Acta Veterinaria Brno, 2000, 69: 69-80 (Amendments on 7 June 2008)
Dictionary of Veterinary Epidemiology. Iowa State University Press, Ames, 1999, XVI and 284 pages. ISBN 0-8138-2639-X
"Dictionary of Veterinary Epidemiology" was published by Iowa State University Press,Ames in 1999 as English edition of the French publication of Toma, Benet, Dufour, Eloit, Moutou and Sanaa: "Glossaire d'épidémiologie animale", Editions du Point Veterinaire, Maisons-Alfort, 1991. The Office International des Epizooties (OIE) provided financial assistance.
The book contains a list of 57 contributors (all but one from North America, France and United Kingdom), 5 pages of Foreword and Preface, 270 pages of term definitions and 4 pages of References. The Foreword stresses that the book presents the "French and the North American perspectives on definitions of terms".
The publication contains definitions of 961 terms of which only a half are epidemiological terms. The rest belongs to general statistics (36 %) and economics (10 %). Unfortunately, many definitions from the French original having 1014 terms were deleted and some new terms were added. A lot of space is allocated to examples (486) and comments (1318).
Original French title is not translated exactly. The terms "animal" and "veterinary" are not of the same meaning. The definitions of these key terms as well of "veterinary epidemiology" used in title (normally indicating publication scope) are missing.
The term "epidemiology" is defined on p. 88 as the "Study of the health status of population." If we compare this definition with the classical "Dictionary of Epidemiology", edited by J.M. Last and published by Oxford University Press in 1995, then we can see a great difference: “epidemiology” is defined as "the study of the distribution and determinants of health-related states or events in specific populations, and the application of this study to control of health problems." This definition stresses dynamics and “makes explicit the aim of epidemiology - to promote, protect, and restore health." Last's publication contains 1399 term definitions (i.e. more by 43 %). One would expect in the "Dictionary of Veterinary Epidemiology" the definitions of much more terms than in human epidemiology due to a large number of animal species, more etiological agents, more environmental and other influencing factors, and more control methods.
Definitions of hundreds of important epidemiological terms currently used in modern human and veterinary literature, documents of international organizations such as OIE, WHO, FAO etc. as well as in veterinary practice are not included. Some of them are only mentioned (however, without definitions) in the comments. Definitions of the most terms of epidemiologically important characteristics of populations, etiological agents and environment and their interactions, representing the basis of population health/disease processes, are missing. Definitions of the majority of indicators used for measuring distribution and determinants of population health-related states and events are missing as well.
The most alarming information about the concept of "new scientific discipline" (p.XIII) which in fact is degrading the epidemiology, is on pp. 110 and 111: epidemiological problems solution belongs to so called "health managers" and not to "epidemiologists" ! This clarifies the relatively low practical importance of this kind of restricted "epidemiology" (less than a "semi-epidemiology") which is being imposed upon international organizations, many countries, undergraduate education and postgraduate training. This clarifies the fact that many so called "veterinary epidemiologists" are not involved in field control programmes with professional responsibility for their results. (What a difference in comparison with clinicians who after case diagnosis solve the problems !) This is obviously the reason why the majority of veterinary faculties have not "veterinary epidemiology" in the list of undergraduate curriculum subjects (in spite of several FAO/WHO recommendations). Epidemiological problems and their solution start and end in the field (usually supported by laboratory investigations) and not in offices. Key output of any animal health activity is a final practical result and not papers. Unfortunately, this dictionary represents a narrow concept based mainly on data collecting, processing and analyzing. The book title should be adjusted to the contents.
One could get the impression that the main concern of this dictionary is to avoid using terms such as "epizootic" (p. 89), "enzootic" (p. 84), etc. and replace them by "epidemic", "endemic", etc. in direct contrast with the French original which accepts these terms without any doubts ! It is strange that this demand is in a publication of the International Office of E p i z o o t i c s which has been using these terms from its foundation in 1924 followed by the member countries. In Last's "Dictionary of Epidemiology" the above mentioned terms are accepted and correctly defined without any polemic. Normal dictionaries first define the terms and then eventually comment on them which is not the case in this book. The contributor instead of defining "veterinary epidemiology" and "epizootiology" tries to impose his view using false, contradictory, unjustified and not convincing arguments without respecting the scientific nomenclature, ethymology and opinion of the others. If we apply his "logic", then does why the book title use the adjective "veterinary" ? He probably doesn't know what "epizootiology" (identifying exactly by one word specific biological science ) means. American Professor Calvin Schwabe wrote: "While the terms epizootic and enzootic are in common usage and are generally understood, the terms epizootiology and epizootiologists are heard less frequently. Strictly speaking epizootiology is a more inclusive term than epidemiology."
