Communicable Disease Report Weekly editorial team, Health
Protection Agency, London, England
The first case of variant Creutzfeldt-Jakob disease (vCJD)
thought to have been infected via a blood transfusion may have been seen in
the United Kingdom (UK). The case, who died in autumn 2003, received blood
during an operation in the first half of 1996. At that time neither the donor
nor the recipient showed any signs of illness. The donor became ill in 1999
and subsequently died. The recipient became ill earlier this year, and post
mortem tests confirmed the diagnosis of vCJD. Although there is no proven
causal link between the two cases, the possibility of the blood transfusion
being the route of infection for the second case cannot be ruled out.
The transfusion took place before 1997, when the first of a series of measures
to protect against such possibilities took place. Since that time all reports
of cases of vCJD are checked against blood donor records, and any stocks
from such donors are immediately destroyed. In 1998 a programme was begun
to remove white cells from donated blood (leuco-depletion), as they were
considered to be a potential source of infection. Also in 1998, the use
of UK sourced plasma in the manufacture of blood products was phased out,
a process that was completed at the end of 1999. The UK National Blood Service
(http://www.blood.co.uk/)and
the expert committee on the microbiological safety of blood and tissues
for transplantation are to review current procedures in the light of this
case.
Up to this point in time, fifteen other people in England and Wales are
known to have received blood from donors who subsequently developed vCJD,
five of whom received blood after the implementation of leuco-depletion.
The earliest transfusion was in 1993, the latest in 2001. These cases are
being contacted.
A full transcript of the statement by the Secretary of State for Health
to the House of Commons on 17 December 2003 is available at http://www.doh.gov.uk/cmo/vcjdstatement.htm.