Tag Archives: Notifiable disease investigation

Other People’s Disasters: A Masterclass in Stress

Blog, Scotland, Vet, , , , , ,

This week has felt very long. Monday was spent catching up on work from last week. Tuesday, I was out on a welfare visit. I haven’t done so many of those lately as our regional vet team are so overstretched that my line-manager is withholding all but the most urgent work. I enjoyed it. It was a well-run dairy farm (the picture at the top of the page is unrelated) which I always find reassuring. We get a few awful welfare visits, but most of the time I find dedicated farmers who concentrate on welfare as part of their routine work. The reality is that animals that are treated well are more productive, which I’m sure has a bearing, but generally they care about the animals they look after.

Wednesday there was a monthly team meeting, and the first in a series of mandatory meetings for the vet team. As I said above, our regional team is struggling. This is straightforwardly as a result of understaffing. We should have a team of ten vets and right now, we have the equivalent of five fully functional vets. Wages for a Senior Veterinary Inspector are not high in comparison with other vet jobs and South West Scotland is the busiest region. Sometimes people come into our team, train for a while, feel the weight and then leave. They go to other jobs, or to different areas, where there is less work. Anyway, at the meeting, a colleague led by saying she wasn’t even able now to work through her emails as they come in. This rang a bell with me. I look through mine and pin the ones I have to deal with at the top of the page. There used to be around five there at any time. Now they’re off the page.

They don’t really have any solutions and I don’t blame my line manager. He is doing all he can to protect us, but only dealing with the most urgent work means that the work we are doing is often heavy or very much time-constrained. If there are horses arriving in the airport, we can’t say, “I’ll handle that tomorrow.” We have to handle the TB cases because if we don’t, there will be more.

The only reason I had the nice welfare visit was because my line manager was away. Those standing in for him seem unable to bear the weight he does, so while he’s away, the welfare visits get distributed and we get pushed to take on other work. We did an Emotional Intelligence training day a while back, where they set us tasks and pushed us to complete them faster. Some of them involved throwing things to each other. The people running it seemed quite impressed that none of the team criticized anyone who slowed us down, by fumbling a catch or throwing badly. I commented, in a wry voice, that we were so used to missing our targets that nobody was going to be uptight about not getting the fastest time in a throwing game. Everyone laughed, but the reality is that working constantly under pressure means that we do understand what is important and we do have quite a forgiving core team.

On Thursday, I thought that I might finally finish and send off my witness statement from the Farm of Doom case, which I last visited back in April. I haven’t been responsible for all the delays on that one. My Local Authority colleague took an age to come back to me with the photographs for numbering, so I couldn’t finish my statement without them. I thought I was more or less done, then sent my work to one of the ex-police Enforcement Officers, who told me I had to be explicit in stating that I took each photo and what it shows. As there are a lot of photos, I was only about halfway through this task and Thursday lunch time was approaching when my line manager rang.

I answered, feeling quite sanguine as I generally do when I finally get the time to complete overdue paperwork. He said, “Sarah, can you start to prepare for a report case please?” The bottom fell out of my day. Thursday afternoon and Friday, when I had planned to get through All the Things, including the almost finished paperwork from Tuesday’s welfare, updating my TB case and writing a long-postponed talk I’m supposed to be giving on deer were immediately thrown out of the window. A report case would take up the whole of the next two days. “What kind of report case?” I asked. “AI,” he replied. Avian Influenza. Mentally, I cast aside my planned quiet days and started to prepare for the onslaught.

When I go on holiday, and especially when flying, there’s a bit of a tense period before setting off. Making sure I have everything I’ll need creates a bit of tension. Obviously, I can buy new underwear, but if I forget my passport or my phone, with its electronic ticket information, and maybe the phone charger, then life would become more complicated. I usually relax once I’m through airport security. Beyond that gate, anything that goes wrong will be dealt with.

It’s a bit similar for me with a report case. Before I set off, I need to make sure I have everything in my car that I might require for my disease investigation. All the right paperwork, all the right kit. Throw on top of there the knowledge that I might not make it home that night, so I have to make sure Triar’s needs are covered too, and you get the picture. Having been “officially informed” that I am the attending vet, I have half an hour before I’m meant to be on my way. The reality is that we usually get this pre-warning and the official time is so vague that I have trouble filling in the form the next day. There’s no chance of getting out of the door in half an hour.

