Overall Blood Supply Strategy with Regard to vCJD

Abstract

While the »classical« Creutzfeldt-Jakob disease (CJD) has been transmitted in rare cases by therapeutic application of human brain-associated materials such as dura mater transplants or injection of pituitary hormones, there has been no documented transmission of CJD via human blood or blood products. The same is true also for the variant of CJD (vCJD). This rather new disease is thought to be a manifestation of BSE in humans, and both BSE and vCJD have been observed mainly in UK (Fig. 1). It is encouraging that in a neuropathological study of 33 UK deceased hemophilia patients, who had been treated for years with UK-sourced plasma products, no sign of vCJD was found [1]. However, the observation time has been too short yet to draw any conclusion on epidemiological grounds as to the transmissibility of vCJD by blood. In contrast to classical CJD, infectivity is found in lymphatic tissues of vCJD patients. Moreover, experimental data from several species point to the possibility that a low level of infectivity is present in their blood. Also the preliminary results of a transfusion experiment in sheep [2] raised such concerns. Taken together, the possibility of vCJD transmission by blood and blood products can so far neither be proven nor excluded.