Combating vCJD In The US And The UK

Main Category: CJD / vCJD / Mad Cow Disease
Article Date: 27 Oct 2006 - 20:00 PDT

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A study of the differences between the approaches adopted by the authorities in the US and UK to combat variant Creutzfeldt-Jakob disease (vCJD) has found that scientific evidence is not the only the factor determining how governments react to health crises. The research was conducted by Dr Maya Ponte of the University of California, San Francisco.

When vCJD, also described as being the human form of 'mad cow disease'(BSE), appeared in the late 1990s, the authorities in many countries became concerned that the disease agent (or 'prion') responsible might contaminate blood supplies for transfusion, thus leading to a major epidemic. In both the US and the UK, procedures were put in place to reduce the chance of this happening. The officials concerned attempted to do so in a fully 'scientific' manner, but faced the problem that there was a lack of reliable information about how the disease was transmitted. In the end, the two countries decided on very different changes to their respective regulations on blood donation. Both countries chose to prevent certain people from donating blood. In the UK, however, the decision was made to remove white blood cells from donated blood, while the US decided that such a step was not merited by the evidence.

Dr Ponte wanted to understand more clearly why the UK and US ended up with different policies: what role was played by science, and how important were other factors? She searched for all relevant official government documents from the US and UK, as well as scientific papers. She also interviewed people who knew about vCJD management in the two Countries; for example, members of government agencies and advisory committees.

Although these documents and interviews suggested that policy making was rooted in the limited scientific evidence then available, many non-scientific factors were also important. Policy makers felt guilty about a previous experience in which people had become infected with HIV/AIDS through contaminated blood and were concerned about repeating this experience. And, in the UK, the possibility of blood contamination was seen as a much more urgent problem than in the US, because BSE and vCJD were found there first and there were far more cases. In addition, the scientific evidence that UK advisors relied on in making their decision to remove white blood cells from donated blood came to them ahead of publication through a social network of regulators and scientists. In the US, a social network made up of different scientists and regulators emphasized contradictory evidence.

Dr Ponte's study has shown that historical and social factors such as previous experience, sense of urgency, public pressure, and the relative importance of different scientific networks influenced the responses to vCJD. The same is likely to be the case in future outbreaks of new diseases.

Citation: Ponte ML (2006) Insights into the management of emerging infections: Regulating variant Creutzfeldt-Jakob disease transfusion risk in the UK and the US. PLoS Med 3(10): e342.

PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://dx.doi.org/10.1371/journal.pmed.0030342

CONTACT:

Maya Ponte
University of California San Francisco
Anthropology, History, and Social Medicine
1446 Rhode Island St.
San Francisco, CA 94107 United States of America

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Social medicine in the 21st century

Contact: Andrew Hyde
Public Library of Science

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