International programs and veterinary public health in the Americas--success, challenges, and possibilities

The veterinary public health (VPH) program at the Pan American Health Organization (PAHO) began in 1949 when an arrangement with the newly founded World Health Organization made PAHO its Regional Office for the Americas to serve as the specialized health agency both for the Organization of American States and the United Nations. It started as a Section of Veterinary Medicine to help eradicate rabies on both sides of the US-Mexico border, and PAHO grew to be the biggest VPH program in the world. By providing a political and technical base, PAHO assisted its member states to organize and develop their national VPH programs and activities, and it provides technical cooperation and works with their national counterparts to solve national and local problems. In the 1980s and 1990s, PAHO concentrated that cooperation on several, specific needs: the elimination of dog-transmitted human rabies, hemispheric eradication of foot-and-mouth disease (FMD), regional action planning for food safety, control/eradication of bovine tuberculosis and brucellosis, and surveillance and prevention of emerging zoonoses and food-borne diseases. The Pan American centers developed a number of diagnostic antigens and a continental system for the surveillance of FMD and vesicular diseases, using geographic quadrant technology to augment sensitivity, analyze data, and make decisions. Another visible accomplishment is the elimination of hydatidosis in the endemic countries and regions of the southern cone. In addition, the VPH program of PAHO pioneered the mobilization of the private sector to participate in official programs. Nevertheless, privatization of animal and human health services has had a negative effect on human resources and infrastructure by weakening essential epidemiological functions in some countries. Today, there is a need for closer coordination between veterinary medicine and medical services. Practically all potential bioterrorism agents are zoonoses, and it is cost-effective to control them at the veterinary level, providing the first line of defense. The opportunities for VPH are boundless, but the challenge is to be able to apply the plethora of available research results and knowledge. What we will need is a new breed of veterinarians who will lead and provide us with a vision, like those we honored in 2005 at the Schwabe Symposium Honoring the Lifetime Achievements of Dr. James H. Steele: veterinarians in public health who will be in the forefront of policy setting, decision-making, and allocation of resources, and veterinarians who will articulate and provide a strategic direction to our unique professional skills.     

New approaches for education and training in veterinary public health: the SAPUVET projects

Continued contact between humans and animals, in combination with the ever-increasing movement of human and animal populations that is one effect of globalization, contributes to the spread of diseases, often with detrimental effects on public health. This has led professionals involved in both animal health and public health to recognize veterinary public health (VPH) as a key area for their activities to address the human-animal interface. Veterinarians, a profession with major involvement in this field, are in need of specific knowledge and skills to prevent and control public-health problems. As a result, VPH must be directly integrated into veterinary educational programs. At present, only few veterinary schools have specific VPH programs; in most institutions, VPH does not feature as a specific subject in either undergraduate or post-graduate curricula. SAPUVET and SAPUVETNET II are network projects supported by the ALFA program of the European Union (EU). Their main objectives are to reach a common understanding between European and Latin American universities in the definition of the areas in which VPH is important in their respective countries, and to design a harmonized training program for veterinarians in VPH, by making use of new technological applications and innovative teaching methodologies. The elaboration of educational material in combination with case studies presenting real-life problems provides a basis to apply the knowledge acquired on VPH. It is envisaged that the material and modules developed during the two projects will be integrated into the veterinary curricula of the participating universities, as well as in other partner organizations.     

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.     

A new approach to teaching veterinary public health at the Ohio State University

Public-health practitioners with expertise in the area of veterinary public health are expected to understand the prevention and control of zoonotic infectious diseases in both human and animal populations. This focus on multiple species is what makes the veterinary public health (VPH) official unique. The development of a new VPH specialization within the existing Master of Public Health (MPH) degree program at the Ohio State University represents a significant new collaboration between the College of Veterinary Medicine and the College of Public Health. The main objective of the VPH specialization is to educate and train professionals to provide them with the skills, knowledge, and resources necessary to protect and improve human health using a One Medicine approach. The program targets a population of students who will likely enter the professional veterinary medicine curriculum but have one year available to enhance their preparatory training in health sciences before beginning the program. A core series of VPH courses was initiated to complement the existing MPH course requirements. The program has been successful in attracting students from the primary target population, but it has also attracted students wanting the MPH as a terminal degree and veterinarians returning to school to expand their career options.     

Global veterinary leadership.

