in shelter biosecurity. When this happens, exposure to infectious agents and disease frequency increases. Therefore, monitoring staff numbers is an important component of a comprehensive disease control program. The National Animal Control Association (NACA) recommends that staff spend a minimum of 15 minutes per animal providing basic care (NACA 2014). Using these recommendations, a shelter's capacity to provide basic care can be assessed by (i) estimating the amount of time that staff should be engaged in basic animal care daily; (ii) calculating the number of hours staff actually is engaged in basic care daily; and (iii) comparing the two estimates. Calculations are described in more detail in other sources (Newbury and Hurley 2013b; Scarlett et al. 2017d).
If staff time for basic care is insufficient or less than that which is suggested in the guidelines, the shelter should consider an investment in additional staff positions, cross‐training of non‐animal care staff, or a reduction in the numbers of animals in the shelter. If a shelter meets the guidelines, it should be noted that the recommended daily time per animal is a minimum estimate solely for feeding and cleaning. Other staffing‐related recommendations are also available (Newbury and Hurley 2013b). Shelters should strive to increase the available staff time per animal to maximize the welfare of the animals in their care. Since staffing needs can vary widely (e.g. by season, after a seizure of several animals, and with the changing physical and behavioral needs of the animals), shelters should evaluate the adequacy of staffing on a regular basis and as animal care needs change. Some shelters routinely utilize trained volunteers to assist staff in providing animal care and enrichment; when these volunteers are adequately trained and reliable and available to help with daily care, they may be counted toward the total amount of available animal care time for the shelter.
3.5 Other Disease‐Related Metrics
Disease surveillance, the ALOS, and C4C metrics are not the only ones that can be useful to shelters. Once data monitoring becomes routine, other disease‐related metrics such as the average time to disease recovery, percentage occupancy of isolation wards, ratio of sick‐to‐ healthy animals, or average sick‐days can be monitored to enhance insight into disease control and understanding and management of population health.
3.6 Software Needs
Many shelters already have protocols outlining the active identification and reporting of animals with infectious diseases. Much of that data is entered into software programs but retrieving disease rates in a useful format is challenging. Shelter software companies have generally been slow to provide disease rates or facilitate flexible, efficient retrieval of much of the data needed to calculate these rates. Fortunately, the ALOS and daily census metrics are now routinely provided.
Medical staff need the ability to obtain overall morbidity, mortality, and medically related euthanasia rates, as well as the ability to classify these rates by age group, source, and over various time periods. Since trends and group comparisons are usually best understood when graphed, an easy means to produce visual presentations is also essential. Inevitably, regular monitoring of basic data leads to new questions and additional analyses. As these new questions arise, software also needs the flexibility of data retrieval that helps veterinarians and shelter staff address such questions.
Software providers should facilitate retrieval and graphing of disease surveillance and related data. They should understand that, without a clear understanding of the incidence of disease, veterinarians cannot assess whether and to what degree their disease‐management recommendations are effective. Similarly, their efforts to set health priorities and communicate the importance of their health‐related goals are hampered by words like “a lot, some or very little disease” because they cannot quantify disease at the population level.
3.7 Shelters Without Shelter‐Specific Software
For veterinarians working for shelters without software or with unwieldy software, the frequency of diseases of interest to the shelter can be monitored by hand or in a spreadsheet. Most shelters have staff or volunteers who could tally numbers or work with the data in spreadsheets. Spreadsheets should:
Identify diseases in each species that are important to monitor.
Record each affected animal's unique identifier along with the diagnosis (e.g. URTD) and its first date of recognition.
Capture these data in a notebook, spreadsheet or by some other means.;
Count all newly diagnosed diseases for various periods (e.g. month of August).
Include data regarding other factors that may affect disease risk, such as those related to the host (e.g. age group), place (e.g. off‐site location) or time (e.g. season) to enhance the usefulness of surveillance data.
3.8 The Future
Disease surveillance in shelters today is predominantly active (not passive or sentinel) surveillance. That is, medical personnel have protocols to actively identify common infectious diseases, report them internally and ensure that affected animals receive appropriate care as soon as possible. In the future, once individual shelters enhance their disease surveillance by using their data more extensively, reporting across communities, regions and at the national level becomes possible. Shelter Animals Count is a collaborative initiative of sheltering organizations that currently focuses on the national collection of basic animal entry and outcome data, but it could expand its data collection to include disease‐related and other data in the future (http://shelteranimalscount.org). Such data could lead to surveillance efforts at regional and national levels, similar to those of CDC and APHIS; this would enhance understanding of regional variations in disease incidence and enhance disease management.
3.9 Summary
Shelter medicine has improved the care of shelter animals dramatically over the past two decades. Veterinarians can now find full‐ and part‐time job opportunities in animal shelters, and veterinarians with a background and training in shelter medicine can bring specific knowledge as well as an arsenal of tools to improve animal health and welfare in animal welfare organizations. Monitoring disease‐related metrics is an additional tool that will enhance the care of shelter populations, as it has for human and livestock populations. For this to occur, veterinarians must embrace the importance of data, enhance their skills at their interpretation, and insist that software companies facilitate the entry, retrieval and visualization of relevant data.
References
1 Anderson, R.K. (1982). Surveillance: criteria for evaluation and design of epidemiologic surveillance systems for animal health and productivity. Proceedings of the 86th Annual Meeting of the U.S. Animal Health Association, Nashville, TN (7–12 November 1982). Richmond, VA, US: Carter Printing Company.
2 Dinnage, J.D., Scarlett, J.M., and Richards, J.R. (2009). Descriptive epidemiology of feline upper respiratory tract diseases in an animal shelter. Journal of Feline Medicine and Surgery 11: 816–825.
3 Edinboro, C.H. and Glickman, L. (2004). A placebo‐controlled trial of two intranasal vaccines to prevent tracheobronchitis (kennel cough) in dogs entering a humane shelter. Preventive Veterinary Medicine 62: 89–99.
4 Edinboro, C.H., Janowitz, L.K., Guptill‐Yoran, L., and Glickman, L. (1999). A clinical trial of intranasal and subcutaneous vaccines to prevent upper respiratory infection in cats at an animal shelter. Feline Practice 27: 7–13.
5 Gourkow, N., Larson, J.H., Hamon, S.C., and Phillips, C.J.C. (2013). Descriptive epidemiology of upper respiratory disease and associated factors in cats in an animal shelter in coastal western Canada. Canadian Veterinary Journal 54: 132–138.
6 Horstmann, D.M. (1974). Importance of disease surveillance. Preventive Medicine 3: 436–442.
7 Karsten,