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The National Companion Animal Surveillance System (NCASP) A Supercourse Lecture

The National Companion Animal Surveillance System (NCASP) A Supercourse Lecture

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The National Companion Animal Surveillance System (NCASP) A Supercourse Lecture

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  1. The National Companion Animal Surveillance System (NCASP)A Supercourse Lecture Larry Glickman, VMD, DrPH Nita Glickman, MPH, PhD Department of Comparative Pathobiology Purdue University School of Veterinary Medicine West Lafayette, IN 47907-2027

  2. Banfield Pet Hospital-Purdue UniversityThe National Companion Animal Surveillance System (NCASP)

  3. Objectives of Lecture • Learning Objectives • understand the principles of syndromic surveillance • appreciate why animals may be good sentinels for human health • Performance Objectives • graph and interpret changes in frequency of health events over time • design a surveillance program using either syndromic events or diseases

  4. What is the National Companion Animal Surveillance Program (NCASP) • NCASP is a national, near real-time, surveillance system that uses the electronic medical records of pet animals seen at >560 veterinary hospitals in the U.S. to detect events that signal the threat of an emerging infection, a terrorist threat, or a natural disaster, for people living in the same geographic area • Supported by a grant from the CDC

  5. Mission of the National Companion Animal Surveillance Program • Provide real-time and near-real-time information on syndromic and disease events that occur among species of pet animals in the United States • Conduct detailed statistical analyses to identify space-time clusters of events and characterize host and environmental risk factors • Alert to the occurrence of potential acts of bioterrorism, emerging zoonoses, and toxic chemical exposures • Serve as a sentinel for the occurrence of environmentally related diseases (e.g.., cancer)

  6. Surveillance – CDC Definition • Ongoing systematic collection, analysis, and interpretation of health data • Essential to the planning, implementation, and evaluation of public health practice • Closely integrated with the timely dissemination of these data to those who need to know

  7. Temporal Sequence of SurveillanceDisease Specific or Syndromic Events Recovery Agent Signs & Symptoms (I & W) Diagnostic Tests Specific Diagnosis or Agent Outcome Death Syndromic Surveillance Exposure Surveillance Traditional Surveillance I & W = Indications & Warnings

  8. Why are Animals Good Sentinels for Emerging & Human Infections? • 1,407 pathogens affect humans; of these 58% are zoonotic • 177 of these pathogens are considered ‘emerging’ or ‘reemerging’ • 38 animal diseases have affected humans over the past 25 years • SARS • Monkey pox • Avian Influenza • West Nile virus

  9. Biothreat A Agents in Dogs & Cats * - CDC 2003: http://www.bt.cdc.gov/agent/agentlist-category.asp ** - reported with species of greatest (or equal) susceptibility first

  10. Advantages of Using Companion Animals as Sentinels • 62% of American households own a pet ■39% dogs ■34% cats ■58% any • Pets less mobile than people • Less confounding (smoking, alcohol) • Explore environment (smelling, licking) • Shorter latency time (exposure to disease) • More sensitive to fixed pathogen dose?

  11. >550 hospitals 18,000 hospitals Purdue University Data Warehouse Data Mining National Companion Animal Surveillance Program (NCASP)

  12. Banfield The Pet Hospital • Currently >560 full service hospitals • Add 2 new hospitals per week • Located in 44 states, Mexico, UK • >3.0 million patient visits yearly • ~ 10,000 patient visits daily • ~ 1-2% of U.S. pet population • Addresses of pets geocoded • Web addresss: Banfield The Pet Hospital

  13. Banfield The Pet Hospital • Paperless practices • Standardized medical records • Computerized records sent nightly to central data warehouse • Subjected to quality control • Corporate HQ in Portland, OR

  14. Banfield PetWare Proprietary Software Pet Demographics Exam findings Diagnoses Office Visits Laboratory Results Treatments Medical Notes

  15. Banfield Hospital Locations in Major Metropolitan Areas Los Angeles Phoenix Dallas Chicago Atlanta Washington DC as of June 13, 2006

  16. Number of Dogs & Cats Visiting Banfield The Pet Hospital in 2005

  17. Number of Other Animal Species Visiting Banfield The Pet Hospital in 2005

  18. National Flea/Tick Pathogen Surveillance Vector ID Pathogen ID Medical Records Web Portal Ticks: Anaplasma sp, Babesia sp, Bartonella sp, Borrelia lonestari, Erlichia sp, Francisella tularensis, Rickettsia sp Fleas: Bartonella sp, Dipylidium caninum, Mycoplasma sp, Rickettsia sp, Yersinia pestis

  19. Relationship between Canine Tick Activity & Human Lyme Disease

  20. Change in frequency of respiratory syndrome in pets following hurricane Katrina

  21. Alert!!!Fayette County-GA’s Own “Silent Summer” • Philips Services, Corp. plant emits noxious chemical • 600 residents sickened by onion-like chemical odor • Like their owners, many dogs and cats are sick, nearly all within 2-mile radius of PSC plant • Pets dying from June-Aug. with signs of vomiting, diarrhea, skin irritation, dyspnea • Chemical pesticide identified as Ethoprop • Purdue contacted Sept. 2 for help regarding the acute & long-term health of animals and residents in community

  22. Banfield Hospitals Near Fairburn, GA Georgia Dept of Health Chemical Hazards

  23. Banfield Dogs and Cats Living Within 15-miles of Chemical Plant in Fairburn, GA Banfield Cats n = 3,065 Banfield Dogs n = 15,753 1129 288 Fairburn Chemical Plant 281

  24. Fairburn Georgia♦ Respiratory syndrome in pet dogs following possible exposure to a hazardous chemical released during week 26♦ Dogs living 10-20 miles from Fairburn, GA were thought to have had the greatest exposure

  25. >550 hospitals 18,000 hospitals Purdue University Data Warehouse Data Mining National Companion Animal SurveillanceProgram

  26. Leptospirosis • World-wide zoonotic disease • Gram negative bacteria • Spirochetes • Genus Leptospira • Over 250 serovars

  27. Transmission • Direct (hospital) • Infected urine • Bite wounds • Ingestion • Indirect (community) • Contact with stagnant or slow moving water contaminated by urine • Leptospirosis at triathlon in Illinois

  28. 2002 2003 2004 Positive >= 1:800 Canine Leptospirosis, US, 2002-2004

  29. Highest Percent Positive Leptospira Serovar by State 2004

  30. Summary • The National Companion Animal Surveillance System provides complementary syndromic surveillance capability to the more traditional use of human hospital records to detect acts of bioterrorism, emerging infections, and to study health effects resulting from natural and man made disasters such as floods, hurricanes, and accidental chemical releases into the environment

  31. Summary-con’t • The success of parallel animal and human syndromic surveillance ultimately depends on development of better statistical and visual methods to identify correlations between temporal and spatial changes in syndrome frequency in humans and animals and better communication between ALL health care providers

  32. The New Yorker, June 16 & 23, 2003