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3 Data Surveillance
Janet Scarlett
Cornell University College of Veterinary Medicine, Ithaca, NY, USA
The availability of scientifically and statistically reliable information is essential to improving the health of animal populations.
L.J. King
3.1 Introduction
The management of the health of shelter animals has improved dramatically over the past two decades. The development of shelter medicine training programs and the shelter medicine specialty has driven this progress. Many shelters have proactive healthcare plans for their populations with specific goals to improve population health. Population health‐related protocols such as those designed to improve animal flow, standardize intake exams, and manage risk during outbreaks are now common. However, another component of population healthcare management, routine monitoring of disease‐related summary data (metrics), has not been as widely adopted. This may be partially explained by the traditional emphasis on individual patient care for companion animals provided in veterinary training programs and private practices. Additionally, the widespread use of disease‐related metrics has also been hampered by shelter software that has been slow to facilitate entry and retrieval of the necessary data.
Summary metrics relating to disease surveillance, animal flow and capacity (housing and staffing) are discussed in this chapter to encourage shelter veterinarians to incorporate the use of these metrics into their population healthcare plans. As these metrics are used more extensively, other influential measures can be added.
3.2 Disease Surveillance
Disease surveillance is an integral component of managing and minimizing disease in public health and preventive medicine programs for livestock (Anderson 1982; Horstmann 1974; King 1985; Langmuir 1963). William Farr is credited with formalizing the principles of human disease surveillance beginning in the mid‐1800s in England. In the 1950s (during the height of polio outbreaks) in the United States, the Centers for Disease Control and Prevention (CDC) began formal surveillance programs for human communicable diseases (Langmuir 1963). It was not until the mid‐1980s that the Animal and Plant Health Inspection Service (APHIS) took the lead in developing a national surveillance program for diseases of U.S. livestock species (King 1985).
Routine disease surveillance requires quantification of disease frequency, descriptions of disease distribution among subgroups of animals, analysis and interpretation of data. Formally, disease surveillance is defined as (i) the ongoing systematic collection, orderly consolidation, analysis and interpretation of health‐related data in populations, and (ii) the prompt dissemination of this information to the people who are in a position to act on that data (Nelson and Williams 2007). Disease surveillance plans can include non‐infectious disease, but this chapter will focus on infectious disease.
3.2.1 Importance of Disease Surveillance
Knowing the nature and extent of disease occurrence in shelter populations enables veterinarians to:
assess population health in quantitative terms
set objective and measurable disease‐related priorities
identify outbreaks
plan and monitor the effectiveness of preventive and control measures
rapidly identify “new” diseases/conditions
justify grant proposals, and
clearly communicate the health of their populations to interested constituencies (e.g. Boards of Directors, funding agencies, community).
The basic metrics of interest in disease surveillance in shelters are measures of morbidity (frequency of illness such as incidence), and mortality (frequency of death). Recommended definitions of these metrics for use in animal shelters have been discussed (Scarlett et al. 2017a). An incidence rate is defined as the number of newly diagnosed cases of a particular disease divided by the number of animals that could develop that disease in a specified period. This fraction is usually multiplied by 100 and expressed as a percentage. By comparison, prevalence refers to the percentage of cases of a particular disease that are present in a particular population at a given time. In this chapter, the terminology “frequency of disease” is used to encompass the disease incidence or prevalence,