The public needs no reminder that deadly infectious diseases such as FMD could emerge in any country at any moment, or that national food security could be compromised by Salmonella or Listeria infections. Protections against these risks include the knowledge that appropriate and equivalent veterinary education will enable detection and characterization of emerging disease agents, as well as an appropriate response, wherever they occur. Global veterinary leadership is needed to reduce the global threat of infectious diseases of major food animal and public health importance. We believe that the co-curriculum is an excellent way to prepare and train veterinarians and future leaders who understand and can deal with global issues. The key to the success of the program is the veterinarian's understanding that there is a cultural basis to the practice of veterinary medicine in any country. The result will be a cadre of veterinarians, faculty, and other professionals who are better able (language and culture) to understand the effects of change brought about by free trade and the importance of interdisciplinary and institutional relationships to deal effectively with national and regional issues of food safety and security. New global veterinary leadership programs will build on interests, experience, ideas, and ambitions. A college that wishes to take advantage of this diversity must offer opportunities that interest veterinarians throughout their careers and that preferably connect academic study with intensive experiential training in another country. At its best, the global veterinary leadership program would include a partnership between veterinarians and several international learning centers, a responsiveness to the identified international outreach needs of the profession, and attention to critical thinking and reflection. The global veterinary leadership program we have described is intended to be a set of ideas meant to promote collaboration, coalitions, and discussion among veterinarians and veterinary educators who may be intrigued by the concept. The impact of the program can be summarized as follows: Outreach Programs: The global veterinary leadership program will establish new partnerships between veterinarians and veterinary college faculty as they supervise the international internships and see a relationship between their goals and the value of food safety to this country. Strategic Opportunity: The program will build on the critical role that US veterinarians and veterinary colleges already play in strengthening the safety of free trade in this hemisphere. Diversity in an Age of Specialization: The program will combine a global orientation, language ability, and access to comprehensive, research- and economic-related work/study opportunities to expose veterinarians to the expanding world market for veterinary expertise. New Linkages Through Corporate Partners: Through the success and high visibility of current research and education programs, most veterinary colleges are well positioned to engage industry, government, and university leaders in ways to use the proposed program to increase the flow of new ideas and talent into the world food enterprise. International Funding: A new partnership among veterinarians, industry, government, and university leaders can coordinate strong multilateral requests for funding from national and international sources. An Interdisciplinary Strategy that Benefits Veterinary Medicine: The program will combine the diverse veterinary research and education system with our strong national and international network of collaborators to provide globally competent veterinarians who will be needed for the corporate and public opportunities of the future.     

在“同一个健康”框架下,加强兽医与人医合作,有效监测和应对人畜共患病和新发传染病

新发传染病主要是人畜共患病,是世界经济和公共健康的沉重负担。这就要求加强检测、鉴别和监视传染病的能力方面投入。高致病禽流感H5N1、新甲型流感("猪流感")H1N1、非典型性肺炎、西尼罗河病毒、地方流行性狂犬病、布鲁氏菌病以及发展中国家暴发的其它人畜共患病及近期猪抗甲氧西林金黄色葡萄球菌,是人类、动物及其环境相互作用的典型范例。面临中国动物和人类常见的新发传染病坚持"同一个健康"战略,这就要求业已存在的兽医和人医及公共卫生机构的通力合作。人的疾病控制系统与动物疾病控制系统虽然都已经建立,但人畜共患病的暴发表明兽医机构和人医机构密切合作的重要性。在保证环境健康的同时,通过动物疾病和人类疾病监测系统的密切合作,中国就一定能够控制人畜共患病。以这种方式进行疾病预防、监测与应对,各层面及各动物生产部门间有效的兽医推广是加强和保持健康生态环境中人和动物健康的有效办法。中国还需大量努力才能达到从制度上保证预防和消灭疾病。透明而准确的人与动物疾病监督通常会产生经济且可持续的预防疾病方法。加拿大在兽医、公共健康、食品安全和人畜共患病预防方面所发挥的作用就是与中国农业部合作,促进必要的、可持续的兽医监督网络的建设。     

Intestinal parasites of dogs and cats in Australia: The veterinarian’s perspective and pet owner awareness

During a recent national study of intestinal parasites in dogs and cats in Australia, questionnaires were submitted to veterinarians and pet owners to evaluate from a veterinary and public health standpoint the veterinarians’ perception, awareness and knowledge of gastrointestinal parasites in their locality. The study included sourcing information with regard to commonly recommended deworming protocols. The awareness of pet owners regarding parasitic zoonoses and the degree of education provided to them by veterinarians was also determined.Very few veterinarians routinely discussed the zoonotic potential of pet parasites with clients but most recommended regular prophylactic administration of anthelmintics throughout a pet’s life. Some pet owners were unaware of the existence of zoonoses. It is possible that an overreliance on anthelmintics may have led to a certain complacency about the need to educate pet owners about the risks of zoonoses. Veterinarians are important educators in the community and it is important to evaluate their performance if improvements are to be made.     

