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


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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


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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


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Mission of the National Companion Animal (NCASP) 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)


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Surveillance – CDC Definition (NCASP)

  • 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


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Temporal Sequence of Surveillance (NCASP)Disease 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


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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


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Biothreat A Agents in Dogs & Cats Infections?

* - CDC 2003: http://www.bt.cdc.gov/agent/agentlist-category.asp

** - reported with species of greatest (or equal) susceptibility first


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Advantages of Using Companion Animals as Sentinels Infections?

  • 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?


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>550 hospitals Infections?

18,000 hospitals

Purdue University

Data Warehouse

Data Mining

National Companion Animal Surveillance Program (NCASP)


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Banfield Infections? 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


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Banfield Infections? 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


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Banfield PetWare Infections?Proprietary Software

Pet Demographics

Exam findings

Diagnoses

Office Visits

Laboratory Results

Treatments

Medical Notes


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Banfield Hospital Locations in Major Metropolitan Areas Infections?

Los Angeles

Phoenix

Dallas

Chicago

Atlanta

Washington DC

as of June 13, 2006


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


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


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National Flea/Tick Pathogen Surveillance Infections?

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




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Alert!!! following hurricane KatrinaFayette 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


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Banfield Hospitals Near Fairburn, GA following hurricane Katrina

Georgia Dept of Health Chemical Hazards


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Banfield Dogs and Cats Living Within 15-miles of following hurricane KatrinaChemical Plant in Fairburn, GA

Banfield Cats

n = 3,065

Banfield Dogs

n = 15,753

1129

288

Fairburn

Chemical Plant

281


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Fairburn Georgia following hurricane Katrina♦ 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


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>550 hospitals following hurricane Katrina

18,000 hospitals

Purdue University

Data Warehouse

Data Mining

National Companion Animal SurveillanceProgram


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Leptospirosis following hurricane Katrina

  • World-wide zoonotic disease

  • Gram negative bacteria

  • Spirochetes

  • Genus Leptospira

  • Over 250 serovars


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Transmission following hurricane Katrina

  • Direct (hospital)

    • Infected urine

    • Bite wounds

    • Ingestion

  • Indirect (community)

    • Contact with stagnant or slow moving water contaminated by urine

    • Leptospirosis at triathlon in Illinois


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2002 following hurricane Katrina

2003

2004

Positive >= 1:800

Canine Leptospirosis, US, 2002-2004


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Highest Percent Positive following hurricane Katrina

Leptospira Serovar by State 2004


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Summary following hurricane Katrina

  • 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


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Summary-con’t following hurricane Katrina

  • 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


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The New Yorker, June 16 & 23, 2003 following hurricane Katrina


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