Essay: United Kingdom’s Foot and Mouth (FMD) Outbreak of 2001

THE OUTBREAK
The United Kingdom’s Foot and Mouth (FMD) Outbreak of 2001 was first reported in 27 pigs on February 19th, by a veterinary inspector at a slaughterhouse in Essex, England. In response, Britain’s Ministry of Agriculture, Farms, and Food (MAFF) immediately imposed a 5-mile movement exclusion zone and began the investigation to identify the origin of the outbreak. Three days after the initial outbreak, the European Commission placed a ban on all exports of meats and livestock from Great Britain. The infected pigs were ultimately traced back to a farm on the Isle of Wright, but by this time, the virus already spread to nearby farms, eventually leading to over 2000 confirmed cases of FMD across the United Kingdom (UK).  In the end, it took over seven months before the last case of FMD was stamped out. Over 6 million animals were culled to stop the spread of the virus, costing the private sector £5 billion and another £3 billion to the public sector.  Even with all the advances in medicine and the previous experience with FMD outbreaks in the country, the 2001 FMD outbreak demonstrated the lacking ability in the British government and public health agencies to respond to a large-scale, self-sustaining health crisis. When analyzing a country’s preparedness protocols and risk management capabilities, all aspects of risk, to include likelihood, vulnerabilities, and consequences, must be taken into consideration. From these analyses, the underlying issues in from the 2001 outbreak originated from the UK’s lacking response package and shortfalls in the country’s critical infrastructure protection. But amongst the devastation, the outbreak can be used as learning lessons to better the United States and other nations’ preparedness and alternative means of risk management to a biological outbreak.
LIKELIHOOD OF THE EVENT
Foot and mouth disease is an airborne virus transmitted from animal to animal with infectious doses as small as one virus particle. The hearty virus has the ability to survive outside the host for an extended period of time and is estimated to be able to travel more than 175 miles on wind currents.  While the disease does not have the ability to transfer from animals to humans, the Center for Disease Control places it on the Federal Select Agent List as having the potential to cause a severe threat to both humans and animals. When analyzing a biological threat in terms of risk management and contingency planning, the pathogen and its capabilities have to be understood. For a virus such as the one that causes Foot and Mouth Disease, the biggest concern is whether the virus is or can become zoonotic. The threat of a disease transmission from animals to humans is a significant issue and addressed by the US Department of Homeland Security. The DHS issues a Material Threat Determination on various pathogens including viruses and bacteria to determine if they are zoonotic. While the Foot and Mouth Virus that caused the 2001 outbreak in England had a low probability of infecting humans, there is always an issue of the virus mutating and gaining the ability to easily pass between humans and animals.    Mother nature is not a thinking enemy that governments identify as terrorist groups or state actors. But, similarly to these thinking enemies, the fundamental mission in viruses and bacteria is to adapt and survive. Because of this aspect, the likelihood of a biological event is always present and contingency planning must maintain a constantly updating protocol to address it.
VULNERABILITIES
No matter the amount of preparedness and contingency planning for a biological threat, there will always be vulnerabilities due to the adaptability and resiliency of pathogens. For the 2001 FMD outbreak, the greatest vulnerabilities lied in the UK’s immediate response protocols. At the First International Symposium on Agroterrorism, Ann Waters, the head of contingency planning division in the United Kingdom’s Department of Environment, Food, and Rural Affairs summarized the complexity of the response issue for the 2001 epidemic of unprecedented size and scale. She stated both local and national resources were quickly overwhelmed, the outbreak brought political pressure from the media and public interest, and the government was left scrambling to meet national needs.
The last major FMD outbreak in the United Kingdom occurred in 1967-1968. Learning from this epidemic, the British government implemented many practices and guidelines to prevent another outbreak and to mitigate damages if one did occur. Part of the contingency planning was simulations to respond to biological threats. Between 1995 and 1999, the United Kingdom held 84 exercises ranging from tracing the movement to direct handling of infected animals and involved a wide range of government and private agencies.  Furthermore, Britain’s contingency planning and response package complied with the European Commission for the Control of Foot and Mouth Disease.  For all the training and simulations, the UK’s contingency plan fell short in addressing a biological epidemic on the scale of the 2001 outbreak. Consequently, while the government was armed with policy amendments and revamped planning, during the 2001 outbreak MAFF leadership relied on the 1968 response protocols instead of adapting novel policy to the new situation.
