Mad Cows and Englishmen Peter Atkins and Paul Brassley History Today vol. 46, no.

9 (1996), pp 14-17 A political tornado has swept through Whitehall and on to Brussels recently because of sensational media stories about the potentially widespread damage to human health which may result from the consumption of beef. The stories have been fuelled by the findings of an expert consultative committee of the Ministry of Agriculture, Fisheries and Food that the brain-degenerative human condition Creutzfeldt-Jakob Disease may be caused by beef products infected with Bovine Spongiform Encephalopathy (BSE) or mad cow disease amongst the British dairy and beef herds. As a result, the European Union has imposed a worldwide ban on the export of British beef and there have been economic consequences for many EU livestock farmers as the consumption of beef has fallen in some countries by up to 50 per cent. Part of the heat generated by the BSE/CJD scare has come from the publics unfamiliarity with the threats to humans of animal disease. Advanced societies have essentially eliminated major risk from zoonotics by a combination of veterinary medicine and state regulation. The human populations of these countries are no longer seriously threatened, as they were only a couple of generations ago. Among the trans-species diseases which once caused concern was one which, in terms of its social and economic impact, surpassed all others. Bovine tuberculosis was responsible for over 800,000 deaths in Britain and a great deal of ill-health during the period 1850-1950, and as such was one of the principal health problems of the age. But the severity of the disease has been forgotten since all herds in the country were certified free of it in 1960. However, the handling of mad cow disease since it was first identified in 1986 has been very reminiscent of the various stages in the history of bovine tuberculosis. Might we then not look usefully at the reaction to this earlier health risk? Furthermore, tuberculosis itself is having a rather alarming revival. The World Health Organisation has recently warned of a possible new wave of millions of TB deaths in the next decade. Although most of this is due to a drug-resistant form of human lung disease, there remains a very significant problem of bovine tuberculosis (usually mostly non-respiratory) in developing countries such as India where milk drinking is an important part of the food culture. Tackling this latter form of TB in poor countries might also draw inspiration from the veterinary and medical history of Britain. Tuberculosis is remarkable for having the widest host range of almost any infectious disease. Many mammals, reptiles and even fish arc susceptible. A link between cow s milk and certain forms of human disease was long suspected, and in 1865 Villemin demonstrated it experimentally In 1882, Robert Koch discovered the tiny mycobacterium to blame, and called it the tubercle bacillus. Subsequent detailed research revealed that the consumption of dairy products and poorly cooked meats infected with Mycobacterium bovis could cause tuberculous meningitis, abdominal tuberculosis, and disease of the bones and genito-urinary system. Most affected were small children who consumed milk and who had little natural resistance. Post-mortems of children in London showed that 30-40 per cent had IB in the late nineteenth century, much of which would have been of bovine origin. In 1930, 60 per cent of

young people were sensitive to the tuberculin test and 85 per cent in 1946. The scale of the problem was staggering. What was the governments reaction? In this period before the Welfare State, neither the public nor politicians necessarily saw intervention as essential, but the control of infectious disease had been high on the agenda of social engineering even in the laissez-faire atmosphere of the Victorian period. Sanitary- measures to manipulate the environment were not new. In the 1890s. then, it was no surprise that local authority Medical Officers of Health, senior medical practitioners and some veterinarians were all calling for action. They had noted the compulsory slaughter of animals during the various rinderpest, foot- and-mouth and pleuro-pneumonia epidemics among cattle but became anxious about the lack of response over bovine tuberculosis a less dramatic disease but in the long-term more deadly for human health. An anonymous writer in the 1895 volume of the Veterinary Record commented: It may be urged that the Veterinary Department being an executive government department, was well within its duty in doing nothing for the suppression of TB until the stock owner and general public had determined that legislation was necessary. There is force in such an argument, for it must be admitted that sanitary laws are very difficult to enforce until the public sentiment is in favour of them. There is. however, a very great distinction between a benevolent neutrality and an active opposition. The department and its advisers were not content to do nothing they solidly opposed any movement, when experiments with tuberculin showed this agent to be a reliable aid to diagnosis, the old objection, of veterinary inability to recognise a large proportion of the infected animals, had to be abandoned and another excuse for inaction invented. This excuse still blocks the way, and every attempt to promote legislation is met with the statement that, the enormous cost of any effective scheme of suppression renders its adoption quite impracticable. It is admitted by everyone that no legislation would be successful which did not provide some definite and fair compensation for the owners of cattle liable to seizure ... Clearly some of the cases may with justice be treated as the law now treats glanders, rabies, and anthrax as unmitigated evils from which it is the duty of the state to protect men and animals. Compulsory slaughter had first been introduced to deal with the Cattle Plague (rinderpest) outbreak which began in Britain in 1865. As with later diseases, its early stages were marked by disagreements between the veterinary experts as to its cause and the best treatment. The first cases were diagnosed in June 1865, and on July 10th, Professor Simmonds of the Royal Veterinary College reported to the Privy Council that cattle were dying of a disease of a malignant character. An Order in Council of July 24th, required the reporting of all suspicious cases, and a further Order in August conferred the power of slaughter on local authorities. Farmers were requested to report the disease in their herds, but they received no compensation for animals slaughtered. By September the plague had reached Scotland and a Royal Commission had been appointed. Its interim report recommended the ending of the slaughter policy, but by the end of the year it had to be reinstated. In January 1866, the Archbishop of Canterbury suggested to the Home Secretary that a Day of National Humiliation might arrest the unabated severity of the cattle plague, but the government decided to persist with the Form of Prayer issued to churches in the previous September.

