Tag Archives: Tuberculosis case handling

Catching Up

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Working as a government vet, there are times when my job brings an intensity to life that I find fascinating, almost addictive at times. I am still dealing with the aftermath of the bird flu investigation. The initial visit – walking round the shed seeing the sick birds was just the start. There followed a tense period of information gathering. Behind the front line workers like me, there are teams working on epidemiology, tracings and licensing. They need to understand the minutiae of the on-farm operations.

So during that period, it’s as if nothing else matters. It’s all-consuming. The rest of life takes such a back seat that any daily struggles and all other work fall into the background. I fall into a seat in front of the TV at the end of my working day and it’s enough.

As the tidal wave of that work begins to slow, the rest of life and the other work tasks trickle back into focus, but at the moment, those (work) tasks are still quite urgent. Principally, I fell back from avian influenza into the slower wave of bovine tuberculosis. As well as dealing with outbreak work, I should also be doing routine work relating to trade and imports and exports. But our work is prioritised and often we are so busy that we are only skimming the top of what needs to be done. That said, I slipped in a Poultry Health Scheme inspection into my calendar on Tuesday, completed the paperwork and sent it off the next day. The deadline was March, but it was painless (actually I enjoy those visits) and now it’s done.

So picking up the reins of my TB cases, one is quite far along. At the start, there’s a lot to be done, contacting the farmer, explaining what will happen. Broadly, no cattle can move on or off the premises, other than to a slaughterhouse (where they will be scrutinized for disease) and even that is done under licence. There follows a period of testing and culling. Most of the tests are skin tests, but we do blood testing too, at the start. Any animals with positive results are culled and those too are inspected for signs of TB infection. Once we have two clear tests in a row and we have paperwork to say the farmer has cleaned and disinfected the area or areas where the sick animals were housed, then we lift the restrictions.

So with the first of my cases, we are past the blood test and the first of the two skin tests just came back clear. It’s not impossible something might show up, but generally from here it’s plain sailing. In my other case, we are just concluding the blood test. It tends to throw up more positive results, so those animals have to be processed, slaughtered and inspected. I guess it may sound barbaric, but compared with the suffering TB can cause if it goes unchecked… well these things have to be weighed against each other.
To me, those results look quite good. There weren’t so many positives. It will be interesting to see whether any of the animals have what are called “visible lesions” – the TB bacteria tend to wall areas off in the body, a bit like abscesses. If they find those, they will do further testing. Finding the bacteria is almost the holy grail because that allows us to get a much better idea of where the disease came from because they can test to see what strain it is and which other cases are closely related. It takes ages though to grow the bacteria and sometimes they can’t.

Anyway, I digress! As well as working through this process, I have to write everything up in a monthly report. My information and that of all the other cases goes to Scottish Government for oversight. The whole thing takes up a lot of time. I’ve also been allocated the job of overseeing the cleansing and disinfection work at my bird flu farm. The cull is finished and the shed is almost empty. But as the end of the week came into view, I was just thinking that next week, I have plenty to do, but that I will also be able to fit in a welfare visit that’s part of another ongoing investigation that has currently been sidelined. And then my line manager asked me to take on another TB case. This one’s just starting. What testing will be required remains to be seen because all we have at the moment is a positive result, found on a routine skin test. If they don’t find visible lesions then the regime will be different again, but my initial tasks include a Disease Risk Form – a visit to the farm to look at possible source and spread. Is this beginning to sound familiar? This is what I do!

Anyway, in among the work, I am trying to sort out when I might take holidays and who I might visit. My attention is so distracted that I realized yesterday that I’ve booked a week’s holiday that overlaps with a weekend on duty, so I’m going to have to work out what to do about that. For now though, I intend to rest and enjoy the weekend. Last week, Triar and I climbed a whole load of rough steps to visit the Waterloo Monument above New Abbey. It was quite a grey day, but I took a few photos.

We didn’t make it all the way to the top. The stairs were very dark and Triar said no halfway up. Unsurprising really and a sensible decision! Anyway, thanks as ever for reading. I hope you have a lovely week.

Case Work and Crocuses

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I went back, both to work and to the doctors’ on Monday. The GP I saw was helpful. He was young and I think may have been in his foundation years as a GP, but he took the time to do a fairly thorough neurological examination. I was laughing to myself afterwards as I’ve had so many of them that I could have told him a couple of bits he’d missed, but he found a few things, at least one of them new.

He told me he will contact the neurological department at the hospital, both to ask them to reassess my triage as urgent and also, to ask if there’s anything that can be done for me while I’m waiting. It will be interesting to see if I am now seen earlier than July. I don’t know when he’ll get an answer to the other question.

So I’m not as fatigued as I was. I am managing to do some things again that had more or less come to a halt, like cooking and tidying the kitchen afterwards. I even took myself upstairs yesterday and did a bit of painting in the bedroom, but the energy I had quickly drained, as it did when I tried to do a veterinary risk assessment yesterday morning.

The veterinary risk assessment (VRA) I have to do is an assessment of the possible consequences of moving cattle from a farm where there is no TB present, to one where it has been confirmed.

This particular VRA is a bit of a wildcard because TB hasn’t been confirmed yet. We are waiting for the results at the moment (they are trying to grow bacteria in a Petrie dish from lesions found in the lungs of a cow that was slaughtered) and they won’t be back until mid-March. The cattle that need to be moved onto the farm are young stock (heifers) which are being wintered on a different farm. They are due to calve in mid-April. If the culture is negative, restrictions will be lifted and heifers can move to the dairy unit with no problems. If it’s positive, the restrictions will remain and we will need to move quickly.

In order to complete the assessment, I will look into all kinds of factors, including how high the risk of spread is. For example, are there cattle on neighbouring farms and how likely is it those cattle have had nose to nose contact with cattle from the infected farm? What are the potential costs to the government? For example, moving a lot of cattle onto the farm might mean the government has to pay compensation later, if those animal become infected.

And there is an absolute requirement to carry out a short interval skin test (SIT) before any cattle can be moved onto the farm. TB is a slow moving disease sometimes. A cow can be infected for years before it is spotted. When we confirm there are TB bacteria on the farm, we have to check, via the SIT whether we have one infected animal, or many. Until we’ve done that, it’s impossible to weigh the risk.

So if we get a positive culture, I will need to be ready with the SIT and the VRA so we can move quickly. There’s nowhere to calve those heifers and nowhere to milk them, where they are, so they need to go somewhere, on welfare grounds. I find this part of my work very interesting, but with so much cross-referencing of data, I need to be on the ball. Hopefully I can get more of it done in the early part of next week. Big welfare case is also due a revisit though, so we will see!

I don’t have so many photos at the moment. I’ve not been out walking or exploring much, though I took a couple of pictures of colourful lichen in Blackbird Lane, which I will share with you.

Taking time to look closely at the nature around me keeps me sane! A few minutes ago, Triar was whining, so I took him outside and stood in the semi darkness, listening to the most wonderful dawn chorus. There were robins and blackbirds and a song thrush, all greeting the new day. Triar stood and listened too, as he sniffed the morning air. I wonder what he could smell.

I saw on Facebook that Norwegian ships from WW2 are coming to Shetland the week I am there. I was oddly emotional when I saw that, hoping I can speak to the sailors who bring them over. I found a rock beside the Nith (which runs through the middle of Dumfries) commemorating the connections between Dumfries and Norway in the war. Funny how things come together sometimes.

Anyway, I will leave you with photos of the stone and the Nith itself. There were flood warnings in place last night, but midweek, when Triar and I took a walk there, it looked benign enough. Triar photobombed the rock shot, but I’ll not crop it! Have a good week all!