Themes in an Outbreak Investigation Series | Part 2

Make a recommendation

After defining and observing the problem, a working diagnosis can be established. Based on the diagnosis, recommendations should be given to the producer to mediate or mitigate potential causes of the disease.

If an infectious process is occurring, the question about antibiotic usage needs to be addressed. Some infectious processes, like viral diseases, will not benefit from the use of an antibiotic. If we are at the tail end of an infection, an antibiotic will not reduce the spread or clinical signs of the disease. In some cases, supportive care with anti-inflammatory medications and supplemental fluids will have a greater impact on survival.

More impactful recommendations address the causes of the problem. For most, a cause of disease is synonymous with an etiological agent but, in this context, a cause of disease means anything that predisposes an individual to succumb to disease. Such causes could be nutritional, environmental, or managerial. Recommendations that target these areas may have a greater impact in preventing future disease. With any recommendation, it is pertinent to try to anticipate the potential downstream consequences that may occur.

If after evaluating an operation and discussing with a producer, no problem exists, recommendations should still be given. In some cases, providing recommendations for nonexistent problems can be difficult but the producer’s concerns can be addressed. There might not be an active problem but minor tweaks in management or the environment can help the producer mitigate future disease problems.

Communicate the findings of the investigation

Communicate what was seen and the recommendations given. Previously, some recommendations were given verbally but a written document should be produced. The document should clearly communicate the problem, history of the herd, observations from the farm, any diagnostics performed, and the recommendations.

This document provides a paper trail of what has happened in the past and how recommendations have modified the disease risk within the population. Additionally, the document can be referred to if another problem is encountered.

Evaluate the recommendation

It is easy to communicate recommendations and leave the operation and never think about it again. But how do you know that the recommendation(s) that you made worked? Periodically checking in with a phone call and a visit can help you to evaluate if the recommendations that you gave helped to improve or worsen the problem.

Sometimes, provided recommendations are not implemented appropriately, or not at all. By revisiting with the producer, you can modify your recommendations if the problem has not improved or if the recommendations were not implemented. This can help your decision-making process and modify how you give recommendations in the future.

Another benefit of following up is that it shows the producer that you are invested in their concerns. By following up, the producer sees that you care about their problem and are willing to take the time to see how things are going. This strengthens the bond between a veterinarian and producer and shows additional benefits of an active veterinary-client relationship.


Further Reading