“Organizational silos,” and how they prevent effective zoonotic disease tracking

It appears that the agencies that we rely on to track disease outbreaks need to start tracking disease, not just their own jurisdiction.

An article in Sociology of Health and Illness piqued my interest this last week that reveals the amount of segregation different government agencies have when dealing with zoonotic disease. The understanding of the goals and connections between livestock, wildlife, and human health among these agencies are often apathetic at best, and antagonistic at worst.

The author of the article took it upon himself to interview several government agencies with different species and regional jurisdictions, and was able to reveal what he calls “organizational silos” that develop when the values and cultures of these different agencies prevent them from working with outside groups. When attempting to monitor emerging infectious disease (EID), identification of cross-species movement is critical to predicting and preventing pandemics. Unfortunately, while they may be able to acknowledge the geographical movement of EID’s, many organizations are blinded by their specific oversight of humans or animals.

Copied from the article: Diagram showing the crossover between domestic animals, wildlife, and human EID. Important emergence factors for each circle are listed on the outside.

There are many telling comments contained in his interviews, and I encourage you to read the article to get the whole scope of the problem, but I’ve chosen to list a few of my favorites here:

From the Director of Animal Health Division at a state Department of Agriculture:

“‘We got a positive [flu result] on one of our routine surveillance tests’ of a poultry farm, Spencer complained, and ‘we were required to contact the USDA right away because of the pandemic Asian strain’. Spencer added, ‘It seems a little silly because there was no clinical illness on the property, and the strain came back something pretty common…’ In Spencer’s eyes, it was ‘hard to justify’ reporting the flu strain to the USDA… These days, Spencer said he passes on information about disease events to the state DOH and leaves it to them to tell local health boards. ‘If somebody screws up’, he shrugged, ‘at least we can blame the [Department of Health]’.”

Not an uncommon perspective for many organizations, or even coworkers! Let’s hear from another director at the USDA Animal and Plant Health Inspection Service (APHIS):

 “Clinton argued that the ‘single biggest threat for disease’ comes from ‘wildlife intermingling with domestic livestock’. He told me, ‘You can’t control the birds’ and he rightly pointed out that ducks are flu incubators. If the bird flu – which Clinton called the top priority of his agency – becomes pandemic in humans, he told me, it will come from waterfowl.”

Interesting, I might argue that we have much more interaction with domestic fowl (can’t remember the last time I handled a wild duck), but let’s see what others had to say about this viewpoint.

“Nina Marano, a zoonotic disease expert at the CDC, told me that ‘most of the outbreaks have occurred through interaction with domestic poultry’. Another example: though poultry farmers singled out wild birds called cattle egrets as the source of a 2004 flu outbreak in California, the egrets tested negative – it turned out that contaminated egg containers circulating between farms were the culprit (McNeil 2004).”

Finally, one last example of how a zoonotic disease often isn’t treated as such by human health agencies. From a Director of the Infectious Disease Bureau of a city Public Health Commission:

“When I asked Sanders to describe a zoonose that she responded to, she mentioned a recent outbreak of salmonella…and she believed that the pathogen came from two live poultry markets in Chinatown. What I found telling was that, in Sanders’ lengthy discussion of this outbreak, she did not mention any communication with veterinary medicine agencies.While the Disease Bureau’s response to salmonella followed protocol, it did not turn to the Department of Agriculture, the USDA, or any other agencies involved in animal health for help or information. Nor did it share information with them.”

Clearly here the city health board considered this a food safety issue, but payed no attention to the implications of getting meat from an approved source (a domain which definitely belongs to the USDA), or the fact that other agriculture agencies may be interested in a salmonella outbreak. There are many other telling quotes within these interviews, and I again encourage you to check out the article.

The author of the study concludes that the only examples we get of harmonious collaboration are for those diseases which are in the public eye such as rabies and influenza (H5N1 and H1N1), though we still have lines drawn even when the public is asking for action (“‘we have enough H1N1 to worry about without worrying about turkeys’. He
concluded that turkey infection is ‘a Department of Agriculture issue’”). The most shining example of the failure to communicate by these institutions in the article is the discovery of Bird Flu in the US.

