Boston. Mass., July 14, 2001 — The images of the Oklahoma City bombing victims remain forever in our minds, all the more painful because of the intent to kill. Weapons of mass destruction are typically used to make a personal or political statement. But the message is not always delivered by a bomb, chemical, or a radiological agent. Bacteria, toxins, and viruses are also weapons of choice — placing veterinarians in key positions for keeping the US safe against bioterrorist efforts.
“Many bioterrorist agents are zoonotic,” said Leslie Tengelsen, PhD, DVM. “These agents often affect animals long before people become ill, so veterinarians are the eyes and the ears of the communities they serve. They are the ones who will discover sentinel disease activity.”
Dr. Tengelsen presented “Veterinarians and Public Health: Partners in Bioterrorism Preparedness” at the 138th annual convention of the American Veterinary Medical Association (AVMA) in Boston, July 14-18.
In the past decade, the United States has received nearly 1,000 threats involving weapons of mass destruction. “The specter of bioterrorism, from both foreign and domestic sources, has risen and can no longer be ignored,” Tengelsen said.
As Idaho’s deputy state epidemiologist, she has been working in her state and across the nation for the past three years, teaching veterinarians how to interface with public health officials and understand reporting mechanisms. Most states, she said, have a strong infrastructure of trained first-responders who deal with catastrophic events, such as hazardous waste spills. A traditional response team includes law enforcement, FBI, fire, and emergency services. In bioterrorism, however, veterinarians and medical professionals may be the first responders.
“Veterinary reports become so vital because rapid detection can lead to rapid resolution, ” Tengelsen said. “Conversely, a delay in reporting can give way to unmentionable devastation.” Thanks to her efforts and those of her peers, most state health departments are experiencing an increase of calls and reports from the veterinary profession.
What pathogens are veterinarians tracking? High-profile biologic agents include plaque, brucellosis, and tularemia, but the most worrisome is anthrax, caused by a bacteria that, when inhaled, causes severe respiratory illness and possibly death. Easily manufactured and aerosolized, anthrax is also produced naturally and can be an occupational hazard in agriculture workers and veterinarians. “We’re tracking zoonotic diseases daily. We know the typical rate of disease in a given area, so we’re also able to determine what’s abnormal and expand our surveillance efforts as needed,” Tengelsen said. “We are now even encouraging the reporting of syndromes before a definitive etiology is determined.”
This enhanced level of syndromic surveillance is due in part to special government funding that has strengthened the ties between public health and veterinary professionals and allowed better information gathering and sharing from nontraditional sources, such as 911, Dial-a-Nurse, pharmacies, humane societies and universities. In Idaho, the state public health department and local veterinarians recently worked together to determine that blue-green algae, not a bioterrorist, was behind the deaths of a dozen dogs and presumably had caused illness in one of the owners.
A sophisticated surveillance and reporting system helps multiple agencies prepare for bioterrorist attacks but also detects and manages emerging diseases.
Take the West Nile virus epidemic. Its sentinel disease activity, signaled by large die-offs of American crows, has alerted at-risk communities to implement early public health intervention programs. Veterinarians are now playing a key role in limiting the disease, which has killed tens of thousands of birds and nine people since its detection in New York in 1999.
Unfortunately, not all threats are hoaxes or unusual, but may be caused by a seemingly common bacteria. Back in 1984, a religious cult leader in the Dalles region of Oregon contaminated 10 salad bars with Salmonella and caused more than 750 people to fall ill. A cult member who was a microbiologist grew the bacteria to make residents sick so they couldn’t vote in a local election.
“It takes a combination of many professions to prevent excessive morbidity, mortality, and devastating losses. Great strides have been made in getting the United States ready to detect and respond to bioterrorist attacks,” Tengelsen said, “and the preparation continues every day.”
The AVMA is a professional organization of more than 66,000 veterinarians. More than 750 seminars were presented during the 138th annual convention, which is one of the largest gatherings of veterinarians in North America. The next annual convention will be in Nashville, July 13-17, 2002.