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EDITORIALS: Debby Reynolds and Liam Donaldson UK government collaborations to manage threats to animal and human health BMJ 2005; 331: 1216-1217 [Full text]

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Anthrax a case study of a zoonosis: were the barriers to control scientific or political?

Tim Carter, none   (30 November 2005)

Anthrax a case study of a zoonosis: were the barriers to control scientific or political? 30 November 2005
Tim Carter, Research Associate Centre for the History of Medicine, University of Birmingham B15 2TT, none Send response to journal: Re: Anthrax a case study of a zoonosis: were the barriers to control scientific or political?	Anthrax was probably the first zoonosis where the interactions between animal and man and the species differences in disease natural history came into regulatory prominence. The BMJ of 26 November identifies many more recent examples and emphasises the need for better scientific and administrative co-ordination. A study which I have just completed but which has yet to be fully published provides insights into these interactions and their political overlays at both national and local level.(1) In the period 1900-1914 Kidderminster in Worcestershire had a very high incidence of anthrax from the use of contaminated wools in its spinning mills. Human cases occurred in mill workers, their families and others in the town. Animal outbreaks were a regular event on the corporation sewage farm, where wool washing water was processed and where operating costs were offset by animal husbandry. Local farmers bought shoddy (wool waste) as a fertiliser and also had outbreaks.(2) Three administrative systems were concerned with different aspects of control: The national Factory Inspectorate with the mills and the wools they used; the Board of Agriculture, acting through the County Council, with animal diseases and the Local Government Board, through the Corporation and its Medical Officer of Health with infectious disease and food standards. Each had well established but different administrative traditions and an urge to contain problems within their own domains. As is still the case, the solutions were, in principle, straightforward: don’t use contaminated wools; dispose of waste safely, and avoid the spread of contamination out of the mills. In practice all were the subject of political and economic compromise. • The Factory Inspectorate suffered a delay of ten years in controlling wool from East India because, in response to industry pressure, the Home Office discretely removed the comma between ‘East India, Cashmere’ from the draft Special Rules thus limiting the restriction to East India Cashmere wool and not to two different wools. The lack of trade union organisation among Kidderminster wool mill workers meant that they were less informed about and active in demanding better precautions than those in Bradford. • The Board of Agriculture considered that if farmers knew that shoddy carried a risk then it was for them to cease to buy it or only use it on arable land. The mill owners denied a risk but appropriately one shoddy related outbreak was on a farm owned by the largest wool and carpet manufacturer in Kidderminster. • The Medical Officer of Health had to gain approval from a council largely made up of mill owners for any action. His proposal for local anthrax notification was contested, as was his advice that dairy cattle should no longer be kept on the sewage farm. Nationally the Local Government Board, probably correctly, did not see anthrax as a priority in comparison with other infections. This view was strongly backed by the Board of Trade which considered that the small number of deaths annually could not justify controls on the importation of an important raw material. Notwithstanding these constraints there was good scientific liaison. Both Factory Inspectorate and Board of Agriculture monitored outbreaks abroad. The Chief Veterinary Officer gave evidence at Home Office enquiries. The role of industrial sources of anthrax spores in animal outbreaks was investigated. Then as now it was the political and economic consequences of taking effective control measures which limited preventative action. A still poignant irony is that one of the anthrax casualties was the Medical Officer of Health’s mare, which grazed on the sewage farm: the only horse to die of anthrax in Worcestershire in 1898. Writing as a citizen he was incensed with the attitude of the Corporation, who were also his employer. He threatened legal action: not for compensation but to secure an apology – pointing out just how many of the Board of Agriculture’s regulations they had broken! Historical study of past outbreaks can provide important and still relevant insights on the barriers to effective preventative action and how they are erected. (1)Carter, T. Anthrax in Kidderminster 1900-1914. PhD Thesis, University of Birmingham, 2005. (The multiple archive sources which form the basis for this letter are referenced here.) (2)Carter T. The dissemination of anthrax from imported wool: Kidderminster 1900-14. Occup. Environ. Med., 2004; 61: 103-107. Competing interests: My main paid work is as part-time Chief Medical Adviser, Department for Transport. The work described was a separate project but was informed by my experience of administrative procedures in government.