As the military prepares for a possible war in the Middle East, the Armed Services Blood Program Office says that U.S. forces have an adequate supply of blood for transfusions, despite concerns about federal regulations implemented last year that bar blood donations from many Americans, including military personnel, who have lived in the United Kingdom or Europe.
For the past year, the Food and Drug Administration has banned American blood banks-both civilian and military-from accepting blood donations from people who spent a cumulative three months or more in the United Kingdom between 1980 and 1996, who were stationed at European military bases for six months or more during that period, or who spent a cumulative five years elsewhere in Europe since 1980.
The FDA established the policy so that the blood supply would not be inadvertently contaminated with rogue proteins, or "prions," that are believed to cause variant Creutzfeldt-Jakob Disease (vCJD), a fatal, brain-wasting illness that is the human equivalent of the bovine ailment commonly known as "mad cow" disease.
While most scientists and physicians agree that reasonable precautions against vCJD transmission are justified, a sizable number of critics consider the FDA rule to be a matter of overkill. They point out that there is no evidence that vCJD can be transmitted through human blood transfusions. And they question whether it is wise to restrict the blood-donor pool at a time when blood banks are already stretched thin.
The U.S. armed forces-whose members have historically been eager blood donors- appear to have been hit more severely by the new donor restrictions, because many soldiers have been based in Europe at one time or another.
Army Col. Michael Fitzpatrick, director of the Armed Services Blood Program Office, said that donor-deferral rates in the military-that is, the percentage of prospective donors turned away for any reason-is now about 18 percent, compared with the 12 percent deferral rate reported by the American Red Cross. Mad cow-specific deferrals are not tabulated by either organization.
Despite this, Fitzpatrick added that donation rates have actually increased due to active donor-recruitment programs implemented around the same time as the mad cow restrictions.
"We currently have sufficient blood supplies within our system to meet our needs," he said. "We like to have a nine-day supply, and we've been able to maintain that level since November 2001."
Fitzpatrick said that all of the blood shipped to date for Operation Enduring Freedom-about 22,000 units-has come from Defense Department donor centers.
By contrast, the situation is more troublesome in the less-regimented civilian sector. Right now, the Red Cross has a 2.5-day supply of blood nationally, which is below its minimum goal of three days.
Experts say that the civilian shortages could have been even worse but for a surge of donations after the Sept. 11 attacks and a little-noticed decision that allowed the transfusion of blood from patients who have a rare but noninfectious disease called hemochromatosis.
Fitzpatrick added that the FDA regulations cover donations, not transfusions. Thus, American soldiers who were injured on the battlefield would not be prevented from receiving transfusions of British or European blood.
"In emergency situations, blood from host nation medical facilities could be transfused to save a U.S. military member's life," he said. "If a U.S. casualty were evacuated to an allied country's medical facility and required a blood transfusion, that person would receive blood maintained at the allied facility."
In this case, the injured soldier would be followed medically for a year to determine if there was any transmission of infectious diseases, mad cow or otherwise, Fitzpatrick said.