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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases 4 Gaps in the Animal Health Framework INTRODUCTION The study’s Statement of Task (Box 1-1) charges the committee with identifying key opportunities and barriers to the successful prevention and control of animal diseases. In its analysis of the existing animal health framework, as presented in Chapter 2, and the lessons of specific diseases and disease outbreaks, as presented in Chapter 3, the committee explored the responsibilities and actions of producers, regulators, policymakers, and animal health care providers and their effectiveness in providing disease prevention and control. Based on that review, the committee found that the main barriers to successful prevention of animal disease are gaps in the animal health framework that make it vulnerable to future animal disease threats, particularly from exotic animal diseases. The key gaps, identified in this chapter, are organized into the following categories: Coordination of Framework Components Technological Tools for Preventing, Detecting, and Diagnosing Animal Diseases Scientific Preparedness for Diagnosing Animal Diseases: Laboratory Capacity and Capability Animal Health Research International Issues Addressing Future Animal Disease Risks Education and Training Improving Awareness of the Economic, Social, and Human Health Effects of Animal Diseases
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases COORDINATION OF FRAMEWORK COMPONENTS Gap 1: A key gap in preventing, detecting, and diagnosing animal and zoonotic diseases is the lack of timely, appropriate, and necessary coordination and leadership among USDA, DOI, DHS, HHS, animal industries, and other responsible federal, state, and private entities. Whether due to historic structures and functions of the USDA, HHS, and related federal, state, and local governments, or because of changes and challenges in funding and resources, there is an apparent disconnect between agencies that should function in partnership. Examples of disease events, whether an emergent disease (monkeypox, West Nile virus, severe acute respiratory syndrome), endemic disease (chronic wasting disease and avian influenza), or exotic disease (foot-and-mouth, exotic Newcastle disease) reveal a lack of effective cooperation among local, state, and federal entities. The Trust for America’s Health (Benjamin et al., 2003) found over 200 different government offices and programs engaged in the response to just five outbreaks of animal-borne diseases (monkeypox, West Nile virus, bovine spongiform encephalopathy, Lyme disease, and chronic wasting disease). It also found that as many as seven cabinet-level agencies and hundreds of state and local public health agencies are involved. State departments of agriculture and environmental protection agencies also play critical roles. Table 4-1 shows the complexity (and the need for coordination and communication) of responsibility and the number of federal government agencies involved with each specific disease/agent examined in Chapter 3. The table does not show the significant overlaps (for diseases such as monkeypox) in the programmatic functions performed by various federal agencies that also exist. Whereas there are clear lines of responsibility and authority for exotic disease agents, such as highly pathogenic avian influenza, the regulatory lines of authority are not defined for endemic agents such as low pathogenic avian influenza, therefore hindering the nation’s ability to prevent the potentially devastating spread of a disease before it develops. Furthermore, the system as a whole lacks integration, not only within the federal system, but also among federal agencies and programs directed through states or animal health organizations. In addition, despite the number of federal agencies responsible for aspects of animal health policy (as shown in Table 4-1), there is a lack of federal oversight of the animal-centered aspects of zoonotic diseases. The monkeypox outbreak revealed no equivalent federal responsibility and only a limited federal animal health infrastructure for addressing a zoonotic disease outbreak transmitted by nonlivestock species. Economic environments, social structures, and management practices are unique to different regions, requiring flexibility and tailored responses
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases TABLE 4-1 Primary Federal Jurisdictions for Specific Animal Diseases Disease Animals Affected Government Agency(ies) Exotic Newcastle Disease Multiple avian species DOI: NWHC USDA: APHIS, ARS, CSREES DHS: Bureau of Customs and Border Protection USTR OSTP Foot-and-mouth Disease Cattle, swine, and other cloven-hoofed species (sheep, goats, deer) DOI: NWHC USDA: APHIS, ARS, CSREES DHS: Bureau of Customs and Border Protection DoD USTR White House: OSTP, OMB Monkeypox Prairie dogs, humans HHS: FDA, CDC DHS: Bureau of Customs and Border Protection DOI: FWS USDA: APHIS, CSREES Bovine Spongiform Encephalopathy Cattle HHS: FDA, CDC, NIH USDA: APHIS, FSIS, ARS, CSREES DHS: Bureau of Customs and Border Protection DOS DoD USTR White House: OSTP, OMB Chronic Wasting Disease Elk, mule deer, white-tailed deer HHS: FDA DOI: BIA, NPS, FWS, BLM USGS: National Health Lab USDA: APHIS, ARS, CSREES EPA DoD West Nile Virus Mosquitoes, birds, humans DOC DOI DoD EPA USDA: CSREES HHS: CDC, FDA, NIH Avian Influenza Avian species, humans, swine, cats HHS: CDC USDA: APHIS, ARS, CSREES DHS: Bureau of Customs and Border Protection DOI: NWHC Severe Acute Respiratory Syndrome Humans, palm civets and raccoon dogs HHS: CDC, FDA USDA: CSREES DOI
