A Professional Diagnostic Service

I would like to present the concept by illustrating how it might have been had such a diagnostic Service been in operation in February 2001.

A: In preparation for an epidemic

Daily diagnostic work will have prepared for emergencies.

B: Development of up-to-date testing methods

C: The preparation of virology policies and protocols for the management of the outbreak will be under the personal control of the lead virologist on the team

D: Dr Paul Kitching (for example), as virologist responsible for the service, would not agree to anyone other than he or his laboratory staff should interpret the laboratory results.

It is poor practice to pass the results of tests to another outside the laboratory for interpretation.

Work once the outbreak has occurred

The veterinary virologist (Paul Kitching, for example) is the hub.
  1. All relevant persons, especially the field veterinary surgeons, are given the instructions for sampling farms where infection is presumed - and further instructions on sampling with regard to vaccination. There are clear rational explanations.
  2. Field vets contact Paul Kitching and his staff, not Page Street. The virology can be explained and differential diagnosis discussed, samples to be taken etc.
  3. Paul Kitching will be responsible for the flying field laboratories doing near-farm testing by PCR and antigen assays, ensuring that confirmatory specimens were also sent to the laboratory.
  4. Paul Kitching and his staff issue printed reports to every field vet giving the interpreted results. Fax is quick and useful.
  5. These results are passed to DEFRA so that there is an accurate epidemiological database.
  6. The laboratory results are used to confine culling to infected farms and trigger local limited vaccination of all susceptible animals with the aim of controlling the spread of infection.

There has been a failure to learn from the 2001 UK epidemic.

There was a failure to apply what was quickly learnt and published by Dr Donaldson; the lack of aerosol spread of the epidemic strain, which rendered the 3km culling policy unnecessary.

A virologist would have planned to learn as much as possible. However, virologists were sidelined during the UK epidemic.

Without authority given to specially trained and dedicated virologists I can see no hope yet that should FMD recur in Britain we are ready to do any better.
Will we continue to make a hash of animal infectious disease?
This has an important implication for human health - just take bovine TB for example, caused by Mycobacterium bovis. This was unjustifiably neglected in the FMD epidemic. There has been a resurgence as untested cattle have been moved all over the country, even from the known residual hotspots, with the spread of TB to previously uninfected herds. What of the dedicated and highly trained veterinary microbiologists?