Select Committee on Science and Technology Minutes of Evidence

Examination of Witnesses (Questions 460-473)



Lord Turnberg

  460. This chicken business all sounds pretty sick. I was going to ask more or less the same question. I understand that campylobacter is probably the commonest cause of food poisoning in the UK as far as humans are concerned. I think there are figures of 50,000 a year, and that is just the tip of the iceberg of the number of cases that have been detected. The question I wanted to ask you was that I did hear that the campylobacter are on the outside of pre-packed chickens—that is, on the plastic sheeting—so that even if you take a plastic-coated chicken and put it in your kitchen on the table, then that is a source for infection, you do not even have to open it. Is that all correct?  (Professor Reilly) Again, my Lord Chairman, perhaps I can start on that. I should perhaps preface this by saying that I eat a lot of chicken and enjoy it, and that as long as we understand how to handle our food, we can minimise the risks. If we look at a processing plant, there is the possibility that contamination in that plant might not only be on the birds but other products within the plant, and so it is certainly biologically possible that we get contamination on the outside of the plastic bag. However, I am not a bacterial expert, so I shall leave that to Professor Thorns. I would have thought plastic was quite a hostile environment for long-term survival of campylobacter, but yes, we must regard the whole food product as potential contamination.

Lord Patel

  461. Are we different from other countries in the way we process?  (Professor Reilly) No.

Chairman: I am sorry, I did not catch that.

Lord Patel

  462. I was asking if we are different from other countries in Europe in the way we process, and the answer was no.  (Professor Thorns) I am tempted to say that a little bit of campylobacter does you good.

Lord McColl of Dulwich

  463. Have you had it?  (Professor Thorns) We may all in this room have been stimulated to produce some form of immune response perhaps at an early age.

Chairman: I have a note that in Sweden you can buy campylobacter and salmonella-free chickens. How can they manage it and we cannot?

Lord Patel

  464. That is why I asked the question.  (Professor Reilly) Perhaps I might be allowed to answer first. I think the nature of the Swedish industry is very different to that of the UK. It is a much smaller industry. Their problem with salmonella and campylobacter is reckoned to be people who go on holiday to other countries, including the UK. I think the British poultry industry has made tremendous improvements in reducing the amount of salmonella contamination. This is now down to less than 5 per cent. I think we are still in the process of identifying the most effective critical control points to do the same with campylobacter. The point I was making earlier was that I think these controls are going to have to be on the farm, because if you put the birds containing the salmonella into the processing plant, you will spread it through the plant. So I have no doubt that the industry could produce salmonella and campylobacter-free poultry, but it would not be available in the volumes and at the price that we expect to pay just now.

Chairman: I think we must move on. Lord Patel.

Lord Patel

  465. Thank you, my Lord Chairman. I think my question was probably answered in the answers to several questions earlier on, but it gives you an opportunity, if you want, to come back more about it. It relates to infection and the outbreak of infection in humans occurring of, say, E-coli O157, or salmonella or salmonella Newport. Is it possible to trace back to the origins of the source of the infection by surveillance or whatever?  (Professor Reilly) My Lord Chairman, I think we agreed that I would start on this one again, but I think I addressed it largely in an earlier answer. We will attempt to trace back. We can often use the system to identify not only animal contacts where people have been on a farm, or perhaps where it is a very specific foodstuff, but we can follow the chain of events, although that is not without its problems. I think that some of the investigations, for example, to follow eggs back to the actual farm production can be fraught with difficulties. We do try to do that, we do try to get back to the farm production, but we still have the problem of what do you do with it if it is not a notifiable disease. So apart from giving advice about personal hygiene on the farm, it is very difficult to know what we do with herds which are infected with E-coli O157. My own feeling is that we should regard all cattle and probably all sheep production as potentially carrying this range of organisms, and so we should be treating all animals and animal products as a potential source of infection. I am very anxious that we do not apply a stigma to a specific production unit because of this trace-back. I think it has perhaps been nothing more than bad luck that we have identified one particular unit. So maybe we need to learn more, and that is what we are trying to do about, having identified a unit, what we can do to reduce the carriage of it. For O157 we are not in that position now.  (Professor Thorns) I would like to agree with that, but also to say that recently the revolution, if you like, in the development of new molecular tools has allowed previously unknown relationships between bacteria and other organisms, and in many ways we now have the tools to be able to link a number of specific outbreaks and sources, especially the microbiological tools and the epidemiological tools. As Professor Reilly says, it is a question of what we do with this information in the future which is very important. Secondly, the only other point I would like to make is about the globalisation of food products. I am reminded of the chicken salad sandwich which is essentially a tour round all sorts of food-producing markets in Europe and elsewhere, therefore to try to identify a component of that chicken salad sandwich as the source of an outbreak is incredibly difficult. Even if you do, such in the case of lettuce, there is the epidemiological case I can remember where lettuce was incriminated in burgers, I believe, and in sandwiches. It emerged that all this lettuce was chopped up and mixed in Holland, and the lettuce was coming from a number of parts of Europe. Therefore, it is a complicated business, and we should not underestimate the importance of globalisation of complex foods.