The contributor who wrote about these terms has obviously not a good idea about veterinary practice in the world. The terms such as epizootic, enzootic, epizootiology, etc. are long established and widely used in veterinary literature, documents of international organizations, legislation (e.g. Mexican Animal Health Law, 1993), etc. The science of epizootiology was introduced in many veterinary faculties as separate subject (with state examination) supported by textbooks and research. Epizootiology covers not only analytic methods but also methods for promotion, protection and restoration of animal population health (including zoonoses control). The syllabus can be found e.g., in the Report on Consultation on Undergraduate and Postgraduate Teaching in Veterinary Public Health, World Health Organization, 1983. This discipline has educated action-oriented veterinarians able to investigate the situation and apply practical measures at field and managerial levels and not "paper epidemiologists" for comfortable and attractive bureaucratic work in offices only who can also "work" without investigating or even seeing the animals. Aim and contents of any discipline are much more important than its given name !
The key term "Animal health" on p. 10 is defined as: "State of well-being applied to animals." This is very superficial definition not respecting the epidemiological aspects required for practical application (e.g., for trade purposes). Several examples are from human instead from animal medicine (e.g., alcoholism on p. 7). On p. 12, there is a sentence with no biological logic: "In this example, the apparent prevalence would be over seven times greater than the true prevalence." One page example of "Balance sheet" on p. 17 is dedicated to financial position of a business instead to animal population health. Other example having nothing to do with epidemiology is on p. 177 comparing annual profit of self-employed small animal veterinarians being $45000 with pet food company veterinarian making $65000.
On p. 111 the term "Healthy carrier" is contradictory; from the epidemiological point of view the carrier without clinical symptoms cannot be declared as healthy. On p. 120, the text regarding the "incidence", the most used population disease indicator, is very confusing: there are two quite different "incidence rates" - new cases once per time unit and once per number of individuals; difference between "incidence proportion" and "incidence rate" is not clear; difference of reproduction periods (speed) between human and animal populations, influencing denominator values, is not considered (second Comment 2).
Example on p. 147 merits mentioning: "It is assumed that, for every case of salmonellosis recorded in humans in the United States, at least nine are not reported." What about animal diseases data processed by "statistical epidemiologists"; exact calculation of data not corresponding with the reality ?!
On p. 162, there is a calculation mistake. On p. 176 "Operational epidemiology" is explained as "the epidemiology of intervention as opposed to the epidemiology of knowledge." Operational epidemiology is not epidemiology of knowledge ? This reflects the underestimation of field practice work which is decisive in epidemiology. Definition of "Population medicine" on p. 189 cannot be restricted to animal populations only.
There are many other definitions which cannot be generally accepted. There are definitions which differ from French original and create confusions in understanding the terms. I fully agree with the Foreword that "the publication of this dictionary will not end the debates over these terms" (p. XII). In this context it should be mentioned the alibi statement (p. IX) about the list of contributors: "Because they have not reviewed the entire work, their inclusion in this list should not be interpreted as their endorsement of all the definitions." !?.
In spite of the above comments, the effort of all who contributed to this not easy work providing definitions of many useful terms which are not available in other dictionaries, should be appreciated. The publication can serve as one of different sources for a future international dictionary that should cover the f u l l spectrum of animal population health/disease terms respecting the needs, experience and use in the w h o l e world.
Prof.MVDr Vaclav K o u b a, DrSc.
Additional comments (not included in ACTA VETERINARIA BRNO):
a) The “paper veterinary epidemiology” is obviously addressed to the officers of public services working mainly administratively in the offices isolated from daily animal population health problems which solution depends on field practical work where is the decisive stratum of the epidemiology - very complex b i o l o g i c a l science.
b) The degradation of veterinary epidemiology as biological science into something else can be demonstrated by the WHO Consultation on Development and Training in Veterinary Epidemiology, Hanover, Germany, 9-11 October 1990: “The meeting demonstrated the gap between theory based on sometimes excessive use of mathematics and computer modelling without orientation to action and the need for cost-effective practical application in the field. The relative isolation of the sophisticated methodology represent one of the major obstacles for the wide use of epidemiological methodology in veterinary medicine, particularly in the developing world.” Among participating “teachers” of veterinary epidemiology were from several veterinary faculties the mathematicians (!?).
c) False concept of the above described purely theoretical “paper veterinary epidemiology” confused with statistics and economics represents de facto a gravedigger of extremely useful animal population health/disease science as a component of biological sciences.
