The World Organization for Animal Health (OIE) states that approximately 60% of existing human pathogens and over 75% of those that have appeared during the past two decades can be traced back to animals. Some of the zoonotic agents food-animal veterinarians have particular expertise in include anthrax, botulism, tularemia, brucellosis, glanders, Q fever and others.
"These are the only doctors capable of diagnosing and treating beef and dairy cattle, pigs, sheep, goats and poultry that exhibit signs or symptoms," says Bruce Kaplan, DVM, Dipl. AVES (Hon), Sarasota, Fla. According to Kaplan, food-animal veterinarians are also essential for recognizing livestock diseases of high economic consequence to our nation's food supply, including African swine fever, highly pathogenic avian influenza H5N1, classical hog cholera, contagious bovine pleuropneumonia, foot- and-mouth disease and others. "These veterinarians are vital to our homeland security."
So in today's environment, where the lives of animals and people collide on a daily basis, how can the food-animal veterinary medical and human medical professions collaborate more?
One Health Initiative
This is where the One World, One Health, One Medicine concept steps in. The program, often called One Health, consists of collaborations between various organizations such as the American Veterinary Medical Association (AVMA), American Medical Association (AMA), Centers for Disease Control and Prevention (CDC), American Society of Tropical Medicine and Hygiene, American Society for Microbiology, USDA-APHIS, American Phytopathological Society, the World and American Associations of Veterinary Laboratory Diagnosticians and others.
What the One Health Initiative currently lacks is much representation from food-animal veterinary organizations. "Veterinarians are far more advanced in their knowledge of zoonotic diseases than are most physicians because colleges/schools of veterinary medicine teach more about the subject than do medical schools," says Kaplan. He has been involved with the One Health Initiative along with physician colleagues Laura Kahn, MD, MPH, MPP, Princeton University and Thomas Monath, MD, Kleiner Perkins Caufield &; Byers Pandemic &; Biodefense Fund. Kaplan is a former veterinary epidemiologist with CDC and food safety veterinarian with USDA-Food Safety and Inspection Service who has also practiced small-animal veterinary medicine for over 22 years. He and his physician colleagues have been spreading the word about One Health worldwide to physicians, veterinarians, scientists and consumers.
"Food-animal veterinarians form a crucial cadre of talented, knowledgeable professionals who protect against bioterrorism if large animals (or small) become targets on farms, feedlots, meat/poultry inspection plants, etc.," Kaplan says. "There is no other doctor better-qualified to help prevent and control such attacks or qualified to give expert advice on rapid response and disease containment and work with local, state and federal agricultural and public health officials and law enforcement."
Veterinary medicine has historically been the health profession positioned to address the health issues associated between animals and humans. The Veterinarian's Oath states that, in addition to protecting animal health, relieving animal suffering and conserving livestock resources, we are to promote public health, states Ralph Richardson, DVM, Dipl. ACVIM, dean of the Kansas State University College of Veterinary Medicine. "That oath applies to all veterinarians. Clearly, veterinarians working with animals raised for food consumption are going to be on the front line of helping to identify food-borne and zoonotic pathogens. They carry an extra responsibility for promoting public health."
For veterinarians, it is vitally important to be knowledgeable of zoonotic and food-borne diseases. "Since over 70% of recently emerging human diseases such as West Nile Virus, Monkey Pox, SARS and Hantavirus have come from animal reservoirs, it behooves the veterinary and human medical professions to work together," Richardson says. "Wouldn't it be fantastic if veterinarians could snuff out highly-pathogenic avian influenza virus at the animal reservoir level before it transforms to replicate in humans? If that were to happen, the world might not have to be concerned about another influenza pandemic. In my opinion, that's what the One Health initiative is all about."
Bob Larson, DVM, PhD, Kansas State University, is the current president of the Academy of Veterinary Consultants, representing about 700 beef cattle veterinarians. "The value of an expanded acceptance of veterinary medicine within the venues of human and ecosystem health may seem distant from day-to-day challenges of food-animal practice, but if food-animal practitioners do not participate in this defining period, we may not be able to overcome momentum that either ignores or moves counter to the biologic principles we are in the best position to understand," he says.
"The concept of One Health greatly expands the roles and expectations placed on the veterinary profession as well as individual veterinarians," Larson continues.
"I think this is a positive step to solidify the value of veterinary medicine to society and of individual practitioners to their communities."
What's holding us back?
