“The Minister may, if he thinks fit, cause to be slaughtered any animal which - (a) is affected or suspected of being affected with any disease to which this section applies; or (b) has been exposed to the infection of any such disease.”
“The negative impact of the administration of tuberculin on the specificity of antibody tests in TBfree animals (i.e. the likelihood of false positive results) is a potential concern when antibody tests [are] used outside TB breakdown situations, such as private routine surveillance or pre-post-movement testing. It has not been possible to assess this effect directly in camelids yet, due to lack of samples from skin-tested animals in unrestricted, TB-free herds.”
“Even so, analysis of data generated with sera from alpacas on premises with confirmed M. bovis infection in GB (under the conservative assumption/worst-case scenario that all the non-visible-lesion seropositive animals in those herds were false positives) did not suggest that the specificity of the StatPak antibody test was substantially different between animals that undergo prior skin testing and those that do not.” vi) The conclusion of the Priming Paper was: “In herds with confirmed or with a strong suspicion of M. bovis infection, priming of the antibody TB tests with a tuberculin skin test conducted 10-30 days before blood sampling is essential for optimal performance of those tests, i.e. to maximise the overall sensitivity (probability that an infected animal is classified as positive by the test). For private routine screening or pre-movement testing presumed TB-free herds, skin test priming of the antibody tests is recommended. Although this increases the cost and complexity of testing, it helps identify any undetected infected animals present in those herds without impacting negatively on the test specificity.”
“The key conclusion from the probability calculations is that, because of the very high Sp [diagnostic specificity of the test] of the post-import TB test that was applied on the imported alpaca, the PPV [positive predictive value] of the test is also high, i.e. there is a high probability that this animal is truly infected with M. bovis. That is the case even where the assumed (prior) probability of infection with M. bovis in the tested alpaca is considered to be as low as 1% (PPV=74%) or 5% (PPV=94%). The PPV then very quickly reaches 100% once that probability exceeds 5% … .”
“a) Summary of the veterinary impact / consequences The negative consequences of the imported Enferplex TBpositive alpaca being truly infected with M. bovis and remaining alive in the UK would be the eventual development of clinical TB and potential death of the animal after a period that can range from a few weeks to years depending on the rate of progression of infection. In the meantime, the animal could infect other alpacas in the same herd and in other herds. The potential for spread of infection would be increased by the alleged high breeding value of the alpaca and its use as a stud male. Potential spread to other species, including badgers, cannot be excluded, although this risk may be mitigated by certain biosecurity (badger exclusion) measures adopted on this farm. b) Summary of likelihood The likelihood of the imported Enferplex TB-positive alpaca being infected with M. bovis (tuberculosis) is high, as demonstrated by the PPV [positive predictive value] calculations [set out in part 5 (risk assessment) of the Veterinary Risk Assessment].”
“In light of this, APHA experts recommend that the Enferplex TB positive alpaca imported from NZ should be retested using the higher-sensitivity protocol routinely applied in all government-funded tests of camelid herds in England with confirmed M. bovis infection (and any tracings thereof). This is in order to minimise the risk of false negative results arising from the moderate sensitivity of the available tests: 1. A skin test with PPDB injection 90 days after the pre-export skin test that was conducted in NZ on 31 July. However, if this interval is considered impractical, it could be shortened to between 60 and 90 days (i.e. skin testing could take place from29 September 2017 ); 2. If the suspect animal is deemed a reactor to the skin test, it will be removed straight away as a reactor with compensation; 3. If this skin test is negative, APHA will carry out a serology test at the Starcross Laboratory between 10 and 30 days after the tuberculin injection with the owners’ [sic] choice of two tests from: twoantigen Enferplex TB, DPP VetTB and IDEXX ELISA. A positive to either (or both) component test(s) will result in the animal being designated as infected with TB and removed with the payment of compensation.”
“Thank you for sending the data from Geronimo’s re-test. I have discussed these with the Enfer team and Neil Watt at SureTest. We note that:- • There is a response to three antigens, albeit just above cutoff for two of them (Mpb70pep and PPDb) – at this level we expect specificity to be about 97% based on the data held so far. • The antibody levels and/or numbers of positive antigens have declined, even in the presence of a PPDb boost, which is not suggestive of a progressive disease state • There has been no response to ESAT6 which is thought to be the most specific antigen for M. bovis. Given these observations, and that there is very reasonable doubt from a clinical and epidemiological perspective as to whether the animal is a true M. bovis positive, then we would continue to highly recommend caution in interpretation of the results.” • There is a response to three antigens, albeit just above cutoff for two of them (Mpb70pep and PPDb) – at this level we expect specificity to be about 97% based on the data held so far. • The antibody levels and/or numbers of positive antigens have declined, even in the presence of a PPDb boost, which is not suggestive of a progressive disease state • There has been no response to ESAT6 which is thought to be the most specific antigen for M. bovis. Given these observations, and that there is very reasonable doubt from a clinical and epidemiological perspective as to whether the animal is a true M. bovis positive, then we would continue to highly recommend caution in interpretation of the results.”
“If the tests were repeated a third time, and then in the highly unlikely scenario that there was no positive result, our Minister would still not have certainty that the alpaca in question was truly TB-free in light of the two previous positive results.”
“Defra is very disappointed to see that Mr Hayton and SureFarm are now casting doubts about the reliability of their own diagnostic test. The upshot of this change of position might well leave Defra with seriously considering withdrawing use of their product as a validated test for camelids because it will become very difficult [to] enforce a positive result in the future whenever a camelid keeper does not like the outcome.”
“APHA and Defra emphasise that it is also paramount for the credibility of the private TB testing scheme that APHA is seen to apply government disease control policy consistently and fairly to all camelid keepers.”
“Allowing a repeat TB positive animal to remain on farm would set a very unhelpful precedent – not just for other camelid keepers, but also for cattle keepers wanting to challenge their positive TB test results. The private camelid TB test scheme will become more difficult to manage and APHA will encounter more resistance when attempting to remove test positive animals in the future on other farms, thus increasing the costs of delivering the policy.”
“I maintain my opinion that we lack the evidence base to categorically say that there is no potential for priming to cause artificially elevated antibody levels which may result in a falsepositive reaction to serological tests like Enferplex, whether after single or multiple priming.”
“There are reports of animals without overt clinical signs having visible TB lesions at post-mortem examination. Therefore, the picture is not as clear-cut as one would like.” iii) The Secretary of State has taken a consistent position in relation to this point regarding Geronimo not yet showing clinical signs of the disease. For example, in the Minister’s letter of13 August 2018 to Ms Macdonald, the Minister said: “Properly validated serological tests, such as the Enferplex test for camelids, are potentially valuable in that they are able to detect disease in the early stages, before clinical signs appear. Given this, it is possible that Geronimo could live for many months or years without signs of ill health … .”
“The court must be astute to avoid the danger of substituting its views for the decision-maker and of contradicting … a conscientious decision-maker acting in good faith with knowledge of all the facts.”
“A reviewing court should be very slow to conclude that the expert and experienced decision-maker assigned the task by statute has reached a perverse scientific conclusion.”
“… in principle the court should afford a decision-maker an enhanced margin of appreciation in cases, such as the present, involving scientific, technical and predictive assessments.”
“Judicial review is not … an appropriate set of proceedings in which to determine … complex scientific questions.”
“[On] public health issues which require the evaluation of complex scientific evidence, the national court may and should be slow to interfere with a decision which a responsible decision-maker has reached after consultation with its expert advisors.”