New Study Finds No Link of Rare Brain Disease to Infected Blood

ADVANCE/SAN FRANCISCO, April 15, 1999 /PRNewswire/ -- Classic or sporadic Creutzfeldt-Jackob Disease (CJD) does not appear to be transmitted through contaminated blood transfusions or blood products, according to new research from the U.S. Department of Affairs (VA). Researchers examined more than 8,000 inpatient episodes and 500 death certificates of veterans who received blood products prepared from plasma of donors subsequently found to have died from CJD. The researchers report that their data showed none of the patients died from, or had medical conditions consistent with, CJD -- a rare and fatal degenerative disorder for which no treatment exists.

The VA study is one of the largest to date to look at the potential risk of contracting this infectious disease from CJD-contaminated blood or plasma derivatives. The findings will be presented at the Ninth Annual Scientific Meeting of the Society for Healthcare Epidemiology of America (SHEA), in San Francisco, April 18-20.

In addition to the CJD study, other significant VA research to be reported includes, poster presentations on a newly developed "early warning" surveillance system for emerging pathogens, and the prevalence of hepatitis C virus (HCV) infection in Vietnam veterans. VA Under Secretary for Health, Dr. Kenneth W. Kizer, (a co-author of the three research papers), noted the work being presented reflects the real-world approach to dealing with the problems of antibiotic resistant-infections and emerging infectious diseases among VA's patient population.

"VA is in the forefront of infectious disease research," said Kizer. "In the past few years, we have applied that knowledge to a global health-care setting by developing innovative intervention and treatment strategies in response to the HCV epidemic and the CJD blood contamination threat."

"The comprehensive way in which we confront these public health care issues has application far beyond our own health care system," continued Kizer. "We look forward to sharing our research findings with our colleagues outside of VA."

The major focus of VA research at the SHEA meeting will be the CJD paper presented by lead author, Abid Rahman, Ph.D., Epidemiologist, VA AIDS Service, Office of Public Health. This study came about as a result of VA's look-back notification program of patients who potentially received CJD-contaminated blood products. According to medical experts, there is no evidentiary basis showing the illness can be transmitted through blood components. In fact, the Centers for Disease Control and Prevention has described the risk as "small, immeasurable and theoretical."

Notwithstanding the theoretical risk, in 1995 VA voluntarily elected to notify all patients of the exposure to potentially contaminated blood products, when it was discovered that patients might have received blood components from donors who died of the disease. "Our patients had the right to know of the potential problem [of blood contamination], even if the risk was minimal," said Dr. Rahman. "The next thing to do was to develop a means of tracking and clinically managing these patients, and determining if there was any indication of CJD in this group."

Rahman and colleagues examined the morbidity and mortality records of 1,568 patients at 62 VA medical centers, who were administered potentially CJD-infected blood derivatives or plasma products. The patient group examined was 98.6% male, 86% white, with nearly 77% over the age of 60. The researchers reviewed 8,614 inpatient episodes of care (including 862 episodes of care since the administration of the contaminated products) and 543 death certificates of patients who may have been infected.

They found the primary diagnoses for inpatient stays was circulatory system diseases (29%), followed by 15% for digestive system diseases and 11.3% for neoplasms. None of the 862 episodes were consistent with conditions associated with CJD. The death certificate review produced similar results. The immediate causes of death indicated that neoplasms and circulatory system disease were the major causes of death at 30% and 28.2%, respectively. Respiratory, infectious and nervous system diseases, along with mental disorders, accounted for the rest.

"The study has significant public heath care implications," said Rahman. "Based on what the data show, thus far, there is only a small theoretical risk of transmitting CJD from contaminated blood products." Noting the disease's long incubation period, Rahman said VA continues to monitor the clinical history of these veterans.

Creutzfeldt-Jackob Disease is rare degenerative disease of the brain and central nervous system characterized by a rapidly progressive dementia. Other symptoms may include cognitive impairment and muscle spasms. It belongs to the class of diseases known as transmissible spongiform encephalopathies. It is the human equivalent of bovine spongiform encephalopathy, more popularly known as "Mad Cow" disease. The illness reportedly affects one in a million people in the U.S. annually.

VA research provides improved medical care for veterans, as well as the general population. Through its unique affiliation with medical schools, VA plays a crucial role in educating future physicians in research and clinically oriented areas.

SOURCE U.S. Department of Veterans Affairs