HOMELAND SECURITY PROGRAM

SCIENCE AND SECURITY SERIES

“Continued Gaps in Biosurveillance: Have the Lessons of West Nile been Learned?”

Dr. Tracey McNamara Veterinary Pathologist

Tuesday, April 17, 2007 1:30 – 3:00 PM

Center for Strategic and International Studies 1800 K St. NW, Room B1-B Lessons Learned from the WNV outbreak in 1999

West Nile virus presented a challenge to our detection and response capabilities because it crossed species boundaries - has this been addressed? “…this case demonstrates the near absence of interagency and contingency planning for zoonotic diseases.”

Report to the Minority Staff, Senate Governmental Affairs Committee to Senator Lieberman, Ranking Member

Given the fact that most of the known biological threat agents and emerging infectious diseases are zoonotic and may be detected in before man…and millions of $$$$ have been spent since 1999… The Role of Sentinel Species in the Early Detection of Zoonotic Events

• 1999 - – significant crow mortality took place well in advance of any human morbidity/mortality but they were “just a bunch of crows”

• 2003 - Monkeypox – the disease was not diagnosed until it spread to people in several states; would it not have been preferable to have tested the prairie ? Integrated Biosurveillance for Real-time Detection of Zoonotic Threats and Emerging Infectious Diseases

• From the point of view of zoonoses, little has changed since WNV– Funding still targets detection in the human population, not in sentinel or reservoir species

• Non-agricultural sentinel species continue to be ignored

• Taxpayers continue to be used as urban biosentinels ZOONOTIC THREATS

We are only looking at Many animal species are not the tip of the iceberg under the jurisdiction of the of federal agencies

Who is responsible for surveillance and testing of

•Pet prairie dogs? •Pet dogs and cats? •Zoo animals •Local wildlife? •Giant Gambian rats?

Urban biosentinels are still left out We continue to take an “Agency-based” vs. “Agent-based” approach to disease surveillance

Homeland Security focus is on getting existing federal agencies to work together

• Does not address the fact that those species that have served as sentinels for EIDs still do not fall under the jurisdiction of a federal agency (pet prairie dogs, zoo species etc) –

• No federal agency has responsibility for detection of zoonotic agents in dogs, cats, exotic pets, zoo animals, wildlife handled by non-state/non-federal personnel (rehabilitators), or local pest species in urban environments We still lack a mechanism for reporting that works across species

• Unlike physicians, have no mechanism through which they can report unusual cases, have them investigated, and have the cost of testing covered;

• There is no equivalent of the “MD-Public Health Dept” system in veterinary medicine (unless a foreign animal disease of agricultural interest only is suspected) From a Biodefense point of view, we have a “species gap”

• Lack of recognition of the double standard applied to non-agricultural species; little diagnostic testing actually being performed in wildlife;

• that, coupled with a lack of uniform standards for those performing diagnostic work on wildlife, guarantees we will continue to miss early warnings Emerging Infectious Diseases

Volume 12, Number 12–December 2006 Introduction

International Attention for Zoonotic Infections

Nina Marano,* Paul Arguin,* Marguerite Pappaioanou,† Bruno Chomel,‡ Esther Schelling,§ Vincent Martin,¶ Jay C. Butler,* C. Ben Beard,* and Lonnie King* *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †University of Minnesota, Minneapolis, Minnesota, USA; ‡University of California, Davis, Davis, California, USA; §Swiss Tropical Institute, Basel, Switzerland; and ¶Food and Agricultural Organization of the United Nations, Rome, Italy

“ surveillance systems are, however, still dangerously deficient in many places in the world, so that an emerging zoonotic problem may be undetected for a while until it has reached such a magnitude that control requires huge efforts.”