Anyway, that prep time, as with the airport planning, is always the worst bit for me. Once I’m in the car and on my way, my mind settles and I am committed. There’s no point in worrying about my other cases or whether I’ve forgotten anything. The next few hours, I have one task only, which is to assess whether there is notifiable disease on the farm or not. This time, I was driving out west. I hadn’t had lunch, so I stopped in a roadside shop for a filled roll. While I was stopped, I saw a message from Donna, saying she would take Triar out (and possibly in overnight). Another weight off my mind.

I’m writing all this as if I’m an old hand, but in reality, this was only my third real report case. It was the second bird flu report case in our region this week. The other farm would still be under restrictions because, after testing, the final all-clear for bird flu takes about a week to come through, but initial results suggested that one was negative. My farm, the one I was heading for, was a laying unit, producing eggs. There were, in total, 180,000 birds on three sites. 80 birds had died overnight in one of the sheds. My job was to go in, take a detailed history, examine both live and dead birds, and then decide whether we need to test for bird flu.

If you’re wondering about now, “well why don’t they just go and test them and see?” the answer is because notifiable diseases are only notifiable because they present a risk. The risk might be economic, for example it might mean animals can’t be sold to other countries because of trade agreements. Scotland is fighting to keep its Bluetongue status as “Free of Disease” because that means more international markets are open to them. Most though, have an animal welfare or human risk aspect. If foot and mouth spreads out of control, as it did in 2001, there is a massive animal welfare issue, as well as a huge economic cost to farming and to the UK. Bird flu presents a risk to human health, as well as a significant welfare impact on the infected birds. Both spread like norovirus through a scout camp, so as soon as there is suspicion of disease, the farm is locked down. The first thing I do, on arrival at the farm, is to serve official papers, confirming the verbal restrictions they were told when they called us.

And when I say locked down, I mean just that. Bird flu spreads easily, so it’s not only birds and animals that can’t move off. People aren’t allowed on or off. Vehicles too. Any movement, from that moment, until the restrictions are lifted, has to be made under a licence. If I can’t rule out disease and we go for testing, this farm is going to be locked down for a week. If I decide this isn’t bird flu, they can open up again this evening. This is an egg producing farm, with 180,000 birds, each laying an egg daily. Eggs can carry bird flu. A week’s worth of eggs… well you get the picture.

I need to be calm when I arrive on the farm. If this day is stressful for me, then think about what the farmer is going through. His or her animals and a chunk of his or her livelihood are on the line. They need me to guide them through this so I want them to have confidence. I bless my years in general practice out of hours and in the emergency clinic. I’ve been dealing with other people’s disasters since I was 23. (As an aside, I love the company of old vets for exactly that reason. Many new vets never do out of hours. It’s not good for the profession.)

My Animal Health Officer (AHO) who will take the samples today, if we sample, is F. She’s even newer than me. My first bird-flu case was hers too, but that time we had an experienced AHO with us. This time, it’s just us. She’s holding up well and was out of her car before me. Deep breath. Grab all the paperwork. I open the car door, climb out, and greet the farmer as if I’ve done this a thousand times before and it’s all routine. Explain who I am: what we’re going to do. There will be a lot of paperwork. Hundreds of questions. Better they know what we’re in for, because they are about to be grilled on all their daily routines, their biosecurity arrangements, who has been on and off the farm in the last 21 days, what has gone to plan, what has happened that was different.

We go into the house. The first thing I do is plug in my phone. I used it to guide me here and later, I have to document everything with photographs. The first time I did this, a few months back, I plugged in my phone, but forgot the switch on the socket. Nobody’s perfect! This time I throw the switch. Then we get down to it, at the kitchen table. I ask them questions. They answer, in detail and at high speed. I’m writing it all down. There is no chance all the information will go into my head and stay there. Several times, I have to ask them to repeat, because they are three facts ahead and I’m still noting down fact 1.

I have to guide the conversation, but it’s difficult. It’s already three in the afternoon and I am mindful of the remaining daylight. We don’t want to be sampling in darkness. I need to drill into the core history. What did they notice first? When? How might disease have been introduced? Where are the weak points in their defences? Are there other possible causes? I’m also vaguely aware that tomorrow, I will be filling in a form which is going to ask me for details which may not be relevant here. I try to balance the depth, get enough information, disregard the unimportant.

