The influence of veterinary epidemiology on public health: past, present and future

This paper summarizes a presentation given at the Association for Veterinary Epidemiology and Preventive Medicine sponsored Calvin W. Schwabe symposium honouring the lifetime achievements of Dr. S. Wayne Martin. While the concepts were amalgamated from many sources, the examples were primarily selected to represent areas where Wayne Martin has been an active researcher and educator. The purpose was to describe the impact of veterinary epidemiology on public health in the past and present and to consider the future of veterinary epidemiology in public health. Veterinary medicine contributes to public health not only in the area of zoonotic disease prevention and control, but also through contributions to animal health, comparative and basic medical research, and population and environmental health. Veterinary epidemiologists contribute to both research in public health and the practice of public health through a wide range of methodological approaches and via the networks of trained epidemiologists working in the area. The contributions of veterinary epidemiologists have resulted in significant improvements in human health. There are considerable challenges and opportunities facing veterinary epidemiologists working in the public health area in the future. Meeting these needs will require continued integration between veterinary and human public health research and practice, and enhanced communication of both content and context expertise.     

Exotic animal corporate practice.

I have attempted to give insight into many of the aspects of a corporate veterinary job in the retail pet industry. Understand that these are my experiences, and corporate jobs are as diverse as the number of corporations in this field. My experiences have been positive because I have been fortunate enough to become an integral part of a company with an outstanding company ethic regarding animal care and business as a whole. This is a dream position for a veterinarian who wishes to make a far-reaching difference for animals. At PETCO I am the Animal Advocate and I do have the responsibility to look at every situation through the eyes of the animals. I take this responsibility very seriously and understand that every decision I make has a lasting impact on not only the animals we sell but also the associates who daily give their heart and soul as they care for the animals in our stores. This is the way I have chosen to make a difference in the world: by using my veterinary education as well as my life experiences in ways that are very different from the James Herriot of old-different from the advanced veterinary practices in this new millennium but steadfastly following the same principles we promised to uphold when we took the veterinary oath... Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering,the conservation of livestock resources, the promotion of public health, and the advancement of medical knowledge. I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics. I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.     

Progress with enhancing veterinary surveillance in the United Kingdom

The UK has experienced various animal health events that have had national impact in recent years. In response, a ;Veterinary Surveillance Strategy' (VSS) was published in 2003, with the objective of enhancing and coordinating national veterinary surveillance practice in a way that would enable important animal health events to be detected and assessed more rapidly and reliably. The VSS adopts an integrated UK-wide approach, which includes widespread engagement with interested parties both within government and beyond. It proposes enhancing surveillance through improved collaboration; transparent and defensible prioritisation of government resources to surveillance; deriving better value from existing resources, and assuring quality of the surveillance reports and source data. This article describes progress with implementing the VSS, in particular the methodology for developing a functional network and creating an effective, quality-assured, information management system, RADAR.     

Journal standards

Despite its many imperfections, the peer review process is a firmly established quality control system for scientific literature. It gives readers some assurance that the work and views that are reported meet standards that are acceptable to a journal. Maureen Revington's editorial in a recent issue of the Australian Veterinary Journal (Revington2002) gives a good concise warts and all overview of the process and is well worth reading. I have some concerns about several articles in the December 2002 issue of the New Zealand Veterinary Journal (Volume 50, Number 6), devoted to the health and welfare of farmed deer, that relate to extensive citing of non-peer reviewed papers. I can understand the need for information to flow from researchers to the wider community but that need is already satisfied by publications such as the proceedings of the Deer Branch of the New Zealand Veterinary Association and Proceedings of the New Zealand Society of Animal Production. Non-peer reviewed papers have been cited in the Journal in the past but never to the extent displayed in this particular issue. It degrades the peer-review process and creates an added burden for reviewers who are forced to grapple with the uncertainties of the science in non-peer reviewed citations. One of my fears is that this process allows science from non peer reviewed articles to be legitimised by its inclusion in a peer reviewed journal and perhaps go on to be accepted as dogma. This is a real danger given the difficulties associated with tracing back to original citations and the increasing volume of scientific literature. It also affords opportunities for agencies to pick up questionable and doubtful science and tout it as support for their products or particular points of view. If deer researchers choose to publish most of their work in proceedings then so be it. However this approach, which seems to becoming increasingly prevalent in the deer sector, is questionable from an established science point of view. For my part, I am increasingly reluctant to spend time reading non-peer reviewed material, despite its appeal. At present there are two distinct baskets for scientific literature, one for non-reviewed articles and another for peer reviewed information. I would sincerely hope that we are not going to need another basket as a halfway house for issues that fall in between that classification.     

