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。     

动物健康体系建设与公共卫生一体化构建研究

动物健康体系最初在澳大利亚和加拿大等国建立,在动物疾病防控方面起到了十分重要的作用.本文对澳大利亚已建立的动物健康体系和我国兽医医疗体制进行对比,分析在我国建立更合理的官方兽医制度和动物健康体系以加快兽医与人医公共卫生一体化进程的对策.     

动物健康体系构建研究

动物健康体系最初在澳大利亚和加拿大等国建立,在动物疾病防控方面起到了十分重要的作用。本文对澳大利亚已建立的动物健康体系和我国兽医医疗体制进行对比,分析在我国建立更合理的官方兽医制度和动物健康体系以加快兽医与人医公共卫生一体化进程的对策。     

Syndromic surveillance using laboratory test requests: A practical guide informed by experience with two systems

Syndromic surveillance systems can enhance early disease warning, endemic disease monitoring, or help to accumulate proof of disease freedom. In order to provide immediate feedback to achieve these goals, the health data sources scanned should be acquired continuously, in an automated fashion, and should be stored electronically. Recognizing that data from diagnostic test requests often meet these requirements, two systems designed to automatically extract surveillance information from animal laboratory databases have been developed and are described in this paper. These systems are designed to contribute to early disease detection, as well as the timely management of epidemiological information, in a province of Canada and in Sweden, the areas served by the diagnostic laboratories concerned. Classifying in-coming requests into syndromes, the first step, was the most time-consuming and the least portable step between the two systems. The remaining steps were more easily adjusted from one system to implementation in the other. These steps included: retrospective evaluation of data to create baseline profiles following the removal of excessive noise and aberrations; the identification of temporal effects; prospective evaluation of detection algorithms; and finally real-time monitoring and implementation. Building upon the institutions’ existing data management software, all steps to use those data for the purposes of syndromic surveillance were set up using open source software; as a result this approach could be readily adopted by other institutions. Relatively straight-forward development and maintenance is expected to lead to the incorporation of these systems into each institution's surveillance processes, becoming an indispensable tool for diagnosticians and epidemiologists, as well as stimulating further technical development of such systems.     

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.     

Animal health monitoring and surveillance in Switzerland

Switzerland has traditionally used a passive disease reporting system for all notifiable diseases. This type of system is not suitable for the documentation of very low prevalences (freedom from disease), sub-clinical cases and non-notifiable diseases. In order to meet the high international standards for animal health surveillance and to fulfil the general need for sound animal health data, Switzerland has evaluated the feasibility of modern monitoring and surveillance concepts. In general, the principle of active surveillance has been acquired and is now being applied whenever possible. In this paper, several examples of Swiss surveillance systems are presented and discussed. They include systematic testing of random population samples, carcase screening at abattoirs and sentinel herd monitoring.     

The Perceived Value of Passive Animal Health Surveillance: The Case of Highly Pathogenic Avian Influenza in Vietnam

Economic evaluations are critical for the assessment of the efficiency and sustainability of animal health surveillance systems and the improvement of their efficiency. Methods identifying and quantifying costs and benefits incurred by public and private actors of passive surveillance systems (i.e. actors of veterinary authorities and private actors who may report clinical signs) are needed. This study presents the evaluation of perceived costs and benefits of highly pathogenic avian influenza (HPAI) passive surveillance in Vietnam. Surveys based on participatory epidemiology methods were conducted in three provinces in Vietnam to collect data on costs and benefits resulting from the reporting of HPAI suspicions to veterinary authorities. A quantitative tool based on stated preference methods and participatory techniques was developed and applied to assess the non‐monetary costs and benefits. The study showed that poultry farmers are facing several options regarding the management of HPAI suspicions, besides reporting the following: treatment, sale or destruction of animals. The option of reporting was associated with uncertain outcome and transaction costs. Besides, actors anticipated the release of health information to cause a drop of markets prices. This cost was relevant at all levels, including farmers, veterinary authorities and private actors of the upstream sector (feed, chicks and medicine supply). One benefit associated with passive surveillance was the intervention of public services to clean farms and the environment to limit the disease spread. Private actors of the poultry sector valued information on HPAI suspicions (perceived as a non‐monetary benefit) which was mainly obtained from other private actors and media.     

