Public Health and Services

1812 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
Public Veterinary Medicine:
Public Health
H
istorically, veterinary medicine has made its great-
est contributions in the public sector and in set-
tings other than direct care of the individual patient.
1
So why are so many of us unaware of our profession’s
achievements in this arena?
My introduction to veterinary preventive medicine
and public health was through military service. My
obligation to serve a two-year doctor draft in the
United States Air Force became an adventure for my
family and me, rather than an unwelcome intrusion on
my ultimate desire to return to private clinical practice.
The operative words are private and clinical. Why was
I unaware of the opportunities available to those of us
educated in this discipline sometimes referred to as
comparative medicine?
C. W. Schwabe, in the second edition of Veterinary
Medicine and Human Health,
2
quotes Rudolf Virchow:
“Between animal and human medicine there is no
dividing line—nor should there be. The object is dif-
ferent but the experience obtained constitutes the basis
of all medicine.”
On July 23, 2000, a symposium titled “Public
health in the new millennium” was held during the
137th AVMA Annual Convention in Salt Lake City to
celebrate the first 50 years of the American College of
Veterinary Preventive Medicine. Prominent, well-
known individuals in the field of preventive medicine
shared their perspectives on the past, current, and
anticipated contributions of veterinarians to this
important medical field.
During the symposium, we learned from the past.
Jim Steele, former Assistant Surgeon General for
Veterinary Affairs, offered his folksy reminiscence of
the origins of veterinary public health in the United
States Public Health Service, which served to remind
us that individuals can make a difference. Retired
Brigadier General Tom Murnane’s articulate recollec-
tion of the initial organizing efforts for the American
Board of Veterinary Public Heath and the American
College of Veterinary Preventive Medicine reminded us
that groups of people sustain individual efforts.
We also learned from today. Current leaders in fed-
eral agency efforts reminded us that opportunities
abound. It is the year 2000, and emerging infectious
diseases of animal origin are major agricultural, animal
industry, and public health challenges.
We reaffirmed that we must learn for the future.
During the symposium, we were reminded that,
although lists of preventive medicine and public health
achievements can be enumerated, the past is the pro-
logue to the future.
Drs. Steele and Murnane and several other speakers
at the symposium offered to share their perspectives with
the entire veterinary community through the Journal of
the American Veterinary Medical Association. I hope the
following articles convince you, members of the veteri-
nary profession, that there is only one medicine.
References
1. Smithcors JF. The American veterinary profession, its back-
ground and development. Ames, Iowa: Iowa State University Press,
1963.
2. Schwabe CW. Veterinary medicine and human health. 2nd ed.
Baltimore: The Williams & Wilkins Co, 1969;ii.
From the School of Public Health, University of Texas, San Antonio,
TX 78229-3900. Dr. Herbold is a retired Colonel in the United
States Air Force.
Symposium: Public health
in the new millennium
Introduction
John R. Herbold, DVM, MPH, PhD, DACVPM
Table of Contents
Introduction—John R. Herbold. . . . . . . . . . . . . . . . . . 1812
The history of public health and veterinary
public service—James Harlan Steele . . . . . . . . . . . . . 1813
Historic and future perspectives
of the American College of Veterinary
Preventive Medicine—Thomas G. Murnane . . . . . . . 1821
Blue ribbon task force report on the future
of Food Safety and Inspection Service
veterinarians: public health professionals
for the 21st century—Bonnie J. Buntain . . . . . . . . . . 1828
The National Antimicrobial Resistance Monitoring
System (NARMS) for enteric bacteria, 1996-1999:
surveillance for action—Nina N. Marano et al . . . . . . 1829
Public health education of veterinarians
and veterinary students for the future
Michael G. Groves . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1831
Ten great veterinary public health/preventive
medicine achievements in the United States,
1901 to 2000—Donald L. Noah et al . . . . . . . . . . . . . . 1834
1812_1836.qxp 9/23/2005 2:44 PM Page 1812
A
nimal diseases are believed to be the origin of
many human diseases. Jared Diamond states,
“Infectious diseases like small pox, measles, and flu
arose as specialized germs of humans, derived by muta-
tions of very similar ancestral germs that infected ani-
mals.” These emerging diseases appeared about 10,000
years ago after the humans changed from being
hunters to farmers with animals in their midst.
1
He
contends that the people who domesticated the ani-
mals were the first to be victims. Those humans then
developed resistance to the zoonotic diseases where
agriculture developed.
The relation of animal disease to human disease
was observed in the ancient civilizations of Babylon,
the Nile Valley, and China. Later, they were described
by Leviticus in the Old Testament, by Hippocrates in
Greece, and by Virgil and Galen in Rome. In the Middle
Ages, rats carried the plague that killed millions of peo-
ple across Europe. The invasion of Europe by rinder-
pest in the 18th century disrupted commerce and gov-
ernment. The Papal authority created a medical com-
mission to advise the Vatican on what measures should
be taken to control animal plague and rinderpest.
2
The movement of animal diseases into the
Americas is believed to have first occurred when live-
stock were used to help create the settlements founded
in Santo Domingo, Dominican Republic, by
Christopher Columbus in 1493. In the next century,
Hernando de Soto, the Spanish explorer of Florida and
the southeast, brought cattle, horses, swine, and dogs.
Further north, the Virginia colonists brought animals
to Roanoke Island, but neither humans nor animals
survived. Later, the Jamestown colonists imported
domestic animals that survived and became valuable
foundation stock. Rabies was the first zoonotic disease
recorded in Virginia in 1753, and later as an epizootic
in the colonies and the Federation of States in the late
18th century.
3
In 1798, editors of the newly founded Medical
Repository were the first to inquire about emerging dis-
eases in the United States and territories. They asked
for information on human diseases, diseases among
domestic animals, accounts of insects, the condition of
the vegetation, and even the state of the atmosphere.
They hoped to put the facts together as an annual
report on the status of health in the United States. In
his address at the AVMA centennial, Surgeon General
Luther Terry of the United States Public Health
Service (USPHS) called that report the first reference
of veterinary medical support of the public health.
4
A
few years after the report was written, Benjamin Rush
called for the establishment of veterinary medical edu-
cation at the University of Pennsylvania.
The United States Sanitary Commission, which
was organized during the Civil War by public-spirited
women, was largely concerned with sanitary condi-
tions and food hygiene. The commission was the first
to call attention to putrid meat, and later embalmed
beef sent to the Army. In the years following the Civil
War, the commission was to be a forerunner of public
health service.
5
In the 1870s, there was interest in developing a
national health service. Yellow fever epidemics were
frightening as they spread up the Mississippi River
from New Orleans. The possibility that yellow fever
involved animals brought Professor John Gamgee, a
famous veterinarian from Germany, to investigate the
epidemic. He recognized a seasonal occurrence (cold
weather stopped the epidemic) and suggested traffic be
limited to the colder months. He failed to associate the
effect of cold weather on mosquitoes, the vector of
virus that causes yellow fever.
The United States Board of Health came into being
largely because of the morbidity and mortality caused
by the yellow fever epidemic. At the same time, malar-
ia was widespread in the south, tuberculosis was a rec-
ognized disease, and typhoid fever and enteric diseases
were common. Animal diseases were of concern, espe-
cially the spread of glanders and anthrax that followed
the Civil War.
In 1879, the president of the United States Board
of Health, Dr. J.L. Cabell, asked James Law, a professor
of veterinary medicine at Cornell University, to advise
the board on how they should supervise diseases and
movements of domestic animals. Law’s report was the
first comprehensive recognition of the importance of
zoonotic diseases to the public health published in the
United States.
6
The two-part report describes the ani-
mal diseases that are directly communicable to humans
and plagues that affect only animals.
7
Further discussion of the organization of public
health service in the post–Civil War period was
reviewed by W.D. Miles, the former historian of the
National Institutes of Health.
8
Miles discussed the
struggle between interests in public health and agricul-
ture in the decade leading up to the inauguration of the
Bureau of Animal Industry in 1884. The bureau’s initial
interest was to protect animal health, but later provid-
ed a meat inspection service for public health, interna-
tional trade, and interstate commerce.
The Relation of Animal Diseases to the Public Health
and their Prevention, by Frank S. Billings, was the first
book to review this subject as well as the state of bac-
teriology and parasitology in the 1880s. It is limited as
to the diseases he writes of: trichinosis, hog cholera,
tuberculosis, anthrax, Texas fever, rabies, and glanders.
His knowledge of these diseases was remarkable for the
time. He observed veterinary activities while he trav-
eled in Europe. While obtaining an education in
Berlin,
a
he learned about the history of animal diseases
The history of public health and veterinary public service
James Harlan Steele, DVM, MPH
From the School of Public Health, University of Texas, Houston, TX
77225
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1813
1812_1836.qxp 9/23/2005 2:44 PM Page 1813
1814 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
in the Greco-Roman period. He states that the Latin
origin of the word “veterinarian” first appeared in the
fourth century writings of Vegetii.
Billings made a strong plea for the development of
veterinary public health to control the animal diseases
that affected humans. He believed it was essential to
have scientifically educated veterinarians. He was one
of the veterinarians active in the early years of the
American Public Health Association. During meet-
ings, there were discussions about trichinosis and
other animal diseases. Billings also pointed out that
milk from diseased cows was dangerous.
9
He appealed
to the government to set up laboratories to use the
new science of bacteriology to find the cause of illness
of milk origin. Billings was a visionary of veterinary
public health.
Pasteur changed science and veterinary medicine.
He created a new concept of the origin of disease. No
longer would myth and spontaneous origin of disease
guide society, even though there were as many objec-
tions to scientific advances then as now. The 1984 cen-
tennial celebration of Pasteur’s rabies vaccine was a
tribute to the man of many accomplishments. He was a
chemist who discovered the cause of fermentation and
applied it to the beer and wine industries, which led to
milk pasteurization. He was known to the
Impressionists of the 19th century because he helped
prepare better paint colors. Pasteur was a genius who
gave public health the science and vaccines to combat
19th century diseases and prepare his followers for the
20th century’s emerging problems.
10
The frightful toll of milk-borne disease is reviewed
by F. Stenn.
11
He cites the shocking figure of 400 deaths
per 1,000 births in New York City in 1880. Spoiled
milk accounted for the deaths of thousands of children
in the early 1900s. In 1905, a milk-borne typhoid epi-
demic in Washington, DC, caused President Theodore
Roosevelt to order the USPHS to investigate the local
supply. Surgeon general Walter Wyman ordered his
staff to examine not only the Washington milk prob-
lem but also the national milk problem. The 1908
records cited by Stenn list many outbreaks of typhoid
fever and diphtheria associated with consumption of
milk. He stated that 16% of the milk cans from farms
sampled contained tubercle bacilli, and in cities, half of
the milk had tubercle bacilli. The 1908 report Milk and
Its Relation to Public Health, issued by the USPHS,
12
brought reform to the dairy industry and support for
the Bureau of Animal Industry program to control
bovine tuberculosis.
13
The eradication of bovine tuberculosis and brucel-
losis has ensured a safe milk supply and protected the
health of farmers, dairymen, veterinarians, and the
handlers of milk and milk products. The case for pas-
teurized milk and milk products is conclusive.
14
In the
late 20th century, however, a new array of milk-borne
zoonoses became a concern.
Salmonella organisms were identified in 1885 by
one of the most distinguished public servants of the vet-
erinary profession, Dr. Daniel Salmon. He was the first
chief of the Bureau of Animal Industry (1884 through
1905). He assembled and trained a great staff including
Theobald Smith, V.A. Moore, and E.C. Schroeder.
Dr. Salmon was the leading proponent of veteri-
nary public health in the 1890s. He asked Congress for
authority for a Federal Meat Inspection Service in 1890
but was circumvented by the local interests citing
state’s rights. The Meat Inspection Act of 1890 was
ineffective. Salmon sought support from the American
Public Health Association and the American Medical
Association for these early veterinary efforts to protect
public health.
15
The Federal Meat Inspection Service
Act of 1906 came about only after Upton Sinclair
exposed the filthy conditions of the Chicago stock-
yards.
16
Although he had no authority, Salmon was
blamed for his lack of control over the local hygiene
failure and was removed from office. Salmon is remem-
bered today for the bacterial organism named after him
as well as by the Salmon Award for Leadership.
In 1906, the Bureau of Animal Industry initiated
tuberculin testing of dairy cattle in the District of
Columbia, which resulted in detection an infection
rate of almost 19%. This was the beginning of success-
ful tuberculosis control campaign that led to eradica-
tion with the guidance of John R. Mohler, who was
director of the Bureau of Animal Industry from 1917 to
1943. Control of bovine tuberculosis was one of the
great accomplishments of veterinary public service.
The late Jay Arthur Myers memorialized the near erad-
ication of bovine tuberculosis in his 1940 book, Man’s
Greatest Victory Over Tuberculosis.
17
At the start of the 20th century, there was great
interest in comparative medicine by pathologists,
which was led by Karl F. Meyer, a Swiss veterinarian
who was to become one of the outstanding leaders and
scientists of the 20th century. He was among the early
public health scientists to delve into virology when he
was a professor of pathology at the University of
Pennsylvania Veterinary Faculty. In 1913, he may have
been among the first to recover a virus causing equine
encephalitis. As director of the Pennsylvania Livestock
Sanitary Board Laboratory, he published information
on glanders, anthrax, anaplasmosis, sporotrichosis,
paratuberculosis, and septicemia among many other
diseases of animals. In 1914, he left the University of
Pennsylvania to accept a position at the University of
California newly established medical center. The fol-
lowing year, he accepted an appointment at the George
Williams Hooper Foundation for Medical Research at
the University of California Medical Center where he
would remain the rest of his life. He became a legend
there. His lectures introduced medical students to
zoonoses, plant life, the atmosphere, and all that is
called the environment today.
At Hooper, Meyer performed research on the ani-
mal diseases of public health importance. He contin-
ued his virus research and was active in the investiga-
tion of human influenza from 1918 to 1920. He went
into the field to define the epidemiologic characteris-
tics of malaria, dysentery, and even dental diseases. His
study of the bacterial causes of abortion in animals
resulted in grouping Brucella abortus, Brucella meliten-
sis, and Brucella suis in a new genus honoring David
Bruce. Another important event was his report on
Bacillus botulinus in nature. Botulism became a nation-
al concern in the 1920s when California canned fruit
1812_1836.qxp 9/23/2005 2:44 PM Page 1814
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1815
and vegetables were found to contain botulinus toxin.
The industry asked him to resolve the problems and he
underwrote a laboratory to maintain surveillance.
Meyer was active in food safety for the remainder of his
life.
In 1933, Meyer and his long-time lab associate,
Bernice Eddie, began their series of reports on psitta-
cosis in birds, which eventually led to control of the
disease 30 years later by feeding seeds impregnated
with tetracycline. The same antibiotic is used to pre-
vent ornithosis in domestic fowl.
18
One of Meyer’s memorable lectures was in 1931
when he called attention to the importance of the ani-
mal kingdom as a reservoir of diseases that endanger
the health and welfare of people throughout the
world.
19
In 1954, he had the opportunity to review ani-
mal reservoirs of diseases, by then referred to as
zoonotic diseases, before the World Health General
assembly. He repeated the same theme before the
World Health Organization (WHO) Expert
Committees for Zoonoses, Plague, and Food Hygiene
and for the Pan American Health Organization
(PAHO) until his 90th year.
Meyer’s work on plague was reported in the special
supplement of the Journal of Infectious Diseases to com-
memorate his 90th birthday, which he failed to reach
by one month. This was underwritten by Max Stern,
president of Hartz Mountain. Hartz Mountain played a
major philanthropic role in supporting investigations
of psittacosis control at the Hooper Foundation.
20
Larry Altman, the medical editor of the New York
Times, wrote a lengthy obituary from which the fol-
lowing excerpt is taken:
21
Dr. Karl Friedrich Meyer was regarded as the most
versatile microbe hunter since Louis Pasteur and a giant
in public health.
As a youth in Basel, Switzerland, pictures of the
Black Death, or plague, so fascinated him that he became
an outdoor scientist instead of following in the aristocrat-
ic business world in which he grew up. He told friends
that in choosing to become a veterinarian he could ‘be a
universal man and study all diseases in all species.’
