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Letter received June 11th 2010 from Roger Breeze

(Click here for letter of June 10th 2010)

 

June 11, 2010


JAPAN: LOST IN THE CRISIS


Dear Mary: 


In my note to you yesterday I remarked upon the April 20, 2010 report of the foot and mouth (FMD) outbreak in Japan that said, " Epidemiology - Source of the outbreak(s) or origin of infection: unknown or inconclusive." As mentioned, there are now microbial forensic tools that allow the contemporary geographical origin of viruses and bacteria to be specifically located, in the case of the 2001 anthrax attack in the USA down to the level of a specific laboratory. We do not have all the information we would like for foot and mouth, perhaps because knowing outbreak sources has not been deemed important, and perhaps even embarrassing for the countries concerned. But we do know enough to answer the question.


Why should we concern ourselves about the source of the FMD virus now devastating Japan when there is an immediate crisis to be solved?


The reason is that the real tragedy of FMD is not displayed in Japan, whose farmers’ suffering will be alleviated by government compensation and support and where no one will go hungry or starve. It is takes place silently every day in those countries that live with FMD as an endemic infection. Peter Roeder, then a Food and Agriculture Organization Field Officer, summed it up well in a June 2001 letter to The Times of London published at the height of the British FMD epidemic, in which he described the effects of FMD in various parts of the world: ‘the Cambodian subsistence farming family loses half its rice crop when the buffaloes are hit during paddy field preparation, and the fattening pigs and calves die or require expensive treatment. The progressive Bangladeshi dairy farmer with ten cows loses overnight most of the milk production and daily income from it. When the disease strikes just after lambing time, the northern Iraqi shepherd loses 400 of his 500 lambs from heart damage, together with much of the milk for consumption and sale. These real examples do not cover the full spectrum of impact, but they do illustrate the immediate, direct effects of FMD. The fight against epidemic diseases of humans and animals is far from over; indeed, for livestock diseases it has barely started in most of the world. A concerted fight against FMD and other epidemic diseases is needed, to start at their source where the reservoirs of infection persist. For the more developed nations to assist the developing nations in this fight must be regarded as enlightened self-interest, not benevolence’.


I believe there are no technological barriers to the elimination of the major transboundary livestock diseases in our lifetimes (1). The diseases I refer to are those transmissible diseases that have the potential for very serious and rapid spread, irrespective of national borders; that are of serious socio-economic or public health consequence; and that are of major importance in the international trade of animals and animal products. FMD is a prime example. These diseases formed the former “List A” of the World Organization for Animal Health (OIE). ‘Elimination’ means a condition where diseases no longer threaten the flocks and herds of the developed world or the livelihoods of hundreds of millions of small farmers elsewhere. For some diseases ‘elimination’ may not be the same as eradication because reservoirs of potential infection may persist, but if we commit to a new vision, eradication of many diseases will occur during the lifetime of our children. This is not incredible even for those that appear the most intransigent: in 1885 Louis Pasteur tested his rabies vaccine in man for the first time; in 1983 trials of a vaccine for foxes and other wild animals began in Germany and now many countries are rabies-free. In 1348 the Black Death began its course to kill 100 million people – half the population of Europe. Today in the US we are vaccinating wild prairie dogs against plague to protect the black-footed ferret, an endangered species. Almost 250 years ago the veterinary profession was itself created in response to a cycle of Rinderpest epidemics that wiped out over 200 million cattle in Europe. Rinderpest has now been globally eradicated, even in countries riven by war and sapped by desperate poverty – and in 20 years at a cost of only $20 million.


The government of Japan could do itself and world a great service by determining the source of the current FMD outbreak and then resolving to help that country eliminate FMD. All the tools to do this are available. Many countries have used them to become FMD free. Japan should seize this opportunity to remove the threat beyond its borders to secure the future of its own farmers and those everywhere else. President Obama recently set out the US National Strategy for Countering Biological Threats (2), including the transboundary livestock diseases, in a document that “articulates our vision for managing these evolving and complex risks. It is a vision of shared commitment wherein the United States Government works with domestic and international partners to advance the health security of all people”. This is the challenge; this is the moment. If Japan seizes both it will be in good company.


Best Regards,


Roger


Reference

(1) R.G. Breeze Technology, public policy and control of transboundary livestock diseases in our lifetimes Rev. sci. tech. Off. int. Epiz., 2006, 25 (1), 271-292, available at

http://www.oie.int/boutique/index.php?page=ficprod&id_prec=96&id_produit=292&lang=en&fichrech=1


(2) National Security Council National Strategy for Countering Biological Threats, Nov 2009, available at

http://www.whitehouse.gov/sites/default/files/National_Strategy_for_Countering_BioThreats.pdf


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

  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)?