Red Cross Bans Chronic Fatigue Patients From Donating Blood

The American Red Cross won’t accept blood from people diagnosed with chronic fatigue syndrome as the U.S. government works to determine if the disorder is tied to a transmissible virus, the group said.

The move, announced yesterday on the Red Cross website, follows by almost four months study findings that tied the condition to an infectious agent called XMRV. More than 1 million Americans have chronic fatigue syndrome, according to the U.S. Centers for Disease Control and Prevention in Atlanta.

The data reported in August was contrary to a report by the CDC a month earlier that failed to find a viral link. The statement by the Washington-based Red Cross, the nation’s largest supplier of blood products, reflects an ongoing medical debate over the syndrome, which is marked by extreme fatigue after mental or physical exertion, sleep that fails to refresh, and joint and muscle pain.

“In the interest of patient and donor safety, the American Red Cross will defer indefinitely any donor who reveals during the donor interview that they have been diagnosed” with chronic fatigue syndrome, the group’s statement said. “XMRV infection has been associated in some studies with prostate cancer and chronic fatigue syndrome, but at the present time these disease associations have yet to be confirmed.”

About four million people donate blood through the nonprofit organization, a volunteer-led relief organization founded in 1881, according to its website.

June Recommendation

The Red Cross decision goes beyond a June recommendation by the AAB, formerly known as the American Association of Blood Banks, that blood-collecting organizations use donor education materials to actively discourage potential donors diagnosed with chronic fatigue syndrome, or exclude them based on a negative response to the question, “Are you feeling well today?”

“The Red Cross has implemented the AABB recommendations and has gone further to implement indefinite deferral for donors who reveal a history of a medical diagnosis,” the Red Cross said. “There is currently insufficient data to conclude that XMRV is transmitted through blood transfusion. However, the National Heart, Lung and Blood Institute Task force is conducting research to determine the frequency of the virus in the donor population, whether it is transfusion-transmitted, and whether recipients become infected and develop the disease.”

There is no widely accepted cure for chronic fatigue syndrome, and no medicines are approved to treat it, according to the CDC.

Antiviral Treatment

While antidepressants, behavioral therapy and pain drugs are given for symptoms of the condition, the latest study suggested that antivirals, including Merck & Co.’s Isentress and Gilead Sciences Inc.’s Viread, be tested for treatment of it.

In that study, published in the Proceedings of the National Academy of Sciences, almost 90 percent of people studied showed signs of infection with a group of mouse leukemia viruses.

“There was a dramatic association with chronic fatigue syndrome, but that’s all it is,” Harvey Alter, senior author and chief of clinical studies of the department of transfusion medicine at the National Institutes of Health, said at the time. “We have to emphasize we have not proven causality.”

The viruses found are associated with murine-related leukemia, a form of an infectious agent known to cause leukemia and other cancers in mice. The study uncovered virus in blood samples taken from 32 of 37 patients with the syndrome about 15 years ago. A repeat test taken this year on 8 of the patients found a slightly mutated form of the virus in 7 of them.

Dilemma Created

The conflict between that finding and the previous CDC research creates a dilemma for researchers, Alter, a senior author of the report, said at the time.

One explanation may be that chronic fatigue syndrome is caused by a virus in some and not in others, he said. It’s also possible that people with the condition are more vulnerable to infections, the researchers said.

“That still has to be sorted out,” Alter said in a conference call with reporters.

Additional work is under way to make sure investigators are using the same methods to check for the viruses, and to confirm the results in a wider and more varied group of patients, the researchers said.

It was the first time these specific viruses were found in people or in the blood supply. Another study of 1,000 blood donors is nearing completion to see if the virus or antibodies to it are in the blood supply, Alter said.

The link between chronic fatigue and the retroviruses was identified previously by a team led by Vincent Lombardi of the Whittemore Peterson Institute for Neuro-Immune Disease, in Reno, Nevada, and published in October in the journal Science.

Those researchers analyzed the genes in tissue samples collected from 101 patients with chronic fatigue, and found evidence of the mouse virus XMRV in 68 of those studied. The virus was also identified in some prostate-cancer patients.

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