  466. Does the quality assessment system in supermarkets have an important role to play in the prevention of food-borne infections?  (Professor Thorns) My Lord Chairman, I do not really know, except that I would presume they would have some form of HACCP (Hazard Analysis and Critical Control Points) control system in that that would look at the process and the effectiveness of the process, rather than specifically looking at organisms, zoonotic organisms or any other organisms.

  467. They do not tend to look at the curing side?  (Professor Thorns) I do not think they do. I do stand to be corrected.  (Professor Reilly) My Lord Chairman, I think in the industry generally there is a movement away from in-product testing and looking at the process such as HACCP. I think I would support that, because in terms of the amount of sampling that can be done of the end product, it is likely to give a very misleading impression of what organisms might be present in that. So the industry, the whole food chain, is looking towards HACCP analysis and critical control points. Indeed, the European legislation is going to push us more and more into that direction.

Chairman: I am wondering, Lord Turnberg, whether your question about IT systems and major barriers has been answered fully and we could go on to the next one, or is there something you wish to follow up there?

Lord Turnberg

  468. No, I think that part has been dealt with, but we are about to see the introduction of the new Health Protection Agency and so sharing of data and microbiology systems. How do you see that new development as being helpful or otherwise, or both?  (Professor Thorns) From my point of view, it simply has to be helpful. I do not think there is any other outcome that is acceptable. Certainly in the Veterinary Laboratories Agency and the PHLS we are working very hard to ensure the smooth transfer between the PHLS and the Health Protection Agency, and we will continue liaising and dealing with, for example, joint reporting of particular issues involved in outbreak investigations, involved in joint research, for example. We are continuing to do that, and I must say that up to now we have been unhindered, but I am aware that my colleagues in the PHLS do have concerns. I can say that the Veterinary Laboratories Agency in 1990 moved from a core government department to an agency, went through a sort of similar process, and we came out pretty well, I think.

  469. It is really the change in the food, water and environmental laboratories and in the regional laboratories and how you see that evolving.  (Professor Thorns) I am aware that the transfer of responsibility has moved, except in some specific reference laboratories, to the NHS laboratories, and I hope that the reporting of food, water and environmental infections is maintained. I think that is very, very important for the continued development of veterinary units.  (Professor Reilly) My Lord Chairman, the changes to the HPA of course do not apply in Scotland the way they are developing in England and Wales, because we do not have a PHLS. My own personal philosophy might have been to establish a PHLS in Scotland, but as it has now been broken up elsewhere I think that is unlikely to be achieved. I think there are many different models for how we can exchange information, if not the raw data, and I think there have been major moves forward on the zoonotic disease front, with the now joint publication of all the relevant authorities in the UK of the annual zoonosis report. I think in Scotland we have had a common data sector of animal and zoonotic diseases by virtue of our link with the veterinary laboratories. One of my suggestions for better integration of data would be to look at our reference laboratory system. I find it very strange that we have reference laboratories for organisms like salmonella and E-coli O157 developing in the medical sphere and veterinary sphere, and whereas they may share standard operating practices, to me it is illogical that they do not actually go through the same laboratory. I think that would give the best integration of the laboratory data, if at reference laboratory level these were being looked at through the same laboratory. In fact I might go so far as to say that I would like to see us moving towards the equivalent of the Danish Zoonosis Centre where we have a recognition that there is a group of infections that are shared between animals and man, and we deal with them as a group with a common laboratory service. I think that would be a major way forward.

