Llewelyn CA et al. 2004, Possible transmission of variant Creutzfeldt-Jakob disease by blood transfusion (Lancet 363:417-421)

This Lancet paper by Llewelyn and six co-authors reported the first possible case of variant CJD spread through a blood transfusion in the UK. It came from a look-back linking national vCJD surveillance cases to blood donation records, which found 48 recipients of components from 15 donors who later became vCJD cases; one recipient developed vCJD 6.5 years after a red cell transfusion. The authors framed it as possible transmission, not proven, because earlier dietary exposure could not be excluded, though they put the chance of such a coincidence at roughly 1 in 15,000 to 1 in 30,000. The UK announced an exclusion of previously transfused donors within about six weeks. Only the abstract was read; the full text is paywalled and was not opened. Information only.

Key facts

  • Citation as verified: Llewelyn CA, Hewitt PE, Knight RSG, Amar K, Cousens S, Mackenzie J, Will RG; The Lancet 2004, volume 363, issue 9407, pages 417-421; DOI 10.1016/S0140-6736(04)15486-X; PMID 14962520. The queued citation was correct apart from the missing issue number and author list.
  • Method: the national CJD surveillance unit shared all probable and definite vCJD cases with the blood services, who searched donation records at blood centres and hospitals; named donors and recipients were matched against the case register and recipients were checked against national death records.
  • Result: 48 people had received labile blood components from 15 donors who later became registered vCJD cases.
  • One recipient developed vCJD 6.5 years after a red cell transfusion, from a donor who became symptomatic 3.5 years after donating.
  • The authors concluded transfusion transmission of vCJD is possible, while noting infection from earlier dietary exposure to the BSE agent could not be ruled out.
  • Without transmission by transfusion, the estimated chance of a vCJD case turning up among recipients was about 1 in 15,000 to 1 in 30,000.
  • Trade press reported it on 26 February 2004 as the first possible case of vCJD spread by transfusion, alongside a Lancet macaque study in which intravenous BSE agent caused disease faster than oral dosing.
  • On 16 March 2004 the Department of Health in England announced that people transfused in the UK since 1 January 1980 could no longer donate blood.
  • The journal record lists the paper as not open access; the abstract is the deepest level read in this pass.

Timeline

  1. 2004Paper published in The Lancet, volume 363, issue 9407 (Europe PMC lists 1 February 2004 as first publication date; the issue date itself was not confirmed).
  2. 2004CIDRAP News reports the paper as the first possible transfusion transmission of vCJD.
  3. 2004Department of Health in England announces exclusion of donors who have been transfused in the UK since 1 January 1980.
  4. 2004Eurosurveillance publishes a report on the UK measures.

Last checked 1 November 2026

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