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"Silence of the lambs, calves, sheep, cattle and mathematicians"An article to his fellow vets in the Veterinary Times, March 2006, by Bob Michell, BVetMed BSc PhD DSc MRCVS, Former President of the RCVS
Rapid Diagnosis RT PCR - " a transforming moment" " ...the means to eradicate and control these diseases are now available ... ..." Read in full
Warmwell.com Archive ~ Bird Flu pages Contact the site How FMD crisis was turned into a disaster - Scotsman, Times Please use F5 button to refresh the page RPA latest bovine TB Harriet - latest-------------------------------- Archive September 2006
Sept 30 2006 ~ It is the duty of all those involved in foot and mouth to remind the next government and those thereafter that we will not tolerate short-term cost cutting policies that cost the country dearly in the long run..."
This quotation from the submission to the Royal Society of Edinburgh Inquiry by two eminent veterinary surgeons seems ever more urgent. Costs are still being cut. Pirbright, as the World Reference Center, should be a disinterested party for the evaluation of FMD technology - but how can it be when forced into commercialisation?
Because of savage cuts in funding, IAH Pirbright has become less and less a public servant over the years. The refusal to collaborate on technology that could later have prevented so much misery becomes clearer in the light of a letter to Fred Brown, dated 5 November 1997: "we have ultimately decided it is not in our interests to collaborate with a company which intends to develop a commercial diagnostic kit in direct competition to our own intentions." See full postingSept 29 2006 ~ Government warned against merely "re-publishing existing disease control procedures with a few minor improvements."
"previously unimaginable tools for diagnosis and detailed pathogen identification.... but the continuing dependence on paper, maps and coloured pins in many countries..." From Biological disasters of animal origin The role and preparedness of veterinary and public health services edited and collated by Dr Martin Hugh-Jones, is prefaced by a warning from Bernard Vallat, Director General of the OIE, against governments "re-publishing existing disease control procedures with a few minor improvements."
One paper in the collection, Use and abuse of mathematical models: an illustration from the 2001 foot and mouth disease epidemic in the United Kingdom by R.P. Kitching, M.V. Thrusfield & N.M. Taylor, will find particular resonance in those anxious for past mistakes to be acknowledged:" The UK experience provides a salutary warning of how models can be abused in the interests of scientific opportunism."
Full postingSept 29 2006 ~ "Discussion focused on the use of diagnostic tests; control measures; and stakeholders' involvement in disease control."
The "Disease Control Workshop: Stakeholders' Interests in the use of Science/Technology and Decision Making" was held on 12 May 2006 by the EU-funded FMD & CSF Coordination Action. Warmwell.com has been asked by John Bashiruddin at Pirbright and the EU-funded FMD & CSF Coordination Action website to post the following Disease Control Workshop Recommendations while the CA site is temporarily out of action. Participants in the workshop included representatives from the
NFU, BVA, RCVS, RVC, VLA, Elm Farm Research Centre, COPA-COGECA, European Livestock Alliance, NBvH (Dutch Smallholders Association), European Livestock and Meat Trading Union, Federation of Veterinarians of Europe, Defra, SVS-Scotland, and the Netherlands Ministry of Agriculture.
Discussion focused on(a) the use of diagnostic tests;
Their specific (draft) recommendations can be seen here and comments are welcome on the CA Forum.
(b) control measures; and
(c) stakeholders' involvement in disease control.
(While the CA website is out of action, any messages about the workshop and its recommendations sent to warmwell will be forwarded immediately. We find the recommendations extremely important and very much hope that real progress can now be made.)September 28 2006 ~ " The report of the development of a field rapid test by the Institute for Animal Health, Pirbright raises a number of questions... there are still unanswered questions..." ProMed Mail
ProMED-mail yesterday FOOT & MOUTH DISEASE - UK (02): FOLLOW-UP DIAGNOSTIC METHODS Archive Number 20060927.2768 Published Date 27-SEP-2006
Date: 27 Sep 2006
From: Martin Hugh-Jones, ProMED-mail Animal Disease Assistant ModeratorThe report of the development of a field rapid test by the Institute for Animal Health, Pirbright raises a number of questions: (1) there are still unanswered questions about the apparent failure of Pirbright to use the correct (i.e. USDA/Tetracore) reagents in 2001;
Please read the posting in full , particularly the links. This is the first time we have seen such a blunt expression of disquiet from such a highly respected organisation. (ProMed is a program of the International Society for Infectious Diseases http://www.isid.org) .
