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Has the World Health Organisation
been asleep on the job?
And what has Pirbright been doing?
Dr James Irvine
Filed 28 Apr 09
No doubt there will much inquiry into why it was that the new strain of H1N1 virus that causes Swine Flu was allowed to flourish undetected in Mexico for allegedly such a long period. Comments from the area indicate that a flu like illness had been uncommonly widespread for many weeks or months. Was it just assumed that this was the usual type of flu? Is it not the job of the World Health Organisation (WHO) to monitor such circumstances?
Was WHO too complacent in its belief that an outbreak of a viral disease, that could cross barriers from animals to humans and then spread among humans, was most likely to arise in Asia? Did WHO have its eye off the ball?
The purpose of WHO should surely go a bit beyond just pontificating in a somewhat pedantic manner whether there is yet a pandemic, or just a level 3, 4 or 5 before a pandemic is declared. And then say that it is too late to try and control it.
WHO took a rather remarkable position in not advocating caution about travel to the infected area until very recently, when they declared that "the genie was already out of the bottle" and restricting travel would not make any difference. Clearly the UK Foreign Office, some airlines and no doubt many potential travellers thought differently.
As in all outbreaks of viral diseases - be they in livestock or humans - speed and accuracy of diagnosis is of the utmost importance in trying to control disease spread. Just how speedy and accurate are the diagnostic techniques being employed in the current threatened pandemic? Where are these tests being done, by whom and using what technologies?
The public in many countries has been widely informed regarding the utilisation - or non-utilisation - of modern scientific advances in such circumstances. This was of core interest in the control - or lack of control - of the spread of Foot and Mouth Disease UK 2001. What one would like to see is a professional and independent analysis of the methodologies currently being used, as well as methodologies that may be could be used but aren't.
Meantime we repeatedly hear in media reports that "the results of tests are awaited". How long is that wait? Are there particular problems when it is a new strain of virus that is the culprit?
It now transpires that the virus may be a cocktail which combines the features of pig, bird and human viruses. Indeed, it may not have arisen from pigs, and that the name "Swine Flu" is a misleading misnomer. Just how this particular strain came about is a matter of key importance.
Whatever the answer, urgent collaboration amongst the world's scientific community is needed to identify the reagents and technologies that can provide fast and accurate diagnosis. WHO and the World Organisation for Animal Health (OIE) should surely be playing a central role in this. But I fear that a somewhat pedantic dormancy prevails.
Another worry is the situation at Pirbright in the UK. Classed as a World Reference Centre, this Institute of Animal Health (IAH), under the control of DEFRA, has suffered a chequered past and government funding restrictions. It was at least partially responsible for the most recent Foot and Mouth Disease outbreak in the UK. Is it up to making the required contribution to the management of the present impending crisis? Or is it still resisting the better integration between human and animal disease control in the field of virology?