Between February 12th and 20th, the Cattle Diseases Prevention Bill was rushed through Parliament and received the Royal Assent. Under its provisions local authority inspectors were to be appointed and given power to enter premises and order the slaughter of diseased animals. The owner was to be paid half of their value. Animals in contact might also be slaughtered, at the discretion of the authority, and at a higher rate of compensation. The movement and importation of cattle was severely restricted. The impact of the Act was rapid: within a week nearly 18,000 new cases of plague were reported; a month later the figure had almost halved and by the end of April it was down to 5,000. By the end of November 1866, only eight cases were found and the country was officially declared to be free of the disease plague in September 1867. Subsequent outbreaks, in 1872 and 1877, were easily controlled by the slaughter policy. Once the principles of notifiability, slaughter and movement and import control had been established for rinderpest, they were gradually extended, by a series of Acts passed between 1869 and 1894, to a whole range of diseases, including foot-and-mouth, rabies and sheep scab. Between 1855 and 1860 contemporary estimates put the losses from disease at over 2 million cattle worth nearly 26 million; from 1884 to 1900 there were no major outbreaks of disease. It is worth noting that these were exclusionist policies in an era of free trade: one historian, J. R. Fisher, has described them as the major political achievement of the agricultural interest in the late nineteenth century. The Cattle Plague Department set up in the Home Office in 1865 later became the Veterinary Department of the Privy Council, a forerunner to the Board of Agriculture established in 1889. There are significant differences between the governments approach to the control of those notifiable diseases, which did not have human health implications, and the legislative inertia, continuing well into the present century, which marked the attempts to control TB. Why was this? During the 1880s and 1890s there had been parliamentary enquiries and two Royal Commissions on tuberculosis but the unenthusiastic response at Westminster suggests that these may have been called to buy time rather than further to embellish the, by then well known, facts. Yet another Royal Commission was set up in 1901, taking ten years to report, but the findings were this time so scientifically detailed and authoritative that they have formed the basis of our present knowledge of the disease. The 1901-11 enquiry was inspired by the extraordinary events of the London Congress on Tuberculosis in 1901. Robert Koch had used the occasion to make the dramatic announcement that he had been unable to experimentally infect laboratory animals with human tuberculosis, the implication being that bovine tuberculosis also was not transmissible across the species divide. The resonances here with BSE are too close to ignore. In fact Koch was correct about his first conclusion but tragically wrong about the second. For years afterwards his name was quoted by those who wished to take no executive action about infected milk even though the 1911 Royal Commission should have settled the issue once and for all. A flurry of public and private research followed Koch s announcement. It became clear from the inspection of cows and dead meat, bacteriological investigation of milk samples and tuberculin testing of both beef and dairy cattle, that the extent of the disease was worse than anyone had imagined. The definitive estimate in the early 1930s was that about 40 per cent of

animals were infected to one degree or another, the worst incidence of the disease anywhere in the world. Not every cow excreted mycobacteria in her milk but the few with udder tuberculosis were enough to spread the germs widely. Because milk was transported in large road tankers holding the output of 1,000 cows, only one diseased cow could do untold damage. Vaccination of cows against tuberculosis proved unsuccessful, as did the segregation of healthy and diseased animals into separate herds. Even milk certified to come from accredited, TB-free herds made little impact because it was sold at a premium beyond the pocket of ordinary people. Pasteurisation on the other hand seemed a potentially perfect solution because the heating process kills mycobacteria, but early machinery was very inefficient and anyway it was only operated initially by the large dairy companies in big cities. Small towns and rural areas saw little pasteurised milk until after the Second World War. Also the anti-pasteurisation lobby was vocal. According to one writer in 1950 probably no subject outside religion and politics had been the cause of more prolonged and bitter controversies than the proposal compulsorily to pasteurise all milk. Other, mostly administrative, measures were operated at local level. Glasgow was the first city, under its Police (Amendment) Act of 1890, actually to take powers for its medical and sanitary officers to inspect any cowshed supplying the city and to prohibit the sale of any milk dangerous or injurious to health. Manchester soon followed with the famous milk clauses of its Manchester Corporation (General Powers) Act of 1899, becoming a bench mark for other authorities. In effect the citizens of these cities were taking the initiative in the absence of any coherent policy at Westminster. Attempts were made by governments to implement relevant Tuberculosis Orders from 1909 onwards to make the Manchester clauses universal but it was not until 1925 that one was put into sustained effect. This insisted on the notification to the authorities of any animals suffering from gross symptoms, such as a tuberculous udder, emaciation or a chronic cough, and the prosecution of anyone who knowingly sold tuberculous milk. The Gowland Hopkins Committee reporting in 1934, however, found that: The evidence that we have received all points to the fact that the Tuberculosis Order of 1925 has done nothing to reduce the incidence of disease. Nor has it done much to protect the public from infected milk, as the majority of cows are not reported until towards the end of the lactation, or when in an advanced state of the disease. The same committee understood very well the nature of the problem and the dilemma of any Minister of Agriculture trying to minimise public expenditure: The total eradication of bovine tuberculosis is generally agreed to be the only complete solution of the problem of tuberculosis milk ... But any such scheme must take account of conditions peculiar to Great Britain. In the first place, the incidence of tuberculosis among our cattle is so high that the wholesale slaughter of infected animals... is out of the question. Not only would its immediate cost be prohibitive, but it would also seriously contract the supply of milk. This quotation goes right to the heart of the problem. Ministers knew what should be done for public safety but could not conceive of a slaughter policy because of the expense. Meanwhile