(2) the matter of willingness or unwillingness to use the technologies rather than the commercially developed technologies;
(3) the potential unfair role of an agency that both advises the government on which devices to use while producing their own devices; and
(4) as a consequence, unfair competition for private companies.September 2006 ~ Not Hindsight. Dr Paul Kitching's evidence to the EU Temporary Committee shows that by May 2001 the government knew 52.76% of Pirbright tests showed absence of disease.
The evidence shows that the Science Committee were repeatedly urged to reconsider the policy. The flaws in the merely mathematical modelling driving the policy were pointed out by the Committee's only veterinary experts, Dr Kitching and Professor Donaldson. To their dismay, proper epidemiological investigation, which would have been so invaluable for the future, was made impossible by the relentless pace of the mass cull carried out after the disease had peaked. As Dr Kitching told the Committee "public perception of control programme both in the UK and abroad was severely damaged..."
"... On 1st May (i.e. 2001), I asked for a summary of results generated at Pirbright; of 1876 premises that had been slaughtered, classified as VDR, DCF and SOS; samples from 52.76% were negative on laboratory tests. This was reported to the Science Committee on 2nd May 2001..... The implementation of the rapid cull also prevented any detailed epidemiological investigations, and sometimes even the collection of any samples from "infected premises" - a concern expressed on the 6th April by the HQ Epidemiology Team.
He told the EU Committee that the consequence of adopting the policy recommended by the models included excessive slaughter, the inability to remove carcasses and the necessity of transporting carcasses through uninfected areas and a " loss of confidence of local Veterinarians and farmers". (read Dr Kitching's evidence in full)
......the question was raised that the sensitivity of the tests being used at Pirbright was not sufficient to identify all infected animals. In my opinion, samples collected... close to 100% sensitive.."September 2006 ~"...at least there is humour! The very same test reagents and Cepheid device that Dr. Ferris manages to smear... have since been deployed across the US... after millions of dollars spent on validation!"
Roger Breeze's response to the Pirbright analysis of how many so-called "Infected Premises" were free of FMD in 2001.
"....My first thought was that if Dr. Ferris and his Pirbright team had bought the ARS/Tetracore real time PCR test reagents for Foot and mouth disease from Tetracore in 2001 and learned how to use them, he could have completed his research much more quickly and published this paper in 2002, thereby saving the British taxpayers a tidy sum and giving his team four years head start on solving a real foot and mouth problem.
read in full See also the posting on http://www.fmd-and-csf-action.org/forums/fmdv
My second thought was "So what?" There is nothing in the news reports or paper to indicate that DEFRA still has any idea how to use real time PCR or other rapid tests to shut down an outbreak of a foreign animal or poultry disease. ...
......The more studies are done, the bigger the mistake will be seen to be. Everyone around the world knows this. But almost everyone involved in that decision in Great Britain has retired or died - soon this will include the Prime Minister.
So can we stop pretending that the decision not to accept the US offer was based on a shrewd scientific assessment of the device and the data and not on political embarrassment at being caught unprepared for the greatest debacle in the history of British veterinary medicine? Can we have a moratorium on revising history and get on with what's important?
In the real world, people are developing multiplex PCR tests that differentiate over 20 different viral and bacterial causes of pneumonia in a single test procedure (so we can test for rare diseases at the same time as common ones at no additional cost in money or time), they are evaluating devices that simultaneously detect all microbial life, known and unknown, in a sample, and they are using microarrays that detect all human and animal viruses plus some 200 bacterial, fungal and parasitic pathogens in a single test procedure. These are just three of the hundreds of novel approaches to pathogen detection that are being studied in the US and elsewhere. I might draw attention to a microarray that not only detects foot and mouth virus but also determines some 1000 bases of the genome of the virus in the sample - thereby solving one of the issues Dr. Ferris identifies as a problem, namely the need to monitor the PCR test genome target for variation during the course of an outbreak.
So you don't need to wait five years to find out how good your PCR test is, you can monitor this in close to real time as the outbreak proceeds. This can be done now - it does not need to be rediscovered in 2011. ...."September 2006 ~ "Not only is it a great read that grips you by the throat from the first paragraph, it's hugely informative about a subject people outside of the rural community know virtually nothing about ..."
A new novel "A Necessary Killing" (Amazon.co.uk synopsis) reminds us that the policy of 2001, analysed now by academics, devastated the lives of those in its path:
" I experienced first-hand the human cost of the epidemic, the fear, anguish and desolation caused by the disease and especially by its management. The epidemic may have been 'forgotten' but it had a dramatic and lasting effect on the personal lives and health of many rural people....." writes its author in this email
Read entry in fullSeptember 2006 ~ Mr Blair assured Rural Affairs Minister Barry Gardiner that all rural concerns could be consigned "to the bottom of his in-tray"
The Western Morning News (WMN) reports that Mr Gardiner has told farmers at the Labour Party Conference that Britain's dairy industry needs "a hell of a shake-out".
