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19 February 2003
DEFRA: FMD Special Edition of State Veterinary Service Journal
Comments by
Dr James Irvine FRSE, DSc, FRCP(Ed), FRCPath(Lond), FInstBiol(Lond)
Formerly Member of Royal Society of Edinburgh FMD Inquiry
(Filed 19/02/03)
© www.land-care.org.uk
The STATE VETERINARY JOURNAL is an official journal
of DEFRA, and is the UK journal specialising in state veterinary
medicine. It published a Special Edition on Foot and Mouth disease
(vol 12 no 1, 2002) (1).
Lateness of publication and availability to the public
This publication became available to the public
on-line on 13th February 2003, although I understand it was published
and hard copies circulated to members of the State Veterinary Staff
in December 2002. From reading the journal it would appear that
it was compiled sometime in May or perhaps early June 2002, as some
of the information appears significantly out of date.
In view of the fact that there is much deliberation
going on at various levels both within the UK (2)
and Brussels (3) as to how a future FMD outbreak
may be prevented and handled (when it inevitably does occur), it
is a pity that this special publication giving the views of the
State Veterinary Service could not have been available on-line in
June 2002. This is especially so as DEFRA have announced that the
closing date for responses to their FMD Contingency Plan is 28th
February 2003 (2) - just two weeks after the publication
became available to the public on-line.
I e-mailed Mike Lamont who was stated in the publication
to be Chairman of the Editorial Board on 14th February 2003 (4).
He promptly replied that he was no longer chairman and would pass
on my comments. I have heard nothing since.
There perhaps could be some excuse for the lateness
in this publication being made available to the public (or indeed
the State Veterinary Service Staff) if there was evidence that the
articles contained in it had been peer reviewed. However, this does
not appear to be the case.
There is also no excuse in terms of lacking the
technology for putting the publication on-line much more promptly.
If DEFRA cannot achieve this simple form of communication, how are
we supposed to have confidence that it will communicate effectively
in the face of a new outbreak of FMD?
The trouble with this publication being in-house
with no peer review is that it exclusively gives the views of DEFRA
and its staff, who not surprisingly describe what a good job they
did and how hard they all worked. This however is not the view of
the many who suffered the consequences of their actions, or lack
of preparedness for such an outbreak (4, 5).
Also worrying is the apparent continuing resistance
of DEFRA to adopt the recommendation of the EU (3)
that vaccination be considered as a first line defence.
Laboratory Investigations at Pirbright
The article by Anderson et al, Pirbright, clearly
describes how lamentably under-resourced they were for coping with
an FMD outbreak. Here we see clearly manifest the trouble of having
a reference centre also having to act as a service centre to deal
with large numbers of samples when an outbreak occurs. It is like
having a high powered Medical Research facility being asked to cope
as a service laboratory in the face of an epidemic - it never has
worked in clinical medicine and never will. These are two different
disciplines requiring markedly different skills and resources.
Using the reference/research facilities of Pirbright
to cope with a clinical epidemic of FMD in UK livestock could never
work efficiently and it didn’t, whatever the assertions of
Jim Scudamore in his introductory article.
The question has to be put again as to why the
State Veterinary Service had such poor contingency planning. With
the long established nature of the livestock trade in the UK (including
the well known extensive and rapid movements over substantial distances
within the UK and Europe and the auction market system), it should
have been blindingly obvious that if FMD (one of the most virulent
viruses known) got into the UK it would spread like wild-fire.
The article describes Pirbright’s workload
for FMD diagnosis prior to the UK 2001 outbreak as around 400 samples
a year from overseas and about 30 - 40 samples from the UK per year
when FMD was suspected. The contingency planning only made provision
for a minuscule number of new cases per day or week in the light
of the obvious potential for a major epidemic. This again is a clear
example of how mixing the functions of a research/reference facility
with that of a service provider on massive scale just does not work.
These two functions require different outlooks, different training
and markedly different facilities.
The result was that a massive number of livestock
were slaughtered, only a small proportion had any diagnostic tests
done, and of those that had tests done on so-called infected premises
only a small proportion were positive. What a waste. What a tragedy,
especially for those with quality livestock that have taken many
years to establish. What an economic disaster for the country as
a whole, and especially those involved in the tourist industry.
Rapid on site tests were available, but not used.
