Avian Influenza:
an assessment of the threat to Scotland.
Royal Society of Edinburgh publishes a
flawed report

James Irvine

DSc, FRCPEd, FRCPath, FInstBiol, FRSE

Teviot Scientific, Cultybraggan Farm, Comrie, Perthshire

Filed 26 Sep 07
©www.land-care.org.uk

Avian Influenza (AI) HPAI H5N1 is a highly virulent virus as far as birds are concerned: especially poultry and water birds, including all species of swans and geese, and some species of ducks, waders and gulls.

The first outbreak of Avian Influenza (AI) virus HPAI H5N1(referred to throughout this article as H5N1) originated in Southern China and was detected in Hong Kong in 1997. This was followed in 2003 by an epidemic that spread like wildfire through poultry in most Asian countries. By July 2005 the disease had reached Kazakhstan and Russia, and then Turkey, Romania and Croatia. The first case in the European Union occurred in Greece. The virus then spread on to Denmark, France, Germany, Italy, Spain, Hungary, Poland the Czech Republic, Slovenia and Sweden.

The first case of H5N1 in the UK was the quarantine centre with the parrot and 50 'finches' which were part of a shady import business. in Scotland H5N1 was identified when a dead swan was found on 29th March 2006, washed up on the shore at Cellardyke, a small coastal village in the East Neuk of Fife. The dead bird was spotted by a villager who happened to know a biologist at St Andrews University, who informed the Animal Health authorities. They established, a week later, that the swan carried avian Influenza virus H5N1 (1).

Not only is the severe threat to the poultry industry recognised, but the world is alerted to the possibility of the virus mutating, or acting in partnership with other viruses, so as to jump the species gap from bird to man. Deaths of people in the Far East who had come into frequent and close contact with birds suffering from H5N1, although uncommon, has been well documented. The fear remains that H5N1 (or possibly a related virus) might trigger another world influenza pandemic.

Kelly Bronze turkeys at Home Farm Condover, Shropshire, UK
©Mike Hayward/ Alamy

On March 1st the Royal Society (the UK national academy of science) and the Academy of Medical Sciences (an independent academy that deals with public policy issues in medicine and healthcare) jointly launched a study into the use of science in UK preparations for an influenza pandemic. The result was an impressive and highly informative report published in November 2006 (2).

For their part the Royal Society of Edinburgh (RSE) set up a working group in October 2006. Its brief was to assess the threat of avian influenza to Scotland. It has just published its report (3), on 17th September 2007. Regrettably, while being informative in some important areas, in too many it makes disappointing reading. In some areas it is potentially very damaging.

Rapid Diagnosis

A key feature in the management of any outbreak of infection is rapid and accurate diagnosis. In veterinary medicine this is so whether the infection in question is a highly pathogenic subtype of AvIan Influenza (HPAI), Foot and Mouth Disease (FMD) or Bluetongue (BT): all of which, among others, currently threaten Scotland's livestock. Just as they do in many other parts of the world.

But the two words "rapid diagnosis" do not get a mention anywhere in the nine pages of the RSE Report. Perhaps the length of time the members of the group took to deliberate on the issue is indicative of their own apparent lack of urgency.

To quote the RSE report:

"If the local veterinary surgeon suspects Highly Pathogenic Avian Influenza (HPAI), the regional State Veterinary Service (SVS) will be alerted and will visit the farm. If the SVS also suspects HPAI, samples of dead birds will be sent to the Veterinary Laboratories Agency (VLA) at Weybridge for laboratory confirmation"

Weybridge is in Surrey. It is not an easy place to get to. A personal visit, starting from Comrie in Perthshire, to the neighbouring Institute of Animal Health Laboratories at Pirbright was proof enough of that. There are many more remote parts of Scotland than Comrie, which has relatively quick access to the airports of Edinburgh or Glasgow. After that, there is the problem of getting from Heathrow or Gatwick to Pirbright.

Ironically, just prior to the finding of the dead H5N1 infected Cellardyke swan, the Scottish State Veterinary Service (SVS) ran a trial in Orkney in which its AI contingency plans were put into operation. The local newspaper, the Press &J ournal, found the situation hilarious, in recording the efforts and the misfortunes of getting the samples to Weybridge (4).

