New variant of Creutzfeldt-Jakob Disease - HÉMA-QUÉBEC studies the possible exclusion of donors who have visited the United Kingdom
VILLE SAINT-LAURENT, May 5, 1999 - Since October 1998, HÉMA-QUÉBEC has been conducting a series of consultations to find a safe solution for the deferral of some donors who have resided in the United Kingdom since 1980. This aims at preventing the as-yet theoretical but nonetheless potential risk of transmitting the new variant of Creutzfeldt-Jakob disease.
"To date, we have consulted the Hemovigilance Committee, HÉMA- QUÉBEC's Safety Advisory Committee, the Association of Blood Donation Volunteers as well as our board of directors," said Dr. Francine Décary, executive director of HÉMA-QUÉBEC. "The two factors that will govern the decision-making process are the safety of blood products and ensuring that we have sufficient blood reserves to meet the needs of hospital patients."
In a letter to HÉMA-QUÉBEC and the Canadian Blood Services, Health Canada's Bureau of Biologics and Radiopharmaceuticals asked both agencies to find a coordinated solution for the deferral of donors by June 10.
"We are prepared to begin working immediately with the Canadian Blood Services to find a coordinated solution," added Dr. Décary. The issue will be discussed at the Blood Safety Council forum taking place in Vancouver on May 6 and 7.
On October 15, 1998, the Bayer Advisory Council on Bioethics, recommended deferring donors who have resided in areas with a high incidence of the new variant of Creutzfeldt-Jakob disease since 1980. Later, on October 27, 1998, Health Canada's Laboratory Centre for Disease Control asked HÉMA-QUÉBEC and the Canadian Blood Services to assess the impact that deferral measures could have on the blood supply. "HÉMA-QUÉBEC assessed the impact that deferral measures would have on the blood supply by conducting a poll of 5,000 of its donors in January 1999. The results showed that, since 1980, 13% and 25% of the respondents had visited the United Kingdom and France respectively at least once," said Dr. Marc Germain, epidemiologist at HÉMA-QUÉBEC.
Risk management, a lesson from the Krever report
The Krever report recommends that organizations in charge of blood management should proceed with caution in matters of safety. In part VI, chapter 40, section 2 e) of his report, Justice Krever raised many interesting points:
"Preventive action should be taken when there is evidence that a potentially disease-causing agent is or may be blood borne, even when there is no evidence that recipients have been affected. If harm can occur, it should be assumed that it will occur. If there are no measures that will entirely prevent the harm, measures that may only partially prevent transmission should be taken."
Although there is no scientific and epidemiological evidence that the new variant of Creutzfeldt-Jakob disease is transmitted by blood, approximately forty cases of the disease have been reported in Great Britain and one in France. The new variant (nvCJD), generally described as a prion disease (infectious protein), is a degenerative brain disorder and is always fatal. Discovered in 1996, nvCJD is said to have been caused by human exposure to "mad cow disease" or bovine spongiform encephalopathy (BSE).
HÉMA-QUÉBEC and the Association of Blood Donation Volunteers are urging the public to continue donating blood. The two organizations work closely to organize blood drives in Quebec in order to keep the blood supply at an adequate level thereby ensuring that the needs of patients in hospitals throughout the province are met.
Each year, the approximately 1,900 blood drives organized throughout the province provide hospitals with the 450,000 units of blood components they need to care for their patients. HÉMA-QUÉBEC relies on donors and a team of 25,000 volunteers to provide the hospitals with this service. HÉMA-QUÉBEC's mission is to provide Quebeckers with safe, top-quality and sufficient blood components, products and substitutes to meet the needs of hospitals and to offer recognized expertise and specialized immunohematology services.