Disaster Planning

“Around our house we don’t bother planning disasters. They seem to happen well-enough on their own.”

If the above is a close description of normal for you and yours, welcome to the club.

In the past I’ve had folks ask about how they could help. (There are lots of different ways and answers for that simple question!) And about a year back I gave folks a brief primer on ICS. This year I’ll visit about disaster/emergency planning & responses before something starts burning. And I’ll give folks a bit of an update to some of the efforts in this vein.

Not that the top in disaster response is the most important, it isn’t really; the ground troops are. But sometimes it’s hard to get the best perspective when you’re underneath everything. So let me start at the top and work my way down, beginning with something we call SERRP.

For starters the State Emergency Response and Recovery Plan is extensive! The “Basic Plan” that’s publicly available at the page that I linked to above runs 40 pages; and that’s really just an overview. The full plan consists of a variety of ESFs – Emergency Support Functions (which also sometimes consist of Annexes, Appendices, and other add-ons.) These follow an outline laid down by the federal government – National Disaster Recovery Framework.

There are 15 ESFs in total with about a double-handful of annexes; the Department of Agriculture (ADA) is listed as a primary, secondary, or supporting agency in about half of these documents. For example ESF#6 – Mass Care, Housing and Human Services – includes responsibilities and plans addressing things like disaster housing (including animals). ESF#11 – Agriculture and Natural Resources – includes things like food security, safety, distribution as well as specific annexes for foreign animal diseases.

Let me take you a notch deeper into the system. Up above I pointed out that ADA is a primary state agency in some of the ESFs. Each Function defines what entity (or entities) has primary responsibility. It also lists secondary agencies. But here’s where we get back to the base question of how to help. ESF also lists the primary and any secondary supporting agencies.

These are the various organizations of volunteers and concerned individuals, non-governmental organizations/charities that have come forward and stated they will provide assistance in time of disaster. Some of these organizations are the Arizona Veterinary Medical Association, Arizona Humane Society, and Humane Society of Southern Arizona. Members of these groups along with myself and folks from AGFD, USDA APHIS WS and VS also have formed AZSART – Arizona State Animal Response Team. If you think of it as a steering committee for developing the supporting organizations’ people and capabilities, you’re on the right track.

Here’s something of a run-down:

SERRP > ESF (mulitples) > ADA (primarily Animal Services Division) > Secondary Agencies (e.g. AGFD) > Supporting Agencies (e.g. AZVMA) > SART, etc > CART (County Animal Response Teams), etc > Volunteer

A few weeks back about a dozen volunteers went through training on how to decontaminate animals (primarily focused on pets). Thanks John Reynolds! Last fall we had our first orientation and training session for folks who wanted to be part of local emergency response efforts. More will be held as we develop the capacity to do so. Stay tuned for details.

And enjoy the ride.

Flying In Formation

Anyone know the definition of a helicopter?

“A helicopter is an assembly of forty thousand loose pieces, flying more or less in formation

A very long time ago I spent a great deal of time with aviation and thought that was where my career would be – learning to fly helicopters was a big part of that dream.

Things change; the rivers of life wash you in different directions; you find yourself listening to folks who’ve been in helicopters when the rotors quit rotating but the machine was still airborne.

Often when I’m involved in trying to resolve some public health related problem the above definition of helicopter comes to mind. We have a whole lot of pieces, many different agencies, and we all try to come together in some formation so as to be effective. Sometimes the “more or less” phrase of the definition seems to be the most pertinent.

I’ll try to illustrate…

Title 3 of Arizona Revised Statutes contains quite a bit of language that directs the state vet to interdict disease or to advise the Agency Director, or Animal Services Associate Director to take steps to do so.

Some of the statutes are structured toward preventing/mitigating diseases solely of animals (principally livestock as defined in ARS § 3-1201(5)) because of the potential for economic devastation. Some are structured toward preventing/mitigating diseases of animals which also can have a direct impact on human health. Much of the “Mandatory Reporting Diseases” fall into this category.

For example, from the Mandatory Reporting list, take “Equine viral encephalomyelitis.” (West Nile Virus or Western Equine Encephalomyelitis are a couple of representatives from that group.) A mosquito carrying the virus bites a horse. The virus is injected into the horses where it begins to replicate. In some cases the horses defenses fail and the horse goes from infected to clinically ill (starts to look sick to its owner.)

The attentive owner quickly realizes she has herself a case of ADR (“ain’t doin’ right’) and calls her veterinarian to take a look. The vet examines the horse; agrees there’s a problem and as part of her diagnostic work-up, pulls a blood sample.

The blood sample will actually likely go a few different directions. But the route we’re interested in for this scenario is as follows. Because the case of ADR gets refined by the vet into a disease of CNS (central nervous system) and because some of the potential causes are included in the Mandatory Reporting Diseases, the vet contacts the State Vet’s Office to notify us of her suspicion.

So at this point we have 3 separate entities involved: owner, veterinarian, and state vet’s office.

For the sake of this example, we’re going to say this horse is infected with WNV. Point of clarification: the horse cannot infect another horse or human; it is referred to as a Dead-End Host“.

