Examination of witnesses (Questions 420-439)
WEDNESDAY 25 APRIL 2001
PROFESSOR DAVID
KING, DR
NEIL FERGUSON,
DR ALEX
DONALDSON AND
PROFESSOR MARK
WOOLHOUSE
420. To conclude on this question, Chair; explicitly,
what we were told was that, if a vet judged that the disease was
present and slaughter also went ahead, even if the result was
negative in a laboratory, that negative result was not necessarily
reliable, and I am just wondering what percentage of confidence
do you have in the outcome of those tests?
(Dr Donaldson) I have to qualify what I have said
by saying that we are dependent on both the quality and the suitability
of the samples which are collected. We are the recipient laboratory,
we would expect anyone investigating a suspected case to take
the appropriate samples, to put them in the appropriate transport
medium and to send them to us by optimal means. If that is done
and we get the appropriate material, in an optimal condition,
then the tests should identify whether the virus is present, whether
the viral RNA is present, or, in the case of serum, whether there
is antibody present.
421. With greater than, say, 90 per cent confidence?
(Dr Donaldson) Absolutely.
Dr Turner
422. I just wanted to follow up on the question
about the origins, if I could, in terms of the way the outbreak
has been observed. Given the question which had been raised as
to whether Heddon-on-the-Wall was the source, first of all, in
observing the outbreak, would you have expected to have had evidence
that it might not have been; and, if so, has there been any evidence
that actually we may not have identified the source? Have I made
that clear?
(Dr Donaldson) Apart from the comment from Mr Todd
about the sheep detected in France which might have antibody,
which is still an open question, I have got no indication that
there was any other possible source.
423. My first question was, would you have expected
to have seen indications in the way in which, would you have expected
to have false trails and not be able to find locations? You pointed
out that the early data was quite carefully carried out; would
you have expected inconsistencies in that if it had been earlier
than Heddon-on-the-Wall, was my question really?
(Dr Donaldson) Yes, I think so, in the pattern of
spread, yes.
424. So you would have expected it, but have
not observed it?
(Dr Donaldson) I am not sure that I am the best person
to answer that, I think it is more a question for MAFF because
they are more aware of the field situation than I am.
(Professor Woolhouse) I think the pattern and timing
of the strain is consistent with an origin of Heddon-on-the-Wall;
it does not, in itself, prove it, but it is consistent with it.
425. And there is no sort of unexplained, question-mark
data which make you think there might be something else to add
to the conclusion?
(Professor Woolhouse) I think not that any of us here
are aware of, no.
426. Can I ask, where was it in the world that
this particular strain arose, on the last occasion?
(Dr Donaldson) The last one where it has caused an
outbreak was in the Republic of South Africa, in and around the
Durban area; but that is not to say that there is any link, necessarily,
between South Africa and the United Kingdom, because this particular
strain has been circulating around the world since about 1990.
The earliest strains in this particular group we found were in
India and then they spread westwards, through the Middle East
as far as Europe, and then they also spread eastwards, across
China to countries in the Far East, including Japan, Korea, Mongolia,
Eastern Russia. But there are many countries around the world
which have poor surveillance for foot and mouth disease, in which
the strain, indeed, may be present, but they have not collected
samples and submitted them to us.
427. One, very quick, final one, if I may. In
talking about immunity, which Mr Öpik was referring to, is
immunity to a specific strain of the virus, and, in which case,
does it mean that even if you have immunity to one strain you
might expect to find another strain appearing and actually once
again being active?
(Dr Donaldson) Yes, very much so. There are seven
serotypes of foot and mouth disease, and immunisation with one
serotype does not protect against the other six; and even within
a serotype there is variation between the strains, such that vaccination
or recovery from infection with one may not protect against another.
Mr Mitchell: I was going to talk about vaccination,
but just following up what George said, in the light of all these
interesting ideas of where it could have come from, an article
in Private Eye this week about the ban on South African
meat imports being imposed rather late, is it your view, as scientists,
that there should be—
Chairman: It is not in The Guardian,
is it?
Mr Mitchell
428. It is in Private Eye . . . a full,
public inquiry into the origins and spread of this disease afterwards?
(Professor King) I think, certainly, we should have
the best possible investigation into the origins, and whether
or not it is an inquiry is entirely a political issue. I am here
as a science adviser to look at the scientific origins and I think
we would like to have a very full scientific investigation.
Chairman: Nice try, Austin.
Mr Mitchell
429. Thank you. Now let us move on to vaccination;
because three weeks ago Dr Donaldson's presentation on vaccination
stressed the very high cost of vaccination, and now you seem to
be changing your advice on the desirability of vaccination. I
thought scientific advice was bright, clear, burning and true;
why are you wobbling around like politicians?