Teaching animal welfare at the University of Sydney's Faculty of Veterinary Science

Animal welfare is part of the Mission Statement of the Faculty of Veterinary Science at the University of Sydney and is taught throughout the undergraduate curriculum. Two units of study have a particular focus on animal welfare: Professional Practice in years 1, 2, and 3 and Animal Behaviour and Animal Welfare Science in year 3. There is an emphasis on the refinement and development of alternatives to the use of animals in teaching. With a conscientious objection policy in place, these elements of our approach demonstrate the increasing importance of ethical teaching in the faculty. Undergraduate students have recently founded a vibrant special interest group called Veterinary Students for Animal Welfare. The faculty is advised on matters relating to animal welfare by its Animal Welfare Advisory Committee, chaired by the Sub-Dean for Animal Welfare. With the development of a Faculty Animal Welfare Policy, the faculty is progressing to a more proactive and public profile on animal welfare issues.     

Training the veterinary public health workforce: a review of educational opportunities in US veterinary schools

This article presents the results of an Internet-based review conducted in January and February 2003 to assess the educational opportunities available in veterinary public health, epidemiology, and preventive medicine at the 27 veterinary schools in the United States. Most professional veterinary curricula are designed to train students for careers as highly qualified private practitioners, although there is an increased need for veterinary perspectives and contributions in the public health sector. The future of veterinary public health relies on the opportunities available in education to teach and encourage students to pursue a career of public service. The results of this review indicate the availability of a wide variety of required courses, electives, and post-graduate training programs to veterinary students in the United States. Veterinary students are exposed to a median of 60 hours of public health, epidemiology, and preventive medicine in required stand-alone courses in these areas. Four veterinary schools also have required rotations for senior students in public health, preventive medicine, or population medicine. Contact time for required public health, epidemiology, and preventive medicine courses ranges from 30 to 150 contact hours. Advanced training was available in these subjects at 79% of the 27 schools. Greater collaboration between veterinary schools, schools of public health, and the professional public health community will increase exposure to and opportunities in public health to all future veterinarians.     

Veterinary extension on sampling techniques related to heartwater research

Heartwater, a tick-borne disease caused by Ehrlichia ruminantium, is considered to be a significant cause of mortality amongst domestic and wild ruminants in South Africa. The main vector is Amblyomma hebraeum and although previous epidemiological studies have outlined endemic areas based on mortalities, these have been limited by diagnostic methods which relied mainly on positive brain smears. The indirect fluorescent antibody test (IFA) has a low specificity for heartwater organisms as it cross-reacts with some other species. Since the advent of biotechnology and genomics, molecular epidemiology has evolved using the methodology of traditional epidemiology coupled with the new molecular techniques. A new quantitative real-time polymerase chain reaction (qPCR) test has been developed for rapid and accurate diagnosis of heartwater in the live animal. This method can also be used to survey populations of A. hebraeum ticks for heartwater. Sampling whole blood and ticks for this qPCR differs from routine serum sampling, which is used for many serological tests. Veterinary field staff, particularly animal health technicians, are involved in surveillance and monitoring of controlled and other diseases of animals in South Africa. However, it was found that the sampling of whole blood was not done correctly, probably because it is a new sampling technique specific for new technology, where the heartwater organism is much more labile than the serum antibodies required for other tests. This qPCR technique is highly sensitive and can diagnose heartwater in the living animal within 2 hours, in time to treat it. Poor sampling techniques that decrease the sensitivity of the test will, however, result in a false negative diagnosis. This paper describes the development of a skills training programme for para-veterinary field staff, to facilitate research into the molecular epidemiology of heartwater in ruminants and eliminate any sampling bias due to collection errors. Humane handling techniques were also included in the training, in line with the current focus on improved livestock welfare.     

Epidemiology of animal diseases in Africa: approach strategies and role of veterinary laboratories

Study of the epidemiology of animal diseases in Africa should only be envisaged when the veterinary diagnosis laboratories and the cattle development structures in the field are fully operational. Veterinary epidemiology may be approached using all usual laboratory techniques. In spite of some limitations described by the author, current diagnosis, intervention in outbreaks, retrospective and prospective surveys all contribute to the knowledge of animal disease epidemiology. In fact, considering the difficulties met in Africa, it seems advisable to combine a mixed approach to maximise the use of field visits. The author concludes that until new techniques allow a decentralised diagnosis, the African veterinary laboratories must play a determinant part in the study of the epidemiology of animal diseases; furthermore current diagnosis, sanitary surveillance and epidemiological surveys have now become almost inseparable.     

