A Professional Diagnostic Service
What actually happened in 2001
A: In preparation for an epidemicWhat actually happened
- Automation was put in place only 3 months after the epidemic started
- Computerisation was not fully in place, all specimens were hand numbered rather than given printed labels and bar codes.
- In-house tests were not modernised: ELISAs still relied on hand washing at the start of the epidemic.
B: Development of up-to-date testing methodsWhat actually happened;
- Pirbright were reluctant to evaluate anyone else's tests, including those offered by commercial companies and USDA. (Pirbright is constrained by financial resources to developing in-house tests for the commercial market themselves)
- There was a failure to recognise the value of a near-farm rapid PCR test - and the opportunity to evaluate it. When an index farm tested negative, culling need not have been carried out on other farms even the index farm.
( All those farms placed on section D notices as a result of an index farm that subsequently proved negative need not have been. They have never received any compensation for their losses.)
- There is a duty, upon any laboratory that has a monopoly as Pirbright does for FMD in the UK, to evaluate tests. This was ignored.
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 teamWhat actually happened.
- No such updated FMD protocol existed in preparation for an FMD epidemic. I believe this was because no virologist had authority and responsibility to prepare one.
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.
What actually happened
- MAFF commissioned Pirbright to do the FMD testing, and assumed therefore that it owned the results
- Although they had a written protocol provided by Pirbright it was persons unfamiliar with the virology laboratory who interpreted the laboratory data
- No printed report was given to vets who saw farms with suspected FMD. They never saw results at all.
- Results were given over the telephone to the local MAFF/DEFRA headquarters
- Officials who had no specialist training in infection, virology or FMD gave advice to vets over the telephone from Page Street.
- Persons who had no professional virology training made the judgement that "confirmed infected premises" would be considered confirmed from clinical observation alone regardless of the laboratory result.
Work once the outbreak has occurredWhat actually happened
- There were no field laboratories during 2001 though some vets attempted to use the pen-side antigen test in the latter part of the epidemic
- The field vets never saw results of their diagnosis and it is doubtful whether they learned to diagnose FMD with any c;linical accuracy without knowing or believing the laboratory results
- The MAFF/DEFRA database was inaccurate in more ways than one during the 2001 outbreak. The curves should be re-drawn, taking into account only the farms testing positive in the laboratory - and republished now that DEFRA have admitted that a farm with a negative laboratory result can no longer be counted as a confirmed infected premises.
- In 2001 there was much bullying and coercion to persuade farmers to have their stock culled that were healthy or did not have FMD on laboratory testing. Dictatorial and threatening tactics were employed.
- Vets ringing Page Street were forced to order the culling of a farm even against their clinical judgement without waiting for results.
There has been a failure to learn from the 2001 UK epidemic.
- failure to test the culling policy of contiguous premises or over 3km premises against independent data such as laboratory results
- failure to apply vaccination in at least some areas
- failure to assess anti-NSP tests
- failure to learn about the spread of FMD under different circumstances such as extensive grazing on the Brecon Beacons where there is in fact no hard evidence of its spread outside the single infected heft whilst up on the mountain.
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?