Seven former medical officials are on trial in France following a 17 year investigation into over 100 deaths from Creutzfeldt-Jakob disease (CJD) of young patients treated with contaminated growth hormones.

The defendants, retired doctors and pharmacists in their 70s and 80s, are accused of manslaughter, aggravated deception and causing unintentional injury, said Reuters news agency.

111 French children and young people have died and over 800 others are at risk of CJD, an incurable disease where the brain gradually wastes away, and whose symptoms can take up to 40 years to appear.

Francine Delbrel, a member of one of the victims’ associations bringing the case against the defendants told the press that:

“Each time we have thought that the danger is passing a new death arrives to dash our hopes.”

Her daughter Benedicte, died when she was 21 years old, in 1993. Her doctors were not able to diagnose the disease, said Times Online.

The trial started yesterday, Wednesday 6th February, in a Paris courtroom packed with 200 relatives of the victims. If convicted the defendants could be sentenced to serve 4 years. One defendant, a pharmacology professor, who is also charged with corruption for accepting bribes, could serve 10 years, according to Guardian Unlimited.

The prosecution will be using the results of a long and complex investigation that took 17 years and looked into many aspects of the cases and the events surrounding them.

Doctors in France continued to treat children with stunted growth using hormones harvested from the pituitary glands of dead humans until the late 1980s. Other countries, the US and Britain included, stopped using human derived growth hormones in 1985 and switched to synthetic versions, after a young American was thought to have died from CJD caught from infected human hormones.

Meanwhile in France, pituitary glands continued to be harvested from human corpses, although procedures were supposed to be tightened up, until 1988. The prosecution case relies on allegations that the the preparation and harvesting methods did not follow the new procedures and that in some cases untrained staff were involved.

Many of the thousands of organs bought by the accused during the 1980s came from Bulgaria and Hungary, said the investigation report, and in some cases the staff of one of the team members took them from bodies in neurological or geriatric wards or from a hospital specializing in infectious diseases. The investigators also found evidence that operation theatre ordelies had been paid small sums for pituitary glands.

The families of CJD victims came together and decided to sue after a French teenager died of CJD in 1992.

Another factor likely to count against the defendants is that the institute where the team worked had been warned in 1980 that the human version of the hormone could be a source of CJD. This warning came from Luc Montagnier, the scientist who identified the AIDS virus, said Reuters.

The defendants are apparently not denying that they made mistakes, but they argue scientists did not know at the time about the risks linking CJD with human growth hormone. There was speculation, but no high degree of certainty, and it was not until 1990 that the link between CJD and the pituitary gland was established.

One of the defence lawyers, Benoit Chabert, told the press that the defendants “acted based on the state of knowledge at the time,” and that it is easy to say today, over 20 years later, that the risk was there, “but in 1983, in 1985, was the risk certain?” he asked.

The court will be hearing evidence from over 20 expert witnesses, said Times Online, including 1997 Nobel Prize Winner for Medicine, Stanley Prusiner, the scientist who discovered prions.

Prions are small proteins that cause a range of brain degenerative diseases such as CJD in humans and bovine spongiform encephalopathy (BSE, or “mad cow disease”) in cattle. The prions from the infected source get into the brain and play havoc with the new host’s neural protein, making it fold into shapes that disrupt the tissue structure and function of the brain.

Sources: Times Online, Guardian Unlimited, Reuters.

Written by: Catharine Paddock, PhD