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University at Albany Center for Public health Preparedness

Agroterrorism: Managing Foreign and Emerging Animal Diseases

Original satellite broadcast: October 12, 2006

University at Albany Center for Public Health Preparedness

Moderator: Good morning and welcome to the University at Albany Center for Public Health preparedness grand round series. I’m Peter Slocum and I’ll be your moderator today. Before we start, I would like to remind you to fill out your evaluations on–line. Your feedback is always important in the development of our future programs and continuing education credits are available. We’ll take your calls later in the hour. The toll–free number is 800–452–0662. You may also send questions by fax at any time during the program. The fax number is 518–426–0696. Today’s program is Agroterrorism: Management of Foreign & Emerging Animal Diseases. Our guest is Dr. Floron Faries Jr. Professor & Extension Veterinarian and Extension Program Leader with the Texas Cooperative Extension, at Texas A&M University. Welcome, Dr. Faries

Dr. Faries: Thank you Peter. It’s a pleasure to work with the outreach mission here at the University of Albany in the school of Public Health for preparedness. Moderator: We’re lucky to have an expert like yourself to come in and fill us in on an area we haven’t covered much in the series, so let’s get started. Could you please tell us why we should be concerned about the animal diseases?

Dr. Faries: Well, it’s the importance of agriculture. Agriculture is very important to the citizens of the United States. As I talk of agriculture, there’s livestock, cattle, sheep, goats, swine, exotic wildlife that’s also included in our poultry and chickens and turkeys and all their products and agriculture extends into crops, fiber crops and food crops, the grains and the nuts, and in 2002, the US Census for agriculture totaled up over $105 trillion for cash receipts in livestock and poultry and their products. That’s the value, the total value of the products and the animals sold in that year. Of course, that’s four years ago. It’s likely it’s increased because of the market value has increased, especially in beef cattle and in some other areas, so it’s probably closer to $200 trillion as cash receipts on an annual basis. So that places agriculture really at the largest economic sector of the United States, and that’s surprising to many people. They didn’t realize agriculture is that large, that it generates that type of dollars, cash receipts to the economy of this nation. That’s way beyond the total value that’s in, you know, in oil and fuel, merchandise, in marketing, banking, entertainment, tourism. All the other industry are below the–– Moderator: Don’t add up to the $200 billion or whatever it is. Dr. Faries: That’s right. Of course we need to realize it’s our principle source of food. We eat agriculture, not only the crop side for grains and nuts, but our point today is to emphasize the food animal. That’s a major aspect of our diets. That’s the beef, pork, chickens, turkeys, the lamb or the mutton. That’s the goat, and then you’ve got the poultry products, the eggs, and the dairy products, the cheese, milk and butter. I mean that’s a principal source of food. But the negative side of that, these livestock, poultry operations are vulnerable to a disease outbreak, and they’re so vulnerable because in many segments of the industry–– livestock and poultry–– they end up in confinement in feeding operations and they’re in lots of tens of thousands, so there’s a risk of exposure to diseases, and that places them as a potential target for bioterrorism because they’re in that concentration point. A major point to make is that the United States really is threatened by the potential occurrences of foreign animal and emerging animal diseases, and we use the acronym FEAD for Foreign and Emerging Animal Diseases.

Moderator: Now let’s help folks out there in the audience by differentiating the foreign and emerging animal diseases.

Dr. Faries: Well it’s really based on the occurrence, whether it is based in the United States or outside of the United States. If we look at the foreign animal diseases first, those would be those animal diseases that do not occur presently currently in the United States; they’re outside the United States. But there’s risk of their entry. Those risks are considered to be high, that they can enter into the United States. There’s different types of occurrences. Accidental, it can definitely be. And we have travelers that are traveling abroad from the United States, US Citizens going abroad to foreign countries where these animal diseases occur. Then we have international visitors, we have those people that live in the livestock farms and poultry farms and they visit the United States. These travelers create a high risk for the entry of these diseases by contamination. Their clothing could be contaminated, their shoes, their ears, nostrils, hands. It’s a risk. As travelers go and come, they quite often bring meat products, in their suitcases, bring them home to eat or give to their friend, and those meat products could be contaminated with pathogens. And of course they even have garbage in their travel and dispose of it improperly as they return. We have international vessels, ships, private cruises that are out, and they collect garbage. The international commercial liners they, by inspection, do appear at an incinerator for disposal of their garbage, but we’re concerned with the private vessels that return with garbage that could have food products in the garbage that’s improperly disposed of in the environment and there’s risk of entry. So the disease outbreak could be a new form of disease or it could be one that we really didn’t experience so much in the foreign countries but now we have it here and than it becomes an endemic–type disease. Of course that places bioterrorism here as a subject, because maybe it is not accidental but intentional, and that is one type of occurrence. And then if you look at emergent diseases, they exist, and they may be endemic or subtle but yet we’re targeting those diseases that are increasing in prevalence and incidence; they are emerging. That may be definitely a new disease. It may be a disease of some species of animals, but it crosses species. So it’s a new disease in a different species. There’s a possibility there’s an environmental habitant in the environment that’s not infecting animals but then may transfer over to animals and adapt and now becomes an animal–type disease. But it could be really a new form of an old disease. We’ve got it and it’s been there but maybe the disease agent is mutated and there’s some change in the DNA, and now the infectivity is increased, the pathogenicity has increased or transmission occurred. So there’s a mutation, and that’s more of a natural type of occurrence. But we can still go back to the accidental side, we have people involved – they’re in commerce, hauling livestock and poultry, so increased exposure to that. And then back to the natural side, we could have weather changes. A lot of states, we’ve been in drought for the last ten or twelve years so that dry environmental conditions allowing environmental organisms to surface. They’re pathogenic but now their exposure increases because of the dusty topsoil, and then we have lots of rain occasionally, so you have erosion and environmental organisms surfacing and there’s increased exposure related to the environment and the weather. But then there’s the intentional side. So it may not be accidental. It may not be natural. The occurrence of an endemic disease may be a disease we have, but a bioterrorist intentionally introduces this highly pathogenic organism that we already have, but the infectivity may be greater, the pathogenicity is greater, and then we have a severe disease–type outbreak. So there’s a number of reasons for the disease to enter the United States or multiple reasons for them to be emerging in the United States. Moderator: Right, and on agroterrorism, anything that can happen accidentally can happen as well intentionally or be magnified.

