Veterinary Public Health
Section Newsletter
Fall 2009

VPH SPIG News about the APHA Annual Meeting and Exposition

VPH SPIG News about the APHA Annual Meeting & Exposition

Business meeting:  4:30 – 6 p.m., Monday, Nov. 9 – check the program for location.

Scientific Sessions:

Monday, Nov. 9, 8:30 – 10 a.m., Emerging Infections: perspectives on zoonotic disease plus monitoring.

Monday, Nov. 9, 2:30 – 4 p.m., One health, public health leadership and the veterinarian – perspectives on various topics from lead to pesticides and human animal bond to food safety.

Tuesday, Nov. 10, 8:30 – 10 a.m., Feral Cats – the challenges to protect cats, public and the environment.

APHA Annual Meeting and Exposition

APHA Annual Meeting & Exposition - Register for the meeting and make your hotel reservation soon (advance registration closes Oct. 2, housing closes Oct. 9). Note: Presenters must be individual members of APHA to present their paper(s) and must register in advance for the meeting. Session organizers and moderators are also required to be members and pay the appropriate registration fee. Hope to see you in Philadelphia!

Greetings from the Chair

Greetings from the Chair

Here is the first of our long delayed newsletter. We invite your inputs and comments.  We hope that many of you can come to the Annual Meeting but understand the budgetary constraints faced so many of you. We continue to look for "new blood" to take on Leadership roles. We hope to hear from volunteers.

Regards,

John Herbold, DVM, PhD

Chair

Elections

Elections – Needed, New Blood

Election of officers will take place at our Business Meeting this November at the APHA Annual Meeting. We need new folks to take leadership roles. Volunteers can submit their names to Jim Dale at jdale@jeffco.us.

 

Current Officers:

 

Acting Chair/Representative to the Governing Council: John Herbold

Chair elect: open

Secretary /Membership/Program Chair: Jim Dale & Jeff Alexander (Assist)

Advocacy: John Sanders

Communication/Newsletter: John Sanders & Megan Davis (Assist)

Member at Large: Bill Courtney

One Health and H1N1

One Health and H1N1

Many of our colleagues are involved in research, surveillance and preparedness in the face of higher levels of H1N1 activity in the coming months. Our own President, Dr. John Herbold, is one of many actively involved:

 

John Herbold, DVM, PhD, is associate professor of epidemiology and director of the Center for Biosecurity and Public Health Preparedness at The University of Texas School of Public Health San Antonio Regional Campus. As a veterinarian, Herbold can discuss the origin of influenza viruses in humans and the role of animals in this recent outbreak. He can also discuss why H1N1 flu is passing from human to human unlike the bird/avian flu. In addition, Herbold can address the importance of clinicians, veterinarians and public health workers joining together to stabilize and fight this outbreak.” (UT Houston - Flu Media Resource Guide)

Name Change

Mulling a name change, expanded missions


Dr William Courtney

Board Member at Large

 

The Veterinary Public Health SPIG is considering a name change to “One Health” to capture its true mission and to expand its reach in public health. 

“Some of us feel the term veterinary may be too restrictive, conjuring images of dogs and cats to most,” said Dr. Jim Dale, program planner and secretary for the VPH SPIG.   There is much more to the roles vets play in public health. 

A recently published article in the Journal of Veterinary Medical Education sums up a veterinarian’s public health role and responsibility:

“The WHO recently redefined veterinary public health as the sum of all contributions to the complete physical, mental, and social well-being of humans through an understanding and application of veterinary science. The traditional domains of veterinary public health have been zoonotic diseases, food and water quality, environmental protection, biomedical research, health education, disaster and emergency response, laboratory animal medicine, biological products and medical devices, and management of animal populations.  Emerging areas where veterinarians have an opportunity to improve public health include communicable diseases excluding zoonoses; non-infectious diseases; human animal relationships; leadership and management of community, state, federal and international health programs, and public health departments; and support in the design and efficacy analysis of public health programs. 

“In support of this role, graduates of U.S. schools of veterinary medicine have a median of 60 contact credit hours in public health, epidemiology and preventive medicine, perhaps the strongest of any professional degree.  They also receive arduous training in medical entomology and parasitology – applying their knowledge of life cycles and the agent-host-environment model of diseases in clinical and public health practice.” 

Although all veterinarians are (or should be) involved in public health, a sizable percent (5-15 percent) apply their training, experience, and expertise fulltime as public health professionals at all levels; local, state, federal and international. Veterinarians should be strong advocates for the responsible use of antibiotics, and of all medications.  Similarly, vets must play an active role in advancing the truth and dispelling common myths about zoonotic issues (i.e., intestinal; parasites, pinworms, head lice, feline HIV, BSE etc.). 

What have previously been described as “Veterinary” Public Health issues, as described above, are being addressed by many other professionals including epidemiologists, food safety specialists, laboratorians, human-animal bond specialists and other public health professionals whose work involves zoonotic pathogens and issues spanning the human health-animal health interface. They too would be invaluable partners in the One Health SPIG.   In short, there is no shortage of public health issues that would benefit from the discussion, debate, and support of a newly named “One Health” SPIG of APHA. 

Comments and feedback are encouraged. Please send them to: william.courtney@brooks.af.mil or jdale@jeffco.us.

The Ongoing Dangers of Raw Milk

Awareness of the risks associated with raw milk consumption is high in our community. Here is but another example of such risks.

