An extension to the precautionary measures to reduce the risk of
transmitting vCJD through blood transfusion and surgical procedures,
began in the UK today. Around 100 people who donated blood to three people who
later developed vCJD, are being told that they may have a greater
chance of carrying the vCJD agent, compared with the general
population.
They will be asked not to donate blood, tissue or organs and to
inform health professionals so extra precautions can be taken should
they have surgery or other invasive procedures.
Although it is not known whether the source of vCJD in these patients
is related to the blood that they received, precautionary steps are
being taken to inform and provide support to the individuals as well
as safeguard public health. This is being done on the advice of two
expert committees and a detailed risk assessment exercise.
Notification of donors is taking place via letters from the National
Blood Service who are working closely with the Health Protection
Agency to identify the people involved. The letters that people
receive will provide the telephone number for a dedicated helpline
staffed by senior transfusion experts from the National Blood
Service, and will also advise them to contact their GP for more
information, advice and support.
The likelihood of a person who may be infected with vCJD going on to
develop symptoms of the disease is uncertain. It is possible that an
infected person may never develop symptoms.
The Chief Medical Officer, Sir Liam Donaldson said:
"We need to ensure that appropriate action is taken on any new
information that becomes available on the risk of transmission of
vCJD, to protect the public as much as possible. When a recipient of
a blood transfusion goes on to develop vCJD, we have to consider the
possibility that the infection could have been passed on through the
transfusion.
"Until a reliable blood screening test becomes available, it is
sensible to proceed with highly precautionary measures such as this
to rule out any possibility of onward transmission of the disease. We
are committed to further research to help us understand this disease
and diagnose infection at an early stage.
"Following the identification of vCJD, we introduced a number of
measure to reduce the possible risk that infection could be
transmitted through the blood supply. Since the announcement in
December 2003 of the first case of possible transfusion-associated
transmission of vCJD, we have further strengthened these preventative
measures.The decisions taken so far have been based on the principles
of caution and openness. This announcement today is a continuation of
the process."
Dr Angela Robinson from the National Blood Service said:
"Blood donors are highly committed to helping other people and we
greatly value their contribution. The NHS depends upon their
continued commitment in order to be able to save lives.
"This notification exercise will affect in the order of 100 donors.
If you have donated blood in the last five years and are not
contacted shortly, you can be assured that you are not involved in
this new safety measure and need to take no further action.
"For those people who are involved, this information may be difficult
to absorb. That is why we have set up the National Blood Service
helpline and are working with their doctors and other clinicians, to
ensure that they have the information and support they need."
1. This notification exercise has been done after a detailed risk
assessment by the Department of Health and reviewed by its relevant
expert committees. The risk assessment can be found at dh.uk
2. The degree of increased risk for any individual donor depends on
many factors, including how many other donors' blood went to the
infected recipient. This varies very widely between these three
recipients. Individual donors will be able to find out more if they
wish.
3. Of the 156 cases of vCJD to date, 4 have been confirmed as having
had blood transfusions that experts believe could be linked with
their vCJD. For one of these cases, the probable source of infection
has already been identified, as one of the donors went on to develop
vCJD. For three cases, transfusion remains a possible source of the
recipient's infection.
4. The blood donors involved in England, all gave blood during 1993.
5. The two expert committees advising this course of action were the
CJD Incidents Panel and the Committee on the Microbiological Safety
of Blood Tissues and Organs.
6. Previous measures taken to improve the safety of blood in relation
to vCJD include the following:
- From December 1997, blood components, plasma products or tissues
obtained from any individual who later develops vCJD, have been
withdrawn/recalled.
- In July 1998, we announced that plasma for the manufacture of blood
products, such as clotting factors, would be obtained from non-UK
sources.
- From November 1999, white blood cells (which may carry a
significant risk of transmitting vCJD) have been removed from all
blood used for transfusion.
- In August 2002 we announced that fresh frozen plasma for treating
babies and young children born on or after 1 January 1996 would be
obtained from the USA.
- The report of the first possible case of transmission of vCJD by
blood transfusion was in December 2003. Following this, we announced
in April 2004 that individuals had themselves received a transfusion
of whole blood components since January 1980, would be excluded from
donating blood. (In July 2004, the second possible case of
transmission of vCJD by blood transfusion was reported.)
- On July 2004, the exclusion criteria for blood donation were
extended to include two new groups, who had received transfusions of
whole blood components since 1980:
- Previously transfused platelet donors
- Donors who were unsure if they had previously had a blood
transfusion.
This means that for blood donation the full exclusion criteria are:
- Recipients of dura mater grafts.
- Recipients of corneal or scleral grafts.
- Recipients of human pituitary derived extracts such as growth
hormone or gonadotrophins.
- Individuals at familial risk of prion-associated diseases. This
includes individuals who have had two or more blood relatives develop
a prion -associated disease and individuals who have been informed
they are at risk following genetic counselling.
- Individuals who had themselves received a transfusion of whole
blood. components since January 1980 are excluded from donating
blood.