Dr. Faries: That’s one of the first investigations. If there’s an outbreak, that investigation will be determined if it’s natural, accidental or maybe the investigation would display that it would be intentional and then of course the FBI will be involved with the jurisdiction to do their investigations.

Moderator: How do these relate to zoonotic diseases which cross over and affect humans as well?

Dr. Faries: Zoonotic diseases are diseases shared by people and animals. Many of them are just going back and forth, and they’re classified as zonoosis, or zoonotic disease, they are diseases that are shared between people and animals. Then there are some referred to more as animal diseases but they can be transmitted to people and that would be going from animals to people, that would be a zoonotic disease. Once it gets into people, it may be a dead end and may not be transmitted among the people. But yet it could be a disease that is transmitted from people to people. Then we have diseases of people that are transmitted to animals. When it gets into animals, it may be dead–end and not be transferred among animals, or yet it may be a disease agent that once goes from people to animals, that may transfer from animal to animal. So we have some disease that are just classified back and forth, and then some more animal–related, going to people, and some more people–related. So when we diagnose an animal disease, we have to decide –– is it an animal disease or is it a human disease that’s come into the animal population? And vice versa. If a physician diagnoses a human disease, is it a true human disease or did it come in from the animal populations?

Moderator: And then of course all these FEAD problems.

Dr. Faries: Yes, there are many of those, FEADs, the Foreign Emerging Animal Diseases that are zoonotic. If you look in literature, there are 200 human diseases that are zoonotic, and many of those could be foreign animal diseases or emerging animal diseases, but of the 200, about 67% are really like an infectious type disease that could definitely be infectious and be transferred back and forth. So that 200 diseases is kind of a class of zoonotic diseases and really infectious diseases in human medicine. They consider about two–thirds, 67% of them really being zoonotic, again transferred back and forth between people and animals.

Moderator: That two–thirds alone suggests how big a potential problem it is.

Dr. Faries: Yes, it is. It is a concern when we have an outbreak that there could be an involvement with the people or human populations with the animal disease outbreak. So to emphasize, we have the types of occurrences of these FEADs – the outbreak occurs naturally, but it could be accidental and we have a lot of efforts, emergency management, and preparedness to educate people to reduce that risk of accidental. But then we have the security issue with the bioterrorism or agroterrorism as being intentional. But when we talk about agroterrorism it may not be a biological agent. It could be a chemical agent, it could be radiation, but in this subject, we’re talking about biological agents, so we could refer to that intentional as being a bioterrorist act or it fits under the area of agroterrorism –– affecting this economic sector of agriculture.

Moderator: Right, let’s address what you hinted at with the economic sector, aside from the zoonotic effect of direct infection of people, what are the other effects that these diseases have on our society?

Dr. Faries: The zoonotic effect may not be an impact; it may be some other areas. Economic is at the top of the list. We can have an outbreak of animal disease that would be economically devastating to the country –– not only locally or state or multi–state but throughout the nation. When we have an outbreak of a highly contagious disease, large numbers of animals are sick and they lose their production. That’s a great economic loss. A lot of them are dying and that’s an economic loss. A lot of them will be quarantined and then depopulated to control and eradicate the disease, very devastating. Of course, there will be losses of farms, loss of income, so you have an emotional, sociological change in that community or state or throughout the nation. So people will be impacted emotionally and socially and with the interstate, national, international trade, political impacts will be involved because of the market. Just in cattle alone, we had a certain disease outbreak that shut this country down, we can’t export, we lose about 15% of our beef production not being exported, and that would be a great economic loss. It leads right into emotional, sociological, political issues.

Moderator: We’ll talk about the disease specific event, but I know the relationship between the US and Canadian government was strained over the very things several years ago. Let’s talk about specific diseases and the first on our list is foot and mouth disease. Can you tell us something about that?

Dr. Faries: Foot and mouth disease is a disease, a foreign animal disease. It’s not currently in the United States. We haven’t had a case of foot and mouth since 1929. It’s declared as a true foreign animal disease. It’s a viral disease, highly contagious–– very highly. There’s no other livestock disease that’s more contagious than foot and mouth disease, so that is a great concern. If that disease returned to the United States, there’s no immunity in our animals and there will be widespread of that very rapidly because low immunity and highly contagious, being a viral type disease. But the animals susceptible to foot and mouth disease would be livestock, but it would be domestic livestock and wildlife. Not just domestic, but it can get into the wild animal population. The livestock that are affected, that are susceptible would be the cloven hoofed animals, livestock that have two toes–– cattle, sheep, goats, pigs, llamas, deer, going to exotics like elephants. It’s not the one–toed, which would be the horse, or the five–toed like dogs and cats, or people. We have tremendous numbers of those two–toed animals throughout the United States. Very highly contagious, enters the bloodstream goes to the mouth and causes blisters and sores. Goes to the feet and causes blisters and lesions in the feet, lots of crippled animals, and animals that can’t eat because of the blisters and sores...

