From the Kovetz Maamarim of Rav Elchonon pg. 253 about why עלילות דם went on for centuries.
Why is the lie of the garment of Yosef connected to the Pesach story? The golut of Mitzraim was all brought about by this lie, by the sale of Yosef and the cover up story that was given to Yaakov afterward. The prophesy given to Avrohom that his descendants would be in golut was very ambiguous and open ended. It was the actions of the shevatim that determined how it played out. This is hinted to in the pessukin of Yehoshua (24:2-4) that we read in the Haggadah. "וָאֶקַּח אֶת־אֲבִיכֶם אֶת־אַבְרָהָם מֵעֵבֶר הַנָּהָר וָאוֹלֵךְ אוֹתוֹ בְּכָל־אֶרֶץ כְּנָעַן, וָאַרְבֶּה אֶת־זַרְעוֹ וָאֶתֵּן לוֹ אֶת־יִצְחָק, וָאֶתֵּן לְיִצְחָק אֶת־יַעֲקֹב וְאֶת־עֵשָׂו. וָאֶתֵּן לְעֵשָׂו אֶת־הַר שֵּׂעִיר לָרֶשֶׁת אתוֹ, וְיַעֲקֹב וּבָנָיו יָרְדוּ מִצְרָיִם." The actions are described as being done by G-d, I took, I led him, I made him have children etc. until the end of the possuk, Yaakov and his children went into Egypt, here it does not say I led thim into golut. G-d did not cause this to happen, the prophesy of Avrohom could have been fulfilled in another manner, it was the actions of the shevatim that caused ti to play out in this manner (based upon lecture by Rabbi Y.Y. Jacobson.)
Rav Shmuel Eliyahu in this shiur develops that that an integral part of the mitzvah of sippur yitziat mitzraim is not to just recant what happened in the past but to talk about one's own personal geulah from their own forms of golut. The constant עלילות דם serve as a reminder that the שיר חדש of the final geulah has not yet happened because עדיין זה מרקד בינינו.
The blood libel originated in the middle ages. When R' Elchanan was writing it had not been going on even for 1000 years, much less "alphei shana."
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