Roger Breeze, who was previously Director of the USA Department of Agriculture at Plum Island and now CEO Centaur Science Group in Washington DC, wrote an interesting follow-up to the Orkney episode (5). Centaur Science Group is a company that specialises in anti-terrorism measures. Understandably, the USA authorities are fearful that viruses, in one form or another, may be in the terrorists' armoury. Central to defence against such an attack is rapid diagnosis, whatever the specific nature of the virus: be it FMD, AI, or other type of biological warfare, such as anthrax.

In his letter to Land-Care he, a graduate of Glasgow University, highlighted the opportunity Scotland had to lead the way, with setting up RAP|D PCR machines in a number of centres throughout Scotland. He stressed that there are plenty of Scots who are accustomed to using such technology and who could learn how to use a RAPID PCR machine in an afternoon. As the samples are totally inactivated prior to testing without influencing the results, the facilities required do not have to be at the highest level in terms of biosecurity. He suggested that such machines be placed at Dumfries, Edinburgh, Glasgow, Oban, Perth, Aberdeen, Kyle of Lochalsh, Inverness and Thurso. In addition to performing rapid tests for exotic diseases such as FMD, AI, classical swine fever and Newcastle Disease the machine can detect all the common animal disease (excepting BSE and scrapie).

But according to the RSE report of September 2007, all samples still have to be transported to Weybridge in Surrey after postmortem examination at any of the eight regional Veterinary Laboratories that exist in Scotland (Thurso, Inverness, Aberdeen, Perth, Edinburgh, St Boswell's, Ayr and Dumfries). They are also well equipped private laboratories in Scotland - such as Biobest, at the Edinburgh Technopole - that specialise in veterinary virology. But they are not licenced by the Government to do diagnostic work on FMD, AI, BT etc, although they could easily be if the Government so wished.

While Weybridge VLA is using Real Time PCR (RT-PCR) technology in testing for viruses such as AI, the fact that all samples throughout the UK have to be transported there is not helpful. There should, at the very least, be one laboratory in Scotland that can be licenced to provide this essential facility. But eight of these machines, one located in each of Scotland's regional veterinary laboratories, is what is really wanted.

Magnus Linklater, writing in The Times of 12th April 06, described the Cellardyke event and its implications with characteristic clarity (6).

Now let us consider what the RSE Working Group on AI has to say about what happens when suspected samples from Scotland eventually get to Weybridge. To quote:

"At VL|A Weybridge, virus detection in the first instance is by real-time polymerase chain reaction (RT-PCR). If negative, both the sender of the samples and the regional SVS office are informed, and no further testing is carried out. If there is evidence of A| virus, attempts are made to isolate it and to type it by haemagglutinationinhibition testing and DNA sequencing before notifying a positive result. Pathogenicity tests are carried out by injecting day-old chicks with the recovered virus"

There is not a mention of lateral flow technology that could be used on-site. While it does not have the sensitivity of RT-PCR, lateral flow technology in simple kit form could be useful on call out to any dead or very sick bird. There is not a mention of how the identification of known AI types, particularly H5N1, could be speeded up on account of the fact that their molecular characteristics have been so well established.

The RSE Working Group would have done well to have picked up the clear statement in the Royal Society Report, available just after the Royal Society of Edinburgh (RSE) started its deliberations, concerning the UK's high-containment laboratory facilities. While much diagnostic work could be done in the absence of such facilities, they are nonetheless essential as reference laboratories and for research. To quote the RS/AMS Report:

"There are six laboratories in the UK equipped to work with highly pathogenic avian influenza which in some cases are ageing and require significant improvement work. Those organisations with suitable animal facilities for handling highly pathogenic influenza-infected poultry and birds are the Institute of Animal Health (IAH) Compton and VLA Weybridge. It is anticipated that the merger of the VLA Weybridge and the IAH facilities for avian influenza research will result in an overall loss of facilities for work with highly pathogenic avian influenza. It is essential that the option to expand these facilities should be investigated further."

The Royal Society (London) recommendation was prophetic. The leak of FMD virus from the poorly maintained complex at Pirbright has had a devastating knock-on effect in terms of Scotland's livestock industry and the commercial enterprises that support it.

