Understanding - Dr. Ruth Watkins, BSc Hons, BFA Oxon, MBBS, MSc, MRCP, MRCPath  

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 – Click here! - 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 bio security 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 variability 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 anti-genicity 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 - Dr. Ruth Watkins.