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EPID 600 - Introduction to Public Health Practice - Fall 2017


EPID-600 Introduction to Public Health Zoonoses.
Julia Murphy - DVM, MS, DACVPM & C.M.G. Buttery MD MPH

Look at Dr. Murphy's PowerPoint shows (1) Zoonoses (2) Rabies. Be sure to use the PowerPoint view that lets you read the notes for both slide sets. Dr Murphy has attached notes to each set of slides.
Click on VDH Web and examine the Rabies Information.  Also look at the CDC Update on Rabies Zoonoses Click on the 'Rabies Information for Doctors link. Look at human rabies in the US in the last 10 years, what was the main vector. A global study on canine rabies, published today (16 Apr. 2015), has found that 160 people die every single day from the disease. The report is the 1st study to consider the impact in terms of deaths and the economic costs of rabies across all countries. Even though the disease is preventable, the study says that around 59 000 people die every year of rabies transmitted by dogs. The study has been published in PLOS Neglected Tropical Diseases, April 2015, and can be accessed at http://dx.plos.org/10.1371/journal.pntd.0003709

Return to the VDH epidemiology home page and select the 'Disease Fact Sheets' and examine the fact sheets on Lyme Disease and Tick-borne diseases such as Typhus and Rocky Mountain Spotted Fever.  Look at the USGS Disease Data then click on West Nile Virus Link, Scan the IOM publication on Tick Disease whch has become more of a problem in recent years, particularly through page 10, then the Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011 (particularly page 10). W hen I was at Johns Hopkins in 1968 obtaining my MPH one the major ongoing studies for several of my classmates in the army was development of a malaria vaccine, we still are not there but getting nearer, see this discussion. We are still seeing emerging new zoonoses zoonoses as in China. and recently in Virginia (I last saw a case of juvenile Chagas disease when Health Director in Corpus Christi in 1982). Look at the AVMA World Rabies Day web page (click on the .link to children). Take a look at this blog from Johns Hopkins on Ebola Face to Face. A recent new zoonosis in the US is from Florida last year for Chikungunya, a mosquito borne disease. A recent report Outbreak of Human Pneumonic Plague with Dog-to-Human and Possible Human-to-Human Transmission — Colorado, June–July 2014 (usually found in small numbers each year in Arizona & Colorado.) While on the last few weeks we are seeing importation of the Zika virus from South America

It is worth thinking about how to define a major zoonosis. You could use the term yo consider the number of people affected which may be in the hundreds of thousands as in the case of food poisonings, you may also consider the number of times preventive interventions are important as with Rabies, there are only one or two cases a year but often several hundred thousand people have to be treated for animal bites to prevent the onset of rabies at a significant cost. You might also consider the cost of treatment for residual effects of an illness, for instance for Zika virus disease itself has little effect on children and adults but when affecting a fetus may result in costs of ten millions dollars per case for lifetime support of the resulting infant born with microcephaly.. Any of these reasons, either single combined could lead to a disease but being considered a major zoonosis.

Optional Video- Ted Talk - A Journalist's view of Malaria

Bioterror Resources
CDC fact sheet on Bioterrorism Agents . Look at the list. Consider why CDC has broken them into three groups (A-C). Select at least one to see how it fits into the different Case Definitions. Those on this list all group, CDC keeps changing the list so you may want to go to the list of all potential Bioterror pathogens and select one that is not in the group A list.

Review  Dr. Buttery's PowerPoint slide show, then visit the following links to examine the issues of animal control as a public health and community health issue as you go review the attached information?   You will find the answers to the question posed below at these web sites. Also determine what the various sites have in common.

Department of Agriculture, Dangerous Dog Registry Have you read about this in any newspapers recently? Click on the links to legislation regulation to see the extent of penalties in Virginia
Examine the home pages of the Fairfax County Animal Control and the Animal Control Department of the City of Seattle,  Animal Control agencies, to view the services they provide and their philosophies of operation. Fairfax County Animal Control Click on the Animal Control link toward the bottom of the web page. First link in the Animal Control and Regulation section. Also go to the Rabies information page for Fairfax County residents. Three people were bitten by rabid animals in March in Fairfax County.
City of Seattle Animal Control (
what do both these two sites have in common? Use the animal control Tab)
Humane Society of the United States (
focus on resources on pets, see links at right column)
Animal Control Officer Activities
Look at The Table of contents to view the spectrum of activities performed by certified animal control agencies & officers.

The controlling law is found in the Virginia Code, in the Title devoted to the Dept. of Agriculture, Division of Animal Health. The director is a public health trained veterinarian. He is responsible for all domestic animals, most of which are found on farms.

What are Feral cats also view this news report.. What should we do about them? AVMA statement on Feral Cats ( are the two statements congruent?) Rabies in a kitten, think about the implications.