Campylobacter Outbreak Associated with Unpasteurized Milk - Montrose County, Colorado.

On April 2, three cases of Campylobacter infection were identified in western Colorado counties: one each in Montrose, Ouray and San Miguel Counties. All cases reported consuming unpasteurized milk from a cow share program operated by a dairy in Montrose County. By April 6, seven additional laboratory-confirmed cases were reported through CEDRS among residents of the following counties: Delta, Eagle, Garfield and Montrose. All of these cases reported consuming unpasteurized milk obtained from the Montrose County dairy.  On average, two cases would be reported during March 15 - April 30 in that region, indicating that this was clearly a significant increase. On April 7, CDPHE issued the dairy a public health order to cease distribution of raw milk.

CDPHE, in conjunction with public health professionals from Eagle, Garfield, Pitkin, Montrose, and Mesa Counties, conducted a cohort study using a standard questionnaire. The cow share dairy operator provided contact information for approximately 200 shareholders who resided in Montrose, Delta, San Miguel, Ouray, Garfield, Eagle, and Pitkin Counties. During the course of interviews, seven additional shareholders were identified who were not on the list provided by the dairy. Interviewers collected information on illness and dairy product information for each person in the shareholder’s household and informed shareholders of the need to discard all milk and milk products obtained from the dairy, as the dairy operator was unable to notify all shareholders of the risk. One hundred and fifty-nine shareholders, representing 372 individuals, responded to the survey, resulting in a 76 percent response rate.

In total, 81 cases (Attack Rate= 22 percent) were identified, of which 12 were laboratory-confirmed and 69 were probable cases. One person was hospitalized, and there were no deaths. The median age was 32 years (range 1-79 years); 36 (47 percent) were female. The dairy distributed unpasteurized milk, eggs, yogurt, kiefer, beef, pork and butter to shareholders. Unpasteurized milk was the only product associated with illness [RR 7.0, 95 percent CI (1.01 - 48.60)].

After meeting several conditions required by CPDHE, mainly focused on improved sanitation and product labeling, the dairy re-opened April 23. Although the sale of unpasteurized milk is illegal in Colorado, cow share programs are permitted, and involve individuals purchasing shares of cows (or goats) so they can acquire unpasteurized milk. Cow share programs are not regulated or routinely monitored for compliance with milk sanitation standards. (Colorado Hot Topics In Epidemiology, June 3, 2009   Vol. 9, No. 22.)

Dr. John P. Sanders, Branch Chief – Food Defense/ Preparedness Coordination, Department of Homeland Security, and member of the VPH SPIG Board of Directors, has been a long standing voice about the myths and dangers surround raw milk consumption. Recently he made me aware of an effort by our colleagues, Dr. Randall Nelson, State Public Health Veterinarian, Connecticut Department of Public Health and Dr. Katherine Feldman, State Public Health Veterinarian, Maryland Department of Health and Mental Hygiene, to further raise awareness about raw milk.  They presented the following to the Council of State and Territorial Epidemiologists (CSTE), urging them to make a position statement on this matter.

 

COMMITTEE:  Infectious Disease
TITLE:  Prevention of illness associated with unpasteurized dairy product consumption
I.          Statement of the Problem
 

Milk and other dairy products are a staple of the American diet, and the United States Departments of Health and Human Services and Agriculture recommend that most Americans include dairy products in their diets. However, numerous pathogens might contaminate dairy products and cause human illness, and milk-borne infections were relatively common before the advent of pasteurization in the late nineteenth century. Pasteurization remains the most effective method to assure milk safety.

Michigan enacted the first statewide requirement for pasteurization of dairy products in 1948 and many other states soon followed.  In 1987, the U.S. Food and Drug Administration (FDA) prohibited the distribution of unpasteurized dairy products over state lines for direct sale to consumers. However, sale of unpasteurized dairy products within the state in which they are produced is regulated by individual states and, as of 2006, 25 states permitted, under some circumstances, the sale of unpasteurized dairy products.

Despite the ban on sales across state lines and the broad use of pasteurization by the dairy industry, illnesses and outbreaks associated with consumption of unpasteurized dairy products continue to occur.  States that permit the sale of unpasteurized dairy products have nearly three times the risk of having unpasteurized product-related outbreaks and nearly twice the risk of having outbreak-associated illnesses.  Of particular concern is the high proportion of children involved in milk-borne disease outbreaks and the potential for serious illness.

States that permit the sale of unpasteurized dairy products also serve as a source of unpasteurized dairy products for importation into states that prohibit sales.  By prohibiting the sale and distribution of unpasteurized dairy products within their borders, states can reduce related outbreaks and illnesses.

Unpasteurized dairy products are perceived by some consumers as healthier, more nutritious or more natural than pasteurized products, despite ample scientific evidence that pasteurized products are nutritionally equivalent to unpasteurized dairy products. Proponents of unpasteurized product consumption are increasingly well organized, perpetuate the claims of health benefits and are intent on increasing availability of unpasteurized dairy products in the United States.  Each year, one or more state legislatures consider bills to relax or eliminate restrictions on unpasteurized product distribution.

The FDA, the Centers for Disease Control and Prevention (CDC), the American Medical Association, the National Environmental Health Association, the American Veterinary Medical Association, and the American Academy of Pediatrics recognize the hazards associated with consumption of unpasteurized dairy products and support limiting the sales to pasteurized products.