Veterinarians
&
their role
in
Bioterrorism
Veterinary Ethics & Jurisprudence
Dr. McCarthy
Written by:
Kim I. Barlowe
4 October 2006
In the last decade, the need for veterinarians in the public health sector of human
medicine has drastically increased. From cases of Bovine Spongiform Encephalitis to
Avian Influenza to Anthrax, there has never been a greater need for veterinarians than
right at this present moment. With the state of the world today and the ever increasing
threat of bioterrorism and agroterrorism, all veterinarians should be required to not
only study that areas of public health, zoonoses and epidemiology but also to learn
how to deal with outbreaks of diseases, emergency plans in case of bio/agroterrorism
disasters on a local level in addition to a large scale area as well. It is important to relate
small and large animal medicine and disease at a small clinic or farm to cases and
outbreaks in towns, cities, states and countries. With the threats of bioterrorism within
domestic soil as well as from international soil, it will become prevalent that all
veterinarians can diagnose, handle and report and suspicious threats to the animal and
human community.
BIOTERRORISM is defined as the intentional use or threatened use of a biologic
agent to hurt people, create fear or disrupt society. AGROTERRORISM is the
intentional or threatened release of a biologic agent to destroy or damage livestock or
crops.
Veterinarians have a broad combination of knowledge and skills that make them
an asset to any crisis or public health team. “Their education includes extensive
knowledge of microbiological, chemical, and physical health hazards of food animals.
Upon graduation, Doctors of Veterinary Medicine have the basic foundation for
building advanced public health and preventive medicine skills in risk assessment,
management, and communication, and in human and animal population ,
epidemiology and statistical evaluation (FSIS, 2000). It is important that with this
knowledge, veterinarians are taught to apply this to current issues in the world today in
addition to being seen as valuable assets to not just animals but the human population
as well! “These skills help veterinarians make individual animal disposition judgments
and target animals that may need more intensive inspection and/or diagnostic work.
Examples include: (1) surveillance for exotic or notifiable diseases (e.g., bovine
spongiform encepholopathy, brucellosis and tuberculosis); (2) monitoring for disease or
physiological states which can increase the potential for, or significance of,
contamination occurring during processing (e.g., severely stressed animals tend to be
high shedders of Salmonella); (3) assessing suitability for entering slaughter of nonambulatory animals (downer animals), injured animals or animals approaching
parturition (about to give birth), and then examining them after slaughter; (4) checking
for signs indicating likely recent drug treatment or exposure to contaminants; and (5)
monitoring for disease or physiological states which make the animals unsuitable for
slaughter for human consumption (e.g., septicemia, toxemia etc); humane slaughter
oversight. While other specialists may be able to evaluate animals as "normal" or "not
normal," a veterinarian should make a specific diagnosis and interpret the significance
of the findings (FSIS, 2000)”. These skills should be applied to small and large animals
on a daily basis. It is important that during each daily evaluation of animals,
veterinarians show diligence in remembering that in these uncertain times, anything is
Veterinarians and bioterrorism. K.Barlowe (2)
possible.
It will be important for veterinarians to ensure that not only are these
animals healthy and disease-free but to confirm that they are not public health hazards.
It is important that veterinarians recognize pathogens of danger to humans and
the environment, as well as animals, that could be used as bioterrorist weapons.
Veterinarians are well placed to detect the possible use of such agents and increased
vigilance by veterinary surgeons at this time can provide a valuable safeguard. Many
potential biological warfare or terrorist weapons are zoonoses. Animal pathogens can
be utilized if the purpose of their release is restricted to causing major economic
damage. Animal pathogens can even cause serious harm if not deliberately released.
“A recent example of veterinarians being crucial in the identification of a serious
zoonosis – one that was unassociated with any deliberate release –was the diagnosis by
a veterinary surgeon in the Bronx zoo in New York City of West Nile Virus (WVA,
).” Early detection in animals can help avoid mass human morbidity/mortality.
Veterinarians can help improve the world’s preparedness for any biologic attack
or outbreak by being specifically gearing their training (aside from their already
extensive educational training, including continuing education) and though processes
to include: “ improving detection and reporting of disease incidence, developing
emergency plans, which include communication, disease containment, and diagnostic
strategies, conducting and participating in practice emergency scenarios, increasing
laboratory capacity, and strengthening partnerships among federal and state agencies
and public and private health officials (AVMA, 2002). It is just critical that the
perception of veterinarians far exceeds just treating animals such as “Old Yeller, Benji,
Garfield, Bambi and Barbaro” when they are ill. It will be important that veterinarians
are compensated by recognition in addition to monetary values as as they are not only
treating animals but they are indirectly protecting the public.
The role that animals play in a public health role is great. When discussing
animals and public health, should call to attention the following facts. There is a
human-animal bond that exists between client and their animal (in domesticated
animals in addition to some large animals). Foodborne illnesses are always a threat to
humans every time they eat some food. Animals serve as sentinels, especially for WNV,
rabies, flue, anthrax, plague, hanta virus, etc. The connection between animals, humans
and public health needs more recognition. It should be considered in disease ecology
and epidemiology. There has been more attention to veterinarians, their role in public
health, animals as sentinels but it is not enough.
Zoonoses impact our lives nearly everyday. Many bioterrorism/agroterrorism
agents are zoonotic. Early detection in animals can save human lives. Veterinarians
and animals should be included in a complete public health. There are some facts that
will help the veterinarian localize a potential zoonosis and think about an intentional
bioterrorist episode. Some of these clues are: (1) a clustering of morbidity or mortality
(temporally or geographically) (animals or people); (2) generally healthy animals or
people are affected; (3) unusual symptoms for area; (4) unusual age distribution; (5)
disease occurring outside the typical season (Rabinowitz, 2006).
Veterinarians and bioterrorism. K.Barlowe (3)
Another constructive step would be to improve the capacity of existing
veterinary rapid-response teams, which exist in many states, to carry out active
surveillance with animal populations as well as to improve the coordination of
veterinary diagnostic laboratories. Additional training should be provided not only to
these veterinarians but other veterinarians who would like to participate and in case
something happens to a team member. In turn, the veterinarians could also educate
their clients in order to help prepare them in case something should occur with their
animal such as a specific disease that is used as a bio/agroterrorist agent or acute
clinical signs of one.
The more that all veterinarians are trained more specifically to address bio/agro
terrorist issues, the more that the public will recognize the critical need for veterinarians
and their role in not only their animals health but their own. If clients question why
veterinarians or public health professionals should care about bioterrorism or
agroterrorism, it is important that veterinarians are prepared to answer. One should
know and understand how veterinarians are a critical part of society today. If and
when such an attack ever occurs, the factors that could be used are susceptible civilian
populations, agents that cause high morbidity and mortality, difficult to detect the
release of the agent(s), and its dissemination may cover a large area. The agent(s)
would also be used to make a select population or country aware of their
vulnerabilities. The agent(s) used could possibly cause a secondary spread (contagion)
from domestic animal to humans, or domestic animals to wildlife, or human to human
transmission. “After an acute attack, active surveillance of wild or domestic animal
populations could help identify many ongoing exposure risks. If certain bioterrorism
agents found their way into animal populations, they could spread widely through
animal-to-animal transmission and prove difficult to control. The recognition of agent
may be delayed days to weeks and/or have a long incubation period. “ (Rabinowitz,
2006) This would provide an easy way to be unable to detect the original location of the
spread or person/people behind it. “Concrete steps could include establishment of
surveillance veterinary clinics in strategic areas with incentives for practitioners to
report unusual events (AASV, 2003).”
As stated before “ veterinarians are qualified by a broad biological education and
experience to deal in a wide range of areas important to food safety, including, but not
limited to: disease recognition, especially zoonotic diseases; emerging pathogens;
bioterrorism threats; foreign animal disease threats; public health; epidemiology
(including outbreak investigations); science-based certification and auditing processes;
Animal science and population medicine experience; pathology; parasitology;
microbiology, virology, bacteriology; comparative medicine and multi-species
experience; chemistry/toxicology and pharmacology, and drug resistance mechanisms.
(FSIS, 2000)” It important that the skill and knowledge of a skilled veterinarian is
utilized to its full capacity. It will not only be important to continue the lines of
communication between veterinarians and human physicians and public health officials
but to establish well defined channels between veterinarians and diagnostic veterinary
Veterinarians and bioterrorism. K.Barlowe (4)
laboratories. This could help to spot sentinels in addition to disease carriers. It would
also continue to help the integration of human and animal surveillance information.
There is a growing awareness that animal health and human health are
inextricably linked. Cooperation between human and animal health professionals are
imperative to strengthen the knowledge of bio/agroterrorist actions and preparedness
of these attacks if they were to occur in the future. Nations throughout the world today
face dangerous and immediate biological and health threats.
Education,
communication, cooperation and collaboration are needed between federal agencies,
federal-state and local veterinarians and human physicians, government and
universities, and between international veterinarians and physicians in order to
counteract this bio/agroterrorism threats and prepare every level for potential disease
agents and outbreaks.
These bio/agricultural threats are an ever-increasing complexity, especially with
respect to new, emerging, and re-emerging infectious diseases. These diseases provide a
significant risk to animals, humans, and the nation's food supply. As each day passes,
the threats continue and more education and proper training is critical to combating
these threats and to protect the human and animal populations. Veterinarians and their
training make them ideally suited to respond, but prompt and sustained action,
training, continued education and compensation by the profession’s leadership is
required.
Veterinarians and bioterrorism. K.Barlowe (5)
Zoonotic awareness
Prepared by CDC
o Category A : highest priority
o Category B: second highest priority
o Category C: third highest priority
Category A:
Agents/Disease
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Category B:
Agents/Disease
Plague
Anthrax
Botulism
Smallpox
Tularemia
Viral
Hemorrhagic Fevers

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
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Category C:
Agents/Disease


Brucellosis
Glanders
Meliodosis
Psittacosis
Q fever
Typhus fever
Viral encephalitis
Toxins
Food safety threats
Water safety threats
Nipah virus
Hantavirus
Disease agents to think of when presenting with the following signs:
Sign in Animal
Possible offending agent (May be species dependent)
Respiratory
Yersenia pestis, Nipah, Hendra, Chlamydophila psitacci, Burkholderi
mallei Burkholderia pseudomallei
Bacilus anthracis, Yersenia pestis, Clostridium perfringens type B & C
Brucella spp, Coxiella burnetti, Rift Valley Fever
Botulism, Clostridium perfringens type B & D, West Nile, EEE, VEE,
Wee, transmissible spongiform encephalopathies
Sudden death
Abortion
Neurological
(Zoonoses & Bioterrorism presentation, Radford B. Davis)
Literature Cited/Reference List
Veterinarians and bioterrorism. K.Barlowe (6)
Antech. Bioterrorism and Biosecurity. Antech Diagnostics News. June 2004.
www.antechdiagnostics.com
AVMA. Physician speaks on agroterrorism,bioterrorism. JAVMA news online. 2005.
www.avma.org
AVMA. Veterinarians key to bioterrorism preparedness initiatives. 2002.
www.avma.org
Davis, R.G. Zoonoses and Bioterrorism. Presentation. Iowa State University. CVM
Center for Food Security and Public Health. www.cdc.gov
Davis, R.G. Agricultural Bioterrorism. www.abis.org. 2001.
Federation of Veterinarians of Europe. Bioterrorism Resolution.www.fve.org
Massachussettes Department of Agriculture: Division of Animal Health, Biosecurity
and Dairy Service. Bioterrorism and Animals: Awareness and Response. www.cdc.org
McCarthy, J. Ethics and Jurisprudence course notes. Fall, 2006.
Meredith, M. Veterinary Role in Bioterrorism Surveillance. www.aasv.org (American
Association of Swine Veterinarians). 2003.
Parker, J.L. The Small Animal Veterinarian’s Role in a Bioterrorise Event. 2005: The
New Criminologist: www.newcriminologist.co.uk/news
Rabinowitz, P., Gordon, Z., Wilcox, M., Odofin, L., Liu, A., Dein, J. Animals as Sentinels
of Bioterrorism Agents. Emerging Infectious Diseases. 2006. Vol 12 no 4.
www.cdc.gov/eid
Thurmond, M. and C. Brown. Bio- and Agroterror: The Role of the Veterinary
Academy. 2002: JVME 29(1)
USDA Food Safety and Inspection Service (FSIS). The Future of FSIS Veterinarians:
Public Health Professionals for the 21st Century. 2000(1-44).
Veterinarians and bioterrorism. K.Barlowe (7)