Wild animals are the responsibility of the Department of Game and Wildlife.

Changes to animal control state law starts in the Committees on Agriculture of the State House or Senate. Can you find out what changes have been made to animal control ordinances/laws in the last decade and why?

A serious hazard from domestic animals is Rabies. It can be passed on to herds of cows, sheep etc. With development of cities and depredation by loose (feral) animals, animal bites are now as much a problem as dog/cat-to-human transfer of rabies. Current law requires immunization of domestic animals against rabies. More recently leash laws, standards for kennels, and licensing requirements have developed. Under the state system, localities can only enact local laws when permitted by state law, which limits the amount a locality can charge for licenses. Because of antisocial behavior by many individuals, new laws protect animals from people, not just people from animals. These include codes on care, feeding, housing, and abuse of animals, including prohibitions against animal fighting.

In addition to rabies a wide array of potential pathogens are both carried and transmitted by animals, including Lyme Disease and Psittacosis.

Several cities, including Richmond, have been concerned about the increase in rabies among cats, the move into the cities by raccoons and the presence of large numbers of unrestrained dogs. The desire was to control wandering of all loose domestic animals as well as pay for control of the animals. City staff worked closely with the humane society to get enabling legislation passed. 

Should the public at large pay for animal control by use of user fees (taxes) on animal owners or from the general tax base?

In Richmond, the division of animal control has moved periodically between the police and health departments. In Texas most animal control resided in either local heath departments or contracted to humane societies. 

Consider the advantages and disadvantages of where the program lies and how you can encourage community support.

How can epidemiology be used to garner support for improved animal control?

Enforcing animal control laws in the courts is extremely difficult. We have the same problems, in the courts, prosecuting animal control violations that we have with restaurants or septic tanks regulations. If we have to go to court we have been unable to change someone’s behavior.

Animals running loose often form packs and attack and bite people.

They also defecate and urinate on public and private property and damage property.
Some breeds are more of a problem than others.
Animal rights groups and the ACLU often prevent protection of the public.

The US Humane society, and its state & local branches, work hard to ensure a fair balance between the privilege of owning an animal versus protection of the public and the animals.

Review  CDC advice on domestic Animal Bites. and dog bites. All you need to know about amount and prevention including a good video on this site, but remember that cats are more likely to transmit rabies in the U.S.)  Also the CDC page on dogbites .Look at this Infographic from the AVMA.

.Consider the Following Questions:

Which animals in Virginia now present a significant likelihood of transmitting rabies?
What can the community do to protect itself from out of control animals?
What can individuals do?
How could you reduce animal bites?        
Who is most likely to be attacked?
Are there circumstances under which attacks may not be illegal?
Why are pets are a hazard to your health?
What diseases can they transmit? What can be done to reduce the hazard?
What is a domestic animal and why is it important to define them?
What animals can be protected by Rabies Vaccination?
What regulations may be available to control non-domestic animals? (pages 23 & 24 of essay).
How would you capture loose animals?
How would you restrain animals?

References:

8 Dangerous Pets
The Deadly Dozen (How many are zoonoses?)
Eliminating Malaria
The Yellow Fever Pandemic, a 1901 classic report by Walter Reed MD, reprinted with comments in the AMA.

The Ecology of Stray Dogs (A study of Free-Ranging Urban Animals). Beck, A. York Press. Baltimore, 1973 Social Behavior in Animals.  Still one of the best references available,
Human Rabies in Florida.  JAMA Sept. 16 1996, Vol. 270 No 11 P 865. 
The Black Widow Spider.  NEJM. June 5. 1997, Vol. 336, Number 23. 

Zoonotic Diseases: TIPS FOR PET OWNERS

Pet owners are far more likely to contract most Zoonotic diseases from contaminated food or drinking water than they are from their healthy companion animals. Still, as added precautions, pet owners should follow these Safety tips:

  • Take your pets to the veterinarian for routine check-ups and at the first sign of health problems (like diarrhea).
  • Have your pets dewormed and vaccinated.
  • Keep your animals and home as free of fleas as possible.
  • Prevent bites and scratches by teaching children to play gently with pets
  • If your pet scratches or bites you, wash the wound thoroughly and apply an antibacterial ointment. (For severe bites or scratches, call your physician.)
  • Keep your cat's nails trimmed (but do not subject them to declaw surgery).
  • Wear gloves when scooping or changing litter.
  • Wear gloves when cleaning up after puppies and removing feces from lawn
  • Make sure children wash their hands thoroughly after they handle pets.
  • Cover children's sandboxes when the children are not playing.
  • Wear gloves during and wash hands after gardening.
  • Keep all pets indoors (or under close supervision).