Select Committee on Science and Technology Written Evidence

Memorandum by Professor Tom Humphrey, University of Bristol

Surveillance, prevention and treatment of infectious diseases in the UK

  Zoonotic disease, particularly that which is food borne continues at a high prevalence in the UK, although with the major pathogens, Salmonella and Campylobacter, the incidence appears to be falling. If this problem is to be brought under control it is vital that there is the closest possible working relationship between those who treat and survey humans and those who undertake the same functions with animals. This is becoming increasingly important as ever more of our food comes from abroad, bringing potentially new microbial hazards. At present in the UK there is a division of responsibility between people dealing with the infection of humans and those dealing with animals. Thus the first is largely undertaken by PHLS, soon to be the Health Protection Agency (HPA), and the latter by the Veterinary Laboratories Agency (VLA). The PHLS surveillance arm is based in Colindale, North London, and VLA is in Weybridge, Surrey. The organisations have different databases, which compounds the physical separation. Although the two organisations have worked more closely together over the last few years there is more that could be done to achieve better integration. The situation in Scandinavia has sometimes been given as an example of what can be achieved by closer integration and certainly the interaction between human and animal health seems to be closer in Norway and particularly in Denmark. Even in these countries the different professional groups can be cautious when it comes to data sharing but my experience of working for PHLS in the past and my quite close current interaction with Danish and Norwegian groups, leads me to believe that the system in those two countries has much to recommend it.

  It is my view that it is time for a radical re-think in the UK about how we undertake surveillance and prevention of food borne infectious disease. There is also a need, because large sums of public money are involved, to ensure that duplication of effort and unnecessary overlap of research and surveillance activity is avoided. There should be a much closer degree of integration between PHLS/HPA and VLA. This should extend to shared databases with easy, but protected access to surveillance and research data. There is a need to ensure that the same techniques are used to identify and to type zoonotic bacteria and to assess antibiotic resistance. It should also be possible to consider bolder approaches and to discuss whether it is necessary for England, Wales and Scotland to have three centres, which are able to type Salmonella spp. and two, which type Campylobacter spp. It is almost certain that eventually all typing will be done using genome-based technologies, which are potentially expensive. Thus consideration should be given to creating a "Zoonoses Centre", which would provide a central facility typing zoonotic pathogens from both animals and people. The economies of scale that this would allow could bring significant cost benefits. It would also ensure that professional jealousies are kept to a minimum and that data are shared in an effective and timely manner. Food surveillance activity, particularly where potential zoonotic pathogens are isolated should also come under the wing of this body. An argument against this approach is that the UK is too big for this degree of centralisation and the committee will need to consider this.

  If the UK Government wishes to be really bold it could take a hard look at how research on food borne infectious disease is conducted in Government-funded agencies. For example, a suggestion was made in the mid to late 1990s that there was a need to examine the activities of VLA and the Institute of Animal Health Compton (IAH), particularly with regard to research. There is still some overlap in research activity and it is important that this is rationalised that the two bodies work to the key strengths. Thus IAH should concentrate on fundamental research and VLA should concentrate on surveillance.

24 February 2003

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