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URL http://www.defra.gov.uk/science/documents/Microsoft Word - SAC-ED _05_ 2 Response to recomendations.pdf


Science Advisory Council

Epidemic Diseases sub-group

Response to the SAC Epidemic Diseases sub-group on their review of the Foot and Mouth Disease contingency plan

Paper: SAC-ED (05) 2 Author: Defra Animal Health and Welfare Directorate General Confidentiality status: For information

Notes:

This paper sets out the Defra responses to the SAC Epidemic Diseases Sub-group on the Plan and explains how work is developing on the areas to which the SAC sub-group drew attention. This response was discussed in full at the meeting of the Science Advisory Council Epidemic Diseases sub-group meeting on 31st January 2005.

This paper sets out the Defra responses to the SAC Epidemic Diseases Sub-group on the Plan and explains how work is developing on the areas to which the SAC sub-group drew attention.

The response to the recommendations is as follows:-

Recommendation 1: It would be useful if the key changes (relative to the Foot and Mouth Disease Contingency Plan that was in place before 2001) were stated, including information on new research instigated and how social science lessons have been analysed and incorporated into the revised plan.

Prior to 2001 the Foot and Mouth Disease Contingency Plan was that required by the EU FMD Directive. It focused on meeting the requirements of the Directive and did not set out the policies that would be implemented or many of the other elements of the Plan, finance, procurement, human resources, and ways of managing the rural impact that are now present. The current Plan has evolved from one initially prepared and consulted on in early 2002 and has been revised before laying before Parliament in March 2003 and March 2004. Detailed veterinary instructions were in place before 2001 and these have been revised and placed on Defraweb. The purpose of the Plan is to provide guidance for operations in an outbreak rather than to explain in detail the policies and the research on which it is based.

Disease profiles are now being prepared and placed on the Defraweb for all the main exotic diseases so that the public will be able to read about the disease and the control strategies. In addition the summary of policies as set out in the Contingency Plan, together with consultations on policy as it is developed, help to inform the public.

Information on the research programme is available on Defraweb.

Recommendation 2: The Government should clearly state its policy priorities in terms of control during an outbreak. Priorities in the event of different outbreak scenarios should be considered.

It is proposed that in the next version of the Contingency Plan due to go out for consultation in February 2005 the objectives in a future FMD outbreak will be set out. These are:-

“The Disease Control Strategy adopted will be consistent with the UK’s EU

obligations and in line with the appropriate EU legislation. The Government’s

objective in tackling any fresh outbreaks of FMD will be to eradicate the disease

and to restore the UK’s disease free status as quickly as possible. In doing so,

Government will seek to select control strategies which balance:-

  • Minimising the number of animals which need to be slaughtered either to control the disease or on welfare grounds, and which keeps animal welfare problems to a minimum;
  • Causing the least possible disruption to the food, farming and tourism industries, to visitors to the countryside, and to rural communicates in the wider economy;
  • Minimising damage to the environment and protecting public health; and
  • Minimising the burden on tax payers and the public at large.

Recommendation 3: A strategy document should be produced to set out a framework for decision-making based on the different scenarios and policy priorities.

The overall objectives are as set out in response to recommendation 2. Further work may be initiated on different scenarios using work commissioned through the Modelling Consortium. This brings together Defra policy officials, vets, epidemiologists and scientists with animal disease modellers from a range of establishments to coordinate and advise on the best use of science, epidemiology and modelling in a major exotic animal disease outbreak.

Recommendation 4: Defra should build UK epidemiological modelling expertise into further refinement of its Contingency Plan. A range of different outbreak scenarios should be modelled and the best approach available for each should be established.

The work being considered within the Modelling Consortium and that undertaken by the Cost Benefit Analysis (due to conclude in February 2005) will provide a greater input from epidemiological modelling, both to deliver further refinement of the Contingency Plan and a more effective deployment of resources during an outbreak.

