Intended for healthcare professionals


Is this the end of the line for flu vaccine as we know it?

BMJ 2001; 322 doi: (Published 17 March 2001) Cite this as: BMJ 2001;322:677

foot & mouth

The letter on flu vaccine raises the issue of herd immunity, and brings up the related problem of Foot-and-Mouth Disease, over which there is much hysteria in the British Isles and indeed in the Northern Hemisphere generally.

The current policies of the governments involved in the control of the epidemic strike me as crazy. To cull hundreds of thousands of animals will achieve nothing except much aggro and substantial financial losses.

If one were to devise a situation in which FMD , or any other viral disease, could spread rapidly, the present policy of containment is exactly that.

The Northern Hemisphere (and Australia and New Zealand) has ensured, by attempting to quarantine the disease, that there will be zero residual immunity in their cloven-footed herds. So that when the ramparts are breached, and the virus enters the community, there is absolutely no obstacle to its rapid advance.

What's the fuss about? Here we have a disease which (unlike BSE) is relatively harmless to humans, and even in animals causes only a 30% mortality, the majority of animals recovering to enter a carrier state. This mortality is certainly a lot less than that occasioned by the current mass slaughter!

Is it not therefore better to take down all controls, and let FMD outbreakes run their course, tolerating a certain percentage loss? Initially of course the mortality will be high ( but not as high as that which we are seeing right now at the hands of the veterinary Einsatzgruppen) but the situation will equilibrate, and a herd immunity will build
up. The cost of this will certainly be a lot less.

I live in Southern Africa, and we have just had a major FMD outbreak near my home town. Initial mass slaughter failed; the policy was changed to one of mass inoculation, and we have eliminated FMD here.
In neighbouring Botswana, veterinary fences erected at the insistence of the European Community have led to massive deaths among wildebeest and other migratory antelopes.
Think again, Europe.

Competing interests: No competing interests

22 March 2001
Philip Cohen
consultant surgeon
St Annes Hospital, Pietermaritzburg, South Africa