to BSE. The position is as
follows:
-
- Definite and probable CJD cases in the UK:
-
- Summary of vCJD cases - deaths
- ------------------------------
- Deaths from definite vCJD (confirmed): 104
- Deaths from probable vCJD (without neuropathological
confirmation): 38
- Deaths from probable vCJD (neuropathological confirmation
pending): 2
- Total number of deaths from definite or probable vCJD
(as above): 144
-
- Summary of vCJD cases - alive
- -----------------------------
- Number of probable vCJD cases still alive: 5
-
- Total
- -----
- Number of definite or probable vCJD (dead and alive):
149
-
- (The next update will be published on Mon 1 Nov
2004)
-
- [Since the previous monthly statistics were released
on Mon 6 Sep 2004, the number of deaths from probable vCJD
(neuropathological
confirmation pending) has increased by 2, raising the total number of
deaths
from definite or probable vCJD to 144. The number of probable vCJD cases
still alive remains at 5. Therefore the overall total number of definite
or probable vCJD cases now becomes 149. - Mod.CP]
-
- ******
- [2]
- Date: Wed 22 Sep 2004
- From: Pablo Nart
- Source: BBC News online, Tue 21 Sep 2004 [edited]
-
- UK - Thousands Warned Over vCJD Rrisk
-
- Thousands of people are to receive letters warning them
they may have been exposed to vCJD through contaminated blood products.
The CJD Incidents Panel says about 4000 in the UK, mostly haemophiliacs,
are thought to be at risk. The patients may have received blood products,
such as clotting agents, from donors who subsequently developed vCJD. But
the government is stressing the risk is very low, and relates to people
exposed to blood products before 1999, when precautions were brought
in.
-
- 9 donors have been identified as having developed vCJD
after giving blood. Their donations would have gone into plasma pools that
would have been diluted by thousands of other donations. The CJD Incidents
Panel said this diluting would reduce the risk of contamination. In total,
6000 letters are to be sent out informing patients of the risk assessment
-- although only 2/3 are being told they may be at direct risk. There is
no test for the brain-wasting disease, so those at risk have no way of
knowing whether they have vCJD. In addition to haemophiliacs, a small
number
of people with immune system disorders will receive the letters.
-
- Government scientists say more work is needed to
determine
the exact risk each individual has been exposed to. But those at risk will
be told not to donate blood, and to inform doctors and dentists if they
undergo treatment in the future in a bid to stop further onward
transmission.
Professor Don Jeffries, acting chair of the CJD Incidents Panel, said:
"In the interests of public safety, we have been advised to take the
most precautionary measure."
-
- Sir Liam Donaldson, the chief medical officer, said the
risk needed to be looked at in context of the exposure the public has had
to BSE in the 1980s and 1990s through meat. "The entire population
of the UK was exposed to a massive risk of vCJD through eating
[BSE-contaminated]
products." And Professor Noel Gill, of the Health Protection Agency,
which is coordinating the informing of patients, said: "The bottom
line is that we are taking this precaution to minimise patient-to-patient
transmission. The price of that is that a number of patients get a letter
saying they could be at risk. This is clearly quite an overwhelming piece
of information to come to them."
-
- Health secretary John Reid launched the review of vCJD
infection risk in December 2003 after announcing that a person had died
from the human form of BSE after receiving blood from a donor who later
developed the disease. A 2nd person who had received a blood transfusion
has subsequently died from other causes but had signs of vCJD in the
spleen.
The government has already identified 17 people who received blood
transfusions
from people who went on to develop vCJD. 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 are thought to carry the greatest risk of transmitting the disease,
have been removed from all blood used for transfusion since 1999.
-
- And blood products have been prepared from plasma
imported
from the US since 1998. Graham Whitehead, the chief executive of the
Haemophilia
Society, said the news would cause anxiety, especially in the wake of HIV
and hepatitis C infection from blood products. But he said it must be put
in context. "It is very reassuring that no-one in the world with
haemophilia
has been diagnosed with vCJD."
-
- Any person with concerns can ring a dedicated NHS Direct
helpline on 0845 850 9850 for England and Wales, and NHS 24 on 0845 4242424
in Scotland and Northern Ireland.
-
- http://news.bbc.co.uk/go/em
- /fr/-/1/hi/health/3675470.stm
-
- --
- Pablo Nart
- p.nart@ntlworld.com
-
- ******
- [3]
- Date: Thu 23 Sep 2004
- From: ProMED-mail
- Source: Eurosurveillance Weekly, Vol. 8, Issue 39, 23
Sep 2004 [edited]
-
- vCJD And Plasma Products -
- Implementation Of Public Health Preecautions In The
UK
- By Anna Molesworth (anna.molesworth@hpa.org.uk), Helen
Janecek, Noel Gill, Nicky Connor, Health Protection Agency Communicable
Disease Surveillance Centre, London, United Kingdom
-
- The CJD Incidents Panel (CJDIP), a United Kingdom expert
committee set up to advise on the management of "incidents" of
potential transmission of Creutzfeldt-Jakob disease) between patients,
has issued recommendations on the management of variant CJD (vCJD) risk
from implicated plasma products. To date, 9 UK plasma donors are known
to have developed vCJD. Collectively, they made 23 plasma donations. The
donated plasma was used to manufacture factor VIII, factor IX,
antithrombin,
intravenous immunoglobulin G, albumin, intramuscular human normal
immunoglobulin,
and anti-D.