Finally, I feel I have enough information. I stand up and go to my phone. Calling my veterinary advisor is the next step. I have to refer the history I’ve gathered to check it’s enough. Because the interview had hopped about a bit, it was difficult to find the information. I have three of four A4 pages, densely written. She asks a few more questions and I have her on speaker, so the farmer answers. It’s time to go and look at the birds.

There are eleven sheds in total, but the dead birds were mostly from shed X. A second shed (Y) has had reduced egg production for a couple of weeks. These two sheds are linked. With plenty of time, I might visit several sheds. If bird flu is confirmed, we will need GPS coordinates for all eleven. I suggest visiting one of the healthy sheds first, then egg-drop Y, then dead birds X. Time is so short though, that after a couple of minutes of discussion, we cut it down to sheds Y, then X which are at Site C. Taking the possibly infected shed last is good practice. I don’t want to infect any sheds that are still clean, though if it is bird flu, every single bird will be dead within the week.

I have a ton of gear to take to the shed and we’re driving down. Two layers of disposable overalls, two layers of gloves. Foot coverings for going into the shed. Breathing hood and filters. Post mortem kit. Sharp safe. Phone, inside a plastic bag. I forget my thermometer. Nobody’s perfect!

I take a photo of the door of Site C and a GPS reading, which I screenshot. If the case goes live, this reading will define the 3km Protection Zone and the 10km Surveillance Zone.

Their biosecurity is reassuring. They ask me to change footwear as I go in, but I decline. All these layers of kit are there to protect me from infection and if I take my wellies off and put their footwear on, I’m compromising that. I disinfect my clean wellies and put on the boot protectors, hoping for the best. Worst case scenario, they don’t have bird flu and I take it in. Oh well.

To get to shed Y, we pass the end of shed X. They have shared air space. There’s a pile of dead birds outside shed X and I cast a glance at them as we walk by, but nothing leaps out. I look in at shed Y through the wire mesh. There are no dead birds visible in the shed. It’s a high rise layer unit with birds on perches right up to the roof. Seeing me in all my get-up all the birds on the floor skedaddle for the high-rise perches or away to the other end of the pen. They look healthy enough.

I don’t go in. It’s time to walk through shed X.

I go in on my own. The birds get alarmed if two people go in together, the farm manager tells me. I think this weird creature with the noisy hood on her head will alarm them anyway, but I don’t say anything. The birds in this shed are as flighty as those in shed Y. It doesn’t matter a fig that I forgot my thermometer. There is not a chance we will be catching any of these birds. I can only see them as they run and climb, and then at a distance, but the view is reassuring. None are lame. No lethargic clumps of sick looking birds. Their tails are up, their feathers smooth. Eyes bright. They stare at me in distant disapproval, but none of them are sneezing.

My mind is fizzing as I walk. Surely, with bird flu, there would be sick birds? Probably dead birds too. These are some of the healthiest birds I’ve ever seen. They can certainly run!

I walk the length of the shed. It’s a well-managed unit. Nice dry litter. Plenty of space. The birds can usually go outside, but today they too are locked down. I walk back, through the pens, taking a few pictures with my plastic-wrapped phone. It’s time to post-mortem some birds. I haven’t seen anything in the shed to suggest there is bird flu, but I still can’t definitively rule it out. We’ve had 80 dead birds overnight and I need to be sure.

I take a look again at the pile of dead birds. With bird flu, I might see swollen heads, deep blue wattles, maybe haemorrhages in the legs or diarrhoea round the cloaca. I don’t see any of those things. I select two birds and photo them. It’s not very bright here, so I ask the farm manager if he has a light. He fetches his head torch. I don’t want to move the birds from where they are. It will have to do.

Kneeling on the floor, I start the post-mortem. It’s a month and a half since I did my last bird PM and that was in a brightly lit lab, on a comfortable bench. Now I’m kneeling on the concrete floor, my head encased in a hood that limits my view, in semi-darkness. This PM is make or break time. I check the head, then open up the throat to look at the trachea. There’s no mucus there, no haemorrage. It’s perfectly normal and when I reach the crop at the base of the neck, it is filled with food. Whatever happened to this bird, it was eating until the moment it died. I open up the body cavity, looking for inflammation, haemorrhage or necrosis, but the only thing that looks abnormal is the liver. Normally, the liver is reddish brown throughout, but this one has brown patches. Some of patches have clear cut edges. They’re not abscesses. I worked in a chicken slaughterhouse for three years, but I’ve never seen a liver like this.

