This article is best viewed on the Land Care website
19 February 2003
DEFRA: FMD Special Edition of State Veterinary Service Journal
Dr James Irvine FRSE, DSc, FRCP(Ed), FRCPath(Lond), FInstBiol(Lond)
Formerly Member of Royal Society of Edinburgh FMD Inquiry
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that it was compiled sometime in May or perhaps early June 2002, as some of the information appears significantly out of date.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.
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.
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 (8)? 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.
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.
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 (9) 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 approaches next week.
) Teviot Scientific Consultancy
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.