Engagement of private veterinary practitioners in national disease surveillance

Policy

1. Private veterinary practices in Australia are a major potential source of surveillance data for diseases of terrestrial and aquatic livestock, wildlife and companion animals.
2. Governments should adequately resource relevant surveillance schemes, and provide reasonable financial remuneration for participation by private practitioners.
3. Governments should provide accessible reporting interface options and relevant feedback to engaged practitioners.

Background

Biosecurity in production animals

In Australian agriculture, our ‘clean and green’ reputation has provided a privileged trading position for many years,¹ ensuring consumer confidence in terrestrial and aquatic livestock production in both local and international markets. This reputation is reliant on a sound animal disease surveillance and reporting system.² Although farmers are able to undertake basic disease surveillance activities, veterinarians provide a unique and essential role in surveillance and biosecurity because of their clinical training and expertise

In Australia, the systematic rationalisation of government veterinary service roles for the past 20 years has had a negative impact on surveillance outcomes through reduced farm health reporting provided by government veterinarians, and reduced laboratory testing of suspect cases by private veterinarians.³ The perception that government veterinary services do not deliver benefits to the broader community and can therefore be provided commercially rather than being treated as a public good, has been expressed as the underlying reason for government withdrawal of funding.³ As the government has increasingly devolved responsibility for surveillance there has been an unspoken expectation that private veterinary practices will embrace these services as business opportunities. However, this withdrawal of Government services has not been met by an equivalent advancement of private services.³

Biosecurity in companion animals

For companion animals in Australia, disease surveillance has historically only taken the form of ad hoc surveys, or has focussed on adverse reactions to pharmaceuticals, and no communicable companion animal disease surveillance activities are currently undertaken by government.⁴ Australia’s only national Australian companion animal multi-disease surveillance system was introduced by a pharmaceutical company in 2010.⁴ It operated for 7 years before being closed through lack of resourcing; over 26,000 cases of disease reports were collected during this time.

An historic lack of surveillance does not reflect a lack of need and it is estimated that tens of thousands of pet animals currently succumb to preventable disease every year in Australia, many fatally.⁵ Current advances in technology are resulting in the development of new surveillance systems for companion animals, including the potential to analyse data from companion animal veterinary practices Australia-wide.⁶ Such systems are being developed by universities and not-for-profit animal welfare organisations, but with very limited funding, and are dependent on grants, donations, and self-generated funds. General practitioners and veterinary clinics have great potential to assist in the development of such systems by logging cases and by allowing access to their clinic data for surveillance purposes.

Biosecurity in wildlife

Disease surveillance in Australian wildlife is supported by Wildlife Health Australia (WHA), a not for profit association who works alongside state governance bodies. They administer the national electronic Wildlife Health Information System (eWHIS) database which receives data from a number of subgroups, including:

• the Wildlife Health Australia Coordinator Group,
• the Zoo Based Wildlife Disease Surveillance Program,
• theSentinel Clinic Wildlife Disease Surveillance Program, and
• the University Based Wildlife Disease Surveillance Program

WHA works collaboratively with a range of government, non-government, private veterinary services and lay wildlife groups and has established protocols and procedures focussed on coordinated national surveillance and reporting in conjunction with government-based reporting obligations.

Why do we need disease surveillance?

Disease surveillance enables early recognition of both infectious and non-infectious diseases in animals. Government biosecurity agencies require disease surveillance data to support claimed disease statuses for market access, timely responses to emerging and emergency disease, and the development of relevant policies on public health, animal production and animal welfare.

Surveillance is a key tool in demonstrating and maintaining Australia’s freedom from many diseases that are endemic overseas.

Endemic disease outbreaks have the potential to impact animal and human health and to have an economic impact on agricultural industries. Surveillance allows for earlier detection of outbreaks and thus a reduction in their impact.

Outbreaks of significant disease occur in companion animals within Australia, including highly contagious and fatal diseases. However, these outbreaks are currently not adequately recognised or addressed, due to a lack of coordinated disease surveillance programs for companion animals. This is a significant, yet unrecognised welfare issue in companion animals and has zoonotic and public health implications.

The potential for rapid spread in the event of an exotic disease incursion, due to remote borders, feral animals, the ability of animals to move rapidly over long distances and multi-species aggregation points, means that any strategies that decrease the time to detection and initiation of a response (such as surveillance) can considerably reduce the absolute spread and impact of an incursion.

Recent breaches show there are deficiencies in national biosecurity networks, which indicates the necessity for surveillance at all levels of the animal health industry. Examples include imported uncooked prawns infected with white spot syndrome virus and non-compliant imported fetal bovine serum.

Seventy-five percent of emerging infectious diseases (EIDs) are zoonotic, so animal disease surveillance should not be confined to agricultural industries.⁸

Why are veterinarians important in this process?