Francois Meslin, World Health Organization, 1992

Reference: Meslin, F.X. Surveillance and Control of Emerging Zoonoses. Wld hlth statist quart, 45, 1992. “Global Pathogen Surveillance Act of 2003”

“Developing countries could benefit from: • Better trained public health professionals and epidemiologists to recognize disease patterns • Appropriate laboratory equipment for diagnosis of pathogens • Disease reporting based on symptoms and signs (known as syndromic surveillance), enabling the earliest possible opportunity to conduct an effective response • Appropriate communications..including Internet based Geographic Information Systems(GIS)”

When it comes to real-time detection of zoonoses across species lines, we are a “developing country”! False sense of security ? We still do not use a species neutral approach to surveillance for zoonotic threats

SENTINEL SPECIES…

BUT, WHO REALLY KNOWS WHO OR WHAT WILL PROVIDE EARLY WARNING FOR THE NEXT ZOONOTIC THREAT??? WNV as a Model of Response to an Unknown Zoonotic Threat

• Question # 1 – What were the factors that contributed to delayed recognition of WNV?

• Question # 2 – Have those factors been addressed?

• Question # 3 – What did we need to make a diagnosis and respond with surveillance?

• Question # 4 – If a similar situation arose tomorrow, would the response differ significantly from that of seven years ago? • Question # 5 - Are we even asking the right questions??? The Point of Biosurveillance

Detect zoonotic threats in animal sentinels or reservoirs before people are in the emergency room! Goal is to detect health threats at the far left of the epidemic curve Logical Approach to Zoonoses Detect zoonotic disease threats prior to significant human morbidity and mortality Find the “index” case

Human

Agricultural Wildlife Species

* Implies a “species neutral” approach to disease surveillance * Implies equity across the agencies responsible for them The Reality of Biosurveillance in the USA

Human Health Agriculture $$$$$$$$ $$$$$$$$$$$

WL Pets Zoos

With the exception of and WNV surveillance, there is little overlap between the human and animal sectors and a marked discrepancy in funding USDA Mission/ Species Bias

• Agriculture - Food animals of economic importance

• Cattle, swine, poultry, some equine

• Primary concerns are foreign animal diseases, not zoonoses (plague/tularemia are not problems in cattle)

• Crows? Raptors? Zoo species? Dogs? Cats? These are not the focus of the NAHLN

• Which of the above might serve as URBAN sentinels? “Program” diseases vs. Pathogen Discovery Vulnerabilities from the perspective of Zoonotic Threats

Zoonoses not emphasis Jurisdiction over WL only as it APHIS WL impacts on NAHLN agricultural species

Zoos? Fed/State Pets? Wildlife

NWRA

Syndromics but no access No emphasis on pathology to diagnostics or real-time diagnoses TMcN Another way of looking at it …

Human Health

Agriculture

Pets/Zoos

WL

If our Our Ability to Detect Zoonotic threats depends upon Non-Agricultural Species, our situation is precarious indeed The Reality of Biosurveillance in the USA

“All animals are created equal but some animals are more equal than others” George Orwell

“Just a bunch of crows” …. # 1 WNV Deaths early June 1999 to mid- August

<------>

Avian sentinels gave early warning well in advance of human morbidity and mortality but were ignored – Why? However, $$$ is not the only issue… Cultural differences between Agencies and emphasis on diagnostics

Diagnostic Double (Triple) Standard across Species

One for people, one for animals with owners, and one for free-ranging wildlife Free Ranging Wildlife and the ability to detect “index” cases

• More than 400 crows had been submitted for testing since early June 1999

• Illustrates fact that wildlife disease surveillance is insensitive to individual losses

• “Mother Nature” mentality – high threshold

• The “culture” of free-ranging wildlife Details Report for: 19-1023.00 Zoologists and Wildlife Biologists

Importance Category Task

Core 78 78 Study animals in their natural habitats, assessing effects of environment and industry on animals, interpreting findings and recommending alternative operating conditions for industry.

74 Core Inventory or estimate plant and wildlife populations. 73 Core Analyze characteristics of animals to identify and classify them. 73 Core Make recommendations on management systems and planning for wildlife populations and habitat, consulting with stakeholders and the public at large to explore options.

Source: Bureau of Labor Details Report for: 19-1023.00 Zoologists and Wildlife Biologists

Importance Category Task

56 Supplemental Coordinate prevention programs to prevent disease outbreaks

53 534038 Prepare collections of preserved specimens or Supplemental microscopic slides for species identification and study of development or disease.