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases to ensure compliance and cooperation in prevention and early detection of disease events. In the current system, there is underutilization of private industry, local, and regional resources, as well as a reluctance to capitalize on expertise located outside of federal agencies. A wealth of scientific expertise in academic institutions and state diagnostic laboratories could be called on to provide expert advice and assistance. Timely communication with those on the front lines could be enhanced to improve disease detection and response. In the case of monkeypox, local stakeholders waited for instructions from the federal government, which hindered their ability to react. TECHNOLOGICAL TOOLS FOR PREVENTING, DETECTING, AND DIAGNOSING ANIMAL DISEASES Gap 2: Efforts for the rapid development, validation, and adoption of new technological tools for the detection, diagnosis, or prevention of animal diseases and zoonoses are lacking or inadequate. New scientific tools and technologies with proven potential have not moved quickly into routine use within the current animal health infrastructure. State-of-the-art scientific approaches and technologies, often developed by and for basic research and military application, are often rapidly adopted by first-responder and public health communities to protect human health, but they have been significantly slower to transition into the animal health arena. Translational (or applied) research and federal funding sources to support the development, validation, and/or implementation of technological tools specifically for animal health applications are limited, and economic incentives for the private sector do not traditionally support these development efforts. In short, society will pay more to learn how to protect human health than to protect animal health. Federal and state laboratories across the country vary greatly in their ability to obtain advanced technologies, such as robotics for surge capacity, instrumental analyses (i.e., gas chromatography, mass spectrometry) for high-resolution toxin and protein detection, and molecular-based tools for rapid and sensitive agent detection or identification. Recent awareness and initiatives related to bioterror preparedness and homeland security have improved both federal and state laboratory access to rapid molecular-based diagnostic tools; however, as an industry, animal health lags behind the military, first-responder, and public health community in the use of field-based air sampling techniques, handheld devices, and similar technologies. As demonstrated by the exotic Newcastle disease outbreak, the existing animal health framework in California was forced to develop and validate an effective detection tool during the outbreak, though awareness of the threat and the technology used had existed for many years. The de-
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases lays in evaluating and implementing new and emerging technologies are also a concern with preventive vaccine strategies. Prevention strategies, including vaccines carrying markers that would allow a laboratory to distinguish a vaccinated animal from one exposed to a naturally occurring pathogen, have not been promoted in the United States. The lessons identified and reported from the 2001 U.K. foot-and-mouth disease (FMD) outbreak clearly indicate the importance of marker vaccines and/or diagnostic tests able to distinguish between an animal vaccinated against a foreign animal disease and an animal naturally exposed as a critical disease control strategy. Yet, little or no progress has been made in this direction in the United States, despite the availability of the technological tools. Unanswered questions remain about the adequacy of the supply and serotypes of FMDV vaccine available to the United States in the event of an outbreak (inadvertent or bioterrorist) and the surge capacity and biosafety level 3 (BSL-3) vaccine manufacturing facilities for rapid production of additional USDA-licensed doses. Although basic research has generated prototype bioengineered animal vaccines, the translational research for their cost-effective production and testing in safety and efficacy field trials is lacking. Further, BSL-3 facilities to conduct translational vaccine research and to manufacture vaccines for BSL-3 pathogens are extremely limited in the United States. Approaches to induce mucosal as well as systemic immunity and other preventive methods to block shedding of pathogens in diverse host species, including wildlife and companion animals, are largely undefined and illustrate the need for comparative medicine studies. The lack of an adequate understanding of safe and effective immune system modulators (adjuvants) to stimulate the various immune responses has resulted in few USDA approvals of adjuvants for use in animals. Stimulation of innate immunity is envisioned as a new strategy to achieve early initial nonspecific immune responses to pathogens; this approach could reduce pathogen load prior to specific vaccine response, shedding, and transmission in animal populations in the face of an exotic, zoonotic, or other pathogen exposure. SCIENTIFIC PREPAREDNESS FOR DIAGNOSING ANIMAL DISEASES: LABORATORY CAPACITY AND CAPABILITY Gap 3: The animal disease diagnostic system in the United States is not sufficiently robust to provide adequate capacity and capability for early detection of newly emergent, accidental, or intentionally introduced diseases. More specifically, the committee found significant delays in development and validation of diagnostic assays and proficiency testing pro-
