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More information about donating blood if you have lived in the UK

What is the Blood Service’s policy regarding blood donation for people who have lived in the United Kingdom (UK)?

A person who has lived in the UK between 1 January 1980 and 31 December 1996 for a total of 6 months or more is ineligible to donate blood. The UK refers to England, Wales, Scotland, Northern Ireland, the Channel Islands, Isle of Man and the Falkland Islands.

Why is this policy in place?

The purpose of this policy is to reduce the possible risk of transmission via transfusion of variant Creutzfeldt-Jakob disease (vCJD), a disease which is attributed to eating products from cows infected with bovine spongiform encephalopathy (BSE, also known as ‘mad cow’ disease).

For several years from the late 1980s there was a large outbreak of BSE among cows in Europe with most cases reported in the UK, where there were almost 1,000 new cases per week at the height of the BSE epidemic in January 1993. The UK has also reported the highest number of confirmed cases of vCJD among people, including a small number who have contracted vCJD through blood transfusions.

Therefore, people who have received a transfusion in the UK since 1980 are also deferred.

Did BSE affect cattle here in Australia?

No, Australia was not affected by BSE and remains BSE free.

What is vCJD?

vCJD is a fatal disease that affects the brain. It has a very long incubation period and infected individuals may not show symptoms for more than 10 years.

What is the causative agent of vCJD?

The agent responsible for vCJD is not a virus or bacterium. It is an abnormal form of a naturally occurring protein (termed a ‘prion’) found in the human body. When they infect a healthy person, the prions are able to convert normal proteins to prions.

Why doesn’t the Blood Service just screen for vCJD?

Whilst there are tests in development that have the potential to detect vCJD in a person with the disease, a suitable screening test for well blood donors is not available. Additionally, there are several issues that would need to be considered before implementing a screening test for blood donors. Therefore, the Blood Service has a deferral policy to manage the transfusion-transmission risk of vCJD.

But why is the deferral time for living in the UK set at six months or more?

The deferral is based on international policy decisions and research indicating an increased risk of contracting vCJD by living in the UK for at least six months total.

The Australian policy is similar to policies in New Zealand, Switzerland, Thailand, Netherlands and Belgium.

So what’s the difference between someone who was in the UK for five months and 29 days, and someone who was there for six months and one day?

The deferral period was decided based on an acceptable level of risk. The period of six months was defined based on scientific evidence for likelihood of exposure.

But I could donate blood in the UK before I moved here. What’s the problem?

The UK was the centre of the massive BSE outbreak and therefore required a different risk management approach that balanced the need to maintain an adequate blood supply versus the risk of transmitting vCJD by transfusion. This was achieved by a policy allowing UK residents to donate blood in order to maintain a supply of red blood cells, clinical plasma and platelets. However, the UK imports all plasma for fractionation into products such as albumin, coagulation factors and immunoglobulins.

My mother was pregnant with me when she was in the UK but left soon after I was born. Does the gestation period count towards time spent in the UK?

No. The deferral does not apply to you if you have not lived in the UK for a period of 6 months or more after you were born.

But I’m a vegetarian – how does this affect me?

There are animal products that can be present in some apparently vegetarian foods. For example:

  • gelatin (made from animal bone marrow) which is found in lollies, jelly, icing and glazes
  • animal products can also be found in jams, yoghurt, cream cheese and margarine
  • in fat-reduced foods
  • in many wines, beer and juices
  • in shortening for baked goods
  • rennet in cheese
  • some refined sugar, and
  • some medicines

I’m a vegan and none of that applies to me, so why can’t I donate?

It is not operationally practical to perform tailored assessments of individual donors prior to every donation. Therefore ‘group’ risks of transfusion-transmissible infections are used for deferral criteria. The ‘group’ vCJD risk is defined in our policy above.

I’m perfectly healthy and haven’t lived in the UK for 20 years or more – why can’t I donate?

While it is true that the cases of vCJD reported to date have had a shorter incubation period (10-15 years) compared to classical CJD, there is a theoretical possibility of a ‘second wave’ of vCJD cases in exposed persons who have a lower genetic susceptibility and thus may exhibit a longer incubation period.

Why is the eligibility for organ donation different to blood donation?

Very few people donate organs, and because the patients who need them are likely to die without the transplant, a different risk-benefit assessment is made.

Are you likely to change the deferral?

We would consider changing the deferral if indicated by medical evidence or if a reliable screening test became available that is suitable for blood donors. Whilst there are candidate tests that have the potential to detect the disease, they are unsuitable for blood donor screening. In addition, any screening test would need to be carefully evaluated before introduction. Consideration of any screening test includes impacts on donors and the possibility of errors. Should this deferral policy be amended, please be assured that this information would be disseminated widely.

Why don’t you separate blood stocks from donors who are not eligible to donate under this policy and give to patients who have lived in UK?

This has been considered in the past but unfortunately the logistics make this solution impracticable. Furthermore, there are ethical and regulatory concerns with collection and transfusion of blood from donors who are at risk of vCJD in the absence of a suitable screening test when alternatives are available.

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