DoD Seeks to Mend Looming Rift in Blood Donor Rules
By Rudi Williams
American Forces Press Service
WASHINGTON, Jun. 1, 2001 DoD is working behind the scenes to create a national standard for collecting blood as the American Red Cross prepares to adopt new donor rules in September.
Red Cross officials have said the rules stem from concerns about the spread of "mad cow" disease in Europe. The Red Cross plans not to take donations from persons who, at any time since 1980, spend or have spent a cumulative three months or more in the United Kingdom, or a cumulative six months or more in any one or more European countries, or received a blood transfusion in the United Kingdom.
DoD and the Red Cross currently follow the Food and Drug Administration's lead, according to Army Col. Mike Fitzpatrick, director of the Armed Services Blood Program. He said the policy for the past two years has been to defer persons indefinitely as donors if they resided in the United Kingdom between 1980 and 1996 for a cumulative six months or more.
The current deferral rule affects 5 percent or less of DoD's donor population worldwide, he estimated. Implementing the Red Cross' new policy throughout Europe would make about 25 percent of the active duty force ineligible to donate blood, he said.
DoD will continue to follow the FDA, he continued, but the FDA has not agreed to the Red Cross' policy -- and two donor standards will be in use unless it does. DoD doesn't want that.
He said department officials believe the better solution is a national standard for blood donors. DoD, FDA, Human and Health Services and Red Cross officials are working to establish a mutually agreed standard, he noted.
"We've prepared draft guidance and are waiting (for) the final determination. … We need to know that before we could do anything," the colonel said. "Because of the way the FDA regulates us, it's going to require time to train people, put together standard operating procedures and a recruitment campaign to get donors -- that's why it's taking the Red Cross until September. We'll have to do the same things, but we can't train anyone until we know what we're training them for."
DoD meets its needs using today's donor standards, he said. Even using the Red Cross' more restrictive policy, "We still think we could collect the blood we need within DoD by increasing recruitment efforts, command sponsorship and command emphasis on the need to donate blood," he said.
DoD collects about 100,000 units of blood per year. It must maintain that rate to have enough blood for troops in Kosovo, Bosnia and other areas where safe supplies would be hard to find and tap, Fitzpatrick said.
Everyone wants to be as cautious as possible, he said. "With all the testing and screening we're doing to blood donors, the blood supply is the safest it has ever been," he said. "So, it's safe to give and receive blood." But there are questions about what's reasonable and necessary.
The incurable, always-fatal "mad cow" disease is caused by an infectious protein that destroys the victim's nervous system. Brain tissues literally turn spongy and shut down. Called variant Creutzfeldt-Jakob disease in humans, the disorder usually kills within 18 months of the onset of symptoms.
Fitzpatrick said there's no evidence the disease is or even can be transmitted through a blood transfusion. To date, fewer than 100 cases of variant CJD have been reported since it was identified, and none was the result of a blood transfusion, he stressed.
The only way the evidence today points to humans contracting variant CJD is by being unusually susceptible to it and eating infected meat. The infectious protein that triggers variant CJD, however, is known to be able to hide for 15 years or more in lymphatic tissue, the appendix, stomach, spleen, white cells, and in the blood at low levels, he said.
At this time, no blood test exists to detect the presence of the infectious protein, he noted.
The DoD veterinarians responsible for the wholesomeness of foods in military systems have determined that service members and their families face little risk of contracting variant CJD, he said.
Deployed service members are at less risk than casual travelers in Europe because military personnel often eat either Meals, Ready to Eat or food from military supply channels, which don't buy meat from the United Kingdom, the colonel noted.