Lay people can be taught to recognise the common clinical signs of disease, but only veterinarians have the qualifications, skills, and legal authority (in all states except Victoria) to comprehensively diagnose and treat disease.

Private veterinary practitioners see animals from a broad geographical area and are able to contextualise disease events in their region both within and across species. Involvement of private veterinary practitioners in surveillance in partnership with government and industry veterinarians would enable collection of surveillance data from across a more diverse animal population, as well as earlier recognition and containment of endemic diseases (e.g. infectious laryngo-tracheitis in chickens), which have the potential for significant disease, animal welfare and economic impacts.

Veterinarians have training in risk management of disease, epidemiology of disease, understanding of biosecurity requirements and protocols and involvement in all areas of the animal health sector from government agencies to private practitioners.

Despite the historical focus on diseases that impact the agricultural and racing sectors, small animal veterinary practitioners often have as their patients a wide assortment of species and settings, from conventional and non-conventional pets to wildlife. This provides potential for a wider view of disease occurrence.

Veterinarians maintain significant databases of animal disease data that would be invaluable for surveillance purposes.

Consequently, private veterinary practitioners are uniquely placed to identify new, emerging and re-emerging animal diseases as they arise. Their involvement in surveillance activities could potentiate early detection of disease events, having a significant impact on both animal and human health outcomes in the case of zoonoses. Veterinarians need to be aware of national and jurisdictional notifiable diseases and cognizant of their legal obligations to report such diseases.

An effective national animal health surveillance program requires collaboration and cooperation between government agencies, private veterinary practitioners, wildlife and environmental health agencies, farmers and commercial enterprises in the animal sector. The unique training and skills possessed by veterinarians are an essential component of this network. Funding and resourcing are also urgently required.

Recommendations

Governments should engage private veterinary practitioners as integrated partners in disease surveillance by:

1. tailoring schemes that factor in the constraints (business, legal, cultural, and technological) to providing surveillance by a private veterinary practice
2. cooperatively developing systems that address both practice and government risks in the provision of timely, de-identified, regional syndromic data of sufficient quality to meet identified needs of both government and practices. Standardising reporting systems across state borders to enable aggregation of data will maximise the reliability, accuracy and useability of surveillance data
3. providing financial remuneration to participation, over and above the recognised community service of this contribution
4. providing clear and accessible information about government veterinary laboratory diagnostic services and costs where indicated for private practitioners engaging in diseases surveillance activities and investigation of significant and unusual disease events.
5. ensuring engaged practitioners have access to information that provides an enhanced knowledge of the disease risks likely to impact their local community and clients
6. ensuring the process of reporting a notifiable disease is well publicised and accessible.
7. ensuring practitioners understand and have confidence in the notification process in terms of who and when to contact government authorities, and how their interests are protected through government-initiated extension activities.
8. ensuring private veterinary practitioners engaged in disease investigation are cognizant of their obligations to comply with the relevant legislation in their jurisdiction, including reporting obligations and appropriate documentation.

Other relevant policies and position statements

• Private veterinary engagement with government veterinary services
• Government veterinary services
• Provision of animal health (veterinary) laboratories

References

1. Daly J et al. Australia’s Agricultural Future, Securing Australia’s Future report. Australian Council of Learned Academies, Canberra, 2015. https://acola.org.au/wp/7-australias-agricultural-future/ Accessed January 2019.
2. Department of Agriculture and Water Resources. National animal health surveillance and diagnostics business plan 2016–2019. The Department, 2016.
3. Schipp M. Australian veterinarians: global challenges. Australian Veterinary Journal 2018;96:4–10.
4. Ward MP, Kelman M. Companion animal disease surveillance: a new solution to an old problem? Spatial and Spatio-temporal Epidemiology 2011;2:147–157.
5. McGreevy P, Thomson P, Dhand N et al. VetCompass Australia: a national big data collection system for veterinary science. Animals 2017;7:74.1.
6. Kelman M, Ward MP, Barrs VR et al. The geographic distribution and financial impact of canine parvovirus in Australia. Transboundary and Emerging Diseases 2018, doi: 10.1111/tbed.13022. [Epub ahead of print].
7. Wildlife Health Australia 2019 available from:https://wildlifehealthaustralia.com.au/Home.aspx. Accessed 15 June 2019
8. Salyer SJ, Silver R, Simone K et al. Prioritizing zoonoses for global health capacity building-themes from One Health zoonotic disease workshops in 7 countries, 2014-2016. Emerging Infectious Diseases 2017; 23, doi: 10.3201/eid2313.170418.

Purpose

• To build recognition of the importance of private veterinarians as part of Australia’s animal disease surveillance network.
• To clearly define the role that private veterinarians play in Australia’s animal disease surveillance network.
• To lobby governments on the importance of building relationships between government agencies and private veterinary practitioners, and for funding and resourcing for this area.