d) If practical results represent the main criteria of any biological science, then catastrophic occurrence of the foot-and-mouth disease in United Kingdom in 2001, causing the highest losses in modern history - 4 million farm animals, has proved a total failure of the “paper veterinary epidemiology” isolated from the reality and needs. R.P. Kitching, M.V. Thrustfield and N.M. Taylor wrote in “Use and abuse of mathematical models: an illustration from the 2001 foot and mouth disease epidemic in the United Kingdom”, Rev.sci.tech.Off.int.Epiz., 2006, 25(1), 293-311 about much higher numbers: “The official figure for the number of animals slaughtered was approximately 6.5 million, but when the total number of still-sucking lambs, calves and pigs that were slaughtered is included, the total could be as high as ten million. The financial cost of the FMD epidemic in the UK was over 12 billion, including US dollar 4.5 billion in losses sustained by the leisure and tourist industry. However, the social cost could not be quantified”. They supported the very critical opinion of the author of this book review when stating: “During the 2001 epidemic of FMD in the united Kingdom (UK), the traditional approach was supplemented by a culling policy driven by unvalidated predictive models. The epidemic and its control resulted in the death of approximately ten million animals (!!!), public disgust with the magnitude of the slaughter, and political resolve to adopt alternative options, notable including vaccination, to control any future epidemics. The UK experience provides a salutary warning of how models can be abused in the interests of scientific opportunism.” They criticized the mathematical modellers: “Their idea was to control the disease by culling in contiguous farms. That is fine if you are sitting in front of a computer screen in London. However, it is different on the ground !” “The consequences following the recommendations of these models were severe: economically, in terms of cost to the country; socially, in terms of misery and even suicides among those involved in the slaughter programme; and scientifically, in the abuse of predictive models, and their possible ultimate adverse effect on disease control policy in the future.” “The utility of predictive models as tactical decision support tools is limited by the innate unpredictability of disease spread..” “..it was carnage by computer !” This graphically exemplifies the isolation and abstraction of ‘armchair epidemiology’ !” “Approximately three million healthy animals were slaughtered to control the epidemic.” The paper is warning over the use of ever-more-detailed models as policy guides. This example demonstrated very dangerous harmfulness of the “paper veterinary epidemiology” deviating the strategy and measures from the field reality and ignoring biological character of the epizootics and thus causing enormous losses.
e) The “paper veterinary epidemiology” international education/training centres (e.g. Reading, Davis, Teramo, Fort Collins, Maisons-Alfort, etc.) have trained thousands of participants mainly from developing countries. The effect has consisted in theoretical knowledge and data processing skills (using the computers), however, without ability to investigate at field level and analyse animal population health/disease situation identifying and solving the main problems of preventive, control and eradication measures at home.
f) Examples of the “paper veterinary epidemiology” conducing to the “strategy of doing nothing” at field practice level, i.e. admitting animal infection spreading, see also in the paragraph 3.3 of www.cbox.cz/vetmanpower.htm and in the paragraph 2.10 of www.cbox.cz/vaclavkouba/orgglobalization.htm.
g) Authors’ letter to Prof. Dr Toma :
Prague, 20 December 1995
Prof.Dr Bernard T o m a
Chef du Service des Maladies contagieuses
Ecole National Veterinaire d'Alfort
F R A N C E
Dear Professor Toma,
I am writing you regarding the definition of "epizootiology" in your excellent dictionary "Glossaire d'epidemiologie animale", Editions du Point Veterinaire, 1991 which I bought in Paris last year. On page 104 after a short definition of "epizootiology" there is a three-line-note with following sentence: "Ce terme, encore parfois utilise, est a eviter."
I would like to ask you to delete this negative note in the next French issue and in the English version being prepared.
The introduction and use of the term "epizootiology" was influenced by the example of the policy and documents of the "International Office of Epizootics" (OIE) in Paris in the past (e.g. see "OIE Resolutions and Recommendations on Epizootiology and Prophylaxis of the Main Epizootic and Enzootic Diseases: 1924-1974", OIE, Paris, 1974 !). It would be not fair to ask for avoiding the term "epizootiology" today when it is relatively widely used.
The one-word-term "epizootiology" reflects precisely the biological contents respecting scientific language (Greek origin) covering all species of animal kingdom. This term is widely used instead of "veterinary epidemiology" in veterinary theory and practice, legislation, education (undergraduate curriculum, postgraduate programmes, school structure), research and literature (including textbooks) of many countries.
a) Many documents of international organizations use words "epizootiology" and "epizootiological" such as:
- FAO/OIE/WHO World Animal Health Information System
- FAO/OIE/WHO Animal Health Yearbook
- OIE World Animal Health.
- In OIE International Animal Health Code, 1992 on page 17 is the Section 1.2. called "Notification and Epizootiological Information".
