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Ban puts strain on Island blood supply

Certain people have been banned from donating blood in a bid to protect residents from mad cow disease.

And the ban -- imposed on people who have spent more than six months in any part of Europe between 1980 and 1996 -- will have a "catastrophic'' effect on the Island's blood supply.

The Bermuda Red Cross Society made the decision at a meeting on Tuesday night in response to similar precautionary measures taken against the disease in the United States and parts of Europe. The ban takes effect immediately and will be in place indefinitely.

Dr. Keith Cunningham, the hospital Director of Labs and the man ultimately responsible for Bermuda's blood supply, yesterday said the effect on local supply would be "catastrophic''.

"Because it covers a period of 16 years that means the only people excluded are the old hands like me who were in the UK before 1980 or the very young ones,'' he said.

He pointed out that the ban includes the majority of European expatriates on the Island as well as residents that attended European schools within the ban period. Those who travelled extensively to Europe over the time period are also on the stop list as the six month criteria is cumulative.

"Short-term visitors to Europe are okay,'' Dr. Cunningham said.

Rejected donors will be given a leaflet explaining why they can not give blood.

"We would like to reassure you, however, that you should not be alarmed about your health, and we do not believe that it is necessary for you to see your doctor as a result of this deferral,'' the pamphlet reads.

Despite the dramatic decline in acceptable donors, Dr. Cunningham said the Island would not be looking for outside supplies of blood.

"We're prepared to rely on our own resources,'' he said. "But those resources are going to be limited.'' The danger of shortages is relative, he added. "We will have limited ability to meet the need for massive transfusions. It's unlikely we'll ever have supplies for 40 pints of the same (blood) group to treat catastrophic injuries.'' Island faces blood shortage But whether shortages will arise out of the need for "two pints here and two pints there'' is as yet undetermined.

Dr. Cunningham said that looking overseas for blood was "not practical'', as it is perishable and must be kept at a constant temperature and would not travel well.

"The blood centre will appeal to the medical fraternity to consider other methods of building blood levels,'' said Dr. Cunningham.

Doctors will be asked to pay meticulous attention to tying off blood vessels during surgery and to provide patients under treatment with the stimulants of red blood cell production.

While he said these measures would not always be possible, it is hoped the cumulative effect will reduce demand on the blood supply.

Blood banks in the United States tightened controls on blood donations in response to the mad cow epidemic in the UK in early January. They add their numbers to those in the UK -- which no longer uses plasma from its own citizens -- and France which will no longer take blood donations from persons who have lived in the UK for longer than six months.

Mad cow disease -- or Bovine Spongiform Encephalopathy (BSE) -- first appeared in the UK in November 1986. Since then 180,000 cases have been confirmed in UK cattle.

That number has steadily declined, but what is worrying the blood banks is possible transmission through blood of nvCJD -- new variant Creutzfeldt Jakob Disease -- the degenerative and often fatal disease which is believed to result from eating products from BSE-infected cattle according to World Health Organisation reports.

The disease, which is believed to have affected 91 people since it first appeared in October 1996, has so far only been found in the UK, France and the Republic of Ireland, according to the WHO.

Blood banks which suffered immensely after failing to respond to the emergence of AIDS in the 1980s are taking a better-safe-than-sorry approach with nvCJD.

At early onset of nvCJD patients reportedly experience depression and a "stickiness'' of the skin and occasionally exhibit schizophrenic behaviour.

As the illness progresses, they experience unsteadiness and involuntary movements and in fatal cases are rendered comatose.

Dr. Cunningham said blood in Bermuda's bank prior to Tuesday's decision will not be discarded however as risk is minimal.

"Nothing will be thrown out,'' he said. "There has been no documented case of transmission of new variant Creutzfeldt-Jakob Disease by transfusion.'' Transmission by blood has only been seen in sheep at this point, he said.

"But after the bitter experience with things like Hepatitis and AIDS in the past, the view taken now is `stop just in case' rather than later saying `didn't think it would happen'.'' But Dr. Cunningham urged local residents not to panic.

"We're not trying to start a panic, we're just being extra conservative with the safety of the debilitated people who receive blood,'' he said. "There is no perceived threat to the health of those living in the area.'' And he said that given a UK population of some 60 million, the number of nvCJD cases to date was "not really that high''.