Public health leaders yesterday called his contribu-
tions to medicine ‘monumental.’ His scientific work had
such broad implications that it touched on virtually all
fields of medicine.
The obituary was placed in the Congressional
Record in May, 1974. Albert Sabin wrote a biographic
memoir for the National Academy of Science in 1980.
22
The 1930s were memorable for scientific advances
in public health. The viral cause of influenza was
uncovered by Richard Shope and Thomas Francis at
the Rockefeller Institute. The use of egg embryos was a
new method of growing viruses that would lead to the
chick-embryo rabies vaccine and other viral vaccines.
The development of strain 19 Brucella vaccine and the
Stern anthrax vaccine in South Africa were important
to the control of brucellosis and anthrax worldwide.
The investigation of toxoids by Gaston Ramon, a
French military veterinarian, led to the discovery of
tetanus toxoid for horses and humans.
In 1938, the brucellosis epidemic among veteri-
nary students and others in the bacteriology building
at Michigan State College raised epidemiologic ques-
tions about how Brucella organisms were spread.
23
Up
to then the disease was believed to be caused by direct
exposure or ingestion of milk containing Brucella bac-
teria. Airborne organisms had not been thought of,
although Professor I.F. Huddleson, whose research lab-
oratory was the focus of this investigation, disagreed
with this opinion. The Michigan state investigators
were public health scientists and engineers who
focused on the water-borne theory of contaminated
glassware not being autoclaved properly, which per-
mitted contamination of the water system.
24
While I
was a student in the brucellosis testing laboratory, I
heard the discussion about the means of spread being
by water and back siphonage.
Dr. Stafseth encouraged many students to consid-
er public health as a career. Dean Ward Giltner learned
of my interest, which had been heightened by my expe-
riences with the brucellosis epidemic, and arranged for
me to become eligible for an USPHS fellowship. That
was done by assigning me to an internship at the
Michigan Health Department. There, health depart-
ment veterinarians, pathologists, and bacteriologists
taught me how to remove and examine an animal’s
brain for rabies and inoculate mice with the matter to
further the diagnosis. I also learned to grow vaccinia
on the belly of a calf that had been shaved, scrubbed,
and disinfected. Harvested scabs were be tested for
contaminants, which was a lengthy procedure. High
standards were maintained for development of pertus-
sis/whooping cough vaccine, equine antiserum for
tetanus, and rabbit pneumococcal antiserum.
Dean Giltner and C.C. Young, the director of the
Michigan Public Health laboratories, put together my
fellowship application to the USPHS and the Harvard
School of Public Health. Approval came the week
before graduation.
The summer of 1941 was spent as an intern at the
Petoskey Animal Hospital. There I learned about swim-
mer’s itch, a common affliction of humans and pets
caused by an avian schistome. At Harvard it became
my thesis subject. In addition, it was the first subject I
reported on at the 1942 AVMA convention in Chicago,
with Dean Giltner in the audience.
Harvard was exciting. There was talk of war, and
President Conant addressed the incoming class with
the admonition there would be important changes in
the world during their student years. The School of
Public Health faculty and students were stimulating. I
was the only veterinarian, which attracted some atten-
tion.
The first position offered to me was from K. F.
Meyer, but it wasn’t funded. After discussing options
with the USPHS Chicago Regional Offices, I accepted a
position as a civilian sanitarian in the Ohio
Department of Health.
In September 1943, the United States Army offered
me a commission as a veterinary officer. I received a
commission as a sanitarian. After I was commissioned,
I spent a short tour of duty in the region with Senior
Sanitarian William H. Haskell, an authority on pas-
teurization methods and practice. He was one of the
civil service veterinarians who were USPHS milk spe-
1812_1836.qxp 9/23/2005 2:44 PM Page 1815
1816 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
cialists brought in as early as 1924. In 1943, other
newly recruited veterinarians, Raymond Helvig and
Ted Price, were also commissioned as sanitarians.
My assignment was in Puerto Rico and the Virgin
Islands, where I was to be responsible for coordinating
milk and food sanitation and evaluating any zoonotic
diseases in areas that had been isolated by the war.
Brucellosis and bovine tuberculosis were widespread.
Diagnosis of Venezuelan equine encephalitis and bat
rabies in Trinidad caused some concern in the Islands,
but did not spread beyond Trinidad. Rabies was indige-
nous in the Dominican Republic and Cuba in the
1940s.
Origins of Organized Veterinary Public
Health in the USPHS
In March 1945, the Pan American Sanitary Bureau
asked the USPHS San Juan, Puerto Rico, office to do an
assessment of the post-war veterinary public health
problems in the Dominican Republic and Haiti, neither
of which had a functional veterinary service. I was
directed to make a report on their problems. There
were no reported diseases, but bovine tuberculosis,
brucellosis, and mastitis were known. Veterinary labo-
ratory support was nonexistent, and the abattoirs kept
no records. There were reports of rabies in dogs, and
possibly in horses. Some years later there was an epi-
zootic of equine encephalitis.
The end of the war in Europe and shortly there-
after changed the reassignments. I met with Assistant
Surgeon General Joe Mountin who asked me, “What
are you veterinarians going to do for the public health
now that the war is over ?” The follow-up to that inter-
view is in the JAVMA article titled “The 50
th
Anniversary of the Veterinary Medical Corps Officers
of the US Public Health Service.”
25
After the approval of a veterinary public health
section in the States Relation Division, some months
were spent at the National Institutes of Health estab-
lishing a liaison with federal agencies, congressional
interests, state relations, and professional associations
such as the American Veterinary Medical Association
and the American Public Health Association.
Inauguration of veterinary public health in 1945 as
a national program in the USPHS stimulated interest
worldwide, especially in the newly created internation-
al agencies. The United Nations Health Office organiz-
ing committee, chaired by Surgeon General Tom
Parran, met in New York in June 1946. The Public
Health Service officers and personnel were asked by
the surgeon general’s chief of staff, G.L. Dunnahoo, to
suggest topics. Veterinary public health was new, but a
few weeks before the organizing group was to meet, I
was directed to make a presentation about veterinary
public health and answer questions at the surgeon gen-
eral’s staff meeting. After the meeting, I asked Dr.
Dunnahoo if he would be interested in recommending
a veterinary public health program for the World
Health Organizing Committee. He urged me to give
him a memo recommending a veterinary public health
activity wherein I indicated that the Veterinary Public
Health (VPH) program would be concerned with ani-
mal diseases transmissible to humans, would carry on
liaisons with veterinary activities in the agriculture
agencies, and collect information on animal health.
Some months later I asked how the VPH recom-
mendation was received. Dr. Dunnahoo said there were
no objections or discussion. The VPH item was accept-
ed and placed in the records.
In September 1947, after Surgeon General Parran’s
approval of the veterinary medical officer cadre, Dr.
Mountin felt my activities were successful. He told me
I was to be assigned to the newly created Centers for
Disease Control (CDC), formerly the Malaria Control
in War Areas. There the veterinary public health pro-
gram was established as a division. The new director of
the CDC was Dr. R.A. Vonderlehr, who previously was
Chief of the Puerto Rico Regional Office, which is who
I served under. He gave excellent support, as did his
deputy, Dr. Justin Andrews, who succeeded Dr.
Vonderlehr a year later.
As the war wound down, I was in Washington for
further assignment. While in Washington, I visited the
Pan American Sanitary Bureau to discuss my report
with Surgeon General Hugh S. Cummings, who served
the Pan American Sanitary Bureau for a decade after
retiring from the USPHS. At our meeting, I emphasized
the need for a veterinary public health program to help
update animal health, prevent zoonotic diseases, and
ensure food safety. Dr. Cummings listened and told me
to discuss the need for a veterinary public health pro-
gram with his medical staff, where the proposal was
enthusiastically accepted. The veterinary public health
program was initiated with Dr. Aurelio Malaga Alba, a
Peruvian military veterinarian, as a consultant in 1948.
Dr. Fred Soper, the post-war director of the reorganized
PAHO, later appointed Dr. Ben Blood to organize a vet-
erinary public health program in June 1949. He served
until the 1960s.
Rabies
Rabies was a national problem after the war. There
was a great movement of people as war industries and
encampments closed. Pets were lost or abandoned. The
incidence of rabies in humans was the highest ever
recorded. Human vaccines were not always effective.
Canine rabies vaccine protection was short and the
vaccines were given every six months. Rabies became
the lead program of the Veterinary Public Health
Division. To head the activity, Dr. Ernest Tierkel, a
University of Pennsylvania graduate who had complet-
ed his Masters of Public Health, was recruited.
He, Bob Kissling, and Martha Eidson, along with a
staff of animal handlers, became the nucleus of the
national rabies program.
26-27
They successfully demon-
strated the effectiveness of a new chicken embryo
rabies vaccine in the laboratory
28
and later in epidemic
situations.
29
Some others who followed from CDC and
who contributed to the control and prevention of
rabies are George Baer, Keith Sikes, Jerry Winkler, and
Charles Rupprecht.
Brucellosis
Dr. Mountin had said that the public health
authorities of Indiana, Michigan, and other states
believed that brucellosis in humans was of concern.
1812_1836.qxp 9/23/2005 2:44 PM Page 1816
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1817
They went so far as to say that, as the sanitariums lost
tuberculosis patients, brucellosis patients would take
their place. The Indiana Health Department was to be
our brucellosis project site under Sam Damen, PhD,
the director of laboratories. The goal was to determine
what action the health agencies should take.
The federal Bovine Brucellosis Control program
was active in all states. It became apparent that if the
health authorities got active, the animals could be
eliminated as a source of human disease. We brought
the problem to the attention of Dr. Herman Bunderson,
Chicago’s health officer who remembered the struggle
to eradicate bovine tuberculosis in the Chicago milk
shed which included dairy herds in six midwestern
states. In 1928, he had required all milk coming into
Chicago to be from tuberculosis-free herds regardless
of whether the milk was to be pasteurized. He recog-
nized the brucella problem and shortly thereafter insti-
tuted the same standards for the elimination of bovine
brucellosis.
The brucella eradication program was supported
by the USPHS milk code, which required that all
Grade-A milk be from disease-free herds.
30
The
Chicago control program was soon adopted by big city
health authorities, which gave impetus to the state fed-
eral testing programs. Human brucellosis declined
rapidly in the Midwest from thousands to hundreds,
and to less in a decade. Most of the human cases were
of occupational origin and among people using raw
milk in rural areas.
There was a scare of brucellosis in Dugway prov-
ing ground in western Utah in the early 1950s. H.G.
Stoenner, who investigated the alleged contaminated
area, found the problem to be a rodent disease caused
by Brucella neotoma, which does not cause disease in
humans or domestic animals, but will cause antibody
formation in cattle.
31
Trichinosis
The late Professor S.E. Gould initiated studies at
the Wayne State Medical School on the use of irradia-
tion to destroy Trichinella.
32
After the war, there was
great interest in the application of atomic energy for
civilian use. He persuaded the American Medical
Association to host a Symposium on Trichinosis in
1953 in which the CDC participated. The evidence was
conclusive that gamma radiation was effective at low
doses.
33
It was not until 1985 that irradiation for com-
mercial use was approved by federal agencies. The
Zimmerman Human Tissue survey from 1966 to 1970
revealed the lowest rate ever.
34
Modern methods in rais-
ing pigs, the prohibition of feeding garbage to swine,
and consumer education are all contributing factors in
the decline of disease in pigs and humans.
35
Trichinosis
gradually declined in the United States.
Other Parasitic Diseases
Other veterinary public health studies of parasitic
diseases involved cutaneous larva migrans caused by
the common dog hookworm larva Ancylostoma can-
inum entering the skin and causing an intense itching.
This was common in the southeast states among per-
sons exposed to damp, sandy soil; children playing in
sandboxes; bathers at the beach, and utility men.
36
Toxocariasis or larva migrans is another parasitic dis-
ease attributed to parasite larvae of dogs migrating in
the body of a foreign host, such as human beings.
37
Toxoplasmosis has been recognized as a common
human infection. The domestic cat is recognized as a
common source of human infection. Infection may be
caused by consuming meat. Irradiation is effective in
destroying the oocyst in pork.
32
Equine Encephalitis, Plague, and Anthrax
In the early 1950s, there was a large equine
encephalitis epizootic in central California that
required the assignment of all CDC Veterinary Officers.
Another equine encephalitis epizootic was in New
Jersey in 1959. Since then there have been a few epi-
zootics of the equine encephalides. The principal reser-
voir is birds. In addition, the virus survives in mosqui-
to eggs over winter. The CDC–Fort Collins laboratory
has been at the forefront of investigations of arbovirus-
es and their role in human health.
Plague is sporadic in the United States. It is pri-
marily a disease of rodents. The appearance of plague
in domestic and feral cats has brought the ancient
scourge to households in the western states.
38
An unusual epidemic of anthrax, introduced by
contaminated bone meal in the 1950s, caused alarm in
public health circles. The problem of whether milk
could be a vehicle was of concern. A search of literature
found that milk was never a cause of human or animal
anthrax disease.
39
Salmonellosis
Salmonellosis was a recognized public health
problem among the civilian populations during and
after World War II.
40
After the war, investigators deter-
mined that it was widely disseminated. Phil Edwards
led the way at the University of Kentucky and later at
CDC. Mildred Galton, Chief of the Veterinary Public
Health Laboratory, contributed in many ways. She had
an unusual ability to find evidence that others had
overlooked. She demonstrated Salmonella in animals.
Her studies on transported pigs revealed how stress
caused latent infection and induced shedding. The
same reaction was found in other species. Her work on
raw egg meats led to their pasteurization even though
the egg slurry was to be in baked or cooked products.
She was among the first to find Salmonella in raw milk
40 years ago. Her work on the frequent presence of
Salmonella led to the federal poultry inspection pro-
gram in the late 1950s.
41
Leptospirosis
Leptospirosis was identified in animals as a sepa-
rate clinical entity in 1850, about 30 years prior to the
time Weil described the disease in humans. In 1898, an
epidemic in dogs was recorded in Stuttgart, Germany,
but it wasn’t until the etiologic agents were discovered
30 years later that it was realized the disease in dogs
and humans was caused by microorganisms of identi-
cal morphology. Three years after the discovery of lep-
tospires, it had already been shown that injection of the
microorganisms into puppies would lead to a severe
1812_1836.qxp 9/23/2005 2:44 PM Page 1817
1818 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
icterohemorrhagic disease. During the first half of the
20th century, analysis of evidence accumulated
throughout the world revealed that morphologically
and serologically identical leptospires could affect vir-
tually all known mammals and some lower vertebrates.
By the late 1940s and early 1950s, leptospirosis in
domestic animals was already established as a disease
of major concern in veterinary medicine and veterinary
public health.
During the years of the late 19th century and early
20th century, especially during the period preceding
the discovery of the causative agents by Insada, only
severe cases of leptospirosis could be diagnosed clini-
cally. This fact led to the still prevailing notion that lep-
tospirosis has to be associated with jaundice and
nephritis. With improvement of diagnostic procedures
and their availability to more laboratories, it was soon
realized that most affected animals have no signs of
disease or may have various clinical signs. Another
point that contributed to the confusion in clinical diag-
nosis was the fact that isolated serovars were given
names denoting the clinical signs observed in the
patients. Thus, it was expected that infection by the
serovar icterohemorrhagia would lead to hemorrhagic
jaundice whereas infection with serovar grippotyphosa
should resemble the signs of catarrhal fever. In fact,
both serotypes can cause both signs.
42
From 1950 to 1970 in the United States, numerous
outbreaks were recognized among animal handlers,
veterinarians, and swimmers, as well as people whose
occupation exposed them to contaminated wastewater.
Galton edited the Leptospiral Serotype Distribution
Lists through 1966
43
and Sulzer carried it up to 1973.
44
They were truly dedicated in keeping records of lep-
tospiral serotypes.
Stoenner and associates investigated a large epi-
zootic involving L pomona in cattle in Washington,
which involved many herds but fortunately few human
beings.
45
The effectiveness of vaccines was observed. In
recent years there have been few epizootics reported,
and epidemics are most commonly reported among
swimmers. There is wide agreement that vaccination of
cattle and dogs has reduced environmental contamina-
tion.
