Cayman retains ‘mad cow’ blood-donation ban

Despite the United States and Australia lifting restrictions on blood donations from donors due to concerns over Creutzfeldt-Jakob disease, Cayman is maintaining the ban following recommendations from the Pan American Health Organization.

PAHO confirmed in a virtual conference this week, with the Cayman Islands Blood Bank and other regional health facilities, that it was continuing its policy of rejecting donations from people who had spent time in certain European countries in the 1980s and ’90s, when cases of Creutzfeldt-Jakob Disease were reported there.

The disease, which is rare but invariably fatal, is related to bovine spongiform encephalopathy, or BSE, also known as ‘mad cow disease’, which affects cattle.

In response to queries from the Cayman Compass, the Cayman Islands Blood Bank said in a statement, “PAHO confirmed that its position remains the same and the region is advised to maintain its current blood donation policies.”

PAHO is the World Health Organization’s arm in the Caribbean and Latin America.

The Cayman Islands Blood Bank said, while it acknowledged that some organisations had lifted the ban on blood donations, “It should also be noted that the [Association for the] Advancement of Blood & Biotherapies (AABB) and Canadian Blood Services, whose guidelines we also reference, still have this matter under review.”

Under its donor-eligibility criteria, the Cayman Islands Red Cross will not accept blood from anyone who lived in the United Kingdom from 1980 to 1996 for a cumulative period of three months, or who spent five years or more from 1980 to the present date in a European country.

According to its website, just 2.4% of Cayman’s residents are blood donors.

US, Australia lift ban

In a guidance document issued in May this year, the US Food and Drug Administration reversed its recommendation – first issued in 1999 – for blood banks and hospitals not to accept blood donations from donors who had spent time in the UK from 1980-1996, or in France and Ireland from 1980-2001.

In October, the American Red Cross adopted the FDA recommendation and began accepting blood from those donors.

Earlier this year, in April, the Therapeutic Goods Administration approved Australia’s Red Cross Lifeblood to receive donations from people who lived in the UK between 1980 and 1996.

Willing to donate

Appeals for blood issued by the Cayman Islands Blood Bank over the years regularly lead to frustrated comments by people who have lived in Europe during the affected period, who query why they are still not allowed to donate their blood.

In one recent online appeal by the blood bank for O-positive donors, one resident responded, “There are hundreds of us who will donate if you let us. My husband and I returned from college in the UK 36 years ago, had been regular donors and can’t donate now.”

Another wrote, “I have type O positive and haven’t lived in the UK for 30 years but I can’t donate?”

And another said, “Please start allowing people from Europe to donate rather than running out of blood that would save a life.”

In its statement, the blood bank said that it “appreciates the willingness and the strong donation culture of UK and European citizens, particularly those who reside in the Cayman Islands, and we recognise blood donor restrictions is a very topical and sensitive issue. We continue to follow regional advice and will also continue to monitor any further changes.”

Decades-old ban

Mad cow disease was first recognised in the UK in 1985 and subsequently spread to many European countries and worldwide. A human version of the disease, variant Creutzfeldt-Jakob, which is believed to be caused by eating beef products from infected cattle, was first detected in the UK in 1996.

The blood-donation ban was introduced in 1999 after it emerged that 18 of the 178 vCJD cases in the UK had donated blood that was subsequently used in 67 blood transfusions. Three deaths from vCJD were linked to blood transfusions between 1996 and 1999 that involved blood from two donors who died from the disease within one to three years of their donations, the FDA said.

According to the FDA, as of April 2021, there had been a total of 232 cases of vCJD worldwide – with 178 in the UK, 28 in France, four in Ireland, four in the US involving former residents of overseas countries, and 18 cases in eight other countries.

The UK is the only country where the disease has been found to be transmitted via a blood transfusion, the FDA noted. The last reported case of the disease being transfusion-transmitted in the UK occurred in 2006.

The agency said it was changing its recommendations based on “new information” in the risk assessments published by the UK’s Advisory Committee on the Safety of Blood, Tissues and Organs, and the Medicines and Healthcare products Regulatory Agency.

The FDA noted, “These risk assessment models, which FDA has independently evaluated, demonstrate that, in the UK, the current risk of vCJD transmission by blood and blood components would expose transfusion recipients to no or minimal additional risk of vCJD in the future.”

Based on the fact that the number of vCJD cases reported in France and Ireland were far lower than in the UK, the FDA also removed the ban on blood donations for people who had spent time in those two countries.