One of the fundamental shortcomings in the UK contingency planning was instituting the appropriate movement ban on livestock after the disease was confirmed. This flaw highlighted how vulnerable the country was to the self-sustaining FMD outbreak. Even though a national movement ban was implemented just three days after the disease was confirmed, it could have been placed much sooner and limited the possibility of spreading the virus. The MAFF hesitated to expand the local ban because the department believed the local ban would control the disease and the evidence at the time did not merit a national ban.  This oversight resulted in the containment delay and put the entire nation at risk to the disease. Vulnerabilities in any risk management scenario are the key areas to address when determining how to mitigate the threat. In the case of the 2001 outbreak, the vulnerabilities became evident as the government relied on previous experience when implementing movement bans and the overall immediate response.
CONSEQUENCES
As in any nationwide crisis, the damages are far-reaching and can range from the national government levels down to the individual. The 2001 FMD outbreak did not discriminate on what or whom it affected. In terms of economic effects, the hardest hit areas of critical infrastructure were the food and agriculture industries along with the tourist industry in the rural areas of the country.
The outbreak caused a significant trickle down effect on multiple industries in both the private and the public sectors. Before even the farmers, the first victims were the more than 6 million livestock that were culled to stamp out the virus. Ranch owners watched their livelihoods be erased as their sheep, pigs, and cows were slaughtered.  The experts overseeing the culling of infected livestock estimated that between 10,000 and 12,000 farms were wiped out due to the outbreak.  Even with the government stepping in to provide over 1.4 billion pounds in payouts to farmers whose herds were culled, many farms never recovered. The effects of the outbreak did not stop at the farms and soon the rest of the livestock industry felt the repercussions. Under the Animal Health Act 1981, farmers were entitled to compensation by the government for consequential losses, but this did not extend to the rest of the livestock industry. While there were government programs enacted to provide some monetary relief including tax deferments and small business recovery funds, the financial burden spread far.  The next victims from the outbreak were the industries that directly support the livestock producers. Grain and feed producers were left with product that no longer was in demand after the culling. Furthermore, farm implement dealers no longer had customers to buy or rent their equipment and soon folded under economic strain. Among the victims were the wholesalers and the retailers that sold the finished product to the public. While there was an initial spike in price of meat, the supply was quickly exhausted and profits for wholesalers suffered. Finally, the consumers felt a direct impact from the outbreak in terms of the livestock meat industry. The cost of meat quickly skyrocketed as the supply dwindled. Wholesalers passed on the rising cost of importing meat to the consumer and the effects were felt around the country.
While the outbreak caused over £5 billion in damages to the private sector, the government spent upwards of £3 billion in relief and response. On average, farms that were affected by the outbreak received payouts of £125,000 under the Animal Health Act of 1981. In addition, when the government instigated the culling response, they inherited the financial and logistical responsibility of the entire process. In total, the government spent roughly £1.3 billion to stamp out the virus in the country.  This included the culling infected livestock, disposal of the deceased animals, decontaminating farms and slaughterhouses, and costs to personnel and equipment throughout the outbreak.
As in many large crises, multiple areas of critical infrastructure faced indirect consequences from the FMD outbreak. Outside of the livestock industry, the tourist industry in the rural areas was devastated by the outbreak. Small shops, hotels, and restaurants saw one of their main forms of income dry up as the many would-be tourists stayed away from the infected areas.  The 10-month movement restriction on livestock imposed by the government virtually brought the tourist industry to a halt in the infected regions. The media did not hesitate to broadcast images of infected animals and large burning pyres around the world, prompting many travellers to stay clear of the region. North Cumbria suffered the greatest number of FMD cases in the UK, resulting in estimated losses to agriculture of about £130 million, and tourism losses of £400 million over one year.  These affects were felt for years after the outbreak as industries in the rural parts of the country recovered. In a Commission of Rural Communities taken in 2005, there remained a total of approximately 1 million households in villages, hamlets, and rural towns that had an income of just 60% of the English average.
Apart from the devastating impacts on the Great Britain’s economy, the 2001 outbreak also had a lasting effect on the country’s political landscape. First, the outbreak caused a suspension in British democracy, a first during peacetime.  The government postponed the general election due to the political strain caused by the crisis. While the government response eventually proved effective in stamping out the virus, the cost and time were critical points of contention in the government. The ministers and decision-makers in the Ministry of Agriculture, Farms, and Food in particular were called into question. The slow response, over-bearing centralized control, and bureaucratic feet dragging were focal points for critics of the Ministry. Following the outbreak, MAFF was abolished and replaced with a new department that combined both agriculture and environment under one agency. The new Department of Environment, Food, and Rural Affairs replaced MAFF after the postponed 2001 general elections occurred.  While the outbreak claimed MAFF as a victim, the new department was the first step in addressing the shortfalls that led to the 2001 outbreak and preventing future epidemics of similar scale.