The next bird is the same. I open it up. A second mottled liver. Maybe a little fluid build up where the air-sacs would be. Maybe metabolic, I think. Very strange, but just as in the sheds, there is nothing screaming bird-flu at me. I take a few photos of my findings. It’s good to have evidence. Packing up, I edge back to my feet. It’s not so easy these days, but I make it and we leave the shed again.

Once outside, clutching my now-contaminated kit, I decide to go back up to the main holding before phoning VENDU. The Veterinary Exotic Notifiable Disease Unit give us directions what samples to take, but it’s my decision whether we need to take any at all. If I decide not to, they will challenge me to try to assess my decision, but the final choice is mine. I’ve stripped off most of my kit. If they challenge me for information I don’t have, I’ll have to go again. I decide to call my veterinary advisor before VENDU. I don’t think this is bird flu. It had not really crossed my mind, as I drove here, that I wouldn’t be testing, but with all the information I’ve gathered, I’m conflicted. For me, testing is the safe option, but it’s hammering in my head. I DON’T THINK THIS IS BIRD FLU!

I call my advisor and tell her. She asks about the livers and I describe them. She will discuss with her advisor, she says, while I call VENDU. I drop two liver photos into the chat and leave them to it. I briefly chat with the farmer. He drops it into the conversation that he has no insurance that would cover a week of lockdown. I can’t let that influence my decision either. I have to be sure.

The VENDU vet is busy, but when she calls back, it’s someone I know. This makes it easier to have that discussion, but even then, as I tell her I don’t think it’s bird flu, she wants me to be certain. I am as certain as I can be. The only thing that’s holding me back is that it’s a huge decision. If I say no testing, this farm will open up overnight. Halted eggs on lorries will be on the move again. If there are hundreds more deaths overnight, and it then goes positive, the whole thing will restart tomorrow and I will have messed up massively.

I’m almost sure. I REALLY DON’T THINK THIS IS BIRD FLU! If I lock down the farm, their own vet can’t come on and take samples for a week, even if early tests are negative. Whatever caused the egg drop and the deaths, they’ll have to live with it undiagnosed.

I can’t let that affect my decision either. I tell the VENDU vet that I am almost decided, but I want to call my advisor again. My advisor and her advisor have seen the photos. “Good pictures,” is written in the chat. I call her back and tell her I want to negate. I explain my reasoning again. “We’ve chatted,” she says, “and if you want to negate, we will back your decision fully. Even if it kicks off again, we are happy to defend your decision.”

I take a deep breath. “I don’t think this is bird flu,” I say, “I don’t want to sample.”

The farmers’ relief was palpable. They made a couple of phone calls and thanked me profusely and all the while, I hope I’ve made the right decision. I drive home and pick up Triar and in all honesty, I was high as a kite. Adrenaline has been my drug of choice for a long time and, perhaps bizarrely, I love this stuff. Still, the worry was there that it could all kick off. I didn’t get a whole lot of sleep. My phone rang when I was out walking Triar in the morning. “11 birds have died in sheds X and Y overnight,” they said. 11 out of the thousands of birds. A lot less than yesterday’s 80. I didn’t quite punch the air, but it was a good start to my Friday morning.

I’m writing this on Saturday morning. Despite negating the case, I still had to process all the paperwork and, with a few distractions, it took me all day yesterday. My advisor told me to drop the not-quite completed form into the case folder, “just in case it kicks off over the weekend,” she said. I don’t think it will, and anyway my workphone is switched on. I’m pretty sure if anything kicks off, it’s me the farmer will call first.

Monday will all be paperwork. This case created a new pile to add to that I already had. Even then, if something else comes in, I might have to drop the paperwork and run again.

And after all that, I found out that I left my phone charger on the farm and will have to go and collect it. Nobody’s perfect!