The Royal Society of Edinburgh Report would have done well to have pressed for rapid diagnostic facilities to be available within Scotland, and also for a high-containment facility to be based in Scotland. But it did neither. These are serious omissions.

Vaccination and EC Rules

Vaccination gets about a half a page within the one page section of the RSE Report headed

"Prevention and control of Avian Influenza".

For what is supposed to be a distillate, produced as a result of profound contemplation for a year by a group of independent experts, it beggars belief.

It starts off thus in para 7.5:

"Vaccines offering protection from H5N1 infection are available commercially. Those licenced for use in Europe contain inactivated virus; these vaccines require to be administered by intramuscular injection, with two doses, 23 weeks apart, required for maximum protection. Such vaccines have been used in some countries, e.g. Mexico, for more than ten years without other control methods. However, while they prevent disease they do no eliminate the virus and it may then remain undetected in flocks with the risk of spread to other birds."

So the threat that vaccinated animals, in this case of poultry vaccinated against H5N1, could act as carriers spreading infection raises its head yet again. Yet experience in the field denies this (7). Perhaps the Working Group were influenced by the brief publication from Professor Mark Woolhouse and his colleagues at Kings Buildings, Edinburgh (8). In a study based entirely on hypothetical epidemiological modelling, using input data that must be questionable, they warned of a

"Silent spread of H5N1 in vaccinated poultry"

Why I criticise the RSE Report so severely is because their report gives no references whatsoever to justify the statements made. The Report could be so easily quoted as an authoritative statement concerning the real dangers of vaccination, but the scaremongering is apparently based on little other than hypothetical modelling based on what appears to be largely hypothetical data. The Report made no mention of the field studies referred to above, that demonstrated that such spread did not occur. Nor does the Report provide any other evidence to support their potentially very misleading statements.

Although the RSE Report clearly referred to the limitations of modelling based on insecure data, it would have done well to have drawn attention to just how misleading modelling turned out to be in relation to UK FMD 2001 as described by Kitching, Thrusfield & Taylor (2006) (9).

A further flaw in the theoretical, but potentially very damaging, conclusion drawn by the Woolhouse group, is that no one, at least in a developed country, would consider using vaccination as the only weapon to counter an outbreak of avian influenza. It would be used along with other measures, such as localised culling and biosecurity.

A young cockerel in a domestic garden
© Paul White/Alamy

The RSE Report makes no comment on the use of avian influenza vaccination that was permitted, and used, in The Netherlands in 2006 in relation to free-range laying hens and hobby birds (10). Some account of their experience would have been helpful for those of us in Scotland. After all, the Netherlands is the biggest producer of poultry products in Europe. The working Group made no reference to the extensive use of vaccination against H5N1 in the Far East, and how effective it was when used in conjunction with culling and biosecurity.

The RSE Report then goes on to say in para 7.6:

"Although stocks of H5N1 vaccines are held by DEFRA for use in an emergency, our understanding is that current contingency plans for the control of AI do not include vaccination of domestic poultry in response to a substantial elevated risk of infection. While vaccination of broiler birds is not an option because of their short life-spans, vaccination of laying and breeding flocks could be considered if virus prevalence were to become so high in the wild bird population that repeated 'spillovers ' of infection to poultry were to occur."

What this demonstrates is a seriously passive attitude, apparently just accepting what Defra says its policy is, as opposed to giving some thought as to what Defra's thinking should be. The European Commission largely leaves it up to the Member State to come up with its own plan as to how it might wish to use vaccination in any given circumstance. If the plan is reasonable, the Member State has only got to ask for a licence to vaccinate, as did The Netherlands and France. Better still, with the adoption of globally available technology, but belatedly applied in the UK, the RSE Working Group should have given some thought to how the European Commission might radically change its thinking in terms of the use of vaccination in the control of AI and other livestock viruses. This is particularly so should localised preventative vaccination be used that may involve an exit strategy on a regional basis.

