PM1ch30.pdf

The Role of Veterinary Public Health and Preventive Medicine During Mobilization and Deployment

Chapter 30

THE ROLE OF VETERINARY PUBLIC

HEALTH AND PREVENTIVE MEDICINE

DURING MOBILIZATION AND

DEPLOYMENT

VICKY L. FOGELMAN, DVM, MPH; JOANNE BROWN, DVM; GEORGE E. MOORE, DVM;

W. DAVID GOOLSBY, DVM, MPH; RANDALL THOMPSON, DVM; AND PAUL L. BARROWS, DVM, P H D

HISTORICAL PERSPECTIVE

VETERINARY MOBILIZATION FORCE STRUCTURE

PUBLIC HEALTH AND PREVENTIVE MEDICINE RESPONSIBILITIES

Food Safety and Quality Assurance

Disease Prevention and Control

Research Support

Military Working Dogs

SUMMARY

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Military Preventive Medicine: Mobilization and Deployment, Volume 1

V. L. Fogelman ; Colonel, US Air Force, BSC; Academic Director, International Health Program, US Air Force Radiobiology Research

Institute, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603

J. Brown ; Colonel, Veterinary Corps, US Army (Retired); Rt 2 Box 152B, Monticello FL 32344; formerly, DoD Veterinary Laboratory,

2472 Schofield Road, Bldg 2632, Fort Sam Houston, TX 78234-6232

G. E. Moore ; Colonel, Veterinary Corps, US Army; Chief, Department of Veterinary Sciences, Army Medical Department Center

and School, Bldg 2840, Suite 248, 2250 Stanley Road, Fort Sam Houston, TX 78234-6145

W. David Goolsby ; Lieutenant Colonel, Veterinary Corps, US Army (Retired); 1247 Shadowood Drive, Spartanburg, SC 29301;

formerly, Chief, Plans and Programs, DoD Veterinary Service Activity, 5109 Leesburg Pike, Falls Church, VA 22041

R. Thompson ; Major, Veterinary Corps, US Army; Attn: Commander, EAMC-VS (Korea), Unit 15252, APO AP 96205-0025; formerly,

Chief, Field Services Branch, Department of Veterinary Science, AMEDD Center and School, 2840 Stanley Rd, Fort Sam Houston,

TX 78234

P. L . Barrows ; Colonel, Veterinary Corps, US Army (Retired); 56 Crazy Cross Road, Wimberly, TX 78676; formerly, Director, DoD

Ve terinary Service Activity, Chief, US Army Veterinary Corps, Department of Veterinary Sciences, Army Medical Department Cen-

ter and School, Bldg 2840, 2250 Stanley Road, Fort Sam Houston, TX 78234-6145

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The Role of Veterinary Public Health and Preventive Medicine During Mobilization and Deployment

HISTORICAL PERSPECTIVE

The US military recognized the need for veteri-

narians as early as the mid-1800s. Horses and mules

were a critical component of the fighting force dur-

ing the Civil War, as they had been in previous con-

flicts, but they often received little or no medical

care. Meat procured for the troops was also fre-

quently unwholesome, resulting in significant mor-

bidity and even death among US fighting forces. 1

Although the US Army Quartermaster General ap-

pealed to Congress for creation of a veterinary corps

in 1853, his request was denied; as a result, more

than 1.2 million horses and mules died during the

Civil War due to lack of sufficient veterinary care. 2

After the Civil War, public attention was drawn

to the inhumane and indifferent care of horses and

the failure to protect military forces from unsafe

food and zoonotic diseases. Generals Grant and

Sherman became proponents of an organized mili-

tary veterinary corps after witnessing the inhumane

treatment of animals during the war and recogniz-

ing the positive impact that a well-trained veteri-

nary corps had on the British and German armies.

The formation of the American Veterinary Medical

Association and the Bureau of Animal Industry also

contributed to the effort to establish an organized

veterinary service in the US military. Both organi-

zations represented organized veterinary medicine,

understood the relationship between public health

and preventive medicine, and made appreciable

gains against many animal diseases. 3 These factors,

plus increased Congressional interest after hearing

of the US casualties from beef “embalmed” in form-

aldehyde during the Spanish-American War, re-

sulted in the formation of a military veterinary ser-

vice under the National Defense Act of 1916. 4

The original mission of the Army Veterinary Ser-

vice was to treat horses and mules and to inspect

meat for the Quartermaster Corps. In 1917, the role

of veterinary medicine in human health was recog-

nized as the Veterinary Corps was integrated into

the Army Medical Department. More than 2,000

veterinarians served in the world wars, more than

1,100 in the Korean War, and more than 1,200 in the

Vietnam War. 3,5 There were more than 1,330 Army

veterinarians and veterinary specialists assigned to

the Army veterinary service and 900 more in the

Reserve Component in 1999. The mission of

today’s military veterinary service is to provide

food safety and inspection services, zoonotic dis-

ease prevention and control, laboratory and medi-

cal research support, and clinical veterinary ser-

vices for government-owned animals.

