An analysis of how such transfusions were used in hospitals during the Spanish flu pandemic of 1918 has indicated that they reduced the risk of death and eased symptoms, raising the prospect that a similar approach could be used against H5N1 influenza.

Although vaccines and antiviral drugs such as Tamiflu are likely to be the front line of defence today, blood plasma transfusions could provide a valuable back-up. They could prove a particularly valuable weapon against the H5N1 virus in developing countries with poor access to vaccines and antivirals, scientists said yesterday.

The study, which is published in the journal Annals of Internal Medicine, adds weight to calls from a leading British scientist, first reported in The Times, for the Government to examine a similar blood product’s possible role in an H5N1 flu pandemic.

Sir Peter Lachmann, Emeritus Professor of Immunology at the University of Cambridge and a past president of the Academy of Medical Sciences, argues that antibodies could be taken from recovering flu patients and used to treat others who develop the disease.

The proposal differs from the blood plasma idea as it involves separating antibodies known as immunoglobulins, which are already used widely against diseases such as hepatitis A, chicken pox and measles.

Blood is removed from a patient who has recovered and the liquid plasma part is mixed with alcohol and separated into its components by fractionation. One of the resulting fractions is rich in immunoglobulins that the immune system has made to fight the pathogen in question, and these can then be given to other patients exposed to the disease.

The approach has not yet been used against flu in humans, largely because existing vaccines and antivirals are more effective and less risky. Research in mice, however, suggests that immunoglobulins would be an effective way of alleviating symptoms. In the new research, a team examined eight contemporary pieces of medical research into the Spanish flu, which killed as many as 40 million people. They found that transfusions of blood plasma from convalescents, which were sometimes performed to treat new patients, appeared to have beneficial effects.

Sir Peter said it would be sensible to start recruiting volunteers to be immunised against H5N1, whose blood could then be used to provide antibodies. “Once there is a pandemic, making immunoglobulins from convalescent patients will be a valuable thing to do. However, if the first wave is explosive there will be insufficient time. But if the initial outbreak stutters then it should work well.”

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