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Calls to improve efficacy of TB skin test and ensure consistency in quality

by
01 February 2013, at 12:00am

VETERINARY PRACTICE looks through the summary produced by the AHWBE following its ‘call for views’ on ‘strengthening the TB eradication programme’

THE Animal Health and Welfare Board for England (AHWBE) has published a summary of responses to its call for views on strengthening the TB eradication programme and new ways of working.

Published in December, it can be read on www.defra.gov.uk/ahwbe/files/ahwbe- btb-summary-responses.pdf. The AHWBE says it will “consider the output from the ‘call for views’ before advising DEFRA Ministers on possible changes to strategic policy on TB eradication in England”

There were 611 responses to the “call for views” which ran from 10th September until 19th October, with 134 people attending workshops, 336 completing the online survey and 141 written submissions.

The respondents came from a wide range of backgrounds, sectors and professions including beef and dairy farmers, farming organisations, breed societies, cattle health advisers, veterinary practices and professional bodies, commercial companies, wildlife groups and community land trusts, local authorities, advice groups and rural support networks, non-bovine and camelid societies and keepers, and members of the public.

The document says that a consensus emerged showing strong support for improving TB testing; both the efficacy of the TB skin test itself and ensuring tests were conducted consistently to assured quality standards.

It continued: “There was some support for carrying out more types of testing while reducing other types, to support disease control while tailoring approaches depending on area- or herd-disease risks. For instance, some suggestions were for more annual surveillance, pre-movement testing (PrMT) and post-movement testing (PoMT) but less tracing and contiguous testing, with no testing for animals if moving to slaughter, either directly or indirectly.

“There was some support for ‘risk- based, targeted testing’ to make best use of resources, such as reducing testing in finishing units, but carrying out more tests on breeding or ‘flying herds’.

“There were several calls for a reduced testing regime for farms with high, assessable biosecurity standards ‘in return for’ reduced or zero compensation for reactor animals. Other ideas included compulsory camelid testing and movement rules, plus increased sheep/goat testing particularly for large flocks/herds, and to test and cull infected deer.

Reduce ‘false positives’ 

“Several vet responses suggested extending the ‘short interval test’ period in high incidence areas and/or large closed herds, which would help reduce costs and reduce the number of ‘false positives’. Some felt that inconclusive TB reactor animals should be re- classified as TB reactors in high risk herds, and be treated accordingly.

“There were calls for improvements to handling facilities, and to fund innovations such as teams with high quality mobile handling facilities and trained staff to support faster, accurate and less stressful testing for farmers, vets and cattle. Many responses felt that there should be improvements to the Animal Health and Veterinary Laboratory (AHVLA)’s turnaround of test results.

“Some called for mandatory whole herd slaughter in low incidence areas to clear infection quicker and reduce the time period of undetected infection, while some pointed out that for some farmers this would threaten the viability of their business.”

Further on, the summary states: “Ideas on dealing with different disease risks included allowing farmers and vets to manage the disease locally by cutting out government and developing private vet-led ‘local area management programs’ based on ‘local knowledge and expertise’. 

“There were several quite detailed responses on how each ‘TB risk area’ (high, low and the edge) should have its own tailored approach, setting out a clear framework for each area to define the disease risk while ensuring farm businesses are able to operate in a financially viable way.”

In a section on “other ideas”, the summary reports: “Many farmer and veterinary responses covered wildlife control including calls to lift the Badger Protection Act with legal safeguards against badger baiting provided by the Wildlife Countryside Act, to license farmers to deal with wildlife control locally, to allow the use of the polymerase chain reaction (PCR) test to identify infected setts, look at using oral contraceptive for wildlife control, and for industry- funded badger vaccination in low incidence areas.

Re-introduce ‘clean ring’ 

“There were several calls to re-introduce the ‘clean ring’ badger culling policy around new TB outbreaks and to bring back the national roadkill badger post mortem survey which would help assess the extent of TB in wildlife. More involvement of wildlife groups in discussions aboutwider TB issues to create a shared understanding of the problem was also proposed.

