Negotiating zoonoses Dealings with infectious diseases shared by humans and livestock in the Netherlands (1898-2001) Colofon This research has been funded by the Faculty of Veterinary Medicine of Utrecht University, the Julius Center of the University Medical Center Utrecht, the Ministry of Economic Affairs, and the Ministry of Health, Welfare and Sport of the Netherlands. The printing was supported financially by the Julius Center of the University Medical Center Utrecht. Graphic design and printing: Gildeprint ISBN 978-90-393-6839-8 Cover illustration: The logo of the Royal Netherlands Veterinary Association (Koninklijke Nederlandse Maatschappij voor Diergeneeskunde) during the 1960s. The Latin motto ‘hominum animaliumque saluti’ means ‘to the benefit of man and animal’ in English (and ‘tot heil van mens en dier’ in Dutch). Negotiating zoonoses Dealings with infectious diseases shared by humans and livestock in the Netherlands (1898-2001) Onderhandelen over zoönosen De omgang met door mens en vee gedeelde infectieziekten in Nederland (1898-2001) (met een samenvatting in het Nederlands) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof. dr. G.J. van der Zwaan, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op donderdag 21 september 2017 des middags te 12.45 uur door Anne Fleur Haalboom geboren op 26 oktober 1987 te Tilburg Promotoren: Prof. dr. F.G. Huisman Prof. dr. P.A. Koolmees To my parents and my brother Contents List of illustrations 9 Introduction 11 Historiography 16 Definitions 22 Sources 27 Structure 29 Chapter 1. Creating the format for zoonotic disease control: bovine 33 tuberculosis (1898-1956) 1. Bovine tuberculosis as a public health problem 33 2. Bovine tuberculosis as an agricultural problem 47 3. Institutional separation between public health and agriculture 55 4. Eradicating bovine tuberculosis 65 Summary 80 Chapter 2. Engaging in comparative medicine in a divided world: 83 influenza (1918-1957) 1. Influenza research and comparative medicine: public health 84 2. Influenza of pigs: agriculture 95 3. Collaborating disciplines, separate domains 103 4. Responding to domain-specific influenza problems 108 Summary 117 Chapter 3. Formalising public-private partnerships in the welfare state: 119 salmonellosis (1951-1978) 1. Defining salmonellosis as a public health problem 120 2. Agriculture and feed trade opposition to the problem definition 131 of salmonellosis 3. The public health camp versus the agricultural camp 139 4. Fighting salmonellosis measures 150 Summary 159 Chapter 4. Exporting public health problems on the common European 163 market: Bovine Spongiform Encephalopathy (1988-2001) 1. Defining BSE as a foreign export danger: agriculture 164 2. Little interest in a British, agricultural problem: public health 174 3. Who owns food safety? 185 4. The harmonious Dutch response to BSE 193 Summary 206 Conclusion 209 Quotations 219 Abbreviations 221 English translation of Dutch names 225 Literature and sources 231 Samenvatting (Summary in Dutch) 257 Acknowledgements 263 Curriculum Vitae 267 List of illustrations Figure 1 Cattle, horses, sheep and goats in the Netherlands (1900-2015) (p. 14) Figure 2 Pigs, laying hens and broiler chickens in the Netherlands (1900-2015) (p. 15) Figure 1.1 State expenses on human and bovine TB control in the Netherlands (p. 68) (1904-1910) Figure 1.2 State expenses on human and bovine TB control in the Netherlands (p. 73) (1904-1918) Figure 2.1 Honorary doctoral degree celebration, Utrecht University, March 16, (p. 92) 1951 Figure 3.1 Salmonella isolated from humans in the Netherlands (1955-1973) (p. 121) Figure 4.1 Protest banner addressed to supermarket Albert Heijn in front of a (p. 171) Dutch cattle farm, 1996 Figure 4.2 Dutch BSE cases found in three surveillance categories (1990-2004) (p. 204) Schematic overview of major institutions and organisations (1898-2001) (p. 218) Introduction In 2007, the Netherlands experienced an unusually large outbreak of Q fever among its human population, most of the cases occurring in the province of Noord-Brabant. By 2009, a total of 3,522 human cases had been registered by the public health authorities, making this Q fever outbreak the largest known worldwide.1 Until today, 74 patients died and a significant number of patients developed chronic Q fever or Q fever-related severe fatigue.2 Among the non-human population of Noord-Brabant – its livestock – the disease had taken hold somewhat earlier. Agricultural authorities had found Coxiella burnetti, the Q fever bacterium, causing abortion storms among dairy goats some years before the increase in human cases was noticed.3 The expanding intensive dairy goat industry concentrated in the southern parts of the Netherlands combined with high human population density was an ideal environment for C. burnetti to spread through the air. Afterwards, Dutch agricultural and public health authorities, and the responsible Ministers of Agriculture and Public Health were severely criticised for their response to the outbreak. Public debate and evaluation reports considered this response to 1 See for a thrilling account: David Quammen, Spillover: Animal Infections and the Next Human Pandemic (New York 2013) 223-234. Rijksinstituut voor Volksgezondheid en Milieu (hereafter RIVM), ‘Q-koorts’ (December 28, 2016), http://www.rivm.nl/Onderwerpen/Q/Q_koorts (January 23, 2017). 