40 Supplemental Raise specimens for study and observation or for use in experiments.

*** 38 Supplemental Collect and dissect animal specimens and examine specimens under microscope.

Source: Bureau of Labor Wildlife Agency Survey – Dr.Milt Friend

USGS Congressional briefing September 26, 2003

• Does your agency /institution currently commit internal resources in support of disease investigations? • What is the nature of that support? (personnel? laboratory?) • What species are dealt with by internal program activities? • What are the sources for your diagnostic cases? • Can non-agency/institutions readily utilize the disease diagnostic capabilities of your program?

These questions were raised in 2003 but remain largely unanswered at the state level Lack of Uniform Standards for Diagnosticians across species

Unless this is addressed in some manner, we could miss sentinel events/early warning of zoonotic disease threats in the future Illustrates the difference in mindset/sensitivity between free ranging wildlife and captive endangered species investigations where emphasis is on the individual animal

# 2 Zoo investigation of bird deaths “Zoonoses” Mindset

When little is known, it is best to assume nothing – Zoos do ACTIVE disease surveillance and Pathogen Discovery Herds/flocks “at risk” Deal with unusual species

Threat of introduced disease from indigenous wildlife Lack vaccines for common diseases Captive Wildlife in Zoological Institutions

• “Valuable” individual animals – endangered species • Sensitive to individual losses due to concern about disease spread to other collection animals • Zoos do active disease surveillance • Zoos do “pathogen discovery” 100 % Necropsy Policy Histopathological evaluation

Archived tissues Real-time retrieval of data WNV as a Model of Response to an Unknown Zoonotic Threat

What did we need ? Do we have them now ???

All were critical to defining, • Baseline data understanding and responding • Serum banks to a novel public health and • Tissue banks veterinary threat but they came • Comparative from an unusual source Histopathology (the private sector)

Are there plans for the creation of National archives ? Synchronicity ? Yes Situational Awareness ? No

# 3 Zoo Bird Deaths

Human Deaths Synchronicity ? Yes Situational Awareness ? No

• There has been little effort to ensure that Information exchange is Bi – directional

• Emphasis seems to be on Public health/DHS obtaining data from the veterinary and wildlife community but not vice versa

• Efforts seem focused at the state or federal level, not at the level of the practitioner ““SituationalSituational AwarenessAwareness”” –– thethe ““Aha!Aha!”” momentmoment

NYC DOH announces SLE Encephalitic people, Labor Day Weekend Encephalitic ? Hmmmmm… Syndrome Reporting Information System

• Real-time, web-based early warning system for preventing emerging health threats, natural or intentional • Detects all diseases of public health importance (e.g. bio- terrorism diseases such as Smallpox and Anthrax and “emerging” diseases such as SARS, Avian , West Nile Fever) • Connects health care providers and analysts (Physicians, Veterinarians, Public Health Officials, Coroners, Emergency Medical Response, Animal Control, Laboratories, etc.)

• Facilitates 2-way communication between doctors and public health officials (syndrome reporting and alert dissemination)

Courtesy of Dr.Al Zelikoff # 4

WNV Diagnosis

Major Issues

(A) Confidentiality? (B) Access to diagnostics? Confidentiality for the source of animal data ? (A) But, within weeks of September 11th, the NYCDOH amended it’s Health Code law and made zoonoses and “unusual events” immediately reportable to public health officials by veterinary practitioners with the guarantee of confidentiality DEPARTMENT OF HEALTH BOARD OF HEALTH NOTICE OF ADOPTION OF A RESOLUTION ADDING A NEW SECTION 11.64, REPEALING AND REENACTING SECTION 11.65 AND AMENDING SECTION 11.66 OF THE NEW YORK CITY HEALTH CODE

(4) An outbreak or suspected outbreak of any disease, of known or unknown etiology, occurring in three or more animals, or any unusual manifestation of a disease in an individual animal, shall be reported to the Department immediately by telephone, and confirmed in writing, either by mail, facsimile or electronic transmission acceptable to the Department, within 24 hours after diagnosis.

Given that we still lack a uniform national reportable disease list, couldn’t other municipalities follow this example??? DEPARTMENT OF HEALTH BOARD OF HEALTH NOTICE OF ADOPTION OF A RESOLUTION ADDING A NEW SECTION 11.64, REPEALING AND REENACTING SECTION 11.65 AND AMENDING SECTION 11.66 OF THE NEW YORK CITY HEALTH CODE

“A person, institution or agency to whom such information is furnished or to whom access to records has been given, shall not divulge any part thereof so as to disclose the identity of the person or institution to whom such information or record relates, except insofar as such disclosure is necessary for the treatment of persons or animals or for the protection of human health.”