Lord Haskel

  470. My Lord Chairman, I think this question has been dealt with to a large extent. It is about the collaboration between animal public health and human public health. You have told us you think it is quite good, but I think you were speaking about a local or perhaps a regional level. Can you tell us whether the collaboration is good at an international level? Could you perhaps indicate how this collaboration might be improved?  (Professor Thorns) I shall take this first. At the local level I am not sure if we mentioned the zoonosis liaison groups yet, but these are very important groups which I think actually were initiated again in Scotland, I believe I am correct in saying, which comprise medical professionals such as the CCDCs, the directors of public health, the environmental health officers and also the senior veterinary investigation officers from regional laboratories. Their regular discussions will obviously involve zoonotic infections, and therefore there is a lot of useful local intelligence which should be captured from these meetings. They are also forums for disseminating information down to the groups which are actually on the front line. They are very active, but they depend a little bit on geographical location. So one could argue that in some areas of the UK, certainly in England and Wales, they are more active than in other areas. Certainly perhaps the effectiveness of incident control teams is sometimes reflected in the activities of the local zoonosis liaison groups. These groups have actually been recognised by, among other things, the UK Zoonosis Group, which is an overarching group who look at the overarching strategy in the UK, as important forums for developing not only the dissemination of information but also its local horizon scanning and intelligence. There is definitely a move to bolster up these liaison groups to make them more harmonised, if you like, between the various localities in the UK. As to the regional area, in my opinion there needs to be, or will need to be, certain clarity of relationships between the various devolved administrations, between obviously England, Wales and Scotland. These are ongoing. In some areas the clarity is quite obvious: in other areas there may be possibilities of duplication and in some cases gaps. At the national level, from my perspective I think it is really quite good with the liaison between, as I mentioned, the VLA, the PHLS and SAC, but also the liaison between my own organisation and, I would like to say, DEFRA is good and very effective, and we are developing our relationship with the Food Standards Agency. However, I do think there needs to be greater clarity in the roles and responsibilities of the Department of Health, the Food Standards Agency and DEFRA in relation to zoonotic diseases. Actually the multi-drug resistant Salmonella Newport which somebody mentioned was quite a case in point where an awful lot of effort has been put into developing contingency plans to try to remove the Newport from a farm if we identified it, but really and truly is this a public health priority in terms of the Department of Health and the Food Standards Agency? It is not totally clear to me that all the resources that we are putting in—and we are doing an exceedingly good job—are actually related to public health. I think somebody mentioned internationally. Internationally, more and more links, especially in Europe, are developing through a number of initiatives. There is Enternet which is a sharing of data of salmonella, antimicrobial resistance of salmonella and other organisms. I believe VTEC is on it. At the moment that is restricted to human isolates, but I would like to see animal isolates involved in Enternet. Pulsnet is a very important initiative which was started in North America, where we are able rapidly to send profiles of outbreak organisms across the world electronically to warn people that this is an outbreak, and if you identify this particular salmonella you may be part of that global outbreak. So we are developing, I believe, very well.  (Professor Reilly) Perhaps I could speak to both ends of the spectrum. The local liaison groups which started in Scotland in the 1970s because of brucellosis problems to me are the keystone for inter-disciplinary liaison and cooperation, because this is where you develop the personal relationships with your colleagues in that geographical area. So we have 15 of these groups in Scotland that meet between three and six times a year. I am very strongly supportive of these. I think that is one of the reasons why we know our colleagues so well, and people from SCIEH go to each and every one of these meetings, so the Centre goes out to the local meetings. That is at the local level. At the international level, I am one of the project leaders for Enternet. This started off as a salmonella surveillance network and has been extended formally to include E-coli O157. One of the disadvantages of these networks is that it creates the impression that the UK has a terrible public health record because we have more of these organisms than any of these other countries. We have to recognise that that is simply because, for all the limitations, our surveillance system is really much more comprehensive than that of our European colleagues, so we report more cases. That does not mean to say that we have more clinical diseases. Enternet has developed as a formal exchange of surveillance data, but also acts as an early-warning system so, as Professor Thorns said, if there is an unusual isolate anywhere in Europe it is widely reported. Enternet has got wider than Europe, it has now got Australian, South African, Japanese, Canadian partners, so we are getting towards a global system. This is, I have to say, based upon, and supported through, the PHLS, and it is through the commitment of the PHLS to this European system that it has been the success that I think it has.

Lord Oxburgh

  471. Does this liaison work very well across the Irish Sea?  (Professor Reilly) Yes, I do believe it does. I think our colleagues in Ireland are part of Enternet, so they contribute to the European surveillance, but many of us have again established personal contact with a lot of the public health individuals in Ireland, both North and South.

Chairman: We are coming to the final question. Lord Lewis.