Listeriosis
Listeriosis was first recorded in 1926 and the first
reported human case was in Denmark in 1929.
Prevention of listeriosis is not possible with the knowl-
edge available. There are no immunizing agents of
proven worth. Killed bacterins have been disappoint-
ing and living attenuated vaccines have not been eval-
uated properly nor have they shown promise in limit-
ed experiments.
High-risk groups are pregnant women, neonates,
diabetics, alcohol dependents, persons with neoplastic
disease, or those being treated with corticosteroids or
antimetabolites. Among animals, ewes are at the high-
est risk late in the first pregnancy. Sheep in late preg-
nancy should not be fed ensilage of doubtful quality
nor be exposed to severe cold, inclement weather, or
crowding. Chinchilla also have high susceptibility.
Lack of accurate epidemiologic information on lis-
teriosis hampers prevention and control. Only by com-
pulsory reporting of human and animal infections can
the prevalence of this uncommon disease be estimated.
Medical and veterinary health agencies should
exchange information and coordinate their control
measures. Farmers and veterinarians should adopt
sound sanitary practices in handling sick or aborting
domestic animals and livestock. Prevention and con-
trol of listeriosis in humans will depend on an increas-
ing index of suspicion and increasing awareness of its
diverse clinical manifestations. Because L monocyto-
genes is susceptible to most antibiotics, early adminis-
tration after the diagnosis substantially decreases mor-
tality. Cortisone and its derivatives may, however, cause
subclinical infections to become overt.
46
After the end of the war in Europe, the breakdown
of veterinary food hygiene allowed salvaged food to
spread zoonotic diseases. Although there likely were
sporadic cases, food-borne listeria went largely unno-
ticed until the period between 1949 and 1957, when a
sharp increase in the number of stillborn infants was
observed in an obstetrical clinic in Halle, in the former
East Germany. Seeliger
47
confirmed that L monocyto-
genes had caused the stillbirths, and he suspected that
raw milk, sour cream, sour milk, and cottage cheese
were the vehicles that transmitted the pathogen. Later
Potel
48
isolated identical serotypes of L monocytogenes
from a mastitic cow and from stillborn twins delivered
by a woman who had consumed raw milk produced by
the mastitic cow. Additional outbreaks of listeriosis
were recorded in Halle between 1960 and 1971
49,50
and
in Bremen, in the former West Germany, in 1960 and
1961.
49
Unfortunately, the vehicle that transmitted L
monocytogenes in these outbreaks was never identified.
At the same time there were numerous cases of abor-
tions, stillbirths, and reproductive tract diseases report-
ed in France. The disease remains prevalent in western
Europe to the extent that all midwives and obstetri-
cians alert their patients.
Listeriosis of food-borne origin was virtually for-
gotten until 1981, when an outbreak occurred in the
Maritime Provinces of Canada and was associated with
consumption of contaminated coleslaw.
51
Two years
later, a major outbreak in Massachusetts was epidemi-
ologically linked to consumption of a particular brand
of pasteurized whole and 2% (milk fat) milk.
52
Although questions have been raised about the ade-
quacy of the epidemiologic study,
53
no other food has
emerged as the vehicle that transmitted L monocyto-
genes in this outbreak. In 1985, Mexican-style cheese
made in a factory near Los Angeles was definitively
linked to a large outbreak of listeriosis.
54
This was fol-
lowed in 1987 by the linking of consumption of
Vacherin Mont d’Or, a variety of cheese, to an outbreak
of listeriosis in the Canton of Vaud in Switzerland.
55
In recent years, food-borne outbreaks continued to
be reported in North America and Europe. During the
1990s, many more human cases and deaths were
reported in the United States. The vehicle being report-
ed as contaminated are cold cuts, canned meats, and
frankfurter sausages. Worldwide, listeriosis is a prob-
lem in the temperate zones.
Emerging zoonotic food-borne diseases
1812_1836.qxp 9/23/2005 2:44 PM Page 1818
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1819
Escherichia coli O157:H7, the enterohemorrhagic
strains, and other E coli characterized by cytotoxins are
major causes of enteric disease in humans, but so less
for food-producing animals that may be infected with-
out clinical signs. Pasteurization of milk is effective in
the control of E coli spread. Now irradiation of other
foods of animal origin is also effective for the protec-
tion of public health.
Other emerging food-borne zoonotic disease
agents, such as Cryptosporidia parvum, a coccidian pro-
tozoa, have been found worldwide. Cyclospora cayeta-
nensis is a coccidian protozoa, which is primarily water
borne, but also found as a contaminant of fruit and
vegetables. A similar coccidia has been associated with
birds. Giardia spp are found in numerous animals.
During the late 20th century, the flagellate protozoan
was identified worldwide as the cause of disease in
humans and animals.
An old problem, but new in the United States, is
the emergence of Taenia saginata and T solium, which
are largely found in migrating persons. The cysts
induced by the Taenia spp are found in beef and pork
and are easily destroyed by irradiation, a technology
that is being accepted in the southern countries where
diseases caused by Taenia are economic as well as pub-
lic health problems.
Tuberculosis
American veterinarian Martin M. Kaplan, VMD,
MPH, was recruited by an English physician with
whom Kaplan worked with in United Nations
Rehabilitation and Recovery Agency in Greece. In
1948, Kaplan came to the newly established World
Health Organization in Geneva, Switzerland. He sin-
gle-handedly developed a VPH program in the com-
municable disease division that is a model for a public
health program. During the next 20 years, he organized
the expert committee meetings and technical reports.
The first was in 1950,
56
which reviewed tuberculosis.
At the end of World War II, tuberculosis was a major
disease problem in humans and animals. American
tuberculosis authorities had reported that 30% of the
human cases in the American-occupied Germany were
caused by Mycobacteria tuberculosis bovis. The problem
was referred to the WHO Expert Zoonoses Committee by
the WHO Expert Tuberculosis Committee. There was no
consensus on what recommendation to make. The
Danish veterinarians spoke for the classical tuberculin
test and identification. The French urged use of BCG vac-
cinations. The success of eradication of bovine tubercu-
losis in the United States was held up as the ideal
method. Eventually the committee recommended test
and removal, with the caveat for developing countries to
try other methods, including BCG vaccination.
World Health Organization
The first WHO Expert Committee on the
Zoonoses was held in late 1950. This was followed in
1958 by zoonoses study groups that were chaired by
K.F. Meyer in Stockholm.
57
In 1965, at the next meet-
ing of the WHO Zoonoses Expert Committee in
Geneva, I was the chairman.
58
The next meeting in
1974 was chaired by Calvin Schwabe,
59
professor of
epidemiology at the University of California School of
Veterinary Medicine and the School of Human
Medicine. Schwabe summarized the WHO Veterinary
Public Health in his third edition of Veterinary Medicine
and Human Health: “The final objective of veterinary
medicine does not lie in the animal species that the vet-
erinarian commonly treats. It lies very definitely in
man, and above all in humanity.”
60
Pan American Health Organization
The PAHO Veterinary Public Health program was
inaugurated in June 1949 with the recruitment of Ben
Blood, a retired United States Army veterinary officer.
25
Blood established the Pan American Zoonoses Center
in Azul, Argentina, in the 1950s, and the Pan American
Foot and Mouth Center in Rio de Janeiro, Brazil, about
the same time. Later, the Zoonoses Center was moved
to Buenos Aires where Joe Held was director.
Pedro Acha succeeded Ben Blood in the 1960s and
gave impetus to VPH in the Americas with support of
the World Bank. He was able to recruit public health
veterinarians and staff to the regional offices of PAHO
and assist national health administrations with trained
officers. Dr. Acha was followed by Dr. Mario Fernandez,
an experienced virologist who had been director of the
PAHO Foot and Mouth Disease Center. Dr. Joe Held, a
former assistant surgeon general, USPHS, was the next
director. Currently, Primo Arambulo is the coordinator
of the VPH program. All have made substantial contri-
butions. The control of urban rabies is important to
population centers. The eradication of foot and mouth
disease in southern South America, with the leadership
of Vincent Estudillo, for the past decade has given stim-
ulus to the goal of the Americas being free of foot and
mouth disease. The progress in bovine tuberculosis
control is credited to Isabel Kantor, who taught scien-
tists how to make tuberculin, evaluate tuberculin test
results, and gather epidemiologic data, which are criti-
cal to good surveillance. Jaime Estupinan, as director of
the PAHO Zoonoses Center, guides the transition to
encompass food-borne diseases.
We in veterinary public health recognize the con-
tributions of Pedro Acha and Boris Szyfres for their
invaluable book, Zoonoses and Communicable Diseases
Common to Man and Animals, in Spanish and English.
62
It has been the foundation of veterinary public health
epidemiology and surveillance in the Spanish-speaking
countries of the Americas.
George Beran is to be recognized as one of the con-
sultants to PAHO and WHO, and for his work in the
Philippines. He has performed in admirable style for
more than 50 years in teaching, research, health pro-
motion, consulting, writing, and editing. He has updat-
ed the CRC Zoonoses Handbook Series
63
and the PAHO
Zoonoses reports, and hopefully will continue to do so.
We pay tribute to all the American veterinarians
who demonstrated and promoted veterinary public
health in the United States. Most of these early pio-
neers were recruited by the CDC and assigned to states
that had zoonotic disease problems. Their service to
the public health in the 20th century is better health in
all humans and animals.
a
Royal Veterinary Institute, Berlin, Germany.
1812_1836.qxp 9/23/2005 2:44 PM Page 1819
1820 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
References
1. Diamond J. Farmer power. In: Guns, germs and steel. New
York: WW Norton, 1997;85–92.
2. Steele JH. The socioeconomic responsibilities of veterinary
medicine. Pub Health Rep 1964;79:613–618.
3. Smithcors JF. The veterinarian in America 1625–1975. Santa
Barbara, Calif: American Veterinary Publications, 1975.
4. Terry L. A century’s progress in public health. J Am Vet Med
Assoc 1963;142:1287–1291.
5. Furman B. A profile of the US public health service
1798–1948. Department of Health, Education and Welfare.
Publication No. NIH–73–369, Washington, DC: US Government
Printing Office, 1973.
6. Law J. Report on diseases of domestic animals. Am Vet Rev
1880;4:215–238.
7. Steele JH. Zoonoses 1879–1883: an update of James Law’s
report on diseases of animals. Vet Heritage 2000;23:14–20.
8. Miles WD. History of the bureau of animal industry. In:
Myer JA and Steele JH, eds. Bovine tuberculosis control in man and ani-
mals. St Louis: Warren H Green Publishers, 1969.
9. Billings FS. The relation of animal diseases to the public health
and their prevention. New York: D Appleton and Co, 1884;1–446.
10. Koprowski H,Plotkin SA, eds. World’s debt to Pasteur. Wistor
Symposium Series. New York: Alan R. Liss, 1985;3:1–303.
11. Stenn F. Nurture turned to poison. Prospect Biol Med
1980;69–80.
12. Rosenau M. Milk and its relation to public health.
Washington, DC: USPHS Hygiene Laboratory, 1908.
13. Myers JA, Steele JH. Attempts to control tuberculosis
among cattle. In: Bovine tuberculosis control in man and animals. St
Louis: Warren H Green Publishers, Inc, 1969;74–76.
14. Fontenot B. Much ado about milk. 2nd ed. New York:
American Council on Science and Health, 1999;1–38.
15. Schwabe CW. Food safety. In: Veterinary medicine and human
health. 3rd ed. Baltimore: The Williams & Wilkins Co,
1984;539–560.
16. Sinclair U. The jungle. New York: Doubleday, Page & Co,
1906.
17. Myers JA. Man’s greatest victory over tuberculosis.
Springfield, Ill: CC Thomas, 1940.
18. Meyer KF. History of medical research and public health: an
oral interview. Berkeley, Calif: University of California Press, 1976.
19. Meyer KF. The animal kingdom—a reservoir of disease, in
Proceedings. Intl Med 1930;8:234–261.
20. Steele JH. Biographical notes on the occasion of Karl F.
Meyer’s 90th birthday, May 19, 1974. J Infect Dis 1974;
129(suppl):3–10.
21. Altman L, Meyer KF. Viral scientist dies—public health
giant. New York Times 1974 April 29.
22. Sabin A. Karl Friedrich Meyer 1884–1974. A biographical
memoir. Vol 52. Washington, DC: National Academic Press, 1980.
23. Holland CF. Undulant fever outbreak at Michigan State
College. Mich State Med Soc 1940;39:666–670.
24. Newitt AW, Koppa TM, Gudakunst DW. Water borne out-
break of Brucella melitensis infection. Am J Public Health
1939;29:739–743.
25. Steele JH, Blackwell MJ, Andres CR. The 50th anniversary
of the veterinary medical corps officers of the US public health ser-
vice. J Am Vet Med Assoc 1998;212:952–954.
26. Steele JH, Tierkel ES. The US public health service national
program for the control of rabies, in Proceedings. US Livestock San
Assoc 1948;201–210.
27. Steele JH, Tierkel ES. Rabies. Problems and control. A
nationwide program. Pub Health Rep 1949;64:785–796.
28. Tierkel ES, Kissling RE, Eidson M, et al. A brief survey and
progress report of controlled comparative experiments in canine
rabies immunization, in Proceedings. Am Vet Med Assoc, 1953;443.
29. Tierkel ES, Graves LM, Tuggle HG, et al. Effective control of
an outbreak of rabies in Memphis and Shelby County, Texas. Am J
Pub Health 1948; 40:1084–1090.
30. US Public Health Service. Milk ordinance and code. Public
Health Bulletin No. 220, Washington, DC: Department of the
Treasury, 1943.
31. Stoenner HG, Lackman DB. A new species of Brucella iso-
lated from the desert wood rat Neotoma lepida (Thomas). Am J Vet Res
1957;18:947–951.
32. Gould SE, Gomberg HJ, Bethell FH. Prevention of trichi-
nosis by gamma irradiation of pork as a public health measure. Am J
Public Health 1953;43:1550–1555.
33. Gould SE, Gomberg HJ, Bethell FH. Control of trichinosis
by gamma irradiation of pork. JAMA 1954;154:653–658.
34. Zimmerman WJ, Steele JH, Kagan IG. Trichinosis in humans
in the United States 1966–1970. Health Serv Rep 1973;7:606–610.
35. Steele JH. Trichinosis. In: Schultz MC, Steele JH, eds.
Handbook series in zoonoses, section c, parasitic zoonoses. Vol 2. Boca
Raton, Fla: CRC Press, 1982;293–330.
36. Cypess RH. Cutaneous larva migrans. In: Schultz MC,
Steele JH, eds. Handbook series in zoonoses, section c, parasitic
zoonoses. Vol 2. Boca Raton, Fla: CRC Press, 1982;213–219.
37. Cypess RH. Visceral larva migrans. In: Schultz MC, Steele
JH, eds. Handbook series in zoonoses, section c, parasitic zoonoses. Vol
2. Boca Raton, Fla: CRC Press, 1982;205–212.
38. Poland JD, Barnes AM. Plague. In: Steele JH, ed. Handbook
series in zoonoses. Vol 1. Boca Raton, Fla: CRC Press, 1979;
515–559.
39. Steele JH, Helvig RJ. Present status of anthrax. Public Health
Rep 1953;68:616–623.
40. Galton MM, Steele JH, Newell KW. The world problem of sal-
monellosis. The Hague, The Netherlands: Dr. W Junk Publisher, 1964.
41. Steele JH, Galton MM. Epidemiology of food borne salmo-
nellosis. Health Lab Sci 1967;4:10–14.
42. Torten M. Leptospirosis. In: Steele JH, ed. Handbook series
in zoonoses, section a. Vol 1. Boca Raton, Fla: CRC Press, 1979;
363–421.
43. Galton MM. Leptospiral serotype distribution lists (through
1966). Veterinary Public Health Laboratory. Atlanta: US Dept of
Health, Education, and Welfare Public Health Service, Centers for
Disease Control, 1966.
44. Sulzer CR. Leptospiral serotype distribution lists (1966 to
1973). Bureau of Laboratories. Atlanta: US Dept of Health,
Education, and Welfare, Public Health Service, Centers for Disease
Control, 1975.
