With the pandemic H1N1 flu attacking from an unexpected quarter, the Institute of Medicine says the U.S. must take the lead in developing a widespread program aimed at disease surveillance in animals.
The pandemic flu -- which originated in pigs -- is only the latest in an increasing number of diseases that have jumped the species barrier, the institute said in a new report.
Such zoonotic pathogens have caused more than 65% of infectious disease outbreaks in the past 60 years, the institute said, and have caused more than $200 billion in economic losses worldwide over the past decade.
"Zoonotic diseases are like wildfires, which flare up unexpectedly and can take a significant toll on human and animal health and damage household livelihoods as well as national economies," said Marguerite Pappaioanou, DVN, PhD, executive director of the Association of American Veterinary Medical Colleges.
"All too often," she said, "our reaction to these outbreaks has been to try containing a wildfire after it has gotten out of control."
Pappaioanou, a co-chairman of the panel that developed the report, was formerly coordinator of the CDC's international response to H5N1 avian influenza and the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak.
Experts on the flu say they had feared a pandemic would emerge from poultry and had made international efforts to ramp up surveillance of the birds. But they were blindsided by the swine-origin H1N1 flu, because pigs had not been under systematic surveillance. (See Special Report: Surveillance Gap Slowed H1N1 Pandemic Response)
The new IOM report was the result of a request two years ago from the U.S. Agency for International Development (USAID), which wanted to explore disease surveillance in animals, an institute official said.
The goal should be to stop responding to the "disease du jour" and implement a sustained and integrated disease surveillance system that allows public health officials to be prepared for outbreaks, panel co-chair Gerald Keusch, MD, of Boston University told reporters.
"Developing an effective global system for detecting and responding to emerging zoonotic diseases is a tall order," Keusch said.
But given the resources that are mustered to fight each individual outbreak, "We believe it is possible to implement a sustainable, integrated human and veterinary disease surveillance system that is acceptable to all stakeholders," he said.
Because the U.S. government leads in disease surveillance, the panel argued that it should lead efforts to build such a system.
Their report urges that the Departments of Health and Human Services, Agriculture, Homeland Security, and the Interior work with the private sector and nongovernmental organizations -- as well as USAID and international organizations -- to spearhead a more effective global surveillance and response system.
Among other things, the report said they should:
- Immediately strengthen surveillance in human populations at high-risk for zoonotic diseases, such as livestock and poultry workers, in countries where animal disease surveillance is weak.
- Develop and strengthen animal surveillance systems so that diseases are detected in animals, rather than through human outbreaks.
- Help develop science-based criteria to pin down what drives disease.