The zoonosis-prone veterinarian

A study of 1,182 Illinois veterinarians revealed that 833 had experienced an accident, and of these 833, 42.7% also had experienced a zoonosis. Brucellosis and animal bites were especially prevalent zoonoses. This percentage differed significantly (P less than 0.01) from the 32.4% of 349 accident-free veterinarians who had experienced zoonoses. The prevalence of zoonoses was even higher (50%) among veterinarians with a history of 3 or more accidents. The prevalence of 16 nonzoonotic health conditions was similar in veterinarians who had experienced an accident and in the total veterinary population, demonstrating a degree of specificity to the accident-zoonosis association. Of the subjects studied, 5.7% had experienced 16.5% of the events, accidents or zoonoses. The subgroup that had experienced 5 or more events and the subgroup that experienced no events differed in many characteristics from the total veterinary population. The biological importance of the characteristics of these veterinarians remains to be determined. The hypothesis was advanced that zoonoses can be considered occupational accidents in veterinarians and that certain veterinarians are zoonosis prone. If true, this hypothesis also might apply to certain communicable diseases in the general human population.     

A survey of pet ownership, awareness and public knowledge of pet zoonoses with particular reference to roundworms and hookworms in Harare, Zimbabwe

A cross-sectional questionnaire-based survey was carried out in Harare to assess pet ownership and public awareness with regard to pet zoonoses. The questionnaire was designed to obtain information on pet ownership, health and welfare of pets, pet owners’ knowledge and awareness of pet zoonoses with particular emphasis on hookworms and roundworms. The results demonstrated that the proportion of pet owners who knew helminths as zoonoses in dogs (21.3%) and cats (1.1%) was low compared to rabies (95.7%) with ancylostomosis (4.3%) and toxocariosis (2.1%) being the specific parasitic zoonoses known to occur in dogs and toxoplasmosis (2.1%) in cats. More than 50% of the pet owners indicated that veterinarians never discussed the potential hazards of zoonoses or discussed it only when asked and 33% indicated that veterinarians initiated discussion of the subject whenever zoonoses were diagnosed in pets. Over 90% of the pet owners indicated that veterinarians should discuss zoonoses with them. Further investigations are necessary to determine the current prevalence of intestinal nematode infections in dogs and cats in the various regions of the country.     

Veterinary public health in a problem-based learning curriculum at the Western University of Health Sciences

As detailed in the Association of Schools of Public Health / Association of American Veterinary Medical Colleges 2007 Joint Symposium on Veterinary Public Health, veterinary public health (VPH) can no longer be viewed as a unique sub-specialty of veterinary medicine. Rather, its practice pervades nearly every aspect of the veterinary profession, regardless of whether the practitioner is engaged in small-animal, large-animal, research, corporate, or military practice. In congruence with the practice of VPH, the teaching of VPH should also pervade nearly every aspect of veterinary education. Accordingly, at Western University of Health Sciences, College of Veterinary Medicine (WU-CVM), public health is not simply taught as an individual course but, rather, is interwoven into almost every aspect of the curriculum, continually emphasizing the relevance of this discipline to the practice of veterinary medicine. This article outlines the teaching philosophy of WU-CVM, provides an overview of the curriculum, and describes the integral nature of public health throughout all four years of the educational program.     

Zoological medicine and public health

Public-health issues regarding zoological collections and free-ranging wildlife have historically been linked to the risk of transmission of zoonotic diseases and accidents relating to bites or injection of venom or toxins by venomous animals. It is only recently that major consideration has been given worldwide to the role of the veterinary profession in contributing to investigating zoonotic diseases in free-ranging wildlife and integrating the concept of public health into the management activities of game preserves and wildlife parks. At the veterinary undergraduate level, courses in basic epidemiology, which should include outbreak investigation and disease surveillance, but also in population medicine, in infectious and parasitic diseases (especially new and emerging or re-emerging zoonoses), and in ecology should be part of the core curriculum. Foreign diseases, especially dealing with zoonotic diseases that are major threats because of possible agro-terrorism or spread of zoonoses, need to be taught in veterinary college curricula. Furthermore, knowledge of the principles of ecology and ecosystems should be acquired either during pre-veterinary studies or, at least, at the beginning of the veterinary curriculum. At the post-graduate level, master's degrees in preventive veterinary medicine, ecology and environmental health, or public health with an emphasis on infectious diseases should be offered to veterinarians seeking job opportunities in public health and wildlife management.     

