CAFOs, novel influenza, and the need for One Health approaches.

Concentrated animal feeding operations (CAFOs) present highly efficient means of meeting food demands. CAFOs create unique conditions that can affect the health and environment of animals and humans within and outside operations, leading to potential epidemiological concerns that scale with operational size. One such arena meriting further investigation is their possible contribution to novel influenzas. CAFOs present opportunities for cross-species transmission of influenza as demonstrated by reports of swine flu and avian influenza outbreaks. Conditions and pathways leading to novel influenza strains are complex and require varied prevention and intervention approaches. Current challenges for prevention of respiratory viruses entering or leaving swine and poultry CAFOs are multifaceted and include adherence of personal safety measures, lack of training and safety provisions for personnel, and incomplete standardized federal, state, and/or county regulation and enforcement coverage across agricultural systems. This report acknowledges that any proposed CAFO-associated influenza intervention should be cross-organizational, and no single intervention should be expected to provide full resolution. Proposed interventions affect multiple components of the One Health triad, and include seasonal human influenza immunization, PPE regulation and adherence, alternative waste management, general biosecurity standardization and an industry best practices incentive program. Due to the complexity of this problem, multiple anticipated communication, enforcement, and logistical challenges may hinder the full implementation of proposed solutions. General and operation-specific (swine and poultry) biosecurity practices may mitigate some of the risks associated with influenza virus reassortment across species. Education and advocacy can help protect workers, communities, veterinarians and consumers from CAFO-associated influenza virus. To achieve this, there must be more complete communication between CAFOs, governing agencies, health services, animal services, researchers, and consumers to better explore the potential health outcomes associated with CAFOs.

Training and Incorporating Students in SARS-CoV-2 Case Investigations and Contact Tracing.

OBJECTIVES: In June 2020, Arizona had the fastest-growing number of cases of coronavirus disease 2019 (COVID-19) worldwide. As part of the growing public health response, the University of Arizona Student Aid for Field Epidemiology Response (SAFER) team was able to modify and increase case investigation efforts to assist local health departments. We outline the recommended logistical and management steps to include students in a public health response of this scope. METHODS: From April 1 through September 1, 2020, the SAFER team identified key components of a successful student team response: volunteer training, management that allows more senior students to manage newer students, adoption of case-management software, and use of an online survey platform for students to conduct interviews consistently and allow for data quality control and management. RESULTS: From April 1 through September 1, 2020, SAFER worked with 3 local health departments to complete 1910 COVID-19 case investigations through a virtual call center. A total of 233 volunteers and 46 hourly student workers and staff members were involved. As of September 2020, students were completing >150 interviews per week, including contact-tracing efforts. PRACTICE IMPLICATIONS: Developing relationships between applied public health and academic programs can relieve the burden of low-risk, high-volume case investigations at local and state health departments. Furthermore, by establishing a virtual call center, health sciences faculty and students can volunteer remotely during a pandemic with no additional risk of infection.