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Response to an outbreak

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THINGS could soon change if the disease pops up elsewhere, but a notable and encouraging aspect of last week's outbreak of highly pathogenic h5n1 avian influenza in a large commercial turkey flock in Suffolk was the measured response from the media and the public. This is not to say that the outbreak did not make the headlines or cause concern; however, reaction to the news did not come close to that encountered during, say, the salmonella scares of the early 1990s, and, while the media rightly focused on the outbreak, their coverage was, for the most part, responsible. Interest continues, and the headline count is not yet complete. However, by Wednesday this week, when this issue of The Veterinary Record went to press, the excitement generated seemed not to have matched that of last year's incident involving a single swan in Cellardyke harbour.

This level-headed response was reflected during a debate in the House of Commons on Monday, when the Secretary of State at defra, Mr David Miliband, made a statement on the outbreak and the steps being taken to contain it (see pp 174-175 of this issue). For once, party politics seemed to have been put aside and, while some questions were asked, the mood among mps from both sides of the House was supportive. Certainly, there seemed to be little dissent among mps from the Secretary of State's view that the response to the outbreak had been ‘rapid, well coordinated and appropriate’, or from the Government's goals of ‘stamping out the disease, protecting public health, protecting animal health and welfare, and regaining disease-free status in the uk’. The response to the outbreak also gained the approval of the European Commission (ec), which, following a meeting of the Standing Committee on the Food Chain and Animal Health on Tuesday this week, endorsed the steps that had been taken.

The reaction may have been different if the outbreak had occurred in an outdoor flock, and there is clearly no room for complacency. However, defra and the other agencies involved can take some satisfaction from the way the incident has been handled so far and the public's reaction to it. This must largely reflect the effort that has been devoted to contingency planning over the past five years; as Mr Miliband pointed out on Monday, plans are now regularly updated and published and ‘thus far they have proved their worth’. It must also reflect the policy of openness, developed with the establishment of the Food Standards Agency in response to the food scares of the 1990s, and of keeping people informed. Quite how the h5n1 virus found its way into the Suffolk plant when the nearest other known outbreak was nearly 1000 miles away in Hungary remains a mystery, and every effort must be made to try to elucidate the source. In the meantime, as the ec pointed out on Tuesday, the uk and other eu member states must maintain heightened surveillance and biosecurity; given what is known about the disease, this surveillance must extend not just to poultry flocks, but also to wild birds.

Last week's outbreak rekindled the vaccination debate, but there is no doubt that stamping out was the appropriate response in this instance. Provision for vaccination is included in the uk's contingency plans, but defra has made clear in these plans and elsewhere that, because of limitations associated with vaccines and their use, it will not be vaccinating poultry in advance of an avian influenza outbreak, nor will it use vaccination as an immediate response. At the same time, it has said that it has no objection in principle to the use of vaccination and that it will keep its policies under review in the light of scientific developments in vaccines. It notes that a large number of factors need to be considered when deciding on the method of control to be employed in an outbreak, and that a decision to vaccinate, which would have to be approved by the ec, would be based on expert veterinary, epidemiological and scientific advice, given the circumstances at the time. The ec's Standing Committee on the Food Chain and Animal Health also revisited the vaccination issue last week. It concluded that, while it may be a possibility in certain circumstances, such as in the French and Dutch programmes agreed last year, it is not feasible to carry out widespread vaccination of poultry flocks at present. The ec is co-organising an international conference on vaccination against avian influenza in Verona, Italy, in March, to discuss the issue in more detail.

The appearance of h5n1 virus in Suffolk has again highlighted the fact that avian influenza is an international problem and one that requires a global response, in terms of surveillance, disease control efforts and research. It is right that countries around the world should make every effort to keep diseases like avian influenza out, and to deal with any outbreaks quickly, but some countries, where the problem may be endemic, do not have the infrastructure that is needed to do this and, ultimately, the problem needs to be tackled at source. This point was well made in last year's Foresight report on the control of infectious diseases (see VR, May 6, 2006, vol 158, p 605): ‘Many regions of the world do not have the laboratory infrastructure, the human resources or the financial resources to support effective disease surveillance programmes. Yet it is increasingly clear that infectious diseases are a global problem and that surveillance is an international responsibility. Investment by richer countries in surveillance capacity in poorer countries may be a sensible response to this problem.’

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