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases grams; inadequate use and coordination of the diagnostic resources and expertise located throughout the country; insufficient integration and coordination of laboratory diagnosis of zoonotic and foodborne diseases; limited surge capacity; inadequate diagnostic BSL-3 biocontainment; and limited research on and implementation of new diagnostic tools and methodologies. Laboratory diagnosis of animal diseases in the United States is multifaceted and involves federal, state, and commercial entities. However, the committee’s review focused primarily on assessing publicly funded laboratories and the current operational status of national laboratory networks. While commercial laboratories are an important part of the system, we did not conduct an in-depth analysis of this component. Funding and implementation of the National Animal Health Laboratory Network (NAHLN) was a major step and is an important and necessary paradigm shift from an exclusive federal to a shared responsibility for foreign animal disease diagnosis (see Chapter 2). However, the current network does not provide the necessary surge capacity and is not prepared for disease agents and toxins outside the narrow list of eight exotic diseases1 that provided an initial focus for network development. Furthermore, coordination among federal and state laboratory networks is not optimum. The committee reviewed the current status of veterinary diagnostic laboratory membership in the Laboratory Response Network for Bioterrorism (LRN) and concluded that there is limited and insufficient linkage among veterinary diagnostic laboratories, the NAHLN, and the LRN to respond to agents with zoonotic concerns, such as monkeypox or West Nile virus (see Chapter 3). The committee reviewed the current status of BSL-3 diagnostic laboratory and necropsy space in the United States and found a significant deficiency in this capital resource. Since all exotic animal diseases are classified as BSL-3 agents, and since most of the OIE category A select agents are zoonotic and require the handling of known or potentially infected animals and animal-derived tissues in veterinary diagnostic laboratories under BSL-3 containment, the current capacity and distribution of BSL-3 space for necropsy (autopsy) of animals and laboratory workups are insufficient for routine diagnosis and grossly insufficient for surge capacity. It is possible that accidental or intentional introduction of these agents could occur in any state or region, and it is unlikely that movement of 1 The eight selected agents are avian influenza, exotic Newcastle disease, foot-and-mouth disease, classical swine fever, rinderpest, bovine pleuropneumonia, African swine fever, and lumpy skin disease.
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases carcasses or shipment of specimens will be time-sensitive enough to rely on neighboring regions for BSL-3 laboratory capacity. In addition to reviewing the diagnostic networks as a component of disease prevention, detection, and diagnosis, the committee analyzed the approach toward laboratory diagnostics currently practiced in the United States. The committee found that the traditional approach, which focuses mainly on individual animal diagnosis and generally does not formally consider population diagnosis, is not addressing the need for population-based diagnostic methods and information that are critically important in identifying the multicausality of disease and the factors predisposing or contributing to development of new or emerging diseases. ANIMAL HEALTH RESEARCH Gap 4: The nation supports only limited multidisciplinary research to address prevention and detection of animal disease (both zoonotic and nonzoonotic) by studying factors related to pathogenesis, interspecies transmission, epidemiology, and ecology. Early recognition of emerging diseases requires a fundamental knowledge of the epidemiology of the disease, which includes an understanding of the agents and hosts in their natural environment. The interactions of the intrinsic and extrinsic factors that lead to emergence of new disease are poorly understood. Many individual researchers address various diseases relatively independently and usually with a focus on a single host species or mouse model. As a result, medical scientists may be unaware of key research done in other species by veterinary scientists studying a similar, closely related, or even unique animal pathogen. For example, the animal reservoir and susceptible species for SARS remain undefined and integrated, and collaborative research efforts to study the responses to SARS in infected humans and diverse animal hosts have not been instituted in the United States. Furthermore, basic and translational research related to prevention, detection, and diagnosis of animal and zoonotic diseases is conducted through an array of government, academic, and private institutions; however, no mechanism exists to coordinate research dollars and priorities to ensure that important topics are not overlooked and to ensure the most effective use of existing research dollars. As demonstrated by SARS and many other disease outbreaks, research ties, interagency funding, and cooperation for shared research between biomedical and veterinary scientists are lacking. Opportunities to train biomedical and veterinary public health personnel in infectious and zoonotic disease research are limited. Funds are lacking to study disease pathogenesis in appropriate animal hosts and to investigate zoonotic diseases including identifying animal reservoirs and the mechanisms and