Report the Second

Blog, Scotland, The Vet Who Came In from the Cold, Vet, , , , , , , , , , , ,

Firstly, a disclaimer. The sheep in the photo at the top of the page are random Norwegian sheep and are in no way related to any invest

Last week’s blog was a week late because I received a phone call as I was writing it. Two weeks ago, I was on call for the weekend and hoping to rest. Most on-call weekends are a matter of keeping your phone near you, maybe dealing with a request by a private vet for a case number so they can go out to test a cow that’s dropped dead to check it wasn’t anthrax or a similar request for itchy sheep that might have scab.

This time, to my surprise, I found my line-manager on the phone. “How would you feel about another report case?” he asked.
Well how I felt was broadly irrelevant. I was the ready-to-go vet, so unless I was seriously unwell, it was my task to be handled, whatever it was. “Another AI?” I ventured.

”Um… no.” He paused. “We’ve been sent photos of lesions from some sheep’s tongues. They’re trying to decide whether to treat it as a bluetongue enquiry, or foot and mouth. This isn’t your official call, just a prewarning so you can start to prepare.”

Once the official call comes in, you are expected to be on the road within 30 minutes. In theory, everything should be in your car and you should be able to get in and go. In reality, there are things you might need for sampling that have to stay in the fridge in the lab at work. The buffer solution used for foot and mouth sampling is one of these, so I was glad for the heads up.

I admit, I did feel slightly breathless. Those living in the UK who are old enough to remember 2001 will recall the horrors unleashed on the country as whole farms and regions were forced to cull their livestock and burn them in the fields on horrific pyres of death. The recent, sporadic outbreaks in Europe mean we are on high alert. That the photographs sent in had the high heidyins in a nine am meeting discussing whether they dared risking treating it as “only” blue tongue felt quite significant.

I dressed and went into the office and started to gather paperwork. In theory, I should have paperwork for every eventually in my car, but having the appropriate papers to hand for setting up restrictions is useful. To my mild consternation, I found the main printer wasn’t working. Thanking my lucky stars that I wasn’t a newbie and knew how to work the secondary printer in the lab, I printed out what I thought I’d need.

I also threw a load of blood sampling equipment into my car. Better to have too many tubes than to create the necessity for someone else to come out and onto a farm with possible foot and mouth because you weren’t well enough prepared.

It was quite a long drive out to the farm. As I neared the farm, I slowed down to cast an eye over animals in the nearby fields. None were drooling or looking sick. A good start.


It had been confirmed that I was to treat it, for now, as bluetongue, but that foot and mouth was still there as a possibility. To explain the difference in requirements, because bluetongue is spread by midges, tramping on and off the farm with dirty boots and tyres isn’t so much of a worry. Not that I do that, but if I did, it’s not a disaster.

The restrictions served on the farmer are different too. Bluetongue restrictions only stop animals coming and going. Foot and mouth suspicions, like avian influenza suspicions, mean that every person and vehicle going on and off the farm has to have an individual license and any and all incursions are strictly limited to absolute necessities.

I arrived at the farm , put on paper suit and gloves and served the restrictions. It’s always the first thing to be done and having signed the form, I read out all the clauses that explained in full what was required. Next was history taking.

This is not like taking a history for a normal vet case, where you mostly want to know what has happened to the animal. For a notifiable disease investigation, by the time you are finished, you should have details of every movement on and off the farm within the last twenty one days. You have to assess whether there are any high risk factors. Are there rights of way and picnic sites where people might have fed the animals? Has anyone from the farm recently been on holiday to a different country? Are there stagnant ponds in the vicinity that might encourage midges? The factors, like everything else, vary with the disease suspected.

Having taken a careful history of the animals and the risk factors, I donned more layers of PPE and prepared to look at the animals. I knew, both by being told and by observation, that there were fields nearby that held another farmer’s cattle. I decided to walk up to look at them first. If it was something highly infectious, they might be showing signs too. Again the picture was reassuring. They were young stock from a dairy farm and could not have looked more healthy. They were eating as we approached, then lifted their heads to look at us. Not a nose lesion among them. Nolameness, no drooling. Bright eyes and shiny coats.

I was already, mentally, beginning to think foot and mouth was less likely. Obviously there were still the sheep to look at, but clinical signs in sheep can be subtle, cattle less so. These animals had been in relatively close contact, so by the time the mature mouth lesions were spotted in the sheep (with the caveat that it might have been caught early) I would expect to have seen some spread.

