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Zoonotic Disease Guidelines

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Ratification Date: 01 Dec 2020

The role of veterinarians in the management of zoonotic disease

Related resources:

Zoonotic Diseases Immunocompromised.pdf

Zoonotic Diseases Pregnancy.pdf

Zoonotic diseases preamble.pdf

Resource

Policy

  1. All veterinarians should be prepared to take appropriate action to minimise the impact of zoonotic diseases on both animal and human health.
  2. Appropriately trained veterinarians should be included in investigative, legislative and advisory groups focused on zoonotic disease identification, prevention and management.
  3. The development of strong One Health collaborations with government backing and legal authority, engaging veterinary, medical, public health and environmental professionals should be prioritised.

Background

Zoonotic diseases are caused by a range of pathogens shared between animals and humans. These diseases can range from non-clinical illness, to minor illness, to those that may cause significant morbidity or mortality. The diseases these pathogens can cause may manifest as specific syndromes or disease with non-specific signs.

Worldwide, there is increased concern about the threat of emerging infectious diseases (EIDs) and their impact on human populations. Many EIDs are zoonoses.[1] As well as the immediate risks to animal and human health, these diseases present a significant threat to global health security.[2]

Locally, endemic zoonoses are frequently encountered by veterinarians, necessitating evidence-based strategies to both mitigate risk to animal and human populations as well as recognition and management of active disease.

The increased incidence and emergence of zoonotic diseases are influenced by a number of factors which impact on the interface(s) between humans, animals and the environment:

  • Pressure from human population growth precipitating deforestation for agriculture, industry, water storage and urbanisation causing changes in the human/animal and animal/animal interface. These changes have resulted in greater interaction between production animals, wildlife, and feral animals, and an increasing risk of spill-over events.[3]
  • Changing climate dynamics resulting in changes in biodiversity, vector and reservoir populations and their concomitant pathogens with the potential to increase the risk of disease introduction, transmission and occurrence. [4]
  • Greater global mobility of humans enabling zoonotic diseases to spread rapidly via transport of animals and animal products, disease vectors and by human passenger movements.[5]
  • Societal norms have expanded leading to closer physical interactions between animals and humans. [6]
  • Current trends towards greater numbers of persons owning or managing a range of domestic and semi-domestic species increases the potential risk for zoonotic disease transmission and adverse impacts on food security.

It is essential to adopt a ‘One Health’ approach to zoonotic diseases to optimise health outcomes for humans, animals and the environment[7-9]. A multi-disciplinary collaboration between medical and public health practitioners, veterinarians, environmental scientists, ecologists and other professionals locally, nationally and globally is essential for the recognition and control of zoonotic disease risks[10]. Advisory and legislative bodies therefore need to be cognisant of the need for collaboration and cooperation between veterinary, human and environmental health agencies and professionals.

Veterinarians with their diverse training, including practical experience in animal health and knowledge of epidemiology and environmental drivers of disease, are ideally placed to respond to increased zoonotic risk in cooperation with other One Health professionals in the public health, environmental and ecological fields.

Veterinarians should be actively involved in addressing zoonotic disease management in the planning and development of government policy and interventions. Veterinarians can assist in prevention of zoonotic diseases by emphasising disease reservoirs and advocating for a global approach, as well as focusing on individual patient well-being. Both government and private veterinarians play a key front-line role in national surveillance of zoonoses.

Government veterinarians play a vital role nationally in the management of notifiable zoonotic diseases and exotic or emerging infectious disease incursions. In the case of diseases with significant human health impacts they work cooperatively and collaboratively with public health authorities to manage disease occurrence and implement risk management strategies in animal populations. [11]

Veterinary researchers are actively involved in advancing knowledge of the epidemiology and environmental drivers of zoonotic diseases, identification of risk factors and development of diagnostic tests, vaccines and treatments, all of which contribute to improved control and management of zoonoses.

Veterinarians in private practice are uniquely positioned to detect zoonotic diseases in animals due to their daily contact with a broad range of animal species (companion animals, production animals and wildlife). Veterinarians should have knowledge of common and locally endemic zoonoses and their clinical impact on both animals and humans, actively educating all clients in strategies to minimise the risk of infection. They have responsibility to advise animal owners and staff members at risk of exposure to a zoonotic disease seek medical advice, and if required, liaise with human health practitioners upon diagnosis or suspicion of a zoonotic disease in animal(s) under their care to minimise the risk of cross-species spread.

Veterinarians require capacity and capability to recognise both common, unusual and emerging zoonotic diseases and be cognizant of their legal and ethical responsibilities. In cases of notifiable zoonotic diseases, Emergency Animal diseases (EADs) or if a newly emerging disease is suspected or diagnosed, veterinarians must bring the disease to the notice of the Chief Veterinary Officer in their State by either reporting the occurrence on the Emergency Animal Disease Watch hotline (1800 675 888) or to Government veterinary services. Where a zoonotic disease is a notifiable disease in humans or has a significant impact on human health, contact with local Public Health units is indicated. Pathways to easily facilitate this should be formally established.  