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases chains of interspecies transmission. The current emphasis of major federal funding agencies supporting research related to animal health or zoonoses (e.g., USDA, NIH, NSF) focuses on basic research, providing less opportunity for translational research aimed at the immediate goals of prevention (e.g., vaccines, antimicrobials, producer behavior), detection, and diagnosis of animal and zoonotic diseases. Development and validation of veterinary diagnostic assays utilizing state-of-the-art molecular techniques has not been a priority for federal funding prior to homeland security interests in protection against agricultural bioterrorism. Existing efforts remain limited and focused on assay development for biothreat agents and foreign animal diseases. While the threat of bioterrorism and the recent epidemics of zoonoses, such as SARS, West Nile virus, and monkeypox, have boosted the priority for this type of translational research, there is little coordination among agencies and a continuing deficit of funding to scientists outside the federal arena. In addition, a robust national system for considering validation data on new assays and for adopting validated assays in one species to other species and matrices does not exist. There is currently limited emphasis on multidisciplinary research on disease pathogenesis, interspecies transmission, or comparative medicine. Gap 5: There are not enough biosafety level 3 (BSL-3 or BSL-3 Ag) facilities and those that exist are not strategically located throughout the United States. Not all level 3 facilities are suitable or equipped for research on diseases (including zoonoses) of livestock, poultry, or wildlife requiring that level of biocontainment. When a new infectious agent is suspected, initial efforts must be directed to the rapid definition and characterization of the agent, as was done during the SARS outbreak (described in Chapter 3). One of the first actions is to contain the agent and to characterize it under strict biocontainment conditions. Subsequent research requires assessment of the pathogenic potential, origin and host range, pathogenesis, diagnosis, and preventive or control measures in the natural and susceptible host species, including large domestic animals and wildlife. State-of-the-art equipment and technological tools to conduct the research needed to understand, prevent, and control these emerging or exotic infectious agents are not widely available. Both the monkeypox and SARS outbreaks helped to identify weaknesses in the veterinary laboratory infrastructure in the United States, which does not have appropriate biocontainment facilities to allow investigative research on potential animal hosts and disease transmission. Preliminary data from a recent survey conducted by the American Association of Veterinary Medical Colleges indicate that federal and state BSL-3
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases large animal biocontainment facilities in the United States are limited to two states, with an additional five ABSL-3 facilities under construction that will be capable of holding large animals. Only one ABSL-3 Ag facility currently exists in the United States (Plum Island), and only two of the facilities currently under construction will be ABSL-3 Ag biocontainment (Richard Dierks, AAVMC, personal communication, November 2004).2 INTERNATIONAL ISSUES International Interdependence and Collaboration Gap 6: The United States is not sufficiently engaged with international partners to develop strategic approaches to preventing, detecting, and diagnosing animal diseases before they enter this country. International collaborations are largely ad hoc, resulting in a nonstrategic system for dealing with global animal health issues. Global trade, population, and production in other countries, along with advancements in technical capacity and our own regulatory infrastructure, are some of the factors eroding the historically strong trade status enjoyed by the United States. Adding to these global factors are international standards and legally binding trade agreements such as the World Trade Organization (WTO) Agreement on Sanitary and Phytosanitary Standards (SPS), formulated with technical expertise from different countries. Every effort is made to adopt standards by consensus, and each country, no matter its size or other qualifying factors, is on equal footing with one vote. Adoption of standards requires the efforts and encouragement of all countries to comply and provide timely notification of zoonotic and exotic diseases. To operate independently is no longer a viable option for the United States, despite its large stake in the global economy and the world. Moreover, although the United States has great economic and political influence, it constitutes a small fraction of the total world population. (World population growth every 3–4 years equals the entire population of the United States.) 2 The committee sought information on the extent of BSL-3 biocontainment facilities for large animals in the United States. Definitive information could not be supplied. However, at the time the report was finalized, the AAVMC had obtained preliminary results from a survey of BSL-3 facilities in veterinary medical colleges and departments in the United States. The information provided is based on preliminary results from AAVMC’s November 2004 survey.