The first human cases of H5N1 in the US were wrongly diagnosed with St. Louis encephalitis, resulting in the deaths of 3 patients. A veterinary pathologist at the Bronx zoo observed neurological symptoms in some of the zoo’s birds and suspected a link, however encephalitis would not have killed her birds. Both the CDC and local DOH would not accept new information from her, instead keeping the encephalitis diagnosis. She then sent specimens to a friend at an Army Medical Research Institute of Infectious Diseases, who revealed the etiology of the disease and I’m sure had a hilarious conversation with the CDC and DOH (could you please explain to us why this veterinarian is doing your job casually on the side, and doing it better?). By the time the CDC received/accepted this information, H5N1 was endemic in the area.

Nothing against the CDC, it’s a fantastic organization, but this highlights the closed lines of communication that exist between human and animal agencies the author discusses. In order to prevent the next EID crisis, rigorous epidemiology is critical. Refusing to acknowledge the importance of cross-species movement to the virulence and emergence of a disease that falls under your agency does not only prevent you from identifying the next source of infection, but leaves you with nothing but reactive measures catered to a epidemic that you refuse to fully appreciate.

ResearchBlogging.org

Jerolmack, C. (2012). Who’s worried about turkeys? How ‘organisational silos’ impede zoonotic disease surveillance Sociology of Health & Illness DOI: 10.1111/j.1467-9566.2012.01501.x

Badger culling in the U.K. – step one: cull badgers, step two: …?, step three: profit!

Image from BBC News

A friend of mine thought this would interest me when I last visited him, and I had him send me the links discussing badger culling in the UK to control the spread of bovine tuberculosis (Mycobacterium bovis).  In addition to having an economic impact,  bovine TB also carries a zoonotic concern. I thought I would learn more about the issue, and see what the literature says about the success of the program.

Badger culling has been a part of TB control in the United Kingdom since 1973. Despite this and other programs in place, incidence of TB has only increased during that time. In the thousands of biological and environmental risk factors that have been associated with TB infection risk, Badgers have been identified as an important reservoir and potential vectors for the disease.

The politics surrounding the issue are interesting, and provides a great case example of how public perception can be skewed for certain species. The regular players are all there: the economically invested (in this case, cattle farmers and associated industries), the scientific community, outspoken animal interest groups, a generalized public perception, and the federal government trying to cater to the majority of voters (or campaign contributors, depending on the official and your own opinion). Lets break down these players.

The Economically Invested

On this issue, everyone seems to be on board that bovine TB is a problem in the UK. The ones who really care though are cattle producers, meat and dairy processing companies, and the retail ends associated with those products. When oppositional parties want to discredit this group, we see them described as “big corporations” only concerned about the bottom line. These claims are many times true, as even the small farmer has to maintain a decent profit margin to provide for him or herself. This group tends to be less publicly oppositional, preferring to exercise their strength through advertizing, lobbying, and funding research that can help support their position. Within this issue, I wasn’t able to find any ads produced by organizations in the UK, however, I did find some farmer concerns over the issue. One was the difficulty in getting approved for a badger cull in your area, and the other was the fear of response from activist groups if they did choose to participate in the program. The position of the farm interest groups is that the spread of bovine TB is an animal welfare and economic concern, and that badger culling will be critical in suppression of the disease. Local wildlife can often aid transmission of disease; however, we have also seen blame placed incorrectly on wildlife in other situations.