Moderator: We have some of your pictures on your slides and you can show the audience quite clearly a lot of reasons why you wouldn’t be too comfortable eating if you were an animal.

Dr. Faries: The upper left picture shows lesions in the gum area, very painful. If it’s a nursing animal, it can’t nurse. If it’s a grazing animal, it can’t eat then the tongue gets lesions and sores. So, they’re not going to die of the disease itself, they can die of starvation because they are not able to eat. They may die of starvation because they can’t walk. In the lower right is pig’s hoof –– very sore, tight pain in crippled animals. Then the nostrils there of that pig. So this is a devastating disease, a debilitative disease in these animals because of the inability to move around and actually be consuming. So that’s a great concern to our livestock producers for this one to occur. Moderator: And the impact on human health is not direct?

Dr. Faries: It’s not direct. It’s indirect. It’s the devastating impact that could be economic or socially or end up being emotional. Then you get into the political impacts. There was a few cases of foot and mouth disease that has been reported in people, but it would be those that I found, four case reports of workers that handled these dead animals, the infected animals and got a real heavy exposure, lots of fluid on them and got mild lesions on their mouths or hands. It’s really a livestock disease, it’s a two–toed animal disease – so this is not classified as zoonotic disease.

Moderator: But the important thing to remember is how highly contagious it would prove if it got loose in the United States.

Dr. Faries: There is a hand foot and mouth disease of people diagnosed in the United States, but that is a different virus –– that is not the same as this livestock disease.

Moderator: Now, the second disease, as the name implies, mad cow disease, also deals with cattle. In your long career as a veterinarian in Texas, you’ve seen mad cow disease.

Dr. Faries: Well I haven’t seen it personally. I would have to go over to the United Kingdoms, as some did back in the 01 time, but I have seen lots of pictures, a lot of video footage. It’s not a disease you can just recognize and identify because it’s a neurological disease.

Moderator: Right.

Dr. Faries: It’s only of cattle, bovine by name. It is a spongiform and encephalopathy, so it is a brain disease that has a spongy type lesions in the brain. It’s concicdered to be at this time a foreign animal disease, it’s not currently in the United States, and I’ll qualify that later, but it’s not been declared to be a true foreign animal disease. It’s working right along with the foot and mouth disease programs, and I want to make that distinction because a lot of people get those two diseases mixed, the foot and mouth disease and the mad cow disease, but the measures on import bans can be applied to the foot and mouth disease. Not feeding meat garbage to swine could be just for the foot and mouth disease, but you get over in the mad cow disease, it’s a brain disease, really of cattle. It’s presumed that it’s been caused by a prion. It’s a prion disease –– not a viral disease or bacterial disease or fungal disease, it’s classified as a prion disease. If anyone asks "what is a prion?" we’re not really sure what a prion pathogen is. It’s still being studied. There are theories. But it’s considered that the causative agent of this encephalopathy in cattle is a prion, a pathogen. Prion is a cellular protein in the brain and people have prions in the brain; animals have prion in the brain. They’re normal. But then if they become modified, not truly mutate because there’s not a change–– there’s no DNA for them to change but there’s a modification of the prion. It becomes modified and when it becomes modified, it’s not a normal prion but a pathogen, an agent that can cause disease. That modified prion then sends signals to the surrounding, normal prions and they become modified and they start clustering together and as they cluster they make holes in the brain which then would be the brain disease. The symptoms are very similar to rabies. They’re rabies–like, so when we see cattle exhibiting some neurological disease –– stumbling, wobbling, staggering, getting down, can’t get up; it’s likely to be rabies, that would be a concern. The concern is, whether this a zoonotic disease, because the United Kingdom––

Moderator: Does it transmit to people?

Dr. Faries: Well, there’s an assumption that it was transmitted to people and they diagnosed it as encephalopathy, compared it to the mad cow and said this is mad cow in the people. It’s very similar to Creutzfeldt–Jakob disease – a disease of older people, normally people over 65 years of age, and in Europe, there were people showing symptoms, but they were younger people, teenagers, 20–year–olds, 30–year–old, so they identified that as a variant form of CJD. They assumed that people did get exposed from this prion from the cattle and this prion is in the brain, in the spinal cord and in the skull and in the vertebra. For people to get the disease, they have to eat brain, spinal cord, skull and vertebra. So those people that got the variant form of CJD, ate cattle but did not eat beef uncontaminated with those parts. So, they ate beef like ground meat and in that ground meet has the brain, spinal cord, skull, bone, vertebra –– that would have been the exposure. But eating beef without the contaminated parts, there would be no means of transmission. But it is considered to be a zoonotic disease.

Moderator: In the outbreak in the United Kingdom in 2003, we’re familiar with that. Have there been any cases in cattle here in the United States?