Government, educational and practitioner bodies continually need to raise awareness and provide continuing education to all veterinary practitioners on zoonotic diseases and emerging disease threats.

Recommendations

  • In the light of increasing zoonotic EID threats, establishment of a national Communicable Diseases body should be a government priority, with veterinarians being an integral part of an infectious disease, public health and environmental health team.
  • All veterinarians should be aware of relevant responsibilities and appropriate procedures with respect to zoonotic diseases, including reporting to the Emergency Animal Disease Watch hotline (1800 675 888) or government veterinary service.
  • Formal pathways for veterinarians to contact Public Health units directly in the case of risk of human infection from significant zoonotic diseases should be established. Veterinarians should be employed as part of current communicable diseases health teams.
  • All veterinarians working in clinical practice have a responsibility to advise clients and staff of risks and preventative measures when potential or real risk of zoonotic disease exist. They should advise clients and other in-contact people to seek appropriate medical services for health advice and management.
  • All veterinary clinics should have biosecurity protocols in place including appropriate PPE to ensure safety of their staff in the case of potential exposures to zoonotic diseases.
  • Veterinarians should be actively involved in consulting with government planning/advisory bodies that are involved in areas which may impact on zoonoses (eg climate change and environmental management, refinement of infrastructure to minimise spread of waterborne zoonoses) or when there is a clear community risk of zoonotic disease (eg major events with animal involvement)
  • Management of zoonotic diseases within a One Health context necessitates changes to enable appropriately qualified veterinarians to collaborate and consult alongside medical practitioners where necessary to optimise outcomes in the case of zoonotic diseases. [13]
  • Where person to person transmission of a zoonosis is known to occur veterinarians should be prepared by training themselves and their staff on the use of PPE and having PPE available.

References

  1. Mackenzie, J.S., et al., One Health: The Human-Animal-Environment Interfaces in Emerging Infectious Diseases. The Concept and Examples of a One Health Approach. Current Topics in Microbiology and Immunology, ed. R. Compans. 2013, Berlin, Heidelberg: Springer-Verlag.
  2. Salyer SJ, et al., Prioritizing Zoonoses for Global Health Capacity Building-Themes from One Health Zoonotic Disease Workshops in 7 Countries, 2014-2016. Emerg Infect Dis., 2017. 23(13).
  3. Aguirre, A.A., Changing Patterns of Emerging Zoonotic Diseases in Wildlife, Domestic Animals, and Humans Linked to Biodiversity Loss and Globalization. Ilar j, 2017. 58(3): p. 315-318.
  4. Zinsstag, J., et al., Climate change and One Health. FEMS microbiology letters, 2018. 365(11): p. fny085.
  5. Stärk, K.D.C. and D. Morgan, Emerging zoonoses: tackling the challenges. Epidemiology & Infection, 2015. 143(Special Issue 10): p. 2015-2017.
  6. Chomel, B. and B. Sun, Zoonoses in the bedroom. Emerg Infect Dis, 2011. 17(2): p. 167-172.
  7. Rabinowitz, P.M., et al., Toward Proof of Concept of a One Health Approach to Disease Prediction and Control. Emerging Infectious Diseases, 2013. 19(12): p. e130265.
  8. Rüegg, S.R., B. Häsler, and J. Zinsstag, Integrated approaches to health, A handbook for the evaluation of One Health. 2018.
  9. Travis, D.A., et al., One Medicine One Science: a framework for exploring challenges at the intersection of animals, humans, and the environment. Annals of the New York Academy of Sciences, 2014. 1334(1): p. 26-44.
  10. One Health Commission. What is One Health? 2019 11 June 2019]; Available from: https://www.onehealthcommission.org/en/why_one_health/what_is_one_health/.
  11. Adamson, S., A. Marich, and I. Roth, One Health in NSW: coordination of human and animal health sector management of zoonoses of public health significance. N S W Public Health Bull, 2011. 22(5-6): p. 105-12.
  12. Hanna, J.N., et al., Hendra virus infection in a veterinarian. Med J Aust, 2006. 185(10): p. 562-4.
  13. Speare, R., et al., Willingness to Consult a Veterinarian on Physician’s Advice for Zoonotic Diseases: A Formal Role for Veterinarians in Medicine? PLoS ONE, 2015. 10(8): p. e0131406.

Purpose

  • To build recognition of the importance of a One Health approach in the management of zoonotic diseases.
  • To define clearly the integral role of veterinarians within the One Health paradigm
  • To lobby governments on the importance of establishing formal One Health bodies (equivalent to the CDC) to optimise outcomes in the case of zoonotic diseases and other areas which would benefit from a One Health approach (eg disease surveillance, food security, animals and humans as sentinels for infectious diseases and toxicants)