Improving Zoonotic Disease Outbreak Detection Practice in the United States Open Access
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Zoonotic diseases are a serious threat to public health; 75% of all emerging infections are zoonotic. There have been few efforts to describe or understand the practice of zoonotic disease outbreak detection and reporting practice in the United States, which is complicated by the federal and bureaucratic system of governance in the United States. Using a mixed-methods approach, this dissertation completes three phases of empirical research: (1) a legal analysis of state reportable animal disease statutes and regulations, (2) an outbreak database to determine who detects zoonotic disease outbreaks and how fast they are detected, and (3) embedded case studies using a survey and interview instrument to understand how federalism and bureaucracy impact zoonotic disease detection and reporting. This dissertation finds that most states have some type of reportable animal disease list, but that there is a wide variation in these lists, with 88 diseases listed on average. The median time to detection of zoonotic disease outbreaks in the United States was 13 days, and laboratories detect zoonotic disease outbreaks both most frequently and most quickly. Finally, respondents reported diagnostics as the most critical factor for rapid zoonotic disease detection and reporting, and highlighted the positive impact that institutional design and bureaucratic behavior can have on outbreak detection and reporting. The results of this dissertation offer not only a description of practice, they provide evidence to support the improvement of zoonotic disease detection and reporting practice. This dissertation suggests a future focus on the development of and increased resources for diagnostic capabilities, particularly at the local level.