There were two groups of sheep – adults and lambs. The lesions in the photographs, nasty red eroded areas on the tongues, had both been from lambs. We therefore looked at the adult sheep first, partly to prevent any possible cross-infection, but also because a complete absence of problems there would go further towards ruling out foot and mouth. No reason why young sheep would be more severely affected than the old in a disease where neither group would have immunity.

What struck me again was that I was looking at a broadly healthy group of animals. There were 43 ewes and as I scanned their mouths, feet and udders (where possible) I saw nothing. Only bright, uncrusted eyes and alert ears. There were two that the farmer had noted had been getting thin for a while. We selected them out and I examined them more closely. Not a lesion in sight. Normal breathing, normal temperature. One was a bit dirty on her backside, but nothing to suggest foot and mouth or bluetongue.

We moved onto the lambs. This time, I decided we should examine all of them. There were thirty two in the group and the farmer caught each one and held them while their mouths and feet were inspected. In the end, there were four with tongue lesions, four with lesions around their lips and one with a sore area above its foot. None of the lambs with lesions was running a fever. I was strongly beginning to think that what we were dealing with was a severe case of orf – a pox virus that affects sheep and can infect humans who come in contact. It would be unusual to have tongue lesions, but not impossible.

Having taken history and examined the animals, it was time to decide where we were going to go with this. At one extreme, if I thought foot and mouth was still in the picture as a possibility, we would have to issue new restrictions as well as taking samples. I might well have to stay on the farm until it was ruled in or out. I’m still a bit sketchy on the details, though I had arranged for Triar to be looked after, just in case.

If I thought everything was ruled out, I would leave the farm with no tests done and hope I’d got it right. To do that, I’d need to be very certain. My gut feeling was that this was orf, based on the fact that it was only affecting the lambs. Orf is common and spreads in flocks to the new crop of animals born each year. Older animals can carry it, but usually have enough immunity that there are no clinical signs.

So on the grounds that only the lambs were affected and the adult ewes and neighbouring cattle were perfectly healthy, along with the fact that all the lesions were quite mature and I would have expected to see more early stage lesions (we have lectures about aging foot and mouth lesions) I felt confident enough to rule out foot and mouth (phew!). But could I rule out bluetongue too? I decided I couldn’t . After all, midges might well have selectively bitten the lambs with their thinner wool pelt. And orf might exist alongside bluetongue. The lip lesions could be orf and the tongue lesions something else.

And so, armed with my evidence, I called VENDU (the veterinary exotic notifiable disease unit) to tell them what samples I wanted to take. I have never been asked so many times and in so many different ways if I was sure, 100% certain, absolutely confident that I could rule out vesicular diseases like foot and mouth. At the start of the conversation I was using words like probably, but by the end, I was telling the, firmly that no, it was not foot and mouth.

So we tested the nine lambs for bluetongue: the four with mouth lesions, the four with lip lesions and the one with the foot. To cut a long story short, the test was negative, but most of Sunday was still spent on paperwork. I strongly suspect all the lesions were caused by orf: an unusual and interesting case all round and a good learning experience for me.

Lots of text so far and not many pictures, so I shall rectify that. Last weekend, I went to Drumlanrig Castle and met Sue (who used to locum with APHA) for a walk and for lunch. The gardens were beautiful.

Have a good week! Thanks for reading.

Report!

Blog, Scotland, The Vet Who Came In from the Cold, Vet, , , , , , , ,

I was in the middle of writing this last Saturday when my work phone rang and that was that! No time for blogging last weekend. I shall finish this now, then leave the next installment for another day. Sometimes, life is crazy!

Last weekend, I had my first real report case. Unlike the disappearing seal, this one involved live animals, or rather birds. I had intended to go down to Yorkshire last weekend. My sister, Helen, and some of her family were there and my intention was to take Triar down to introduce them. I had a couple of tasks I had to complete first. Some birds that had been imported (as eggs) from the US had been in isolation for three weeks. I had to inspect their health and make sure all the paperwork was in order before releasing them.

In addition to that, one of my TB cases was on its final test and while I was looking at chickens, that test went clear. After they’ve been locked down and unable to move cattle on and off the farm for months, I try to prioritize getting their restrictions lifted as soon as I can.

