What Are the Chances I Have Mad Cow Disease?

The Emporium of Medicinal Wonderments: In an ongoing series, the curious men and women of The Atlantic bombard me with their physiological curiosities.

medman.jpg [C.E. Brock/FOBO]

J.J. Gould: I haven't eaten meat in about five years. But the years before that included a couple in the U.K. during the mid-and-late '90s. I was in grad school, at the time, and prone to running into McDonald's for cheeseburgers -- frequently, if not as a way of life.

Gotcha.

As you know, there's a blood shortage right now, and we're having a company blood drive next month.

I do.

Oh I see, and you can't give blood because you ate meat in London during the "Mad Cow" outbreak.

Yes. Which is frustrating. But it can also give me a vaguely uneasy feeling about the future.

I've thought about that. It's at least a little stigmatizing to tell people their blood isn't safe to give to other people.

Especially when those other people need the blood so badly.

Well "Mad Cow" (Creutzfeld-Jacob) disease is a fascinating type of infectious process that we still don't understand as well as most others. The chances that you're harboring some latent prions in your brain or spine that are going to activate and kill you are super slim, though.

Those prions must exist, right? Otherwise the Red Cross would clear me and take my blood.

Ah, so do you really want to give blood -- or do you want them to take your blood as a form of validation? It's like you're in an abusive relationship with the Red Cross?

I want to give blood, not to get psychoanalysis. Maybe I should just go back to my desk? It's too dark in this tent anyway.

Please don't leave!

OK, so in Britain in that time period there were hundreds of thousand of cows that had Creutzfeld-Jacob disease and died. The human version, vCJD has killed a lot of people, too -- though nowhere near as many people as cows. Still we've seen how quickly and easily it can spread. So the Red Cross doesn't mess around with it.

But it's been almost 20 years. If I were going to die a horrible Creutzfeld-Jacob death, wouldn't I be showing some symptoms by now?

Probably. But there have been some reports of prion disease with very long latencies. A few years ago The Lancet found that prions can hang out in our brains for 50 years. But that study was looking at kuru -- which is analogous but not the same as vCJD. 

Kuru -- isn't that the one from, like, Papua New Guinea, where cannibals were ritualistically eating dead family members?

Yeah, so as I understand it cannibalism was outlawed there in the 1950s, but then there was an outbreak of kuru much later in the century. It seemed like the kuru prions had been latent for 50 years in people's brains before they actually developed the disease. The potential flaw there is that just because it was outlawed doesn't mean people weren't still eating each other. So the ballpark latency of vCJD is contested, but to be safe, inferred to be very long. I'd say your chances are very low at this point, but not entirely zero.

Aha. So will I ever be able to give blood?

If we get a reliable screening blood test for vCJD, then I'd think yes. That's in the works, and it would be wonderful. But until then, you can use your enlightened perspective to encourage all of your friends who do have the ability to donate blood to appreciate their privilege and act on it.

...But they're not better than you. You're just as good as anyone who can give blood.

Thank you. Again, psychoanalysis: not why I'm here. I'm just curious about the facts.

Also, I know it's generally not socially advisable to ask vegetarians why they're vegetarian, but I can't help but wonder if your current vegetarian lifestyle is reactionary?

I'm going back to my desk.

Presented by

James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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