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Conference Summary
Converging Issues in Veterinary
and Public Health
Suggested citation for this article: King L,
Khabbaz R. Converging issues in veterinary and public health. Emerg
Infect Dis [serial online] 2003 Apr [date cited]. Available from:
URL: http://www.cdc.gov/ncidod/EID/vol9no4/03-0037.htm
More than 20 key officials from the American Veterinary Medical Association
and the Association of American Veterinary Medical Colleges met with staff
from the Centers for Disease Control and Prevention (CDC) December 5–6,
2002, to discuss the increasing convergence of issues confronting human
and animal health. Among the officials in attendance were the deans from
more than half of all U.S. veterinary schools.
The meeting goals were to increase the veterinary community’s understanding
of CDC programs and the varied roles played by veterinarians throughout
the agency; to provide CDC officials an opportunity to gain insight into
current issues in veterinary medicine as well as the public health perspectives
of veterinary leaders; and to provide a forum for discussions on ways
to increase partnerships between the human and veterinary medical communities
to meet critical public health needs. Presentations were made by James
Hughes, Michel Bunning, Patricia Griffin, David Bell, Nina Marano, Tracee
Treadwell, Thomas Ksiazek, and Peter Schantz, National Center for Infectious
Diseases; Marguerite Pappaioanou, Office of Global Health; Hugh Mainzer
and Andrew DAnnenberg, National Immunization Program; and Douglas Hamilton,
Epidemiology Program Office. Many of these speakers are CDC veterinarians,
who described their paths from veterinary training to public health.
The daily interactions of humans, animals, and the environment have a
dramatic impact on public health. Current and evolving health threats
include infections transmitted through animals, insects, food, and water,
as well as illnesses resulting from environmental toxins, the misuse of
antibiotics, and bioterrorism. Factors affecting these threats include
the international movement of people, animals, and animal products; globalization
and management of the complex food and fiber system; climate and other
environmental changes, including those affecting wildlife populations
and their interactions; and national and global security. Effectively
meeting these challenges requires strong links between human and animal
health clinicians, researchers, laboratorians, and public health officials.
Specific topics presented included West Nile virus and other vectorborne
diseases, emerging viral and parasitic zoonoses, food safety, antimicrobial
resistance, CDC’s role in the 2001 anthrax investigations, and the agency’s
bioterrorism preparedness and response program. Presentations highlighted
public health issues such as the need to upgrade containment facilities
and to define optimal antibiotic use for farm animals. Efforts needed
to further protect the health of humans, companion animals, zoo and exotic
animals, and wildlife were also discussed. These efforts include improving
strategies to reduce the occurrence of intestinal parasites in pets and
increasing surveillance among imported animals and products to recognize
infections not previously seen in the United States.
Several presenters emphasized the importance of surveillance systems
in enabling prompt recognition of disease occurrences. Examples included
two food safety surveillance programs: FoodNet, a collaborative project
involving nine states, the U.S. Department of Agriculture, CDC, and the
Food and Drug Administration; and PulseNet, a national and international
network of public health laboratories that subtype foodborne bacteria
to enable rapid comparison of DNA patterns through an electronic database.
Other surveillance systems discussed included the National Antimicrobial
Resistance Monitoring Systems and the Laboratory Response Network (LRN).
LRN is a tiered system of laboratories with varying diagnostic capabilities,
ranging from confirmatory analysis to specialized identification of agents
potentially used in a bioterrorist attack. The network is supported through
funding designated for bioterrorism preparedness and response. Meeting
participants discussed the need to increase participation of veterinary
clinicians and diagnosticians in these surveillance systems, especially
LRN, noting that 80% of the agents classified as “category A” (i.e., those
posing a major risk to national security because they can be easily disseminated
or transmitted from person to person, result in high death rates, and
require special efforts to ensure preparedness) are zoonotic. Strategies
discussed at the conference toward this end included adding veterinary
and animal health laboratories to LRN as well as establishing a similar
network among such laboratories to collect more comprehensive data on
the occurrence of infections affecting veterinary and human health.
CDC veterinarians participating in the meeting described their experiences
as well as the roles of other agency veterinarians. Many CDC veterinarians
are epidemiologists who joined the agency as officers in the Epidemic
Intelligence Service (EIS), CDC’s 2-year, hands-on comprehensive epidemiology
and public health training program. Of the approximately 75 veterinarians
who work at CDC, nearly half are in the National Center for Infectious
Diseases, where they work in laboratory animal research as well as epidemiology.
Discussions at the meeting described the critical roles played by veterinarians
at the local, state, and national levels in responding to the recent West
Nile virus outbreaks. Approximately 42 states currently have state public
health veterinarians.
Many discussions focused on ways to increase the number of veterinarians
in public health clinical and laboratory programs. Several CDC veterinarians
cited classes in herd health as stimulating their interest toward public
health careers. At the initial level, efforts are needed to ensure that
veterinary students are aware of these career opportunities early in their
education. Potential strategies include offering externships and public
health rotations, such as at CDC or at local and state health departments,
as part of veterinary medical school training courses and offering combined
degrees in veterinary medicine and public health (i.e., DVM/MPH)—a course
of study already offered by several veterinary colleges. Other innovative
public health programs that could be incorporated by veterinary medical
colleges include studies in food safety, environmental toxicology, healthy
ecosystems, international diseases, and population medicine.
More veterinary EIS Officers are also needed. Approximately one third
of veterinarians applying to EIS are accepted, essentially the same acceptance
rate as for other professions. Increased numbers of qualified veterinary
applicants would therefore translate into higher numbers of accepted veterinarians.
Similarly, efforts are needed to increase the number of veterinarians
and veterinary students applying for other training programs at CDC such
as the Emerging Infectious Diseases Laboratory Fellowships. Through this
program, bachelor’s or master’s level scientists are recruited for 1-year
assignments and postdoctoral level scientists for 2-year assignments at
state, local, and CDC public health laboratories. More veterinary applicants
are also needed for other training programs offered by CDC, such as the
elective in epidemiology for senior medical and veterinary students—a
6- to 8-week introductory course in preventive medicine, public health,
and applied epidemiology.
The World Health Organization (WHO) will soon be making available on
the Internet its findings from a study group on the future of veterinary
public health (WHO Technical Report Series 907). The report describes
the increasing emergence and reemergence of zoonotic diseases in the 1980s
and 1990s and their importance for global public health (1).
To effectively meet these challenges, human and animal health issues
must be merged into a new public health agenda. Creating and responding
to such an agenda depends on strong interactions between the human and
veterinary clinical, laboratory, and public health professional organizations.
These interactions are essential for developing new and strengthening
existing partnerships necessary for implementing effective public health
programs. This meeting was a step toward this goal.
Lonnie King* and Rima Khabbaz†
*Michigan State University College of Veterinary Medicine, East Lansing,
Michigan, USA; and †Centers for Disease Control and Prevention, Atlanta,
Georgia, USA
Reference
- World Health Organization. Future trends in veterinary
public health: report of a WHO study group. (Technical report series,
No. 907). Geneva: The Organization; 2002.
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