Dr. Faries: Yes, the first was as you mentioned was in the state of Washington in 2003, a dairy cow, an old dairy cow, she was traced back to Canada. She was born and raised in Canada, became infected in Canada, came across the state line. They don’t show any symptoms until several years later. So as she was in the state of Washington, she got down and couldn’t get up and she was examined and by lab tests and diagnosed as the first case of mad cow in the United States. Then in Texas last year, 2005, there was one cow diagnosed in Waco, Texas, at a slaughterhouse. She was down and can’t get up. So all the downers are tested, so she was tested and found to be positive. She was a native Texan cow, over ten years of age. Then this year, a cow down on the farm in Alabama, a veterinarian went out and examined that cow, ended up having her tested and she was positive. So, we’ve had three cases: Alabama, Texas, and the Canadian cow in Washington. Statistically, they’re projecting there’s five to seven more. But there old cows and they’re dying and being disposed of and ending, so statistically, we cannot declare mad cow disease to be an endemic disease in the United States because of the low numbers and the old cows that are dying.

Moderator: And as I understand it, it does not spread cow to cow, right?

Dr. Faries: It doesn’t spread from cow to cow. As you see in the slide with a spongy form appearance in the brain, there are prions, abnormal modified prions in it. They don’t get out of that brain. For it to go from this brain of this cow to another cow, the other cow has to eat portions of this brain. That’s the way it was done in the past. As we feed cattle protein – that can be plant protein or animal protein. A common practice is to not only feed plant protein like corn and soybeans but to feed animal protein, ruminant protein, ground–up leftover of the cows –– the brain, bones, spinal cord and skull, make meat meal and bone meal and the prions got contamination of the bone meal and the cattle ate it. It’s not a cow–to–cow transfer.

Moderator: So that leads us into our next questions, what are the primary methods to make sure or control the spread of the disease, of course it has to do with the feedlot industrial practice.

Dr. Faries: That’s right, so the first step was to just ban the feeding of ruminate protein to cattle. In the United States, no cattle are being fed ruminate protein. It’s a new law since 1997. So that’s been 9 years ago. Any cattle that ate it prior to that, they’re old cows and many are already gone. So there’s no way it’s going to spread within the United States because it’s against the law to feed them animal protein. How did it come to the United States – there had to be cattle coming in, but there’s a ban, an import ban. Any country that has been diagnosed with the mad cow disease are not permitted to import any ruminates or their products into the United States. Moderator: Now, the first two we’ve talked about are reportable foreign animal diseases. The next one, chronic wasting disease is actually an emerging disease here in the United States.

Dr. Faries: Yes, that’s right. It’s not a foreign animal disease, it’s an endemic disease, it’s been endemic for years, started back in the ’60s, started off in Colorado. It is a prion, (supposedly) disease, which would be an encephalopathy, it would be a spongiform encephalopathy, making holes in the brains; but instead of bovine it would be the surrogate and so it is commonly called CWD. But as a brain disease, it would cause neurological symptoms–– stumbling, staggering, wobbling and some rabies–like symptoms, down, can’t get up, but in addition to that; more so then with mad cow, they become chronic emaciated, just get thin and poor. It’s predominantly the deer and the elk, somewhat in the moose.

Moderator: Hence the "wasting" terminology.

Dr. Faries: Yes, the wasting, the emaciated type. It’s easy to recognize in some of the deer and elk, just the thin, wasting–type condition. And to the one’s that get concerned about eating the deer and the elk; it’s not considered to be a zoonotic disease. There’s no evidence that it’s transmissible to people, but as long as the hunters are killing the deer and elk that are alert and running, they would not have any symptoms of the CWD.

Moderator: It’s concentrated in several pockets in the country; isn’t it?

Dr. Faries: It started in the state of Colorado. We have a map that shows as cluster––

Moderator: We do have that up.

Dr. Faries: There’s a cluster of six states there: Colorado, Wyoming and South Dakota, Nebraska, Kansas and Utah, that cluster of six. Then you drop down to New Mexico, which would make it seven states. Then you jump to the eastward direction and Wisconsin and Illinois make it eight, nine states. Even here in the state of New York, number ten, and then down a bit to West Virginia. That’s eleven states now that have been considered to have free–roaming deer that’s been diagnosed with the CWD. Then of course we have some farm raisers that’s also infected. If you look in Oklahoma and Montana, they have some farm deer in Oklahoma and Montana that are infected. So there’s a total of 13 states, but the true strong endemic is the cluster of six. And there’s some safeguards in place so that as deer and elk are moving out of here, they’re under restrictions. They may not just move them freely. Movement of any live deer may have to be through a volunteer monitoring program. That’s all in place. States will have restrictions on deer and elks coming into the state to keep that state free. Like Texas is free, there’s restrictions on bringing farm deer and farm elk into Texas. And of course, the game wardens are busy during hunting season, doing a killer–test type of program, so there sampling killed deer, taking the brain, sending it to the lab as surveillance, to detect that. So it’s pretty well under control but it’s been emerging and moving into some other states, so the restriction have become strengthened.

Moderator: Right, let’s talk a little bit about one which a lot of our audience is more familiar with probably in terms of their own public health experience, and that’s West Nile encephalitis, which first appeared in North America in 1999, right?

Dr. Faries: Well, if we could first skip back to the anthrax.

Moderator: You’re right. I’m sorry. Let’s talk a bit about the anthrax threats to us.

Dr. Faries: Maybe viewers would be more familiar with anthrax with the scare that we’ve had with human cases of anthrax. But to explain that, that was laboratory cultures in powder that was a dusty, aerosol–type form that could be inhaled, and there’s evidence that this is a route of entry to people, inhaling. As you look at the anthrax of livestock, it could be any livestock, including horses. It could even be over in dogs and cats. So really any animals, it could be in the wildlife, deer and elk. Anthrax is in the United States. Anthrax is in Texas.