Overview of issues pertaining to the manufacture, distribution, and use of antimicrobials in animals and other information relevant to animal antimicrobial use data collection in the United States

This paper provides condensed literature review and contextual information concerning antimicrobial use in animals and antimicrobial use data collection techniques. Information is summarized into the following topics: (I) antimicrobial use for animal growth promotion; (II) regulatory framework for approval of veterinary antimicrobials and feed additives in the United States; (III) animal health product manufacturing and distribution networks; (IV) existing estimates of animal antimicrobial use in the United States; (V) additional sources for animal use data in the United States; (VI) recommendations from international expert groups; (VII) animal antimicrobial use surveillance systems in other nations and (VIII) human use data collection systems in the United States.     

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.     

The state of veterinary epidemiology and economics

Recent developments in the fields of veterinary epidemiology and economics are critically reviewed and assessed. The impacts of recent technological developments in diagnosis, genetic characterisation, data processing and statistical analysis are evaluated. It is concluded that the acquisition and availability of data remains the principal constraint to the application of available techniques in veterinary epidemiology and economics, especially at population level. As more commercial producers use computerised management systems, the availability of data for analysis within herds is improving. However, consistency of recording and diagnosis remains problematic. Recent trends to the development of national livestock databases intended to provide reassurance to consumers of the safety and traceability of livestock products are potentially valuable sources of data that could lead to much more effective application of veterinary epidemiology and economics. These opportunities will be greatly enhanced if data from different sources, such as movement recording, official animal health programmes, quality assurance schemes, production recording and breed societies can be integrated. However, in order to realise such integrated databases, it will be necessary to provide absolute control of user access to guarantee data security and confidentiality. The potential applications of integrated livestock databases in analysis, modelling, decision-support, and providing management information for veterinary services and livestock producers are discussed.     

Economic Assessment of Zoonoses Surveillance in a ‘One Health’ Context: A Conceptual Framework

Collaboration between animal and public health sectors has been highlighted as a means to improve the management of zoonotic threats. This includes surveillance systems for zoonoses, where enhanced cross‐sectoral integration and sharing of information are seen as key to improved public health outcomes. Yet, there is a lack of evidence on the economic returns of such collaboration, particularly in the development and implementation of surveillance programmes. The economic assessment of surveillance in this context needs to be underpinned by the understanding of the links between zoonotic disease surveillance in animal populations and the wider public health disease mitigation process and how these relations impact on the costs and benefits of the surveillance activities. This study presents a conceptual framework of these links as a basis for the economic assessment of cross‐sectoral zoonoses surveillance with the aim of supporting the prioritization of resource allocation to surveillance. In the proposed framework, monetary, non‐monetary and intermediate or intangible cost components and benefit streams of three conceptually distinct stages of zoonotic disease mitigation are identified. In each stage, as the final disease mitigation objective varies so does the use of surveillance information generated in the animal populations for public health decision‐making. Consequently, the associated cost components and benefit streams also change. Building on the proposed framework and taking into account these links, practical steps for its application are presented and future challenges are discussed.     