Toward harmonization of the European food hygiene/veterinary public health curriculum

Prompted by developments in the agri-food industry and associated recent changes in European legislation, the responsibilities of veterinarians professionally active in veterinary public health (VPH), and particularly in food hygiene (FH), have increasingly shifted from the traditional end-product control toward longitudinally integrated safety assurance. This necessitates the restructuring of university training programs to provide starting competence in this area for veterinary graduates or a sub-population of them. To date, there are substantial differences in Europe in the way in which graduate programs in FH/VPH are structured and in the time allocated to this important curricular group of subjects. Having recognized this, the European Association of Establishments for Veterinary Education (EAEVE) recently instituted a working group to analyze the current situation, with a view to produce standard operating procedures allowing fair and transparent evaluations of universities/faculties constituting its membership and in concurrence with explicit European legislation on the professional qualifications deemed necessary for this veterinary discipline. This article summarizes the main conclusions and recommendations of the working group and seeks to contribute to the international efforts to optimize veterinary training in FH/VPH.     

Healthy pets, healthy people.

Zoonoses, diseases that can be transmitted from animals to humans, can pose serious health risks to immunocompromised people. Although pets can carry zoonoses, owning and caring for animals can benefit human health. Information exists about preventing transmission of zoonoses, but not all physicians and veterinarians provide adequate and accurate information to immunocompromised pet owners. This disease prevention/health promotion project provides physicians and veterinarians with information, created specifically to share with patients and clients, about the health risks and benefits of pet ownership. Further, "Healthy Pets, Healthy People" encourages communication between veterinarians, physicians, clients, and patients and can serve as a model program for a nation-wide effort to aid health professionals in making recommendations about pet ownership for immunocompromised people.     

Texas fever, two-headed calves and the Hatch Act--100 years and counting for veterinary parasitology in the United States

The structure, historical development and major research problems confronting veterinary parasitology in the U.S.A. are reviewed 100 years after the cooperative federal-state experiment station system was authorized through passage of the Hatch Act by the U.S. Congress in 1887. The story of Texas cattle fever eradication from the American south exemplifies historical and functional aspects of the experiment station system. The distribution and importance of parasite problems of livestock, companion animals and parasitic zoonoses are summarized in the context of larger national agricultural issues.     

The Epidemiological Importance of Bats in the Transmission of Rabies to Dogs and Cats in the State of São Paulo,Brazil, Between 2005 and 2014

In Brazil, rabies control in dogs and cats was pioneered by the state of São Paulo with the adoption of the Pan American Health Organization recommendations for prophylaxis and control, which led to a reduction in rabies cases from 1994 onwards. As a result of these measures, the rabies virus (RABV) genetic lineage associated with dogs has not been found in the state since 1998, and all the cases in domestic animals reported since then have been caused by bat‐associated lineages of RABV. In the light of this, this study sought to investigate rabies cases in dogs and cats in the state of São Paulo between 2005 and 2014 and identify the associated transmission cycles by characterizing the RABV lineages responsible for these cases. Nine samples from dogs (n = 5) and from cats (n = 4) were collected between 2005 and 2014. The tenth animal, a rabid cat, was analysed by a different laboratory. The N gene nucleotide sequences obtained were analysed with the neighbor‐joining algorithm and Kimura 2‐parameter model using the MEGA 6 program. Phylogenetic analysis revealed that the genetic lineages identified in all the samples were those circulating in Brazilian bats. The findings of this study demonstrate that bats play an important role in the transmission of rabies to domestic animals in São Paulo state and that emphasis should be placed on the implementation of public policies to support surveillance of chiropterans for rabies.     

Swine and wild pigs as carriers of zoonoses]

This paper deals with zoonoses in European pig herds and wild boars in general and in particular with the risk of infection carried by veterinarians, farmers and workers handling pigs and pork in slaughterhouses and meat processing companies. Furthermore the risk of infection and intoxication as a result of pork consumption is discussed. Special reference is made to the responsibility of veterinarians for keeping production animals healthy and informing animal owners and consumers about zoonoses. It would appear that it will be necessary in future to intensify veterinarian herd care, perform regional monitoring and surveillance programmes, participate in establishing specific pathogen-free herds and to foster diagnosis and research into zoonoses together with human medicine.     