Animal Interest Groups

There are many groups in the UK that advocate for Animal interests, and they’re pretty much unanimous in the opinion that culling badgers is not an effective or ethical way to combat bovine TB prevalence. However, they do have different techniques in approaching opposition. While many of them strictly condemn the practice and advertize to sway public opinion, one group (with the support of many others), Gloucestershire Wildlife Trust, has been independently vaccinating wild badgers for bovine TB. At this time they haven’t investigated the effectiveness of the vaccine itself, but rather the economical viability of the process. Their results so far have shown that it would cost more than twice as much to vaccinate an entire hectare instead of culling. Typically these same groups in other controversial situations are very politically active.

The General Public

Generally the least informed and (arguably) the most powerful, the majority of public opinion represents the majority of voters and consumers. Regarding badger culling however, most of the general public has been shown in polls to oppose the practice. Agricultural controversies are often represented by government and industry actions that don’t necessarily mirror consumer or public preference, but instead are economically viable. Whether it’s often advocated for or not, above all else the majority of the public wants inexpensive food, and that benefit often outweighs other consumer preferences (though not always). An interesting examination of the public perception of badgers is discussed within this controversy, and this argument can also apply to other similar situations we have seen over the years. BBC explored the role of badgers in popular children’s stories, and related them to other species that receive special protection even if they are not endangered. An example from the states would be our attachment to wild horses as an icon of America, and some of the debates we’ve seen surrounding not only control of wild horses, but within discussions on using horses for food. Kevin Pierce from the article sums this feeling up well:

“It’s an image issue. A lot of farmers like badgers but we also want to control the disease. If your vector spreading TB was a rat, I’m sure that there’d be no problem for farmers in securing a license to take action.”

The Government

Tasked with the burden of trying to please everyone, the federal government often responds to the loudest collective voice along with their own advisers, analysts, and ethics. In this case, we do know that the government has moved forward with culling as they have in the past. Evaluating the motivation behind these decisions is an endless discussion, whether it’s a working system or corrupt is beyond the scope of this post. Feel free to express your opinions on the process in the comments below. The best I hope for is that while looking out for my interests, my officials attempt to remain objective, and speaking of objectivity…

The Scientific Community

I’ve left us for last. The example of objectivity and a lens of evidence to weigh a cost-benefit analysis of the issue not directed by personal interests, concepts of morality, or hidden goals. Or so we would hope. As a realistic scientist who has read a lot of peer-reviewed research, I know that we are never truly objective. All funding comes from somewhere, we interpret our own results, and while we try as hard as we can to be objective, there is no perfect experimental design immune to bias. However, as creator of this site, I obviously hold research in high esteem, so lets look at some of the literature regarding the effectiveness of badger culling in curbing the spread of bovine TB.

According to the sources I found, it appears that badger culling does have a positive effect on the rates of bovine tuberculosis, but strictly within the areas the culling occurs. There’s a beneficial cumulative effect after several years of a culling program (in the reduction of detrimental effects in surrounding areas), but it isn’t necessarily lasting, cost-effective, or repeatable in different situations. The consensus amongst several studies is that localized culling actually increases TB rates in the surrounding areas, due to the displacement of normally local badger populations, and additional factors that we don’t fully understand. Given these effects, there seems to be a general consensus in the literature I viewed that at best badger culling is not a cost effective way to reduce TB transmission, and at worst contributes to the spread of disease.

Culling programs always have fierce opposition from many sources, whether it be culling sea lions to protect Columbia river salmon, culling grey wolves to protect livestock, or culling tame geese that are causing damage to city parks. There are serious concerns from conservationists and animal activists about the effectiveness of such programs that can be well founded, and the controversy surrounding badger culling in the United Kingdom is a clear example  of why these decisions would be more effective if they are backed by empirical research and economic analysis before being presented as a moral dilemma.