It appeared that the research facilities at Pirbright were swamped
doing routine diagnostic tests, and did not have time to check out
tests that had been used elsewhere in the world: or indeed to gather
essential data on the outbreak itself. Here again is an example
of how research and diagnostic work essentially do not mix unless
clear provision is made as to who is responsible for what.
Scaling-up Serology
Ruth Lysons of the Veterinary Laboratories Agency
(VLA) describes how the VLA had no experience in FMD. They had to
scale-up their services from scratch. Whatever happened to contingency
planning here.
Meeting the Demands of Serology
Michael Dawson, Manager of Serology Desk at Page
Street, describes how at the outset of the UK FMD 2001 outbreak
the serology testing capacity was only 400 samples a week. As stated
above, this clearly highlights a lamentable lack of contingency
planning in the face of a well-known and well- recognised risk.
It demonstrates the necessity to think forwards
rather than backwards. The backward thinkers take comfort in that
the UK had not seen a significant FMD outbreak since 1967/8, and
that the small outbreak on the Isle of Wight in 1981 was easily
controlled. The forward thinkers would have been ringing alarm bells
about what would happen now if FMD got into the UK. They would have
recognised that this was now much more likely to happen in view
of the liberation of international travel, linked with poor biosecurity
and inadequate safeguards and regulations about pig swill (a well
established cause of FMD outbreaks).
Differentiation of Infection from Vaccination in FMD
This section is written by David Mackay, Epidemiology,
Page Street, London. It reads as though an epidemiologist was talking
about immunology - a phenomenon that has been highly troublesome
throughout the UK 2001 FMD crisis. But before analysing that let
me say that I find it quite extraordinary that Jim Scudamore, the
Chief Veterinary Officer and Director General Animal Health and
Welfare, in his introduction admits that this article was written
before the publication of The Royal Society’s report (June
2002) (6). Yet this in-house journal was not published
in-house until Dec 2002 and on-line for the public until 13th February
2003. Could he not have insisted on some updating during this time,
or did neither he or the author bother themselves? To add to the
discourtesy he made no mention of the Royal Society of Edinburgh
inquiry (7) and a whole lot of others (5)
that had something to say about vaccination and the possible use
of serological tests in differential diagnosis.
David Mackay perpetuates much pseudo-scientific
mischief in this article which at this stage of the proceedings
is reprehensible.
Much play is made by him of the possible role
of carriers and talking about how vaccination prevents disease but
does not prevent infection. He builds an argument to show that vaccination
is thrawt with hypothetical difficulties. Fortunately, experience
throughout the world does not support this. Vaccination was the
norm throughout much of Continental Europe until 1991. When it was
stopped in order to obtain "FMD free without vaccination"
status, there was no relapse of FMD. This has also been the case
in other countries (8).
There have been numerous outbreaks of FMD in other
parts of the world where vaccination has been used, but where are
the results of studies done in the field that could surely have
established the point one way or another. Is it because Pirbright
have been looking after their own commercial interests and not co-operating
with others as they should in their capacity as a World Reference
Centre (9)? It defies belief that in 2003 this
point has apparently not yet been comprehensively addressed.
No reference is made to the use of on-site tests
for FMD virus that are in an advanced state of development. If one
is really concerned about whether a vaccinated animal that has also
been infected is persistently carrying the virus (a carrier), then
an on site test for detecting virus could be used.
The author does not define what he means by a
carrier. Some define the carrier state as an animal that still harbours
virus after 2 months. Such an animal may well not be able to transmit
the virus to another animal. In others, the ability of a vaccinated
animal to transmit the virus may well be greatly reduced. If over
80% of its colleagues are vaccinated, the virus is not going to
be able to spread. It is therefore quite mischievous to make such
statements that vaccination prevents disease but does not prevent
infection. Also, remember that with an effective vaccine the only
time that it is at all likely a vaccinated animal is susceptible
to infection is in the 3-4 days after the initial vaccination. By
vaccinating from a distance away from the infected premises and
working towards it, this risk is greatly reduced.
Comment is made about the availability of suitable
FMD vaccines to allow differential diagnostic tests to be used.
The author did not come clean and say that the vaccine sent up to
Cumbria from Pirbright for possible use was an old 1990 vaccine
that they had in store. Modern type vaccine licensed for use and
suitable for the employment of differential serological diagnostic
testing was available but not mobilised. Why not?
What is also reprehensible about this article
is that the only reference given at the end of it is to a journal
published in 1998.
The Royal Societies of London and Edinburgh after
taking extensive evidence both concluded that the importance of
the carrier state much trumpeted in this chapter by David Mackay
is over-emphasised.