AVMA wholeheartedly embraces the One Health initiative, but what about food-animal organizations? The American Association of Bovine Practitioners, representing nearly 5,000 members worldwide, has been involved in the One-Health Initiative from the onset, notes AABP President Mike Bolton, DVM, "including involvement in One Health conference calls and having former AVMA President Roger Mahr, DVM, bring the One Health message to AABP's annual meeting. The concept is great and necessary, but it seems to have been a little more difficult to distill this initiative into an action plan."
The American Association of Swine Practitioners (AASV) and its members have been aware of the One Health Initiative and are watching its progression says AASV President Kerry Keffaber, DVM. "While always important and critical, the One Health concept is not new to our profession," Keffaber explains. "Veterinarians have been involved in this issue long-term. Leadership from veterinarians has been significant and is obvious from meat inspection to Brucellosis eradication. I am confident that veterinarians are best-qualified and will continue to use their strengths and training to protect animal and human health."
Larson believes one of the things holding the food-animal industry back is its perception that the importance of an abundant and safe meat and milk supply, and the potentially negative interaction of pathogens between livestock and humans, are obvious to the scientific community at large. "It is hard for us to imagine anyone not understanding these concepts. But, it appears that what is obvious to those involved in the day-to-day production of meat and milk is not necessarily obvious to the broader medical community and the public at large."
Because the concept of One Health is not consistently defined and broadly accepted yet, different people are likely to have different perceptions as to its meaning, Larson adds. "In many areas of the world, the lack of efficient and consistent production of sufficient foodstuffs is a primary limitation to human health. It is very important that those involved with what is arguably the most important human health concern an abundant food supply be involved in all discussions concerning One Health."
Keffaber notes that the concept can be an elusive subject and at times difficult to get one's arms around. "Historically, interface with some aspects of human medicine has not always been cooperative," he says. "Sometimes bullying and intimidation has been the driver versus collaboration. If the pattern is to follow a precautionary approach as recently pushed in antibiotic and confinement issues and avoiding other areas, then there will be significant disappointment for the food-animal practitioner."
Will future veterinarians respond?
Many veterinary schools/colleges have increasingly become specialized in their training which can help students narrow career paths and decrease extraneous studies. Students can practically pick their specialty and head straight through on that track without having to bother much with training for other species that don't interest them for their future career. However, in light of issues such as potential foreign animal diseases, bioterrorism or zoonoses outbreaks, is it wise to let veterinary students skip over some basic livestock and public health curricula that have been in place in veterinary schools for years? Some in the profession don't think so.
AABP's Bolton says it is more important than ever that companion-animal veterinarians, as well as other branches of the veterinary profession that are not on the front lines of disease transfer with farm animals, be well-versed in this arena. "Fewer people in the populous at large have any agronomy experience but they do have regular contact with their dog or cat doctor and should be able to get valuable public health information and some sort of risk rationale from their veterinarian," he says. "So having all of us educated in this area is necessary."
"There is no question in my mind that removing zoonotic disease and/or food-animal disease training from veterinary medical curricula would be short-sighted, foolish and dangerous when the time comes for current or future outbreaks of disease," Kaplan states. "While I recognize and appreciate the value of restructuring veterinary medical education by offering veterinary medical students access to targeted and expanded training for careers they might prefer, the modern veterinarian in our changing society needs to have basic training continued in large-animal medicine, zoonotic diseases and food safety as it applies to meat, milk and poultry products."
KSU's Richardson believes that all accredited veterinary colleges should be required to have the topics of zoonotic diseases, trans-boundary (foreign) animal diseases, and food safety in their core curricula. Some colleges, like Kansas State University, have also created degree offerings in public health. "Nearly 10% of our students are pursuing combined DVM/MPH degrees," he says. "I think we'll see more of that as society continues to expect greater food safety and personal health."
It is important to allow opportunity for education in all areas of veterinary medicine, adds Keffaber. "What could be more essential then supplying safe, affordable food? A shortage in quantity or quality of food would be disruptive. Veterinarians have been the leaders in this assurance and it is critical that this should remain part of our core responsibility and area of excellence. Healthy animals equal healthy food equals healthy people."
Veterinarians, especially food-animal veterinarians, should take the broadest view possible of food-borne and zoo-notic diseases. "The sayings ‘from farm to fork" and ‘we are what we eat" have a lot of relevance to veterinarians," Richardson says. "If we don't pay attention to the big picture, we are missing a key part of the Veterinarian's Oath where we solemnly swear to use our scientific knowledge and skills for the benefit of society. That means that we have made a promise to benefit the world in which we live. And we ought to take that promise seriously."