- Individuals identified as 'at risk' by CJD Incidents Panel.
- Previously transfused platelet donors.
- Donors who were unsure if they had previously had a blood
transfusion.
- In September 2004, the Department of Health announced further
precautionary measures for patients who had received certain batches
of plasma products.
- In July 2005 the use of USA sourced fresh frozen plasma (FFP) was
extended to all children up to the age of 16.
7. There is currently no validated diagnostic test that can be used
before the onset of clinical symptoms to diagnose whether someone has
contracted vCJD. Since 1995, the Department has contributed over ???30
million into CJD research, including research for the development of
an effective test.
8. For media enquiries only contact Sophie Coppel in the Department
of Health Media Centre on 020 7210 5707.
=================
HOUSE OF COMMONS
Notice of Written
Ministerial Statement
Title of Secretary of State/Ministerial
head of department: The Under Secretary of State (Public Health)
Subject of Statement: Secondary Transmission of Variant CJD
Recommendations for Further Health Precautions
1. Notice of written Statements for the following day will be placed
on the effective Orders of the Day. Otherwise, the notices will be
placed on Future Business E (written ministerial statements). Notices
may be given of written statements to be made not later than 5
sitting days after the day on which notice was given.
WRITTEN MINISTERIAL STATEMENT
DEPARTMENT OF HEALTH
20 July 2005
The Under Secretary of State (Public Health): Written Ministerial
Statement on secondary transmission of vCJD
The Under Secretary of State (Public Health): (Ms Caroline Flint)
Further to the statements made to the House by the then Secretary of
State (Dr John Reid) on 17 December 2003 and 16 March 2004 (and the
written statements of 22 July 2004 and 9 September 2004) concerning
variant Creutzfeldt-Jakob disease (vCJD) and blood, I wish to provide
a further update on this subject.
Following cases of possible transmission of vCJD by blood
transfusion, we have already put in place a series of precautionary
public health measures. These include:
- In December 2003 we put in place arrangements for contacting
recipients of blood from donors who went on to develop vCJD so that
any necessary action could be taken;
- Since April 2004 we have excluded anyone who has received a blood
transfusion since January 1980 from donating blood.
- In September 2004 we announced arrangements to identify and notify
patients who had received certain batches of UK manufactured plasma
products.
In the light of further advice I have received from two of my
Department's expert committees, the CJD Incidents Panel (CJDIP) and
the Committee on Microbiological Safety of Blood, Tissues and Organs
(MSBTO), I am now announcing further public health precautions in
relation to a small group of blood donors whose blood has been
transfused to people who later developed vCJD.
The Chief Medical Officer, Sir Liam Donaldson, had asked the expert
committees to consider the implications for donors where a recipient
of their blood had developed vCJD. The recommendations of the
committees are based on an assessment of risk undertaken by the
Department of Health's analysts. The risk assessment is being
published on the Department's website.
There are 110 donors in the UK whose blood was given to three people
who later developed vCJD and for whom this blood might be a possible
source of their infection. The advice of the committees is that,
although we do not know whether these cases of vCJD could be related
to the blood that they received, we should take precautionary steps
to inform and support the individual blood donors concerned and to
safeguard public health.
As an extension to the current precautionary measures, these people
are being contacted by the National Blood Service and advised not to
donate blood, tissues or organs. Current donors from this group of
110 are being contacted today and offered expert advice and support.
The National Blood Service will contact the GPs of lapsed donors,
that is those who have not donated blood during the last five years,
and make arrangements to contact these people as soon as practicable.
The committees have also advised that the donors in question should
be considered at risk of vCJD for wider public health purposes and
that the donors and their clinicians should be informed of their risk
status and asked to implement the public health precautions currently
specified by the CJD Incidents Panel. This means that they should
inform doctors, nurses and dentists of their status if they present
for surgery or other invasive medical procedures.
These public health precautionary measures are the same as those
applied to any patients considered by the CJDIP to be at risk of
vCJD, including the individuals notified following the previous
statements to the House.
There is another group of people for whom further public health
precautions may need to be considered. This group is all the other
recipients of blood from the currently identified group of 110 donors
(estimated to be up to 3,000 individuals). At present, these people
are already excluded from blood donation themselves by the measures
implemented in April 2004. I have asked for additional expert advice
on this group and I will take further action if necessary.
Blood donors should be assured that it is not possible to contract
vCJD by giving blood. Blood donors are highly committed to helping
others and we greatly value their contribution. The NHS depends on
their continued commitment to donating blood which saves lives every
day in this country.
The vast majority of the over two million current blood donors will
not be involved in this new safety measure and need take no action.
However, current and past blood donors who are concerned can contact
the National Blood Service helpline on 0845 7711 711.
People who have received blood donations and other members of the
public who are concerned should contact NHS Direct on 0845 850 9850.
As with our actions to date on the possible transmission of vCJD, we
continue to follow a highly precautionary approach.
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Issued by : DOH Press Office
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