45. Stoenner HG et al. The epizootiology of bovine leptospiro-
sis in Washington. J Am Vet Med Assoc 1956;129:251–259.
46. Bomer EJ, Conklin RH, Steele JH. Listeriosis. In: Steele JH,
ed. Handbook series in zoonoses, section a. Vol 1. Boca Raton, Fla:
CRC Press, 1979;423–445.
47. Seeliger HPR. Listeriosis. New York: Hafner Publishing,
1961.
48. Potel J. Aetiologie der Granulomatosis. Wiss Z Martin
Luther Univ 1953/1954;3:341–354.
49. Fischer M. Listeriose-Häufung in Raume Bremen in den
Jahren 1960 and 1961. Dtsh Med Wochenschr 1962;87:2682–2684.
50. Ortel S. Bakteriologische, serologische und epidemiologis-
che Untersuchungen während einer Listeriae-Epidemie. Dtsch
Gesundheitswes 1968;23:753–759.
51. Schleck WF, Lavigne PM, Bortolussi RA, et al. Epidemic lis-
teriosis: evidence for transmission by food. N Engl J Med
1983;308:203–206.
52. Fleming DW, Cochi SL, MacDonald KL, et al. Pasteurized
milk as a vehicle of infection in an outbreak of listeriosis. N Eng J
Med 1985;312:404–407.
53. Ryser ET, Marth EH. Listeria, listeriosis, and food safety.
New York: Marcel Dekker, 1991.
54. Linnan MJ, Mascola L, Lou XD, et al. Epidemic listeriosis
associated with Mexican-style cheese. N Engl J Med 1988;319:823–828.
55. Bille J, Rocourt J, Mean F, et al. Epidemic food-borne listeriosis
in western Switzerland. II. Epidemiology. Presented at the Interscience
Conference of Antimicrobial Agents and Chemotherapy, 1988.
56. World Health Organization. Joint WHO/FAO Expert Group
on Zoonoses: Bovine tuberculosis, Q fever, anthrax, psittacosis,
hydatidosis—Report on the first session. WHO Technical Report
Series No. 40. Geneva: WHO, May 1951.
57. World Health Organization. Joint WHO/FAO Expert
Committee on Zoonoses, 2nd report. WHO Technical Report Series
No. 169. Geneva: WHO, 1959.
1812_1836.qxp 9/23/2005 2:44 PM Page 1820
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1821
58. World Health Organization. Joint WHO/FAO Expert
Committee on Zoonoses, 3rd report. WHO Technical Report Series
No. 378. Geneva: WHO, 1967.
59. World Health Organization. Parasitic zoonoses: report of a
WHO expert committee with the participation of FAO. WHO
Technical Report Series No. 637. Geneva: WHO, 1979.
60. Schwabe CW. Veterinary medicine and human health. 3rd ed.
Baltimore: The Williams and Wilkins Co, 1984;192–242,309.
61. Acha PN, Szyfres B. Zoonoses and communicable diseases
common to man and animals. Washington, DC: Pan American Health
Organization, 1980.
62. Beran GW. Handbook of zoonoses—section a: bacterial, rick-
ettsial, chlamydial and mycotic. Section b: viral. 2nd ed. Boca Raton,
Fla: CRC Press, 1994.
T
his year, the American College of Veterinary
Preventive Medicine, originally incorporated as the
American Board of Veterinary Public Health
(ABVPH), in Washington, DC in 1950, is celebrating
the 50th anniversary of its founding. The AVBPH and
the American College of Veterinary Pathologists
(ACVP) were the first specialties in veterinary medi-
cine to be recognized by the American Veterinary
Medical Association (AVMA). This distinction was
conferred unanimously by the AVMA House of
Representatives during its 88th annual meeting in
Milwaukee, Wis.
1
Such was the birth of specialization
in veterinary medicine in the United States or else-
where in the world.
Actions taken by the House of Representatives
were important for the future of specialty practice in
veterinary medicine in the United States. First, the
AVMA Council on Education was authorized “to
express its approval of such examining boards in vet-
erinary medical specialties as conform to standards of
administration formulated by the Council.” Second,
the Essentials of Approved Specialty Boards or Colleges in
Veterinary Medicine, formulated by the Council on
Education, was approved. Finally, as noted, the appli-
cations from the ACVP (Feb 10, 1950) and the ABVPH
(Jul 31, 1950) for specialty recognition were approved
unanimously by the House.
Unrelated, but equally indicative of the progressive
outlook of the AVMA in 1951, was the action by the
House to approve an AVMA Executive Board recom-
mendation for “the establishment of some type of
AVMA representation in Washington, at a beginning
maximum expenditure of $2,500 a year.” Thus was the
beginning of the AVMA Washington Representative.
Specialty Evolution in Human Medicine
The growth of specialization in human medicine is
linked to advancements of medical science and result-
ing improvements in medical care and diagnostics
since the turn of the 20th century. The American Board
for Ophthalmic Examinations, the first recognized
medical specialty, was incorporated in 1917. It was the
first time guidelines were established for training and
evaluating candidates desiring to practice ophthalmol-
ogy. The second specialty board, the American Board of
Otolaryngology, founded and incorporated in 1924,
developed along the same lines as its predecessor.
Others followed in the 1930s, and by 1948 there were
18 recognized medical specialties. Among the later
medical specialties was the American Board of
Preventive Medicine and Public Health. It was incor-
porated in 1948 and recognized in 1949, only two
years before the ABVPH. In 1952, the name was
changed to the American Board of Preventive
Medicine. Diplomates of this board are certified in the
specialty area of aerospace medicine, occupational
medicine or public health, and general preventive med-
icine. Undoubtedly, the establishment and recognition
of the American Board of Preventive Medicine and
Public Health spurred the interest of veterinarians to
promote a specialty in veterinary public health.
Today, there are 24 member medical boards recog-
nized by the American Board of Medical Specialties and
20 member boards or colleges recognized by the
American Board of Veterinary Specialties. Unlike the
early medical specialties, which were clinically orient-
ed, five of the first seven veterinary medical specialties
recognized in the period of 1951 to 1970 were in the
public or institutional practice sector.
Evolution of Veterinary Public Health and
Preventive Medicine as a Specialty
The history of the American College of Veterinary
Preventive Medicine (ACVPM) can be traced to 1949,
when a group of 12 veterinarians formed an organizing
council for the purpose of establishing what they then
Historic and future perspectives
of the American College of Veterinary Preventive Medicine
Thomas G. Murnane, DVM, DACVP
Dr. Murnane is a retired Brigadier General in the United States Army
This historical and future perspective account of the American
College of Veterinary Preventive Medicine is based on documents
and correspondence in the archives of the college; personal com-
munications; information kindly provided by the American
Veterinary Medical Association, the American Board of Medical
Specialties, and the American Board of Preventive Medicine; and
comments and additions offered by 35 diplomates of the ACVPM.
1812_1836.qxp 9/23/2005 2:44 PM Page 1821
1822 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
designated the American Academy of Veterinary Public
Health. The first meeting of the council was held Jul
11, 1949, in Detroit, Mich, during the annual meeting
of the AVMA.
2
The successor to the academy, the
ABVPH/ACVPM has held its annual executive and
membership meetings concurrently with the annual
convention of the AVMA, an annual alliance of 50
years!
The organizing council members were distin-
guished public health practitioners and academicians:
three were active duty United States Army Veterinary
Corps officers (Lieutenant Colonels Frank A. Todd,
Phillip R. Carter, Mervyn B. Starnes); one was a com-
missioned Public Health Service officer (Dr. James H.
Steele); one was an international veterinary public
health consultant (Dr. Benjamin D. Blood); three were
city or state health department veterinarians (Drs. L.W.
Rowles, Martin D. Baum, Alexander Zeissig); three
were academicians (Drs. Ival A. Merchant, Henrik J.
Stafseth, Franklin A. Clark), and one, Dr. John G.
Hardenbergh, after a distinguished practice, military,
and academic career was serving as the executive sec-
retary of the AVMA. Colonels Todd and Carter had
served together for several years in the European
Theater of Operations during and following World War
II, where they were assigned to civil affairs/military
government operations. Colonel Carter, one of two
surviving members of the council said, “We had many
talks about the idea of a veterinary public health spe-
cialty,” and “we kept up such interest after our return
to the United States.”
Dr. James H. Steele, the other surviving member of
the 12-member council, who is known and familiar to
many as a leading icon in veterinary public health,
served as the first secretary to the organizing council.
His report of the first meeting of the council stated that
Frank Todd was elected temporary chairman and he
was selected temporary secretary. Chairman Todd
appointed two committees: one to establish a defini-
tion of veterinary public health; the other to develop
bylaws to include criteria for eligibility. The next meet-
ing of the council was scheduled for Sunday, Oct 23,
1949. This coincided with the annual meeting of the
American Public Health Association, with which some
council members were affiliated.
Secretary Steele included this cautionary note in
his first report:
It should be explained to all members of the Organizing
Council and interested parties that physical presence at
these organization meetings does not make one a charter
or founding member. Membership cannot be determined
until the bylaws eligibility report of Doctor Rowles’ com-
mittee can be accepted by the Organizing Council.
At some time during or immediately following the
New York meeting in October 1949, the academy
redesignated itself as the American Board of Veterinary
Public Health. A copy of the constitution and bylaws,
dated Nov 30, 1949, stated that the name of the orga-
nization would be the American Board of Veterinary
Public Health. Perhaps this designation was prompted
by the fact that the term “board” is more accurate for
the purpose of the organization, which is the examina-
tion and certification of veterinarians in the specialty of
veterinary public health. Likewise, the name of the cor-
responding specialty in human medicine, the
American Board of Preventive Medicine and Public
Health, which was officially recognized earlier in 1949,
and may have inspired the change from academy to
board. Whatever the circumstances, the designation
was professionally and technically appropriate. The
ABVPH was officially incorporated as a non-profit
organization under the jurisdiction of the District of
Columbia on Feb 3, 1950.
Early Organization of the ABVPH
The first constitution and bylaws of the ABVPH
provided for an executive council of a president, vice
president, secretary, treasurer, and six councilors. The
positions were filled by 10 of the 12 organizing fellows.
Dr. Frank Todd, then Lieutenant Colonel Frank Todd
of the US Army Veterinary Corps, the first president,
was elected by the other organizing fellows. Terms of
office were three years for all positions. Initially, a pair
of councilors served one or two years in order to estab-
lish a turnover of two councilors each year.
Four classes of membership or fellowship were
established. They were organizing committee fellow,
charter fellow, fellow, and honorary fellow. The term
“fellow” persisted until the constitution was amended
on Aug 14, 1960. The term “diplomate” supplanted the
term “fellow.”
The original prerequisites described for applicants
wishing to take the board examination were that they:
' Be a graduate from a veterinary school recognized
by the AVMA
' Have an Masters of Public Health (MPH) or
equivalent degree from a school of public health
recognized by the American Public Health
Association (APHA) and at least six years of expe-
rience in a recognized civilian or military public
health agency, and have made a distinct contribu-
tion to the advancement of veterinary public
health; four years of additional experience along
with recognized accomplishments in veterinary
public health may be substituted for an advanced
degree
' Possess a license to practice veterinary medicine
issued by a recognized national or state licensing
agency.
Administration of the board and all other duties
and powers ordinarily delegated to the governing body
of a corporation were vested in the board’s council of
officers. The council also judged compliance of candi-
dates with prerequisite requirements for examination,
appointed the examining board, and certified all suc-
cessful candidates as specialists in veterinary public
health. The early constitutions did not provide for any
standing committees. In essence, the council, com-
posed of the four elected officers and six councilors,
was responsible for the entire operation of the ABVPH.
The first meeting of the newly constituted ABVPH
was held in Miami Beach, Fla, in August 1950 during
the annual meeting of the AVMA.
3
The constitution
decreed that all regular meetings of the board and
1812_1836.qxp 9/23/2005 2:44 PM Page 1822
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1823
council be held annually at the time and the place of
the annual meeting of the AVMA. The board and its
successor, the ACVPM, have adhered to this practice
faithfully for the past 50 years.
In 1950, the board was occupied largely with the
processing and approval of applicants for charter fel-
lowship. An initial group of 55 candidates was com-
piled from veterinarians recommended by the 12 fel-
lows of the organizing committee. The group was
screened by the council and those selected were invit-
ed to apply for charter fellowship. Twenty-one appli-
cants were approved as charter fellows bringing the
total number of fellows in the ABVPH to 33 in early
1951.
The second annual meeting of the ABVPH was
held in 1951 in Milwaukee, Wis. Thirteen of the 33 fel-
lows attended this meeting. The occasion was of par-
ticular importance as the AVMA House of
Representatives approved the applications of the
ABVPH and the ACVP as the first recognized special-
ties in veterinary medicine.
President Todd also announced with pleasure that
the definition of veterinary public health, as prepared
by the board and adopted in 1950 at its first meeting,
had since been adopted by the World Health
Organization and the Food and Agriculture
Organization of the United Nations. The definition,
developed in response to President Todd’s 1949 request
reads, “Veterinary public health is all community
efforts influenced by the veterinary medical arts and
sciences applied to the prevention of disease, protec-
tion of life and promotion of the well-being and effi-
ciency of man.”
Prerequisites and Examination Process
The method, time, and place for holding the first
examination of candidates was discussed intensely at
the second annual meeting of the ABVPH. President
Todd appointed the first examining committee, which
consisted of four fellows: Drs. Alexander Zeissig,
Stanley L. Hendricks, James E. Scatterday, and Mervyn
B. Starnes. For the balance of the year and through
much of 1952, the committee reviewed the possible
methods of conducting the examinations. A set of
questions based on the APHA merit system examina-
tions and New York State Health Department examina-
tions were used in developing a multiple choice writ-
ten examination. No further details are available on the
nature of the written examination. The first examina-
tion was planned to be given in connection with the
APHA meeting in Cleveland, Ohio in October 1952.
Seven veterinarians were approved to take the first
formal examination. All were in the military services:
six Air Force and one Army veterinarian. They passed
and were certified as veterinary public health special-
ists on May 29, 1953. Brigadier General Wayne Kester,
first Chief of the Air Force Veterinary Corps, was insis-
tent that his officers receive postgraduate public health
education and take the board examination in the pub-
lic health specialty. His interest carried substantial
influence with his officers, as they comprised 82% of
the 1953 and 1954 successful candidates examined by
the ABVPH. The predominance of military veterinari-
ans among veterinary public health and preventive
medicine specialists no doubt reflects the focus of this
professional group of veterinarians, the strong career
development policies of their agencies, and the encour-
agement of senior officers like General Kester of the
Air Force, Brigadier General Charles “Chuck” Elia of
the Army, and their successors.
The qualification or prerequisite requirements for
examination, and the examination format, consisting
of a written and oral examination, continued essential-
ly the same over the next few years. In 1956, the pre-
requisites for board examination were strengthened by
requiring sponsorship of applicants by a fellow of the
board. The sponsors were assigned the responsibility to
provide a written statement addressing the applicant’s
abilities, training, and experience.
From 1953 through 1960, 60 veterinarians were
examined and certified as fellows of the ABVPH. A
total of 93 veterinarians, including the 33 charter and
organizing committee fellows, were certified as veteri-
nary public health specialists during the first decade of
operations of the board. From 1953 to 1960, a format
of written and oral examinations was followed.
However, there is no record of the exact composition of
the written examination or specific subject matter
addressed in the oral examination. Applicants were
reviewed and evaluated by the nine-member council of
the ABVPH and examined by a committee appointed
by the council.
The first ad hoc evaluation committee appointed
by the board reported its concern for the examination
process on Aug 15, 1959, stating, “Our administrative
control, examination and review procedures as now
established in the Constitution and Bylaws leave much
to be desired.”
a
The resulting constitution and bylaws
revision of Aug 14, 1960, instituted several changes in
the examination process, the most important of which
was creation of an examination committee and specif-
ic guidelines for its composition and responsibilities.
The council of the ABVPH retained sole authority for
review and approval of applicants for examination and
the review and approval of all actions of the examina-
tion committee.
This revision also designated members of the
ABVPH as diplomates, eliminating the designation of
fellow. The board reasoned that the term diplomate is
used almost exclusively by medical specialty boards.
