WASHINGTON – Baltimore City health officials who are sniffing around for signs of bioterrorism have turned to dogs and cats — specifically, dead dogs and cats.
Because smaller mammals might be more susceptible to the effects of a bioterrorism attack, the city has started keeping tabs on how many dead dogs and cats are collected daily, said Health Commissioner Peter Beilenson.
It’s one prong of the city’s low-cost bioterrorism surveillance system, which will monitor emergency rooms, ambulances and elementary schools. Beilenson also hopes to track over-the-counter drug sales, with emergency legislation requiring city pharmacies to comply expected to be introduced at a council meeting next week.
“We’re looking at several different streams of data that make sense,” Beilenson said. “None are perfect markers, but when put together, they make a pretty good surveillance system.”
The initial signs of a bioterrorism attack are the symptoms of a common cold or flu for humans. Such attacks could be deadly, but can be treated with common antibiotics if detected early enough, which is why health officials have focused on surveillance.
“We’re looking for common symptoms in uncommon numbers — any major spikes,” Beilenson said.
Using animals to track human diseases is not new — Maryland and other states have been tracking the progress of West Nile virus through the trail of dead crows the disease has left.
Tracey McNamara was the first to identify West Nile Virus in New York crows in 1999. The Bronx Zoo pathologist said it is important for public health officials to forge partnerships with veterinarians and local zoos to stay on top of outbreak surveillance.
“I’m urging public health to tap into veterinary resources,” McNamara said. “It doesn’t matter if it’s in a dog, cat, flamingo, rabbit or monkey. We’ve just got to know about it and diagnose it.”
But Baltimore’s plan does not require diagnosis — just corpses.
Animal Control typically picks up four or five dead animals a day, Beilenson said, and any sharp increase in that number would raise concerns.
State Veterinarian Roger Olson said veterinarians are not required to report all animal deaths but that most vets and animal control boards do report any unusual animal diseases or large numbers of deaths to their health departments. Olson, of the state Agriculture Department, also said he is in regular contact with the state health department.
The Maryland Department of Health and Mental Hygiene, meanwhile, is reaching out to vets to help with the state’s bioterrorism plan, said the department’s Ross Brechner. He said the department has sent veterinarians a manual about bioterrorism response and that, while it does not have a formal tracking system, it has been keeping track of any unusual animal deaths.
Baltimore began surveillance for bioterror on Sept. 12, the day after hijackers crashed airliners into the Pentagon, the World Trade Center and a field in southwestern Pennsylvania.
Records from the average 300 daily ambulance runs have been reviewed since then for suspiciously large numbers of respiratory or gastrointestinal complications, the likely initial symptoms of many biological agents. On Oct. 1, officials began monitoring the 10 hospital emergency rooms in the city to look for similar symptoms.
Beilenson said the city plans to begin monitoring absenteeism at schools Monday and monitoring over-the-counter drugs sold at pharmacies in the next few weeks.
Johns Hopkins University has been testing the pharmacy monitoring at select drug stores, and Beilenson hopes to make it citywide. It is important, he said, because most people who experience the cold or flu-like symptoms of a bioterror attack would probably buy an over-the-counter treatment rather than make a trip to the emergency room.
Animal, ambulance and emergency room data comes in once every 24 hours, so “it’s not exactly real-time,” Beilenson said. But it doesn’t really need to be, since most biological agents have an incubation period of a few days before symptoms develop.
While the system is not without flaws, it is running “for free,” said Beilenson.
The data was already being recorded and health department officials can pull the information up on a personal computer with a couple clicks of the mouse. Two statisticians and Beilenson review the data every weekday and on weekends it can be checked by one of the statisticians from his home computer.
“It has cost us nothing,” Beilenson said. “We are collecting existing data.”
But that hasn’t stopped the city from applying for a federal grant to finance the system. Beilenson said the money would mainly be to staff to oversee the data collection.
“The system is not perfect, but we’re fixing it as we go along,” Beilenson said. “It’s not the Cadillac, but you don’t need the Cadillac.”