-
- The potential risk of vCJD infection following treatment
with any implicated plasma products, on top of the risk from dietary
exposure
to the bovine spongiform encephalopathy (BSE) agent, is very uncertain.
So far, there are no recorded instances of vCJD being spread through
surgery,
nor have there been any cases among recipients of plasma products sourced
from individuals who later developed vCJD. In December 2003, the death
from vCJD of a person some years after receiving a blood transfusion from
a donor who had died of vCJD was announced (1). In July 2004 a 2nd probable
case of transfusion-associated vCJD infection was identified (2). These
2 events have increased concern about the potential infectivity of blood
and plasma products.
-
- The CJDIP now recommends that certain special public
health precautions need to be taken for some recipients of UK-sourced
plasma
products that were manufactured using donations from individuals who
subsequently
developed vCJD. This is in order to reduce any possible risk of iatrogenic
transmission of vCJD.
-
- The CJDIP has used a vCJD blood risk assessment,
- (http://www.dnv.com/consulting/news_consulting
- /RiskofInfectionfromvariantCJDinBlood.asp),
- together with information on how the particular batches
of plasma products were manufactured, to assess the potential levels of
infection that patients were exposed to.
-
- The CJDIP advises certain special public health
precautions
need to be taken for recipients of UK sourced plasma products who have
been exposed to a 1 per cent or greater potential additional risk of vCJD
infection, as these patients could pose a risk to others in defined
circumstances.
These at-risk patients are asked: (a) not to donate blood, organs or
tissues,
(b) to inform their clinician if they need medical, surgical or dental
treatment, so that infection control precautions can be taken to reduce
any possible risk of spreading vCJD, and to consider informing their
family,
in case they (the patients) need emergency surgery in the future
http://www.advisorybodies.doh.gov.uk/acdp/tseguidance/.
-
- The CJDIP has categorised each batch of implicated plasma
products according to the likelihood that special public health precautions
need to be taken as follows: (a) High: the amount of potential infectivity
in product batches was high enough to warrant special public health
precautions
following the administration of a very small dose. These batches should
be traced, and the recipients advised of their exposure and asked to take
special public health precautions. (b) Medium: substantial quantities of
the material in question would need to have been administered to warrant
special public health precautions. Efforts should be made to trace these
batches and assess the additional risk to individual recipients to
determine
whether pecial precautions should be taken. (c) Low: the potential
additional
risk to recipients is considered negligible. These batches do not need
to be traced and the individual recipients do not need to be
informed.
-
- This categorisation is based on very cautious
assumptions,
and the uncertainties underlying the assessment of 'risk' are great. The
CJDIP guidance is to limit any possible iatrogenic human-to-human
transmission
of vCJD. It should NOT be interpreted as an estimate of an individual
patient's
additional risk of developing vCJD, which is uncertain, and likely to be
very low.
-
- The patients who may be affected include some with
bleeding
disorders, some patients with primary immunodeficiency (PID), and some
patients with other conditions, who may include, for example, patients
with secondary immunodeficiencies, certain neurological and autoimmune
conditions, plasma exchange recipients and patients with severe burns,
and with some other conditions requiring critical care. Patients in the
UK who are 'at-risk' of vCJD for public health purposes are being contacted
by their doctors and informed of the precautions they will need to
take.
-
- The product manufacturers are providing details to
individual
countries to which parts of batches with a 'High' or 'Medium' likelihood
that public health precautions might be required were exported. The UK
Department of Health and the Health Protection Agency are providing further
details to authoritative bodies in these countries as well as to the
European
Commission and WHO. The Health Protection Agency's (HPA) CJD section at
the Communicable Disease Surveillance Centre is coordinating the patient
notification in England, Wales, and Northern Ireland. The Scottish Centre
for Infection and Environmental Health (SCIEH) is coordinating this
notification
in Scotland. Background information about vCJD with useful links is
available
from their websites: HPA:
-
- http://www.hpa.org.uk/infections
- /topics_az/cjd/menu.htm; SCIEH:
-
- http://www.show.scot.nhs.uk/scieh.
-
- References
- ----------
- (1) Llewelyn CA, Hewitt PE, Knight RS, Amar K, Cousens
S, Mackenzie J, et al. Possible transmission of variant Creutzfeldt-Jakob
disease by blood transfusion. Lancet 2004; 363: 417-21.
-
- (2) Peden AH, Head MW, Ritchie DL, Bell JE, Ironside
JW. Preclinical vCJD after blood transfusion in a PRNP codon 129
heterozygous
patient. Lancet 2004; 364: 527-9.