He represents the London borough of Brent North. He told delegates at a meeting organised by the National Farmers' Union that he had only taken a job at the Department for Environment, Food and Rural Affairs after being assured by the Prime Minister that he could push rural concerns to the bottom of his in-tray. While this government thinks it is presiding over a "post agricultural era", it may perhaps, too late, wake up.
Professor James Lovelock in The Revenge of Gaia: "... Unfortunately our nation is now so urbanised as to be like a large city and we have only a small acreage of agriculture and forestry. We are dependent on the trading world for sustenance; climate change will deny us regular supplies of food and fuel from overseas.. ......we need secure indigenous supplies of food and energy....our gas and oil will soon be gone and we can not rely on supplies from abroad..."September 2006 ~ The justification that mass killing was necessary to "get ahead of the disease" must at last be seriously challenged.
"You can't leave animals that may be excreting the virus while you make up your mind....I don't know whether you would say it was unnecessary because in the circumstances pertaining at the time there was perhaps no alternative." said David Paton on a Radio Gloucestershire interview on Sunday. No alternative? The UK had the choice both of effective vaccination and the offer of the newly developed on-site diagnosis kit - both of which were summarily rejected for reasons that had nothing to do with veterinary concerns - and both of which worked so well in Uruguay in the same year. As Dr Breeze says here,
"Fortunately, we were able to take the devices and test system into the field in Uruguay in November 2001, where they performed splendidly on farm in a remote area."
( Uruguay was granted Disease Free Status (with vaccination) from the OIE on 1 November 2001, just 2 months after the last outbreak on 21 August. See Uruguay pages)
It is becoming apparent now to anyone who looks at the data that the adopted policy actually made the 'epidemic' worse.
Defra's insistence on central control from Page Street, telling vets to slaughter even when the doubts were great, ignoring local veterinary skill, turning a deaf ear to all protest - all this served to create the very misdiagnosis that led to such massive overkill. Dr Paton's support for the government's insistence that such draconian policy was necessary to "get ahead of the disease" looks very thin when, as Janet Bayley reminded listeners to BBC Radio Gloucester, the disease had already peaked before the contiguous cull policy began. Test results came back again and again as negative.September 2006 ~ Warmwell.com was updating daily from early in 2001. Our deep disquiet now is not "hindsight" after the event.
At the time, we recorded daily agonised dissent from experienced farmers, frustrated vets in the field, FMD scientists whose expertise was rejected and from concerned members of the public distressed and unbelieving at what they were seeing. (See also Fields of Fire)
The BBC interview shows that the Forest of Dean at least - and many other areas too that suffered such losses - could well be justified in calling FMD 2001 "the epidemic that never was." For the whole of Wigtownshire, for example, there were only 2 positive results, yet at least 88,446 animals there were automatically slaughtered and protest went unheeded.
In spite of warnings such as that of the Drummond Report ("Notifiable Disease Preparedness within the State Veterinary Service"), there had been no proper contingency plan. Small wonder that the contiguous cull was described by the 2001 - 2002 EFRA report as " a response to a desperate situation, not a pre-meditated response to a known, assessed risk."September 2006 ~ "No evidence of FMD virus, antibody or nucleic acid was found in approximately 23 per cent (390 of 1730) of IPs from which samples were received, suggesting that the incidence of FMD during the outbreak may have been over-reported. "
The research in The Veterinary Record 159:373-378 (2006) refers to actual supposed Infected Premises. It would be interesting indeed to know the situation with regard to the other categories ie Dangerous Contacts, Slaughter on Suspicion and, of course, those animals culled contiguously.
Could the figures not be really appalling - as they certainly seemed to be when we published some of the county figures? If a so-called "Dangerous Contact" premises could be later termed an "Infected Premises" - as claimed - why were there so many IPs that returned negative results still referred to by the category of IPs? Similarly for dangerous contacts (DCs), Contiguous Premises (CPs) and Slaughter on Suspicion (SOSs). How were the untested "IPs" distinguished from "SOS"? By what criteria were "IPs" that were not laboratory-tested identified? It needs to be remembered that this research suggests that a third of animals killed on farms designated as INFECTED and subsequently tested have now been shown to have been free of disease. The percentage of the total number of healthy animals killed as assumed contacts or "contiguous" is therefore likely to be very much higher.
These questions continue to haunt us. Is anyone able to help?September 2006 ~ "I am afraid a lot of animals lost their lives unnecessarily..."
