FMD - UPDATE

8 April 2001

Everything is under control. The Army is doing its job. The MAFF is wonderful. The vets are on top of things. The countryside is open for business and Mo Mowlem had a drink in a country pub with her husband over the weekend. Nothing can go wrong… 

Except that it just has… in a place called Whitby! 

Managing an epidemic 

The key to managing an epidemic successfully is "modelling", working up possible scenarios and developing contingency plans to deal with the most likely outcomes. But rarely does one have the luxury of complete information. All too often, experience and intuition are the best (and only) guide. Every epidemic is different from all others which, according to World Health Organisation epidemiologist P Brès, makes them both "difficult and interesting". This, he says, is where an "epidemiological sixth sense" is so valuable. 

The trouble is that you cannot bottle a "sixth sense" nor put it down on one side of one sheet of paper. You have either got it or you haven't. And neither this government, nor its technical advisors, have it. Instead they rely on bogus science, meaningless statistics and "spin". But you can't spin away an epidemic. Sooner, rather than later, it leaps up and bites you somewhere where it hurts. 

And it has just started biting… In Whitby there has been an outcrop of disease in cattle, some forty miles away from the nearest infected area. 

The Importance of Whitby 

Why Whitby is so important depends on your model - your perspective. If it is a remote outcrop, an aberration, then there is nothing to worry about. Nothing can go wrog… 

But there is a different model. Whitby is not a remote outcrop - it is a harbinger. It is the first in a new, massive "third wave" of infection. Consider… Heddon-on-the Wall in February was by no means the first case of foot and mouth disease in this current epidemic. If anything, the disease was passed to the pigs by the MAFF vet who visited the unit on 24 January. That vet worked out of Carlisle, where the disease was already rampant in sheep. In fact, the disease had been spreading though the sheep population for many months… 

In contrast to the "urban myth" about the way foot and mouth spreads, however, it does not "race" through sheep. It spreads slowly and poorly. In any one flock, only a few sheep may be infected. They are infective for only a short time, with few outward signs of disease which are easily mistaken for other conditions. Thus, the infection ripples slowly through a flock, passing from a few sheep to a few more, while those originally infected recover. For the disease to passage through a whole flock may take many months. 

By this means, the epidemic has been smouldering, unnoticed, for many months before February, slowly and insidiously spreading. By now, in most areas of England, Wales and Scotland, the bulk of flocks have been infected. Many still are infected, albeit at a low level. 

The Ministry, of course, would not notice. Its slender resources, originally, were devoted to chasing up known contacts, and testing for disease in those contacts. It was not doing any random testing. It was not searching outside the immediate range of known infected areas, looking at the margins to see how far the disease had spread. It was reactive, not proactive. 

As the crisis has progressed, MAFF officials have become more and more involved in the administration of the slaughter policy, the cull and, latterly, the welfare slaughter scheme. And the contact-tracing activity has tailed off - with only a fraction of animal movements traced - as the administrative burdens have been added to by a growing number of disease reports from farmers. So busy reacting, the MAFF has not had time to look beyond its own nose. Even if it wanted to - or had the brains to see the need - it could not. The laboratories are swamped. They could not handle routine surveillance samples. In short, MAFF has no idea how far the disease has spread - and no resource to find out. But it has spread. 

Nor does it have any idea how the epidemic is developing. Figure produced on outbreaks (or "cases" as the Ministry prefers to call them) are a completely unreliable indicator. They would only be reliable if all new cases were being identified, but that is far from the case. For a start, it is very difficult to detect FMD in sheep and scale of the movements (1.35 million sheep in the first two weeks in February) have been such that only a fraction of the actual outbreaks can have been detected. 

With disease being so widespread, the figures actually reported can only reflect the resource being applied to looking for the disease - which is tailing off as the cull and welfare schemes take precedence. No wonder the reports are tailing off. But that does not mean the epidemic is on the wane. 

Then we have Whitby. The overwhelming likelihood is that disease did not suddenly "jump" forty miles to reach this location. It was already there, in sheep, waiting for new, susceptible hosts to come alone. In this case, it was cattle, turned out to grass early. And with cattle, the disease is more violent, more noticeable and less easily confused with other conditions. It was spotted. 

Jedburgh too… 

The same has happened at Jedburgh, 30 miles outside an infected area. The disease didn't "jump". It was already there. It had probably been there for weeks, if not months - in the sheep. But when it affected cattle, it was spotted - and reported. 

And all over the country there are cattle in winter housing. Soon they will be turned out to grass. The NFU and the MAFF are aware of the danger and are asking farmers to keep their cattle indoors. But few can heed the warnings. Many farmers do not have the feed and they do not have the money to buy more feed. And they do not have the bedding. The straw has been bought up by the MAFF. 

Susceptible and vulnerable, these cattle will be exposed to infection from the "woolly time bombs" that are the sheep, from the deer which are harbouring the disease, and the other wildlife, not least the carrion crows and magpies that have been picking at infected carcasses. 

Shortly, we will see a "third wave" of infection in this epidemic, the like of which will make the current experience look like a mere dress rehearsal. For FMD does not spread slowly in cattle. It is much more infective and is passes on more easily. It will rip through the cattle population faster than the MAFF will even be able to count the outbreaks. 

Or maybe not…. 

Perhaps MAFF have got it right. Perhaps they have been able to kill their way out of trouble, and the epidemic is really on the wane. But if there is a third wave, by the time it is upon us, it will be too late to do anything about it. In epidemics, you rarely have the luxury of complete information. You have to guess. You have to rely on your epidemiological sixth-sense. 

My sixth-sense says we need to act now. 

Dr. Richard NORTH PhD. [UKIP]

ends

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