Hawaii veterinarians' bioterrorism preparedness needs assessment survey

The purpose of this study was to assess the objective bioterrorism-related knowledge base and the perceived response readiness of veterinarians in Hawaii to a bioterrorism event, and also to identify variables associated with knowledge-based test performance. An anonymous survey instrument was mailed to all licensed veterinarians residing in Hawaii (N = 229) up to three times during June and July 2004, using numeric identifiers to track non-respondents. The response rate for deliverable surveys was 59% (125 of 212). Only 12% (15 of 123) of respondents reported having had prior training on bioterrorism. Forty-four percent (55 of 125) reported being able to identify a bioterrorism event in animal populations; however, only 17% (21 of 125) felt able to recognize a bioterrorism event in human populations. Only 16% (20 of 123) felt they were able to respond effectively to a bioterrorist attack. Over 90% (106 of 116) expressed their willingness to provide assistance to the state in its response to a bioterrorist event. Veterinarians scored a mean of 70% correct (5.6 out of 8 questions) on the objective knowledge-based questions. Additional bioterrorism preparedness training should be made available, both in the form of continuing educational offerings for practicing veterinarians and as a component of the curriculum in veterinary schools.     

Perceptions of state public health officers and state veterinarians regarding risks of bioterrorism in the United States

OBJECTIVE:To assess perceptions of state public health officers and state veterinarians in the United States regarding the risks of bioterrorism and determine the degree of support provided for activities related to bioterrorism. DESIGN: Cross-sectional survey. SAMPLE POPULATION: State public health officers and state veterinarians. PROCEDURE: A questionnaire was sent between April and June 2001 to the state public health officer and state veterinarian in each of the 50 states and the District of Columbia. RESULTS: Perceptions of the risk of bioterrorism attacks were similar for state public health officers and state veterinarians. Veterinarians perceived the risks associated with foot-and-mouth disease and Newcastle disease to be higher than did physicians. State veterinarians perceived the risks associated with an anthrax hoax, brucellosis, and ricin toxicosis to be lower than did state public health officers. Risk posed by agents that affected animals exclusively was perceived to be higher than risk posed by agents that affected humans exclusively and zoonotic agents. Number of full-time-equivalent positions devoted to bioterrorism surveillance and percentage of the budget devoted to bioterrorism activities were significantly lower for offices run by state veterinarians than for offices run by state public health officers. State veterinarians were significantly less likely to have knowledge of bioterrorism incidents within their state or district than were state public health officers. CONCLUSIONS AND CLINICAL RELEVANCE: Provision of additional resources to state veterinarians and explicit integration of their expertise and surveillance capabilities may be important to effectively mitigate the risk of bioterrorism.     

Veterinarians and public health: the Epidemic Intelligence Service of the Centers for Disease Control and Prevention, 1951-2002

Public health affords important and exciting career opportunities for veterinarians. The Epidemic Intelligence Service Program (EIS) of the Centers for Disease Prevention and Control (CDC) is a two-year post-graduate program of service and on-the-job training for health professionals, including veterinarians, who are interested in careers in epidemiology and public health. EIS serves as a major point of entry into the public health arena. Veterinarians applying to the program must have a Master of Public Health or equivalent degree, or demonstrated public health experience or course work. EIS officers are assigned to positions at CDC headquarters or in state and local health departments. During two-year assignments, they are trained in applied epidemiology, biostatistics, conducting outbreak investigations, emergency preparedness and response, and scientific communications. They conduct epidemiologic outbreak and other investigations, perform applied research and public health surveillance, serve the epidemiologic needs of state health departments, present at scientific and medical conferences, publish in the scientific literature, and disseminate vital public health information to the media and the public. EIS officers apply their training and skills to actual public health problems and issues, establish mentorships with recognized experts from CDC and other national and international health agencies, and travel domestically and internationally. Since 1951, 195 veterinarians have graduated from the program and gone on to make substantial contributions to public health in positions with federal, state, or local governments, academia, industry, and non-governmental organizations.     

A survey of teaching and implementation: the veterinarian's role in recognizing and reporting abuse.

