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The management of Avian Flu H5N1.
If not us, who? If not now, when?
Letter from
Roger Breeze
Formerly Head of Plum Island, US Department
of Agriculture
Filed 07 Apr 06
©www.land-care.org.uk
Dear Dr Irvine
I enjoyed your report on the avian influenza investigation
in Orkney (1) and thought I
might give you some perspective on the additional investment needed
to make government reaction "sharper", as the Professor
said in that case. As I was writing this, news came of the positive
diagnosis in another bird and your report of the sequence of events
in that instance (2) only reinforced
what I wanted to say.
A RAPID PCR machine (www.idahotech.com) costs about 40,000 pounds
and the tests for exotic diseases like foot and mouth, classical
swine fever, avian influenza, and Newcastle disease cost about 3
pounds each. Of course, with other test reagents, this same machine
can detect all the common animal diseases too (with the exception
of BSE and scrapie). If there was a RAPID in Dumfries, Edinburgh,
Glasgow, Oban, Perth, Aberdeen, Kyle of Lochalsh, Inverness and
Thurso - 9 sites in all - these could quickly serve all the major
livestock population centers. This would cost about 360,000 pounds
for the equipment (probably less) and let's say 10,800 pounds for
100 tests at 3 pound per test for each of foot and mouth, classical
swine fever, avian influenza and Newcastle disease for each of 9
machines (9x4x100x3=10,800). So for about 350,000 pounds, assuming
a 20,000 pound discount, Scotland could be the best equipped country
in Europe! Perhaps I should have added one in Orkney too to round
it off at 400,000 pounds.
There are hundreds of scientists and technicians in Scotland today
who know how to do PCR tests (a standard lab tool) and who could
learn the works of the RAPID in an afternoon. There are also plenty
of labs with the necessary but minimal infrastructure to handle
the analyses safely (when the sample goes into the test reagent
tube any virus is inactivated so it can't cause disease). So the
total cost of a distributed lab system in 9 sites really is about
350,000 pounds. Such a lab system can be expected to give a result
in less than 6 hours after being notified of a sick animal or bird
- enough time to go to the site and back and run the PCR test. Having
detected the virus, Scotland can take action immediately while a
sample is on its way to Weybridge or Pirbright (or waiting at the
airport, or going nowhere) for confirmation by conventional, but
slower, means.
The RAPID is being used for avian influenza H5N1 detection in countries
where this disease has caused illness in birds and people. In January
2006 there was an avian influenza conference in Kiev Ukraine attended
by over 350 medical and veterinary officials from the US, Europe
and seven countries of the former Soviet Union: this was followed
by hands on avian influenza H5N1 detection training on the RAPID
for veterinary lab staff from six countries.
I expect you are astounded that we are actually talking about moving
Scotland to the head of Europe for about 350,000 pounds one time
and perhaps 12,000 pounds a year thereafter for new test kits. But
this is exactly true because the RAPID replaces procedures that
previously required very costly biological high containment laboratories
with enormous fixed operating costs. And costs are low because you
already have all the other infrastructure and the trained people.
And the 350,000 is for equipment for all infectious diseases of
livestock (there will be extra costs for disease-specific test
cassettes). Of course, one can buy empty cassettes and fill them
with reagents invented and made in Scotland for other diseases (there
are some special chemical labels that have to be added to the reagents),
it is not essential to buy them all from one supplier. In fact,
you would want the RAPIDS to be fully used every day for common
disease diagnosis so that everyone is familiar with their use through
daily repetition. The RAPID is the same technology as the Roche
Lightcycler, a common laboratory PCR machine, and uses the same
cassettes.
Best wishes,
Keep up the good work,
Roger Breeze
References
1. Irvine, James (2006) Putting
the contingency plan into operation - but with the same mistakes,
yet again. Blunders are revealed in Scots bird flu scare.
See ANIMAL HEALTH - GENERAL Homepage, filed 28 Mar 06, www.land-are.org.uk
Click
Here to View
2. Irvine, James (2006). So Avian
Influenza H5 has arrived in GB, but how is it being handled?
See ANIMAL HEALTH - GENERAL Homepage, filed 06 Apr 06, www.land-are.org.uk
Click
Here to View
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