EXTRACT from the letter from Dr Roger Breeze. Read in full below

I have a few questions:

1. Why in 2010 - in Japan of all places - is a government vet turning up to a reported case of suspect FMD without the tools to make a diagnosis? For sure, if positive and missed, this will be the most important decision of that person’s career and a catastrophe for animal agriculture. An on-farm PCR test for FMD on April 9 (using the $50 Tetracore FMD real time PCR test, www.tetracore.com) on a $50,000 IdahoTechnology RAPID PCR machine (www.idahotechnology.com) would have given the answer within an hour. Since this is a preclinical test that detects FMD-infected animals 2 to 3 days before they show clinical signs of disease a pooled sample from several animals could have been used. The best science could have given the answer in one hour: in fact it took 11 days.

2. And to confirm that infection, why does Japan not have the Tessarae resequencing microarray at the NIAH so that within 5 hours ALL the pathogens in the sample can be identified and 1500 bases of the actual genetic sequences of all those present can be directly defined (www.tessarae.com)? A PCR-positive sample taken on April 9 could have been identified by microarray the same day along with actual sequence information - in fact it was 14 days later before the official confirmation.

3. How is it that on 19 April the local government veterinary service tests by PCR for all the diseases except the one that matters - FMD? Is it because that regional lab did not possess the FMD PCR test used at NIAH? (Just as regional labs the world over defer to the National Lab as if it were still 1999!) If the lab is equipped and competent to run PCR tests for bluetongue, bovine viral diarrhoea-mucosal disease, infectious bovine rhinotracheitis and Ibaraki disease, why not FMD? For the want of a $50 PCR test kit in the right place Japan is paying dearly.

4. Why is the source of an FMD outbreak or infection always "unknown or inconclusive"? Why are we not applying modern microbial forensic tools to trace the virus to its source outside Japan by its biological signature (Carrillo, C. and Rock, D. Molecular epidemiology and forensics of RNA viruses, in Microbial Forensics, Editors Breeze, R.G., Budowle, B. and Schutzer, S. E., Elsevier, 2005, 174-185)?

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JUNE 9, 2010 FOOT AND MOUTH DISEASE: JAPAN IN CRITICAL SITUATION SAYS MINISTER. HOW COULD JAPAN EXPECT ANYTHING ELSE SAYS YOUR CORRESPONDENT.




Dear Mary:




Before writing to you I looked out of my window in Washington DC, prompted by the metaphor of "Starlight" that inspired the 2000 US National Reconnaissance Office study of the future of surveillance known as "Proteus." For thousands of years humans stared at the night sky without realizing that it had depth as well as breadth. They did not understand that light from the nearest star you will see tomorrow night in France took 4 years to reach Earth and that from the farthest 4000 years. When one set out George Bush was still President and as the other left Abraham was still at home in the Land of the Two Rivers. Starlight is a great metaphor for the current state of disease surveillance because we know that an event we will all see tomorrow night was actually over and done with long ago - just like reports of animal disease outbreaks where today’s surprising news was inevitably determined by things that happened in the past.




Today’s (June 9, 2010) ProMedmail has a report (20100609.1925) from new Agriculture Minister Masahiko Yamada that Japan faces a "high risk" that an outbreak of foot and mouth disease may spread from southwestern Miyazaki prefecture to other livestock regions. "Japan is in a critical situation where the disease may break out anywhere, anytime," as infected animals are still alive, Yamada told reporters in Tokyo today. "We must speed up culling and burying them."




Remember "Starlight" as we go back to another ProMedmail report (20100420.1284) of April 20, 2010 that told us that foot and mouth (FMD) was suspected in a cow, the first time in Japan since 2000.

" Epidemiology - Source of the outbreak(s) or origin of infection: unknown or inconclusive.

Epidemiological comments: a private veterinarian first found a suspicious case in the affected farm and reported it to the local government's veterinary service on 9 Apr 2010. An official veterinarian observed that a cow had fever, anorexia, salivation, and erosions in the oral cavity on the same day but the others had no clinical signs. Since other 2 suspicious cases were found in the same farm on 16 Apr 2010, the veterinary service examined similar diseases such as bluetongue, bovine viral diarrhoea-mucosal disease (BVD-MD), infectious bovine rhinotracheitis and Ibaraki disease but they showed negative results by PCR tests on 19 Apr 2010. The veterinary service submitted the samples to the National Institute for Animal Health (NIAH) on the same day. The NIAH affirmed the cattle were infected with foot-and-mouth disease virus [FMDV] by PCR test on 20 Apr 2010. The samples are being examined by virus isolation. If it is confirmed, it will be the 1st outbreak of FMD in Japan since 2000."




The NIAH confirmed FMD infection by cell culture on April 23. Today the mass slaughter of cattle and swine has been in full swing for weeks, as Minister Yamada said, and infected swineherds now generate large amounts of virus to threaten even more.




I have a few questions:

1. Why in 2010 - in Japan of all places - is a government vet turning up to a reported case of suspect FMD without the tools to make a diagnosis? For sure, if positive and missed, this will be the most important decision of that person’s career and a catastrophe for animal agriculture. An on-farm PCR test for FMD on April 9 (using the $50 Tetracore FMD real time PCR test, www.tetracore.com) on a $50,000 IdahoTechnology RAPID PCR machine (www.idahotechnology.com) would have given the answer within an hour. Since this is a preclinical test that detects FMD-infected animals 2 to 3 days before they show clinical signs of disease a pooled sample from several animals could have been used. The best science could have given the answer in one hour: in fact it took 11 days.

2. And to confirm that infection, why does Japan not have the Tessarae resequencing microarray at the NIAH so that within 5 hours ALL the pathogens in the sample can be identified and 1500 bases of the actual genetic sequences of all those present can be directly defined (www.tessarae.com)? A PCR-positive sample taken on April 9 could have been identified by microarray the same day along with actual sequence information - in fact it was 14 days later before the official confirmation.

3. How is it that on 19 April the local government veterinary service tests by PCR for all the diseases except the one that matters - FMD? Is it because that regional lab did not possess the FMD PCR test used at NIAH? (Just as regional labs the world over defer to the National Lab as if it were still 1999!) If the lab is equipped and competent to run PCR tests for bluetongue, bovine viral diarrhoea-mucosal disease, infectious bovine rhinotracheitis and Ibaraki disease, why not FMD? For the want of a $50 PCR test kit in the right place Japan is paying dearly.

4. Why is the source of an FMD outbreak or infection always "unknown or inconclusive"? Why are we not applying modern microbial forensic tools to trace the virus to its source outside Japan by its biological signature (Carrillo, C. and Rock, D. Molecular epidemiology and forensics of RNA viruses, in Microbial Forensics, Editors Breeze, R.G., Budowle, B. and Schutzer, S. E., Elsevier, 2005, 174-185)?




Of course Japan is in a critical situation two months later. You can’t misdiagnose the world’s most infectious virus disease in an intensive animal agricultural region full of cattle and swine for 10 days and not expect catastrophe. Governmental failure to adopt the best science and methodology for FMD surveillance, reporting, investigation and response is like a second marriage - the triumph of hope over experience. Governments keep doing exactly the same things and hoping for a different outcome each time. If it were mandated that all suspected FMD cases were to be tested by PCR on farm Japan would have had a 10 day start on trying to halt the outbreak while it was still small. Sad to say, like we will see the moon and stars again, we know we will be writing much the same sometime soon - just keep this email and change the name of the country when it happens.




Best regards,

Roger

 

 

 

 

 

 

 

 

 

 

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