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases Importation, Sale, and Transport of Exotic Animals Gap 7: The current patchwork of federal policies and agencies with limited or ill-defined jurisdiction for the import, sale, and movement of exotic and wild-caught companion animals and zoo specimens is a significant gap in preventing and rapidly detecting emergent diseases. As the monkeypox outbreak revealed, there is no defined federal responsibility beyond that for protecting public health, and only an informal federal animal health infrastructure, for addressing a zoonotic disease outbreak transmitted by a nonlivestock, nonwildlife species. Prior to the interim final rule (banning the import, sale, or distribution of prairie dogs and some African rodents responsible for the monkeypox outbreak), import and movement of exotic animals was uncontrolled. Some states have bans on sale and distribution of prairie dogs to prevent transmission of plague. However, no uniform federal regulations that would provide equivalent controls nationwide have been established. Tracking of these animals in the United States is inconsistent and ineffective, and there is a disturbing lack of standardized testing of the health status of exotic animals at the point of origin or importation, in companion animal shops, at trade fairs, and in other venues. Regulatory authority for the intrastate movement of these animals once they are in the United States lies with the states. However, state infrastructure to oversee and effectively monitor movement of nonlivestock species is inconsistent and often weak, with neither the budget nor the personnel within most states. Exotic animals are imported daily into the United States with little or no health monitoring, increasing the probability of an animal pathogen or zoonotic disease entering the United States through an imported animal such as occurred with human salmonellosis via turtles or monkeypox through African rodents. Wild animals transported from their native habitat and introduced into live animal markets may harbor unknown disease agents transmissible to humans such as monkeypox, influenza, and perhaps SARS, which is highly likely to also be a zoonotic disease (as described in Chapter 3). ADDRESSING FUTURE ANIMAL DISEASE RISKS Gap 8: The current animal health infrastructure for food-animals, wildlife, and companion animals does not have formal and comprehensive-based science and risk analysis systems for anticipating potential challenges to animal health; ranking their likelihood of occurring and likely severity; evaluating alternative prevention, detection, and diagnostic systems; and using this information to make appropriate policy decisions.
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases The traditional approach for disease prevention in the United States has been to formulate disease control strategies based on whether the specific disease is present or absent, rather than relying on a risk-based approach for developing disease control strategies. For infectious and economically devastating animal diseases such as FMD, the United States has made substantial investments in disease eradication and historically has moved to restrict trade from countries where the disease is reported if it poses risk to the health status of the U.S. population or jeopardizes U.S. export markets. In the past, the United States adopted a zero-risk policy for disease introduction as the most expedient approach, though this relied on a strong infrastructure with financial resources to rapidly respond should the disease be inadvertently or intentionally introduced. On the other hand, trade partners intrinsically link the economic viability of entire export markets with the absence or presence of disease within their borders, creating issues of compliance and international cooperation. Trade restrictions, and even perceptions of unfair regulation, have created significant uneasiness among trading nations, as witnessed by markets and political responses in Europe, Asia, Canada, and the United States following respective initial detection of BSE. EDUCATION AND TRAINING Gap 9: There is an inadequate supply of veterinarians educated for careers in research, public health, food systems, ecosystem health, diagnostic laboratory investigation, and rural and/or food animal practice. The face of veterinary medicine has changed over the years from a focus on rural practice to a profession dominated by practitioners serving small companion animals. There are not sufficient graduates to meet the needs in a number of major and distinct fields of veterinary medicine dealing with various species of food animals, rural practice (mixed domestic animals), ecosystem health (including wildlife and conservation medicine), public health, the many dimensions of the food system, and biomedical science. In addition, veterinary graduates are not adequately prepared to deal with foreign animal diseases, public health (Hoblet et al., 2003; Walsh et al., 2003), the food system (Hird et al., 2002), ecosystem health (Van Leeuwen et al., 1998), and biomedical research, without further postgraduate education. According to the Association of American Veterinary Medical Colleges (AAVMC), the 28 veterinary colleges in the United States graduate approximately 2,300 veterinarians per year, and currently they cannot keep up with societal needs in private or public practice (AAVMC, 2004). The committee also found a steady decline in the number of rural practitioners and of veterinarians employed in regulatory agencies, due to consolidation in the animal production sector and decreases in exten-