The US Air Force also formed a veterinary ser-

vice after it became a separate entity in 1947. This

service, while similar in function to the US Army

Ve terinary Service, included the additional mission

of overseeing base food service sanitation programs

and performing foodborne illness outbreak inves-

tigations. In 1980, by Congressional mandate, all

clinically related veterinary activities were placed

under the auspices of the Army Veterinary Corps;

veterinarians and veterinary technicians who chose

to remain in the Air Force became public health of-

ficers or technicians with the function of managing

all food safety, communicable disease, occupational

health, medical entomology, epidemiology, and

public health education programs for the base or

command to which they were assigned. The Air

Force still recruits veterinarians as public health

officers.

VETERINARY MOBILIZATION FORCE STRUCTURE

The veterinary deployment force is transitioning

to a flexible structure, which consists of specialized

detachments that can be assembled into a tailored

veterinary support package based on mission needs.

The initial deployment element is a team from the

Ve t e rinary Surveillance Detachment, which pro-

vides the initial food inspection and food microbio-

logical laboratory support, sets up zoonosis control

programs, and provides primary and preventive

care for military working dogs in-theater.

A Veterinary Food Procurement Detachment is

also available to support local procurement of such

foodstuffs as red meats, poultry, eggs, dairy prod-

ucts, ice, and bottled water. Finally, an Animal

Medical Detachment provides full-service medical

and surgical care to deployed military working

dogs. This detachment also supports zoonosis con-

trol programs and civic action animal health pro-

grams as directed.

The US Army Civil Affairs and Psychological

Command, which is part of Special Operations

Command, has veterinary staff officers at the bat-

talion and brigade levels and as part of their

deployable teams. These staff officers establish li-

aison with the host-nation government, coordinate

in-country support, and define potential humani-

tarian civic action projects for US forces within the

mission. Civil Affairs veterinarians are often de-

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Military Preventive Medicine: Mobilization and Deployment, Volume 1

ployed in support of conventional military units

that lack veterinary assets.

Veterinarians are also assigned in support of Spe-

cial Forces operations. During deployments, the

Special Forces Group (SFG) veterinarian may serve

with the Environmental Science Officer as the SFG’s

preventive medicine team. This team focuses on the

prevention of disease and nonbattle injury in Spe-

cial Forces personnel. The preventive medicine

team’s mission includes food and water safety, field

sanitation and hygiene, pest control, and preven-

tion and control of zoonotic diseases. During de-

ployments with a primary medical mission, such

as humanitarian civic action, the veterinarian works

with the host nation to improve the lives of the lo-

cal human population primarily by improving the

health and welfare of their animals. The Special

Forces veterinarian is also involved in sustainment

training of the Special Forces medic. This training

includes a range of topics from zoonotic and for-

eign animal disease recognition to local procurement

of food, including field slaughter and carcass evalua-

tion. The SFG veterinarian serves as a member of the

Group Surgeon’s office and a special staff officer to the

SFG commander on all veterinary matters.

The US Army Veterinary Corps, as the Depart-

ment of Defense (DoD) Executive Agent for Veteri-

nary Services, provides equitable veterinary sup-

port to all the military services. Veterinary Staff

Officers identify resourcing requirements in the

operational plans of the warfighting Commanders

in Chief (CINCs) and individual military services.

Examples of veterinary support across military ser-

vice lines include food inspection support of Navy

supply ships at sea; support of Marines during the

training exercise Operation Ocean Venture, and

support of US Central Command and the Air Force

in Southwest Asia.

PUBLIC HEALTH AND PREVENTIVE MEDICINE RESPONSIBILITIES

Food Safety and Quality Assurance

safety, may be shared among the participating nations.

Differences in standards may exist, but the underly-

ing principles of sanitation and food safety remain.

Food safety involves control of physical, chemical,

and microbiological threats. A potentially hazardous

food (PHF) is a food that is capable of supporting

either the rapid and progressive growth of infectious

or toxigenic microorganisms or the relatively slower

growth and toxin production of organisms such as

Clostridium botulinum . It is the PHFs that are the

biggest concern in food safety. An additional

concern is contamination of generally safe foods (or

non-PHFs) with a significant dose of an infectious

agent, such as the contamination of salad with

Salmonella . Exhibit 30-1 shows examples of PHFs and

of generally safe foods.

