title: All clinically-relevant blood components transmit prion disease following a single blood transfusion: a sheep model of vCJD.
abstract: Variant CJD (vCJD) is an incurable, infectious human disease, likely arising from the consumption of BSE-contaminated meat products. Whilst the epidemic appears to be waning, there is much concern that vCJD infection may be perpetuated in humans by the transfusion of contaminated blood products. Since 2004, several cases of transfusion-associated vCJD transmission have been reported and linked to blood collected from pre-clinically affected donors. Using an animal model in which the disease manifested resembles that of humans affected with vCJD, we examined which blood components used in human medicine are likely to pose the greatest risk of transmitting vCJD via transfusion. We collected two full units of blood from BSE-infected donor animals during the pre-clinical phase of infection. Using methods employed by transfusion services we prepared red cell concentrates, plasma and platelets units (including leucoreduced equivalents). Following transfusion, we showed that all components contain sufficient levels of infectivity to cause disease following only a single transfusion and also that leucoreduction did not prevent disease transmission. These data suggest that all blood components are vectors for prion disease transmission, and highlight the importance of multiple control measures to minimise the risk of human to human transmission of vCJD by blood transfusion.
authors.affiliation: The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Edinburgh, United Kingdom.
authors.forename: Sandra
authors.initials: S
authors.lastname: McCutcheon
authors.forename: Anthony Richard
authors.initials: AR
authors.lastname: Alejo Blanco
authors.forename: E Fiona
authors.initials: EF
authors.lastname: Houston
authors.forename: Christopher
authors.initials: C
authors.lastname: de Wolf
authors.forename: Boon Chin
authors.initials: BC
authors.lastname: Tan
authors.forename: Antony
authors.initials: A
authors.lastname: Smith
authors.forename: Martin H
authors.initials: MH
authors.lastname: Groschup
authors.forename: Nora
authors.initials: N
authors.lastname: Hunter
authors.forename: Valerie S
authors.initials: VS
authors.lastname: Hornsey
authors.forename: Ian R
authors.initials: IR
authors.lastname: MacGregor
authors.forename: Christopher V
authors.initials: CV
authors.lastname: Prowse
authors.forename: Marc
authors.initials: M
authors.lastname: Turner
authors.forename: Jean C
authors.initials: JC
authors.lastname: Manson
mesh_terms: D000818:Animals; D016913:Blood Component Transfusion / Q000009:adverse effects* / Q000662:veterinary; D001782:Blood Donors; D001921:Brain / Q000378:metabolism / Q000473:pathology; D002417:Cattle; D007562:Creutzfeldt-Jakob Syndrome / Q000097:blood / Q000209:etiology* / Q000635:transmission; D004195:Disease Models, Animal; D016643:Encephalopathy, Bovine Spongiform / Q000097:blood / Q000635:transmission; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000662:veterinary; D006801:Humans; D015151:Immunoblotting; D007150:Immunohistochemistry; D047589:Leukocyte Reduction Procedures; D017713:Platelet Transfusion / Q000009:adverse effects / Q000662:veterinary; D018620:PrPSc Proteins / Q000032:analysis; D017096:Prion Diseases / Q000097:blood / Q000209:etiology* / Q000635:transmission; D012756:Sheep
chemical_list: D018620:PrPSc Proteins