Many families seeking assistance from domestic violence agencies are known to local humane societies or animal control officials because of previous incidents of animal abuse. This is because pets are often the first victims of family disputes that erupt into violence. Analysis of domestic violence statistics indicates that veterinarians potentially treat hundreds of thousands of abused pets each year. Because veterinarians may be the first or only individuals to have access to abusive family situations, it is it important for veterinarians to be aware of potential signs of abuse of pets and their owners and to be familiar with the mechanisms for reporting suspected incidents of abuse. Thirty-one North American veterinary schools and a sample of large and small animal practitioners in Indiana were surveyed to understand to what degree current veterinary curricula prepare students to recognize abuse of animal patients and human clients and to what extent practitioners recognize and report their suspicions of abuse to appropriate authorities. The data indicate a discrepancy between beliefs about prevalence of abuse and the amount of time spent educating veterinary students to recognize and report that abuse. I hypothesize that: 1) practicing veterinarians are reluctant to report suspicions of domestic family violence directed against animals, children, or spouses for various reasons (e.g., lack of adequate training, fear of litigation, time constraints, fear that violence will escalate, belief that it is not their place to intervene, lack of contact information, fear of losing a client's business); 2) practicing veterinarians (in large and small animal practices) may not be aware that animal patients and human clients may have been abused and being unfamiliar with this diagnosis, are unfamiliar with the mechanism for reporting the abuse, especially when it involves human victims; and 3) veterinary school curricula could be modified so that veterinary students are trained to recognize human and animal abuse, thereby reducing risks to animal patients, other animals in the household, and human clients. I believe that recognition of animal and human abuse is in line with veterinarians' responsibilities to protect animal health, relieve animal suffering, and promote public health.     

Historical perspective and future directions in training of veterinary pathologists with an emphasis on zoo and wildlife species

This article discusses the history of the field of zoo and wildlife pathology, training opportunities for veterinary students and graduate veterinarians, and current and future job opportunities. The niches occupied by veterinarians in this field and their contributions to animal and human health are also highlighted. The field of zoo and wildlife, or "non-traditional" species, pathology has its roots in comparative anatomy, zoology, wildlife biology, and medical pathology in the mid- to late nineteenth century. The initial emphasis was on comparisons between animal and human diseases or on management of game animals. Veterinarians became increasingly involved during the twentieth century, gradually changing the emphasis to improvement of conservation strategies, captive care, and elucidation of diseases of concern for the animals themselves. Currently there are several zoos and wildlife agencies in the United States employing full-time veterinary pathologists. Private and government diagnostic laboratories, veterinary schools, and other academic institutions in the United States with pathology departments are other employers. The field requires post-DVM training by means of a residency program leading to board certification, graduate school (MS or PhD degrees), or both. Veterinary students can gain valuable experience in the field through externships and, at some schools, through elective courses in the curriculum. Current concerns about ecosystem health, bioterrorism, and the recognition that captive and free-ranging wildlife can serve as sentinel species will increase the demand for veterinary pathologists choosing this very rewarding career path specializing in non-traditional species.     

The future of training for aquatic animal health veterinarians

This article describes educational approaches for training veterinary students, veterinary graduates, and practicing veterinarians in the area of aquatic animal health and lists a range of general research, training, internship/residency, and continuing-education resources.     

Reaching beyond our walls: library outreach to veterinary practitioners

The Texas A&M University Medical Sciences Library (MSL) supports lifelong learning for Texas veterinarians and College of Veterinary Medicine and Biomedical Sciences (CVMBS) alumni through several ongoing outreach efforts. The MSL provides free document delivery and literature search services to practicing veterinarians in support of patient care. The MSL also responded to unique opportunities to expand services and increase its visibility through collaborations with the American Association of Equine Practitioners and CABI, provider of VetMed Resource. The MSL continues to explore ways to expand its mission-critical veterinary outreach work and market library services to veterinarians through participation in continuing education, regional meetings, and veterinary student instruction.     

