Animals As Early Detectors Of Bioevents: Veterinary Tools And A Framework For Integrated AnimalHuman

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Animals As Early Detectors Of Bioevents
Veterinary Tools And A Framework For Integrated
Animal-Human Zoonotic Disease Surveillance

• Diane M. Gubernot, M.P.H.
• Gubernot_at_alumni.gwu.edu

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Purpose

• Design a reporting system for integrated
  zoonotic surveillance
• Enhance detection of human zoonoses
• Sentinel events/ early detection
• Facilitate a rapid response to an outbreak or
  bioterrorist incident
• Help monitor the scope of an epidemic
• Increase awareness of biological threats among
  large and small animal veterinarians

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Zoonotic Reporting

• Pets, livestock and wildlife as potential
  clinical sentinels
• Zoonotic bioevents
• Animal illnesses reported to health department
• Veterinary tools
• Integrates veterinary and human health
  surveillance

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Background Infectious Diseases

• Zoonoses
• Bioevent
• 1415 species of organisms of these 868 (61) are
  zoonotic
• 175 emerging species 132 (75) are zoonotic
• (Taylor, 2001)

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Emerging Infectious Diseases Introduced to the
U.S. via

• Travel
• Immigration
• International trade
• Environmental changes
• Rapid adaptation of microorganisms

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Introduction of Disease Threats

• Naturally
• Inadvertently (i.e. smuggled animals)
• Intentionally, via weaponized biological agents
• West Nile Virus in the U.S
• Introduced 1999 (inadvertently via trade/travel)
• 23,886 human cases 934 deaths reported (CDC,
  2006)

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The Canary in the Coal Mine

• Sentinel any non-human organism that can react
  toan environmental contaminant before the
  contaminant impacts people (Stahl, 1997)
• West Nile Virus surveillance

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The Value of Animal Sentinels

• Share environments with humans
• Respond to many toxic (or infectious) agents in
  analogous ways to humans
• Clinical signs may manifest sooner
• Animals can propagate an epidemic

West Nile Virus Incidence
1999
2001
2003
2005
CDC West Nile Virus Maps
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Strengthening our Public Health Infrastructures

• Public Health Agencies
• Human health-oriented
• Bioterrorism

• Animal Health Reporting
• Economic
• Agroterrorism

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Current Surveillance Activities

• Each state/locality has different surveillance
  plans for zoonoses
• Unified approach is obstructed by
• Organizational differences
• Jurisdictional conflicts
• Geographical boundaries

Lessons learned from the West Nile Virus 1999
investigation (GAO Report)
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Reporting Plan Agent Selection Criteria

• Zoonoses or toxins
• Clinically apparent in the animal population
• Public health significance
• CDCs Potential Bioterror Agents
• Categories A, B C

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Region-Specific Elements

• Human and animal population estimates
• Proximity to other potential threat sites
• Potential vulnerabilities (e.g., airports)
• Analyze government infrastructure
• Epidemiological data

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Framework Elements

• Reporting instructions
• Who? ? Veterinarians, etc.
• What? ? Selected Agents/ Events
• When? ? Timeframe
• Where? ? Responsible Agency/Official
• Tools/Resources
• Education
• Lab information
• Experts

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  Zoonoses Reporting Potential Sources
State Veterinarian USDA
State Wildlife Dept.
Small Animal Vets
State Department of Health CDC
County Health Department
Large Animal Vets
US Customs
Zoos Refuges
Animal Control Services
Pet Stores
Animal Wildlife Rescue Groups
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Selected Agents

• CDC Category A
• Anthrax
• Botulism
• Plague
• Tularemia

• CDC Category B
• Brucellosis
• Glanders
• Melioidosis
• C. psittaci
• Q fever
• Toxins
• S. Enterotoxin
• Ricin
• C.perfrigens

• CDC Category C
• Nipah Virus
• Hendra Virus
• Rift Valley Fever

• Other
• HP Avian Influenza
• Unusual Events

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Other Considerations

• Awareness
• Responsibilities
• Partnerships
• Review statutory authority
• Logistics
• Training
• IT capabilities

• Barriers to reporting
• Analysis of data
• Defining thresholds
• Report dissemination
• Risk communication
• Consequence management
• Emergency Response Plan

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Veterinarian Survey
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Tools Selected Agents and Clinical Severity in
Sentinels
H High M Moderate L Low U Unknown
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Discussion

• Flexible and adaptable (all-hazards)
• Passive reporting ? active
• Sensitivity and timeliness most important
  attributes
• Coordination and communication
• Promotion to Partners ?Task Force

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Summary

• Bridging human and veterinary medicine
• Animal zoonoses reported to health department
• More data
• ? Early detection of a bioevent
• ? Rapid response
• Enhanced disease tracking during an emergency
  response
• Decreased morbidity and mortality in human and
  animal populations

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Acknowledgements

• Benita Boyer, RN, MS, CIC, District
  Epidemiologist, Loudoun County Health Department
• Marina Moses, M.S.,Dr. P.H., Special Project
  Advisor
• Rebecca Parkin, Ph.D., M.P.H., Associate Dean for
  Research and Public Health Practice

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Thank You! Gubernot_at_alumni.gwu.edu