Fellow is more commonly used in referring to individ-
uals in a preferred status in a professional association
or educational institution.
Between 1978 and 1983, the organization and con-
tent of the written examination were again revised sub-
stantially. Examination questions were evaluated for
ambiguity, currency, applicability, and correctness. This
was a major effort and the first time that the examina-
tion questions had been totally consolidated, edited,
and then assembled into a computerized databank
since the inception of the college.
b
The college con-
tracted with Texas Tech University School of Medicine
for data processing services and assistance in the main-
tenance and evaluation of examination questions.
Questions failing scrutiny were eliminated. Members,
particularly new diplomates, were requested to con-
1812_1836.qxp 9/23/2005 2:44 PM Page 1823
1824 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
tribute new questions. These were major steps in orga-
nizing and advancing the quality and security of the
examination process.
The examination was organized into five areas rel-
evant to veterinary preventive medicine and appropri-
ately balanced. The categories of questions encom-
passed in the examination process were infectious dis-
eases, particularly zoonotic diseases, immunology, and
pharmaceuticals (35%), environmental health (20%),
food hygiene or safety (20%), epidemiology (20%),
and public administration and health education (5%).
The same subject matter was carried over into the oral
examination, not in a format of specific questions, but
as a guide for the areas of questioning.
The examination process was again revised in
1992.
4
The oral examination was eliminated and the
entire examination formatted into three sections.
Section one consists of 300 multiple-choice questions
covering infectious diseases (25%), environmental
health (25%), food hygiene (20%), epidemiology
(20%), and health education and administration
(10%). Section two consists of five problem-solving
scenarios for which logical and reasonable solutions
must be composed. Section three consists of one essay
question to measure the ability of a candidate to com-
municate effectively. The database for the examination
questions was transferred from Texas Tech University
to the college’s computer, which was maintained by the
executive vice president. These arrangements continue
today.
Transition of the Board to the American
College of Veterinary Preventive Medicine
The most important development in the history of
the specialty of veterinary public health and preventive
medicine was the transition of the ABVPH to the
ACVPM.
5
The resulting college was formally recog-
nized by the AVMA on Jul 16, 1978, and incorporated
in the District of Columbia on Jan 23, 1979. This seam-
less transition preserved the continuity of the organi-
zation, its legacy, and the historical founding in 1950,
expanded the opportunity for all practitioners of vet-
erinary preventive medicine to achieve specialty recog-
nition.
The transition was much more than a constitu-
tional revision and organizational restructuring. It
enabled the bonding of two sometimes-quarrelsome
factions, veterinary public health and veterinary regu-
latory medicine practitioners, into one specialty orga-
nization: veterinary preventive medicine. It occurred
during a 12-year period, from 1966 to 1978,
c,d
resulting
in evolution and maturity of the membership of the
ABVPH, as well as the organizing members of a series
of proposed specialty groups variously identified as the
American College of Veterinary Public Service
Practitioners (1966), the American College of
Regulatory Veterinary Medicine (1971),
6
and as the
American College of Veterinary Preventive Medicine
(1973),
e
which was granted probational status by the
Advisory Board on Veterinary Specialties (ABVS) in
1975. The last is not to be confused with the ACVPM
(1978) successor to the ABVPH. There were a number
of meetings, telephone conversations, and exchanges
of correspondence between representatives of the
ABVPH and the probational college representatives,
particularly between 1971 and 1978.
7,f
Although the
prolonged process detracted energy and money from
the operations of the ABVPH, the beneficial outcome
atones for the labor and costs. Ultimately, it was the
decisive action of the administration of the ABVPH to
scrub previous approaches to unifying the specialty
interests of public health and regulatory veterinarians
and simply revise the constitution of the functioning
ABVPH.
8
Past accounts of this transition have described this
outcome as a merger of the ABVPH and probational
ACVPM (1975). In fact, there was no merger of these
organizations, but rather an induction of members of
the probational college into a fully recognized and
functioning certifying organization. The constitution
and bylaws of the ABVPH were revised and unani-
mously approved by its membership to rename the
board the ACVPM, and adjust the categories of mem-
bers and representation on the council and examina-
tion committee. Twenty-six veterinarians, members of
the probational college, were invited to become charter
diplomates of the ACVPM. Twenty-three accepted,
three of whom were appointed to the board of coun-
cilors and two to the examinations committee. The
expertise of members of the probational college was
merged with the ACVPM. Certification and examina-
tion procedures remained essentially the same. An
amendment to the responsibilities of the council to
“recognize specific subspecialties and approve proce-
dures for certification in such subspecialties,” which
would separate diplomates into public health, public
administration, or regulatory medicine subspecialties,
was never approved.
The first meeting of the fully approved ACVPM
was held Jul 17, 1978, with Dr. John H. Helwig presid-
ing. It was appropriate that Dr. Helwig preside at the
first meeting of the ACVPM, as he had been involved
in this issue since 1966. At that time, he was the
ABVPH representative to the ABVS. At the time, there
was interest for specialty recognition among some reg-
ulatory veterinarians who were members of the com-
mittee on Meat and Milk Hygiene of the United States
Livestock Sanitary Association.
9
Addressing the group’s
interest, Dr. Helwig reasoned that food inspection is a
part of public health and stated, “I see no reason for
having a separate specialty board for this area” but sug-
gested that “we (ABVPH) give some attention to the
possibility of incorporating new needs in our ABVPH”
and “perhaps a name such as the American Board of
Veterinary Preventive Medicine would take care of
their needs.” Much later, in a Nov 30, 1977, corre-
spondence to Dr. John O’Harra of the probational
ACVPM, Dr. Helwig stated, “There is no question
about wanting to merge and we hope to do so with
consideration and dignity for everyone.”
Dr. Helwig was succeeded by Dr. William E.
Jennings (1979 to 1982). Dr. Jennings was the last of
the three-year-term presidents. Succeeding presidents
served one-year terms; however, beginning in 2000,
the presidents of the ACVPM will serve two-year
terms.
1812_1836.qxp 9/23/2005 2:44 PM Page 1824
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1825
Like many of their predecessors, Drs. Helwig and
Jennings gave much of their time and abilities to
strengthening the organization and improving the
quality of service of the college. For their exceptional
contributions, these two men were recognized with the
establishment of the Helwig–Jennings Award in 1980.
The award recognizes diplomates who have rendered
outstanding and prolonged service to the college.
Other Historical Aspects and Progress
of the ACVPM
' In March 1983, the ACVPM submitted a proposal to
the ABVS for the establishment of a specialty in epi-
demiology. The ACVPM Epidemiology Specialty
was granted full approval by the AVMA in 1984.
10
Twenty-six charter members were initially recog-
nized by the specialty. Examinations for the special-
ty commenced in 1987. The specialty now has 59
active diplomates. The preferred name, “ACVPM,
Epidemiology Specialty,” was approved by the ABVS
and ACVPM Board of Councilors in 1992.
' Epidemiology is the only specialty that has sought
college recognition. Interest in other specialty
areas waxes periodically. Currently there is grow-
ing interest in a food safety specialty.
' Perhaps one of the distinctive developments in
recent history of the college was the formulation of
a definition for veterinary preventive medicine.
This was initially detailed in Article II of the July
1989 revision of the college’s constitution. In
essence, veterinary preventive medicine is
described as an integral component of veterinary
medicine concerned with improving animal and
human health through the prevention and control
of animal diseases, infectious waste contamina-
tion, and related human illnesses. Veterinary pre-
ventive medicine is a more encompassing practice
than veterinary public health practice. Diplomates
of the ACVPM are engaged in public, private,
industrial, military, or institutional practice and
are involved in regulatory medicine, diagnostic
medicine, extension service, public health, epi-
demiology, food safety, research, teaching, herd
health management, population medicine, con-
sulting, and other similar activities.
' The need for executive assistance became apparent
with increased activities and growth of membership
in the 1980s. In 1989, a salaried position for an
executive vice president was established and filled.
The incumbent serves as the chief administrative
officer of the college and is responsible to the exec-
utive board. The employment of an executive offi-
cer has been of critical importance in enhancing the
quantity, quality, and timeliness of services offered
to the membership, profession, and the public.
' The organization, management, and composition of
the college were intensely reviewed in 1990.
11
Changes were effected in the constitution in
September 1992 to create a smaller, more efficient
executive group, improve financial management, fur-
ther define the position of the executive vice presi-
dent, and elevate the status of emeritus membership.
' An ad hoc credentialing committee was formed by
the president’s direction in 1995 to study and make
recommendations concerning the prerequisite qual-
ifications for examination; the avenues for attaining
the prescribed education, training, and experience;
and the need to establish a credentials committee,
separating the function from the examination com-
mittee.
12
These issues were reviewed and appropri-
ate amendments to the constitution and bylaws
were prepared and approved in November 1996.
These amendments enabled the formation of a per-
manent standing credentials committee, awarded
greater time credit for formal postgraduate educa-
tion and training, and established an application
process to include documentary evidence of veteri-
nary preventive medicine experience. Subsequently,
the college’s constitution and bylaws were amended
in April 2000 to award additional time credit for for-
mal education and training to remove any percep-
tion of a waiting period before a candidate might
qualify for examination.
' In recent years, many United States veterinary med-
ical schools have de-emphasized or eliminated
departments, faculty, and curriculums of veterinary
public health and preventive medicine. To counter-
act this unseemly movement, the ACVPM has
developed a model curriculum for teaching veteri-
nary preventive medicine programs. Unfortunately,
it has received limited use. Colleges of veterinary
medicine, however, seem to be showing an increas-
ing interest in food safety.
' An early attempt was made in 1967 to promote a
residency program in veterinary public health, but
unfortunately was discontinued for lack of finan-
cial support.
13
There are a few opportunities open
to veterinarians for residency training in public
health with the Centers for Disease Control and
Prevention, the California State Health
Department, and a new program in applied epi-
demiology and preventive medicine at the
University of Virginia-Maryland Regional College
of Veterinary Medicine. These, particularly the lat-
ter, offer encouragement that other residency pro-
grams will become available to veterinarians.
' The college has endeavored to encourage students
and enhance the professional abilities of certified
veterinary preventive medicine specialists through
sponsorship of awards and educational programs.
The ACVPM routinely sponsors or cosponsors sci-
entific programs at the AVMA and other profession-
al associations’ regional meetings. The college
cosponsored and participated in the seminar
“Public Health in the New Millennium” at the
AVMA Annual Convention in July 2000. In 1997,
the epidemiology specialty, ACVPM, cosponsored a
session at the AVMA Annual Convention titled
“Medical Geography and Geographic Information
Systems.” The college has repeatedly served as an
affiliate sponsor of the meetings of the International
Society for Veterinary Epidemiology and
Economics, which are held every three years. The
ACVPM’s Paul S. Schnwrenberger Award is present-
ed annually to a veterinary student for excellence in
public health research or studies. The college
1812_1836.qxp 9/23/2005 2:44 PM Page 1825
1826 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
awards an honorarium and plaque at the annual
meeting of the Conference of Research Workers in
Animal Diseases (CRWAD). As a result of the col-
lege’s participation in the CRWAD, a scientific sec-
tion, “Epidemiology and Animal Health,” was
established in 1992. In 1988, the ACVPM, the
University of Iowa, and the National Coalition for
Agricultural Safety and Health cosponsored an
international Conference on Agriculture and
Environmental Health. The conference has led to a
national policy to protect the health of the nation’s
farm communities. During the past 10 years, the
ACVPM has co-sponsored and participated in the
USDA/APHIS symposia emphasizing the veterinari-
an’s role in public health.
' Strategic approaches to meet the needs of a grow-
ing list of users of veterinary preventive medicine
have been undertaken. For example, an ad hoc
committee on production medicine is studying the
integration of teaching and research of preventive
medicine into clinical veterinary education, the
inclusion of preventive medicine topics at live-
stock specialty meetings, and encouragement of
veterinary students and clinical practitioners to
become board certified in the ACVPM.
' The college has entered into a partnership with the
American Association of Public Health
Veterinarians (AAPHV), formerly the Conference
of Public Health Veterinarians, to combine their
respective ACVPM News and Views and the
AAPHV Newsletter into a single publication. This
enables distribution of news and information to a
larger professional community having common
interests and increases awareness of both organiza-
tions. The arrangement benefits the organizations,
and the combined force of the two groups assists
the coalition of veterinary organizations involved
in public health and preventive medicine in
addressing issues of mutual concern.
Future Perspectives
The number of diplomates in the ACVPM has
grown steadily from the initial membership of 286 in
1978 to 666 members entering the year 2000. Of these,
455 (68%) are active, 107 (16%) have emeritus status,
15 (2%) are honorary, and 89(14%) are inactive,
according to the ACVPM Directory 2000.
Analysts expected substantial growth (61%) of vet-
erinarians in the nonprivate practice sector between
1980 and 2000.
14
Although this has not been quanti-
fied, the impression is that the predictions were cor-
rect. With such growth in the nonprivate practice sec-
tor, which is the principal employment area of veteri-
nary preventive medicine specialists, one might expect
a similar surge in certification of these specialists.
Indeed there has been a modest increase in the number
of certified veterinary preventive medicine specialists.
In a 20-year period, 1980 to 1999 inclusive, 367
new diplomates have been certified with the ACVPM.
This is almost half (49%) of the total 751 veterinarians
who have been certified as veterinary public
health/preventive medicine specialists since 1950. The
number of veterinarians certified in each five-year peri-
od was 35 from 1980 through 1984, 128 from 1985
through 1989, 117 from 1990 through 1994, and 87
from 1995 through 1999. This represents an overall
favorable growth for the 20-year period; however, the
collective downward trend in the most recent 5 years is
disquieting. There were also successive years in which
few veterinarians were certified (eg, five, six, and eight
in years 1982, 1983, 1984, respectively, and 13 and 12
in years 1995 and 1996, respectively). Given increased
promotion and recruitment, the 128 veterinarians cer-
tified from 1985 through 1989 suggests an attainable
goal for the number of veterinarians to be certified in
the next five years and thereafter.
From 1950 through 1999, 751 veterinarians have
been certified as veterinary public health/preventive
medicine specialists. Today, the ACVPM is the sixth
largest of the 20 veterinary specialty organizations rec-
ognized by the AVMA. The 455 diplomates of the
ACVPM comprised about 7% of the 6,518 veterinary
specialists active in the United States in 1999.
Approximately 12% of the 55,380 United States
veterinarians of known employment in 1999 were cer-
tified veterinary specialists. Although veterinary prac-
titioners are trending toward specialization, the pro-
portion of veterinary specialists among all practitioners
is not substantially high. The expectation of reaching
25% of all employed practitioners is perhaps a distant
reality.
On the other hand, the 455 active veterinary pre-
ventive medicine specialists comprised only about
4.5% of the 10,180 veterinarians engaged in public and
corporate practice in 1999. It is reasonable to expect
the proportion of veterinary preventive medicine spe-
cialists to increase in the public and corporate sector
even though federal, state, and local government
employers, with the exception of the Uniformed
Services, have not emphasized nor compensated pre-
ventive medicine specialization in their employment
systems.
Recent legislative action awarding veterinarians in
the Uniformed Services annual bonus payments for
specialty certification will sustain, if not increase, the
number of veterinarians seeking specialty status, par-
ticularly in the Public Health Service. Retirees from the
Uniformed Services often pursue a second career in
other federal, state, or local public or animal health
agencies. There will be an increasing transfusion of
specialists and accompanying interest for promoting
veterinary medical specialties. Perhaps, too, other fed-
eral or state agencies will follow the lead of the
Uniformed Services and award monetary bonuses for
the veterinary specialty certification.
Compensation is but one motivational factor for
board certification. Underlying remuneration for certi-
fication are other less tangible but far more profession-
ally motivational forces. Attaining specialty certifica-
tion is a distinguishing professional career accomplish-
ment. Peer recognition for one’s qualifications and
competence in the exclusive practice of a specialty is a
rewarding experience of itself. Members of the college
share a commonality in professional objectives that
focuses their efforts and improves the quality of pro-
fessional services.
