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RESULTS
Thirty-one vCJD cases were
reported to have been blood donors. Four additional cases
who were not reported to have been blood donors were found to be
registered with UKBTS. One of these cases was found to
have been a blood donor while the other three cases were registered as
donors but never made any donations. Twenty-four of the cases have been traced
at blood centres including the four additional cases mentioned
above. Components from 18 of these individuals
were actually issued to hospitals. It has been established
that 67 components were transfused to named recipients (49 dead,
18 alive).
Four
instances of probable transfusion transmitted infection have been identified.
The first recipient (Case 1) developed symptoms of vCJD 6½ years after
receiving a transfusion of red cells donated 3½ years before the donor (Donor
1) developed symptoms of vCJD. The
second recipient (Case 2) died from a non-neurological disorder 5 years after
receiving blood from a donor (Donor 2) who subsequently developed
vCJD; protease-resistant prion protein (PrPres) was detected in the
spleen but not in the brain. This is the first recorded case in the UK
of autopsy detection of presumed pre- or sub-clinical vCJD infection.
The third recipient (Case 3) developed symptoms of vCJD 7 years, 10
months after receiving a transfusion of red cells donated about 21 months before
the donor (Donor 3) developed symptoms of vCJD.
The fourth recipient (Case 4) who also received a transfusion from
the same donor as Case 3, developed symptoms of vCJD 8 years, 4
months after receiving a transfusion of red cells donated about 17 months before
this donor (Donor 3) developed symptoms of vCJD.
(see
publications).
These findings strongly suggest that vCJD may be transmitted via blood
transfusion. The identification of a third case of vCJD in this small
cohort of known recipients of blood from persons incubating vCJD establishes
beyond reasonable doubt that blood transfusion is a transmission route.
In the reverse study, 15 vCJD cases were
reported to have received blood transfusions in the past.
A further case received a blood transfusion after onset of
illness. This case is excluded from the figures
quoted. Checks revealed that of these 15 cases, one was not
transfused, 4 had transfusions which pre-dated available records
(pre 1980), and 10 had records of transfusion which could be traced (see
vCJD cases who received blood transfusion(s) in the past).
These 10 had received 209 donor exposures (with one patient given 103
components), which have been traced to 192 named donors (two of
whom had vCJD as described above).
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