[광우병] 영국인 2000명 중 1명 수혈로 인간광우병 감염됐을 것(영국정부 보고서)

건강과대안 — Wed, 15 May 2013 20:00:02 +0000

Policy paper vCJD and transfusion of blood components: updated risk assessment

Organisation:: Department of Health
Published:: 15 April 2013
Applies to:: England

https://www.gov.uk/government/publications/vcjd-and-transfusion-of-blood-components-updated-risk-assessment

vCJD AND TRANSFUSION OF BLOOD COMPONENTS:
AN UPDATED RISK ASSESSMENT
Peter Bennett and Maren Daraktchiev
Health Protection Analytical Team
Department of Health
Wellington House
133-155 Waterloo Road, London SE1 8UG
February 14th 2013
CONTENTS
SUMMARY 1
1. INTRODUCTION 2
2. CASE EVIDENCE, PREVIOUS SCENARIOS AND MODEL CALIBRATION 4
3. INPUTS AND ASSUMPTIONS REVISITED 9
4. MODELLING METHODS 17
5. RESULTS AND DISCUSSION 29
6. CONCLUDING COMMENTS AND CAVEATS 32
ANNEXES
A. BACKGROUND EVIDENCE AND DATA
1. Total usage of components
2. Distribution of units by age of recipients
3. Post-transfusion survival
4. Transfusion-related vCJD infections and follow-up of recipients
B. ESTIMATING THE RISK OF vCJD INFECTION FROM PAST RECEIPT OF
BLOOD COMPONENTS
C. PAST AND FUTURE SECONDARY CASES: ILLUSTRATIVE SCENARIOS
D. SUMMARY OF “CALIBRATED” MODEL RUNS

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영국의 병원에서 인간광우병에 감염된 혈액의 수혈로 인한 인간광우병으로
사망한 사람이 1000명에 이를 수 있다는 영국 정부 보고서가 2013년 4월
15일 발표되었습니다.

영국 정부의 전문가들은 3만명 정도의 영국 국민들이 수혈로 인해서 인간광우병에
감염되었을 것으로 추정했습니다.(이 추정치는 이전 추정치의 2배)

Frank Dobson 전 보건부장관은 총리에게 장래 수혈을 통한 인간광우병 사망을
막기 위해 헌혈자들을 위한 전국적 검사 프로그램을 시행할 것을 촉구했습니다.

영국 정부의 조치로 지금은 쇠고기에 의해 인간광우병에 감염될 가능성은 거의
없지만, 영국 국민 2000명 중 1명(즉 3만명)은 이미 수혈에 의해 변형 프리온에
감염된 채 증상이 나타나지 않는 채 다른 사람에게 변형 프리온을 전염시키는
침묵의 매개자(“silent” carriers)을 하고 있다고 볼 수 있습니다.

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Mad cow infected blood ‘to kill 1,000’

By Rowena Mason, Political Correspondent

10:00PM BST 28 Apr 2013

http://www.telegraph.co.uk/health/healthnews/10024078/Mad-cow-infected-blood-to-kill-1000.html

The Government continues to encourage ‘people of all ages to give blood’ Photo: AFP

Up to 1,000 people could die of the human form of “mad cow” disease through infected blood given to them in British hospitals, ministers have been told.

Government experts believe there is still a risk of people contracting variant Creutzfeldt-Jakob Disease (vCJD) through blood transfusions, as about 30,000 Britons are likely to be carrying the brain-wasting illness in a dormant form — double the previous estimate.

They warn the current total death toll of 176 from vCJD could rise more than five-fold as the infection has not been wiped out of the blood supply like it has been in the food chain.

Frank Dobson, a former health secretary, tonight urged ministers to develop a nationwide screening programme for blood donors to stop future infections of vCJD, which has the potential to cause “horrendous deaths”.

People are no longer in danger of getting vCJD from eating British beef, after ministers ordered the slaughter of millions of cows when the “mad cow” disease scandal broke in 1989. Fears that hundreds of thousands of people could contract the human form of bovine spongiform encephalopathy (BSE) proved unfounded.

However, the Government acknowledges that one in 2,000 Britons – or approximately 30,000 people- are already “silent” carriers of infectious proteins that lead some people to develop vCJD.

A little-reported study last summer concluded the prevalence of this “silent” vCJD is likely to be twice as high as previously thought.

These 30,000 carriers can unknowingly pass on the infectious proteins – known as prions – to new potential sufferers through donated blood.

Because so little is known about vCJD, there is no telling which carriers will go on to develop the disease or whether any new cases will actually materialise at all.

There have been no new cases for two years and there are thought to be no surviving sufferers of vCJD, which has always historically proved fatal.

However a new risk assessment published this month by the Government’s Health Protection Analytical team reveals that infected blood donations could cause up to 1,000 deaths in a high case scenario.

About half of the cases could develop in people who have already received blood transfusions and up to 580 cases from people who are yet to be infected with the disease. The central estimate of infections yet to occur is 205.

It suggests ministers could consider recruiting young blood donors born after 1996 once they become eligible, as they will not have eaten infected beef.