- In the Report on WHO Consultation on Undergraduate and Postgraduate Teaching in Veterinary Public Health, Brno,1983 the term "epizootiology" is often used (e.g. in Annexes 10 and 11 are undergraduate syllabi for General Epizootiology).
- FAO Seminaire sur l'epizootiologie et les aspects economiques de la sante animale, Niamey, Niger, 1983.
- Seminario regional de la FAO sobre la epizootiologia y economia de sanidad animal, Lima, Peru, 1984.
b) Many Latin American countries use this term instead of "veterinary epidemiology" (e.g. new Mexican Animal Health Law adopted by Mexican parliament in 1993 for the new conditions of NAFTA uses only terms "epizootiological" and no one word "epidemiological").
c) In the majority of Central and Eastern Europe as well as Central Asia countries "epizootiology" is used in legislation, research, literature, undergraduate and postgraduate education with strong separated action-oriented "Epizootiology" subject in undergraduate curricula (e.g. in Brno and Kosice Veterinary Universities a 240 hours including laboratory and field practicals) supported by university textbooks entitled "General Epizootiology" and "Special Epizootiology" and by University Institutes or Departments of Epizootiology. The terms "epizootiology" and "epizootiological" are used in these countries veterinary practice (incl. networks of specialists called "epizootiologists" - provincial and regional) where "epizootiological" methods have been successfully applied in the field at national and local levels.
d) Also in Western Europe this term is not avoided (e.g. Institute of Bacteriology and Epizootiology in Swedish Veterinary Faculty in Uppsala - Prof.Dr I.Mansson). The paper presented by Foot-and-Mouth Disease World Reference Center in Pirbright at the Session of the Research Group of European Commission for the Control of Foot-and-Mouth Disease in Vienna, September 1994 is entitled "Molecular Epizootiology of FMD type Asia 1"(Report, p.56-60).
e) In "Illustrated Manual for the Recognition and Diagnosis of Certain Animal Diseases", vol. 2, 1988 prepared by top level specialists of Plum Island Animal Disease Center, USA and Mexican-US Commission for the Prevention of Foot-and-Mouth Disease and other Exotic Diseases the heading "Epizootiology" of particular paragraphs is used on pages 7, 17, 20, 25, 30, 64, 71 and 79.
f) In the most important African country - Nigeria the veterinary faculties curricula are using the subject called "Epizootiology" as the component of preventive veterinary medicine education ( see World Veterinary Congress 1995 Abstracts, FC5.4, p. 101 presented by Prof. Dr. Esuruoso).
g) Prof.Dr C. Schwabe in his Veterinary Medicine and Human Health, 1969 on page 163 correctly explains and comments on the term "epizootiology". He also writes: "Strictly speaking epizootiology is a more inclusive term than epidemiology."
Name of "International Office of Epizootics" as well as general use of the term "epizootic" do not support avoiding the use of term "epizootiology".
Epizootiology has had major importance in many countries with prevailing large scale animal production units giving priority to population and preventive medicine aiming to increase animal production and protect human health. Therefore, in these countries General and Special Epizootiology was included in veterinary faculties undergraduate curricula as a separated subject with particular examination (incl. final state exams).
In many of above mentioned countries where so called "new policy" consists in debilitating state veterinary services, population and preventive medicine (under the false monetary arguments) and strengthening curative medicine veterinary is extremely difficult to defend modern animal population health policy and activities against financially attractive pet animals curative practice. At the universities there are powerful clinicians pressing "epizootiology" to be changed in "veterinary epidemiology" and thus, referring to examples of faculties of some developed Anglo-Saxon countries, to be reduced or to disappear from the curricula subjects. "Saved" teaching hours to be added to curative medicine. They use as the arguments, without respecting different national conditions, needs and traditions, the examples e.g. from USA where in none vet. faculty is veterinary epidemiology as separated subject of undergraduate curriculum and is only included in limited size into some other subjects such as veterinary public health (with minimum field practicals components). You can see how the problem of terminology can be abused with very negative impact.
Let the international organizations, countries, veterinary services, schools, institutes and specialists to use the terms which they want and which are locally traditional and proved to be useful under particular country conditions. Avoid imposing from abroad unnecessary changes which create unnecessary problems with negative consequences.
I hope that you have understood correctly my concern particularly now when the English version will be globally distributed and used. Therefore, once again, I would like to ask you to delete the above mentioned note in next issues of your dictionary ! Thanks in advance !
As far as our discussion in Yokohama on the next Symposium of the Association for Veterinary Epidemiology and Economics to be held next year in Paris is concerned, I will send you my proposals soon.
Prof.Dr Vaclav K o u b a , DrSc.
P.B.516 , 17000 Praha 7
Czech Republic, tel.0042-2-374584