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases sion education and research. Today, veterinary capacity in rural areas is largely composed of consulting veterinary businesses and limited numbers of mixed animal practices. These decreases threaten to undermine the nation’s capacity to protect animal and human health and to respond to potential national emergencies. The USDA, presently underserved, predicts a shortfall of 584 veterinarians by 2007. Fifty percent of U.S. Public Health Service veterinarians are currently eligible for retirement (AAVMC, 2004). Furthermore, the changing emphasis toward and greater specialization in companion animal private practice has created a critical gap in the current animal health infrastructure. Critical areas—including food safety, emerging and foreign animal diseases, public health, food systems, and animal agriculture in general—are no longer being adequately addressed. This gap is further accentuated by the fact that training and continuing education are now primarily focused on companion animal practice which, in turn, has reduced the overall awareness and importance of these critical needs and weakened the current animal health infrastructure. Thus inadequate veterinary capacity is a growing problem from the perspective of its distribution, total number, and range of competencies. It is beyond the scope of this report to undertake an in-depth analysis of veterinary shortages, as described in the NRC report National Need and Priorities for Veterinarians in Biomedical Research (NRC, 2004b). However, the impact of this shift in the profession away from rural animal practices and public service sectors has a profound impact on the recognition and early detection of foreign animal diseases. Gap 10: Education and training of those on the front lines for recognizing the signs of animal diseases is inadequate. Animal handlers and people working and living with animals on a day-to-day basis form the true first line of detection for animal diseases. Producers and animal personnel may not report suspicious signs to the herd veterinarian or government official simply because they do not know what the signs look like, or do not recognize them and understand the implications of delays in recognizing and reporting signs of disease. Each year, only about 250 to 300 foreign animal disease investigations are submitted to the Foreign Animal Disease Diagnostic Laboratory (FADDL) (Tom McKenna, Plum Island Animal Disease Center, personal communication, June 2005). As noted in Chapter 3, veterinary oversight of animal units in the United States is hit-and-miss, with progressive, health-minded producers more likely to engage veterinary services to provide education and training and to promote observation for animal diseases and early reporting. Veterinarians also may not be able to readily recognize a foreign or exotic disease when examining animals with clinical diseases that mimic common indigenous diseases. Furthermore, animal handlers and
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases other personnel working directly with animals may be inadequately educated and trained in the detection of foreign and exotic animal diseases. The committee acknowledges the critical need for professionals in human medicine, wildlife health, and public health, as well as domestic animal health, to identify, recognize, and report cases of zoonotic diseases within their respective areas of expertise and responsibilities. Although it was beyond the capacity of its review, the committee was nevertheless very concerned about the level of knowledge and understanding of zoonoses and especially emerging zoonoses within the various health protection communities. IMPROVING PUBLIC AWARENESS OF THE ECONOMIC, SOCIAL, AND HUMAN HEALTH EFFECTS OF ANIMAL DISEASES Gap 11: Despite the vital role that animal health plays in preserving the safety of the food supply and other important societal resources, there is little national consumer awareness or public investment in maintaining a viable animal health infrastructure to protect and defend this critical resource. As described in Chapter 3, the recent outbreaks of foot-and-mouth disease in the United Kingdom; of SARS in Asia and Canada; and of exotic Newcastle disease, avian influenza, and BSE in the United States are reminders of the threats such diseases pose to the U.S. food supply (as well as confidence in the safety of the food supply), the global economy, and public health (Shadduck et al., 1996). Today the entire food and fiber system—including farm inputs, processing, manufacturing, exporting, and related services—is one of the largest sectors of the U.S. economy and accounts for output of $1.5 trillion, or nearly 16 percent of the gross domestic product, and 17 percent of the civilian labor force (USDA, 2003). The annual value of livestock production (cash receipts) was nearly $100 billion during the 1993-2002 period, about half of the total value of agricultural sector production (McElroy et al., 2003). The United States exported nearly $55 billion in agricultural exports in 2002, with animals and animal products accounting for over 20 percent (USDA-ERS, 2001). Wildlife and companion animals also have significant recreational and environmental value. Economic activity based on wildlife-related recreation in 2001 in the United States was estimated to be $108 billion. In 2005, expenditures on pets are projected at a record-high of $35.9 billion (APPMA, 2005). Given the economic value of animals, a key question is whether sufficient resources have been allocated to safeguard animal health; in other words, to prevent disease outbreaks from occurring. Although not all disease events are catastrophic on a large scale, one analysis suggests that