Epidemiological surveillance of infectious diseases in France

Epidemiological surveillance, namely the continuous monitoring of diseases and health determinants in a population, has developed over the past fifteen years, in the sphere of human health as well as in animal health. All epidemiological surveillance networks include the following four stages: data collection, data transmission, data processing and dissemination of information. However, despite this basic similarity, the very many networks existing in France are extremely varied in nature. At the national level, the bodies involved in epidemiological surveillance for infectious animal diseases are the Direction générale de l'alimentation, the Agence fran?aise de sécurité sanitaire des aliments and, to a lesser degree, the Institut fran?ais de recherche pour l'exploitation de la mer. In the field, the networks rely on the Direction des services vétérinaires, veterinary practitioners, laboratories in each département, and livestock producers' groups (especially animal health protection groups). Some twenty French networks currently in operation are presented in this article according to a classification based on published criteria. In the case of human infectious diseases, epidemiological surveillance is carried out almost entirely by the Direction générale de la santé and the Directions départementales d'action sanitaire et sociale, the Institut de veille sanitaire and the various Centres nationaux de référence (CNRs). Most human infectious diseases are monitored by one or more of the following broad categories of networks: reporting of notifiable diseases, the CNRs, the network of sentinel doctors, the network of hospital laboratories and departments, and medical causes of death. An example where surveillance is covered by several networks is also presented, namely surveillance for salmonellosis and Salmonella. Lastly, methods for evaluating networks are discussed.     

Veterinary public health: past success, new opportunities

Animal diseases are known to be the origin of many human diseases, and there are many examples from ancient civilizations of plagues that arose from animals, domesticated and wild. Records of attempts to control zoonoses are almost as old. The early focus on food-borne illness evolved into veterinary medicine's support of public health efforts. Key historical events, disease outbreaks, and individuals responsible for their control are reviewed and serve as a foundation for understanding the current and future efforts in veterinary public health. Animal medicine and veterinary public health have been intertwined since humans first began ministrations to their families and animals. In the United States, the veterinary medical profession has effectively eliminated those major problems of animal health that had serious public health ramifications. These lessons and experiences can serve as a model for other countries. Our past must also be a reminder that the battle for human and animal health is ongoing. New agents emerge to threaten human and animal populations. With knowledge of the past, coupled with new technologies and techniques, we must be vigilant and carry on.     

OIE抗菌药耐药性国际标准

兽用抗菌药耐药性已经成为一个全球普遍关注的公共健康问题,各国际组织都积极采取相应的措施控制耐药性的产生和蔓延。介绍了国际组织世界动物卫生组织OIE制定的五个国际标准,包括协调抗菌药耐药性监督和检测程序指南、畜牧业抗菌药消耗量监测指南、兽用抗菌药慎用指南、抗菌药敏感性检测的实验室方法指南、动物源抗菌药耐药性对公共健康潜在影响的风险分析方法指南,以期为我国政策制定者和决策者参照国际标准制定出符合我国国情的耐药性相关指南。     

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.     

The Canadian Cooperative Wildlife Health Centre and surveillance of wild animal diseases in Canada.

The Canadian Cooperative Wildlife Health Centre (CCWHC) was established in 1992 as an organization among Canada's 4 veterinary colleges, with a mandate to apply veterinary medicine to wildlife management and conservation in Canada. A major function of the CCWHC is nation-wide surveillance of wild animal diseases. Disease surveillance is conceived as consisting of 4 different activities: detection, diagnosis, information management, and use of information. In the CCWHC surveillance program, detection of disease is carried out by a wide range of professional and avocational field personnel, and much effort is expended to stimulate and support this activity. Diagnosis is done by personnel of provincial and federal veterinary laboratories and the CCWHC. Information management is achieved through a national database of wildlife disease incidents developed and maintained by the CCWHC. Use of information is enabled through established channels for distribution of information derived from the surveillance program to persons responsible for wildlife programs and policies, and to the public. There has been a high demand for the services of the CCWHC since its establishment. The CCWHC responds to approximately 2000 requests for information annually, distributes its newsletter to over 1700 recipients, examines approximately 1200 wild animal submissions each year, and has accumulated records of over 5000 disease incidents in its database. Technical information from the CCWHC has benefited federal, provincial/territorial, and nongovernment wildlife agencies; endangered species recovery programs; federal and provincial veterinary services; and federal and provincial public health programs.     

