PERSPECTIVE zoonotic diseases. Of these, 2 require reports of rabies only. Names and contact information were obtained from the US Department of Agriculture Animal and Plant Health Inspection Service website (http://www.aphis.usda.gov/vs/ sregs/official.html) and the Council of State and Territorial Epidemiologists Point of Contact Veterinarians website (http://www.cste.org/). State agencies such as departments of agriculture, environment, or boards of animal health are the usual primary recipients of animal disease reports. However, these agencies may not have the resources to conduct animal disease prevention and control activities at the local level. In addition, in the case of departments of agriculture, their mission, historically, has been to promote agriculture, not necessarily to control infectious diseases in all types of animals. Animal disease reporting and oversight are split between different agencies in some states. This is the situ- ation at the federal level and has prompted a recent National Academy of Sciences report to recommend that a federal-level, centralized coordinating mechanism be established to improve collaboration and cooperation among all the players in animal health oversight, including industry and local, state, and federal agencies (13). A sim- ilar mechanism for improving communication and collab- oration across state agencies, such as between state animal health and public health veterinarians, would be important since evidence suggests that veterinarians preferentially report to more “animal-centric” state agencies. For example, the Alaska Department of Health and Social Services and the Alaska Department of Environmental Conservation (DEC) mailed a laboratory usage and needs assessment survey to all 200 licensed vet- erinarians in Alaska. Of the 140 who responded, 95% stat- ed that they would report to the state veterinarian at DEC, 4% to the state department of health, and 1% to the US Department of Agriculture when asked, “Who would you contact if you suspected or diagnosed a reportable animal disease?” (R. Gerlach, pers. comm.). In 2004, I surveyed 4,144 randomly selected licensed veterinarians in 4 states: New Hampshire, New Jersey, New York, and Pennsylvania. When asked, “Which government agency would you first notify if your companion animal or livestock patient had an unusual infectious disease?” the largest percentage of the 1,070 respondents chose “State Agriculture Agency.” Some veterinarians, ≈10% for com- panion animals and 14% for livestock, would skip the state and local agencies altogether and notify a federal agency. Twenty-eight percent of the veterinarians did not know if their community had a local public health agency. The sur- vey did not include questions about wildlife. Veterinarians’ names and addresses were obtained from each state’s licensing boards except for New York State, which pro- hibits access to this information. For New York State, names and addresses were obtained from the American Veterinary Medical Association (Tables 1 and 2). In addition to working with state officials during seri- ous zoonotic outbreaks, veterinarians should also commu- nicate and collaborate with local public health officials. During the 1999 WNV outbreak, the presumptive diag- noses for the initial human cases included Guillain-Barré syndrome, encephalitis, meningitis, and aspiration pneu- monia. (14). Public health officials assumed the cause of the outbreak was St. Louis encephalitis (SLE) until a vet- erinary pathologist at the Bronx Zoo linked the animal and human outbreaks (12). She realized that crows and other birds ordinarily resistant to SLE were dying, so the agent was not likely SLE. Her work helped set the stage for the discovery of WNV in the Western Hemisphere (12). At the population level, zoonotic pathogens cause food- borne, waterborne, and arthropodborne disease outbreaks. These pathogens include Salmonella, Escherichia coli O157:H7, Cryptosporidium, yellow fever virus, and Borrelia burgdorferi (15). Many of the category A, B, and C bioterrorist agents, such as Bacillus anthracis, Yersinia pestis, Francisella tularensis, Coxiella burnetii, and Nipah virus, cause zoonoses (16,17). The magnitude of the problem of zoonoses illustrates why the efforts of medicine, veterinary medicine, and pub- lic health need to overlap. Taylor and others identified 1,415 infectious agents and found that 868 (61%) could be transmitted between animals and humans (18). They found that zoonotic diseases were twice as likely to be associat- ed with emerging or newly discovered infections than non- zoonotic pathogens and that viruses and protozoa were the zoonotic pathogens most likely to emerge. RNA viruses, in particular, have been identified as highly likely to emerge (19). These agents include WNV, avian influenza virus, hantavirus, and severe acute respiratory syndrome–associ- ated coronavirus. Joint surveillance of animal and human zoonotic disease outbreaks is already reaping benefits worldwide. For exam- ple, recognition of the first human case of H5N1 avian influenza in Hong Kong in 1997 was facilitated by the sur- veillance of ducks, geese, and chickens in southern China during the preceding decades (20). On the domestic front, in 1999, the Centers for Disease Control and Prevention established ArboNET, a cooperative surveillance system that monitors the geographic spread of WNV in humans, mosquitoes, birds, and other animals in response to the out- break of WNV disease (21). ArboNET has provided an invaluable system for tracking the disease’s spread and severity across the United States, identifying early WNV activity, and justifying continuing support for mosquito control (22). These types of surveillance systems should be continued and expanded to include other serious zoonotic diseases such as plague and tularemia. 558 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 12, No. 4, April 2006