I had just completed these two time-specific tasks (it was around midday) and was about to go complete all the surrounding paperwork (I had to look up the import isolation release as it was my first) when my phone rang. It was my line manager. “How would you feel about going on a report case?” he asked.

Well I couldn’t really say no. I’ve put in an application for special pay, competence based, and one of the weak points in my application was that I had never done a report case. If my Veterinary Advisor had to defend my application, one of the easiest ways would be if she could point out I now had done one, competently. And apart from that, I wanted to get the first one out of the way. It’s an important part of the job.

My mind was working quickly. I’d seen last night that there was a bluetongue report case in, to be done this morning and, though it seemed unlikely nobody had gone there yet, it seemed even more unlikely there was a second suspicion of notifiable disease report in our region. The reason I hadn’t been to one was because there hadn’t been any locally in the last year and a half.

”Is it the bluetongue one?” I asked. I had been hoping my first one would be. After all, blue tongue is spread by midges. Infection control is still considered, but compared to diseases that spread directly, animal to animal, or worse, to humans as well, there’s a whole lot less PPE to worry about.

”Um… no,” came the reply. “It’s an avian influenza one in pheasants.”

He told me where it was – an hour in the wrong direction for driving to Yorkshire. Mentally cancelling my planned weekend, “Yes, okay,” I said.

I could hear the relief in his voice, and no wonder. We’d had few report cases recently and alongside our two, there was a third in the north already. Depleted as we are by summer holidays and staff signed off from fieldwork, finding willing staff locally must have been a relief.

I spent the next couple of minutes ripping through my Teams contacts to see if someone could talk to me. I knew where all the gear was, but I needed paperwork and some of it had to be printed out before going. Each different notifiable disease has a different form to restrict movement. They quote the relevant sections of the law, under which the restrictions are put in place, so you need the right one. And then there were sampling forms, which are different depending on whether the birds are classified as wild. I had to take hard copies as those need to go with any samples I decided were necessary.

Frankly, my mind was whirling. I needed someone to give me instructions. Fortunately, one of the Veterinary Advisors called me back and (as is my habit) I started the first of the many lists I was going to need over the next few hours, to keep everything straight. Having printed out all the forms I would need, and having thrown the “grab and go” boxes with all the report case gear in them, I set off.

Traffic was awful. Going round the Dumfries by-pass on a Friday afternoon is a nightmare at the best of times. They’d found me an animal health officer, who was being deployed from Ayr. He wanted to know what kit to bring for sampling and I had to pull into a couple of lay bys to talk to him. The whole exercise was obviously going to take a while and going back to collect something we’d forgotten between us would be a real pain.

There was a small incident when I had been stuck behind a dawdling camper van for some time. There was a short section with two lanes on my side of the road. I pulled out to pass (I bought a car that can accelerate fast for a reason) and some idiot motorcyclist waiting in a queue going the other way dawdled over a double white line and right into my lane so I couldn’t. It’s just as well I wasn’t driving a car marked with APHA on it. It’s a long time since I have given someone the finger while driving, but really, some people are beyond the pale in their selfishness and I was undoubtedly fueled by adrenaline at this point, as well as diesel.

By the time I arrived on the farm, I was my usual professional self. This is my job. It’s the animal owner who’s having a bad day and my task to present a calm exterior and offer guidance. At any time, I could call for advice, but to be too obviously ignorant is to invite worry. My first task was to complete the movement restriction form. There was a section with two boxes on it where I couldn’t decide whether I should write my name, or strike through them. Phoning to ask would be the most obvious indicator to the poor gamekeeper whose birds were dying that I hadn’t done this before. I struck through them, carried on and handed over the form, reading out the instructions on the back to make sure he knew what was and wasn’t allowed.

There was a slightly disconcerting moment, when the gamekeeper looked at me and asked, “Is this your first?”
I was surprised he could tell, but am old enough to know honesty is the best policy at these moments. “Yes,” I said. “It is, actually.”

”Oh,” he said. “I knew from her questions on the phone that the person I spoke to on the phone knew nothing about pheasants. I thought they probably wouldn’t find a pheasant expert. She didn’t even seem to know that partridges and pheasants are different.”

My shoulders sank a couple of inches. I hadn’t been rumbled after all and I did, at least know enough about game birds not to make an idiot of myself.