“The number of “silent” vCJD infections associated with transfusion would be much higher than the number of clinical cases,” it said. “It is therefore important to maintain, and if possible enhance, measures to prevent onward transmission of infection, notably the exclusion of recipients from donating blood.”

Mr Dobson, the former Labour Health Secretary, said “everything humanly possible should be done to develop a blood test”.

“There is no room at all for complacency,” he told The Daily Telegraph. “With a blood test, you would be able to screen every potential donor. If that screening showed the incidence was higher than thought then maybe you would do it for the whole population.”

Professor John Collinge, an expert from University College London, whose research unit has developed a blood test for vCJD, said there is an element of “wishful thinking” within the Government, with officials hoping the problem has gone away.

He said he is “sceptical of guesstimates” of future cases and believes ministers need to start a study of vCJD in blood, rather than appendices, to get a proper grip on the risk of infection through transfusions.

“The figure of one in 2,000 in the appendix study was pretty worrying,” he said. “I was pretty alarmed by that. It’s clear there is a very substantial pool of infection in the community. There needs to be blood testing to answer this question of prevalance properly.”

Sir Paul Beresford, an MP and former Conservative environment minister, also believes the Government must wake up to the potential for future vCJD infections and is campaigning for more filtering of donated blood.

“If we’ve got it wrong our grandchildren are going to potentially have an epidemic of vCJD that we can do nothing about but we can prevent it if we act now,” he said.

“There’s some quite simple things they can do. For example, there’s a new system that’s being developed that will filter red blood cells before transfusion.

“[The system] is not adequate at the moment but the Government’s argument is that there’s no sign of a risk because the number of people turning up with vCJD is going down. But it can take 10, 15, 20, 25 years for this to pop up.”

A spokesman for the Department of Health said the Government continues to encourage “people of all ages to give blood”, adding “we have one of the safest blood supplies in the world”.

“Independent experts from the Advisory Committee on the Safety of Blood, Tissues and Organs have used this study during their considerations of measures to reduce the potential risk of transmission through blood transfusions,” she said. “There is no evidence of any UK clinical cases of vCJD being linked to a blood transfusion given after 1999.

“In fact there have been no new cases in the UK for more than two years.”

She said the study relates to people’s future potential to develop vCJD, not actual new cases that have occured.

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영국서 인간광우병 수혈 감염으로 1천 명 사망 우려”

SBS 최종편집 : 2013-04-29 17:46
http://news.sbs.co.kr/section_news/news_read.jsp?news_id=N1001760657

영국에서 인간광우병인 변종 크로이츠펠트-야콥병(vCJD)의 수혈을 통한 감염으로 1천여 명이 사망할 수 있다는 보고서가 나왔습니다.

영국 일간지인 텔레그래프에 따르면 영국 정부의 보건 분석팀은 수혈로 인간광우병 사망자가 1천여 명이 될 것으로 예측했습니다.

이 가운데 절반은 현재 수혈을 받은 사람들이지만 나머지는 앞으로 받을 수혈로 발병할 거라고 분석팀은 보고 있습니다.

이에 따라 보고서는 광우병에 걸린 소를 먹지 않은 1996년 이후 출생자만 헌혈할 수 있게 하는 방안을 제안했습니다.

이에 대해 영국 보건부 대변인은 이번 연구는 혈액·조직·기관 안전 자문위원회의 전문가들이 수혈을 통한 vCJD 감염 위험을 줄이는 방안을 검토하는 과정에서 나온 것이라며, 1999년 이후 영국에서 발병한 어떠한 vCJD도 수혈과 연관됐다는 증거가 없고 특히 지난 2년간은 신규 발병자가 아예 없다고 밝혔습니다.

또, 영국정부는 앞으로도 모든 연령의 사람들에게 헌혈을 계속 장려할 것이라고 덧붙였습니다.

영국에서는 지금까지 176명이 vCJD로 사망했으며 대부분 광우병에 걸린 소고기를 먹고 발병한 것으로 조사됐습니다.

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Risk assessments for CJD

http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/CreutzfeldtJakobDisease/CJDIncidentsPanel/RiskAssessmentsForCJD/
Risk Assessments

Panel advice is based on risk assessments commissioned by the Department of Health:

Risk Assessment of Exposure to vCJD Infectivity in Blood and Blood Products February 2003 [external link]
Risk Assessment for vCJD and Dentistry July 2003 [external link]
Assessing the risk of vCJD transmission via surgery: an interim review March 2005 [external link]
vCJD risk assessment calculations for a patient with multiple routes of exposure June 2009 [external link]
The risk of secondary vCJD Infection of patients receiving a high number of blood transfusions. July 2009 [external link]
vCJD in blood recipients with a possible donor in common: coincidence versus causality February 2010 [external link]

The first version of the Framework document was based on the following risk assessment:

Risk Assessment for transmission of vCJD via surgical instruments: a modelling approach and numerical scenarios March 2001 [external link]

Last reviewed: 3 April 2013

건강과 대안 » 영국정부 보고서

[광우병] 영국인 2000명 중 1명 수혈로 인간광우병 감염됐을 것(영국정부 보고서)

Policy paper vCJD and transfusion of blood components: updated risk assessment