1. Companion Animal Veterinarians and Public Health Initiatives: Tools for Integrated Zoonotic Surveillance Diane M. Gubernot, M.P.H. Rebecca Parkin, Ph.D., M.P.H.

2. Purpose Increase awareness of companion animal zoonotic diseases of public health significance Encourage collaboration and communication between veterinarians and public health officials Describe some of the greatest public health threats that affect pets Reservoirs Clinical sentinels Sources of infections for humans

3. Veterinary Awareness Evidence that animals can serve as effective sentinels of pathogens and chemical exposures (e.g., bioterrorist agents) Evidence that animals can serve as effective sentinels of pathogens and chemical exposures (e.g., bioterrorist agents) Facilitate and expedite the early identification and control of emerging zoonoses in animals Facilitate and expedite the early identification and control of emerging zoonoses in animals Improve communications and interventions with clients and public health officials Improve communications and interventions with clients and public health officials

4. Veterinary Awareness  Enhance detection of human zoonoses  Sentinel events  Facilitate a rapid response to an outbreak or bioterrorist incident  Help monitor the scope of an epidemic

5. Zoonotic Reporting Animal illnesses reported to health department Animal illnesses reported to health department Dialogue Dialogue Veterinary tools Veterinary tools Integrates veterinary and human health surveillance Integrates veterinary and human health surveillance

6. Background: Infectious Diseases Zoonoses Zoonoses One Health One Health 1415 species of organisms; of these 868 (61%) are zoonotic 1415 species of organisms; of these 868 (61%) are zoonotic 175 emerging species; 132 (75%) are zoonotic 175 emerging species; 132 (75%) are zoonotic (Taylor, 2001) (Taylor, 2001)

7. Emerging Infectious Diseases Public awareness of zoonotic health risks Public awareness of zoonotic health risks Monkeypox, SARS and Avian Influenza Monkeypox, SARS and Avian Influenza Common Risks/ Zoonotic exposure: Common Risks/ Zoonotic exposure: Immunocompromised Immunocompromised Occupational Occupational Recreational Recreational Wildlife Wildlife Farm animals Farm animals

8. Introduction of Disease Threats  Naturally  Inadvertently (i.e. smuggled animals)  Intentionally, via weaponized biological agents  P  Pets   Environment   Wildlife   Farm animals

9. The Canary in the Coal Mine The Canary in the Coal Mine Sentinel: “any non-human organism that can react to…an environmental contaminant before the contaminant impacts people” (Stahl, 1997) Sentinel: “any non-human organism that can react to…an environmental contaminant before the contaminant impacts people” (Stahl, 1997)   West Nile Virus surveillance

10. The Value of Animal (Pet) Sentinels Live in close proximity to humans Live in close proximity to humans May infect people with May infect people with environmentally- acquired environmentally- acquired zoonoses zoonoses Are clinically more sensitive to certain biological agents Are clinically more sensitive to certain biological agents May serve as effective sentinels for early detection May serve as effective sentinels for early detection Pets live in approximately 71.1 million homes in the US (American Pet Product Manufacturers Assoc.) Breaking news April 18, 2007 (10:00 am CDT) Pet food products recalled by Natural Balance Pet Foods on Monday have been shown to contain melamine, the company announced today. The source of the melamine is believed to be a rice protein concentrate.

11. Common/Emerging Zoonotic Illnesses Campylobacteriosis Clostridium difficile E. Coli 0157:H7 Highly Pathogenic Avian Influenza Leptospirosis Listeriosis Pasteurellosis Salmonellosis Staphylococcus aureus (MRSA) Yersinosis

12. Zoonotic Bioterror Agents Anthrax Anthrax Botulism Botulism Brucellosis Brucellosis C psittaci C psittaci Epsilon toxin Epsilon toxin Glanders Glanders Hendra virus Hendra virus Melioidosis Melioidosis Nipah virus Plague Q-fever Ricin Rift Valley Fever Staphylococcal Enterotoxin B Tularemia

13. Cooperation with Public Health Officials Each state/locality has different surveillance plans for zoonoses Many states: Rabies and C psittaci are the only reportable pet diseases Communication is lacking Communication is lacking Lessons learned from the West Nile Virus 1999 investigation (GAO Report)

14. Tools: Selected Agents and Clinical Severity in Sentinels

16. Tools: Public Health Significance Chart

18. Discussion Communication Communication Collaboration Collaboration Cooperation Cooperation Education Education Task Force Task Force Reporting Mechanisms/ Illnesses Reporting Mechanisms/ Illnesses Case Definitions Case Definitions Contacts Contacts

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

20. Summary Bridging human and veterinary medicine  Animal zoonoses reported to health department More data More data  Early detection of an outbreak  Rapid response  Rapid response Decreased morbidity and mortality in human and animal populations Decreased morbidity and mortality in human and animal populations

21. Acknowledgements Benita Boyer, RN, MS, CIC Benita Boyer, RN, MS, CIC District Epidemiologist, Loudoun County Health Department District Epidemiologist, Loudoun County Health Department Marina Moses, Dr. P.H., M.S. Assistant Research Professor of Environmental and Occupational Health Marina Moses, Dr. P.H., M.S. Assistant Research Professor of Environmental and Occupational Health

22. Gubernot@alumni.gwu.edu Gubernot@alumni.gwu.edu THANK YOU!