Para 7.7 of the RSE Report reads:

"Vaccination of rare collections of birds held privately or in zoos may be allowed if they are at high risk of infection, but the efficacy of the vaccination in birds other than domestic poultry is largely unknown"

We are repeatedly told that conservation and biodiversity are of great importance. Perhaps the RSE Working Group could have seen its way to supporting the recommendation of the combined report of the Royal Society and the Academy of Medical Sciences, that there should be increased provision of high-biosecurty facilities to enable research in this area.

As their final contribution to the matter of vaccination for AI, the RSE Report says (para 7.8):

"Vaccination as a protective measure could be attractive if more effective, cheap vaccines can be developed, particularly if their method of delivery were to allow easy administration to large flocks without the requirement to handle each individual bird. We recommend that Government provide financial support for research into, and development of, more effective and user-friendly vaccines"

What the Report does not mention is that millions of chickens were vaccinated in the Far East by intramuscular injection in their successful drive to control the H5N1 epidemic. But labour is cheap in China and other parts of the Far East, and we want cheap food. The penny is slowly beginning to drop that if the British public want home grown food, produced to a high standard of animal welfare and health, it will be expensive. Otherwise there will not be any significant home production. As an island we will be vulnerable, as the world demand for food increases.

The RSE Report completely fails to come up with any suggestions as to how free-range poultry are to be cared for when an outbreak of AI is threatened. The Report simply says (para 7.1):

"Clearly, there are limits to what can be achieved by way of protection for free-range flocks"

In many instances it is simply not possible, and for welfare reasons highly undesirable, to try and house free-range birds for prolonged periods. The obvious thing to recommend is to follow what the Dutch did: voluntary vaccination with appropriate controls.

This brief contribution to forward thinking as to how Scotland might fare in the future, makes no reference to the urgent provision of rapid diagnostic testing that cannot only detect viraemia, but whether a bird has been infected or vaccinated according to the characteristics of the antibody response. Or indeed, if a vaccinated bird is capable of shedding virus that can infect other birds in a flock that has been vaccinated. At the very least vaccination will lead to substantial reduction in the virus load.

One might have expected such a Report to have at least a brief attempt at describing how new vaccines are being developed, albeit largely outside the UK (see below). These new techniques are aimed to speeding up vaccine production in the bulk that is required. They are as relevant to Scotland as they are throughout the rest of the world.

Biosecurity

In para 7.2, the Report says:

"... the industry is unclear as to the relative importance of the risks of disease, for example, from wild birds or from farm visitors, and would welcome clearer guidance to inform its biosecurity planning"

But in reality, surely the risk from wild birds is related to the migratory patterns of these birds and where avian influenza is currently active geographically. Surely also, poultry units should have high biosecurity in terms of visitors as part of good practice, to prevent the introduction of a whole range of possible infections. Surely they should assume that gulls may pose a particular risk, and ensure that no waste is lying around that might attract them.

The Report made brief mention of the outbreak of H5N1 on a poultry farm at Holton, Suffolk (para 4.4), but made no reference to the deficiencies in biosecurity that led to poultry products being imported to this massive Bernard Matthews turkey farm from their related enterprise in Hungary, where H5N1 was recognised to be active in geese close by, but outside the official control zone. Was it common sense to take the risk of importing poultry or poultry products from a site of such dubious biosecurity into a massive poultry enterprise at Suffolk? And what about the Borders checks by Customs (complete with new uniforms) when the lorry entered the UK? It would have been informative to know whether modern technology could provide a regional veterinary laboratory with the capability of screening dead meat parts for dangerous viruses, although sampling and sensitivity problems may make this impractical.

Why was biosecurity allegedly so lax that the virus allegedly passed from a food processing plant to the live poultry houses? What exactly do the poultry farmers need to be advised about that they should not already know? Do they, along with certain academics, want proof of the use of common sense?

Perhaps the RSE Report might have suggested that the size of the Protected and Surveillance zones dictated by the international authorities should be reviewed , rather than just accepting them, as in para 7.4).

Modelling

One of the major weaknesses in the management of UK FMD 2001 was the over emphasis on what epidemiological modelling can achieve. The RSE Report on Avian Influenza has a tendency to continue that practice, but fortunately includes some important caveats.

