We need to define their rights and responsibilities and those of others

In December 2003 the health secretary, John Reid, told parliament of the death of the first probable victim of variant Creutzfeldt-Jakob disease (vCJD) after being transfused blood in 1996 from a donor who had been incubating vCJD.1 The disease manifested in the donor in 1999, who died from it. This is the first probable case of transmission of vCJD following blood transfusion. The incubation period of under seven years in the recipient was notably short—consistent with human to human transmission.2 We now need to take steps to define the rights and responsibilities of recipients of “at vCJD risk” blood and blood products and also those of the rest of the population. These steps promise to be expensive and intrusive and have enormous implications for those at risk.3

The issues faced are more parlous than for HIV, against which the blood supply is protected by HIV testing and surgical instruments by autoclaving.4^–6 As yet we have no blood test for vCJD and no cure, and surgical instruments used on patients with vCJD have to be destroyed. People who have received blood or blood products that are highly at risk for vCJD will now need to be managed as if vCJD had been diagnosed. This means surgical instruments (including dental) used on these patients cannot …