Meeting report: panel on the potential utility and strategies for design and implementation of a national companion animal infectious disease surveillance system

This meeting report summarizes the discussions and recommendations of a Blue Ribbon Panel convened by the Science and Technology Policy Institute at the Institute for Defense Analysis on behalf of the White House Office of Science and Technology Policy (OSTP) on 13 September 2006 to discuss the potential utility and possible strategies for design and implementation of a companion animal health surveillance system. The panel comprised representatives from federal agencies, state agencies, academia, professional societies, and the private sector. The panel concluded that a companion animal surveillance system might prove valuable to efforts to protect public health, but that further study of the relationship between companion animal health and human health were needed to assess the utility and potential applications of a companion animal surveillance system. The findings of this panel may be used, along with other important sources of information, to inform policy discussions focussed on identifying strategies for recognizing and monitoring zoonotic disease threats appearing in companion animals in the USA.     

A Qualitative Study of State‐Level Zoonotic Disease Surveillance in New England

Zoonotic diseases are infectious diseases transmittable between animals and humans and outbreaks of these diseases in animals can signify that humans are also infected (or vice versa). Thus, communication between animal and human health agencies is critical for surveillance. Understanding how these agencies conduct surveillance and share information is important for the development of successful automated zoonotic monitoring systems. Individual interviews were conducted with 13 professionals who perform animal or human zoonotic disease surveillance in one of the New England states. Questions centred on existing surveillance methods, collaborations between animal and human health agencies, and technological and data needs. The results showed that agencies routinely communicate over suspected zoonotic disease cases, yet there are barriers preventing automated electronic linking of health data of animals and humans. These include technological barriers and barriers due to sensitivity and confidentiality of information. Addressing these will facilitate the development of electronic systems for integrating animal and human zoonotic disease surveillance data.     

The future of veterinary parasitology: a time for change?

The future of veterinary parasitology is discussed at a time when R&D funding from the pharmaceutical industry is declining, yet the opportunities for veterinary parasitologists to diversify their activities has never been greater. Emerging and re-emerging areas requiring input from veterinary parasitologists include: veterinary public health; conservation and wildlife diseases; emerging and exotic infectious diseases; surveillance strategies; economic effects of parasitic diseases; aquaculture; molecular epidemiology; dietary and biological control of parasitic diseases; animal welfare; organic agricultural systems; novel vaccination strategies; drug target characterisation and rational drug design. Without change, the survival of veterinary parasitology as a viable, distinct discipline is under threat. In this environment, veterinary parasitologists must be adaptable, imaginative and pro-active in terms of setting the agendas for establishing strategic alliances, promoting research needs and developing research programs.     

Perspectives on emerging zoonotic disease research and capacity building in Canada

Zoonoses are fundamental determinants of community health. Preventing, identifying and managing these infections must be a central public health focus. Most current zoonoses research focuses on the interface of the pathogen and the clinically ill person, emphasizing microbial detection, mechanisms of pathogenicity and clinical intervention strategies, rather than examining the causes of emergence, persistence and spread of new zoonoses. There are gaps in the understanding of the animal determinants of emergence and the capacity to train highly qualified individuals; these are major obstacles to preventing new disease threats. The ability to predict the emergence of zoonoses and their resulting public health and societal impacts are hindered when insufficient effort is devoted to understanding zoonotic disease epidemiology, and when zoonoses are not examined in a manner that yields fundamental insight into their origin and spread. Emerging infectious disease research should rest on four pillars: enhanced communications across disciplinary and agency boundaries; the assessment and development of surveillance and disease detection tools; the examination of linkages between animal health determinants of human health outcomes; and finally, cross-disciplinary training and research. A national strategy to predict, prevent and manage emerging diseases must have a prominent and explicit role for veterinary and biological researchers. An integrated health approach would provide decision makers with a firmer foundation from which to build evidence-based disease prevention and control plans that involve complex human/animal/environmental systems, and would serve as the foundation to train and support the new cadre of individuals ultimately needed to maintain and apply research capacity in this area.