Recommendation 5: Constraints on electronic data capture, transmission and access that could limit use of real-time information for prediction during an outbreak should be addressed.

It is clearly in Defra’s interest that data should be gathered as efficiently as possible for disease control purposes, to enable it to report on progress in disease control and to provide data for modelling purposes. IT systems are being reviewed by the SVS with its system provider to develop an integrated system enabling a more efficient management and rapid transmission of data.

Recommendation 6: Independent experts should be involved in the development of data capture systems.

The collection of data during a disease outbreak is currently being reviewed by the Defra veterinary epidemiologists who will staff the National Expert Epidemiology Group in the event of an outbreak and by the State Veterinary Service and AHWDG who will use the information for disease control purposes. This data will also be discussed within the Modelling Consortium to ensure that it will meet the needs of the independent academic modellers.

Recommendation 7: In peacetime, mechanisms that provide the proposed independent modelling consortium with easy access to the modelling data collected at the centre must be agreed and tested.

Agreed. The development of the Modelling Consortium and discussions on the way in which independent academic modellers would operate in an outbreak will ensure that this recommendation is fully met. The outcome will be captured in the Contingency Plan.

Recommendation 8: A review of the experiments and epidemiological data on the efficacy of vaccines should be undertaken as a high priority.

Agreed. There are several research projects ongoing at the Institute for Animal Health that seek to address aspects of the efficacy of vaccines. These include work on potency testing funded by Defra, a new BBSRC project on transmission and immunology and collaborations with EU partners and Indian immunologicals on cross protection. A review as recommended would be beneficial.

Recommendation 9: Modelling, including systematic sensitivity analysis, should be done to determine how vaccine efficacy, availability, deployment. post vaccination monitoring and other factors will influence a success of a given vaccination strategy in different outbreak scenarios.

Agreed. There are benefits to be gained from carrying out this work and we are assessing how best to take it forward.

Recommendation 10: Discussions to better define a dangerous contact (DC) should continue.

Agreed. This work is being taken forward within the FMD Expert Group chaired by Fred Landeg, Deputy CVO.

Recommendation 11: The non-outbreak standstill time of cattle and sheep should be reviewed. If there are overriding factors favouring six days then these must be clearly stated.

The standstill time for cattle and sheep relates to current conditions and it is not therefore appropriate for it to be justified in the Contingency Plan. The decision by Ministers in 2002 to set it at 6 days, was based on commissioned modelling and fully explained at the time that it was introduced. The decision balanced a diverse range of views from the industry, vets and scientific modellers. The current standstill now appears to be accepted by the bulk of the industry. Preliminary modelling for the control strategy Cost Benefit Analysis suggests that the 6 day standstill means that FMD is unlikely to get the same foothold through silent spread as it did in 2001.

Recommendation 12: Defra should explore innovative ways to work with farmers to encourage adoption of good biosecurity at national, regional and local levels. Options might involve new selective incentives e.g. a scaling of the levy burden on farmers according to the level of biosecurity adopted.

We intend to explore this further in the consultation on proposals for an exotic disease levy. There are some technical issues to resolve, but the general approach is to see the levy as incentivising good biosecurity and changing farmer behaviour.

Under the Animal Health and Welfare Strategy, work is being taken forward to encourage farm health planning in all livestock farming sectors. Farm health planning is considered by most as the most suitable way to increase standards of animal health and welfare, including disease prevention. Under the “Positive Animal Health Action Pan” ideas are being developed for communicating the importance of farm health plans to farmers. This is being underpinned by research on the costs of disease and the benefits of preventing disease.

We also have a new initiative to promote personal biosecurity at livestock markets aimed at all users of markets.

Recommendation 13: Accurate pen-side tests should be developed for the diagnosis of FMD in cattle and pigs. The Department should develop the capability to identify further research needs, including a review of current technology and the identification of novel technologies.

