Foot and mouth 20 years on: what an animal virus epidemic taught UK science

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Christine Middlemiss was a young vet working in Scotland in February 2001 when foot and mouth disease struck Britain. Having grown up on a farm, and having later worked in veterinary care in Cumbria, she volunteered to help battle an affliction that would eventually take a terrible toll on UK livestock.

“I volunteered as a temporary veterinary inspector at 4pm and was told to report to a farm in Cumbria by 8am the next day,” Middlemiss told the Observer last week. “I got there and was given an A5 piece of paper with instructions about what I had to do. That was all the recorded advice that was available at the time.”

It was one of her duties to examine cattle on farms and then give the heart-rending news to farmers and their families that the herds they had built up over decades were infected and would have to be culled. Her experiences on the outbreak’s frontline exactly 20 years ago made their mark – for Middlemiss is now the chief veterinary officer for the United Kingdom and in charge of protecting the nation’s farm animals from future outbreaks of foot and mouth and other devastating illnesses.

“What I vividly recall is the support we got from the farmers at the time, despite the terrible news we often had to give them,” recalled Middlemiss. “I would be supervising the culling of a herd, their livelihood, and yet they kept coming over to ask me if I was all right, had I eaten and would I like a sandwich. That was in the middle of what was a real heartache for them. It was remarkable.”

The first case of foot and mouth – a highly infectious, frequently fatal ailment that affects cloven-footed animals such as cattle, sheep and pigs – was reported in Essex on 19 February 2001, with a second being diagnosed in Northumberland only four days later. It was immediately clear the disease had already spread across the country with most evidence indicating that infected animal products had been imported from the far east and had been used as animal feed on pig farms, passing on the virus.

“Pigs are a real problem,” said Middlemiss. “When they become infected they produce a huge amount of virus. They act like virus factories. That is one of the reasons that the infection spread so quickly.”

As the number of cases mounted dramatically over the following weeks, more and more animals had to be slaughtered and their carcasses burned. Britain was transfixed by grim television and newspaper images of pyres of animal corpses being incinerated across the countryside. Vast tracts of land were turned into crematoria and a foul-smelling haze settled over the landscape.

The general election, scheduled for 3 May, had to be delayed; the tourist trade in many areas, particularly the Lake District, suffered badly; public rights of way across the country were closed; and a complete ban was imposed on the sale of British pigs, sheep and cattle.

It took more than seven months of culling and burning to bring the disease under control and the impact on British agriculture was devastating. Nationally, more than six million pigs, cattle and sheep were slaughtered on more than 10,000 farms before the disease was brought under control by the end of September. The total cost to the nation was estimated to be more than GBP8bn.

Chief veterinary officer Christine Middlemiss.

“I initially volunteered for three weeks but ended up working for six months as an inspector,” said Middlemiss. “There were some really hard times but equally we felt a sense of purpose – that we were working to get this under control to limit the suffering. And I really learned the importance of communications, of making sure farmers and communities knew what we were doing and why we were doing it.”

Several other critical lessons were learned. Feeding farm animals with swill – untreated kitchen waste and scraps – is now banned and movements of livestock are now far more strictly recorded and controlled than they were 20 years ago. In addition, the development of gene-sequencing technologies has allowed veterinary scientists to track the movement of virus variants and to work out patterns of infection with much greater confidence. That was to prove invaluable when foot and mouth reappeared in 2007. Crucially this outbreak was halted before it spread beyond a handful of farms.

Middlemiss said: “With gene sequencing, we could see how the genetics of the virus changed with each infection. We could work out links between cases rather than having to rely on speaking to individuals about their movements. It told us very quickly in 2007 that we had beaten the disease.

“And it is not just foot and mouth control that has benefited from subsequent improved contingency planning. Dealing with other diseases such as avian influenza has also been boosted from the lessons we learned in 2001.”

Her experiences of the foot and mouth outbreak 20 years ago obviously made their mark on Middlemiss – though they were not the very worst that she has endured as a vet. “In terms of scale it was the worst, but there have been times when you get really involved with an animal and that has consequences. I have treated dogs for cancer, established a bond between myself and the animal and then, when the treatment hasn’t worked, I have had to put it to sleep. You really have to learn how to manage your own emotions then.”

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