The present article has already referred to the potentially highly damaging brief communication by the Woolhouse group, based on hypothetical modelling, whereby they warn about the "Silent spread of H5N1 in vaccinated poultry", while there is no evidence of such in the field, either in relation to Avian Influenza or FMD when vaccination is combined with biosecurity and localised culling.

Again, in evidence given to the RSE Working Group, it would appear that the modellers were suggesting that the manner in which the Suffolk outbreak was handled (essentially by extensive culling) would be typical of most outbreaks, with the disease not spreading beyond the index case. Fortunately, the RSE Report clearly points to the severe limitations of such a claim, based on the limited validity of the data used by the modellers.

Indeed, so poor have been the preparations over the years by Defra to manage a potential outbreak of AI that it is only very recently that it has established a poultry register for flocks of over 50 birds. Where smaller flocks are is quite unknown. Even the register of larger flocks is thought to be incomplete.

Surveillance

As pointed out in the RSE Report, Scotland's poultry is certainly at risk of introduction of H5N1 virus. Scotland has a concentration of bird sanctuaries to protect migrating birds, especially water birds including waders. Gulls are rightly referred to as being possible carriers of the virus, as they frequent farms. The risk to free-range poultry from wild birds is referred to, but nothing is recommended as to how this risk could be countered. As already mentioned above, the RSE Report chose to totally ignore the Dutch experience of this very problem.

The Report highlights its concerns about the wild bird surveillance programme, including who should conduct it and who should pay for it.

Scotland is also at risk because, in the case of commercial laying flocks, no birds are hatched in Scotland and most are brought in from English hatcheries.

Para 4.2 states:

"Poultry chicks , gamebird chicks (especially pheasants) and mallard ducklings are imported into Scotland, but mainly from elsewhere in the EU where the incidence of the disease is low. and the level of monitoring for the disease is high. Moreover, all imported birds are subject to veterinary inspection and monitoring at an early stage following their arrival in the country"

But the EU now consists of 27 member states. Its borders now extend into geographical areas where diseases of livestock are not well monitored and are commonplace. There is also no mention of the trade of importing birds illegally, or of the biosecurity fiascos of Customs and Excise even when birds are imported legally.

Would it not be useful for the regional veterinary laboratory to have a mobile machine that could detect virus, even before the clinical signs of the disease become obvious?

Risks to human health

The RSE Report rightly points out that in the view of the World Health Organisation we are closer to another human pandemic than at any time since 1968. The RSE Report also rightly draws attention to the thoroughly competent report, "Pandemic influenza: science to policy", produced jointly by the Royal Society and the Academy of Medical Sciences (2).

While the risk of a new human pandemic evolving in Scotland or elsewhere in the UK may well be small, should there be a mutation of H5N1 any where else in the world that enabled the virus to cross the species barrier so as to infect man, world travel is such that that it could arrive in Scotland or elsewhere in the UK very easily.

The RSE Report makes no mention of the possibility that H5N1 virus may act in conjunction with common influenza viruses that attack humans in a seasonal manner every year. In so doing, it is conceivable that they can cross the species barrier from bird to man, enabling the H5N1 virus to infect not just the upper respiratory tract but the whole body. Should that happen, there would be a massive inflammatory response which would overwhelm the body's defences with rapid death following. It is for this reason that groups such as poultry cullers are offered seasonal vaccination against the predicted human influenza strains each year. The aim is reduce the chances of such a worker being exposed to H5N1 and seasonal viruses at the same time. Such dual infections might give the avian and human viruses an opportunity to exchange genes, possibly resulting in a new influenza virus subtype with pandemic potential.

Para 8.5 of the RSE Report states:

"... the risk of a new human pandemic strain of virus evolving in Scotland or elsewhere in the United Kingdom is very small. However, it will be important to detect an incipient pandemic originating elsewhere if we are to be prepared for it striking the UK. It will only be feasible to produce a meaningful projection of a pandemic if good data are available at an early stage, and this means identification of changes in the virus in the first 100 cases. This is unlikely in some of those parts of the world considered most likely to be the source of any pandemic, but this emphasises the importance of surveillance."

But surveillance means quick and accurate detection of the virus and its subsequent spread. The present outbreak of FMD in Surrey, following a leak from the Pirbright complex just a few miles away, should have been an opportunity to demonstrate how viruses in the environment can be effectively monitored using modern technology to the full. Currently, that apparently cannot be effectively achieved,: even when the source of the infection is pinpointed so precisely as a leak from the World Reference Centre itself.

