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From: TSS ()
Subject: Re: UK blood donors identified as at increased risk of vCJD are to be notified of their status
Date: July 21, 2005 at 6:24 pm PST
In Reply to: UK blood donors identified as at increased risk of vCJD are to be notified of their status posted by TSS on July 21, 2005 at 1:32 pm:
----- Original Message -----
From: "Terry S. Singeltary Sr."
To: "Bovine Spongiform Encephalopathy"
Cc:
Sent: Thursday, July 21, 2005 8:28 PM
Subject: [BLOODCJD] Re: NOTIFICATION EXERCISE BEGINS TO REDUCE RISK OF VCJD TRANSMISSION
> an old friend ponders.
>
> this is a very big story -- i am trying to figure out what the heck has
> been left out.
>
> They must have done in-depth medical procedure histories on the
> victims, noticed that all 3 were blood recipients in the same year,
> then gone ballistic when they saw overlap in donors, but could not
> narrow it down any more than these 100 because of poor records or blood
> pooling. overall the statistics must have been astronomically against
> such a coincidence.
>
> How could 3 people have received blood from 100? Was this whole blood
> used during big trauma surgery or some pooled blood product such as
> leucocytes (now banned) going to regular recipients such as
> hemophiliacs? Did the 3 die after the same length incubation say 12
> years or was it proportionally shortened according to the number of
> units they received?
>
> "A further 3,000 people who received blood from the donors but have not
> shown signs of vCJD may also be contacted."
>
> How could 3000 people receive blood from 100 donors? Unless they were
> very regular donors or it is some pooled blood product such as
> leucocytes. How many of the the 3,000 recipients themselves have gone
> on to be leucocyte donors themselves? It is quite common for
> appreciative recipients to later become donors. And their recipients no
> doubt have gone on to be donors.
>
> It seems to me the multipliers are just prodigous at each round. start
> with 100 to 3000 is a 30x multipliere. 3000 at 30x is 90,000. 90,000 x
> 30x = 2.7 million. It is like walt disney running amock in the
> Sorcerer's Apprentice.
>
> Why aren't the 1993/94 donors of the infected blood dead or at least
> symptomatic? Well for one thing they might be met-val or val-val which
> would open up a whole can of worms of whether these genotypes become
> carriers -- typhoid marys -- that don't develop or only very slowly
> develop neurological sign. oops, that would be 60% of their population
> or 36 million people.
>
> fascinating lack of discussion of what followup studies are in the
> works.
>
>
> Blood donors warned over vCJD
> About 100 UK blood donors are being warned they may have vCJD.
>
> All gave blood to three people in 1993/4 who have since died from the
> human
> form of mad cow disease.
>
> Precautions were brought in during 1999 when it became apparent that
> there
> was a potential for the prion disease to be transmitted through donor
> blood.
>
> The Department of Health has asked the 100 donors to notify their
> doctors
> so extra precautions can be taken if they have surgery or other invasive
> care.
>
> It is sensible to proceed with highly precautionary measures such as
> this
> to rule out any possibility of onward transmission
> Chief Medical Officer Sir Liam Donaldson
>
> They are also being asked not to donate any more blood, tissue or
> organs.
> The department said the move was a precautionary measure.
>
> A further 3,000 people who received blood from the donors but have not
> shown signs of vCJD may also be contacted.
>
> It is not known whether the source of vCJD in the three patients who
> died
> was related to the blood that they received or BSE-infected meat that
> they
> ate.
>
> Back in September, the government identified 17 people who received
> blood
> transfusions from people who went on to develop vCJD and sent out 6,000
> letters to others informing them of the potential risk.
>
> Since 1997 all cases of vCJD that are reported to the National CJD
> Surveillance Unit and diagnosed as having "probable" vCJD are passed on
> to
> the National Blood Service which searches its blood donor records.
>
> If the patient has given blood, subsequently any stocks of that blood
> are
> immediately destroyed.
>
> White blood cells, which it is thought may carry the greatest risk of
> transmitting the disease, have been removed from all blood used for
> transfusion since 1999.
>
> And blood products have been prepared from plasma imported from the US
> since 1998.
>
> At the end of December 2003, the total number of vCJD cases was in the
> UK
> was 145, including 139 deaths.
>
> There is no test for the brain wasting disease so those at risk have
> no way
> of knowing whether they have vCJD.
>
>
> Public safety
>
> Chief Medical Officer Sir Liam Donaldson said: "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."
>
> Dr Angela Robinson from the National Blood Service said: "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."
>
> She urged the public to continue donating blood, saying that the NHS
> depended on this continued commitment in order to be able to save lives.
>
> Story from BBC NEWS:
> http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/4699349.stm
>
> Published: 2005/07/20 12:08:03 GMT
>
> © BBC MMV
>
> TSS
>
>
>
> ----- Original Message -----
> From: "Terry S. Singeltary Sr."
> To:
> Sent: Wednesday, July 20, 2005 1:30 PM
> Subject: NOTIFICATION EXERCISE BEGINS TO REDUCE RISK OF VCJD TRANSMISSION
>
>
> ##################### Bovine Spongiform Encephalopathy
> #####################
>
> Wednesday 20 July 2005 13:15
> Department of Health (National)
>
> NOTIFICATION EXERCISE BEGINS TO REDUCE RISK OF VCJD TRANSMISSION
>
>
> An extension to the precautionary measures to reduce the risk of
> transmitting vCJD through blood transfusion and surgical procedures, began
> 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."
>
> Notes to editors:
>
> 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 http://www.dh.gov.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.
>
>
>
>
> 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.
>
>
>
>
>
>
>
>
>
>
> Client ref 2005/0256
>
> GNN ref 118433P
>
>
>
> http://www.gnn.gov.uk/content/detail.asp?NewsAreaID=2&ReleaseID=164111
>
>
>
> TSS
>
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> ####################
>
>
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