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vCJD may have been passed on in blood

January 29, 2002 The Guardian (London) by James Meikle
Twenty-two people who unknowingly received blood donations from victims of the human form of BSE are to be told that they may have been infected with the fatal disease.

Blood services have always been aware of their identity but took the decision not to inform them unless they tried to give blood themselves because there is no test, no cure and no treatment for the condition. But the policy is to change because of the potential public health dangers if those who have received the blood were to have surgery, donate organs or need serious dental treatment. The 22 people received blood from eight donors who were subsequently diagnosed with vCJD, a disease that has so far killed or incurably infected 113 Britons.

The risk of infection from the blood donations is unquantified.

The patients' GPs or other doctors caring for them will probably be given the task of imparting the information which government advisers have described as "burdensome and of little overall benefit to the individuals themselves. It might additionally result in practical difficulties, eg, insurance."

The individuals will be told that the risk to which they have been exposed is not known, although they will be ranked in the high-risk category of patients, which includes those who might have been exposed to accidental infection through blood or contaminated surgical instruments.

Experts in the disease will advise doctors on giving the bad news.

The individuals will be asked to collaborate with medical authorities and advised not to try to donate blood or organs and to tell doctors if they are about to undergo medical, optical or dental surgery. Special precautions are already taken with relatives of known vCJD victims.

There is some concern among ethical and medical advisers to the government that the responsibility for informing medical authorities would lie principally with those at risk and government officials accept that under current proposals, there will be no powers to compel them to do so.

The recipients of potentially infected blood will be the first group of high-risk patients to be informed, partly because so much is known about them.

Others at risk include patients who underwent brain or eye surgery shortly after someone who was later discovered to have vCJD.

The risk of contamination through surgical instruments is said to fall considerably as equipment is repeatedly sterilised, although no current procedures can completely remove traces of the rogue prion thought to be involved in spreading the disease.

For that reason, not everyone who has undergone surgery with potentially contaminated equipment will be automatically told about potential exposure.

But patients who fear that they might have been exposed but have not been officially informed will be able to ask whether they are on a new national database of people exposed to potential hazard.

Current ethical guidance has suggested there is no benefit to patients knowing they might have been accidentally infected with vCJD while leaving it open to doctors to inform them if they judge it appropriate.

Haemophilia centres, which have been routinely informed of batches of clotting factors that might contain contaminated blood, have often offered patients the chance of knowing after appropriate counselling - despite the fact such products are thought to pose a lower hazard than other blood donations because they are made up from blood from many thousands of donors.

There was concern in several countries last year, especially Brazil, Turkey and Egypt, when the Guardian revealed that they had received stocks of albumin, to restore blood volume, and immunoglobulin, which replaces antibodies, which included donations from donors later struck down by vCJD.


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