2 Ibidem. 3 G. van Dijk et al., Van verwerping tot verheffing: Q-koortsbeleid in Nederland 2005-2010 (Den Haag 2010) 34-35. be slow, badly coordinated, lacking a precautionary principle perspective and inconsiderate towards sufferers of Q fever.4 What went wrong? This question has inspired widespread interest in zoonoses (infectious diseases shared by humans and animals), and in the international ‘One Health’ movement in the Netherlands.5 ‘One Health’ is defined and used in various ways, which partly explains the popularity of the concept – it can be used for a variety of needs.6 In most definitions,interdisciplinary collaboration between human medicine, animal medicine and environmental sciences is put centre stage.7 In the Netherlands, current discussions of zoonoses and One Health primarily stress the need for better collaboration between human medicine and veterinary medicine, accompanied by the (implicit) assumption that such collaboration has been non-existent or ill-founded in the past.8 It is generally seen as the central point of attention in improving responses to zoonotic outbreaks like Q fever.9 But is this focus on interdisciplinary relations sufficient to understand and evaluate responses to livestock-associated zoonoses like Q fever? It seems rather limited in its scope of stakeholders, to say the least. After all, indignation about Dutch responses to Q fever was not primarily directed at the medical disciplines, but at the public health and agricultural authorities and the power relations between them. Moreover, dairy goat farms – private companies – were the source of the outbreak, so not just public parties influenced negotiations on how to respond. Therefore, this book studies the broader domains of public health and agriculture in relation to one another in responses to zoonotic outbreaks. Its central questions focus on the 4 See for evaluation reports: Van Dijk et al., Van verwerping; N. van der Bijl et al. (de Nationale ombudsman), ‘Het spijt mij’: Over Q-koorts en de menselijke maat (Den Haag 2012); Emily Govers, Petra van Dorst and Lina Oomen (de Nationale ombudsman), Q-koorts, een kwestie van erkenning: Een onderzoek naar de lessen die de overheid uit de Q-koorts epidemie heeft getrokken (Den Haag 2017). In 2015, Q fever patients started legal proceedings against the Dutch state, and they started another lawsuit against individual goat farmers. On January 25, 2017 the The Hague Court judged that the state has not responded unlawfully to the Q fever outbreak. The patients appealed, and the case is still before the court. 5 For instance, as a response to Q fever, the zoonoses network Brabants Kennisnetwerk Zoönosen was founded in 2009, followed by a similar regional initiative Kennisnetwerk Zoönosen Midden-Nederland in 2013. The RIVM launched: RIVM, ‘One Health portal’, www.onehealth.nl (January 23, 2017). 6 Angela Cassidy, ‘One Health? Advocating (Inter)disciplinarity at the Interfaces of Animal Health, Human Introduction Health and the Environment’, in: S. Frickel, M. Albert and B. Prainsack (eds.), Investigating Interdisciplinary Research: Theory and Practice across Disciplines(New Brunswick 2016) 213-235. 12 7 Cassidy, ‘One Health?’. 8 See for instance: M. van Vijfeijken, ‘Eén jaar Kennisnetwerk Zoönosen Midden-Nederland’, Tijdschrift voor Diergeneeskunde (hereafter TvD) 139:5 (2014) 48-49. 9 See for instance: Verslag der Handelingen van de Tweede Kamer der Staten Generaal (hereafter Handelingen Tweede Kamer) 2015-2016, Bijlage, 28286 Dierenwelzijn / 25295 Infectieziektenbestrijding, nr. 844, Brief van de Minister van Volksgezondheid, Welzijn en Sport (hereafter VWS) E.I. Schippers (October 13, 2015). power relations between these parties from a historical perspective. How did the domains of public health and agriculture negotiate control over livestock-associated zoonoses in the Netherlands during the twentieth century? Who decided what responses would look like? What can we say about the roles of and relations between the disciplines of veterinary and human medicine and their apparent lack of collaboration