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Variant Creutzfeldt-Jakob Disease Impact on U.S. Military Service Members

Variant Creutzfeldt-Jakob Disease Impact on U.S. Military Service Members. Lt. Col. David Lincoln Deputy Director Armed Services Blood Program Office. Slide 1. vCJD -DoD Current Deferral Policy. In residence or traveled to UK cumulative ≥3 mo(1980-1996)

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Variant Creutzfeldt-Jakob Disease Impact on U.S. Military Service Members

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  1. Variant Creutzfeldt-Jakob Disease Impact on U.S. Military Service Members Lt. Col. David Lincoln Deputy Director Armed Services Blood Program Office Unclassified Slide 1

  2. vCJD-DoD Current Deferral Policy Unclassified In residence or traveled to UK cumulative ≥3 mo(1980-1996) DoD & affiliated personnel in residence or traveled to BSE risk countries (Europe) cumulative ≥6 mo (1980-1996)* DoD affiliated personnel in residence or traveled to BSE risk countries (Europe) cumulative ≥5 yrs (after 1996) Other personnel in residence or traveled to BSE risk countries (Europe) ≥5 yrs or more (1980-present) Transfusion blood/blood product in UK or France (1980-present) Received bovine insulin prepared in the UK since 1980 *No distinction for Northern Europe vs. South of the Alps

  3. Saudi Arabia Residency vCJD Deferral Unclassified • New vCJD case in Canada • Believed to have contracted vCJD while living in Saudi Arabia • Two other patients from outside Canada also believed to have contracted vCJD while living in Saudi Arabia • Canadian Blood Services to follow Héma-Québec (2008) and implement an indefinite deferral for donors who spent >6 months (cumulative) in Saudi Arabia 1980-1996 • DoD implementing same deferral effective Aug/Sep 2011

  4. Rationale Supporting Deferral Unclassified • Between 1980 and 1996, Saudi Arabia imported beef from the U.K., which could have been exposed to BSE-- U.K. beef was likely available at DoD facilities • 1990 DoD begins to discontinue purchase of UK beef • Interviews with DoD Veterinary Command consultants and personnel deployed to Saudi Arabia for Desert Shield/Desert Storm indicate: • U.K. beef consumption by U.S. military, civilians, and contractor personnel during that period • Estimated 10% proportion of UK beef to total beef consumed by US forces in Saudi Arabia during DS/DS force due to beef consumption on local economy. Contractors may be higher

  5. Rationale supporting deferral Unclassified Slide 5 • Not known with certainty if vCJD cases related to food consumption in Saudi Arabia, but a possible source of infection • It is possible that other bases within the Persian Gulf region may have acquired U.K beef during this time frame • May have been acquired indirectly by third party • Possible expansion of DoD deferral to include the entire Gulf Region under consideration

  6. Deployments to Saudi Arabia 1980 – 2003 Unclassified Slide 6 • U.S. Military Training Mission (USMTM) Saudi Arabia (1980-1990) • Approximately 1,000 troops deployed annually • Operation Desert Shield/Storm (Aug 1990-Sept 1991) • Approximately 550,000 troops deployed • 90% greater than 6 months • Operation Southern Watch (1991-2003) • U.S. combat troops and air crews enforce southern Iraqi “no-fly” zone • Approximately 5,000 troops deployed annually

  7. Loss to Blood Supply from DoD Exposure Unclassified Slide 7 • Estimated number of U.S. troops based in Saudi Arabia from 1980-1996 = 590,000 • Fact: DoD civilians, government civilians, contractors could add another 200,000 • Assumption: 5% blood donor population 790,000 X 5% = 39,500 donors • However, approximately 30% of this population already deferred for vCJD risk based on European deferral or other conditions . • A large number of this population retired or left active duty service and may be donating to civilian blood collection facilities • Impact to Blood Supply appears to be minimal

  8. LOOKBACKs Unclassified No recipient look backs based solely on new geographic risk deferrals will be performed by DoD

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