“There were many responses urging for more funding and much faster progress on cattle vaccine development, and to look at other ways round the EU legal issue such as introducing a register of vaccinated herds and only permitting trade between these herds.

“Strong support was shown for funding and developing more research and development (R&D) into areas such as TB links with other animal diseases, the extent of TB in wildlife carriers, developing and deploying different and better TB diagnostic tests, and the role of genetic immunity.”

There was strong support, says the summary, for local private vets leading or being much more integrated into advice and support programs [sic], including preventative work such as designing and monitoring on-farm 

disease strategies with the farmer. Many responses said that vets with local knowledge were best placed to give guidance.

Other responses said that anyone with ‘vested interests’, namely those who could potentially profit from other services delivered, should not act in an advisory capacity and that ‘independence is key’.

There were calls to roll out dedicated support programmes such as the South West TB Farm Advisory Service (SWTBFAS) nationally, as many respondents felt the individual, tailored and practical support offered by the SWTBFAS was effective. There were some opposing views in the south-west questioning the money spent on SWTBFAS.

Bespoke advice

Several responses highlighted the need to ensure TB advice was evidence-based and independently delivered, and called for streamlining of different information sources.

Other ideas included more local, bespoke advice services such as “TB Champions”, accredited local vets offering consistent advice who could also mentor “at-risk” farms. There were calls for “regional eradication boards” to be set up linking stakeholders and drawn from those with knowledge of, or affected by, TB who could provide education and support.

In answer to the question, “Who do you think should give advice to farmers after a breakdown?” many responses said local vets should be part of the solution and play the biggest role in post-TB breakdown support, including case management.

In stressful situations for farming families, it was felt the existing trust and relationship between vets and farmers could offer emotional support as well as practical help. Vets also offered advice on other areas of animal health and farm practices, and could therefore offer a more joined-up approach to supporting farmers in addressing disease risks.

Closer working between AHVLA vets and OVs was highlighted as an area for improvement, to ensure a coherent and unified approach in breakdown cases. Some felt that OVs should play the greater role, taking charge of the outbreak and the post-breakdown monitoring period.

To the question “If you could make one change to the way in which TB is current [sic] managed by the government, what would it be?” responses said that changes and improvements could be made to the testing regime, including introducing annual or two-yearly testing for all herds and improving testing sensitivity.

Immediate re-tests

Further suggestions included immediate re-tests for doubtful cases, reducing the number of days between tests and reduced shut down periods, PrMT of all livestock and allowing farmers to arrange tests with their own vets.

Tighter movement controls and more information for farmers on the cattle they were purchasing should be introduced to protect ‘clean areas’. PoMT and regionalisation could also be introduced.

The management of TB could also be reassessed, including ensuring devolved governments adopt a consistent approach, establishing a dedicated agency or an industry-run board to deal exclusively with TB and increasing local control of TB and risk assessments. Introducing cattle vaccination, more efficient removal of reactors and compensating farmers for consequential losses were also mentioned.

  • 22% of responses were from vets, veterinary practices and veterinary professional bodies (including a joint response from the BVA and BCVA and one from the Cornwall Veterinary Association); 36% from farmers or farm organisations and related groups and 36% from commercial companies and members of the public.

Practices which responded included Alnorthumbria Veterinary Practice, Broughton Veterinary Group, Camlas Vets, Cliffe Veterinary Group, EC Straiton & Partners, Four Crosses Vets, George Veterinary Group, Kingsway Veterinary Group, Lambert Leonard & May Vets, Longbridge Veterinary Services, Marches Veterinary Group, Pelyn Vets, Penbode Vets, Riverside Veterinary Centre, Shires Veterinary Practice, Shropshire Farm Vets, St David’s Farm Practice, Stapeley Veterinary Practice, Starnes & Gatward Vets, Swale Vets, The Green Veterinary Surgery, Three Rivers Vet Group, University of Liverpool Farm Animal Practice, Westover Vets, Westpoint Veterinary Group, White Lodge Veterinary Clinic and Wright and Morten Veterinary Surgeons.