Lord Lewis of Newnham

  472. Both of you are obviously involved in university teaching in some aspect or other. How far do present courses on veterinary science as a whole discuss adequately veterinary training about zoonosis and the potential or possible interaction of animal-borne diseases on human health? In particular, how are people being trained in veterinary epidemiology to support the effective veterinary and human infectious disease surveillance systems that are being talked about?  (Professor Reilly) I think we agreed, my Lord Chairman, that I would start this. I obviously have to declare an interest, in that I have an involvement in two veterinary schools in teaching veterinary public health. I think that the attitude of veterinary professionals and therefore of veterinary teachers to public health has changed dramatically since BSE. There has been a transformation in the recognition that my profession has a commitment to this. If I were to say that at this moment in time I am teaching first year in Edinburgh, fourth year in Edinburgh, final year in Edinburgh, third year in Glasgow, final year in Glasgow, on veterinary public health, I think for those two schools alone we recognise there is a commitment to the undergraduate curriculum. I understand that the same commitment is also taking place in the other veterinary schools. One of the other hats I have been wearing recently is Chairman of the Review Panel that looked at the DEFRA food-borne fellowships. These are fellowships established by DEFRA at three different veterinary schools—Liverpool, Cambridge and Edinburgh—and the result of that initiative has also created an infrastructure at these schools for teaching epidemiology and microbiology. So my belief is that the veterinary schools have picked up this responsibility for veterinary public health and are now putting it through at the start of the curriculum, so that undergraduates are recognising the public health significance of all aspects of their work as they go through their undergraduate course. That encompasses both epidemiology and microbiology, and in my opinion the epidemiology side of this has been, and is being, addressed very well. There is a lot of veterinary epidemiology, particularly public health epidemiology, taking place in the veterinary schools, perhaps to the detriment of veterinary microbiology and pathology, because I think there has been a shift away towards epidemiology. So the simple answer is that I think the schools have recognised that there has to be a change, and these changes have already been taking place and are still taking place, but there are other areas in microbiology and pathology that I think need further work.  (Professor Thorns) From my perspective, which mainly is that sometimes I have to recruit veterinary public health people and other people to posts, in recent years we have noticed that actually trying to get good veterinary epidemiologists is now relatively straightforward, but there are quite a few young veterinary epidemiologists out there. This no doubt is as a result of the initiative that Professor Reilly was talking about and the general interest and recognition of the importance of veterinary epidemiology. I would like to endorse what Professor Reilly said, though, about pathologists and microbiologists. The whole point of a successful team involved in zoonotic activities is that it must be multi-disciplinary, including statisticians, modellers, but also epidemiologists, pathologists and microbiologists. As an organisation as a whole, we have found in the last three years that veterinary pathology is becoming quite a scarce commodity, and so is veterinary microbiology in fact. It is by a number of these new initiatives—and VLA is also involved in new veterinary teaching and research initiatives sponsored by DEFRA—that we hope to develop younger veterinarians with an interest in pathology and microbiology. It is always difficult in veterinary public health. Quite rightly, most vets like to diagnose clinical disease, but of course a lot of the diseases that we have discussed in the last hour or so do not cause diseases. A healthy animal, cattle or sheep could walk by with VTEC or campylobacter and you would not know that it had it.


  473. Your comments are interesting, because one might say "Not before time", of course, because the veterinary teaching in this country up to now has been very heavily criticised in the Continent of Europe and in North America, so it is good to hear that it is coming back again—or reaching its proper place, not back again.  (Professor Reilly) My Lord Chairman, perhaps I could make a comment here. I think perhaps that has been because of the misconception that veterinary public health really means meat hygiene and meat inspection, and I think there has been a failure, not only of the profession but of other groups, to recognise that there is far more to veterinary public health than simply passing the inspection of food; it extends back onto the farm, it encompasses all the issues we have been talking about this morning. So I think we have ourselves only now begun to recognise the very major contribution the veterinary profession can make to the whole sphere of public health.

Chairman: Gentlemen, we are just on time. Thank you very much indeed for coming along. It has been a long, but interesting and most informative session. If there is any point or if there are any points which you think we have missed out and should address, we would be very grateful to hear from you in writing. You will receive a transcript of the session this morning. Any factual modifications you want to make we shall be glad to receive. Again, thank you very much indeed for coming along. You have given us a good overview of the role of the veterinary profession in epidemiology, food hygiene and food-borne infections. Thank you very much.

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