Volume 2: Science
7. Conclusions drawn from the scientific response to BSE
The investigation and management of potential zoonoses

7.78 The magnitude of the BSE epidemic and its tragic consequences, particularly for those affected by vCJD, raise concerns about whether the UK has an adequate structure for the investigation and management of potential zoonoses. There are very many diseases of animals that are known to cause illness in humans, and for which a reservoir of infection in animals may exist. Novel ones will doubtless continue to emerge or be identified. ¹ Diseases of humans carried by animals in one way or another are a significant public health problem facing the UK. The 'Overview of Communicable Diseases' produced by the Public Health Laboratory Service (PHLS) ² listed a number of zoonotic diseases with reservoirs of infection in animals that pose serious threats to public health. These include, by way of example, salmonellosis, E. coli 0157, listeriosis and vCJD.

7.79 There already exist specialist agencies with duties and expertise in animal health (the SVS and VLA) and public health - for instance the PHLS. The same types of laboratory expertise are required in the investigation of pathogens that cause disease in both humans and animals. Similarly, the epidemiological methodology required for the study of outbreaks of infectious disease in both animals and humans is essentially the same. The BSE story illustrates the importance of the agencies dealing with human health and those dealing with animal health working together if threats to human health posed by zoonoses or potential zoonoses are to be managed in the most effective way.

7.80 By way of example, there are a number of respects in which the PHLS might have been able to offer MAFF assistance in relation to BSE. The PHLS is described in more detail in vol. 8: Variant CJD, but briefly it has two centres for communicable disease surveillance and a regional network of laboratories closely associated with NHS hospitals, university medical schools and institutes of public health throughout the country. In addition, each region now has a specialist epidemiologist associated with a group of PHLS laboratories. The service has an efficient communication system to primary care doctors and nurses and to NHS consultants in communicable disease control in every district authority. Its central public health laboratories at Colindale in London provide a referral centre to regional laboratories for strain-typing of pathogens and other specialist services. The facilities and expertise of the PHLS might have been of assistance to MAFF in, for example, the development of ELISA tests.

7.81 We understand that since 1996 a number of joint committees have been established to encourage cooperation and collaboration between those responsible for human and animal health when dealing with zoonoses or potential zoonoses. They include:

1. the National Zoonoses Group for England (1999);
2. the Epidemiology of Foodborne Infections Group (1996);
3. the Surveillance Group on Disease and Infections of Animals (1999);
4. the Joint Food Safety and Standards Group (1997), now absorbed into the Food Standards Agency (2000); and
5. the High Level Committee on Research into TSEs (1997).

7.82 We reiterate the importance of continuing to develop closer collaboration in the investigation and management of human and animal disease.

7.83 What matters equally is that administrators, vets, physicians and others recognise the importance of alerting each other to new potential zoonoses, or to new outbreaks of such diseases, and of working together on appropriate investigations and control measures where necessary. They should do so whatever the formal structures within which people are working and whether there are many agencies and institutes involved or only a few. This did not happen in the early days of BSE. The BSE story suggests to us that such collaboration may be facilitated by clear allocation of a lead responsibility for a new disease, or a new outbreak of disease, to an organisation and, within that, to an individual who will need to consider which other organisations need to be involved.

7.84 We think that the BSE story also suggests that consideration should be given to joint working at a more detailed level, especially where there is very limited specialist expertise. For example, there could be practical advantages in combining what are currently separate VLA and PHLS laboratories which may work on sub-typing the same organism. A centralised laboratory could serve both animal and human infections. Similarly consideration should be given to whether two separate organisations are needed to study the epidemiology of a disease which affects both animals and humans. A number of those giving evidence to the Inquiry commented on the lack of veterinary epidemiologists in the UK. Yet, as we said above, the methodologies used by epidemiologists in human and animal disease are essentially the same. Joint training programmes and joint working in laboratories or institutes seems likely to make the best and most flexible use of existing and future experience. Enhancing the role of epidemiologists in this way may also help to attract talented individuals into this specialism.