in public they minimised the human health risk for fear of panic about one of the farming industrys most important products. It was not until 1950 that an area eradication scheme was finally mounted. This was a complex operation but it ran relatively smoothly and by 1960 compulsory slaughter had rid the British herd of TB. Why had it taken over half a century to realise the need for such a scheme when it had been suggested in the 1890s, while other radical measures had regularly been proposed by the professions? The British Tuberculosis Order of 1925 was anticipated by a Danish equivalent in 1893; certified milk, introduced in 1923, lagged behind an American experiment of 1893; compulsory slaughter in Britain began in 1950, but was introduced in Finland in 1899; pasteurisation was also very slowly adopted, along with tuberculin testing and the BCG inoculation of humans against tuberculosis, all tried on the continent years or decades in advance. This woeful litany was not a series of unfortunate accidents but the result of an institutionalised conservatism in the executive which seems to have remarkable parallels in the experience of BSE over the last decade during which time some fifty-seven BSE-related Acts or statutory instruments have been passed. The time-scale is much shorter of course in the latter disease but similarities in reactive policy-making are notable. First, the science of each disease was contested. The fact that scientists could not form a consensus gave governments an excuse for erring on the side of caution and doing little. In contrast, when the experts agreed among themselves and with the farmers, as they eventually did over cattle plague, effective legislation rapidly followed. Second, for both TB and BSE the public were calmed by pronouncements that there was no proof of any danger, but they later became cynical about the intentions of politicians. Third, in the case of TB, Local Medical Officers of Health campaigned for the risks to be taken seriously by government. The general public were gradually sensitised. By comparison BSE has been more of a dramatic health scare fuelled by the power of the modern media. Fourth, countries like Denmark and the USA instituted a range of measures designed to reduce the cattle disease at source and in the food chain. They did not hesitate to enforce radical measures such as compulsory slaughter when all other options had been exhausted. The present continental reaction to BSE in British beef is quite consistent with this historical context. Fifth, in Britain anti-TB measures in cattle were half-hearted. At all times, at least until the slaughter scheme from 1950 to 1960, administrators were motivated by minimisation of expenditure and the desire to protect the prosperity of the farming industry. The political dynamic of the Ministry of Agriculture over the last hundred years has always been economic and over that period consumer interests have very definitely come second in the order of priorities. Finally, it is interesting to note that when production is threatened, for instance with cattle plague and foot-and-mouth disease, the Ministry of Agriculture, Fisheries and Food acts speedily and slaughter is introduced immediately.

What are the lessons to be learned? Those countries who still have a bovine tuberculosis problem will find eradication to be very expensive. It may well be that improved bovine vaccines engineered by biotechnology might save them the trauma of wholesale slaughter, but the fundamental issue facing any government is what value does it put upon the lives and health of its citizens. In the early stages of development that valuation may be low but there must be a point when the balance shifts away from purely economic considerations. Meanwhile, there are a number of other health issues related to livestock products which are of great concern to the public and which need sensitive handling. For instance, there have been recent scares about the possibility of toxic chemicals in baby milk powder and a suggested link between Johnes disease (paratuberculosis) in milk and chronic bowel problems in humans. We live in a risk-aware society where people are anxious about their foodstuffs, particularly those consumed by babies, yet it is clear that politicians and civil servants have been unable to adjust their approach to this new situation. Their reassurances have not been convincing because they still have the same mindset which prevaricated for so many years over TB and BSE. Such scares will continue unless the administrative ethos of the Ministry of Agriculture, which frankly seems to have changed very little over the last hundred years, can be fundamentally readjusted to be more responsive to consumer needs. If not, then we must break the mould and start again with a separate Ministry of Food.