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http://www.newscientist.com/news/news.jsp?id=ns99992632

vCJD risk from blood transfusion "appreciable"

12:50 05 August 02

from www.NewScientist.com news service

People are more likely to contract the human form of mad cow disease through
blood transfusions than scientists thought, say researchers at the UK's
Institute of Animal Health. Their research also questions whether current
blood separation precautions are sufficient.
The ongoing study on 24 sheep has found that two have contracted BSE after
being transfused with blood from infected sheep, and two more have clinical
signs of the disease.
"If the clinically suspect BSE-transfused sheep progress as expected, this
would bring the transmission rate for BSE up to 17 per cent," the
researchers, led by Nora Hunter at the IAH Neuropathogenesis Unit in
Edinburgh, write in the Journal of General Virology.
BSE-infected sheep are thought to be the best animal model for humans
infected with vCJD. "From these preliminary results, it would appear that
measures taken to safeguard the blood supply in the UK are fully justified,"
the team writes. But those precautions may not be enough.

Red alert

Previous work has suggested that BSE, and by extension vCJD, infectivity is
concentrated in the white blood cell fraction of blood. Therefore, blood
donated in the country is filtered to remove most white blood cells, and
most of the plasma used is imported from overseas.
But the sheep in the study got transfusions of whole blood or white blood
cell fractions. And so far none of the seven sheep transfused with
BSE-infected white blood cells have developed the disease. The two confirmed
and two suspected cases are both among the 17 sheep that received one unit
of whole blood.
The study could take five years to complete, but "these results suggest that
there may also be significant levels of infectivity in the plasma and/or red
cell fractions," the researchers write. Another study by the team on the
transmission of scrapie - a BSE-like sheep disease - through blood
transfusion has found similar results.
The researchers reported the first confirmed case of BSE transmission to
sheep via blood transfusion in September 2000. This first case received
blood from a donor before the donor showed clinical signs of BSE.
The UK Department of Health says it recognises that the blood of patients
with vCJD might contain transmissible levels of activity before clinical
signs become apparent.

Tonsil test

So far, there is no evidence that anyone has contracted vCJD as a result of
a blood transfusion. In the UK, 115 people have died from vCJD, and another
10 people are showing classic symptoms. Twenty-two people have received
transfusions from eight people who later developed vCJD - but none has yet
shown symptoms of the disease.


But post-mortem studies of the sheep suggests that infectious prions
transmitted through transfusion do not spread through the body in the same
way as prions transmitted through eating infected material.
The researchers found far fewer prion deposits in the lymphoid tissues -
such as tonsils - of the transfused infected sheep. "There may be
implications for human patients with the misfortune to have received blood
products from vCJD cases, because a negative tonsil biopsy might very well
be unreliable," the team writes.
The UK government is now reviewing blood donation procedures. It has
appealed to the public to continue donating blood.
Journal reference: Journal of General Virology (vol 83, DOI:
10.1099/vir.0.18580-0)

Emma Young


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