The needs for public health education: reflections from the 27th world veterinary congress

The needs for public health education are addressed based on papers presented at the 27th World veterinary Congress held in Tunis, Tunisia, on September 25-29, 2002. The article first summarizes the public health problems presented from developing countries, followed by the problems from developed countries. A summary of the solutions proposed or practiced by each group of speakers is presented. On the basis of the problems and solutions presented, the author suggests how education can address the problems and their solutions. The dichotomy between developed and developing countries is not new, but educational advances in veterinary public health (VPH) are required to provide the citizens of all countries with safe food and less risk of zoonotic diseases. This is true whether a country is too poor to have adequate veterinary services for good food safety and preventing major zoonoses, or is a wealthy country plagued by the emerging pathogens associated with modern intensive agriculture systems.     

Surveillance and control of rabies in La Reunion,Mayotte, and Madagascar

Mayotte and La Reunion islands are currently free of animal rabies and surveillance is performed by the French Human and Veterinary Public Health Services. However, dog rabies is still enzootic in Madagascar with 4 to 10 confirmed human cases each year. The number of antirabies medical centres in Madagascar is still scarce to provide easy access to the local population for post-exposure rabies prophylaxis. Furthermore, stray dog populations are considerable and attempts to control rabies by mass campaigns of dog vaccination have not received sufficient attention from the national health authorities. To address these challenges, an expanded program to control rabies needs to be initiated by the Malagasy authorities.     

Veterinarians and public practice at the Virginia-Maryland Regional College of Veterinary Medicine: building on a tradition of expertise and partnership

The Virginia-Maryland Regional College of Veterinary Medicine (VMRCVM), a regional veterinary college for Maryland and Virginia, has a long and unique tradition of encouraging careers in public and corporate veterinary medicine. The VMRCVM is home to the Center for Public and Corporate Veterinary Medicine (CPCVM), and each year approximately 10% of the veterinary students choose the public/corporate veterinary medicine track. The faculty of the CPCVM, and their many partners from the veterinary public practice community, teach in the veterinary curriculum and provide opportunities for students locally, nationally, and internationally during summers and the final clinical year. Graduates of the program work for government organizations, including the US Department of Agriculture, the Food and Drug Administration, and the Centers for Disease Control and Prevention, as well as in research, in industry, and for non-governmental organizations. Recent activities include securing opportunities for students, providing career counseling for graduate veterinarians interested in making a career transition, delivering continuing education, and offering a preparatory course for veterinarians sitting the board examination for the American College of Veterinary Preventive Medicine. As the VMRCVM moves forward in recognition of the changing needs of the veterinary profession, it draws on its tradition of partnership and capitalizes on the excellence of its existing program. Future plans for the CPCVM include possible expansion in the fields of public health, public policy, international veterinary medicine, organizational leadership, and the One Health initiative. Quality assurance and evaluation of the program is ongoing, with recognition that novel evaluation approaches will be useful and informative.     

Survey of veterinary extension in the United States

OBJECTIVE: To assess veterinary extension in the United States as perceived by veterinary extension personnel. DESIGN: Cross-sectional survey. SAMPLE POPULATION: Extension veterinarians in the United States. PROCEDURE: 2 surveys were designed and mailed to extension veterinarians listed by the USDA and the American Association of Extension Veterinarians. RESULTS: 34 states had > or = 1 extension veterinarian. The majority (> 60%) of extension veterinarians did not commit time to resident education and were not involved in research activities. Paradoxically, 23% of responding extension veterinarians did not report extension work. Programs for food animal producers, horse owners, and companion animal owners were provided by 100, 63, and 37% of states, respectively. Continuing education (CE) programs were provided for food animal veterinarians, equine veterinarians, and companion animal veterinarians by 96, 63, and 52% of states, respectively. Challenges facing veterinary extension included limited recognition of veterinary extension activities by universities, lack of university personnel to support CE programs, and decreased support for companion animal extension programs. CONCLUSIONS AND CLINICAL RELEVANCE: Extension veterinarians need to identify and clearly articulate the mission of veterinary extension, develop more collaborative programs across regions, and continue to serve as catalysts to bring diverse constituents together. Extension veterinarians must distinguish their mission not solely as information transfer, which can be accomplished in a variety of ways outside of extension, but as a coherent and consistent program of education and policy developed on a national level and distributed locally.