Carcase Disposal
While some carcase disposal will inevitably be
necessary when the next FMD outbreak occurs, let it not be on the
obscene scale that was witnessed in 2001.
Conclusion
The State Veterinary Journal special edition on
FMD does not provide any conclusion. It is a retrospective analysis
and an unconvincing attempt to justify what happened.
We must ensure that such a catastrophic and tragic
event cannot happen again.
This should be achieved by applying science effectively
- not complicated by the alterior political motives of others, or
the lack of the veterinary profession keeping up to date with modern
immunological advances.
Reviewer's suggestions as to the way forward
As recommended by the European
Parliament Temporary Committee on Foot and Mouth Disease
(3) the answer must surely be through the use of
vaccination as a first line of defence - not as a persistent after-thought.
So persistent an after-thought that it never actually happens, because
by then it is too late.
What is of paramount importance is speeding up
the application and standardisation of rapid on-farm serological
diagnostic tests for antibodies to distinguish between infection
and vaccination: together with the use of rapid on farm PCR testing
for FMD virus. It is rapid diagnosis that is the essential key.
Livestock traceability for individual sheep can
become so cumbersome that it is very likely to be counter-productive.
Traceability on a flock basis is much more manageable and should
be sufficient.
Standstill regulations recently announced by DEFRA
(10) that cripple the industry are not helpful.
The Scottish system whereby 20 day isolation facilities are recognised
on farm for in-coming stock is much more practical.
Sensible tagging requirements and sensible standstill
arrangements, coupled with rapid on farm diagnosis are likely to
be the most effective means of identifying and controlling a new
outbreak.
Should it appear at all probable that the disease
will spread beyond an immediate stamping out in the area, vaccination
should be implemented without delay using modern type vaccines that
are available now (and have been since 1997).
Consideration should be given to farm staff administering
the vaccines as on most farms they are well experienced in such
a routine procedure in relation to a variety of other diseases.
Veterinary staff can readily check on whether vaccination has been
carried out or not, and severe penalties imposed for false claims
(which would include the organic farming lobby with their illogical
objection to vaccination as an animal welfare measure).
The public should be reassured now that there
is no hazard whatsoever to their health from eating meat from vaccinated
animals, and prohibitions should be placed on supermarkets or anyone
else if they suggest that there is.
What is distressing is what little progress appears
to have been made as the second anniversary of the start of the
UK 2001 FMD epidemic is tomorrow, 20th February.
© www.land-care.org.uk
Land-Care Note:
Because of the impending deadline for comments on DEFRA's FMD contingency
plan (28 February 2003) this article has been produced as quickly
as possible.
For this reason additional references will added in the near future.
References
1. DEFRA (2002). State Veterinary
Journal, 12: 1. Foot and Mouth Disease Special Edition. (Download
PDF [1.6MB]).
(Note: This edition of the
SVJ can be downloaded in five parts from the DEFRA Website:
www.defra.gov.uk/animalh/svj/fmd/index.htm).
2. DEFRA requests comments
on Foot and Mouth Contingency Plan by 28th February 2003.
(Filed 9 January 2003, www.land-care.org.uk,
click
here to view).
3. Final Report of the European
Parliament Temporary Committee on Foot and Mouth Disease.
(Filed 18 December 2002, www.land-care.org.uk,
click
here to view).
4. Letter from Dr. James Irvine
to Mike Lamont, Chairman of the editorial board, State Veterinary
Journal. Click here to view.
5. Land-Care. Foot-and-Mouth Disease
Inquiry Reports. Click
here to view.
6. The Royal Society. Infectious
Diseases in Livestock. July 2002. (Visit
Website).
7. Royal Society of Edinburgh.
Inquiry into Foot and Mouth Disease in Scotland. July 2002. (Download
PDF).
8. Sutmoller, P. and Olascoaga,
C. (2002). Unapparent foot and mouth disease infection (sub-clinical
infections and carriers): implications for control. Rev. Sci. Tech.
Off. Int. Epiz., 21(3): 519-529.
9. Letter submitted by Alan
Walfield (Director Patent and Licensing Affairs, United Biomedical
Inc.) as evidence to the Royal Society Inquiry. (Download
PDF).
10. 20-day
Farm Standstill Reduced to 6 Days for England and Wales - DEFRA
News Release, 23/01/03.
(Filed 24 January 2003, www.land-care.org.uk,
click
here to view).
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