A survey concerning the equine fescue toxicosis malady

The objective of this research was to determine the scope of equine fescue toxicosis, current procedures to control the disease, and to gain veterinary insight to possible new therapies. A survey was developed with help form experts in the area of fescue toxicosis. From a list of members of the American Veterinary Medical Association (AVMA), a sample was obtained by selecting large animal/equine veterinarians from states where fescue toxicosis is common. These states included: Alabama, Arkansas, Georgia, Illinois, Indiana, Kentucky, Missouri, Mississippi, North Carolina, Ohio, South Carolina, Tennessee, Virginia, and West Virginia. One-fifteenth of the veterinarians (515 total) were mailed questionnaires; 207 responded. Veterinarians were grouped into regions based on latitude. Region 1 included veterinarians practicing north of 39.0° latitude; Region 2 included veterinarians practicing between 36.5° and 39.0° latitude; and Region 3 included veterinarians practicing south of 36.5° latitude.A majority of horse pasture in the area of the survey is comprised of at least 50% fescue, with approximately 70% of the pasture being at least partially comprised, of fescue.Almost 50% of the brood mares in the area of the survey are exposed to endophyte-infected fescue. Many gravid brood mares in the area of the survey were suffering from acute and subacute symptoms, with over 43% warranting some kind of management technique to prevent toxicity from occurring. A large majority of veterinarians in the area of the survey feel that fescue toxicosis is, to some level, a problem. Current management techniques can be tedious and expensive. New management techniques and/or therapies are needed to handle the problems associated with equine fescue toxicosis. A large majority of veterinarians in the area of the survey feel an effective drug therapy would be valuable in treating equine fescue toxicosis. If a drug therapy were developed, a daily feed additive or an oral gel would be the most popular method of dosing with veterinarians.As a result of trends noticed in the rates of equine fescue toxicosis in different areas, statistical analyses were conducted on data generated from this survey along regions that seemed to have different infection rates. There was no difference (P>0.05) in levels of fescue in pastures, mare exposure to the endophyte, and mare expression of acute or subacute symptoms between regions 2 and 3. There was a difference (P<0.05) between region 1 and regions 2 and 3 for all of the factors tested except for number of mares seen by veterinarians.     

The Ontario Animal Health Network: enhancing disease surveillance and information sharing through integrative data sharing and management

The Ontario Animal Health Network (OAHN) is an innovative disease surveillance program created to enhance preparedness, early detection, and response to animal disease in Ontario. Laboratory data and, where available, abattoir condemnation data and clinical observations submitted by practicing veterinarians form the core of regular discussions of the species-sector networks. Each network is comprised of government veterinarians or specialists, epidemiologists, pathologists, university species specialists, industry stakeholders, and practicing veterinarians, as appropriate. Laboratorians provide data for diseases of interest as determined by the individual network, and network members provide analysis and context for the large volume of information. Networks assess data for disease trends and the emergence of new clinical syndromes, as well as generate information on the health and disease status for each sector in the province. Members assess data validity and quality, which may be limited by multiple factors. Interpretation of laboratory tests and antimicrobial resistance trends without available clinical histories can be challenging. Extrapolation of disease incidence or risk from laboratory submissions to broader species populations must be done with caution. Disease information is communicated in a variety of media to inform veterinary and agricultural sectors of regional disease risks. Through network engagement, information gaps have been addressed, such as educational initiatives to improve sample submissions and enhance diagnostic outcomes, and the development of applied network-driven research. These diverse network initiatives, developed after careful assessment of laboratory and other data, demonstrate that novel approaches to analysis and interpretation can result in a variety of disease risk mitigation actions.     

Purdue University graduate certificate program in Veterinary Homeland Security

Our nation lacks a critical mass of professionals trained to prevent and respond to food- and animal-related emergencies. Training veterinarians provides an immediate means of addressing this shortage of experts. Achievement of critical mass to effectively address animal-related emergencies is expedited by concurrent training of professionals and graduate students in related areas. Purdue University offers a Web-based Graduate Certificate in Veterinary Homeland Security to address this special area of need. The program is a collaborative effort among the Purdue University School of Veterinary Medicine, the Purdue Homeland Security Institute, the Indiana State Board of Animal Health, the Indiana State Police, and others with the overall goal of increasing capacity and preparedness to manage animal-related emergencies. Individuals with expertise in veterinary medicine, public health, animal science, or homeland security are encouraged to participate. The Web-based system allows courses to be delivered efficiently and effectively around the world and allows participants to continue their graduate education while maintaining full-time jobs. Participants enhance their understanding of natural and intentional threats to animal health, strengthen their skills in managing animal-health emergencies, and develop problem-solving expertise to become effective members of animal emergency response teams and of their communities. Students receive graduate credit from Purdue University that can be used toward the certificate and toward an advanced graduate degree. Currently, 70 participants from 28 states; Washington, DC; Singapore; and Bermuda are enrolled.     

