27.9.04

Times Online

BRITAIN EXPORTED BLOOD PRODUCTS WITH vCJD RISK

By Sam Lister, Health Correspondent
September 27, 2004

BRITAIN has exported blood products that could be contaminated with the human form of mad cow disease to at least 11 countries, raising fears of further transmission of the deadly condition.

Officials last week contacted five of the countries identified as most at risk from the imported blood products, which were donated by nine people who died from variant Creutzfeldt-Jakob disease (vCJD).

The warnings have been issued after two British cases, discovered in the past year, where people are thought to have contracted the brain- wasting disease from blood transfusions.

However, the Government has been accused of “lethal secrecy” after refusing to identify publicly the five nations, which have been the subject of risk assessments by the Health Protection Agency.

The five countries come from a longer list of 11 — including Ireland, Russia, India and Brazil — to which Britain exported the suspect products in the late 1990s.

Patient bodies and politicians condemned the Government’s secrecy as a face-saving strategy that could hamper proper surveillance of a fatal and incurable infection. Of the more than 150 people worldwide who have died of the disease to date, 143 have been from the UK.

Frances Hall, secretary of the Human BSE Foundation, which represents the families of victims, said that the Government’s refusal to reveal countries most at risk was irresponsible to the population at large. Mrs Hall’s son, Peter, died from the disease at the age of 20 in 1996.

“It is being left to foreign authorities to act as they see fit, but the greatest precautions must be taken at all levels to make sure any possible vCJD infection is not passed on,” she said. “Britain, sadly, leads the way in vCJD — it is our affliction — and we should be taking full responsibility for it. This disease is a death sentence and we must take every possible precaution.”

A spokesman for the Department of Health defended the decision not to name the countries. Such action was not felt appropriate, he said, and it was up to the countries in question to take action should they wish to do so. “We are giving them the information. We have taken a very precautionary approach. Other countries may take the approach that they don’t want to do anything. We are happy to advise them.”

Revelations of the export list have emerged after an announcement by Sir Liam Donaldson, the Chief Medical Officer, that 6,000 British patients who had a theoretical risk of vCJD infection — having received blood products from donations from the nine vCJD donors — were being contacted. The patients have been banned from donating blood, tissue or organs and will have to tell their doctors and dentists before having any future treatment.

The HPA’s risk assessment followed the first possible case of a person dying after contracting vCJD through a blood transfusion, announced by John Reid, the Health Secretary, last December.

This led to a ban on people who have received a blood transfusion since January 1980 donating blood. In July, it emerged that another patient who received donated blood was found to be carrying the vCJD agent, although they died of unrelated causes.

Britain stopped exporting blood products in 1999 in the wake of concerns about the possible transmission of vCJD. Since 1998 all blood products used in this country have been imported from America.

The Irish authorities said in 2000 that polio vaccine administered in 1998-99 had included more than 80,000 vials of albumin from a British vCJD victim. Brazil received nearly 45,000 vials, used to restore and maintain blood volume in patients.

A spokeswoman for the Irish Blood Transfusion Service said that it had not been contacted by the British Government as an “at risk” country and was confident that the risk of contracting vCJD remained negligible.

The Bio Products Laboratory, part of the NHS’s blood service, also sent products to Dubai, India, Turkey, Brunei, Egypt, Morocco, Oman, Singapore and Russia. Immunoglobulin, which helps to replace antibodies, and factor VIII, a clotting agent, were also exported.

Paul Burstow, the Liberal Democrats’ spokesman on health, said that the Government’s stance only hampered efforts to monitor vCJD.

“Given that the whole sorry saga of vCJD is mired in distrust and secrecy, actions such as this only add to public fears. Surely the lesson that we have learnt is that we need to be quick, open and straightforward,” he said.

Andrew Lansley, the Conservatives’ health spokesman, said that, while vCJD problems had reached the public forum in Britain, it was imperative that the Government ensured that similar approaches were adopted abroad.

WHERE THE DANGER LIES

Ireland: polio vaccine, 83,500 doses
Brazil: 44,864 vials albumin, 80 vials immunoglobulin
Dubai: 2,400 vials albumin
India: 953 vials albumin
Turkey: 840 vials immunoglobulin
Brunei: 400 vials albumin
Egypt: 144 vials albumin
Morocco: 100 vials albumin
Oman: 100 vials immunoglobulin
Russia: 23 vials factor VIII
Singapore: three vials immunoglobulin

THE BATTLE AGAINST vCJD


Blood donors or apheresis donors (who give components such as platelets) who received a blood transfusion in the UK since January 1, 1980, can no longer give blood

Countries such as the United States, Ireland, Canada, New Zealand, Australia and Germany have introduced rules to exclude donors who have spent more than a specified period of time (often one year) in the UK from giving blood

Any blood components, plasma derivatives or tissues obtained from any individual who later develops vCJD to be withdrawn or recalled (from December 1997)

Import of plasma from the US for fractionation to manufacture plasma derivatives (from October 1999)

Leucodepletion (removal of white cells) of all blood components (October 1999)

Import of clinical fresh frozen plasma from the US for patients born after January 1996 (introduced spring 2004)









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