Acta vet. Brno 2003, 72: 648-651

Book Review

Foot and mouth disease: facing the new dilemmas. OIE Scientific and Technical Review, Volume 21 (3), December 2002, 498 pages. ISBN 92-9044-568-8 and ISSN 0253-1933

This excellent compendium of 42 papers, full of rich useful information, while not providing an explicit answer to this simple but multifaceted question, attempts to provide the readers with the facts on the various interacting issues and the answers that need to be found in improving the management of foot and mouth disease (FMD) in future. Because there are no simple solutions there are differing opinions which, to some extent are reflected by the views of different authors. Papers are devoted to the behaviour and impact of FMD in different regions of the world – one of the reasons why it presents a truly global problem, its economic effects in both the developed and developing worlds as well as technical issues related to epizootiology and control of the disease.

The publication was edited by Dr G.R. Thomson and is composed from 11 blocks of different topics. The first bloc of very informative papers is reviewing the world FMD status and approaches to control and eradication covering separately South America, Sub-Sahara Africa, Middle East and North Africa, East Asia, South-East Asia, Europe and Central Asia (experience of Central and Eastern Europe, at least for comparison of methods and results, is missing as usually).

Information on FMD control in Europe (including short history) was written by J. Leforbane from European Commission for the Control of Foot and Mouth Disease (EUFMD) and G. Gerbier entitled “Review of the status of foot and mouth disease and approach to control/eradication in Europe and Central Asia”. There can be found optimistic FMD risk assessment expressed by the sentence “Preparedness and capacity of the UK Veterinary Service to control FMD, if introduced, was considered good in comparison with other countries in Europe”. What was the criterion for this statement which proved to be absolutely unjustified ? The attention merits important information that “the level of awareness of the different stakeholders plays a major role in the early detection of FMD. After little or no FMD in western Europe over the last twenty years, awareness of the disease has decreased dangerously. To improve the level of awareness, training and information are needed. Simulation exercises should be encouraged to verify that the different steps of contingency plans are really in place”. Unfortunately, as I know, the majority of simulation exercises internationally organized for veterinarians were too theoretical ones: instead of “learning by doing” under field conditions (including individual clinical and epizootiological investigations at herd and population levels) were applying only methods of learning by watching, listening, reading and data processing. In the text dealing with origin of the FMD primary outbreaks in Europe (1991-2000)” there is an information on FMD introduction in Italy in 1993: “the real origin of the imported cattle and how or where they became infected has not been established but the sequencing by the World Reference Laboratory for FMD of a portion of the genome of the virus and comparison with sequences for other contemporary type O viruses indicated a Middle Eastern origin.” This statement finally officially rectifies false information on this particular case that “The cattle imported from Slovenia numbered 45, 40 of which had originated in the Czech Republic..” published by the EUFMD in the world FAO-WHO-OIE Animal Health Yearbook, 1993, p. 155 (unjustified slander harmful to one FMD two-decades-free country prestige complicating its export).

Following paper on FMD risk management of international trade deals only with emergency preparedness, passing by the key problem – country protection against FMD introduction. Excellent papers of top level specialists such as R.P. Kitching, P. Sutmoller, R. Casas Olascoaga describe the effect of FMD infection, in particular clinical variations in different animal species, sub-clinical infections and carriers (incl. differentiation from vaccinated animals) as implication for FMD control which is of extraordinary practical importance for field diagnosis and control.