(Professor King) Chairman, I am delighted to have
this question, because one of the factors that I have had to learn,
in all of this, is the need to speak with great clarity in front
of the media, and then to hope. The answer to your question is
that we have not changed our minds, I do not think, one bit, about
the usefulness or otherwise of vaccination; and what was leaked
to the press was a document that I think Dr Donaldson wrote, that
the science committee had, and I would stand behind that document
as very sound advice. So the answer to the question depends on
the question being asked, and if you asked us would we use vaccination
to control this epidemic, the answer, which is what was leaked
to the press at that time, was "No, vaccination is not an
option for controlling the epidemic." If you then come back
to us and say, "Does vaccination have any role to play in
this epidemic?" the answer, which we put forward very thoughtfully,
by which I mean it gave us a lot of hours of consideration, was,
"Yes, we can see a potential usefulness for vaccination."
And that was aimed specifically at the two major hot spots, Cumbria
in particular, possibly also Devon, where there were a large amount
of cattle, particularly, being overwintered in sheds. And what
we said, and it was specific advice, Mr Mitchell, was that if
the cattle in sheds were vaccinated before they were let out of
the sheds it could save a large number of cattle lives, precisely
because the cattle would be let out into a highly infectious area.
Now there is an advantage in having cattle in sheds, because the
disease does not spread to them quite as easily as if they are
free to roam; there is also an advantage because they are in a
captive state it is easier to vaccinate them before you let them
out of the sheds. We could see no other role for vaccination than
that very specific role that I have just described to you. Now
if you see that as a U-turn you may, but I do not.
430. No; but your advice is, therefore, that
there is a limited role for vaccination, in these particular circumstances.
It is not an alternative to search and destroy, or, in other words,
culling?
(Professor King) Absolutely not, that is right. I
could ask Dr Donaldson, if you like, to amplify on the reasons
why it is not.
Chairman
431. May I just clarify that question, because
it is very important. I attended, along with many MPs, a seminar
in Westminster Hall at which Dr Donaldson and an official from
MAFF gave us a presentation, a lot of it was about vaccination;
every single MP went away from that convinced that there were
powerful arguments against vaccination, that the purpose of the
seminar had been to tell us how difficult vaccination was as an
option. Then, with respect, we hear from the Government, after
a little while, that actually vaccination may be really quite
close, and even in his evidence two days ago the Minister said
simultaneously that vaccination was receding but there were very
powerful arguments in favour of it. Now, we are confused, and
we are anxious to know what your recommendation now is?
(Professor King) Right. Chairman, political machinations
are one thing, and then there is scientific advice. All I can
repeat to you is that our scientific advice is that vaccination
was not a clear, workable option for bringing this epidemic under
control, in such a way that we did not end up with an endemic
disease situation in Great Britain; and we are still saying that.
And perhaps I could stop at that point, take a breath and then
say, however, if we look at this one specific situation of cattle
in sheds, where they have been overwintered, kept in sheds throughout
the outbreak, before they are let out there is this option of
vaccinating them, to save cattle, not to bring the epidemic under
control. We were not recommending—and, let me say, my advice
to the Prime Minister, which was dated 11 April, had two contingencies
on the use of vaccination. The first was that the 24-/48-hour
cull policy should not be threatened by the introduction of vaccination
in any way; in other words, if vaccination took personnel away
from the 24-/48-hour operation then it would not be a useful intervention.
And, secondly, we said that it would require the acquiescence
or agreement of the farmers; and the requirement of agreement
from farmers is based really on two factors. One is the understanding
we have that the vaccinating of animals requires knowledge of
the animals themselves, that only the farmer can impart, and so
what we needed was the co-operation of the farmer in the vaccination
process; and, secondly, it was clear to us that going down the
vaccination route was only going to be successful if a very significant
percentage of the farmers went along with the policy. In other
words, if we were going to vaccinate cattle in Cumbria it should
be a very large percentage of those that were in sheds. So those
two contingencies were clearly stated. Given the above, we said
there is the option of using vaccination; it was never pushed
by us as a very, very hard route, and subsequent to that my team
had something like five hours of discussions with Ben Gill and
his team and with the vets from around the country. I went up
to Cumbria and discussed this with local farmers and with vets
and the Farmers' Union up there; and, incidentally, perhaps I
could also say that my science team have been out to the regions
individually. We came back and then have left it really to the
policy-makers again to decide what to do with that.
Mr Mitchell
432. The arguments given though, the ones you
have just given now, insufficient resources, need for consultation
with the farmers, need for their consent, these are practical,
political arguments, not scientific arguments, are they not? And
the arguments given by Dr Donaldson, which conclude, in huge letters,
"VERY HIGH COST", are basically European and economic,
that is to say, severe restriction on exports, cessation of export
of fresh and frozen meat, and single-pasteurised milk. Now these
are, essentially, economic arguments, rather than scientific arguments?
(Professor King) I am not going to disagree with that;
but I think Dr Donaldson is burning to come in at this point.
(Dr Donaldson) The science committee was unanimous
in its opinion that, for the specific instance of protecting the
housed dairy cattle and for saving the lives of something like
90,000 cattle, I think, in Cumbria, and a somewhat larger amount
in Devon, against an unquantifiable but believed risk of contacting
sheep on pasture, or, indeed, contaminated pasture, it would be
worthwhile to vaccinate them, and this, I think, was the only
vaccination strategy which this science group had considered and
supported.