BOOK REVIEWS

Book reviewed in this article:
Tropical Animal Health, 2nd edn , HSH Seifert
Small Animal Ophthalmology , a Problem-Oriented Approach, 2nd edition, RL Peiffer Jr and SM Petersen-Jones
Update on Clinical Pathology, The Veterinary Clinics of North America, Small Animal Practice , edited by RE Raskin and DJ Meyer
Veterinary Epidemiology. 2nd edn. M Thrusfield
Poultry Meat Hygiene and Inspection , A Bremner and M Johnston
Feline Practice 2 , editors E Boden & M Melling     

Policy-driven development of cost-effective, risk-based surveillance strategies

Animal health and residue surveillance verifies the good health status of the animal population, thereby supporting international free trade of animals and animal products. However, active surveillance is costly and time-consuming. The development of cost-effective tools for animal health and food hazard surveillance is therefore a priority for decision-makers in the field of veterinary public health. The assumption of this paper is that outcome-based formulation of standards, legislation leaving room for risk-based approaches and close collaboration and a mutual understanding and exchange between scientists and policy makers are essential for cost-effective surveillance. We illustrate this using the following examples: (i) a risk-based sample size calculation for surveys to substantiate freedom from diseases/infection, (ii) a cost-effective national surveillance system for Bluetongue using scenario tree modelling and (iii) a framework for risk-based residue monitoring. Surveys to substantiate freedom from infectious bovine rhinotracheitis and enzootic bovine leucosis between 2002 and 2009 saved over 6 million € by applying a risk-based sample size calculation approach, and by taking into account prior information from repeated surveys. An open, progressive policy making process stimulates research and science to develop risk-based and cost-efficient survey methodologies. Early involvement of policy makers in scientific developments facilitates implementation of new findings and full exploitation of benefits for producers and consumers.     

Animal welfare training at the Ontario Veterinary College

The University of Guelph is internationally recognized as a leader in animal welfare and is home to the Colonel K.L. Campbell Centre for the Study of Animal Welfare and to numerous faculty with expertise in the discipline. However, while animal welfare receives significant attention within the agricultural college, its didactic teaching within the veterinary curriculum has been limited. Veterinary students receive four hours of instruction in animal ethics and apply their knowledge within the communication lectures and laboratories, totaling 11-15 hrs. Compulsory coursework explicitly addressing factual components of animal welfare science, welfare assessment, and associated animal-related policy constitute only 12 hrs throughout the four-year Doctor of Veterinary Medicine curriculum. However, an elective final-year clinical rotation and a graduate course specific to animal welfare were offered for the first time in 2004/2005. Student interest in animal welfare is evident through their participation in summer research projects in animal welfare, an animal welfare mentor group, and a student-run animal welfare club that organizes an Animal Welfare Forum each October. Veterinarians have important contributions to make in decision making about animal welfare issues, at clinician and policy levels. Although motivated individuals can seek out opportunities to expand their knowledge of animal welfare, a compulsory senior-level course in animal welfare is needed to develop the necessary depth of understanding of this discipline if veterinarians, as a profession, are to meet society's expectations about animal welfare.     

Field Epidemiology and Laboratory Training Programs in West Africa as a model for sustainable partnerships in animal and human health

The concept of animal and human health experts working together toward a healthier world has been endorsed, but challenges remain in identifying concrete actions to move this one health concept from vision to action. In 2008, as a result of avian influenza outbreaks in West Africa, international donor support led to a unique opportunity to invest in Field Epidemiology and Laboratory Training Programs (FELTPs) in the region that engaged the animal and human health sectors to strengthen the capacity for prevention and control of zoonotic diseases. The FELTPs mixed 25% to 35% classroom and 65% to 75% field-based training and service for cohorts of physicians, veterinarians, and laboratory scientists. They typically consisted of a 2-year course leading to a master's degree in field epidemiology and public health laboratory management for midlevel public health leaders and competency-based short courses for frontline public health surveillance workers. Trainees and graduates work in multidisciplinary teams to conduct surveillance, outbreak investigations, and epidemiological studies for disease control locally and across borders. Critical outcomes of these programs include development of a cadre of public health leaders with core skills in integrated disease surveillance, outbreak investigation, vaccination campaigns, laboratory diagnostic testing, and epidemiological studies that address priority public health problems. A key challenge exists in identifying ways to successfully scale up and transform this innovative donor-driven program into a sustainable multisectoral one health workforce capacity development model.     

Book Reviews

Book reviewed in this article: Animal Laparoscopy. Ed. by Richard M. Harrison and David E. Wildt Veterinary Practice Management. Ed. by Paul W. Pratt Statistical Epidemiology in Veterinary Science. By F.B. Leech and K.C. Sellers Outlines of Animal Immunobiology by Duncan Allan Handbook of Diseases of Laboratory Animals, Diagnosis and Treatment by J. M. Hime and P. N. O'Donoghue     