CONCLUSIONS AND RECOMMENDATIONS
Risk management is the ability of an organization to modify and control the threats they could potentially face. To implement an effective contingency plan that addresses the full spectrum of risk, the threat likelihood, vulnerability in various sectors, and consequences of the threat must be taken into consideration. By analyzing each of these sectors and applying effective risk management at all levels of action, the overall risk is lowered. To do this, the Department of Homeland Security recommends five key areas to address to insure contingency planning is carried out. Unity of effort, transparency, adaptability, practicality, and customization, are all essential elements to an effective risk management plan.   For the 2001 outbreak, risk management should have played a larger role on all levels. From the individual farmers to the highest echelons of the government, identifying risks and ways to mitigate them could have potentially lowered the effects of the outbreak. For conclusions and recommendations to mitigate damages in future outbreaks of this scale, two focal points need to be reevaluated. Customizing effective vaccination alternatives to the nationwide culling as a practical means of containment and implementing a unity of effort on all level to enhance biosurveillance and biosecurity have the potential to manage risk and minimize damages.
Based on the delayed, initial response at the local level, the first recommendation addresses enhancements in biosurveillance and biosecurity at the local and regional/province level. The first steps in improving biosurveillance focuses on identifying symptoms and reporting possible infections of livestock to proper authorities. In the 2001 FMD outbreak, the identification occurred at a slaughterhouse and was very likely unnoticed at a local farm for an extended period of time. Farmers and private vets are required to report possible symptoms of biological infections to the proper authorities. Whether the local farmers were unaware of the FMD symptoms due to lack of knowledge or there was a level of negligence in timely reporting, infected livestock were allowed to spread the virus for a number of days prior to detection.  Farmers must be trained to identify various types of animal health crises and know the proper steps to notify the necessary authorities. This can be addressed through nationwide education programs through a number of media outlets to include television and Internet based trainings.
Furthermore, once symptoms are reported, the need for timely identification by authorities becomes a necessity. During the outbreak, there was significant lack of field bioassays for the vets and public health officials. Many of the samples collected by vets had to be tested in labs far away from farms, slowing down the containment process.  The access of these diagnostic measures in the field would have expedited procedures and provide on the spot analysis of infected livestock. Finally, the number of vets readily trained and available to respond to a nationwide epidemic needs to be increased. During the initial weeks of the outbreak, there was a significant shortage of properly trained vets, which directly led to delays in the disease control.  A possible solution to many of these biosecurity and biosurveillance issues would be to have each province or local jurisdiction maintain their own specialized response outfit. These comprehensive groups would have the knowledge set and access to equipment to respond to a multitude of animal health crises. The issue of funding and available personnel could be an issue, but can be addressed by augmenting standard operating procedures of vets, public health officials, and first responders with biological response tactics, techniques, and procedures.
Along with improvements in biosurveillance and biosecurity, many nations with a significant economic stake in the livestock should look to alternatives to culling in the case of a biological outbreak. Vaccinations have the possibility to provide a stopgap for dealing with a nationwide infection. In the 2001 FMD outbreak, experts claim that if a nationwide vaccination program would have been implemented immediately after the first case, billions of pounds and millions of animals could have been saved.  Because of the complexity and number of different strains of the FMD virus a preventative vaccine is not feasible and outlawed by the European Union. There are 10 known types of the FMD along with over 60 subtypes and immunity from one strain does not guarantee protection from the others.  But, in the event of an emergency outbreak, vaccines can be used to curtail the spread of the FMD virus and provide protection to animals in regions not yet infected. But for this to be feasible, there must be a national vaccine stockpile available and a means to distribute to every region quick and effectively. Production of vaccine can be through government contractors, while storage and dissemination of the vaccines can be controlled by regional veterinaries. This alternative to culling reduces overall cost of livestock disposal and payouts to local farmers whose herds would be slaughtered.
The impacts from the 2001 Foot and Mouth Disease in the United Kingdom are still being felt today. The agriculture and tourist industry took years before they functioned at the levels prior to the outbreak, and some farmers never recovered. For all the millions of livestock lost and the billions the epidemic cost, the outbreak stands as a learning lesson to the UK and the rest of the world. Extensive analysis of all aspects of risk to has the potential to prevent another epidemic of this scale. But, knowing is only part of the fight. Government’s must take this information and apply it contingency planning. This ever-evolving plan must utilized key aspects of risk management to insure every level in a nation is prepared to address all types of biological threats and their possible consequences.