When a practicable, presymptomatic test for vCJD becomes available prior to the development of any effective prophylaxis or treatment, an ethically based screening protocol is suggested. We recommend compulsory testing of all blood/organ donors and individuals undergoing surgery and invasive procedures with a significant risk of disease transmission, and also the provision of testing to any individual who voluntarily requests it. Counselling and support services similar to those established in the HIV model are strongly recommended. Testing should also be subject to legislation that bans the discriminatory use of presymptomatic test results by insurance companies or employers. The preferred protocol is akin to that used for current HIV screening and would benefit public health by minimising the risk of covert transmission events.
We would like to thank Professor John Collinge for his helpful comments on the manuscript.
Competing interests: none declared