The Western Morning News quotes Dick Sibley in an article that suggests that some of the main perpetrators of the slaughter policy of the FMD crisis are still anxious to defend what happened. Mark Woolhouse, it will be remembered, claimed at the time that "50% of new cases turned up in the immediate neighbourhood of previous cases." and this sort of thinking justified the contiguous cull. Disease was, in fact, incubating from contacts made before the movement ban came into operation. Moreover, very many suspected cases were simply wrongly diagnosed. Dubious vets were told by Page Street to slaughter anyway - and livestock owners who objected to this discovered that they were up against political rather than veterinary pressure. We look forward to the foot and mouth data being made public so that it is apparent at last where the disease really was - and where it was not.
The language of the WMN article is interesting:"Vets said"
DEFRA even says: ".. swift action to slaughter was used to slow down the spread of foot and mouth disease" - as if even the slaughter itself was rapid. In fact, in very many cases, farmers were left waiting until long after clinicial symptoms would have been apparent, only to see their evidently healthy animals being killed. (EFRA Report "...Given that the objective was to carry out slaughter and disposal of livestock on infected premises within 24 hours of the disease being confirmed, and within 48 hours on contiguous farms, the length of time actually taken was extremely disappointing...Delays in slaughter cannot but have contributed to the spread of the disease.") All too often, this was in a manner that left otherwise tough vets and farmers in tears.
"drastic action had to be taken".
"you could not afford to miss any"
" you needed more accurate tests.".....
Of the millions of animals who were so killed, the number actually infected was heartbreakingly low. The Farmers Guardian quotes Ben Gill who has, perhaps, more reason than most to defend the NFU stance during the FMD crisis. He uses the flawed Pirbright rubbishing of the 2001 test as jusification for its rejection - but forgets that that piece of bizarre research failed even to use the proper reagents proprietary to ARS/Tetracore test and that were essential for it to work correctly.
A statement made by Roger Breeze of USDA explained this clearly to the Royal Society Enquiry in 2002."......Given the extensive validation studies in vitro and in vivo that had already taken place at Plum Island, our expectations were that after a short familiarization period (1 to 2 days) for UK colleagues at Pirbright we would be able to take the devices and tests into the field during the 2 0 0 1 FMD outbreak in cooperation with UK authorities from Pirbright or MAFF. Such studies would have provided the US and UK with valuable data under field conditions: we would have used these data to support USDA licensure and OIE test approval. ...."
September 2006 ~ "massively important" rapid diagnosis - rejected by the UK in 2001 - may at last be on the cards because there could be a UK test.
The present talk of a "new" penside test is interesting. The desire by the UK government, using its own laboratories and commercial partners, to develop and market its own rapid diagnosis tests helps explain the apparently senseless rejection of almost identical technologies that could have transformed animal health policy in 2001. Pirbright's research, suggesting that more than one-third of sheep farms and 23 per cent of all livestock premises were wrongly diagnosed as having foot-and-mouth disease, is reported in Cumbria's Times and Star which also emphasises the commercial nature of Pirbright's research into penside tests. This comes to light - not to demand accountability - but presumably to suggest the need for a rapid on-site test. Such a UK test could create state revenue if accepted for use. (See background to this issue.)
The Farmers Guardian (22 Sept) reports that Pirbright is "..... trialing a diagnostic test that will deliver an on-the-spot result in under an hour, without having to wait for results from a laboratory..."
But the article rightly reminds us that a" similar rapid penside test, already developed in the USA, was offered to the UK during the 2001 outbreak but was rejected by the Government because it had not been validated in the UK."
DEFRA still talks of its being " inevitable that slaughter of some animals may have to be undertaken preemptively before definitive laboratory evidence is available." and the phrase "no officially validated tests" is used to justify a five year wait for a test we could have used in 2001. Roger Breeze exposed the "waffle from those insisting on "further validation" in a letter. in January this year :"......I am not arguing in any way that diagnostic tests should not go through an independent validation process to validate the claims of their makers. Indeed, I was astonished to discover that APHIS actually did not have such a process. What happened with the FMD and other PCR tests is that "validation" became a smokescreen.... ."
John Thorley, former National Sheep Association chief executive, is also quoted in the Farmers Guardian. Unlike the defenders of the extraordinary policies of 2001, Mr Thorley is quoted as saying that the test, was "massively important" . Its use in 2001 would have ensured that Bob Michell, a former President of the RCVS, would never have had to refer to "the greatest unnecessary slaughter of healthy animals in the history of our profession".September 2006 ~ Quis Custodiet Ipsos Custodes?