1812_1836.qxp 9/23/2005 2:44 PM Page 1826
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1827
Veterinary preventive medicine is the most pub-
licly involved of all veterinary specialties. Yet, despite
50 years of activity, the veterinarian’s role in public
health is not appreciated or is ignored by some physi-
cians, other health professionals, and agriculture offi-
cials. Most often, this attitude is for lack of association
or familiarization with veterinarians and their special-
ty education and training. This lack of recognition is an
impediment to expanding use of the veterinary pre-
ventive medicine specialist. A sustained and focused
effort in public relations and physician education must
be mounted by veterinarians, individually and collec-
tively, if the profession, and particularly the specialty,
are to ensure its rightful place in the maintenance of
human and animal wellness.
A Noble and Serving Specialty
The veterinary profession exists primarily to pro-
vide preventive health care services and expertise to
animals and humans. Of all the recognized specialties
in veterinary medicine, veterinary preventive medicine
is the single specialty that most nearly fulfills all the
proclaimed objectives of the profession as described in
the Veterinarian’s Oath. Contrary to popular terminol-
ogy, the practice of veterinary public health/preventive
medicine is not nontraditional practice. Practitioners
of the specialty prefer the collective designation of
public/institutional or corporate practice and, individ-
ually, veterinary preventive medicine or public health
practitioners.
The college has been an instrument not only for
certification of veterinary specialists and the advance-
ment of veterinary public health and preventive medi-
cine, but also the basis for the formation of lasting
friendships and many pleasurable experiences. It
serves as a network for like-minded practitioners and
enhances professional relationships. The college has a
distinguished heritage, counting among its diplomates
some of the most outstanding veterinary personalities
in public health and preventive medicine on the
national and international scene. Many are the recipi-
ents of prestigious AVMA awards. Slightly over half of
all the recipients of the AVMA Public Service Award,
established in 1968, are diplomates of the ACVPM.
The areas of societal needs serviced by preventive
medicine specialists include research and disease pre-
vention, and control programs for zoonoses, foodborne
illnesses, antimicrobial resistant microorganisms,
chemical and microbiologic safety of the national food
chain, animal herd health and protection of the live-
stock industry from foreign animal diseases, disaster
preparedness, and environmental and occupational
health.
Veterinary preventive medicine is a public and ani-
mal health service-oriented specialty. Specialists are
prepared to complement traditional practices with new
strategies for disease prevention and control, as has
been achieved in Texas with the containment and
reduction of rabies in coyotes and foxes using oral
rabies vaccine.
Often animal diseases are amenable to biological
and chemical prophylaxis, quarantine, and slaughter, if
necessary, given responsible and cooperative owners. In
the case of owner irresponsibility or opposition, ways
must be found to effect human behavioral changes.
Fines and other penalties promote some compliance,
but there remains a segment of resistant humans who
must be treated with effective persuasion. Health edu-
cation is an aspect of the specialty to be emphasized for
enhancement of animal disease control measures.
In this increasingly complex world in which there
is resurgence of old and new diseases, veterinary pre-
ventive medicine specialists practicing community
health and animal population medicine will contribute
substantially to the improvement of human and animal
wellness and welfare.
The Legacy
The legacy of the founders of the specialty of vet-
erinary public health/preventive medicine is convic-
tion and the will to carry on. They were convinced
there was a professional role for the veterinarian as a
specialist in public health. Despite the novelty of the
idea, they had the will to carry on and secured recog-
nition for a unique professional organization. Later
there were leaders who took control of a fractious situ-
ation and provided an expeditious and effective resolu-
tion binding all parties in a common organization ben-
efiting public and animal health.
The college has had a long series of able and dili-
gent elected officers and committee members.
Constraints of this report do not permit recognition of
the many individuals who have made substantial con-
tributions. However, special mention should be made of
secretaries and secretary-treasurers who worked, often
sacrificing personal time and resources, to maintain the
day-to-day activities, respond to urgent inquiries, and
ensure the fiscal security of the organization. They are
the unsung heroes and heroines of the college.
The ACVPM is endowed with a remarkably rich
heritage and foundation for further growth and the
expansion of specialty involvement. The college
respects this inheritance and will continue to move for-
ward for the next 50 years in advancing the cause of
veterinary preventive medicine.
a
Baum MD. Letter to Stanley L. Hendricks, President, American
Board of Veterinary Public Health. Sep 25, 1959.
b
Rosser WW. Letter to Thomas G. Murnane. Nov 17, 1999 and Jun
12, 2000.
c
Hummer RL. Letter to Stanley L. Hendricks, President, American
Board of Veterinary Public Health. Mar 17, 1971.
d
Atkinson JW. Letter to members, American Board of Veterinary
Public Health. Nov 29, 1974.
e
O’Harra JL. Letter to Advisory Board of Veterinary Specialties of the
American Veterinary Medical Association. Mar 11, 1971.
f
Grogan EA. Letter to Council Members, American Board of
Veterinary Public Health. Feb 14, 1978.
References
1. Specialty Examining Boards. Business sessions, in
Proceedings. Am Vet Med Assoc: 1951:335–336.
2. Steele JH. Secretary’s report of the first meeting of the council
to organize an American Academy of Veterinary Public Health; 1949.
3. Blood BD, Secretary, American Board of Veterinary Public
Health. Secretary’s Annual Report, 1950-51; 1951.
4. Donham KJ. Five year in-depth report of the American College
of Veterinary Public Health, 1988–1992. San Antonio, Tex: American
College of Veterinary Preventive Medicine, 1993.
1812_1836.qxp 9/23/2005 2:44 PM Page 1827
1828 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
5. Clayton FW. Five year in-depth report of the American
College of Veterinary Preventive Medicine, 1978–1983. San
Antonio, Tex: American College of Veterinary Preventive
Medicine, 1983.
6. Schroeder RJ. A specialty board for regulatory veterinary
medicine? J Am Vet Med Assoc 1969;155:2182–2187.
7. Whitehair LA. Memorandum for record. American Board of
Veterinary Public Health, 1975.
8. Helwig JH. Status report to all diplomats. American Board of
Veterinary Public Health, 1978.
9. Jennings WE. Report of committee on meat and milk hygiene.
US Livestock Sanitary Association, 1966.
10. Murnane TG. Five year in-depth report of the American
College of Veterinary Pubic Health, 1983–1988. San Antonio, Tex:
American College of Veterinary Preventive Medicine, 1988.
11. Nossov G, Groves M, Gunnels R. Report of ad hoc committee
on organizational structure. American College of Veterinary
Preventive Medicine, 1991.
12. Russell LH. Five year in-depth report of the American College
of Veterinary Public Heath, 1992–1997. San Antonio, Texas: American
College of Veterinary Preventive Medicine, 1997.
13. Blenden DC, Parrish HM, Price ER. Experimental residency
program in veterinary public health. Public Health Rep 1967;82:545–548.
14. Wise JK, Kushman JE. Synopsis of US veterinary medical
manpower study: demand and supply from 1980 to 2000. J Am Vet
Med Assoc 1985;187:358–361.
I
n 1999, the USDA Food Safety and Inspection
Service (FSIS) established a Blue Ribbon Task Force
of experts (internal and external to the agency) to eval-
uate the role of veterinarians in public and animal
health and food safety. The veterinarian’s role is
described as the purveyor of knowledge and expertise
bridging animal and human health. The intent of this
report is to fuel a renaissance in thinking about how
veterinary medical expertise is considered, cultivated,
nurtured, and used in the FSIS.
The task force developed recommendations
around five major issues: defining the role of the FSIS
veterinarian; education, training, recognition, and
recruitment; partnerships; coordinated information
management; and veterinary contributions to interna-
tional credibility of FSIS.
In 1996, the FSIS issued the Pathogen Reduction
Hazard Analysis and Critical Control Point
(HACCP) Systems final rule to control and reduce
foodborne pathogens on meat and poultry products.
Federal and state meat and poultry plants must adopt
HACCP, a system based on hazard prevention with
performance standards set by FSIS. The rule gives all
FSIS employees a much greater role in food safety
and public health. Overseeing HACCP systems
requires FSIS employees to make increasingly more
science-based judgments. Veterinarians in the FSIS
now have unique opportunities to enhance food safe-
ty by interacting more with other animal and human
health professionals, promoting implementation of
farm-to-table food safety and quality systems,
improving the sharing of information, conducting
scientific analysis of complex food safety systems,
and enhancing public health through better use of
resources.
Roles and Responsibilities of the FSIS
Veterinarian Outside the Slaughter Plant
Environment
By virtue of their broad education and experience,
veterinarians are qualified to deal with a wide range of
areas important to food safety, including but not limit-
ed to:
' Disease recognition, especially zoonotic diseases
' Emerging pathogens
' Threats of bioterrorism
' Threats of foreign animal disease
' Public health
' Epidemiology (including outbreak investigations)
' Science-based certification and auditing processes
' Animal science and population medicine
' Pathology
' Parasitology
' Microbiology, virology, and bacteriology
' Comparative medicine and multi-species chem-
istry/toxicology and pharmacology
' Drug resistance mechanisms
The FSIS will depend more and more on the vet-
erinarians’ analytical and problem solving skills for
development and evaluation of broad public health
policy, risk assessment, data management and evalua-
tion, leadership, and administrative activities that have
national and international impact.
An increasingly important role will be that of eval-
uators of risk-based data systems. Veterinarians in
FSIS currently serve by sharing epidemiologic data
from live animals and in-plant and post-processing
pathogens and residues. Data collection and evalua-
tion are essential components of risk analysis (assess-
ment, management, and communication).
Veterinarians need to lead effective food safety moni-
toring and surveillance programs to identify risks,
evaluate interventions, and improve the allocation of
risk-based resource management. The data results will
Blue ribbon task force report on the future
of Food Safety and Inspection Service veterinarians:
public health professionals for the 21st century
Bonnie J. Buntain, DVM, MS
From the Office of Public Health and Science, Food Safety and
Inspection Service, United States Department of Agriculture,
Washington, DC 20024.
1812_1836.qxp 9/23/2005 2:44 PM Page 1828
guide veterinary epidemiologists in their risk analysis
duties from farm-to-table.
The expanded duties of FSIS veterinarians will
also include more opportunities as educators, man-
agers of teams, and creators of partnerships with
researchers, industry, and consumer groups. In the
future, partnering will require FSIS veterinarians to
build consensus among diverse groups that are exter-
nal to the agency. Commodity groups, government
agencies, academe, and the food industry are key part-
ners in producing safe food from farm-to-table. The
FSIS veterinarians will play important roles in provid-
ing information on food safety and public health to
assist our partners in developing verifiable HACCP-
compatible systems all along the food chain.
To meet the expanding roles for agency veterinari-
ans, FSIS envisions a Career Planning Guide for
Veterinarians with the following potential career tracks:
' Public health policy and assessment—This track
will hone veterinary analytic and problem-solving
skills for risk assessment, data management, epi-
demiology, research, and policy development and
evaluation.
' Inspection application—In addition to traditional
roles in antemortem and postmortem inspection,
FSIS veterinarians will verify and monitor animal
health and product safety systems from farm-to-table.
' Administration/management—Veterinarians will
be trained and mentored to be the future execu-
tives and program leaders.
' International—The FSIS veterinarians will learn
the skills necessary for international negotiations,
foreign languages, policies, and consensus-build-
ing around issues involving foods of animal origin.
An FSIS Chief Veterinarian Public Health Officer
could be appointed to coordinate FSIS activities in
domestic and international technical issues related
to meat, poultry, and egg products.
T
he National Antimicrobial Resistance Monitoring
System (NARMS) for enteric bacteria was initiated
in l996 as a collaboration between the National Center
for Infectious Diseases at the Centers for Disease
Control (CDC), United States Food and Drug
Administration Center for Veterinary Medicine (FDA-
CVM), the Agricultural Research Service, Food Safety
and Inspection Service, and the Animal Plant Health
Inspection Service of the United States Department of
Agriculture (USDA).
1,2
Bacterial isolates from humans
are currently provided by 17 state and local public
health laboratories. The purpose of NARMS is to
prospectively monitor antimicrobial resistance in iso-
lates of selected enteric bacteria collected from humans,
animals, and animal products. The goals of NARMS are
to provide descriptive data on the extent and temporal
trends of antimicrobial resistance in enteric organisms
from the human and animal populations; provide time-
ly information to veterinarians and physicians; prolong
the life span of approved drugs by promoting the pru-
dent use of antimicrobial agents; identify areas for more
detailed investigation; and guide research on antimicro-
bial resistance. This paper addresses NARMS surveil-
lance conducted at CDC from 1996 through 1999.
Materials and Methods
The total population in 17 NARMS sites (California,
Connecticut, Colorado, Florida, Georgia, Kansas,
Massachusetts, Maryland, Minnesota, New Jersey, New York,
Oregon, Tennessee, Washington, West Virginia, Los Angeles
County, and New York City) in 1998 was 103 million people,
or 38% of the United States population. Since 1996, NARMS
has conducted surveillance for antimicrobial resistance among
isolates of nontyphoidal Salmonella. In 1997, surveillance was
expanded to include human isolates of Campylobacter.
Clinical laboratories isolate Salmonella or Campylobacter
from patient specimens. Salmonella are isolated from blood,
feces, urine, or other specimens; Campylobacter isolates are
obtained from fecal specimens only. Most clinical laborato-
ries in participating sites submit almost all Salmonella, but
few submit Campylobacter isolates to state or local public
health laboratories. Serotyping of Salmonella isolates is done
at the submitting state public health laboratory. Participating
state and local public health laboratories submit every 10th
nontyphoidal Salmonella isolate and one Campylobacter iso-
late per week to CDC for susceptibility testing.
The National Antimicrobial Resistance Monitoring System
(NARMS) for enteric bacteria, 1996–1999:
surveillance for action
Nina N. Marano, DVM, MPH; Shannon Rossiter, MPH; Karen Stamey, BS; Kevin Joyce, BS;
Timothy J. Barrett, MS, PhD; Linda K. Tollefson, DVM, MPH; Fredrick J. Angulo, DVM, PhD, MPVM, DACVPM
From the Foodborne and Diarrheal Diseases Branch, Centers for
Disease Control and Prevention, 1600 Clifton Rd, MS C-09,
Atlanta, GA 30333 (Marano, Rossiter, Stamey, Joyce, Barrett,
Angulo); and the Office of Surveillance and Compliance, Center
for Veterinary Medicine, Food and Drug Administration, 7500
Standish Pl, HFV-12, Rockville, MD 20855 (Tollefson).
Dr. Marano’s present address is the Meningitis and Special Pathogens
Branch, MS C-O9, Centers for Disease Control and Prevention,
1600 Clifton Road, Atlanta, GA 30333.
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1829
1812_1836.qxp 9/23/2005 2:44 PM Page 1829
1830 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
At CDC, isolates are tested for susceptibility using min-
imum inhibitory concentrations (MIC). Salmonella isolates
are tested with a semi-automated system
a
for susceptibility to
17 antimicrobial agents. Campylobacter isolates are tested
using the E-test system
b
for susceptibility to 8 antimicrobial
agents. Data are analyzed by a SAS system.
c
Results
From 1996 through 1999, 5,592 NARMS
Salmonella isolates were serotyped and tested for sus-
ceptibility. In 1999, the most frequently isolated
serotypes included S Typhimurium (24%) and S enter-
itidis (18%). Other common serotypes included S
Newport (6.5%), S Heidelberg (6%), S Montevideo
(3.5%), S Muenchen (3.4%), and S Javiana (2.8%).
Other serotypes accounted for 36% of isolates and
included 120 other serotypes. Antimicrobial resistance
is more common in some serotypes than others. In
1999, all S Hadar isolates and 51% of S Typhimurium
isolates were resistant to ≥ 1 agent, whereas only 2.4%
of S Javiana isolates were resistant to ≥ 1 agent. In
1999, 26% of Salmonella isolates were resistant to ≥ 1
antimicrobial agent. Although most Salmonella isolates
remain susceptible to the 17 antimicrobial agents test-
ed, several concerning trends in antimicrobial resis-
tance among Salmonella are evident. These include
multi-drug resistance, highly resistant isolates, and the
emergence of resistance to ceftriaxone and fluoro-
quinolones, which are antimicrobial agents commonly
used to treat people with Salmonella infections.
