Dear Hitoshi,

Since there is no case of vCJD in Germany (and hopefully, there will be no cases in the future), the cost-benefit ratio of introducing a prion filter is very poor. We exclude transfusion recipients and people staying > 6 months in the UK during the "high risk" period (1980-1996) from blood donation. Apart from this, epidemiological modelling showed no additional benefit from adding further safety measures.

Best,,

Markus

There are two major reasons. The first one is the decrease in the cases of vCJD world wide especially in countries where this had been a problem (UK, France, Italy etc.). The reason for the decline is because some of the measures that are in place appear to be effective in rediucing the risk of vCJD in blood transfusion. For example, if you lived in the UK in for 3-6months during the period of mad cow disease, you are prevented from donating blood in the US and other countries.

Since there have not being any new cases of vCJD the interest in the disease gradually decreased because it is felf that the current measures are working.

The other reason is cost. Most of the blood banks are very reluctnat to introduce a new technology that will add usbtantial cost to their operating cost of producing a unit of blood component for transfusion.

Hi Hitoshi

Yes the UK has considered implementing a prion filtration system for blood transfusions. Below I have posted one link to a surveillance trial (there are other interesting articles and papers which can easily be found online if you are interested in reading more) http://www.nhsbt.nhs.uk/clinicaltrialsunit/current-trials/prion-filter-pms/

Best

Daryl

In addition here is a link to CJD statistics (vCJD does still exist, contrary to popular assumption) http://www.cjd.ed.ac.uk/documents/figs.pdf

Furthermore, sporadic and genetric cases of CJD (which affect 1 in 1 million) are also infectious, thus regardless of the state of the vCJD epidemic, a prion filtration system for blood transfusions should, in my opinion, be considered.

Jerard Seghatchian- International consultancy in blood component quality/ safety & DDR strategy, London /UK-

The combined process of leucocyte and prion removal also works very well with the current second generation viral inactivation process for WB/ RBC with the benefit of reducing the levels of microparticles/ microvesicles hence having potential of reducing some immunological side effects

As far as France is concerned, ask Dr Jean-Philippe Desly, CEA, Fontenay aux Roses

E-mail: [email protected]

As far as France is concerned, ask Jean-Philippe Deslys,

CEAFontenay aux Roses which is experimenting such a filter.

E-mail: [email protected]

For countries with low or zero problems of vCJD it should be enough the reduction of WBC, but it is true that sporadic and genetic cases of CJD are also infectious, so maybe a prion filtration system for blood transfusions should be considered at least in patients withs haemoglobinopathies requiring frequent transfusions.

Dear all,

the most important risk reduction measure for sporadic CJD is the exclusion of relatives of CJD patients from blood donation and the exclusion of pts. receiving tissues at risk (e.g. dura, cornea, etc.). In countries with a high prevalence of vCJD, a prion filter might be considered, in countries with a low or a zero prevalence, it is much better to invest in other risk reduction measures like bacterial testing, pathogen reduction or reduction of plasma in RBC or platelet concentrates.

I agree totally wiith DR Markus Müller

I also absolutely agree with the risk differences between countries. However, I ask all interested people to read, when published, the submitted paper by Emmanuel Comoy, Nina Jaffré and coworkers from different French research labs on Prions and neurodegenerative diseases. Cynomolgus monkeys and mice inoculations by different ways showed that prions can be infectious at very low titers, and that the phenotype may be quite different from the classic Human Prion diseases. Woud they occur in Humans, they would never be identified as such.(PhD thesis of Nina Jafré, Paris 7 University).

Wednesday, July 23, 2014

After the storm? UK blood safety and the risk of variant Creutzfeldt-Jakob Disease

Conclusion

22. SaBTO’s decision not to recommend the adoption of prion filtration, taken alongside the other evidence that we have gathered during this inquiry, in our view signals a change from what was a genuinely precautionary approach to vCJD risk reduction in the late 1990s to a far more relaxed approach today. Much of the uncertainty surrounding prions, their potential modes of transmission and the possible rate of undetected infection and disease remains: recent evidence that subclinical prevalence could be as high as one in 2,000 people would suggest that a precautionary approach is now more warranted than ever. (Paragraph 94)

23. Our fear is that the Government’s current attitude is driven less by the available scientific evidence than it is by optimism: a hope that the storm has now passed and that vCJD is no longer the threat to public health that it once was. In the current economic environment, this attitude is not surprising. However, it is not justified. For all we know, the storm may well be ongoing. We conclude this report by recommending that the Government take a more precautionary approach to both vCJD risk mitigation and blood safety more generally, in order to safeguard against future infections. We suggest that it begin by assessing the key risks, known and unknown, that the UK blood supply currently faces and might face in the future, so that it can identify and fill relevant knowledge gaps and support the development of appropriate risk reduction measures and technologies. The Government should initiate this work immediately and we ask that it provide us with an update on its progress well before the dissolution of Parliament. (Paragraph 95)

56After the storm? UK blood safety and the risk of variant Creutzfeldt-Jakob Disease EMBARGOED ADVANCE COPY Not to be published in full, or in part, in any form before 00.01am on Thursday 24 July 2014 Formal Minutes Wednesday 16 July 2014

http://www.parliament.uk/business/committees/committees-a-z/commons-select/science-and-technology-committee/news/140718-bto-report-to-be-published/

http://vcjd.blogspot.com/2014/07/after-storm-uk-blood-safety-and-risk-of.html

Friday, October 11, 2013

Removal of exogenous prion infectivity in leukoreduced red blood cells unit by a specific filter designed for human transfusion

ORIGINAL ARTICLE

http://vcjdtransfusion.blogspot.com/2013/10/removal-of-exogenous-prion-infectivity.html

http://vcjdtransfusion.blogspot.com/

Thursday, January 22, 2015

Transmission properties of atypical Creutzfeldt-Jakob disease: a clue to disease etiology?

http://creutzfeldt-jakob-disease.blogspot.com/2015/01/transmission-properties-of-atypical.html

MAD COW DISEASE nvCJD TEXAS CASE NOT LINKED TO EUROPEAN TRAVEL CDC ***

Sunday, November 23, 2014

*** Confirmed Variant Creutzfeldt-Jakob Disease (variant CJD) Case in Texas in June 2014 confirmed as USA case NOT European ***

the patient had resided in Kuwait, Russia and Lebanon. The completed investigation did not support the patient's having had extended travel to European countries, including the United Kingdom, or travel to Saudi Arabia. The specific overseas country where this patient’s infection occurred is less clear largely because the investigation did not definitely link him to a country where other known vCJD cases likely had been infected.

http://vcjd.blogspot.com/2014/11/confirmed-variant-creutzfeldt-jakob.html

Sunday, December 14, 2014

*** ALERT new variant Creutzfeldt Jakob Disease nvCJD or vCJD, sporadic CJD strains, TSE prion aka Mad Cow Disease United States of America Update December 14, 2014 Report ***

http://transmissiblespongiformencephalopathy.blogspot.com/2014/12/alert-new-variant-creutzfeldt-jakob.html

kindest regards, terry