Having served the papers that locked down everyone and everything on the farm, it was time to start the investigation. Most of the birds were healthy, but I needed to have eyes on them and I also needed to map where they all were. It’s not so hard when you have chickens and they are all in a shed in the farmyard. You can print out a satellite image or map of the premises, put an X on the spot and provide a GPS reading. That reading is essential because if disease is confirmed, that X becomes the centre of the 3km restriction zone and the 10km surveillance zone. This time, I had 15 different GPS readings, spread over different farms: at least I think they were. I was taken to them in a kind of buggy on back roads and tracks. There was no way I could mark where they all were on a printout of the steading.

I lost contact with the team and with time. We drove between pens and I took readings with my OS maps app. I screenshot each reading, took a photo of the pen and any nearby animals and scrawled notes on a piece of paper. How many birds? What species? Were they in or out? The last question was crucial. When they are young, the pheasants are in closed pens with mesh over the top. At that point they are kept. Eventually, the gates of the pens are open and the birds can roam fully. At that point they are wild. In between is a grey zone.

Coming back to the steading, I saw the animal health officers had arrived, one experienced, the other in training. I still hadn’t seen a single sick bird. After yet another conversation with the Veterinary Advisor, I put on a second layer of PPE over the single layer I’d been wearing up until that point and we headed up to see the sick birds. I had with me the Sundstrøm hood that we are given for AI cases. Even though I would be outdoors, I still had to wear the full kit. It was rather bizarre, outside the pen, on a patch of grass on a forest track, donning a hood that would isolate me from everything. It felt very incongruous.

I had occasionally worried about how I would cope with the hood, which blows air into your face, but it was actually fine. I walked into the pen alone and surveyed the sorry picture. Sick birds, feathers puffed out, tails down and looking sorry for themselves, carcasses of others that hadn’t made it. Yet there were no specific signs. Birds with bird flu often have neurological signs and pheasants have been described as having cloudy looking eyes, but there was nothing. I should perhaps, have done some post-mortems, but hadn’t brought kit and there wasn’t really much time remaining. We are on a strict twelve hour limit when it comes to driving for work and Triar was waiting at home.

We went back, again, to the steading and I checked in with my report. Could I rule out avian influenza? I couldn’t. No specific signs to rule it in, but none that would rule it out either. Were they wild or kept. Grey zone. It was time to call VENDU. The Veterinary Exotic Notifiable Disease Unit are the body that dictates what tests should be taken, once the on-site vet decides disease can’t be ruled out. The answer was to sample 20 birds, swabs from the throat and cloaca, plus bloods and two heads.

It was time for the AHOs to don their gear and as they started to do their work, it was time for me to leave. It was a 45 minute drive home and I had to get there by 20:30 if I wasn’t to get a slapped wrist for going over my twelve hours. Luckily there was no traffic now and I made it by the skin of my teeth. I hadn’t eaten all day, so having passed the office (so technically onto my commute) I stopped at the chip shop. The time on the receipt is 20:32, thank goodness, so I could prove I hadn’t gone over!

After that, there was all the follow up to do. Saturday was spent filling in EXD40, a colossal document where I had to transfer all the GPS and other data I’d collected, as well as explaining in triplicate, why I felt that testing was justified. There were calls flying at me as well. Because the birds were tested they would be locked down for at least a week until the final test results were through.

A positive result would be quick, but would raise all the complicated questions about what and how to cull. Again, not like birds in a closed shed. These were ranging about and half wild in pens that spread over acres of forestry. In the event, just as I was about to be sent out on Saturday afternoon to do a valuation (healthy birds are paid for as compensation – a good incentive for early reporting) the initial results came back: not confirmed.
Still, it would be another week until they were certain. Along with my form filling, there was someone from the licensing team doing more form filling. Everyone who might enter, every vehicle that drove onto and off the locked-down premises had to have permission.

And so, that was my first report case. For a week, even after the initial results were back, I had daily contact with the gamekeeper as the mystery disease spread slowly, though still all in that one pen. I supported as best I could and then, with relief, handed over to his private vet. Finally they could go on and sample for other things, now it was confirmed there was no bird flu. And as I said at the top of the page, no sooner was this case handed over, I had a different one to tackle, but this is more than long enough already.

Thanks for reading. Over and out!