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CJD fear over blood donation grows
Fears that unwitting carriers of the
human form of BSE might have infected patients via blood transfusions
were strengthened last night with the publication of evidence from
laboratory tests on sheep.
The results suggested that blood of an infected animal can transfer
BSE-like disease to another long before it displays outward signs of
the condition, and appeared to confirm the prudence of human blood
donation controls introduced last year.
Scientists from the institute of animal health, based in Compton,
Berkshire, and Edinburgh, took the rare step of publishing the work in
a medical journal, the Lancet, within weeks of the discovery because
of its importance. Only last month researchers based in London
suggested that their work, using hamsters and mice, raised serious
questions about how animals thought to be healthy and incapable of
acquiring BSE could in theory pass the disease on.
Variant CJD, which has so far claimed 82 victims in Britain, is now
widely regarded as BSE in human guise. In another development
scientists in Paris today claim a breakthrough in the struggle to
understand how BSE-like diseases attack the brain, leading to hopes
that treatment for the incurable condition may be on the distant horizon.
The scientists involved in the sheep experiments fed animals with
cattle brain infected with BSE and, before they displayed any
symptoms, transfused blood into healthy sheep imported from BSE-free
New Zealand. The one sheep to have so far shown signs of BSE began
displaying the symptoms 610 days after transfusion. The donor sheep
had eaten the BSE material 318 days before the transfusion but did not
display signs of the condition for a further 311 days, indicating the
blood had been infective halfway through incubation.
All UK blood has to be filtered so the white cells thought most
likely to carry vCJD are removed. Plasma used in blood products is
imported from countries where there is no evidence of vCJD. The
measures cost the NHS £80m last year.
The government insisted last night this was a precautionary
safeguard to counter a theoretical risk and there remained no evidence
that vCJD "has ever been transmitted to humans through blood
transfusion or blood products".
The scientists warned their report "suggests that blood donated by
symptom-free vCJD-infected humans may represent a risk of vCJD
infection among the human population".
They had no evidence of levels of infectivity of pre-clinical CJD
cases. But the presence of BSE activity in sheep blood suggested it
would soon be possible to identify which blood cells carried the
infectivity. This could help test the effectiveness of blood donation
controls and develop tests for vCJD based on blood samples.
Colin Bostock, the institute's director, said: "This work shows it
was prudent to take action against a theoretical risk."
The implications of the work, along with that of the London team,
are to be studied by the government's advisers on BSE this month.
The Paris researchers studied prions, molecules of a chemical
called PrP, which are thought, in abnormal form, to be closely
associated with BSE-like diseases. Healthy humans manufacture PrP in
their bodies but its function has been a mystery.
In an article in Science, scientists at the Pasteur institute and
the Lariboisiere hospital argue it helps carry messages between nerve
cells in the brain. Prions, abnormal PrP molecules, interfere with the
process, leading to the crisis in the brain which is the beginning of
CJD.
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