Abstract
If a recipient of donated blood develops a disease that might have come from the transfusion, what are the implications for the donors concerned? This is a question of particular concern if the recipient develops variant CJD. There is as yet no test available to determine whether someone is carrying the infection without yet showing symptoms - a state that may last for decades. Nor is there any way of reliably eliminating the infective agent from blood or from surgical instruments used on an infective patient. If the recipient's infection did come from a blood donation, that donor might unknowingly infect others, either through further donations of blood or tissues, or through undergoing certain forms of surgery — e.g. neurosurgery. On the other hand, the recipient may have been infected by some other route, with no implications for anyone who donated blood to them. Responses to incidents of this type face a difficult balance between the need to protect public health (by reducing any risk of further infection) and avoiding needless alarm and distress to individuals. Using a simple Bayesian model, OR analysis has helped assess the implied risk to donors in such situations, and has guided decisions on how such incidents should be handled.
Additional information
Notes on contributors
Peter Bennett
Peter Bennett has worked in the Department of Health for ten years, having previously been a Reader in Management Science at Strathclyde University, and now heads its London-based OR team. This is a part of a multi-disciplinary group providing policy analysis on a wide range of topics, ranging from public health issues such as obesity and smoking, to preparations for pandemic flu and other emergencies, through to delivery of national strategies for cancer and vascular disease. He has specialised in different aspects of risk, including communication about risks to public health, and latterly in risk analyses to underpin precautions against the spread of vCJD.
Stephen Dobra
Stephen Dobra is a Principal Operational Research Analyst in the Department of Health. For the last 3 years, he has provided analytical support to the National Blood Service on a variety of Issues including improving the supply chain, risk analysis and evaluation of proposals to improve blood safety. In addition, he has provided analytical advice on risk, cost-effectiveness, blood safety and supply to support policy development in the Department of Health and to various government and blood services’ advisory committees. Prior to this, he worked for more than 15 years in strategic planning and business development in the telecommunications sector.
Johanna Gronlund
Johanna Gronlund joined the NHS in 2005 after completing her MSc in Health Care Management, Economics and Policy in Universita Commerciale Luigi Bocconi in Milan, Italy. As part of that course, she worked as an intern in the Department of Health in London, contributing to the analysis described here. She currently works in Brighton & Hove City Primary Care NHS Trust as an analyst.