Moderator: In the soil.

Dr. Faries: Right, it’s in the soil. We have an endemic area in Texas, which is south of San Antonio, down I–35, down I–10 and down to the Rio Grande, and it’s an endemic area reported every year. Many other states have anthrax reported. But it’s soil–borne, the soil is always contaminated, once it becomes contaminated. But these bacteria of anthrax are in the environment, they’re heavy, sticky, they’re clustered together, they’re not in the air. They’re not going to be an aerosol. So people live in that area, you can go in there and go deer hunting, sit on a blanket and have a picnic; just don’t eat the dirt. The livestock is in there grazing and that’s how they become infected…

Moderator: But it’s not jumping up and getting into our airways..

Dr. Faries: So you ask, how do you get it? If you’re in that area and you find a dead deer and take home the antlers and say “I’ll take them homeâ€� or bones–– any exposure to a dead carcass–– we have a slide of dead cows that died suddenly. This is a symptom of anthrax. They just dropped dead – they are dead when they are falling. They die standing and they decompose very rapidly. The buzzards don’t like them. You see no buzzard on these carcasses, they stay back. These animals blow up with gas. In time, they’re going to rupture. You don’t get close to these. If you get close to them and get that fluid on you, there could be that type of exposure. So the restriction here would be burning of those carcasses.

Moderator: Okay. Now, I’m sorry; I jumped ahead on you, but now let’s talk about West Nile a little bit.

Dr. Faries: Many are familiar with West Nile because it began in 1999 here in the state of New York and it’s moved southward down to Georgia and Florida and then it moved westward and now it’s throughout the United States. West Nile, encephalitis is an endemic disease. It was a foreign animal disease, it’s no longer classified as a foreign animal disease but it’s endemic and endemic now in all 48 states. It’s a bird disease, a brain disease of birds, so it’s an encephalitis of birds. The natural host would be birds. – transmitted by mosquitoes. So, mosquitoes bite the bird that are infected, that have a viremia; the mosquitoes become infected and bite more birds and more birds. There’s probably over 100 species of birds that’s susceptible, but the major bird that seem to be most susceptible, that we find dead with a lot of brain disease and liver disease, kidney disease, would be the crows and blue jays and hawks. They’re highly, highly susceptible. Is it a zoonotic disease? As mosquitos are looking for the birds, and prefer the birds, but if they are hungry and if they can’t find the birds, they’ll bite any mammal: dogs, cats, horses, cows, sheep, goats, and people. Those are incidentals. This virus doesn’t like these people and the animals. They want to be in the birds to multiply. But if they get in the incidental host, normally the animals are not affected. You see symptoms like in dog and cat or, you know, in a cow or pig. Their body, their microenvironment is not suitable for the virus to be multiplying. Horse is a little bit. Maybe 1% of the horses might show symptoms. Then people are a little bit, so the virus gets into people and maybe 1% of people might show symptoms. So, the incidental host that is primarily showing symptoms would be 1% of the horses and the people.

Moderator: I see. So it’s the host’s behavior or their environment––

Dr. Faries: That’s right. The slide shows the cycle from bird to mosquito, bird to mosquito, and then on the right side of the slide, go over to the other host and that depicts then the people and the horses. But again, it’s more like a 1% infection rate, that show some form of symptoms.

Moderator: We have a slide of a horse here, is that one that is infected?

Dr. Faries: That is one that is showing symptoms, right. One percent would show the symptoms. Those horses that show the symptoms, most of them don’t die. There’s about 30% that will, but most of those were euthanatized because of humane reasons. Maybe on the human side, maybe only 6 or 7% die. There going to get some immunity now throughout the United States from previous exposures from previous years. We see more West Nile more in August, September. So the symptoms may be getting less and less. Moderator: Now, bovine tuberculosis is another disease also of concern. Can you tell us about that and its relationship to the human population?

Dr. Faries: If you were to see that word, bovine tuberculosis –– bovine, being cattle, and tuberculosis, now is this human tuberculosis, like human T.B.? It’s not. It’s a mycobacterium, but it’s a different species. The human T.B. is a different species of mycobacterium. This is mycobacterium bovis and it’s been in the United States, many of the states over the years have eradicated it, but we just received from the USDA a classification of being T.B.–free in the United States. It’s a zoonotic disease, it’s a bacterial disease. It involves the lungs, it gets in the lymph nodes, it causes a lot of lesions, there’s a lot of abscess, a lot of pus, a lot of tubercles, nodules in the lungs; very respiratory distress–type disease. But it’s been on eradication for years. We’re practically free. As for zoonotic, there’s been a few cases of cattle TB going across species to people, but it’s very, very rare. Seldom is that ever diagnosed. But then when a physician diagnoses tuberculosis in people, they classify it as human strain as mycobacterium tuberculosis or the lab may report it as mycobacterium bovis, but not likely. Just every few years is there ever a case, but the exposure has to be direct to an infected cattle. So. places that have had TB, like dairy cows, the workers who have close contact, maybe through aerosol transmission. It does go through the milk but then pasteurization will kill it.

Moderator: So that’s not the type of disease that will have a major impact on human health.

Dr. Faries: It’s not. It’s been emerging over years, but we’re going to soon take this off the list because with all the USDA and the eradication programs, it’s been very effective to keep this out of the cattle population as well as the human population.

