When news came this month that a second person had become infected withvariant Creutzfeldt-Jakob disease from a transfusion, memories of afrightening phone call came rushing back for The Globe's ALANNA MITCHELL

By ALANNA MITCHELLTuesday, August 17, 2004 - Page A13

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I still remember the day I got that phone call: Friday, May 3, 1996, atabout noon. My daughter, the hellishly cheery voice told me, was one ofseveral thousand Canadians who had received a blood transfusioncontaining some blood products from donors who developed the fatalCreutzfeldt-Jakob disease, the human form of mad-cow disease.

I put my head in my arms and cried so hard that colleagues came into myoffice to see what was wrong. My daughter, then 5, had been fullytransfused at birth, a measure that saved her life. We'd dodged allsorts of health bullets since then, and thought it was all behind us.And now this.

But what was this? What were the implications of the fact that she hadreceived blood from someone who then died from CJD?

The cheery voice couldn't tell me. And when I investigated, I found thatnobody else could, either. At the time, doctors did not know whether CJDcould be transmitted by blood transfusion.

They only knew that there had not been a documented case of transmissionby transfusion so far. They said it was theoretically possible. Iremembered when they used to say that about HIV, too, and it was coldcomfort.

But it has been more than eight years since that phone call, and myfamily had moved on. Until earlier this month, that is, when a snippetfrom the respected medical journal The Lancet caught my eye. It told ofa second person who had been infected by blood transfusion with theBritish-born form of CJD, which is known as variant or vCJD. In 1996,the first case of vCJD emerged in Britain. It was linked to theconsumption of beef from a cow infected with mad-cow disease.

Clearly, it was time to ask more questions.

Kumanan Wilson, an assistant professor in the University of Toronto'sdepartment of medicine, has been one of the foremost researchers ontransfusions and CJD in Canada since the issue first hit the publicradar 10 years ago. He took time out from his holidays to provide someanswers.

The nub of it is that vCJD is quite a different beast from classic CJDand is transmissible by transfusion, but it turns out that classic CJDprobably is not. Because of research done in the intervening years,fears about whether classic CJD can be spread through the blood supplyare far less today than they were 10 years ago.

Back in 1994 and 1995, fears about the safety of the blood supply randeep and wide. Canada's Krever inquiry into the HIV-tainted-bloodscandal was in full swing; one hematologist who testified at the inquirysaid he believed that CJD could be the next big threat to the blood supply.

At the time, the American Red Cross had already recalled blood productsfrom donors who later developed CJD. In 1995, the Canadian Red Crossfollowed suit, informing about 900 hospitals that they had bloodsupplies from a donor who went on to develop CJD. Each hospital then hadto decide whether to inform patients who had received the blood. A fewdid, including my daughter's hospital; many did not.

Later that year, Health Canada declared that it would no longer acceptblood donations from people known to be at risk of developing CJD.

At the same time, five studies were launched around the world to seewhat happened to people who had received the CJD-donor blood, and tocheck out the blood-transfusion history of people who died from CJD.

When vCJD hit Britain in 1996, doctors were immediately worried aboutthe blood supply. They reasoned that if people could get vCJD fromeating meat, it was likely they could get it from blood, said Dr. Wilson.

Classic CJD affects only neurological tissue and can be transmitted bytransplants of infected neurological tissue. But the new type, vCJD,also attacks lymph tissue, which is intimately connected with the body'sblood supply. And in vCJD, the concentrations of prions, the malformedproteins that cause the infection, are far higher than in classic CJD.

Meanwhile, the results of some of the "look-back" studies on thetransfusion history of people who developed classic CJD were coming in.The logic behind the studies was that because blood transfusions havebeen common for 60 years, looking back at transfusions given to peoplewho later died from classic CJD might hint at whether blood was involvedin the deaths.

The studies found that people who died from classic CJD had not receivedmore transfusions than other people. As well, the rate of classic CJD inthe population has remained stable over 60 years, even as transfusionhas grown more common.

For classic CJD, it all added up to what doctors now consider a closedcase, said Dr. Wilson. As an extreme precaution, though, Canadian BloodServices does not accept blood from people who have classic CJD in theirfamily. (People like my daughter, however, are as free to donate bloodas anybody else.)

And if the blood-services agency finds out that a donor went on todevelop classic CJD, it tracks down the blood and withdraws whatever isleft in the system. Again, this is just to be on the safe side, giventhe mounting evidence that classic CJD cannot be transmitted throughblood, noted Lesly Bauer, manager of strategic communications forCanadian Blood Services in Ottawa.

However, because of the growing evidence that vCJD can be transmittedthrough the blood supply, the focus instead is on making sure thatdonors are barred from giving blood if they have lived in the UnitedKingdom and several other parts of Europe where tainted beef was consumed.

And as for my daughter? She's so busy living life to the fullest thatshe rarely gives a thought to her blood. Now 14, she's happy, healthyand preparing for high school in the fall.

Guarding our blood

To protect against possible transmission of variant Creutzfeldt-Jakobdisease (vCJD) in the Canadian blood supply, you cannot donate blood orplasma:

if you have spent a total of three months or more since 1980 in theUnited Kingdom (England, Scotland, Wales, Northern Ireland, the Isle ofMan and the Channel Islands) or France;

if you have spent a total of five years or more since 1980 in Belgium,Germany, the Republic of Ireland, Liechtenstein, Luxembourg, Italy, theNetherlands, Portugal, Spain, Switzerland, Austria and Denmark;

if you have had a blood transfusion or have had medical treatment with aproduct made from blood in the U.K. since 1980;

if a blood relative (parent, child, sibling) has developedCreutzfeldt-Jakob disease.