Has Egypt received contaminated blood from Britain? Mustafa El-Menshawy investigates Egypt has vehemently denied importing British blood products that could be contaminated with the human form of "mad cow" disease. An in-depth report in the 27 September edition of the British paper The Times indicated that 11 countries had imported blood products donated by nine British people who died after contracting variant Creutzfeldt- Jakob disease (vCJD). Although Egypt was amongst the 11 countries listed in the report, the next day an official statement from the Egyptian Health Ministry was quick to dismiss the claims as "groundless". The report alleged that Egypt had imported 144 vials of albumin (protein in blood plasma) containing the contaminated products, which include Immunoglobulin, which helps to replace anti-bodies, and factor VIII, a clotting agent. Countries sometimes resort to importing blood for reasons that include a shortage in domestic donations, and the lack of certain blood plasmas and types. Health Minister Mohamed Awad Tageddin told Al-Ahram on 2 October that Egypt's appearance on the 11-country list was a "misprint. We have contacted British officials in Cairo and in Britain, and they all dismissed the paper's claim. The Egyptian Embassy in London's medical attaché said the list of vCJD importers was full of" other mistakes, Tageddin said. His comments appeared on Al-Ahram 's front page. Tageddin's advisor for blood bank affairs, Salwa Youssef, went even further, denying that Egypt had recently imported blood from the UK in the first place. "Egypt has not imported any blood or plasma derivatives from Britain for 20 years," Youssef told Al-Ahram. Youssef is also the head of the Blood Banks Centre, the only authority that can import blood and blood products. Helen Janecek of the CJD Incidents Panel at the UK's Health Protection Agency -- an independent body which carried out vulnerable countries' risk assessment -- confirmed that Egypt was not amongst the countries affected by the most recent warning. Al-Ahram Weekly, however, obtained an e-mail written by Janecek saying that in 2001, then Egyptian Health Minister Ismail Sallam was notified that Egypt had received "vCJD-implicated plasma products. It is possible that the confusion has arisen as a result of this previous notification," Janecek wrote in the e-mail. At the time, another British paper, The Guardian, had reported Egypt's name as being on a list of countries that could be at risk of getting the vCJD-contaminated blood. When confronted by the Weekly about the earlier notification, Youssef became more specific about Egypt's importation of blood from Britain. "We have not received blood products from Britain since the 1990s." Her earlier statement to Al-Ahram had indicated that the last blood delivery from the UK took place in 1984. A spokesperson at the British Department of Health told the Weekly in a phone interview that Egypt was one of 30 countries that occasionally used blood exports from Britain. "Egypt has imported British blood products several times in the past," said the spokesperson, who refused to provide further details on the frequency of imports, types and amount of blood. As for the five countries that were most at risk as a result of importing the tainted blood products this year, according to a UK Health Department statement sent to the Weekly by e-mail, "it is up to each of these countries to decide how best to deal with the information provided, and whether, and in what format, to make it public. It is not the Department of Health's role to dictate public health policies to other countries." Reaction to the Times report in the Egyptian press was somewhat tepid. Opposition paper Al-Wafd published parts of the report on its front page, although without their usual biting commentary. In a press release, meanwhile, the Egyptian Initiative for Personal Rights (EIPR), a Cairo-based human rights advocacy organistaion, said that the measures the government should take "should include immediate investigation into the incident, [and] identification and monitoring of people who received the implicated blood products to guarantee that they do not donate blood or organs to other individuals. Egypt has a legal obligation to take measures to face the possible public health threat." In Britain, meanwhile, politicians said the government's refusal to reveal which countries were most at risk was an irresponsible, face-saving strategy that could hinder proper surveillance of a fatal and incurable infection. Historically, more than 150 people worldwide have reportedly contracted the disease to date; 143 of them were from Britain. The list appeared after an announcement by Sir Liam Donaldson, the UK's chief medical officer, that 6,000 British patients who had a theoretical risk of vCJD infection were being contacted and banned from donating blood, in both tissue or organ forms. According to the Department of Health statement obtained by the Weekly, no treatment has yet been proven to prevent the development of vCJD. Patients usually show signs of "behavioural disorder, depression and anxiety followed by problems with sensation and coordination leading to progressive dementia and death over a period of six months to two years." Furthermore, the clinical and epidemiological data all point to vCJD being caused by the same strain as "mad cow" disease. The patients that donated blood could have acquired the disease by eating meat infected with "mad cow" disease. Unfortunately, blood donors infected with vCJD cannot be identified since their blood does not show signs of the disease at an early stage, the Department of Health source said. The blood in question came from two British donors who only discovered that they had the disease after having donated their blood. Other than Youssef, no one at the Egyptian Ministry of Health would speak to the Weekly about anything related to the issue of blood imports. Dubai and Morocco were also on the Times list; both were also quick to deny having imported the diseased blood. Turkey, also on the list, admitted in late September that the British Embassy in Ankara had warned them about 3,000 vials of blood products that had arrived from London. India, also on the list, pledged to carry out more rigid checks to dissipate patients' fears regarding the contaminated blood. Despite assurances by Egyptian officials that Egypt is not at risk, observers hoped that precautions would still be taken. Human rights activists regretted that while Egyptian officials were quick to deny the entire incident, health officials in other countries began immediate investigations. "Egyptians should have the right to a flow of honest and accurate information on their own health, and to see a clear official policy that puts all facts on the table before rushing to attack any such reports without verification," head of the Cairo Centre for Human Rights Bahieddin Hassan told the Weekly. Hassan lamented the fact that most of the news on the alleged contamination in Egypt came from foreign countries and newspapers. Additional reporting by
