May 21, 2001 (Washington) -- In an attempt to protect the nation's blood supply from mad cow disease, the American Red Cross said Monday that starting in September, people who have spent three months in Britain or six months in the rest of Europe can no longer donate blood to the organization.
"This is a judgment call," Bernadine Healy, MD, tells WebMD. The president of the American Red Cross notes that scientists still don't know a lot about mad cow disease and how it is transmitted, nor do doctors have a test to screen for it. But organizations like the Red Cross still have to function when all the answers are not available.
"The nature of medicine, when [you] don't have complete scientific information, is to make a judgment and then you modify your judgment as more science comes along," Healy says.
Mad cow disease is a degenerative brain disease in animals. Infected animals act crazy, or "mad," displaying changes in mood such as nervousness or agitation and having difficulty standing up, and usually die within two weeks to six months. Mad cow disease seems to spread to people through eating infected beef. There is no proof yet that it or its human counterpart, new variant Creutzfeldt-Jakob disease, spreads through blood. But getting prepared in case there is a risk to the blood supply has become a real controversy.
Healy adds that the ban could be temporary, lasting until doctors have a better way to gauge who might have contaminated blood. But for now, the Red Cross is making its new donation restrictions.
Under the Red Cross policy announced Monday, donations will be banned from:
- Anyone who has lived in the U.K. for a total of three months or longer since 1980.
- Anyone who has lived anywhere in Europe for a total of six months since 1980.
- Anyone who has received a blood transfusion in the U.K.
The new rules are much stricter than those recommended by the FDA, although according to a report from Monday's Wall Street Journal, the federal regulators are still discussing policy on mad cow disease and the blood supply -- something that affects not only blood for transfusions but also blood products that help patients with clotting problems.
Experts worry that the conflicting guidelines will further confuse the public about the baffling disease.
Last year, the federal government banned blood donations from anyone who spent a total of six months in Britain between 1980 and 1996, when that country was the epicenter of the mad cow outbreak.
But with mad cow disease spreading throughout Europe, in January scientific advisers to the FDA recommended banning donations from anyone who spent a total of 10 years in Portugal, France, and Ireland since 1980. The expert panel, which included some of the nation's top mad cow experts, concluded that these countries were of most concern but said the risk there was lower than that in Britain.
In February, the FDA indicated it would stick closely to the recommendations of its advisers, who argued that the Red Cross' call for tighter restrictions went farther than necessary. The agency said then that it was likely to impose the ban only on travelers to Portugal and France.
The Red Cross, which collects about half of the nation's blood supply, is legally allowed to set stricter standards than required by the government. But its blood banks may not say or imply that their blood is safer than those collected by banks following the government standards.
Competing blood banks fear patients will perceive the Red Cross policy as safer and thus they will have to follow suit, risking shortages by turning away longtime donors such as military families.
Healy notes the Red Cross also has presented a plan to the FDA to address the shortage risks that the new rules could cause.
"We have an obligation to compensate for that," Healy says. She notes her organization has presented to the FDA its four-point plan to bring in more blood. First, the Red Cross will promote the use of new collection techniques that could allow double the red blood cells to be taken from a donor. Blood surpluses, when they occur, could be frozen instead of discarded, to prepare for lows. There are plans underway to encourage the existing four million annual donors to give five times yearly instead of about twice a year, and media campaigns are to be expanded to bring in new donors.