Food service in the field must provide nutritious,

wholesome food to military personnel. Veterinary ser-

vices, logistics, food service, and preventive medicine

are all involved in ensuring that wholesome food

reaches the force. Veterinary Service personnel ensure

that all food entering, stored in, procured in, or is-

sued in a theater of operations meets wholesomeness

and quality assurance standards through a series of

inspections beginning before food enters the theater

and ending at the point of issue to personnel. De-

ployed veterinary personnel inspect food intended for

military local purchase in foreign countries, approve

sanitation levels at local food production facilities, in-

spect food transport vehicles, and perform in-storage

surveillance inspections of all foods, including opera-

tional rations. Veterinarians may also on occasion per-

form antemortem and postmortem inspection of food

animals intended for consumption by military forces.

Veterinary personnel also provide recommendations

and support to commanders on disposition of con-

taminated food, foodborne illness outbreak investi-

gations, and food decontamination. Veterinarians are

also trained to inspect, monitor, and test food and food-

producing animals suspected of being contaminated

with nuclear, biological, and chemical (NBC) agents.

During contingency operations, Army veterinary

food inspection personnel are usually located at the

theater surgeon’s office, with area support teams as-

signed to support the food supply system. In multi-

national operations, the responsibility for food pro-

curement, preparation, and delivery, as well as food

Procurement

Assuring the safety of the food supply begins with

procuring wholesome subsistence. Within the

continental United States, numerous government

agencies contribute to the maintenance of a safe food

supply, including state and local public health agencies,

the US Department of Agriculture (USDA), the US

Department of Commerce, and the US Food and Drug

Administration, as well as the Army Veterinary Service.

In most overseas areas of operation, the Army

Veterinary Service and the US Air Force Public Health

Service are charged with performing all of the food

safety functions of these agencies.

All local food production sources must be ap-

proved by the US Army Veterinary Service or the

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The Role of Veterinary Public Health and Preventive Medicine During Mobilization and Deployment

EXHIBIT 30-1

POTENTIALLY HAZARDOUS FOODS

Potentially Hazardous Food is food that is natural or synthetic and that requires temperature control because

it is in a form capable of supporting

1. The rapid and progressive growth of infectious or toxigenic microorganisms,

2. The growth and toxin production of Clostridium botulinum , and

3. In raw shell eggs, the growth of Salmonella enteriditis .

Examples include:

• Food of animal origin that is raw or heat-treated

• Food of plant origin that is raw (eg, raw seed sprouts) or heat-treated

• Garlic and oil mixtures that have not been modified to stop growth of infectious or toxigenic microorganisms

This definition does not include:

• Food in an unopened, hermetically sealed container commercially processed to achieve and maintain

commercial sterility under conditions of nonrefrigerated storage and distribution

• Food for which laboratory evidence demonstrates that the rapid and progressive growth of infectious

or toxigenic microorganisms or the growth of S enteriditis in eggs or C botulinum cannot occur (It may

contain a preservative, another barrier to the growth of microorganisms, or a combination of barriers

that inhibit the growth of microorganisms.)

US Air Force Public Health Service personnel be-

fore the military purchases foods from these sources.

These approvals vary greatly in their complexity, de-

pending on the food being procured (Table 30-1). In

TABLE 30-1

COMPLEXITY OF APPROVAL FOR VARIOUS FOODS

Complexity of

Food

Approval

Reason

Dairy/ice cream

Very complex

Herd health, plant sanitation, equipment

standards, no final consumer safety process

Herd health, plant sanitation

Herd health, plant sanitation, items cooked

before consumption

Flock health, plant sanitation, items cooked

before consumption

Plant sanitation, water source, filtration

systems

Usually not potentially hazardous but may be a problem

if feces (night soil) are used in the growing area

Cooked product, usually not potentially hazardous

Flock health, plant sanitation

Plant sanitation, food handler risks, no final and

prepared foods consumer safety process

Agricultural practices, plant sanitation, water treatment

Processed dairy

Beef, pork, lamb, veal

Complex

Poultry

Complex

Ice and water

Moderately complex

Fresh fruits and vegetables

(whole)

Bakery

Shell eggs

Sandwich, salad, and prepared

foods

Minimally processed fresh fruit

and vegetable juice

Less complex

Moderately complex

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