ResearchBlogging.org
Donnelly CA, Woodroffe R, Cox DR, Bourne J, Gettinby G, Le Fevre AM, McInerney JP, & Morrison WI (2003). Impact of localized badger culling on tuberculosis incidence in British cattle. Nature, 426 (6968), 834-7 PMID: 14634671
Donnelly CA, Wei G, Johnston WT, Cox DR, Woodroffe R, Bourne FJ, Cheeseman CL, Clifton-Hadley RS, Gettinby G, Gilks P, Jenkins HE, Le Fevre AM, McInerney JP, & Morrison WI (2007). Impacts of widespread badger culling on cattle tuberculosis: concluding analyses from a large-scale field trial. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 11 (4), 300-8 PMID: 17566777
Donnelly CA, Woodroffe R, Cox DR, Bourne FJ, Cheeseman CL, Clifton-Hadley RS, Wei G, Gettinby G, Gilks P, Jenkins H, Johnston WT, Le Fevre AM, McInerney JP, & Morrison WI (2006). Positive and negative effects of widespread badger culling on tuberculosis in cattle. Nature, 439 (7078), 843-6 PMID: 16357869

What your intoor/outdoor cat could be sharing with the local pumas

Image from Pet-peeves.org

Generally not small talk, though I imagine they might be interested in the projections for this year’s salmon run (pause for polite awkward laughter). A new article from PLoS ONE has been discussed, implying that, while direct contact may not be routine, exchange of disease between domesticated and wild cats may be fairly common.

The group of scientists involved were examining the occurrence of Toxoplasmosis, Bartonellosis, and FIV. They went out to rural Colorado and California and trapped 260 bobcats and 200 pumas to take blood samples. They also collected blood from 275 domestic cats that lived in the areas investigated, most of whom were feral and free ranging. They tested the serum of these animals for antigens that indicated infection, and ran a statistical analysis that looked at the prevalence of each disease compared to factors such as age, location, sex, and species. The data was collected over a ten year period.

I’m not going to discuss much of the wild species data, but there are some important trends for those interested in pet health, though it’s not very surprising. The researchers revealed that the prevalence of disease was much higher in domestic animals near urban areas than in those rural. This indicates that even though there is a larger number of hosts and vectors (fleas and ticks primarily) in rural areas, clearly the higher concentration of animals in urban areas and increased interactions between domestic cats and wild species (created by human expansion into undeveloped areas) plays a much larger role in the transmission of infectious diseases.

There are also some cool snippets about FIV here as well. The discussion mentions that male cats were slightly more likely to be carrying FIV, which is to be expected due to the higher rate of sex hormone driven behaviors such as roaming and fighting. The FIV strains found in the wild felids also had greater genetic diversity, suggesting that the FIV we know and vaccinate for may be a relatively new disease (at least in comparison to wild FIV serovars). The data shows that the highest combination of pathogens that the domestic cats tested positive for were FIV and Bartonellosis, and the authors mention that because Bartonellosis and FeLV infection have also been correlated in other studies, this data implies that there may be a relationship between the three. However, that relationship may be as simple as having similar risk factors.

The take home message of the study is that wild populations can serve as an important reservoir for multiple zoonotic diseases, and that exposure to this reservoir is mediated by the domestic cats we frequently come into contact with. Just one more reason to think about convincing your kitten that the outside world is scary, and that they don’t necessarily have to go check out what the big cats are doing. Feel free to check out the paper yourself, its light on jargon and easy to read. I’m actually a little disappointed to see that they collected this data over a ten year span, but chose not to do any comparison of the rates of disease from year to year. It would have been interesting to see how climate differences and population growth may have affected the number of vectors and associated risk. Additionally, because all of the samples were collected opportunistically when wild animals were trapped for other non-related studies, there was no way to ensure sampling without replacement, which may have skewed the data.

ResearchBlogging.org
Sarah N. Bevins1*, Scott Carver2, Erin E. Boydston, Lisa M. Lyren, Mat Alldredge, Kenneth A. Logan, Seth P. D. Riley, Robert N. Fisher, T. Winston Vickers, Walter Boyce, Mo Salman, Michael R. Lappin, Kevin R. Crooks, & Sue VandeWoude (2012). Three Pathogens in Sympatric Populations of Pumas, Bobcats, and Domestic Cats: Implications for Infectious Disease Transmission PLoS ONE