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Email to warmwell October 6th 2007 from Dr Ruth Watkins

"if we had vaccinated immediately upon finding the IP 3 at Egham (having the vaccinators on standby and some 300,000 doses of vaccine ready) infection at IP 7 and IP 8 could have been prevented."

Dear Mary
When epidemiologists are wheeled out of IAH and refuse to acknowledge
the usefulness of vaccination against FMD I am still surprised, though I
should not be as anyone in the employ of DEFRA will never admit it.  I have
looked at a very useful web site
on which one can look at slide presentations.  The one on FMD in the United
Kingdom is interesting having a slide on the timeline of the first 7 IPs,
slide number 12.  If an epidemiologist looked at it, it should strike him
that if we had vaccinated immediately upon finding the IP 3 at Egham (having
the vaccinators on standby and some 300,000 doses of vaccine ready)
infection at IP 7 and IP 8 could have been prevented.

    The consideration of cost for vaccination by the epidemiologist shows
that DEFRA employees haven't read the reports following the 2001 outbreak
and still think of costs as being those that DEFRA would shell out to put
vaccinator teams on standby and doses of vaccine at the ready (even if
unused I presume these have been bought and the money spent, so how much
more expensive is actual vaccination?); these are internal costs.  However
one of the most important lessons from 2001 was that the external costs,
those of farmers without any compensation and rural businesses and tourism
dwarfed the internal costs.  That is the same now, the effect on farming has
been disproportionate even if tourism has not been impacted and it dwarfs
the internal costs of this outbreak.

    The second question I believe referred to changing the European rules to
remove the economic disadvantage of vaccination so that export
considerations could not rule the response to FMD (The recent permission for
export of live cattle for breeding caught 7,000 of them in transit from the
UK and these were all killed).  The answer the epidemiologist gave was
unchallenged because the interviewer did not understand the irrelevance of
Saudi Arabia or South America to the UK.  As a virologist I should have
asked the epidemiologist what relevance he thought these examples had to
Western Europe.  Saudi Arabia  is a corridor from Africa to the Middle East
and many poor herdsmen move animals through, and a very similar situation
exists in South America.  The biosecurity of their borders and veterinary
facilities for quarantine etc is rudimentary compared to Western Europe.
FMD is not endemic in Western Europe and routine vaccination is not
therefore necessary hence the banks of vaccine to all serotypes of FMD kept
at the ready to use to control an incursion, or escape from a laboratory.

    The epidemiologist made FMD apparently an equivalent of influenza in its
variablility limiting the usefulness of vaccines, which is untrue and shows
the limitations of a too focussed life of work on one or two infections with
no general specialist training and experience in the subject of virology.
Professor Fred Brown (who elucidated the structure of the FMD virus and was
made a Fellow of the Royal Society for his work, he was also an erstwhile
Head of Pirbright) was clear on the conservation of the antigenic site over
long periods of time excepting one FMD serotype (I think C) that had some
significant changes in antigenicity over the last 20 years.  The viruses in
the family picornaviridae, to which FMD belongs, have lent themselves to
making good vaccines, for instance against poliomyelitis where we continue
to use the same live attenuated oral vaccine viruses to the 3 serotypes that
were developed 50 years ago.

    There was at least one episode of FMD virus escape from a laboratory in
Europe giving rise to an outbreak but that was decades ago and everything in
the science of virology and vaccine manufacture has moved on considerably in
the interim.   The condition that Pirbright had fallen into through lack of
investment in a timely manner to update facilities is shocking, and cannot
be compared with times past because we do know better now.

yours sincerely
Ruth Watkins

























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