Moderator: Right. Now, another one that seems similar at first, Johne’s disease.

Dr. Faries: Yes. Johne’s was diagnosed and identified and named after the researcher, a German Veterinarian, in I think 1895. He pronounced the name "yo–nees" which when you see the word, it looks like Johne’s. It’s a mycobacterium, it’s like TB, same genus, but a different species. It’s an avian, it’s the bird–type species, it’s mycobacterium avian, but it’s a variety and it’s a para–tuberculosis, not tuberculosis. Para means beside, something similar. It’s a para– T.B. But instead of being a lung disease, it’s an intestinal disease. It gets in the intestine, orally, spreads up and down the intestines, causes lots of chronic disease to the intestine, causes severe diarrhea, profuse projectile diarrhea, just wasting away. Cattle become infected only at a real early age–– under six months of age–– but they don’t show the disease until they get older, usually well over 4 years of age, maybe six or eight. With profuse diarrhea, appetite – they eat you out of house and home, but they just lose weight, lose weight.

Moderator: So, they won’t have the symptoms at all during that time.

Dr. Faries: No –– years later. It’s been emerging over the years. Maybe some of it is related to diagnostic tests because the tests have improved, the technology, so we’re recognizing it more. We want to keep it on the emerging list because we’re getting more cases in more states every year (diagnosis of Johne’s disease). It’s a debilitating, chronic diarrhea–type disease in people–– in cattle.

Moderator: Your slide did show some link to Crohn’s disease in humans?

Dr. Faries: It’s considered possibly a zoonotic disease. There’s still a question mark by it. There’s no scientific proof or evidence that this is a zoonotic disease, but with the case studies in human medicine, which they have Crohn’s patients that have a debilitating, chronic diarrhea, they have isolated the same bacterium; mycobacterium, avian variety para–tuberculosis, from the intestine of some Crohn’s patients. And some reports, studies show 3%, all the way up to 75%, so there may be a linkage that Crohn’s disease possibly, but not singly, but in this complex cause, could be related to this same bacteria –– but that has not been scientifically proven. Is it in the milk of dairy cows? Yes, it is. But pasteurization kills it. So, the exposure basically has to be around cow manure, cow feces, to get that exposure.

Moderator: Now, we talked about these diseases in animals, now how can animals be potential agents of agroterrorism?

Dr. Faries: Definitely yes, these agents, if we look at a definition written by Ohio State University – the use of biological to include toxins, like anthrax–produced toxins. So it could be the bacteria itself or the toxin, as well as chemicals or radiological agents, again some component of agriculture, and that is what we are covering today, those biological agents, in such way that adversely impacts the agricultural industry, or any component thereof; the economy as we stressed, the consuming public. So definitely these biological agents that are animal diseases, maybe foreign at this time or endemic at this time, are definitely the agents that can be chosen to be used as bioterrorist agents. The one on the top of the list is the foot and mouth. It is not a zoonotic disease, but it would be so devastating to the economy of our nation to bring in foot and mouth disease because it’s so highly contagious and spreads so rapidly. It will spread four to eight miles by way of wind quickly. That one is at the top of the list. So don’t always think that a bioterrorist may choose a zoonotic human disease agent, but they can but it in animals and let that be the terror.

Moderator: Right, and as you say on your slide, the key factors are the easily spread and rapid spread.

Dr. Faries: Yes, without boundaries. They choose the agents that can easily handle it, develop it, maintain it and get it distributed. And many agents are that way, and foot and mouth is at the top. They may not be choosing a plague disease or cholera disease or a tularemia disease –– they just want to create some terror, and of course there would be a lot of human deaths involved in that because of suicide. I mean the emotional upset—there are a lot of people in Europe committed suicide in the ’01 foot and mouth disease outbreak. It’s very devastating. It starts locally, a local outbreak, but it becomes a state, interstate, national issue in a short time, short, short time.

Moderator: Now, let’s turn specifically to some the steps that are being taken. How are you involved in the protection of US Public Health and animal agriculture from Texas?

Dr. Faries: Well, I’m a member of the Center for Foreign Animal Zoonotic Disease Preparedness Defense Center in Texas. Texas is the lead agency. This is a center of excellence which is under the US Department of Homeland Security and we have collaborating agencies and institutions: the University of California at Davis, the University of Texas Medical Branch, University of Southern California. So we as four institutions collaborate together. The lead agency is the Texas A&M System and I’m in the Texas cooperative extension, an agency member of the A&M system. Our office there is the lead agency. The director is there addressing foreign animal diseases, zoonotic diseases, and emerging diseases. I’m also collaborating with the Texas A&M Rural Public Health Preparedness Center, working closely with Kay Carpenter, Jill Arts Berger, Barb Quirram, Annie Graham. We have a good focal group there at the preparedness center, I collaborate with them. They send me out with lots of their outreach missions at county level to do educational programs.

Moderator: You have a list of key priorities that the whole center works on?

Dr. Faries: That’s right. We work across the board following the parties that were identified by the US Department of Homeland Security for prevention and detection and those are the major areas, the work in prevention and detection. We have programs working with response and recovery. I’m pretty heavy in the risk communication and education side, and we divided it into components so we have these themes and have components. Some are into strictly into research, the biological side, there in work to produce new vaccines against these animal diseases, new diagnostic tests, so that’s the biological side. Now there’s the computerized modeling and research going on to test a lot of the effectiveness of these discoveries, whether they were vaccines or diagnostic tests or some prevention programs. We have education; there’s a number of graduate as well as undergraduate programs, and we have the outreach that I’m heavily involved in. Those are the components across the board addressing these issues related to foreign animal and zoonotic disease issues.

