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Email to Dr James Irvine at Land Care from Dr Roger Breeze copied to warmwell.

If not us, who? If not now, when?

I enjoyed your report (warmwell note:see www.land-care.org.uk ) on the avian influenza investigation in Orkney 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 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