"Defra works for the essentials of life: water, food, air, land, people, animals and plants" but this claim for itself by DEFRA has no mechanism by which anyone can judge the meaning of such a statement. The Department's performance is never measured, the NAO notwithstanding. In 2001 we really needed good management, good science and common sense. What we got - because a sound contingency plan had never been prepared - was 'cure' by mass slaughter, bullying and a refusal to listen to genuine expert advice. Billions were wasted; money and coercive legislation used to silence opposition to a policy now widely seen to have been dreadfully wrong. Five years on, one wonders whether decent and humane animal health policies are really any nearer.
The EU one-size-fits-all legislation can now hardly even be questioned, let alone voted against. Proposed change tends to be cloaked in impenetrable legalese; DEFRA's own language, rather than interpreting and guiding, is far too often florid, empty and obscure.
All this matters. Animal diseases and human diseases are increasingly interconnected and we need to work together.
This extract from a West Country farmer's email is an indication of the widespread unease now felt:"... if farmers are penalised for reporting suspect candidate animals or poultry, then they will not do so. And an opportunity of early, decisive action to prevent endemic spread will have been lost. This is serious for two reasons; first, economically for international trade obligations and also for the effect on other species, including man, of zoonotics like Tb and avian flu."
DEFRA does not value its smaller shareholders. Even the plea below to Defra to " please post this information with the correct page and paragraph reference" has been ignored. Without cooperation from all, disease in the UK will be left to spread. Never before has genuine partnership between government and farming , complete with Performance Benchmarks to be met both by government and by industry, been so urgently needed. If there is only an arrogant laying down of the law on the one side and frustration on the other, heaven help the essentials of life in the UK, its water, food, air, land, people, animals and plants.September 2006 ~ EU-wide disease slaughter compensation down to 75%?
Stakeholders given only days to respond - and even then - "No negotiations or vote on these issues.."(See relevant section of European Commission's proposed exemption regulation.)
Although the EU Consultation began on August 18, a Defra email dated 8th September to stakeholders says"We have just been made aware that they are holding a public consultation period which ends on the 17 September....."
Sunday is the deadline for comments to the European Commission Directorate General for Agriculture ( Agri-State-Aids@ec.europa.eu) on proposed changes - due to come into force next January - that will drastically cut the amounts given to livestock owners who have their animals compulsorily slaughtered (as were over 10 million in the tragically mishandled FMD crisis of 2001)
DEFRA tells stakeholders:".. the Commission has been given the power by Member States to decide which forms of aid are to be allowed and under which conditions. There are therefore no negotiations or vote on these issues - the Commission will decide having listened to the views of the Member States and those with an interest...."
It is not clear whether other Member States have held meaningful discussions on the proposed changes.
The posting by Mary Marshall, Member, Defra's FMD, CSF, Bluetongue and Avian Influenza stakeholder groups, can be seen in full at http://www.fmd-and-csf-action.org/forums/fmdv/post200609113053373524
As Mary Marshall, points out"The document with the proposed revised guidelines that Defra sent to stakeholders has only 24 pages, so we ask Defra to please post this information with the correct page and paragraph reference on the Defra website."
The Farmers Guardian says, " The potentially devastating proposals are contained in a far-reaching consultation on EU state aid rules for agriculture that also includes potential new restrictions on the use of public money to promote national brands."
***We recommend again the paper by Dr Roger Breeze Disease control: Ideas for cost sharing between industry and government " - which sets out a practical blueprint for genuine partnership between the government and farming. "....Cost sharing offers industry a chance to sit at the table as a partner to make sure that when it pays what is asked, it gets what is promised."September 2006 ~ Bluetongue moves north "Globalisation, the change in weather patterns and the increase in speed and volume of international transport as well as passengers" are, hardly surprisngly, the suggested causes.
European Research "....Bluetongue cases were first confirmed on a farm in the southernmost region of the Netherlands, and then also detected across the borders in Belgium, Germany and later France. Positive cases of the insect borne virus were found in sheep in the Lihge province of Belgium and in cattle in the Aachen area of North Rhine Westphalia in Germany..
.... the virus strain detected recently in the north has been previously unknown in Europe. The Community Reference Laboratory located in Pirbright....identified the serotype responsible of the current outbreak as serotype 8. Early tests suggest it is similar to the serotype 8 found in sub-Saharan Africa. How it came to infect animals in northern Europe is under investigation. As in other emerging diseases, possible explanations for how the virus arrived in northern Europe include "globalisation, the change in weather patterns and the increase in speed and volume of international transport as well as passengers," the World organisation for animal health (OIE) says.................................................
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