Chairman
433. So, Dr Donaldson and Professor King, if
in two hours the Prime Minister 'phoned you and said, "I've
got Prime Minister's Questions this afternoon, and I am going
to have to say whether I am proceeding with vaccination of cattle
kept in" what you call "sheds," though I have never
known a farmer who keeps cattle in sheds, funnily enough; what
do you tell him? Do you say, "Prime Minister, we recommend
that you tell the House of Commons, this afternoon, that you are
going to vaccinate," in, say, Cumbria and Devon, or do you
say, "We now believe the epidemic is on such a course that
this is no longer the recommendation we make to you"?
(Professor King) The recommendation we made on 11
April was based on the situation as it stood then; and, as I understand
your question, you are now asking me what would be the recommendation
today.
434. No. The minute you get out of this room,
somebody says, "Professor King, the PM wants you desperately
on the 'phone," and that is the question, "Mr Campbell
wants you on the 'phone;" what are you going to tell him?
(Professor King) I am getting quite used to this situation,
Chairman. At the present time, as you know, vaccination is still
being held as an option, and ADAS has had a green light to prepare
for vaccination, so, if a policy decision was made to vaccinate
today, I believe implementation could be carried out within a
few days. My advice previously was based on farmer co-operation,
farmers had economic concerns that we are not, here, capable of
answering, and those concerns are based on whatever European Union
policy will be, in terms of vaccinated animals. Now I do not want
to get into that, and nor will I be able to get into that. My
advice would be based simply on where the epidemic is now.
435. That is understood.
(Professor King) And, on the basis of that, the urgency
of vaccinating cattle in Cumbria has fallen away, for precisely
the reason that Dr Ferguson gave earlier, that the epidemic, particularly
in Cumbria, is falling away faster than we had anticipated, so
that the extent of infectiousness that those cattle in sheds are
faced with is rather less than we had anticipated at that time.
436. So your advice would be, "Prime Minister,
there may well be other considerations which you have to take
into account, but, from the purely scientific opinion which you
are seeking of me, my scientific advice to you would be that you
should no longer contemplate vaccinating the housed or `about
to go out' dairy cattle in Cumbria"?
(Professor King) It is very kind of you to put the
words in my mouth, but if I can—
437. I am inviting you—as you have not
given me yours quite yet in the way I want them, that is why I
am trying to do it?
(Professor King) I would not say it quite like that.
I would say, as we stand at the moment, because I am not at all
clear as to what will happen as the density of animals on the
ground in Cumbria and in Devon increases; in other words, as we
let those cattle out of the sheds, there may well be an increase
in the number of infected premises. However, having said that,
one of the things that we have learned is that, very unfortunately,
we have had quite a significant number of infected premises reported
where the only animals on the premises are cattle in sheds, and
even where there are no animals left in neighbouring premises.
So the answer, Chairman, is that we are learning as we proceed,
perhaps not only about the infection but also about human involvement
with their animals; there are a large number of complex issues
here.
Mr Mitchell
438. I think it is time I intervened and stopped
this effort to cram the Chairman's words down your throat, substituting
mine. Essentially, that is a political argument, and the Chairman
should know that only decisions about Peter Mandelson are reached
under that kind of particular imperative. But the question I was
seeking to ask, from which we have got diverted, was that if these
economic and European arguments apply earlier on against vaccination,
they also apply to any vaccination scheme in specific areas, such
as Cumbria, because then the reputation of the country, or the
stock, are tainted by vaccination; so the economic imperatives,
which Professor Donaldson put so highly earlier on, would still
apply to a limited vaccination programme?
(Professor King) The economic imperatives do apply,
and this may well be the reason why we have not vaccinated the
cattle in sheds. I think that the concern about the economic outturn
is a concern of moving into an unknown. The farming community
understands the cost of the cull, the outcome of the cull and
what will happen when we are once again FMD free. The farming
community is not clear, I would suggest, about what would happen
if we go down the vaccination route. We have had discussions with
retailers on the specific issue of the milk from vaccinated cows,
the meat from vaccinated animals, and on both those issues the
Food Standards Agency has also made a very clear statement since
what you are reading to me was written, and so actually the authorities
have moved the goal-posts a little on the issue. But I think the
concerns of the farmers, as you are about to learn, are still
ones of stepping into the unknown.
439. Is there any way of estimating the scale
of the increase in the number of cases you would expect? You seem
to be, in a sense, undercutting the need for it, even in Cumbria.
Is there any indication, therefore, on the scale of cases you
would expect to see if cattle are turned out in Cumbria and Devon
without vaccination?
(Professor King) Let me first answer, and then ask
Dr Ferguson to comment. The number of cases reported in the last
two 24-hour periods was 13; we are seeing, amongst those 13, something
like, if I can move from the English to the Scottish territory
and see that as one hot spot, the Cumbrian/Dumfries/Galloway,
then the largest proportion of those, I think 11 yesterday, came
from that area, and within that group we are finding a large number
of cattle in sheds being reported. Now the infectivity in Cumbria
is seeming to hold up at the moment, I suspect it is because it
is moving from sheep into cattle, and so we are already seeing
this as a problem.
|