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases 3–4 percent of the value of animal production in agriculture is routinely lost to animal diseases (Hennessy et al., 2005) including the cost of prevention. Another estimate suggests that the losses might be even higher: up to 18 percent of the annual farm gate value of animal commodities, costing production agriculture and the U.S. economy billions of dollars each year (FAIR, 2002). A study of livestock diseases in the United Kingdom estimates a range in the costs of losses from disease relative to the costs of treatment and prevention measures (Bennett, 2003). In that study, mastitis in dairy cattle ranked the highest in terms of direct costs from losses (over £120 million or nearly $200 million dollars, in 1996 values), while prevention expenditures were estimated to be £4 million, or $6.6 million dollars. The financial investment to prevent disease may be far less than the losses in value should a disease occur, particularly when losses include not only the cost to producers and associated industries, but also the value of social welfare such as the loss of food and other products, or the loss of a companion or zoo animal. However, for several reasons, the general public is unaware of the full costs of disease. First, a large and growing percentage of the general population is increasingly removed from a basic understanding of agriculture, its links with animal health, and related sectors (Whitener and McGranahan, 2003). A lack of personal experience or knowledge about animal production may lead the general public (consumers) to undervalue efforts required to prevent animal diseases, or to recognize that losses from disease may be reflected in higher costs for food, recreation, or health care. When the public is not aware of these costs, they (consumers, business) will underestimate the value of prevention, detection, and diagnosis (Colorado State University and Farm Foundation, 2003; Sumner, 2003). The public understanding of the purposes and the need for animal research and for disease prevention measures might also be affected by societal attitudes toward animals that have been fostered by animal activists. Public education and ongoing risk communication with the general public improve the ability of consumers to make appropriate decisions and build support for national animal disease management efforts. Research on effective methods and tools of risk communication would make an important contribution to building an effective animal health infrastructure. SUMMARY The current animal health framework was built on animal management practices, economic impacts, and societal norms that are no longer
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Animal Health at the Crossroads: Preventing, Detecting, and Diagnosing Animal Diseases valid. At the same time, animal and human populations and their interfaces have changed and continue to change. The committee analyzed the current capabilities and limitations of the animal disease framework and identified the following 11 gaps that hinder effective prevention, detection, and diagnosis: There is a lack of timely, appropriate, and necessary coordination and leadership among USDA, DOI, DHS, HHS, animal industries, and other responsible federal, state, and private entities. Efforts for the rapid development, validation, and adoption of new technological tools for the detection, diagnosis, or prevention of animal diseases and zoonoses are lacking or inadequate. The U.S. animal disease diagnostic system is not able to provide adequate capacity and capability for early detection of newly emergent, accidental, or intentionally introduced diseases. The nation supports only limited multidisciplinary research to address prevention and detection of animal disease (both zoonotic and nonzoonotic) by studying factors related to pathogenesis, interspecies transmission, and ecology. The number of BSL-3 facilities is inadequate, and the existing labs are not strategically located in the United States nor are they suitably equipped for research on diseases requiring biocontainment. The United States is not sufficiently engaged with international partners to develop strategic approaches to preventing, detecting, and diagnosing animal diseases before they enter this country. Federal policies and agencies have limited or ill-defined jurisdiction for the import, sale, and movement of exotic and wild-caught companion animals and of zoo specimens, creating a loophole, allowing a significant gap in preventing and detecting emergent diseases. The nation lacks a formal and comprehensive-based science and risk analysis system for anticipating potential challenges to animal health and for use in policy decisions. The supply of veterinarians in research, public health, food systems, ecosystem health, diagnostic laboratory investigation, and rural and/or food-animal practice is inadequate. Education and training of those on the front lines for recognizing the signs of animal diseases is inadequate. Little national consumer awareness or public investment in maintaining a viable animal health infrastructure exists. Based on these gaps, the next chapter provides key opportunities to strengthen the framework to successfully prevent, detect, and diagnose animal diseases.
Representative terms from entire chapter: