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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

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

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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


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


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


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


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)


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


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


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


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


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?


>550 hospitals

18,000 hospitals

Purdue University

Data Warehouse

Data Mining

National Companion Animal Surveillance Program (NCASP)


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


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


Banfield PetWare Proprietary Software

Pet Demographics

Exam findings

Diagnoses

Office Visits

Laboratory Results

Treatments

Medical Notes


Banfield Hospital Locations in Major Metropolitan Areas

Los Angeles

Phoenix

Dallas

Chicago

Atlanta

Washington DC

as of June 13, 2006


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


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


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


Relationship between Canine Tick Activity & Human Lyme Disease


Change in frequency of respiratory syndrome in pets following hurricane Katrina


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


Banfield Hospitals Near Fairburn, GA

Georgia Dept of Health Chemical Hazards


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


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


>550 hospitals

18,000 hospitals

Purdue University

Data Warehouse

Data Mining

National Companion Animal SurveillanceProgram


Leptospirosis

  • World-wide zoonotic disease

  • Gram negative bacteria

  • Spirochetes

  • Genus Leptospira

  • Over 250 serovars


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


2002

2003

2004

Positive >= 1:800

Canine Leptospirosis, US, 2002-2004


Highest Percent Positive

Leptospira Serovar by State 2004


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


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


The New Yorker, June 16 & 23, 2003


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