Blood fear over CJD

April 1, 2001 Scotland on Sunday by Tom Peterkin
TENS of thousands of people could have been infected with the human form of mad cow disease after receiving transfusions of infected blood, according to new research.

Scottish and French scientists have uncovered the first hard evidence that new variant CJD can be passed from person to person, most likely by blood transfusions.

In the past, experts have said there is a theoretical risk of vCJD being passed in this manner, and as a result UK blood supplies have been filtered since the late 1990s to reduce the risk of contamination.

But new experiments on monkeys have proved vCJD can be transmitted from primate to primate. The study also showed that prions - the infectious agents that cause the disease - become more virulent when they jump from animal to animal, and lie dormant for less time once they are transferred.

This opens the chilling prospect that thousands of people who received vCJD -contaminated blood before screening began in 1998 will develop a worse form of the disease in less time.

Dr Jean-Phillipe Deslys, of the Departement de Recherche Medicale, Recherches du Service de Sante des Armees, said they had proved the BSE agent believed to cause vCJD could be passed between primates.

He said: "This study means that the risk from transfusions is high and we also think that it means that infection through surgical instruments is possible. It is impossible to calculate how many people may have been infected through these means."

The scientists found that the behaviour of the BSE agent in monkeys was almost exactly the same as in humans, making the experiments, carried out in France, as close as possible to a human model. Previous studies investigating the transmission of vCJD have concentrated on mice and sheep.

The process of blood transfusion was recreated by injecting a type of monkey known as a macaque with brain tissue from a BSE-infected cow.

Brain tissue from the monkey was then injected into the blood stream of other macaques. Within just 25 months the monkeys were showing the deadly symptoms of the disease. Brain tissue was used to speed up the experiment although it has the same ultimate effect as blood.

Dr Moira Bruce of the Institute for Animal Health in Edinburgh, who collaborated on the project, said: "Intravenous transmission between primates is really quite quick. This possibility has been examined from a public health point of view and there have been measures recently introduced to substantially reduce the risk of the spread of the disease."

In July 1998 the government's expert panel on BSE and vCJD, the Spongiform Encephalopathy Advisory Committee, predicted that there was a risk the agent could be transmitted in white blood cells.

A screening programme was introduced to filter out white blood cells before transfusion. New variant CJD has claimed 80 lives since it was first detected in 1996, but its incubation period has kept its incidence shrouded in uncertainty.

Operations to remove tonsils have also been banned in many hospitals throughout the UK because of the risk that the disease can be transmitted by the re-use of scalpels.

It is known that at least 13 of the British victims of variant CJD have been blood donors and authorities have been struggling over the ethical problem of whether people who have received blood transfusions or vaccinations including donations from these should be informed of the potential risk. General guidance is that recipients should not be informed since there is no test, no cure and no treatment for vCJD.

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