There is no mention in the RSE Report of on-site testing for virus, using pooled samples and transportable RT-PCR machines. Hopefully, the clinical laboratories will be able to respond much more promptly than the veterinary laboratories appear to be able to do with H5N1 or with FMD to date.

According to the RSE Report,

"The evidence from the modelling studies suggests that movement restrictions would have little impact on the spread of disease and that there is no intention to introduce restrictions on travel here in the case of a pandemic. It is difficult to predict how people will react to a pandemic, for example by staying at home"

There seems to be no end to the arrogance of the modellers. How can they suggest anything of the kind when, as in so many other instances, they have no good data with which to feed their models. There also seems, as often the case with academics, that common sense is ignored while everybody waits for a research paper to emerge confirming what was common sense in the first place. Or finding that common sense can be difficult to prove in strict scientific terms, but is nonetheless highly valid. You bet people will stay at home if they possibly can. Or may try to get as far away from other people as possible, but somehow keep in contact with the emergency medical services, which are of course concentrated in the cities.

If a pandemic is caused by a mutation or a variant of Avian Influenza, then the characterisation of the virus would be imperative. The RSE Report makes no mention of the impressive international cooperation in the field of science in identifying the SARS virus, nor of the equally impressive speed at which it was achieved (11, 12). It was notable that there was no UK contribution to that excellent example of international cooperation.

The RSE Report makes depressing reading regarding the possible use of vaccination against a new strain of H5N1, or even against the present strain. It states (para 8.9):

"We recognise that it is unlikely that a vaccine effective against a new strain of pandemic influenza virus could be produced before the disease affects the UK. Even if a vaccine were to be available, there would be significant costs in making this available to the whole population. In addition, consideration would have to be given to the possible risks of neurological complications associated with the widespread use of a new vaccine. Small stocks of an H5N1 vaccine are available and could be used, if appropriate, to protect key health workers. The hope is that, should there be a pandemic, a vaccine might be developed to protect certain priority groups from the second wave of infection"

Gosh!

Perhaps the RSE academics could have offered just a little hope. There have been exciting new developments that have the potential to shorten the time taken to produce new vaccines (13, 14, 15).

To quote the NIH News article written in 2004 (12):

'In the case of SARS, we have dramatically cut vaccine development time with powerful new tools from two different fields, molecular biology and information technology," says Anthony S. Fauci, M.D., director of NIAID.

Instead of using weakened or inactivated virus, which is typical for vaccine development, the new vaccine is composed of a small circular piece of DNA that encodes the viral spike protein. Scientists modified the DNA to minimize the risk of it combining with the SARS virus or other viruses of the SARS type, called coronaviruses.

Scientists expect that the DNA will direct human cells to produce proteins very similar to the SARS spike protein. The immune system should recognize these proteins as foreign and then mount a defense against them. If the vaccinated person ever encounters the actual SARS virus, his or her immune system will be primed to neutralize it.

"It is truly remarkable that less than two years ago we were facing an unknown global health threat, and now we are testing a promising vaccine that may help us to counter that threat should it re-emerge," Dr. Fauci said'

Alright, it will still take time, and there could be problems with the new type vaccines that are not yet resolved. These relate to what might happen when the vaccinated subject is re-challenged with the virus. Might the body over react, making matters worse, or would there be a booster effect? Proper trials are essential, but let us have a flicker of hope as to what science can do when it applies itself urgently to a problem on an international scale.

But it is not just the science that is the problem. There is the problem of the state in which commercial vaccination production is in, globally. It is allegedly poorly coordinated with each country doing its individual ordering, as it thinks fit, and joining the queue, which can be a long one when an epidemic or worse, a pandemic, strikes.

But did you like the bit that said

"there would be significant costs in making this (vaccine) available to the whole population?"

The inference is that most of us would not be worth it!

The statement made in the RSE Report that "Small stocks of an H5N1 vaccines are available " for humans may be disingenuous.