In the bloc entitled “Response to emergencies” dealing with predictability of FMD spread and decision-support tools for FMD control, special attention merits the paper of R. S. Morris et al. about EPIMAN software, in particular following statements: “The authors describe the tools which can be employed to minimize the impact of a disease incursion, using the example of FMD”. “The original version of EPIMAN, developed in the early 1990s, was focused entirely on FMD”. “The tool to calculate virus production from each infected farm.” (!?!). “All the data required is also needed for management of the epidemic, and in the 2001 epidemic in the UK, information was simply transferred daily by email between London and New Zealand and results returned typically within 8 h.” “The only integrated system for FMD control which contains spatial data and a comprehensive suite of decision support tools is EPIMAN.” Integrated decision-support systems offer the best method of managing FMD outbreaks to minimize the cost and size of the epidemic.” Because the EPIMAN system developed in New Zealand appears to be the only fully functional and tested software system providing the types of tools needed for FMD control.” I wonder why the “fantastic” EPIMAN software for FMD control, developed a decade ago (in a FMD free country), is not yet generally used and why 2001 FMD in UK caused within limited space and time, the most catastrophic losses in the world history (4 million mammals, 3.1 billon £) in spite of the application of this software which, as the author repeatedly says, is minimizing the losses. Without the EPIMAN the losses would be much more catastrophic ? The only usefulness criterion of any theoretical model is its practical impact, i.e. results. How control/eradication of a biological phenomenon such as FMD can be theoretically modelled for practical use under emergency when: every case is different, the situation is continuously changing requiring immediate actions, there is a great number of influencing factors (including human one) and available data depending on field investigations are usually incomplete (garbage in, garbage out) ? The paper inform on a “novelty” when the UK data were sent daily to the antipodes (to other part of the globe) to analyse them indicating the solution in a very distant country, previously supposed to be the best prepared for FMD control, in the country giving for decades the lessons, even to all the world, how to manage FMD and many other infectious diseases.

Very interesting is information of A.I. Donaldson and S. Alexandersen that the peak excretion of airborne virus by sheep occurs before the clinical phase of disease which could seriously complicate FMD investigations and measures. Following papers deal with FMD inactivated vaccines, their banks and use in zoo animals, endangered species and exceptionally valuable animals. Five papers are devoted to economic aspects of FMD providing methods and data on control cost and losses in different parts of the world. Unfortunately, estimates on losses caused to neighbouring and other FMD free countries due to emergency preventive measures (reduced trade and tourism, extra border sanitary measures, etc.) are missing at all.

Eight papers describes FMD control methods in different countries. Of particular importance is the contribution “Control of FMD: lesson from the experience of the outbreak in Great Britain in 2001” written by J.M. Scudamore and D.M. Harris describing in details this panzootic. There it can be found surprising information: “infection being present but unreported for at least three weeks before the first case was identified” (confirmation on 20/2/2001). This reconfirms the key role of early detection of the primary outbreak and then also of secondary outbreaks which requires firstly sufficient number properly trained (not only theoretically and using computers) staff for specific practical activities under difficult field conditions.

One of the best papers is written by M.M. Rweyemamu and V.M. Astudillo “Global perspectives for foot and mouth disease control” giving attention also to one of the most important factor in animal disease control, i.e. public veterinary services: “Since the mid-1980s structural adjustment programmes in developing countries have led to a demand for the privatization of veterinary services, thus aiming at drastically diminishing the role of the state in these activities. Surveillance, early warning, laboratory diagnostic services, planning, regulation and management of disease control programme, as well as ensuring the quality and safety of animal products were secondary considerations. The chain of veterinary command that required notification of disease outbreaks enabling a response to disease emergency and which also ensured the management of national disease control programme, was often dismantled.” These statements of leading UN specialists are valid also for the majority of other countries, including UK. It reflects global crisis of veterinary medicine being not able to cope effectively with epizootics.

Papers of following block are describing environmental impacts, mainly the problems with carcass disposal. In Great Britain in 2001 over 4 million animals were slaughtered and disposed as a direct result of FMD. During the course of the outbreaks a disposal hierarchy was developed to reflect environmental and public health concerns, namely rendering and incineration ranked first, licensed landfill next, followed by burning with mass burial or on-farm burial as the least preferred options. Finally, several papers deal with farming perspective to reduce FMD risks, animal welfare perspectives and future research in FMD control.

This publication is of value to veterinarians and other animal health professionals, particularly those involved in management of emergency animal diseases, agriculture economists, consumers, environmentalists involved in farming issues and those concerned with the impacts of animal diseases on farmers and their livelihoods.

Prof.MVDr Václav K o u b a , DrSc.