Increasing multiresistance is most evident within
certain serotypes, particularly S Typhimurium. In
1999, 28% of S Typhimurium isolates were resistant to
ampicillin, chloramphenicol, streptomcyin, sul-
famethoxazole, and tetracycline (R-type ACSSuT), the
characteristic pattern of Definitive Phage Type 104.
Some S Typhimurium R-type ACSSuT isolates were
also additionally resistant to kanamycin (11.8%),
cephalothin (8.8%), amoxicillin/clavulanic acid
(6.9%), trimethoprim-sulfamethoxazole (6.9%), ceftio-
fur (2.9%), and ceftriaxone (1%). Another penta-resis-
tant pattern is prevalent among S Typhimurium iso-
lates; resistance is to ampicillin, kanamycin, strepto-
mycin, sulfamethoxazole, and tetracycline (R-type
AKSSuT). The percentage of S Typhimurium isolates
with this pattern increased from 4.5% in 1996 to 11%
in 1999, making it the second most common multi-
drug resistant pattern.
From 1996 through 1999, 59 (1.1%) of 5592
Salmonella isolates were highly resistant, that is, resis-
tant to ≥ 8 of 17 antimicrobial agents. Among highly
resistant Salmonella, 42% were S Typhimurium and
39% were S Newport. Other serotypes included S Berta,
S Stanley, and S Paratyphi-A. The most resistant isolate
in the NARMS collection was an S Typhiumurium vari-
ant Copenhagen isolate; it was susceptible only to
apramycin, amikacin, and ciprofloxacin.
Since 1996, 22 Salmonella isolates were identified
with resistance to ceftriaxone, an extended-spectrum
cephalosporin. Most of these isolates were S
Typhimurium. The percentage of Salmonella isolates
with decreased susceptibility to ciprofloxacin (MIC ≥
0.25µg/ml) has increased since 1996. The percentage
of isolates with decreased susceptibility to
ciprofloxacin was 0.4% in 1996, 0.6% in l997, 0.7% in
1998, and 1.0% in 1999. These data included two
ciprofloxacin-resistant isolates from 1998 to 1999.
From 1997 through 1999, 881 Campylobacter iso-
lates were tested; 60% of Campylobacter isolates were
resistant to ≥ 1 agent; 25% were resistant to ≥ 2 agents.
Of concern, the percent of Campylobacter isolates resis-
tant to ciprofloxacin increased from 13% in 1997 to
18% in 1999.
Discussion
Since 1996, NARMS has accumulated information
on antimicrobial resistance among Salmonella and
Campylobacter isolates collected from humans. Among
Salmonella isolates, several multi-drug resistant strains
are prevalent, particularly S Typhimurium R-type
ACSSuT and AKSSuT. There is also emergence of resis-
tance to antimicrobial agents that are commonly used
to treat people with Salmonella infections (ceftriaxone
and ciprofloxacin).
Increasing resistance to ciprofloxacin is also evi-
dent among Campylobacter isolates.
The public health utility of NARMS data is wide-
ranging; the data have supported field investigations of
outbreaks of illness marked by a pathogen that dis-
played an unusual antimicrobial resistance pattern,
provided data for a risk assessment of the human
health impact of fluoroquinolone use in poultry, stim-
ulated research in molecular characteristics of resis-
tance emergence and transfer, improved knowledge of
risk factors associated with the development of an
antimicrobial-resistant infection, and triggered broader
research projects of prudent antimicrobial use in ani-
mals and the role of the environment in the emergence
and spread of antimicrobial resistance.
For example, the FDA recently proposed to with-
draw approval of the use of fluoroquinolones in poul-
try based on their risk assessment.
3
The risk assess-
ment concluded that the use of fluoroquinolones in
poultry causes the development of fluoroquinolone-
resistant Campylobacter in poultry, which is transferred
to humans, compromising the use of fluoroquinolones
for the treatment of human Campylobacter infections.
The FDA’s action is based on data from NARMS and
other sources. This example, and others, demonstrate
that the NARMS multi-agency collaboration has
brought the problem of antimicrobial resistance to the
forefront; it is indeed “surveillance for action.”
a
Sensititre, Trek Diagnostics, Westlake, Ohio.
b
E-test system, AB Biodisk, Solna, Sweden.
c
SAS, version 6.12, SAS Institute, Cary, NC.
References
1. Tollefson L, Angulo FJ, Fedorka-Cray PJ. National surveil-
lance for antibiotic resistance in zoonotic enteric pathogens. Vet Clin
North Am Food Anim Pract 1998;14:141–150.
2. National Center for Infectious Diseases, Centers for Disease
Control and Prevention. National Antimicrobial Resistance
Monitoring System (NARMS) for Enteric Bacteria Website. Available
at: http://www.cdc.gov/ncidod/dbmd/narms.
3. Center for Veterinary Medicine, Food and Drug
Administration. Enrofloxacin for Poultry; Opportunity for Hearing.
Federal Register 27832:64954-64965, October 31, 2000. Available at:
http://www.fda.gov/OHRMS/DOCKETS/98fr/1031001.htm.
1812_1836.qxp 9/23/2005 2:44 PM Page 1830
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1831
I
t is important to define what is encompassed by the
term veterinary public health. Public health includes
all those topics that are traditionally associated with the
subject, such as zoonoses, food safety, and environmen-
tal studies, as well as the discipline of epidemiology. In
modern day public health, it is impossible to separate
the study of human diseases related to animals from the
science that studies the distribution and determinants
of disease in human and animal populations.
I approach this topic from the perspective of a per-
son who has spent considerable time in what some
might call public practice, that being 26 years in the
United States Army conducting research on infectious
diseases and research administration. This was fol-
lowed by nine years as head of the Department of
Epidemiology and Community Health at the Louisiana
State University (LSU) School of Veterinary Medicine,
where I taught graduate veterinarians and veterinary
students public health and epidemiology. The
Department of Epidemiology and Community Health
is one of the few stand-alone veterinary epidemiology
and public health departments remaining in a United
States school of veterinary medicine. Finally, for a little
more than a year, I have viewed the training of veteri-
narians and future veterinarians in public health from
the standpoint of the chief administrator of the LSU
School of Veterinary Medicine.
All that said and done, I find myself in a predica-
ment. I cannot say with any certainty what the relative
importance veterinary public health, in the profession-
al program and at the graduate level, will assume in the
crowded curriculums of the new millennium. I can
predict that there will be ups and downs. Like so many
things in life, components of curriculums can be
viewed as a giant sine wave with peaks and valleys that
have a periodicity of five to more than 30 years.
Educators are not very original, and we tend to recycle
things as a new generation of teachers mature. One
common phrase heard at faculty meetings is, “Oh, we
tried that 20 years ago.” Depending on where we are on
the sine wave of veterinary public health (ie, in a
trough or on a peak), we may think that outlook is
either gloomy or rosy.
Still, I think there are some things we can look at
that will help us make some predictions on what we
might see in the short term. They are:
' What will be the relative importance of public
health and epidemiology in medicine and health in
the near future?
' How much of public health will be related to veteri-
nary medicine and what role will veterinarians play?
' What are the external and internal factors and
pressures on schools of veterinary medicine that
will influence the teaching of public health?
First, what will be the relative importance of pub-
lic health and epidemiology in medicine and health in
the near future? I think the outlook for public health is
very bright. I believe it will be the most critical and
important thrust in medicine for the foreseeable future.
The world’s major health problems and emerging dis-
eases are almost all related to public health. Many of
the factors responsible for making public health a high
priority for funding and research include human
demographics, international travel and commerce,
technology and industry, microbial adaptation and
change, human encroachment into wilderness areas,
global climate changes, and bioterrorism.
Human demographics account for societal events
that encompass such things as population growth,
which is in part responsible for deforestation, war, and
malnutrition. Also included are those preventable
human diseases classified as behavioral risks. These
include everything from not wearing a seatbelt and
smoking to the human conduct that has contributed to
the current modern pandemic of AIDS. International
travel and commerce needs no explanation. Whether it
is diarrhea caused by cyclospora infection from South
American raspberries, brucellosis from Mexican
cheeses, cases of malaria and leishmaniasis, or new
strains of influenza, all are related to the break down of
trade barriers and the rapidity and ease with which
people can move around the globe.
Technology and industry include such things as
the integration and concentration of food animal pro-
duction facilities. In the United States, trends in all
food animal production are following the poultry
industry. For example, there are less than 350 produc-
ers of swine in the United States today, and conserva-
tive estimates place the number at less than 100 by the
year 2003. The dairy and beef industries are following
suit. All of this translates into increased stress on ani-
mals caused by intensive husbandry practices that
push rapid gains and greater distances that animals
must be shipped for processing. The increase in
Escherichia coli O157:H7 infections in the United
States, as well as the recent epidemic of infections and
deaths in humans and swine in Malaysia caused by the
previously unknown Nipah virus, are believed to be
related to intensive animal husbandry.
Another example of technology’s effect on public
health is the widespread long-term use of corticos-
teroid and immunosuppressant drugs in humans with
cancer and various other medical conditions and those
receiving organ or tissue transplants. Because of this
Public health education of veterinarians
and veterinary students for the future
Michael G. Groves, DVM, MPH, PhD, DACVPM
From the Dean’s Office, School of Veterinary Medicine, Louisiana
State University, Baton Rouge, LA 70803.
1812_1836.qxp 9/23/2005 2:44 PM Page 1831
1832 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
trend, new diseases and life-threatening illnesses
resulting from infectious agents considered to be of
low pathogenicity have emerged.
Recent examples of microbial adaptation and
change are the genetic reassortment of influenza
strains that threaten to cause an influenza pandemic
and the current controversy over the use of low-level
antibiotics in animal feeds. For years, those of us in the
veterinary profession have questioned whether med-
icated feeds contribute measurably to increased resis-
tance in human pathogens. The answer now appears to
be yes. A Minnesota study revealed an increase in
quinolone-resistant Campylobacter jejuni infections
that were acquired from poultry.
Human encroachment into wilderness areas
results in closer contact with wild animals and vectors
of disease. Fairly recent examples include the outbreak
of monkey pox in humans in Africa, and borreliosis,
babesiosis, and ehrlichiosis, all tick-transmitted dis-
eases that have arisen in the United States because of
increased intrusion into underdeveloped and undo-
mesticated areas.
Global climate changes brought about by El Niño
and La Niña account for epidemics of Rift Valley fever
in Africa and new world hantavirus infections and
deaths in the southwestern United States. During the
past two years, we have seen deaths of large bulls in
Louisiana caused by persistent hyperthermia, which
has been attributed to drought and higher than normal
ambient temperatures.
Finally, during the past two years there has been
an increased fear that the United States is vulnerable to
bioterrorism aimed at human, livestock, or crop tar-
gets. Governmental public health, agricultural, law
enforcement, and national defense organizations have
all greatly increased their financing in these areas to
educate first responders, upgrade diagnostic laborato-
ries, establish communication networks, and develop
rapid diagnostic methods.
If we are convinced that public health will be an
expanding field over the next decade and beyond, the
question then becomes a matter of how much of the
public-health pie will be related to veterinary medicine
and what role veterinarians will play. Even narrowly
defined, I believe veterinarians will be involved in lead-
ing large portions of public health activities focusing
on disease control and research. Veterinarians are cur-
rently doing this in such traditional areas as food safe-
ty, zoonosis control, and regulatory medicine. Some
public health veterinarians function seamlessly across
veterinary and strictly human-disease-related spheres.
This will no doubt expand in the future as the need for
public health professionals increases.
I conclude that the future is bright for public
health careers in general and in veterinary public
health specifically. The question now becomes a matter
of what internal and external factors will influence the
relative importance of veterinary public health educa-
tion in the curricula of United States veterinary
schools. One is that students are not drawn to veteri-
nary medicine because they are seeking a career in
public service. Overwhelmingly, veterinary students
enter professional school with the goal of practicing
clinical medicine. A few students will begin to think of
alternatives to practice in the second and third years,
and, depending on their clinical experience, some may
even make a career change in their final year. These
conversions from the “dark side” usually result from
either disappointments in the clinical training or posi-
tive experiences in public health course work or sum-
mer jobs.
Schools are moving away from the passive model
of letting students choose their careers by default to a
more active, anticipatory approach. First-year students
are frequently required to take courses that provide
career options in addition to such topics as history, vet-
erinary administrative structures and professional
organizations. Later in the curriculum, students may
take specialized electives that may include working in
areas of public health and epidemiology.
One trend in graduate public health education is
the dissatisfied practitioner who is looking for a career
change. These individuals have spent a varied amount
of time in clinical practice and found it wanting. One
extreme example of this at LSU was a particularly out-
standing student in his early 40s. He had owned and
operated a solo dairy practice in Oregon for 17 years.
Two things influenced this individual to pursue a
career in public health. One was a strong social com-
mitment, and the second was the fact that he was
exposed to an excellent public health program at the
University of Minnesota during his veterinary training.
The important message here is that faculty and
school administrators must continuously deliver the
message about the rewards and challenges of a public
career, and they must never underestimate their
responsibility as a role model. It is a basic precept of
academia that students are relentlessly judging faculty
and their education. These have long-range conse-
quences from alumni donations to career choice. Also,
it is important that at least some schools of veterinary
medicine maintain a nucleus of public health faculty
capable of providing graduate education. If veterinary
schools do not do this, then all public health training,
including veterinary public health, will be done at
schools of public health, medical schools, or some
other academic setting.
A factor that negatively impacts veterinary public
health education during professional education is the
crowded curricula. In the early days of veterinary edu-
cation, physiology, histology, and gross anatomy con-
sumed large portions of the curriculum simply because
that was where the science existed and there were
excellent textbooks on these subjects. Relatively little
was known about other disciplines. Later, pathology,
pharmacology, microbiology, and parasitology assumed
importance as these disciplines matured. This was the
situation until the 1970s when there was an upsurge of
specialization and knowledge in the clinical sciences
and some of the basic sciences. This is still true and
will no doubt continue well into the millennium.
Great advances have been made in basic science
areas such as immunology, pharmacology, and micro-
biology because of the advent of recombinant DNA
techniques and other advanced technologies. The basic
science teaching, if we can call veterinary public health
1812_1836.qxp 9/23/2005 2:44 PM Page 1832
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1833
a basic science, began to shrink to make way for hith-
er to unheard of courses like problem solving, ethics,
practice management, animal behavior, and informat-
ics, and the more specialized clinical courses such as
production management, oncology, cardiology, anes-
thesiology, and exotic and laboratory animal medicine.
This downsizing of some traditional areas was not all
bad, because many of them were overtaught.
Despite this reluctance to change, curriculum
review is an ongoing, albeit contentious, process. The
curriculum is under the control of and jealously
guarded by the faculty at all the schools of veterinary
medicine with which I am familiar. Because of our
large teaching hospitals, clinicians make up approxi-
mately half of most faculties, so there is some danger
that curricula in veterinary schools can become
skewed toward the clinical sciences. Clinical faculty
are not, however, unreasonable, and most are aware of
the increasing importance of public health and epi-
demiology in our modern society. We in public health
occupy a unique position in veterinary schools in that
we sit with one foot in the basic sciences and one foot
in the clinical sciences. Therefore, it is up to us to con-
tinuously demonstrate our importance and relevance
to all members of the academic community to ensure
support for our programs. Also, we in public health
must likewise be sensitive to the need to create a bal-
anced curriculum that does not overload veterinary
medicine at the expense of biomedical and basic sci-
ences.
The size and content of public health and epi-
demiology courses in a curriculum implies that their
presence is not debatable. One particular threat to pub-
lic health as a separate academic subject is the notion
that public health is taught across the entire curricu-
lum in all disciplines and courses. For example, the
dermatologists will teach the public health aspects of
ringworm, parasitologists will teach the prevention of
visceral larval migrans, and microbiologists will speak
to the epidemiology of Borrelia burgdorferi infections.
This is just not true, and meticulous reviews of curric-
ula will substantiate this. Let us take, for instance, an
important zoonotic disease such as rabies. Rarely will a
microbiology instructor (which in many schools is not
a veterinarian) or a clinician discuss the epidemiology
of rabies, wildlife vaccination, pre- and post-exposure
prophylaxis, or the various quarantine periods. In
addition, there are a whole host of important zoonotic
diseases such as cat scratch disease, borreliosis, plague,
Rocky Mountain spotted fever, and tularemia that
cause little or no disease in domestic animals. Also, key
subjects such as pet animal bites, animal-bite infec-
tions (probably the most important modern day
zoonotic disease), environmental toxicology, and food
safety do not lend themselves to inclusion in the teach-
ing of other disciplines. A stand-alone public health
course and faculty is a must!
