Letters to the Editor: Blood Bank adheres to rules

The front page headline in Monday’s 26 April Caymanian Compass – Prospective blood donors turned away – gives the unfortunate impression
that the Health Services Authority has deliberately turned away donors from
giving blood.

The Blood Bank takes a conservative approach to ensure the safety of
our blood supply and therefore, follows international guidance relating to both
known infectious diseases as well as potentially emerging diseases that could
impact our blood supply.

To reduce the possible risk of transmission of Creutzfeldt-Jakob
Disease and New Variant Creutzfeldt-Jakob Disease by blood and blood products
several countries implemented a policy to restrict blood donors from the United
Kingdom where cases of the CJD variant were clinically diagnosed. Although rare, CJD is an invariably fatal degenerative disease of
the central nervous system.

The implementation of similar guidelines by the HSA is not unique to
the Cayman Islands and, as a matter of fact, consistent throughout the
Caribbean, the United States and many other countries. It is therefore
unfortunate that your article seems to suggest that the HSA has unilaterally
implemented this policy without due regard to international best practices and
clinical evidence.

It is also necessary to highlight the fact that even in the UK there
are certain restrictions on blood donors. The UK Blood Services imports fresh
frozen plasma from US volunteer donors for the use in children born after 1
January, 1996. The rationale for this cut off date is that children born since
1996 are considered to have received minimal exposure to the variants of the
disease. Many of the rules implemented in the UK on who can give blood are a requirement
of European law.

Whilst the restrictions impact some of our consistent donors and one
which we would hope will be removed, based on scientific evidence and
conclusions, it is important to point out that the restrictions affect only a
particular group of individuals:

If they travelled or resided in the United Kingdom for a cumulative
total of three months or more at any time from 1980 through the end of 1996.

If they received a blood
transfusion in the United Kingdom at any time from 1980 to present.

If they travelled or resided
anywhere in Europe for a cumulative total of six months or more at any time
from 1980 through the end of 1996.

If they travelled or resided
anywhere in Europe for a cumulative total of five years or more at any time
from Jan. 1, 1997, to the present.

It may be worthwhile pointing out that from time to we have had to
defer accepting donors from other jurisdictions due to health concerns and international
regulations.

We understand the difficulties and witness almost daily the impact of
this decision on patient care and recognise the sensitivity of the issue but
must follow the guidance of global health experts on this issue. If we for a moment
decide to go against these international recommendations and the life of a
single patient is impacted in the Cayman Islands, think about the consequences
and castigation from all levels of society including journalists who will heap
proverbial coals of fire on us for not following international guidelines.

We recognise that the scientific technology for determining
individuals at risk for CJD and nvCJD, and detecting the infectious agents in
tissues and in products, is continuing to advance, and that there may be a need
for future updating of the relevant guidance and when those have been adopted
the H.S.A will follow the recommendations of the international experts.

Sincerely,

Lizzette Yearwood
HSA chief executive officer

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