Another UK Patient May Have Caught vCJD From Blood

[CVX]

CIDRAP News) -- A second possible case of transmission of variant Creutzfeldt-Jakob disease (vCJD) via blood transfusion has been reported in the United Kingdom, triggering new restrictions on who can give blood.

The UK Department of Health announced, "A patient in the UK received a blood transfusion in 1999 from a donor who later went on to develop vCJD. The patient died of causes unrelated to vCJD but a post mortem revealed the presence of the vCJD agent in the patient's spleen."

The department said it had expected to see further cases after the first case of possible transmission via donated blood was reported in the UK in December 2003. The second case is "of particular scientific interest" because the patient had a different genetic type from that of other vCJD patients so far, the announcement said. A detailed report of the case will be published in The Lancet.

The official statement provided no details about the patient who received the blood transfusion.

As a result of the first possible transfusion-related vCJD case, the UK in April stopped taking blood donations from anyone who had received a blood transfusion since January 1980. Starting Aug 2, the department said, donations will not be accepted from people who are unsure if they have had a transfusion since January 1980. This includes apheresis donorsóthose who frequently give blood and have it retransfused after the removal of certain components.

This group was not excluded in April because the government wanted to assess the impact of the new restrictions on the blood supply, officials said. Now it appears that the impact is small, so the committee that oversees blood safety recommended adding the new restriction.

Health Secretary John Reid stated, "I would emphasise again that the exclusion criteria are being tightened because of a small but unquantifiable risk. People should continue to have a blood transfusion when it is really necessary. Any slight risk associated with receiving blood must be balanced against the significant risk of not receiving that blood when it is most needed."

The UK uses several other precautions to protect the blood supply from vCJD infectivity, the Department of Health noted. Since 1997, new cases of vCJD have triggered a search for and destruction of any blood donated by the patient. Since 1998 the UK has used blood plasma from the United States to produce all plasma derivatives. And since October 1999, white blood cells, which may pose the greatest risk of transmitting vCJD, have been removed from blood used for transfusions.

When the first possible transfusion-linked case was reported, officials said the patient had received blood in 1996 from a donor who became ill with vCJD in 1999. The recipient had died of the disease shortly before the suspected case was announced. But officials said the recipient might have acquired vCJD in the usual way: by eating meat products from cattle infected with bovine spongiform encephalopathy (BSE), or mad cow disease. BSE spread through British cattle herds in the 1980s and 1990s.

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