RT-PCR tests have been developed for laboratory diagnosis of FMD, which are shown to be at least as sensitive as current diagnostic protocols, and much quicker. Current work is ongoing to validate this technique and also to develop portable PCR based tests for use in the field.

Defra is currently funding research into the development and validation of chromatographic strip tests for pen-side detection, based on serology. The use of serological tests (including the NSP based test) to identify vaccinated livestock that carry FMD will provide a basis for differential diagnosis. Work is currently ongoing on the development and validation of these tests.

Defra is also the sponsor Department of a Foresight project on the Detection and Identification of Infectious Disease (DIID). The project will look at future threats posed by infectious diseases of animals (as well as humans and plants), part of which will include a review of current and future technologies for disease detection and identification. This work is largely futures based and will review possible technology developments over 10-20 years.

Recommendation 14: During any future outbreak the Science Directorate should ensure the production of a daily email of scientific briefing, outlining the science and underpinning the various policy options.

An emergency site on the Defra website for Foot and Mouth disease is being developed to provide information on the disease control policies and their operation to keep the public informed in the event of an outbreak. We plan to include scientific background and briefing on such a website.

Recommendation 15: It is important that the Plan be presented in an accessible format to all including clear explanations of objectives and strategy and risk.

Current proposals for disease contingency plans are to develop a generic plan covering the structures and systems that would apply in any outbreak of exotic animal disease and specific disease chapters for Foot and Mouth Disease, Avian Influenza, Newcastle Disease and Classical Swine Fever. The plans focus on what has to be done in an outbreak to control the disease, not, other than in summary, on the policies that lie behind the operations that are being delivered.

Separately, as part of the Veterinary Surveillance Strategy, disease control strategies will be published on the Defra website that will include explanations of the objectives and the strategy for dealing with outbreaks of disease.

Recommendation 16: Defra should take proactive steps to ensure the engagement of farmers, vets and the public with the Plan. Uncertainties influencing the Plan should be identified and made public.

We agree with the importance of ensuring the engagement of farmers, vets and the public in understanding the purpose and method of disease control. We are seeking to do this through the engagement of the Divisional Veterinary Managers with their Local Veterinary Inspectors and with other bodies at a local and regional level. Using representative bodies such as the National Farmers Union and British Veterinary Association provides an easy and usually effective way of contacting a wide range of farming and other interests and gathering their views and comments, but we are also exploring other avenues including the Rural Affairs Forums. One of our most important concerns has always been to set out the range of policies that would be implemented, but always to make clear the factors that constrain the development of decisions until an actual outbreak.

Recommendation 17: Defra should produce clear explanatory notes for the public on what the policy would be in the event of another outbreak and what it would mean for them in terms of access to rural areas.

In the period between outbreaks it is difficult to set out precisely what an outbreak would mean in terms of access to rural areas: this will depend on the nature of the virus. The statement in the Contingency Plan that the aim is to keep the countryside open and that footpaths would not be closed, except in the protection zone, is probably as far as it is possible to go at this time. We will however consider whether further advice for the public should be prepared alongside the advice currently provided to farmers and vets on foot and mouth disease.

Recommendation 18: The sub group should meet again to consider what scenarios should be modelled and how best to take this work forward.

This work is being picked up by the Modelling Consortium, which has been set up to engage independent academic modellers with those in Defra who would be using the models. The aim is to ensure that models are developed that meet the needs of policy makers and are soundly based in the policy and operational issues.

Recommendation 19: Members of the sub group should visit the Institute of Animal Health (Pirbright) to follow up on some of the issues raised.

The sub group visited the Institute for Animal Health and has followed up on some of these issues.

Recommendation 20: The operations of the SAC during an outbreak, including their interaction with policy colleagues and the modelling consortium require formalising.

All the structures for the operation of the SAC, the Animal Disease Policy Group and senior management within Defra are currently being reviewed and will be set out in the revised Contingency Plan to be laid before Parliament in July 2005. They will be tested in future exercises and revised accordingly.