Finally, there are budgetary constraints that can
threaten the future position of public health in veteri-
nary curricula. State funding for higher education has
suffered over the past few years. The public’s demand
for lower taxes combined with their desire for
improved health care, highways, and crime prevention
has meant that funding for most state universities has
not kept pace with inflation. To save money, schools
have tended to consolidate departments so that many
basic science disciplines are lumped together in a sin-
gle megadepartment. This leads to a loss of identity
and, more importantly, can lead to an imbalance in dis-
ciplines if a strong department head selectively hires
new faculty in a single research area. Also, more and
more, schools of veterinary medicine are turning to
alternative funding sources, such as private develop-
ment dollars and research grants and contracts. At
LSU, only slightly more than half of our budget is made
up of state appropriated monies.
To maximize their portion of the research funds
available from federal agencies, schools have moved
away from their strong agriculture connection and
begun to paint themselves as the biomedical research
facility of the campus. This has increasingly meant
that, more and more, basic science faculty are hired for
their research competence and, more specifically, their
ability to bring in the large, federally funded grants
related to human health or the environment.
Consequently, many new faculty in the basic sciences
are not veterinarians, but rather PhDs with existing
grants and postdoctoral experience. If I may use my
own school again to illustrate, the Department of
Microbiology and Parasitology at LSU, a truly out-
standing research department, has 11 faculty, only
three of whom are veterinarians. Classic veterinary
public health and epidemiology does not lend itself to
securing large research grants, but there are areas close-
ly allied with human health and environmental toxi-
cology that can be exploited. Also, the renewed inter-
est in food safety by the public and increased funding
in this area is encouraging.
Given that public health has a place in the veteri-
nary school curriculum, what should be taught in the
modern curriculum? I believe the core teaching should
be unchanged from what it has been over the past few
decades. Epidemiology, zoonoses, food safety, and the
environmental aspects of public health are all still
important. Beyond that, electives that offer advanced
concepts or hands-on training should be offered. Some
schools will allow tracking so students can emphasize
a particular area, such as equine, small animal, food
animal, or public practice.
In conclusion, I believe that, for the foreseeable
future, public health will occupy a small but important
niche in schools of veterinary medicine. To ensure this,
we must continue to have advocates for veterinary
public health at university and national levels. We
must also communicate to our best and brightest stu-
dents the advantages and rewards of a career in public
practice. And finally, we must seek to retain and grow
good graduate and resident training programs.
Symposium continued on next page.
1812_1836.qxp 9/23/2005 2:44 PM Page 1833
1834 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
S
ince the beginning of the 20th century, veterinarians
have contributed to the health and welfare of ani-
mals, humans, and the environment. In fact, that centu-
ry marked nearly the entirety of American veterinary
medicine to date, as the American Veterinary Medical
Association was christened in 1898 (subsequent to its
origin in 1863 as the United States Veterinary Medical
Association), and there were few graduates of American
veterinary colleges until the early 1900s.
1
At the dawn of
the century, nearly all veterinarians were engaged in pri-
vate general practice, with horses being the focus of
those practices.
2
Today, more than 70,000 veterinarians
in the United States are engaged in a wide variety of pri-
vate, public, corporate, and government endeavors and
may pursue one of 20 board specialties. Among the first
of these board specialties was the American College of
Veterinary Preventive Medicine (ACVPM), officially
recognized by the AVMA in 1951.
3
The Apr 2, 1999,
issue of the Centers for Disease Control and Prevention’s
Morbidity and Mortality Weekly Report celebrated the
20th century’s greatest public health achievements in the
United States.
4
The ACVPM’s 50th anniversary of its
founding provides a similarly fitting occasion to identify
and celebrate a few of the many veterinary public
health/preventive medicine accomplishments during the
past century. Although it would be impossible and per-
haps inappropriate to exhaustively list or prioritize those
contributions within this text, we offer this categorical
summary of some of the more important.
Animal Disease Eradication
Largely attributable to the efforts of local, state,
and federal veterinarians, the following diseases were
eliminated (year of elimination is in parentheses) from
animal populations within the United States
1
:
' Contagious pleuropneumonia (1892)
' Fowl plague (1929)
' Foot and mouth disease (1929)
' Glanders (1934)
' Dourine (1942)
' Cattle tick fever (1943)
' Vesicular exanthema of swine (1959)
' Screwworm myiasis (1959)
' Sheep scabies (1973)
' Exotic Newcastle disease (1974)
' Classic swine fever (hog cholera, 1978)
Laboratory Animal Science
The first professor of laboratory animal science in
the United States was Dr. Carl Schlotthauer, appointed
in 1945 at the University of Minnesota. Dr. Charles
Griffin oversaw the development of pathogen-free ani-
mal colonies at the New York State Board of Health
Laboratories from 1919 to 1954. Other veterinary pio-
neers in laboratory animal medicine included Dr.
William Thorp at the National Institutes of Health, Dr.
James Steele at the Centers for Disease Control and
Prevention, and Dr. Karl Meyer at the University of
California at San Francisco.
1
Infectious Disease Control
In 1900, tuberculosis was the single leading cause
of death in humans in the United States
1
and common-
ly resulted in malformations in the bones of children.
Of this disease burden, 40 to 50% was reported to be
bovine in origin. Constant veterinary disease control
measures have reduced this prevalence to near zero
among Americans and marked the passing of the
hunchback.
5
The early 1900s also saw the discovery of
the etiologic agents for many prevalent animal diseases.
Among these were African horse sickness (1900),
rinderpest (1902), sheep pox (1902), rabies (1903),
hog cholera (1903),
1
and the first discovery of a viral
cause of a cancer, fowl leucosis (1908).
a
On a broader
scale, the first cancer-preventing vaccines, which are for
protection against Marek’s disease and feline leukemia
virus, were developed by veterinarians and are con-
tributing to the development of human applications.
1
Livestock Herd Health and Production
Optimization
In 1937 and 1938, Dr. C.L. Cole, who was at the
North Central Experiment Station at Grand Rapids,
Minn, was the first to demonstrate that large numbers
of cows could be bred successfully by artificial insemi-
nation.
1
The first calf sired by artificial insemination of
frozen semen was born in 1953.
1
A 10-year dairy pro-
duction study published in the late 1940s noted that
among the many benefits of annual physical examina-
tions for dairy cattle was an average increase in milk
production by 40 percent.
6
Food Safety (Human)
Although the 1904 publication of Upton Sinclair’s
provocative book The Jungle led to the dismissal of Dr.
Daniel E. Salmon from the fledging Bureau of Animal
Industry, the resultant public furor successfully rein-
vigorated his mission and facilitated the promulgation
of the Meat Inspection Act of 1906.
a,1
Dr. Salmon’s total
contribution to foodborne disease control was consid-
ered so valuable that the Salmonella spp were named
for him. Montclair, NJ, was the first community to
Ten great veterinary public health/preventive medicine
achievements in the United States, 1901 to 2000
Donald L. Noah, DVM, MPH, DACVPM; J. Kevin Grayson, DVM, PhD, DACVPM; Lester C. Caudle III, MD
From the Office of the Surgeon General, United States Air Force, 110
Luke Avenue, Bolling AFB, DC 20332-7050 (Noah); Tricare
Golden Gate Region, 510 Mulheron Street, Travis AFB, CA 94535
(Grayson); and the Office of the Surgeon General, Medical Corps,
United States Army, Pentagon, VA 20310 (LTC Caudle). Dr. Noah’s
present address is 902 Seminole Road, Frederick, MD 21701.
The views expressed in this article are those of the authors and
should not be construed as an official Department of Defense or
United States Government position, policy, or decision.
1812_1836.qxp 9/23/2005 2:44 PM Page 1834
JAVMA, Vol 217, No. 12, December 15, 2000 Vet Med Today: Public Veterinary Medicine 1835
institute routine microbiologic examination of milk in
1900; in 1908, Chicago was the first to require pas-
teurization of dairy products,
1
and in 1948, Michigan
became the first state to implement a state-wide milk
pasteurization law.
7
In the 1920s, veterinarians also
accomplished the basic work in developing the United
States Public Health Service Milk Ordinance and
Code.
a
Although slow to achieve industry acceptance,
irradiation of food has been shown to have substantial
beneficial effects on the safety and quality of many
foodstuffs. Previously approved for items such as
spices, fruits, vegetables, and poultry, ionizing radia-
tion was approved for use in 1999 to reduce bacterial
loads on frozen raw meat and meat by-products.
8
Recognition and Enhancement of the
Human-Animal Bond
Throughout recorded history, mankind has
befriended and benefited from its association with ani-
mals. Indeed, the histories of all animals, including
humans, cannot be dissociated. That symbiotic part-
nership, perhaps the cornerstone of veterinary medi-
cine, became the life work of Dr. Leo Bustad, who once
stated, “One cannot have a healthy community with-
out a strong human-animal bond.”
9
From an enhanced
understanding of that inextricable bond have evolved
such relationships as guide dogs for the sight and hear-
ing impaired and military working dogs. Further, the
positive physical and psychologic benefits of these
human-animal relationships, such as the lowering of
blood pressure
10,11
and as companions for elderly and ill
people,
12
have been described.
Border Inspection/Surveillance
The USDA has the responsibility for preventing
the introduction or reintroduction of foreign animal
diseases into the United States. The Herculean propor-
tions of this task are exemplified by the fact that prior
to free trade, the United States imported 1.9 million
cattle, 700,000 swine, and about 28 million birds
annually.
13
Inspecting representative samples of these
animals and their by-products is the task of the veteri-
narians, directly or indirectly, of the USDA. This effort
has been greatly aided since 1954 by the USDA Foreign
Animal Disease Diagnostic Laboratory on Plum Island,
NY, which provides valuable research toward the pre-
vention and control of these biologically and econom-
ically devastating diseases.
1
Surgery and Medicine
In the field of fracture repair, Dr. Otto Stader
developed the first steel pin method for external frac-
ture fixation.
a,14
This was followed in the 1950s by Dr.
H. A. Gorman’s development of the first surgically
implanted prosthetic hip joint and Dr. F. L. Earl’s dis-
covery of the tranquilizing effects of reserpine.
a
Regional anesthesia via the spinal route was first intro-
duced into the United States in 1926 at a meeting of
the American Veterinary Medical Association.
15
Uniformed Services Veterinary Medicine
In 1916, with the establishment of the United
States Army Veterinary Corps, the United States was
the last of the industrialized countries to commission a
corps of military veterinarians.
a
During World War II,
Army veterinarians were credited with providing high-
er quality rations for troops as well as more space for
armaments on cargo ships by thoroughly trimming
meat products and freezing them in compact contain-
ers.
16
Dr. Robert A. Whitney, Jr. reached the pinnacle of
United States health care as Deputy Surgeon General,
and later as the Acting Surgeon General in 1993. Today,
veterinarians in the United States Army, Air Force, and
Public Health Service contribute substantially to mili-
tary and civilian public health missions, such as
human and animal disease control, occupational
health, food safety, medical research, deployment
health surveillance, and biological warfare/terrorism
defense.
Integration With Public Health
Practitioners
Under the leadership of Dr. Karl Meyer, an early
architect of veterinary public health, the Hooper
Foundation of Medical Research became a world’s lead-
ing institute for the study of comparative medicine and
zoonotic diseases. Additionally, he developed the orig-
inal curriculum for the University of California School
of Public Health.
1
One of the many important achieve-
ments by Dr. James H. Steele was the status elevation
of veterinarians in the United States Public Health
Service from sanitarians to veterinary medical offi-
cers.
1,17
Finally, one of the most concrete examples of
this integration is provided by the 1964 publication of
Dr. Calvin Schwabe’s seminal work, Veterinary Medicine
and Human Health.
1
Historically, the term public health has referred to
the process of the betterment of groups of humans
through medical assessment, surveillance, research,
and intervention (primarily by physicians) and that
veterinary public health applied exclusively to groups
of animals.
a
Evidence of the integration of these activi-
ties is provided by the ACVPM’s 1989 definition of vet-
erinary preventive medicine. In essence, veterinary
preventive medicine is an integral component of the
process of improving animal and human health
through the prevention and control of animal diseases,
infectious waste contamination, and related human
diseases.
18
The future of this integration was eloquent-
ly stated by Dr. Calvin Schwabe:
The real challenge of one medicine derives, therefore,
from the fact that veterinary medicine, like human medi-
cine, is a human activity which was created by man most-
ly for its positive effects upon man’s physical and mental
well-being, that is his own health. This is not to say vet-
erinary medicine’s creation did not also reflect concern for
other animals’ well-being, because it did so in those cir-
cumstances where man closely identified himself with
other animal species, as he did, for example, in creating
many of his religions. Realization that veterinary medi-
cine is a human health profession, however, whatever
these additional qualities, extends the social conse-
quences of one medicine far beyond most current percep-
tions of each of its branches functioning separately.
19
a
Dr. Edward L Menning, National Association of Federal Veterinarians,
Washington, DC: Personal communication, Sep 29, 1993.
1812_1836.qxp 9/23/2005 2:44 PM Page 1835
1836 Vet Med Today: Public Veterinary Medicine JAVMA, Vol 217, No. 12, December 15, 2000
References
1. Dunlop RH, Williams DJ. Veterinary medicine: an illustrated
history. St Louis: Mosby-Year Book Inc, 1996;421, 424, 559, 560,
564, 565, 574, 579, 580, 639, 653, 656, 664.
2. Armistead WW. From my armchair: Y2K. J Am Vet Med
Assoc 2000;216:1081.
3. American Veterinary Medical Association. 2000 Membership
Directory & Resource Manual. Schaumburg, Ill: AVMA, 2000.
4. Centers for Disease Control and Prevention. Ten great pub-
lic health achievements—United States, 1900–1999. MMWR Morb
Mortal Wkly Rep 1999;48:241–243.
5. The passing of the hunchback [advertorial]. J Am Vet Med
Assoc 1940;96:iii.
6. 40% more milk [advertorial]. J Am Vet Med Assoc 1946;
109:xxxv.
7. Steele, JH. History, trends, and extent of pasteurization. J
Am Vet Med Assoc 2000;217:175–178.
8. Meat irradiation gets green light, approval process stream-
lined. J Am Vet Med Assoc 2000;216:472.
9. Olson PN. The human-animal bond: a multidisciplinary
approach for the 21st century using guide dog schools as a model.
2000 Convention Notes. Schaumburg, Ill: American Veterinary
Medical Association, 2000;320–321.
10. Anderson WP, Reid CM, Jennings GL. Pet ownership and
risk factors for cardiovascular disease. Med J Aust 1992;157:298–301.
11. Nagengast SL, Baun MM, Megel, et al. The effects of the
presence of a companion animal on physiological arousal and behav-
ioral distress in children during a physical examination. J Pediatr
Nurs 1997;12:323–330.
12. Beck AM, Meyers NM. Health enhancement and com-
panion animal ownership. Annu Rev Public Health 1996;17:
247–257.
13. Animal and Plant Health Inspection Service, United States
Department of Agriculture. Report to the import-export committee of
the US animal health association. Washington, DC: USDA–APHIS,
1993.
14. That bones may mend [advertorial]. J Am Vet Med Assoc
1944;104:iii.
15. Easier childbirth [advertorial]. J Am Vet Med Assoc
1945;106:iii.
16. More space for armaments [advertorial]. J Am Vet Med Assoc
1942;101:iii.
17. Steele JH, Blackwell MJ, Andres CR. The 50th anniversary
of the veterinary medical corps officers of the US Public Health
Service. J Am Vet Med Assoc 1998;212:952–954.
18. Murnane TG. ACVPM: historical and future perspectives.
2000 Convention Notes. Schaumburg, Ill: American Veterinary
Medical Association, 2000;802.
19. Schwabe C. Veterinary medicine and human health. 3rd ed.
Baltimore: Waverly Press, Inc, 1974.
1812_1836.qxp 9/23/2005 2:44 PM Page 1836