Response of a veterinary college to career development needs identified in the KPMG LLP study and the executive summary of the Brakke study: a combined MBA/DVM program, business certificate program, and curricular modifications

In the present market, veterinarians with a strong background in career development, practice management, and business skills have a clear advantage in achieving financial success. Although there is ample evidence that the scientific and clinical skills of veterinary college graduates are high, there are also data that suggest that additional capabilities in the business realm may promote greater economic success. As noted in the KPMG executive summary, the field of veterinary medicine must make changes in its "current business practices and attitudes" to be successful in the future. Furthermore, the KPMG study found that 36% of industry employers reported that some jobs within their companies had specific job requirements that were not met by a veterinarian with only a veterinary medical degree. The areas of additional training most often cited included business, administration, personnel management, sales and marketing, and financial skills. Yet, Lewis and Klausner found that veterinarians reported challenges in the business realm, such as "how business works and how business goals are translated into action. This challenge held true for veterinarians in industry, academia, government, and private practice." The present gender trends in the field of veterinary medicine provide additional impetus to make career development and business skills training more prevalent. Presently, women comprise >65% of the veterinary student population and approximately 45% of all practicing veterinarians. In some areas of practice, the rate is much higher. For example, in 2002, women comprised 48.2% of all small animal exclusive private practitioners. Unfortunately, the KPMG study found that female veterinarians in private practice report lower self-evaluation of business management and financial skills, compared with their male cohorts. Female veterinarians in nonprivate practice report lower self-evaluation in communication, personnel management, business management, and marketing skills than that reported by males. As a result of these pressing needs, CSU CVMBS has undertaken a major initiative to improve the veterinary practice management and business skills training of veterinary students by offering a variety of options to gain this knowledge: a combined MBA/DVM degree program, a Business Certificate Program for Health Professions, and core curriculum courses. In this way, students can select the amount of focus they want to place on career development and business skills as they earn their DVM degree, to best ensure that they become successful veterinarians.     

The future of veterinary medicine in poultry production

The poultry industry is a highly complex food-animal production system. Its success is dependent upon sophisticated techniques and systems to ensure disease prevention and product quality. Poultry veterinarians play a key role in the overall business and are typically the only individuals within poultry companies who are involved in the entire production process, including production management, health management, product quality, nutrition, and economics. Preparing veterinarians to work effectively in the poultry industry can no longer be accomplished within the DVM instructional program. Post-DVM training programs specializing in poultry medicine are now producing the veterinarians entering the North American poultry industry. Regionalization of training in poultry medicine has already taken place. These training programs are very important to food animal production in North America; in the future, they must be nurtured and supported in order to remain able to supply the veterinary workforce for our dynamic poultry industry.     

Current and future trends in demographics of veterinary medicine in California

OBJECTIVE: To evaluate the present and future supply of veterinarians in California, in light of changing trends in animal ownership. DESIGN: Database analysis. SAMPLE POPULATION: Human and animal populations, including populations of veterinarians, throughout the United States. PROCEDURES: Data on animal and human populations were compiled from a number of sources, including the US Census Bureau, American Veterinary Medical Association, State of California Department of Finance, and State of California Veterinary Medical Board. The distribution of veterinarians in California was contrasted with other health professionals in California and with that of veterinarians in other states. Recent changes in veterinary medical demographics in California were quantified and used to develop in-state projections about the supply of veterinarians for the next 20 years. RESULTS: Although California is the most populous of the 50 states, only 7 states had fewer veterinarians per capita. Furthermore, California ranked next to last among states in increase of number of veterinarians between 1990 and 1995. Los Angeles County had the smallest per-capita number of veterinarians among 9 populous California counties. During that period, California had a net gain of only 6 veterinarians who were exclusively or predominantly large-animal or mixed-animal practitioners. CONCLUSIONS AND CLINICAL RELEVANCE: If current trends continue, the per-capita number of veterinarians will continue to decrease in California. To maintain the current ratio of 17.8 veterinarians/100,000 people in California in the future, we estimate that an additional 50 veterinarians above the currently predicted increase will be required annually.     

Veterinary accreditation and some new imperatives for national preparedness

IN the first of a 5-part series of articles examining the role of the veterinary profession in national preparedness, the authors examine the skills, knowledge, and aptitudes expected of accredited veterinarians and discuss additional skills and knowledge likely to be expected in the future.     