An evaluation of scrapie surveillance in the United States

Animal health surveillance systems should reflect national disease control priorities and promote the best use of public resources by maximizing effectiveness and efficiency. A surveillance system should be routinely evaluated to assess the degree to which the system accomplishes these goals, fulfills its stated objectives, and meets accepted surveillance standards. In the United States, there are a number of disparate endemic disease surveillance and eradication programs. The National Animal Health Surveillance System is a federal initiative designed to combine animal health surveillance and monitoring activities into a comprehensive and coordinated system. A protocol has been developed to facilitate the evaluation of animal health surveillance systems and investigate opportunities for coordination between the different surveillance and eradication programs. The evaluation protocol was based largely on protocols developed for public health but adapted for the specific needs and goals of animal health surveillance. The evaluation process was designed to identify program strengths and areas for improvement and facilitate the system's adaptability to changing situations. The evaluation protocol was applied to the scrapie surveillance system in the United States; scrapie surveillance was found to be an important part of surveillance for transmissible spongiform encephalopathies. Results from the evaluation of sensitivity, sampling methods and representativeness are presented.     

Science,politics and animal health policy: epidemiology in action

Public policy decisions underlie society's response to current animal health issues ranging from emerging diseases and public health threats to food safety concerns and sustainable animal agriculture strategies. Despite strong calls for "science-based" decisions, animal health policy most commonly emerges at the interface of science and politics. Too often scientists' disdain for politics limits their involvement in formulating policy. By contrast, epidemiologists are ideally qualified to bring scientific skills to complex policy issues through analytical, macro-epidemiological approaches that consider the economic, legal, and cultural context of policy issues as well as the biological and medical aspects. Risk analysis provides a systematic approach to evaluating animal health issues and comparing policy options. Capturing these opportunities for applied epidemiology requires an understanding of the policy-making process as well as the basic principles of epidemiology. Furthermore, epidemiology training programs must incorporate communications skill building and experiential learning opportunities in a team environment.     

Experiences and difficulties encountered during a course on veterinary public health with students of different nationalities

Veterinary public health (VPH) issues have received increased attention over the last few years as a result of the rising threat of emerging zoonoses (i.e., those due to globalized trade in animal and animal products and to changes in livestock production systems and the environment). The international dimension of VPH is gradually becoming recognized, and there is a growing need for veterinarians with experience in this field. In order to familiarize (future) veterinarians with the international dimension of VPH, the Department of Public Health and Food Safety of the Faculty of Veterinary Medicine, Utrecht University, has been organizing a course in Veterinary Public Health and Animal Production for over the last 10 years. This course has been intended for Dutch as well as foreign final-year veterinary students and recent veterinary graduates. By bringing together participants from different countries, the course reinforces the international dimension of the issues addressed through the exchange of experiences by the participants themselves. The present article provides information about this course on Veterinary Public Health (VPH): it discusses logistics, didactical approaches, the course program, and the use of information and communication technology (ICT). Special attention is given to the intercultural aspects of higher education, all of which play an important role in the efficient exchange of knowledge between lecturers and students. International courses are an important tool to enable participants to interact in a multicultural environment and address issues that demand international cooperation and a global public health focus.     

Uses of informatics to solve real world problems in veterinary medicine

Veterinary informatics is the science of structuring, analyzing, and leveraging information in an effort to advance animal health, disease surveillance, research, education, and business practices. Reference and terminology standards are core components of the informatics infrastructure. This paper focuses on three current activities that use reference standards in veterinary informatics: (1) the construction of a messaging standard in a national animal health laboratory network, (2) the creation of breed and species terminology lists for livestock disease surveillance, and (3) the development of a standardized diagnoses list for small animal practices. These and other endeavors will benefit from research conducted to identify innovative and superior tools, methods, and techniques. The authors believe there are many areas requiring study and special focus in order to advance veterinary informatics, and this paper highlights some of the needs and challenges surrounding these areas.     

Epidemiology and quality assurance: applications at farm level

Animal production is relevant with respect to farm income and the position of the sector in the market, but also with respect to the quality and safety of products of animal origin, related to public health. Animal production is part of a chain of food production. Therefore, producers have to take consumer expectations and demands in the domains of animal health, welfare and environment into account. A different attitude for production has to be adopted; this attitude can be visualized in good farming practice, GFP, codes. Farmers who focused on quality in its broadest sense need a system supporting them in their management and control of quality risks. Generally speaking, there are three systems for that purpose: GFP, ISO and HACCP. When the hypothesis followed relates to animal health being a feature of quality, or else welfare and environmental issues, then animal health care can be executed following quality control principles. The HACCP concept is well suited for quality control at farm level, involving risk identification and risk management. The on-farm monitoring and surveillance system of critical control points in the animal production process is the most important tool in this procedure. Principles for HACCP application as well as certification fitness of HACCP are elaborated upon. They are illustrated by using salmonellosis in meat-pig farms as objective for an HACCP approach. It is further discussed that, in addition to animal health and quality, animal welfare and environmental issues could also be covered by an HACCP-like system in an integrated manner. Ultimately, the HACCP modules could end up in an overall ISO certification.