-
- (byline: Anna Molesworth (anna.molesworth@hpa.org.uk),
Helen Janecek, Noel Gill, Nicky Connor, Health Protection Agency
Communicable
Disease Surveillance Centre, London, United Kingdom)
-
- ******
- [4]
- Date: Mon 27 Sep 2004
- From: ProMED-mail
- Source: The Times of India, Mon 27 Sep 2004
[edited]
-
- India: Tainted Blood Products Received From The UK
-
- Britain has exported blood products that could be
contaminated
with the human form of mad cow disease to at least 11 countries, including
India, raising fears of further transmission of the deadly condition, a
leading daily reported on Mon 27 Sep 2004.
-
- Officials last week contacted 5 of the countries
identified
as most at risk from the imported blood products, which were donated by
9 people who died from variant Creutzfeldt-Jacob disease (vCJD), The Times
reported. However, the government has been accused of "lethal
secrecy"
after refusing to identify publicly the 5 nations which have been the
subject
of risk assessments by the Health Protection Agency. The exports of the
suspect products were effected in the late 1990s. The warnings have been
issued after 2 British cases discovered in the past year in which people
are thought to have contracted the brain-wasting disease from blood
transfusions.
-
- Besides India, where 953 vials of albumin were sent,
the other 10 recipient countries are Ireland (polio vaccine, 83 500 doses),
Brazil (44 864 vials albumin, 80 vials immunoglobulin), Dubai (UAE)(2400
vials albumin), Turkey (840 vials immunoglobulin), Brunei (400 vials
albumin),
Egypt (144 vials albumin), Morocco (100 vials albumin), Oman (100 vials
immunoglobulin), Russia (23 vials factor VIII) and Singapore (3 vials
immunoglobulin).
-
- http://timesofindia.indiatimes.com
- /articleshow/865692.cms
-
-
- ******
- [5]
- Date: Mon 27 Sep 2004
-
- Source: Yahoo News, UK, Mon 27 Sep 2004 [edited]
- http://uk.news.yahoo.com/040927/323/f3d3q.html
-
- Britain Exported Potentially Dangerous Blood
Products
-
- The United Kingdom has exported to "at least 11
countries" blood products at risk of contamination with the prion
responsible for variant Creutzfeldt-Jakob Disease (vCJD), the human form
of mad cow disease, The Times reports. The blood plasma products resulted
from donations by 9 people who later died of the incurable disease.
-
- The countries, in order of the number of samples sent,
are Singapore (3 samples), Russia (23), Oman (100), Morocco (100), Egypt
(144), the sultanate of Brunei (400), Turkey (840), India (953), Dubai
(2400), Brazil (44 864) and Ireland (83 500). Five of these countries were
warned by Britain's sanitary services, The Times said, but the daily did
not know which. Last week letters went out to 6000 patients in Britain,
most of them haemophiliacs, who may have been exposed to vCJD through blood
plasma products.
-
- According to health ministry figures, 141 [144 as of
4 Oct 2004] people are known to have died in Britain from vCJD, a spongy
deterioration of the brain causing personality change, loss of body
function,
and eventually death. Cases of the disease peaked in 2000, when 28 deaths
were reported. Since then the trend has been generally downward, with 17
cases in 2002 and 18 last year. In May government-funded scientists
estimated
3800 people in Britain could be harbouring the human form of mad cow
disease
without knowing it.
-
- ******
- [6]
- Date: Sun 3 Oct 2004
- From: ProMED-mail <promed@promedmail.org
-
- UK- Wife And Sister Of Man Die Of Sporadic
CJD
By Helen Morgan
The Scotsman
10-3-4
-
- A man today described the deaths of his wife and sister
from Creutzfeldt-Jakob Disease (CJD) as a "horrific coincidence".
The man's wife, from Walham Green, Sandhurst, Gloucestershire, died last
month after battling the sporadic form of the brain disease for 9
months.
-
- The man's sister died 2 years ago after contracting the
same form of the disease. Both women were 67 when they died. They were
both treated in the same ward in the Gloucestershire Royal Hospital. His
wife's walking was first affected before her memory started to go. He said
latterly she got very angry and violent due to her frustration at the
disease.
-
- Her husband, a retired fitter who is 70, said: "I
feel terrible. I can't believe it. I feel completely in the dark and have
no idea whatsoever why they died." CJD Support Network co-ordinator
Gill Turner said there was one in a million cases of this form of the
disease.
She said every case of the disease is looked at by the CJD incident panel
and believed the findings of these deaths would be "very
interesting".
"The likelihood of such close non-blood relatives getting CJD would
be very unusual," she added.
-
- According to the CJD Surveillance Unit in Edinburgh,
993 people have died of all forms of CJD in Britain between 1990 and 2004.
Some 740 of those deaths were attributed to sporadic CJD, the most common
form of the disease.
-
- http://news.scotsman.com/latest.cfm?id=3572329
-
- ProMED-mail
-
- Patricia A. Doyle, PhD
- Please visit my "Emerging Diseases" message
board at:
- http://www.clickitnews.com/ubbthreads
- /postlist.php?Cat=&Board=emergingdiseases
- Zhan le Devlesa tai sastimasa
- Go with God and in Good Health
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