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From: TSS ()
Subject: Re: Fourth case of transfusion-associated vCJD infection in the United Kingdom
Date: January 18, 2007 at 7:25 pm PST

In Reply to: Fourth case of transfusion-associated vCJD infection in the United Kingdom posted by TSS on January 18, 2007 at 8:32 am:

HPA Press Statement

18 January 2007

4th case of variant CJD infection associated with blood transfusion

A new case of variant-Creutzfeldt-Jakob disease (vCJD ) associated with a
blood transfusion has recently been diagnosed.

This latest patient has been diagnosed with vCJD about nine years after
receiving a blood transfusion from a donor who later went on to develop
vCJD. A transfusion from the same blood donor was also associated with one
of the previously identified cases. The patient is still alive and is under
specialist care.

This fourth case of vCJD infection associated with blood transfusion
increases the concern about the risk of vCJD transmission between humans via
blood transfusion. All four cases relate to the transfusion of blood
components: no cases have been reported relating to treatment with plasma
products.

The patient is one of a small number (less than 30) of living individuals
who are known to have received a blood transfusion in the UK from a donor
who later developed vCJD. All these individuals have previously been
informed of their potential exposure to vCJD and asked to take certain
precautions to reduce the chance of passing on vCJD to other people via
healthcare procedures, such as surgery.

The Health Protection Agency has been in contact with doctors caring for the
other patients who have been exposed to blood transfusions from donors who
later developed vCJD. This is to ensure that they are informed of this new
development and provide access to the latest information and specialist
advice about their risk due to blood transfusion.

Professor Peter Borriello, Director of the HPA's Centre for Infections said,
"This new case of vCJD infection increases our concern about the risk to the
small group of people who had blood transfusions from donors who unknowingly
at the time of donation must have had vCJD infection. However, this new case
does not change our understanding of the risk for other people in any
specific way. It does however reinforce the importance of the precautions
that have already been taken to reduce the risk of transmission of vCJD
infection by blood."

Dr Angela Robinson, Medical Director of NHS Blood and Transplant said,
"Blood transfusions are often given to save or prolong the life of patients
who are very ill and the benefit of receiving a transfusion when needed must
always be balanced against any possible risk. Nonetheless, our primary
concern is the safety of our patients through maintaining the quality of
blood used for medical treatment. Since 1997, the NBS has introduced a range
of precautionary measures against the risk of vCJD."

vCJD is a rare disease, and less than 2% of the vCJD cases reported to date
in the UK have been associated with blood transfusion.

Notes to Editors:

To date, there have been 66 people identified in the UK who have received
vCJD implicated blood transfusions. The transfusions received by these 66
individuals were donated by eighteen different donors who were diagnosed
with vCJD after their blood donation. Of these 66 people, 40 have died of
illnesses other than vCJD, including one patient who was found to have
evidence of vCJD in parts of their body after their death. Including the new
(4th) case, 3 of these people who have received vCJD implicated blood
transfusions have developed symptoms of vCJD. There are 23 people who have
received vCJD implicated blood transfusions who are alive and have not been
diagnosed with vCJD.


The identification of cases of variant-CJD associated with blood transfusion
has depended on the Transfusion Medicine Epidemiology Review, a
collaborative study between the National Blood Services, the National CJD
Surveillance Unit and the Office of National Statistics. For further
information about this study see Hewitt et al Creutzfeldt-Jakob disease and
blood transfusion: results of the UK Transfusion Epidemiology Review study.
Vox Sanguinis 2006 91:221-230.


'Blood Transfusion' means transfusion with labile blood components (e.g. red
cells, platelets, fresh frozen plasma). This latest case (and the previous
three referred to) relate to transfusion of blood components and not
treatment with plasma products (i.e. products that are manufactured from
plasma). To date, no case of vCJD has been associated with treatment with
plasma-products (e.g. clotting factors used to treat individuals with
bleeding disorders such as haemophilia).


This fourth case has been classified by the National CJD Surveillance Unit
( www.cjd.ed.ac.uk ) as a 'probable' case of vCJD. Of the 158 vCJD cases
that have died (data to 5 Jan 2007), all 112 that have undergone post-mortem
(46 have not) have been 'confirmed' by neuropathological examination
(examination of brain tissue).


The first clinical case of vCJD associated with transfusion was identified
in December 2003. A case of vCJD 'infection' associated with transfusion was
identified a few months later. The patient had no symptoms but evidence of
infection (abnormal prion proteins) was identified in a post mortem
investigation. The individual died from causes unrelated to vCJD.


Following the first case of vCJD associated with a blood transfusion in
2003, the Department of Health asked all recipients of blood transfusions
not to donate blood as a precautionary measure to protect the blood supply
from vCJD.


Patients who are informed that they are considered to be 'at risk' of vCJD
for public health purposes are asked to take the following precautions to
reduce the chance of passing on vCJD to other people:
Not to donate blood, tissues or organs and
To inform their healthcare providers of their 'at-risk' status so that
special procedures may be arranged for certain instruments used in their
healthcare (NB. Their GPs are also asked to do this.)


A range of measures have been put in place by the Department of Health to
minimise the possible risk of vCJD being passed through blood:

Since 1997 all cases of vCJD that are reported to the National CJD
Surveillance Unit and diagnosed as having 'probable' vCJD, result in a searc
h of the UK Blood Services blood donor records. If the patient has donated
blood, any unused parts of that blood are immediately removed from stock.
The fate of all used components of blood from the donor is traced, and
surviving recipients informed of their risk.
In July 1998, the Department of Health announced that plasma for the
manufacture of blood products, such as clotting factors, would be obtained
from non-UK sources.
Since October 1999, white blood cells (which may carry the greatest risk of
transmitting vCJD) have been removed from all blood used for transfusion.
In August 2002 the Department of Health announced that fresh frozen plasma
for treating babies and young children born after 1 January 1996 would be
obtained from the USA, extended to all children under 16 years of age
(Summer 2005).
In December 2002, the Department of Health completed its purchase of the
largest remaining independent US plasma collector, Life Resources
Incorporated. This secures long-term supplies of non-UK blood plasma for the
benefit of NHS patients.
Since April 2004, blood donations have not been accepted from people who
have themselves received a blood transfusion in the UK since 1980. This has
been extended to include apheresis donors and donors who are unsure if they
had previously had a blood transfusion (August 2004).
Since late 2005, blood donations have not been accepted from donors whose
blood was transfused to patients who later developed vCJD.
The UK Blood Services continue to promote the appropriate use of blood and
tissues and alternatives throughout the NHS.


The likelihood of a person who may be infected with vCJD going onto develop
symptoms of the disease is uncertain, and may depend on individual
susceptibility. It is possible that infected individuals may never develop
symptoms.


For further information contact the HPA press office on 0208 327
7098/7097/6055


Specialist care for vCJD is available from The NHS National Prion Clinic,
based at The Hospital for Neurology and Neurosurgery, Queen Square, London
http://www.nationalprionclinic.org/


The National CJD Surveillance Unit is based at the Western General Hospital
Edinburgh: www.cjd.ed.ac.uk


For further information about vCJD go to:
http://www.hpa.org.uk/infections/topics_az/cjd/menu.htm
http://www.dh.gov.uk/PolicyAndGuidan...pics/CJD/fs/en
http://www.blood.co.uk/
http://www.cjd.ed.ac.uk
http://www.nationalprionclinic.org/


http://www.hpa.org.uk/hpa/news/articles/press_releases/2007/070118_vCJD.htm




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