Couldn’t other municipalities follow this example???

If not, we may need to discuss indemnification for non-Ag species (B) Access to diagnostics for the sentinels was not found in any mission statement

“Several persons involved in the outbreak commented that the zoo community is currently left out of the animal and public health paradigm”

(GAO/HEHS-00-180)

The sentinels were left out of the surveillance plan !

Many D.O.H.’s said “We will only test crows”…

But, there is a downside to approaching zoonotic threats strictly from a Public health point of view… What was learned from the Veterinary Investigations on zoo birds and crows?

How can you look for what has not been defined? What tissues should be submitted for testing? Brain? Heart? Intestine? Kidney? Pantropism of WNV 99

• Primary Target: Cerebellum • Purkinje Cells • Molecular Layer • Brainstem Neurons • Meningeal Fibroblasts, Macrophages Cerebellar folia Brainstem neurons • but also

• Heart, Kidney, Adrenal, Spleen, GI, pancreas • Skeletal/smooth muscle • Ovaries, testes • Feather follicles Myocardium Adrenal

Dr.Keith Steele, Dr. Jonathan Smith, Dr. George Ludwig- USAMRIID WNV in Zoo Birds

• 24/26 Brains (92%) • 10/13 Adrenals (77%) • 24/25 Hearts (96%) • 12/13 Intestines (92%) • 15/18 Spleens (83%) • 10/12 Pancreata (83%) • 13/20 Livers (65%) • 5/12 Lungs (42%) • 20/20 Kidneys(100%) • 4/8 Ovaries (50%)

If one only tested 1 tissue, the possibility of false negatives was high

In 2000, NYSDOH revised it’s submission protocols and advised multi-tissue sampling Serosurvey of Zoo Species

Very Broad Species Susceptibility

Passeriformes - Crows, Black Billed Magpies Ciconiiformes - Chilean Flamingos, Black Crowned Night Heron Pelicaniformes - Guanay Cormorants Charadriiformes - Laughing Gulls Anseriformes - Mallard, Bronze Winged Ducks Galliformes - Impeyan Pheasants, Tragopan Falconiformes - Bald Eagle Strigiformes - Snowy Owl Mosquito Species ?

Culex pipiens was assumed to be the primary vector but we wondered if mammal feeding species could be involved

•Neurologic rhinos •Neurologic elephants Biosafety Level

•Immunohistochemical stain for WNV •How much virus was in these birds? Alternative Modes of Transmission?

Carnivory? Vertical ?

Diptheritic membrane gi Fixed tissue WNV gi IHC Horizontal – fecal-oral? A Big Assumption…most rehabilitators volunteer their services and have no funding for diagnostics of any kind The Private Sector paid for experimental studies out of their concern for the birds themselves… New Modes of WNV Transmission in Humans

• Organ transplantation • Transfusions • Transplacental • Breast Milk • Occupational – extraordinary viral titers in bird tissues • More than 39 species of mosquito vectors

In future zoonotic disease outbreaks, who will decide which studies need to be pursued? The turning point….

CDC WNV Planning Meeting 2001

NYS DOH evaluated two summers of data and concluded that “traditional means of surveillance had not been predictive of human risk”

Recommended “dead bird” surveillance Zoos as sentinels for E.I.D.S.

• “We need a diagnosis now” mindset • Petting zoo domestic livestock/poultry • Veterinary expertise • Supportive of diagnostic pathology • Serum banks/tissue archives • Do active disease surveillance for zoonoses • Use a “Pathogen discovery” approach

Built in long term epidemiological monitoring stations

WNV Surveillance system in Zoological Institutions

CDC Zoo Zoo Central Zoo DB Zoo Zoo Cornell Zoo Zoo Zoo

Zoo Zoo Local PH Joint CDC/Zoo Program established in 2001 This cooperative Zoo/CDC program was the first to deal with the issue of confidentiality of the source of animal data when shared with public health Success of the network = Simplicity + Mutually beneficial

• CDC provided $$ for the cost of diagnostic testing at a veterinary diagnostic lab; the private sector did the rest

• Zoos gained access to diagnostic testing and confidentiality Win – Win – Mutually beneficial

• Public Health received data at the local, state and federal level for inclusion into ArboNet

• Public health leveraged the infrastructure, manpower, expertise of the zoo community nationwide (standardized submissions, standardized testing and reporting; built-in sentinel population covering the geographic breadth of the nation) “Surveillance for West Nile virus in Zoological Institutions” Database

Federal Funding from CDC Private Sector – For cost of diagnostic testing Lincoln Park 2001-2004 Zoo/Cornell/SilicoInsights

EllisonFoundation • Project provided service Funding for Development for unrepresented of Database portion of the animal community (zoos/WL rehabilitators) • Data shared with local DOHs ArboNet Our Reality The Challenge of dealing with States versus “The State”

How can we detect biologically related but geographically separated “events” when it is still difficult to see human or animal data across state lines? Unique features of the Zoo Network

• Provided a “Bird’s Eye View” of the nation

• Could see data across state boundaries every 24 hours in centralized zoo diagnostic database

• Captured data on species not otherwise represented

• Can be expanded to other wildlife groups, veterinary diagnostic labs, other pathogens

2001 -2004

Only 300 K !

Nationwide zoo participation The advantage of surveillance in non- agricultural (zoo) species

• Unique Database – captured epidemiological information not normally found in veterinary diagnostic lab databases and lends itself to predictive modeling

• Leveraged the work already done by the National Animal Health Laboratory Network/Laboratory Response Network on bioinformatics

• Enhanced the NAHLN/LRN effort in that the focus of ZooNet is on zoonoses

•Ensured quality of diagnostic data by linking captive/free- ranging wildlife communities to academic veterinary diagnostic laboratories Expansion of Zoo Network for Transboundary Wildlife Disease Surveillance

Canadian Zoos Mexican Zoos

Centralized Zoo Database June, 2001 - Surveillance for West Nile Virus in Zoological Institutions Workshop Lincoln Park Zoo, Chicago

August, 2002 - National Zoo and Veterinary Zoonotic Infectious Disease Surveillance Meeting

February, 2003 - 2nd Infectious Zoonotic Disease Surveillance Meeting

CONCEPTUAL FRAMEWORK FOR AND IMPLEMENTATION OF AN INTEGRATED NATIONAL ZOONOTIC DISEASE SURVEILLANCE SYSTEM January 9-10, 2006 Lincoln Park Zoo meeting in Chicago Funded by the Davee Foundation

Avian Influenza: bridging the gap between zoo, agricultural, and public health communities

CDC, USDA, USGS, AZA, AAZV, PH, Academic Wildlife Centers, Veterinary Diagnostic Labs Proposed Expansion of Zoo Network for Detection of Zoonotic Threats in 2007

U Minnesota

Cornell

Central UC Davis Zoo Database

1. IT support to complete existing centralized zoo WNV database

2. IT support to create messaging capabilities at 2 additional veterinary diagnostic labs that have agreed to test zoo/wildlife samples (U Minnesota; UC Davis)

3. Expansion of data fields to capture H5N1 diagnostic results generated in 2007 Regional Diagnostic CDC? Centers for Detection DHS? of Zoonotic Threats NBIS?

Source of samples ??

Designated Users Zoos Cornell Wildlife Rehab. U Minnesota Centralized Practitioners UC Davis Database SQL Server

1. Samples submitted to Vet Dx Labs for •Generates automatic testing reports to designated users 2. Vet Dx Labs send results back to submitting •Geolocation of data institutions •Geographic coverage USA 3. Submitters report results to CDC, USDA, ? 52

50 66

34 ?? The advantage of surveillance in non- agricultural species

• Baseline data on the incidence of zoonotic agents in urban environments can be obtained by incorporating diagnostics into routine pest control programs

• Window into the illegal exotic animal trade – Confiscated animals end up in zoos pending legal proceedings; animals represent opportunity to do “pathogen discovery” testing to see what might be coming across our borders illegally

•Free-ranging wildlife handled by wildlife rehabilitators – ZooNet coordinators and the National Wildlife Rehabilitators Association (NWRA) have working agreement to support NWRA’s syndromic surveillance with diagnostics – would be means of validating syndromic surveillance in wildlife DATA MINING

Federal Efforts Cover a Wide Range of Uses GAO-04-548 May 2004

• Emphasis has been on linking existing data sets.