Moderator: Right, You have this trainer guide, a slide of the train the trainer handbook I guess they call it, that comes out of that program.

Dr. Faries: The author of that book. That was one of our products, used in education, a major effort to train the trainers. We have already done that in Texas. California is currently doing it this month and next month. We’ll merge the curriculum together so Texas curriculum and California curriculum will come together and we’ll have a national curriculum to train the trainers in foreign emerging animal disease issues. It will become a national curriculum so other states will do the multiplying effect to train trainers and they’ll train trainers because that’s the key as we move forward in preparedness against foreign and emerging animal diseases.

Moderator: We don’t have a lot of time left but I want to cover some discussion of exactly how we can manage this and reduce the potential for the devastating impact on human health. Dr. Faries: Okay. It’s to create the first line of defense. And as I said, our first line of defense is to get in there with education. Education is so key. We’re targeting animal owners. The county extension agents or the farm advisors, the faculty and education at the county level, and get our private veterinarians involved. Get in that education, establish that through education. Then we move into more key measures like biosecurity. That’s being taught to all of our farmers and ranchers create biosecurity measures to keep the disease agents from coming in. It’s done at the international level, the state level, as well as the local farm level. Detect it early; get it reported early so there can be rapid response. Then our regulatory agencies come onboard, make a quick diagnosis, quarantine, hold orders, maybe move into an eradication program – that might need to be some kind of depopulation. Move in surveillance at international borders, state borders, also in local areas where there’s pre–harvest, harvest or post–harvest of these animals. Have an animal identification system and there’s a program in place that’s been reviewed and developed so that in time there will be a national animal identification program so animals in commerce will be individually identified so if there’s a disease outbreak, the identity can be traced out where they have been, where they come from, all the animals that are here, were they raised here or did they come from somewhere else. Find out where they have been. This system can trace a disease within 48 hours. That program is not in place but in time, the USDA is continuing to develop this national ID program and when it comes in place, it will be much quicker in surveillance and tracing in and tracing out. Right now as we trace animals, we have to use a lot of sale papers, ear tags that are not the national program. It works well but sometimes goes beyond the 48 hours. We need tracing within 48 hours, especially with foot and mouth disease because it moves so fast.

Moderator: We’ve come a long way from the branding on the open range.

Dr. Faries: Another key point is for regulatory agencies is to work with all of us. In education, right on down to the state and local level. We need to get regulatory agencies working together with education, and with the general public and with the animal owners. That’s the state area, the state department of agriculture, the state animal health regulatory agencies, the state public health agencies, going down to the local level, the county public health offices on down to animal owners, to private veterinarians – the list continues. We need to work together in this preparedness so that in preparedness we work through the county level in preparedness and work right on up to the state level, the federal level. But then in disease outbreaks, everybody then becomes involved in the disease outbreak to coordinate all the various plans: local plans, state plans and emergency plans. In the outbreak of disease that’s under regulation, the regulatory disease, the local jurisdiction will not be in charge. If it was a hurricane or wildfire or natural disaster, the local plan would be activated. But all animal disease outbreaks are under the jurisdiction of USDA, directed down to the state level to the department of agriculture or animal health regulatory agencies and then they’ll utilize local plans in pieces and activate those and deploy as necessary. But if there’s a bioterrorist, the FBI then will have jurisdiction, working shoulder–to–shoulder with the animal health regulatory agencies.

Moderator: That’s interesting,that’s something different for our audience of public health people. Usually as you say, it’s the local or state agencies will be in charge of the response, but here in an animal outbreak, the USDA would be in charge.

Dr. Faries: That’s right. The USDA will be in charge. Now, if it’s not a regulatory disease, they can maintain that; it may be an E.coli outbreak in public health or Listeria: ... But if it’s a reportable disease, and some of the slides pointed out whether it’s reportable or not. The veterinary profession would report that disease clinically to the USDA or the state animal health agencies, or if it’s zoonotic, reported to the state public health agencies, but if it’s not a reportable disease, then it’s not required to be reported. But if the animal disaster was a flood or wildfire, there would be local jurisdiction for those. Moderator: An important part of emergency management in all areas is mitigation. What steps can we take as a society to mitigate the threat here?

Dr. Faries: It’s a major effort of education is to identify biosecurity measures and most things that make the list are just common sense: sanitation, being clean, starting with washing your hands – about every time you walk by a water faucet, you should wash your hands. It may be unnecessary to have soap and hand antiseptics, but wash, just by friction, rubbing, 20 seconds. Count your ABCs maybe, 30 seconds. Great biosecurity measure as you go in and out to prevent diseases from coming in. Any contaminated things like clothes and boots and tires, trailers and trucks, equipment, they need to be washed and disinfected. Anything that goes off the premise and comes back needs to be washed and disinfected. Be careful about garbage – don’t let it get out into the environment. It needs to be disposed of properly. The issues of bioterrorists or concern about a person around needing to keep the gates locked, watch the strangers; they may be the terrorist–type person. Be careful about international visitors being contaminated. Normally we have a field day when we have internationals invited, we have them come in, but we want to stay away from their livestock for at least 48 hours. Most of these diseases, like foot and mouth disease, they lose the contamination after 48 hours. Within that 48 hours, it could be in the nostrils and their ears. So we have some issues there in the international district, but it’s easily handled. Any livestock coming in, minimum of 2 weeks, preferably 6–8 weeks of quarantine to watch for any type of symptoms. So its isolation, running tests, just being concerned – observing, watching the livestock closely, not driving by at 40 miles an hour but getting out and walk along with them and looking at anything unusual, unusual symptoms, unusual sickness, unusual deaths, too many deaths. Because this could be a zoonotic disease and in the veterinary profession or in the animal world, they’re going to recognize it first because of the large number of animals involved, before human medicine recognized, because they are seeing one patient at a time. But in the animal world, you’ll see in one confinement maybe 1,000 patients already sick, just like that, and then 10,000, and that’s reported to the public health departments and then we realize we have a zoonotic disease. So that’s that close observation, detected early; that’s the key, following education, is to detect it early and rapidly report it so we can get a response from the regulatory agencies.

