Dr Sheila Bird argues that the death of the first probable victim of vCJD from a blood transfusion means that steps must be taken to define the rights and responsibilities of those at risk, as well as the general public.

Because there is no way of testing blood for vCJD, people who have received products that may be contaminated need to be managed as if the disease had been diagnosed. This means that they must accept certain responsibilities, such as refraining from blood donation and providing information to ascertain the size of the risk to others. It will also be necessary to clarify criminal justice liabilities for reckless transmission of the disease.

However, steps must also be taken to protect patients' rights, for example by protecting them against intrusion from the press.

Dr Bird also argues that the case has implications for tests (due to begin this year) for prion protein in tonsils collected from children and adults following tonsilectomy. While it is not certain that a child whose tonsillar tissue tests positive for abnormal prion will develop vCJD, they are potentially at risk. The potential transmission of vCJD through blood may now mean that any positive specimens will have to be identified, raising issues of anonymity and parental consent.

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Contact: Linda Millington
pressoffice@bma.org.uk
44-207-383-6473
BMJ-British Medical Journal
15-Jan-2004