• But, the data we seek may not exist….

• Lack of baseline can make it hard to detect a blip above normal Need to leverage the Technology being developed by other Interest groups (DOD, National Labs - Los Alamos, Sandia, Lawrence Livermore) and apply to non-agricultural species

Why don’t the National Labs place high throughput multiplex PCR into the NWRL? NWHC? Veterinary diagnostic labs that are testing zoo/WL samples? Zoo species offer the possibility of doing ACTIVE disease surveillance but tests will need to be validated

Built- in “Sentinel Flocks”

+ Routine Pest Control + Confiscations At a time of shrinking budgets, how can we meet the needs for zoonotic disease detection in urban settings under 2 distinct Time frames ?

Embrace the private sector

Sporadic “Event” detection – tests to be performed on zoo species/urban fauna based on detection of “clusters”

Long term urban “Situational Awareness” through active disease surveillance for zoonotic threats/emerging infectious diseases using captive zoo species/ local fauna as urban “sentinel flocks” ZooNet - Zoos/ WL rehab Biodefense Technology Active/Passive Surveillance •Field Diagnostic technology •+++ species •High Throughput Diagnostics •serum samples •Tissue samples Validation of new technologies •Clinical Histories •Necropsy data •Ability to follow known STOP ! individuals over time MITIGATION Samples Public Health gets Real-time dx Results of Zoonoses

Veterinary Diagnostic Labs Regional Centers of Excellence •Veterinary , • Sequence novel isolates •bacteriology, serology •Pathogenesis studies •Etiologic diagnoses emphasized •Animal models •Veterinary cell lines to pursue •Immunology studies novel findings •Source of materials for RCEs TMcN Application of real-time, high throughput multiplex diagnostics and species neutral serosurveillance assays to captive/free-ranging wildlife

• Justification: Not in use for non-agricultural species; High throughput will enhance real-time diagnosis of “events”; will also speed creation of baseline data on zoonoses/emerging infectious diseases

• Estimated Cost: $ 300, 000.00/lab; to set up at the National Wildlife Research Laboratory ; National Wildlife Health Center; Participating veterinary diagnostic labs Support for the creation of a “lingua franca” veterinary medical terminology center

• Justification: Non-agricultural veterinary communities lack economic push for standardized reporting

• without support, will not be able to share data on non-agricultural species that could serve as urban biosentinels (zoo species; wildlife; pets)

Dr. Jim Case (UC Davis); Dr Jeff Wilcke; Dr.Julie Green (VA-MD Tech) National Animal Health Laboratory Network

Nat'l Veterinary Colorado State Services Lab New York State University VDL Wisconsin Animal (NVSL) VDL - Cornell Health Laboratory

Iowa State Washington Animal University VDL Disease Diagnostic Laboratory

North-central Northeastern Region Region

Western Region Rollins Animal Disease California Diagnostic Animal Health Laboratory, and Food Safety Southern North Carolina Laboratory Region

Arizona University of Veterinary Georgia Athens Diagnostic Diagnostic Laboratory Laboratory Texas Veterinary Medical Diagnostic Laboratory Louisiana Veterinary Medical Diagnostic Laboratory Oklahoma Animal Disease Diagnostic Laboratory Florida Animal (Animal Diagnostic Disease Laboratory Support) Support for the creation of centralized archives

Justification: Mechanism to ensure samples will be available for future testing and for more than the one “disease du jour”

Historical example: WNV was one of the largest wildlife disease surveys ever performed in the USA but, public health only looked for 1 disease and threw out WNV negative samples without further testing – we could have used archived samples to test for H5N1 and other zoonotic threats Support for the creation of centralized archives

Near term:

• Funding to support creation of a centralized archive at the National Wildlife Research Laboratory (NWRL), Fort Collins, CO. of zoo samples/isolates that will be tested for H5N1 this fall; the lab has BL-3 and software to curate samples; archive negative samples for further testing Estimated Cost: $ 400, 000.00

Longer term:

• Creation of centralized Biomaterials Repository for zoo/wildlife specimens; possibly at the Smithsonian Institution, Museum of Southwestern Biology, N.Mex.? ISIS ZIMS

• International Species Information System

• World’s largest member organization of zoos and aquariums

• 30 years of sustained membership growth

• US 501c3 non-profit organization. – Headquarters in Minneapolis: – Branch offices in Amsterdam, Sydney

• Specialized on animal information services – Inventory, pedigree, demographics – Veterinary, epidemiological – Animal IT system provider (>600 institutions and ~20,000 users run ISIS current desktop software systems). ISIS ZIMS Network Advantages

• The monitored animals are •ALREADY PAID PROFESSIONALS mostly downtown– most are doing the monitoring – trained zoos are located near the and in place - hundreds of zoo vets, vet technicians, plus vet center of our major urban pathologists. centers. 140 Million US citizens visit these animals yearly. ISIS has member zoos in 200 US cities in 47 states (plus 400 other cities internationally). WNV as a Model of Response to an Unknown Zoonotic Threat

• Question # 1 – What were the factors that contributed to delayed recognition of WNV? • (Agency based/ Species bias/Lack stds)

• Question # 2 – Have those factors been addressed? (No)

• Question # 3 – What did we need to make a diagnosis and respond with surveillance? • (Samples/Comparative pathology/Mindset)

• Question # 4 – If a similar situation arose tomorrow, would the response differ significantly from that of seven years ago?

Volume 19 | Issue 19 | Page 60 | Oct. 10, 2005

To Fight Plague, Look to Russia's Past

The Tsars, and then the Soviets, created a Yersinia pestis surveillance system that today's epidemiologists should envy

By Janet Ginsburg

Center for Nonproliferation Studies, Monterey Institute of International Studies The budget requests $481.4 billion in discretionary authority for the Department of Defense base budget, an 11.3 percent increase over the projected enacted level for fiscal 2007, for real growth of 8.6 percent; and $141.7 billion to continue the fight in the Global War on Terror (GWOT) in fiscal 2008.

NEWS OF THE WEEK 2008 U.S. BUDGET: Research Rises--and Falls--in the President's Spending Plan Jeffrey Mervis

On 5 February, President George W. Bush sent Congress a 2008 budget request for science that favors a handful of agencies supporting the physical sciences and puts the squeeze on most of the rest of the federal research establishment as part of an overall $2.9 trillion plan that clamps down on most civilian spending. How can we move away from the “disease du jour” mentality?

How can we create a system that detects sporadic events as well as providing sustainable urban Biosurveillance?

The key to sustained biosurveillance is in working with those private sector groups that routinely perform those activities Here & Now Down the road

• Link 3 vet dx labs doing • Link all NAHLN labs zoo/ NWRA work now • Expand NAHLN to • Address confidentiality issues zoonoses/EIDs vs. • Discuss “what-if” above traditional FADs only fails • Hire State Public health • High-throughput Vet in all states microarrays for non-Ag • ZIMS worldwide (buy- species in) • NYCDOH Health Code- Governers Assoc? • Other Intl. efforts The advantage of surveillance in non- agricultural species

• Leverages the “bird-in-hand” opportunities for active disease surveillance without additional cost to public health

• Sustainable due to inherent interest on the part of participants in animal health and long term conservation efforts

• Leverages the tradition of maintaining serum banks, tissue archives, and animal records on captive wildlife, all of which were critical to the investigation of WNV and could play the same role in future emerging zoonoses

•Capitalizes on the untapped manpower, interest, and “astute diagnostician” expertise available in the non- agricultural veterinary arena HHS Biopreparedness Soviet Anti-Plague Funds System

•Did activedisease surveillance State DOHs – Local DOHs for zoonotic threats • Have baseline data on zoonoses How can we achieve the same results $$$$$ to Private quickly? Sector Data Sources for cost of testing

•Local wildlife found on grounds of zoos as part of routine pest control activities can provide baseline data on zoonoses in urban settings

•WL rehabilitators can collect samples for archive and testing prompted by syndromic surveillance

TMcN Human

Agriculture Wildlife/ Other

Even with very different mission Statements, we can identify overlapping areas of “enlightened self-interest” The next sentinel species may be a lot closer than we expect!