We need an integrated medical and veterinary approach

The World Health Organization defines veterinary public health as, “The sum of all contributions to the complete physical, mental and social well-being of humans through an understanding and application of veterinary medical science.”1 With this definition every veterinary surgeon contributes to public health, whether through provision of health care for pets, protection of animal welfare, biomedical research, or ensuring adequate food animal production and food safety.

Veterinary public health impacts on human health by reducing exposure to hazards arising from animals, animal products, and their environment. Examples of these hazards include zoonoses, vector borne infections and other communicable diseases, chemicals and drugs used in animals, envenomations, and injuries from exposure to animals.1

The concept of veterinary public health originates in ancient Egypt, when healer priests drew no distinctions between caring for human patients and animals. They gained much knowledge from the anatomy and diseases of animals, which they applied to the healing of humans.2 This “one medicine” approach prevailed until the 19th century. Since then, the gulf between human and animal physicians has been increasing, mainly because of changes in political and cultural rules rather than scientific logic.2 Although public and political interest in veterinary public health declined in Britain towards the end of the 20th century, it remained an important part of veterinary education and is now a recognised specialty in the United Kingdom and the rest of Europe.3

Newly emerging and re-emerging infections are recognised as a global problem, and 75% of theseare potentially zoonotic.4 The general public and health professionals perceive that the emergence of a new “killer” disease in any area of the world is a threat for all humans.5 Recent examples that support this belief include the outbreaks of H5N1 avian influenza in Asia, bovine spongiform encephalopathy in the United Kingdom, West Nile virus and monkeypox in North America, and H7N7 avian influenza in the Netherlands.6

The re-emergence of zoonoses, together with other issues such as bioterrorism, pollution incidents, antimicrobial resistance, xenotransplantation, and the socioeconomic importance of food production, make a collaborative interprofessional approach to veterinary public health more urgent.The specialty may also offer early insights into the cause of unusual or unexplained illness.7 Multidisciplinary teams comprising all those who contribute to the treatment, control, and prevention of diseases of animal origin are essential, not only to determine the source of disease but also to assess the risk of further outbreaks and to make recommendations for future controls.8 9

Raptor keepers at the Woodland Park Zoo in Seattle give Otus, a Western Screech Owl, a vaccination for the West Nile virus

Credit: LOREN CALLAGHAN/AP

Likewise, liaison between organisations at government and national levels is a prerequisite for deciding policies and disseminating information clearly and quickly. Local collaboration also has an important role in discussing local and national issues. Meetings are currently mostly confined to regular and ad hoc meetings between professionals from organisations such as the state veterinary service, health protection agencies, and local and water authorities. 10 Little routine local collaboration occurs between the medical and veterinary professions in general practice.

But sharing local knowledge and expertise would have real benefits for the immediate human andanimal populations. Sporadic or community and animal outbreaks of salmonellosis may, for example,have a common source of which only one profession is aware. Other potential benefits include reduced incidence of antibiotic resistance through sharing and comparing use, highlighting common environmental hazards such as farm discharges, and identifying research priorities.

The time has surely come for medical and veterinary general practitioners to get together to share knowledge and voice concerns. Local concerns, which may become national problems, can be identified only through an open and integrated professional approach. Willingness by both the veterinary and medical professions at both local and national levels to collaborate and share information is therefore essential for the protection and promotion of public health.