Moderator: And you point out the large animal issue, large population issue, but there are a tremendous number of small farms raising animals, cattle particularly, where you could have beginnings of these outbreaks, too, but it’s harder to get the word out to thousands of smaller farmers, I assume.

Dr. Faries: Yes, it is, but we have an extension, faculty throughout the counties. Like in Texas we have 254 counties and we have faculty in every county working hard and fast with seminars, conferences, news media, just public information, awareness. Just making more people aware just be careful and watch and report, and we’re publicizing throughout the United States 800 numbers that are answered 24 hours a day. A live person will respond to that call. Based on the symptoms, they may quickly report it to the department of health for that state if they consider that to be a possible zoonotic disease. They’ll respond within hours –– they’re on that farm, collecting samples and putting in test orders. I’m comfortable with the surveillance, the firewalls, and the number of people out there that don’t even work for the government that are involved in assisting the government through education and observations and early detections.

Moderator: I know certainly here in New York Cornell cooperative extension does pretty much the same kind of thing.

Dr. Faries: And our regulatory agencies are working closely, like here in state of New York, the department of agriculture, an animal industry division in which they have the animal health regulatory agency. They’ll work closely with the centers for preparedness and education in any University and cooperative extension. So, there’s been people coming together that have never worked together but in the last four or five years, they’re just joining hands and working together. These centers have brought that around a lot, and that’s why I appreciate our center at Texas A&M University. They’ve brought a lot of people together who use to not work together.

Moderator: We have shared an awful lot of information and have kind of a sum–up slide to give people a take home message and then we want to show some references that you referred to. So understanding the difference between foreign and emerging animal disease differences, is number one?

Dr. Faries: That’s at the top. We want the audience who review this tape or any seminar, to know that there are foreign animal disease and emerging animal disease. We expect the foreign animal disease to be really devastating because there’s no immunity, there is no previous exposure. But we have some emerging going on, there are mutations that have also created some problems. That’s one of the three bullets.

Moderator: Number two...

Dr. Faries: Is just to understand that we that we have these potential threats. Not necessarily just bioterrorism but the commerce and movement of animals and movement of people. Then we have the weather conditions, many reasons for these threats to occur, whether it’s an emerging or foreign animal disease. Just recognize that we’re under threat and that threats continues since 2001 with the terrorist attack, beginning with the World Trade Center. To me, it’s just a matter of time. It’s not will it, it’s when. I suspect they have a list of disease agents that will target animals. It’s just a matter of when they drop foot and mouth disease. We need to recognize that early.

Moderator : And we need to understand the different roles of different agencies in combat.

Dr. Faries: That’s right. And not stay separated, like local agencies like county health departments, there are emergency management coordinators, under the mayors, under the judges, working with emergency management plans, state plans for health, human health/animal health. Then there’s the federal level –– these need to come together. My work in Texas is working with emergency management planners and go right to the local level, right to the emergency management coordinator. That coordinator has the plan or jurisdiction of the county judge. Build into that plan animal issues–– not only human issues but animal issues. If we activate at the local level, we’ll be activating the local plan, even though it’s under the jurisdiction of USDA.

Moderator: Right, now we have a slide here and we don’t have to talk about all these, but it shows some of the resources that are available. People will get these in their packages around the country, but there’s cooperative extensions both in Texas and elsewhere and the USDA site, of course.

Dr. Faries: Right. These are valuable sites for people to get additional information. You have my web site, the national center web site and there is a lot of good information on foreign, zoonotic or emerging–type diseases. Right here in the state of New York, go to department of agriculture, the animal industry division of the animal health regulatory group. And the center, this last one is an excellent, information source.

Moderator: We made you put up a slide with your personal information in case folks want to contact you afterwards.

Dr. Faries: I welcome anyone who wants to contact me to discuss this further and look at future educational activities or to receive any information. I welcome that.

Moderator: Well, we thankyou very much for joining us today and welcome back to New York anytime.

Dr. Faries: Thank you. I appreciate that.

Moderator: Thank you very much for joining us. We would like to ask you to please fill out your evaluations on–line. Your feedback is always helpful in the development of our programs and continuing education credits are available. We hope you’ll join us on November 9th for Mass Evacuations to Rural Communities. Our guest will be Dr. Brian Gerber, Assistant Professor in the Division of Public Administration at West Virginia University’s School of Applied Sciences, and Dr. Donald Rowe, Public Health Liaison at the University at Buffalo, School of Public Health and Health Professions. I’m Peter Slocum. See you next time on University at Albany Center for Public Health Preparedness Grand Rounds.

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