The stocks available are small allegedly because that is all the UK Government has ordered from the vaccine manufacturers. Other countries may well have ordered much more at an earlier date. The RSE Report makes no recommendation as to whether or not the people of Scotland should have access to such a vaccine: that is, whether the Government should order more now in preparation, knowing that it may not be used or that a different virus may be involved in a future pandemic. We are not told in the Report whether the members of the Working Party thought it wise just to have small stocks against the most likely virus, and take the dire consequences when a pandemic starts. Instead the Report simply reiterates what Government has done. That is not the purpose of an "independent" report. If the members of the Working Party agree with what the government has allegedly planned for us, then they should say so.

One wonders if the UK is in a position any more to fund research leading to the commercial development of new vaccines. May be under funded Pirbright is no longer the leader it used to be. May be other countries, such as the USA with its massive agricultural interests, and large biological/chemical commercial enterprises, are unmatchable, while we are just left scraping at the surface. But if that is the case, then we should not hesitate to buy in the results of their efforts.

Recommendations

In contrast to the RSE Report, i would suggest that the recommendations should have been the following.

1. The provision for rapid diagnostic facilities within Scotland. Technology that enables rapid, accurate and highly sensitive on-site diagnosis must be used to the full.

Perhaps the sensible approach to "Avian Influenza: an assessment of the threat to Scotland" would be to ask in what way does the situation in Scotland differ from that elsewhere in the UK, in the EU and in the world. And in what way is the situation in Scotland the same as elsewhere.

Great Britain is an island, and Scotland is part of that island. This has great potential advantage provided the borders of that island are carefully monitored to prevent the importation of diseases, such as AI. It was the movements of poultry products that caused the outbreak at Suffolk earlier this year. As it is recognised the world over, that it is the movement of poultry products that forms the main risk to the spread of AI, a top priority for Scotland would be to ensure our guard against this is optimal. To do this effectively comes down to the provision of regional veterinary laboratories equipped with the means of rapidly and accurately detecting AI and other such viruses on site when suspicion is aroused. It should be emphasises that available technology can detect virus in the preclinical stage of disease, and is much more sensitive and accurate than visual inspection, no matter how experience the vet may be.

Geographically, much of Scotland is rough and rugged terrain with relatively poor communications to the main centres within the UK. This is another reason why it is important for Scotland to have its 8 regional veterinary laboratories equipped with the ability to carry out rapid and accurate diagnostic tests. More than that, Scotland should have its own high-containment biosecurity facility, rather than depend entirely on remote Pirbright in Surrey.

2. The importance of taking part, along with the rest of the UK, in persuading Brussels to adapt its Directives to keep pace with the application of modern technology, and to do so promptly according to the regional requirements of Member States. This is of particular importance if the most effective weapon against viral infections, vaccination, is to be used. The main obstacle to its use at the present time are the EC rules regarding the exit strategy.

3. Scotland, along with the rest of the UK, should adopt the Dutch policy whereby, under veterinary supervision, free-range poultry enterprises and hobby poultry keepers can vaccinate their flocks on a voluntary basis. under appropriate supervision by their vets. The fact that the RSE Report essentially ignores the immense welfare problems of housing free-range poultry for long periods is not acceptable.

4. Scotland should join the rest of the UK, and the EU, in emphasising the importance of an integrated international policy with regard to the development of appropriate vaccines. No single country within the EU can achieve this on its own. Substantial government funding for collaboration between vaccine manufacturers and research laboratories is required, rather than the present system of each Member State ordering vaccines that it thinks it may require, but which may not be available in time for commercial reasons.

5. Once the above has been achieved, it is then sensible to address what the RSE Report puts as its top recommendation: the monitoring of Scotland's wildbird population for A|. The Report states that Scotland's wildlife is not threatened by AI. We know that migrating birds can carry the virus to our shores from lands where AI exists. We know that that situation will change with the seasons and with the geographical location of the different AI subtypes at any particular time throughout the world. Suspected deaths of wild birds from A| should be rapidly checked in regional veterinary laboratories that are properly equipped to do the job. The provision of these facilities would enable the RSPB to liaise locally with the regional veterinary laboratories. RSPB is one of the best funded charities. Pleas for them to be additional funded, provided well equipped regional laboratories are available, should not be regarded as a main recommendation.

