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The bovine tuberculosis (TB) research programme led by Professor Donnelly at Imperial College has been informing policymakers for over a decade. Professor Donnelly played a leading role in the design, oversight, analysis and interpretation of the £50 million Randomised Badger Culling Trial (RBCT, 1998-2006), overseeing a bovine-TB research team at Imperial since 2001. The RBCT compared two candidate culling policies (large-scale culling repeated annually and one-off small-scale culls near farms affected by bovine TB) with areas in which no badger culling took place. Informed by RBCT results (in which widespread culling decreased cattle incidence inside the culling area but increased it on neighbouring farms), the Secretary of State Hilary Benn ruled out badger culling as a control measure in July 2008. However, the coalition government took a different view and in December 2011 announced that farmers could apply for licences to undertake farmer-led (and farmer-funded) badger culling to control TB in cattle. Several of the government's licensing requirements for badger culls in England were based on many of the team's results. In contrast, having proposed in 2010 a large government-led cull, the Welsh government chose in March 2012 to vaccinate, rather than cull, badgers informed by the same set of results.
A novel, reliable, non-invasive and rapid method has been developed to detect excretion of Mycobacterium bovis, the causal agent of bovine tuberculosis (bTB), into the environment ("shedding") by wildlife hosts. This test has been used to establish the efficacy of the bTB vaccine on reducing environmental contamination by shedding of M. bovis in the faeces (from January 2010). It has also become an important monitoring tool used by VisaVet (European Veterinary Health Surveillance), targeting bTB in wild boar and red deer (from July 2010) to establish bTB reservoirs and take action to protect the cattle stocks. Farmers will benefit and now be able to monitor environmental contamination by M. bovis, which allows them to establish biosecurity best practice.
The method includes both a presence/absence score and a quantitative assay of infectious disease load in faecal matter in the environment. This is the first standard assay to determine environmental contamination, the main route for disease spread to cattle, and allows evaluation of the impacts of vaccination, culling and increased movement of badgers during disease- management strategies. This test also enables precise monitoring of cattle herds infected with bovine tuberculosis (bTB) as it advances from the South West to the North East of England.
Despite increasing surveillance, outbreaks of bovine tuberculosis (bTB) in the UK have steadily increased over the past two decades, with the disease now costing an estimated £100 million per annum in test and slaughter costs, and compensation payments.
Research by Professor Wood and Drs McKinley and Conlan has determined that successful control efforts will depend upon within-herd surveillance and also on reducing reintroduction from external sources; these results have directly altered the Department of Environment, Food and Rural Affairs' (Defra) new (July 2013) bovine TB strategy for England, which directly cites Dr Conlan's research when justifying changes in proposed regulations. On publication this research prompted questions during bovine Tuberculosis debates in both Westminster and the Scottish Parliament by Andrew George (MP, St. Ives) and Helen Eadie (MSP, Cowdenbeath) respectively. The work has also received national and specialist media coverage raising public awareness and understanding of bTB control in cattle.
The parasite Neospora caninum is the leading cause of abortion in cattle in the UK, resulting in around 6,000 abortions per year; and a $1.3b pa international problem. There are no effective drugs or vaccines to control neosporosis. University of Liverpool (UoL) research on the development of diagnostic tests, understanding the pathogenesis, epidemiology and transmission of N. caninum has made an important contribution to developing best practise herd health schemes, now offered by the Animal Health and Veterinary Laboratories Agency (AHVLA) and by a commercial company `myhealthyherd', to eradicate N. caninum infection from a herd. This has enabled cattle farmers to improve their businesses by reducing abortion rates and other costs associated with neosporosis.
A University of Glasgow bovine tuberculosis (bTB) surveillance model was fundamental to new Scottish Government policy on bTB testing. Implemented on 1st January 2012, the policy change used the Glasgow model to indicate which cattle herds can be exempt from routine testing while still maintaining Scotland's Officially bTB Free status. In 2012 this translated to exemption of more than 30% of Scottish herds from routine testing, with an associated government saving of £150,000. The revised policy also provided savings to the Scottish farming industry in the region of £100,000 (2012) and limited the risks of bTB testing to farmers, veterinarians and cattle. The rapid success of the ground-breaking Scottish research-led bTB policy development has been highlighted by the Civil Service as best practice and has been presented to numerous policy audiences including the European Commission, providing the opportunity to transform industry practices and livestock surveillance policy across the UK and beyond.
Impact: Economics, policy, animal and human health: In 2006, SoS (a Public Private Partnership-PPP) was established involving: University of Edinburgh, a pharmaceutical company, a charity, and the Govt. of Uganda to control sleeping sickness by eliminating Trypanasome carriage in cattle. The prevalence of trypanosomiasis has been reduced by 75% and sleeping sickness cases have fallen year on year since the PPP was established and Uganda has received a cost benefit between US$125 and $400M
Beneficiaries: The Ugandan population, Ugandan Cattle population.
Significance: Sleeping sickness, which is difficult to diagnose and treat in humans, is often fatal. Ten million Ugandans are at risk from sleeping sickness. SoS established a veterinary network in Uganda producing
Attribution: Professor Welburn (University of Edinburgh, UoE) founded SoS and developed essential diagnostic techniques.
Reach: SoS provides a model for the elimination of the disease across sub Saharan Africa in an economically sustainable fashion - with over 22 million people at risk.
The use of non-steroidal anti-inflammatory drugs (NSAIDs) for their pain-relieving properties in cattle medicine has lagged behind that of other species (e.g. companion animals) where analgesic use is now routine. University of Nottingham (UoN) research exploring the attitudes of vets and farmers to the use of NSAIDs in cattle, and subsequent marketing by Boehringer Ingelheim, a multinational pharmaceutical company, has led to a substantial increase in analgesic use. UoN research increased sales for Boehringer Ingelheim and almost doubled the UK market value of NSAIDs for use in cattle. With administration of up to 2 million additional doses per year, the research had clear benefits for animal welfare.
Developed in 2001, the University of Oxford's T-SPOT test is capable of detecting both latent and active TB infection more rapidly and accurately than the tuberculin skin test (TST). Since its commercial release in 2004, T-SPOT has been adopted by public health agencies for TB control and prevention in the US, UK and Europe. Tuberculosis (TB) is the second leading cause of death from an infectious disease, killing an estimated 1.5 million people worldwide each year. One-third of the approximately 9 million people infected with TB each year are asymptomatic, yet many go on to develop active TB if left untreated.
HIV-1 tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS) is an immune complication of antiretroviral therapy that has vastly increased in frequency in low- and middle-income countries over the last decade. This results from the high tuberculosis rates and the widespread availability of antiretroviral therapy. Mortality from this iatrogenic condition is estimated at 3%. Prior to our work this syndrome was poorly defined and management guidelines anecdotal. We produced the widely accepted and implemented case definition. Imperial also conducted the only randomised controlled trial to date of treatment of this condition. The results are incorporated into international guidelines.