Thousands of patients were exposed to CJD

September 30, 2001 Sunday Times (London) by Jonathan Leake
HOSPITALS are having to warn thousands of patients that their operations may have exposed them to the human form of mad cow disease. Research has shown that up to 41 hospitals unwittingly operated on patients incubating variant CJD (vCJD) -and then used the instruments on other people.

The study has also found 22 people who were given transfusions of blood donated by people later diagnosed with vCJD. Both findings have potentially serious public health implications. A panel of experts at the health department has warned that anyone contaminated through blood or operations could spread the disease by donating blood or organs.

Alan Milburn, the health secretary, is expected to announce an initiative in the next few weeks to trace those exposed to vCJD.

He is, however, thought to be deeply concerned about the impact on people of being told that they have been exposed to a disease for which there is no conclusive test -and no cure.

A health department source said the hospitals that had used the instruments would probably write to all patients in general terms, backed by media adverts, telling them they can call hotlines. "The aim would be to let people at risk decide if they wanted to know more."

The most at-risk patients had operations on the brain or spine, where there are the highest concentrations of the protein prion that causes vCJD. There have already been cases in which brain probes used on patients with sporadic CJD, a similar disease, passed the condition to other patients despite repeated sterilisation.

In a separate case, a woman incubating vCJD had two operations and gave birth shortly before symptoms appeared. She has since died and her child is suspected to have the disease.

Professor Robert Will, director of the National CJD Surveillance Unit, believes vCJD presents greater risks because the prions spread to many more organs.

However, the biggest and most immediate dilemma is what to do about the 22 patients who have been given blood from people known to have developed vCJD. Their identities are all known, but they have not been told that they were exposed.

The actual total could be much higher. The study said up to 15 of the 106 people diagnosed with vCJD gave blood before diagnosis, but only eight had been traced. It was their blood that went to the 22 identified recipients.

A health department spokesman said: "Under the guidelines, blood donated by these 22 people will be thrown away and they will not be told, but this is under review."

The department's experts have warned that, if any of the 22 gives birth, has surgery or donates organs while unknowingly incubating vCJD, more instruments and people could be infected and nobody would know about it until too late. There are similar risks if they visit a dentist.

The potential for blood to transmit such diseases was shown recently when British scientists infected sheep with BSE. They then transfused the animals' blood into healthy sheep, which subsequently also went down with the disease.

oLast week agriculture ministers warned that they may have to order the slaughter of Britain's 40m sheep if any are found to have BSE.

Yesterday the Department of Health announced that it is to set up a Pounds 55m fund to compensate the victims of vCJD. So far 106 people in Britain have contracted the illness.

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