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From: TSS (216-119-144-9.ipset24.wt.net)
Subject: SHOULD I WORRY ABOUT THE BLOOD THAT SAVED MY DAUGHTER ?
Date: August 17, 2004 at 7:35 am PST

-------- Original Message --------
Subject: Should I worry about the blood that saved my daughter?
Date: Tue, 17 Aug 2004 09:06:24 -0500
From: "Terry S. Singeltary Sr."
Reply-To: Bovine Spongiform Encephalopathy
To: BSE-L@uni-karlsruhe.de


Should I worry about the blood that saved my daughter?

When news came this month that a second person had become infected with
variant Creutzfeldt-Jakob disease from a transfusion, memories of a
frightening phone call came rushing back for The Globe's ALANNA MITCHELL

By ALANNA MITCHELL
Tuesday, August 17, 2004 - Page A13

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I still remember the day I got that phone call: Friday, May 3, 1996, at
about noon. My daughter, the hellishly cheery voice told me, was one of
several thousand Canadians who had received a blood transfusion
containing some blood products from donors who developed the fatal
Creutzfeldt-Jakob disease, the human form of mad-cow disease.

I put my head in my arms and cried so hard that colleagues came into my
office to see what was wrong. My daughter, then 5, had been fully
transfused at birth, a measure that saved her life. We'd dodged all
sorts of health bullets since then, and thought it was all behind us.
And now this.

But what was this? What were the implications of the fact that she had
received blood from someone who then died from CJD?

The cheery voice couldn't tell me. And when I investigated, I found that
nobody else could, either. At the time, doctors did not know whether CJD
could be transmitted by blood transfusion.

They only knew that there had not been a documented case of transmission
by transfusion so far. They said it was theoretically possible. I
remembered when they used to say that about HIV, too, and it was cold
comfort.

But it has been more than eight years since that phone call, and my
family had moved on. Until earlier this month, that is, when a snippet
from the respected medical journal The Lancet caught my eye. It told of
a second person who had been infected by blood transfusion with the
British-born form of CJD, which is known as variant or vCJD. In 1996,
the first case of vCJD emerged in Britain. It was linked to the
consumption of beef from a cow infected with mad-cow disease.

Clearly, it was time to ask more questions.

Kumanan Wilson, an assistant professor in the University of Toronto's
department of medicine, has been one of the foremost researchers on
transfusions and CJD in Canada since the issue first hit the public
radar 10 years ago. He took time out from his holidays to provide some
answers.

The nub of it is that vCJD is quite a different beast from classic CJD
and is transmissible by transfusion, but it turns out that classic CJD
probably is not. Because of research done in the intervening years,
fears about whether classic CJD can be spread through the blood supply
are far less today than they were 10 years ago.

Back in 1994 and 1995, fears about the safety of the blood supply ran
deep and wide. Canada's Krever inquiry into the HIV-tainted-blood
scandal was in full swing; one hematologist who testified at the inquiry
said he believed that CJD could be the next big threat to the blood supply.

At the time, the American Red Cross had already recalled blood products
from donors who later developed CJD. In 1995, the Canadian Red Cross
followed suit, informing about 900 hospitals that they had blood
supplies from a donor who went on to develop CJD. Each hospital then had
to decide whether to inform patients who had received the blood. A few
did, including my daughter's hospital; many did not.

Later that year, Health Canada declared that it would no longer accept
blood donations from people known to be at risk of developing CJD.

At the same time, five studies were launched around the world to see
what happened to people who had received the CJD-donor blood, and to
check out the blood-transfusion history of people who died from CJD.

When vCJD hit Britain in 1996, doctors were immediately worried about
the blood supply. They reasoned that if people could get vCJD from
eating meat, it was likely they could get it from blood, said Dr. Wilson.

Classic CJD affects only neurological tissue and can be transmitted by
transplants of infected neurological tissue. But the new type, vCJD,
also attacks lymph tissue, which is intimately connected with the body's
blood supply. And in vCJD, the concentrations of prions, the malformed
proteins that cause the infection, are far higher than in classic CJD.

Meanwhile, the results of some of the "look-back" studies on the
transfusion history of people who developed classic CJD were coming in.
The logic behind the studies was that because blood transfusions have
been common for 60 years, looking back at transfusions given to people
who later died from classic CJD might hint at whether blood was involved
in the deaths.

The studies found that people who died from classic CJD had not received
more transfusions than other people. As well, the rate of classic CJD in
the population has remained stable over 60 years, even as transfusion
has grown more common.

For classic CJD, it all added up to what doctors now consider a closed
case, said Dr. Wilson. As an extreme precaution, though, Canadian Blood
Services does not accept blood from people who have classic CJD in their
family. (People like my daughter, however, are as free to donate blood
as anybody else.)

And if the blood-services agency finds out that a donor went on to
develop classic CJD, it tracks down the blood and withdraws whatever is
left in the system. Again, this is just to be on the safe side, given
the mounting evidence that classic CJD cannot be transmitted through
blood, noted Lesly Bauer, manager of strategic communications for
Canadian Blood Services in Ottawa.

However, because of the growing evidence that vCJD can be transmitted
through the blood supply, the focus instead is on making sure that
donors are barred from giving blood if they have lived in the United
Kingdom and several other parts of Europe where tainted beef was consumed.

And as for my daughter? She's so busy living life to the fullest that
she rarely gives a thought to her blood. Now 14, she's happy, healthy
and preparing for high school in the fall.

Guarding our blood

To protect against possible transmission of variant Creutzfeldt-Jakob
disease (vCJD) in the Canadian blood supply, you cannot donate blood or
plasma:

if you have spent a total of three months or more since 1980 in the
United Kingdom (England, Scotland, Wales, Northern Ireland, the Isle of
Man and the Channel Islands) or France;

if you have spent a total of five years or more since 1980 in Belgium,
Germany, the Republic of Ireland, Liechtenstein, Luxembourg, Italy, the
Netherlands, Portugal, Spain, Switzerland, Austria and Denmark;

if you have had a blood transfusion or have had medical treatment with a
product made from blood in the U.K. since 1980;

if a blood relative (parent, child, sibling) has developed
Creutzfeldt-Jakob disease.

Source: Canadian Blood Services website

http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20040817/HBLOOD17/TPHealth/

TSS





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