Part of the notification of the SVO by the practitioner (the “real vet”) is supplying data concerning the history, location, vaccination status, etc of the horse. The state vet reviews this data, along with conferring with the practitioner to assess the likelihood of WNV infection. The reason is so that a decision can be made to spend public money wisely in pursuit of this potential public health problem. Because if the state vet decides the sample merits testing for WNV, 2 other state agencies become involved.

The state vet will notify AZDHS of a potential WNV case and that the case has been reviewed and approved for testing. AZDHS has the actual funding for paying for the service at the lab (but not to pay the practitioner). Staff at AZDHS will also notify staff at the VDL along with notifying the Environmental Health folks of the county/municipality in which the horse (and thus the mosquito) is located.

Were you keeping track? That’s 3 more parties involved. Now we’re up to a total of 6 (owner, vet, SVO, AZDHS, VDL, local health dept).

The sample will be shipped (or couriered by SVO staff or affiliated agency personnel) to the VDL (University of Arizona Veterinary Diagnostic Laboratory) in Tucson. The test will be run with the results being reported to SVO and AZDHS. Since we’re working with a positive in this scenario, SVO contacts the practitioner so that she can relay the results to the owner and discuss adjusting the local vaccination program and possibly mosquito control.

The folks at AZDHS will follow up with the local health department folks with the positive results. They (both groups) will also review other data concerning WNV activity (mosquito trap samples, human health/disease reports, test results from sentinel chicken flocks, etc) to determine if some type of mitigation of the mosquito population is warranted. A similar assessment will be made as to doing more education and outreach efforts to the public to alert them to the danger and to the steps they can take to mitigate it.

For the sake of this example, let’s say there have been several reports of WNV positive mosquitos along with complaints in a given neighborhood about mosquitos. The local authorities decide to treat the area. Now we add one last group of folks to this party – the folks who go out late at night/early morning to actually treat the area – doing mosquito abatement.

I hope you see what I mean by the helicopter analogy. And more importantly that you see how many pieces are involved from separate layers of your government. The modern age of consumerism has dramatically adjusted personal expectation frameworks. It gives a person something to think about when it comes to the concept of separation of powers versus the efficiency of operation.

Enjoy the ride.

Notes, Updates, Advisories, Etc.

This issue is a collection of updates, alerts, notices, etc. concerning various veterinary, animal agriculture, and public health related matters in no particular order…

Salmonella and reptiles – update regarding the eight mult-istate outbreaks of human Salmonella infections linked to small turtles is available: http://www.cdc.gov/salmonella/small-turtles-03-12/index.html.

USDA’s Wildlife Services’ (WS) National Wildlife Research Center (NWRC) announced that the U.S. Environmental Protection Agency (EPA) has granted regulatory approval for the use of GonaConTM – Equine immunocontraceptive vaccine (GonaCon) in adult female wild or feral horses and burros. GonaCon was developed by NWRC scientists and is the first single-shot, multiyear wildlife contraceptive for use in mammals.

Rabies – 2 bats, 2 skunks, and 2 foxes have tested positive from Cochise, Gila, Pima, Yavapai counties along with a positive bat in Maricopa Co last week.

Measles (speaking of humans now) – confirmed case in Pima Co (recent international traveler). FYI – Measles is an upper respiratory system and is highly transmissible among unvaccinated or immunocompromised populations.  Measles typically starts with a fever with a cough, inflamed eyes and nose; followed shortly by a rash on the face that then progresses downward and outward to the trunk and limbs.

Avian Influenza in China (H7N9) – As of April 17, 2013, the World Health Organization reports a total of 82 patients have been laboratory-confirmed with human infection with avian influenza A(H7N9) virus in China; including 17 deaths (http://www.who.int/csr/don/en/). Investigations into the possible sources of infection and reservoirs of the virus are ongoing. Until the source of infection has been identified, it is expected that there will be further cases of human infection with the virus in China. So far, there is no evidence of ongoing human-to-human transmission. (emphasis added)

Also in the flu realm – National Association of State Public Health Veterinarians in conjunction with National Assembly of State Animal Health Officials have released updated guidance on mitigating risks of transmitting flu between humans and hogs. If you visit the fairs, shows, or other exhibitions, please respect any notices to refrain from interacting with the animals.

Our Meat & Poultry Inspection section regulates the slaughter and processing of poultry. But chickens aren’t part of any stray statutes. So, matters concerning where they can be kept, how many, and other such points are not within AZ Dept of Ag jurisdiction. Please contact your county or municipal zoning folks for information that may pertain to your situation.

I continue to receive notices from labs in the region of test results that are positive for T. foetus (“trich”) from samples that various bovine veterinarians have submitted at their clients request. AZ implemented a testing requirement rule a few years back (AAC R3-2-612(J)). But keeping the positive ones out doesn’t affect the positive ones already here. I encourage all cattle producers to discuss surveillance strategy with their veterinarian.

West Nile Virus activity seems to be ahead of schedule in several places around the country. Please consider this as you review your vaccination program and your mosquito control efforts.