Reports of zoonotic disease outbreaks associated with animal exhibits and availability of recommendations for preventing zoonotic disease transmission from animals to people in such settings

OBJECTIVE: To assess the number of zoonotic disease outbreaks associated with animal exhibits and identify published recommendations for preventing zoonotic disease transmission from animals to people in exhibit settings. DESIGN: Literature review and survey of state public health veterinarians and state epidemiologists. PROCEDURE: MEDLINE and agriculture databases were searched from 1966 through 2000. Retrieved references and additional resources provided by the authors were reviewed. A survey was sent to state public health veterinarians and state epidemiologists to determine whether their states had written recommendations or guidelines for controlling zoonotic diseases in animal exhibition venues, whether their states maintained a listing of animal exhibitors in the state, and whether they had any information on recent outbreaks involving animals in exhibitions. RESULTS: 11 published outbreaks were identified. These outbreaks occurred in a variety of settings including petting zoos, farms, and a zoological park. An additional episode involving exposure to a potentially rabid bear required extensive public health resources. A survey of state public health veterinarians identified 16 additional unpublished outbreaks or incidents. Most states did not have written recommendations or guidelines for controlling zoonotic diseases or any means to disseminate educational materials to animal exhibitors. CONCLUSIONS: Recent outbreaks of zoonotic diseases associated with contact with animals in exhibition venues highlight concerns for disease transmission to public visitors. Only a handful of states have written guidelines for preventing zoonotic disease transmission in animal exhibition venues, and published recommendations currently available focus on preventing enteric diseases and largely do not address other zoonotic diseases or prevention of bite wounds.     

Veterinary medicine protecting and promoting the public's health and well-being

Dr. Calvin Schwabe's vision of "One Medicine" has long inspired many in the public health community to strive toward bringing human and veterinary medicine together to improve the public's health and well-being around the world. In an increasingly human-dominated world, as Dr. Schwabe suggested many years ago, human health provides the most-logical unifying or apical cause in veterinary medicine's hierarchy of values. Veterinarians in all aspects of the profession-have opportunity and responsibility to protect the health and well-being of people in all that they do, including protecting food security and safety; addressing threats to antibiotic sensitivity; preventing and controlling zoonotic emerging infectious diseases; protecting environments and ecosystems; participating in bio- and agro-terrorism preparedness and response; using their skills to confront non-zoonotic diseases (such as malaria, HIV/AIDS, vaccine preventable diseases, chronic diseases and injuries); strengthening the public-health infrastructure; and advancing medical science through research. This article provides an overview of contributions made by veterinarians in each of these areas, and discusses the challenges to be overcome and the need for strategic thinking and action to achieve the vision of "one medicine".     

Bioterrorism and equids

A bioterrorism attack can affect the health of many different populations, even those that were not intended as targets. Whether the aim of an attack is humans, animals or crops, the result can be manifested in many species, including equids. Equids comprise a multibillion-dollar industry in the United States, and any disease that affects this trade can have a devastating impact on the economy. In addition, equids could potentially serve as sentinels of an attack against humans, or as amplifying hosts for certain diseases. Knowledge of what diseases have the greatest potential as bioterrorist or agroterrorist agents, how they may present, and what preventive measures are needed to stop their spread is the first step in preparedness. Surveillance for disease outbreaks in equids should be ongoing, with immediate reporting of any unusual findings to the appropriate veterinary and public health authorities.     

Number and distribution of Australian veterinarians in 1981, 1991 and 2001

OBJECTIVE: To analyse the number and distribution of the Australian veterinary work-force, and to assess changes in it that have occurred since 1981. PROCEDURE: The postcode and gender of each veterinarian who was registered, resident and apparently working in each state and territory in 1981, 1991 and 2001 was obtained from veterinary board lists, entered on an Excel data base, and analysed using the statistical program SAS System 7 for Windows 95. The Official Australian Postcode Map was used to determine the location of postcode areas, and publications of the Australian Bureau of Statistics provided data on human populations. RESULTS: At the end of June 2001, 6358 veterinarians were registered, resident and apparently working in a state or territory of Australia. This was 100% higher than in 1981. Over the intervening 20 years, the number had increased by 3181, 2001 of whom were female. Between 1981 and 1991 the increase in major cities was 898 and in rural areas 682, of whom 357 were male. Between 1991 and 2001 the increase in cities was 1139 and rural areas 462, of whom only 98 were male. The density of veterinarians in Australia - 330/million people - is higher than in the UK (213/million), USA (218/million) and Canada (250/million). CONCLUSIONS: The relative number of veterinarians in Australia is now higher than in the UK, USA and Canada, and is likely to continue to increase. There is evidence of maldistribution, with many rural practices facing shortages of veterinarians with the experience and inclination to maintain veterinary services over the longer term, and some cities likely to become overcrowded with veterinarians.