21 January, 2011Washington D.C.

Aaron Scott, DVM PhD DACVPM Center Director, NSU

USDA/APHIS/VSCenter for Epidemiology and Animal Health

Comprehensive and Integrated National Animal Health Surveillance

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Centers for Epidemiology and Animal HealthNational Surveillance Unit

“Building Partnerships and Leading Change”

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Stakes are high

Curvesahead

Map???

Road ends

Traffic delays Run

out of gas

Surveillance

Information for action

Animal Health Safeguarding Review 2001 Primary

Recommendation:

Congress and the USDAmust provide funding and act to rebuild the state and national infrastructure foranimal disease control,emergency disease preparedness and response.

Principle 1a – A comprehensive, coordinated, integrated surveillance system is the foundation for animal health, public health, food safety, and environmental health

Value of Surveillance

1.Early detection– reduce spread2.“Proof” of freedom3.Food safety/security4.Public health

Market Access

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Role DefinitionNational surveillanceSAHO / Tribal AuthoritiesProducerPrivate Veterinarian / National

Veterinary Accreditation Program

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Return on Investment

Estimate $565,000,000 per hour cost of FMD outbreak

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Return on Investment endemic diseases

10% reduction in morbidity/mortality

~$ 1,400,000,000

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National Surveillance

Exchange of information between health authorities is needed for safe flow of commerce and for disease control decisions.

• Ongoing publication of statistical data on diseases and populations

• Prompt notification of unusual or emergency situations• Public Policy

• Transparency in methods used for analysis• Access to complete and correct information• Challenging assumptions

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$11,7 00,000,000

> $25,000,000,000 to economy

~150,000 jobs11Safeguarding Animal Health

The stakes:2009 meat/poultry exports

But that’s only part of the story….

food safety

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food security

Agro-terrorismEmerging diseases

Public healthNational economy

Greater Demands on National Animal Health Surveillance System

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Road hazards:

Information sharing?Confidentiality?

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More curves: Federal/State budgets

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“The answer is obvious - to

accomplish more with less….”

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Comprehensive and Integrated National Animal Health Surveillance

“Building Partnerships and Leading Change”

Innovation Partnerships Metrics

Cost efficientBenefit to broad stakeholder baseDisease flexibleRapidly responsive

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Comprehensive Integrated NAHSS

And gives Information for National Status

P (intro) * SSe* p(success) * costs averted______________________________

Cost of surveillance

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Weighted Benefit/Cost for surveillance

Stakes are highWe know surveillance conceptsWe know the budget is limitedWe’ve learned how to value/prioritize

Let’s talk about approaches to surveillance

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So far…

Disease Specific Surveillance

Random sampleTargeted toward higher risk

Inference possible with RR Definition of subpopulation

Concepts of compartmentalization, zoning, regionalization – risk based recognition

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Disease Surveillance (non-specific)

High Se and low Sp

Anomalies in animal health

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Surveillance Approach for EradicationSurveillance Approach for Eradication

Tuberculosis

JohnesBrucellosis

BSE

TX

Ruminant Swine Poultry Emerging Aquaculture

Identify Emerging DiseasesEarly Detection of FADs

Enhanced Program Disease SurveillanceMonitor and Control Domestic Diseases

Standardized National Data Systems (AHSM, NAHLN, others) NAHLN Laboratories

Standardized and Coordinated Planning Analysis Modeling Reporting

Strategic Planning Prioritization Collaboration Communication Response

Government and industry infrastructure built over a century of disease management

Sampling Streams Passive Reporting Traceability NAHMS Studies

SurveillanceInformation for Action

CSF

FMD

PRV

FMD

BSE

Scrapie

Brucellosis

AIVHS

Open source

Intelligence

RiskAssessment

ISA

B. suis

Pathways

NPIP

TB

Livestock markets

NAHLN labs

Slaughter plants

Accredited vets on farm

Interstate movement

Surveillance information for action

IT bucket

Disease programs

“Turn on the faucet”

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AnalysisInterpretation

Reporting

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August 2010

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Slaughter plant

condemns

Laboratory submissions

[On-farm]Accredited

veterinarians

Livestock markets

Data providetriggers for

investigation

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“Enhanced passive” surveillance systemReadily modified to be disease specific

P(intro) highSSE also highMitigation potential yes, it’s realtimeCost averted many diseases, very highCost of surveillance relatively low

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Remember our cost benefit formula?

Creative Thinking

Cooperation and participationConfidentiality and data sharingInformation management systemsNational coordination of procedures for

reporting and actionGovernment verification roleEpidemiologic investigationsTAIO

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Thank You