5. The recommendation within the RSE Report for more funding for modelling, second in their view to monitoring wild birds, should only come after the above recommendations have been met.

6. The RSE Report should be much more careful in making unsubstantiated statements. For example, that in the face of an AI pandemic affecting the human population, travel restrictions would not be effective.

Conclusion

For the reasons given in this article, it is considered the Report by the Working Party of the Royal Society of Edinburgh, "Avian Influenza: an assessment of the threat to Scotland" is seriously flawed. The Report should be either radically revised or withdrawn.

References

1. Irvine, James (2006). So Avian Flu H5 has arrived in GB. But how is it being handled?
See ANIMAL HEALTH - GENERAL Homepage, filed 06 Apr 06, www.land-care.org.uk Click Here to View

2. Skehel, Sir John (2006). Pandemic influenza: science to policy. Report of the combined working group of the Royal Society and the Academy of Medical Sciences.
ISBN-13: 978 0 85403 635 6 Click Here to View (pdf: large file 41pp)

3. Coggins, John (2007). Avian Influenza: an assessment of the threat to Scotland. Report of working group of Royal Society of Edinburgh.
ISBN 978 0 902198 45 6 Click Here to View (pdf: 9pp).

4. Irvine, James (2006). Putting the contingency plan into operation - but with the same mistakes, yet again. Blunders revealed in Scots flu scare.
See ANIMAL HEALTH - GENERAL Homepage, filed 28 Mar 06, www.land-care.org.uk Click Here to View

5. Breeze, Roger (2006). The management of Avian Fu H5N1. If not us, who? If not now, when?
See ANIMAL HEALTH - GENERAL Homepage, filed 07 Apr 06, www.land-care.org.uk Click Here to View

6. Linklater, Magnus (2006). Defra is like a dead swan: discuss.
Article originally published in The TImes of 12th April 2006. Reproduced with kind permission
See ANIMAL HEALTH - GENERAL Homepage, filed 12 Apr 06, www.land-care.org.uk Click Here to View

7. Ellis, T. M. et al (2004). Vaccination of chickens against H5N1 avian influenza in the face of an outbreak interrupts virus transmission.
Avian Pathology (August 2004) 33(4), 405-412.

8. Savill, N. J., St Rose, S.G., Keeling, M. J. and Woolhouse, M. E. J )2006). Silent spread of H5N1 in vaccinated poultry. Brief Communication.
Nature: Vol 442/17 August 2006

9. Kitching, R.P., Thrusfield, M.V. and Taylor, N. M. (2006). Use and abuse of mathematical models: an illustration from the 2001 foot and mouth disease epidemic in the United Kingdom.
In: Biological disasters of animal origin: the role and preparedness of veterinary and public health services.
Edited by M. Hugh-Jones
Rev. sci. tech. Off. int. Epiz. 25(1) 293-311.

10. Landbouw, natuur en voedselkwaaliteit (2007). Preventive vaccination against AI in The Netherlands: the follow up.
SCOFCAH, 05-07-2007 Click Here to View pdf

11. Irvine, James (2003). SARS virus: just look at the speed of scientific progress.
If it can be done for SARS, why not for FMD?
See SCIENCE Homepage, filed 06 Apr 03, www.land-care.org.uk Click Here to View

12. NIH News (2004). First U.S. SARS vaccine trial opens at NIH.
http://www.nih.gov/news/pr/dec2004/niaid-13htm (Accessed 22 September 2007)

13. Leroux-Roeis, I. et al (2007). Antigen-sparing and cross-reactive immunity with an adjuvanted rH5N1 prototype pandemic influenza vaccine: a randomized control trial.
Lancet. 370: 580-589.

14. Cinatl jr. J. et al (2007). The threat of Avian Influenza A (H5N1). Part IV. development of vaccines.
Med. Microbiol. Immunol. 196: 213-225.

15.Treanor, J.J. (2006). Safety and immunogenicity of inactivated subvirion influenza A (H5N1) vaccine.
N. Eng. j. Med (2006). 354: 1343-1351.

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Avian Influenza: an assessment of the threat to Scotland. Royal Society of Edinburgh publishes a flawed report