Planning for the Human- Animal Interface

United States Department of Health & Human Services Office of the Assistant Secretary for Preparedness and Response Planning for the Human- Animal Interface Ty J. Vannieuwenhoven, DVM, MPH, MSS, DACVPM Chief Veterinary Officer OEM/National Disaster Medical System Evan Shukan, DVM, MPH, DACVPM, DACLAM CDR, U.S. Public Health Service Clinical Veterinarian/Staff Scientist National Institute of Neurological Disorders and Stroke 1

Human-Animal Interface Not just about infectious diseases What is the right term? One Health One Medicine Dilemma of responsibilities and authorities 2

The Planning Gap or Seam Human response issues normally well-planned Disease Decontamination and post-decontamination treatment Sheltering Animal agriculture issues similarly well-planned FADs Feed contamination Animals as a persistent threat to their people aren t well planned for Zoonotic disease outbreaks Animal decontamination and post-decontamination treatment, hospitalization and monitoring 3

Planning for People Human outbreaks Local health departments State health departments HHS/CDC Human decontamination Hazmat teams/fire departments State hazmat teams or National Guard HRFs or CERFPs DOD CBRN Response Force Human sheltering Local Red Cross State mass care plan ESF 6? NRF ESF 6 4

Planning for Animal Events Led by Agriculture FADs Other animal agricultural events 5

Planning for the Interface Who leads? Few current plans at any level There aren t 2 sides Un-addressed animals can be a persistent threat to their people Zoonotic disease outbreaks Contaminated animals 6

Why Should Health Agencies Care About Animal Planning Animals (primarily companion and service) are intimately involved with people every day and everywhere in the US. Many of the select biological agents and other CBRNE threats also affect animals Affected animals can be a source of infection or contamination for people in the short and long term Health agencies have responsibility to protect human health and typically the authority to address the animal issues needed to do so 7

Opportunities Addressing the human-animal interface is hard and takes serious planning Can t segregate the human response from the animal response or the human response will fail Since interface actions are done primarily to protect human health, health agencies are responsible as for Rabies and other zoonoses When addressing the interface is done outside of the human health system, it doesn t allow for adequate planning, exercising, and funding 8

Current Federal Plans Although most human health agencies have authority to address human-animal interface issues few plans exist Affected service animals are required (by ADA) to be addressed with their owners in CBRNE events but rarely planned for CDC s A Guide to Operating Public Shelters in a Radiation Emergency and their Community Reception Center plans introduce possible animal decontamination techniques but are not prescriptive FEMA REPP manual limits its discussion of animal decontamination because no national standard exists DHS/HHS document Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities merely introduces animal decontamination without addressing it The draft Biological Incident Annex to the NRF and NDRF FIOPS addresses the interface but does not specify countermeasures 9

Planning for the Interface Who leads and under what authority Who supports and with what capabilities Human response and animal response aren t separated Modeling includes the interface Appropriate countermeasures are determined and developed 10

Planning for Zoonoses Human health trumps animal health Health has the lead Other agencies support Health has to plan and act through the interface to control the disease including the delivery of countermeasures Unity of effort 11

Countermeasure Development CBRNE agents threaten people s animals and themselves and if MCMs and NPIs for animals are not developed and implemented, exposed or affected animals will continue to be a threat to human health. Humans may even divert their MCMs to their animals. The National Veterinary Stockpile is limited to measures for a livestock or poultry disease outbreak Assets of the SNS may have to be distributed to prophylax or treat animals to protect human health The PHEMCE processes need to be broadened to include incidents that impact the human-animal interface and its appropriate countermeasure to protect human health 12

Planning for Contamination Integrate animal decontamination with human decontamination Pre and post-decontamination treatment Post-decontamination hospitalization and monitoring National capability gap 13

Summary The human-animal interface is a gap in our plans Addressing the human-animal interface is hard and takes serious planning Can t segregate the human response from the animal response or the human response will fail There is only one side and plans have to bridge the interface 14