Policy, Pastoralists, Pillars, Pirates, and Pathogens

The One Health Intellectual Exchange was privileged to welcome Dr. Corrie Brown from the University of Georgia College of Veterinary Medicine for the last regular weekly session. Dr. Brown’s talk on “Policy, Pastoralists, Pillars, Pirates, and Pathogens” spoke to the bigger picture of One Health, with the example of Rift Valley Fever in Saudi Arabia.

Given changes in policy and the creation of the World Trade Organization, standards for preventing the spread of disease are an issue of international concern. The example of Rift Valley Fever (RVF) involves pastoralists from the horn of Africa, who provide the majority of animals for ritual sacrifices at Mecca in Saudi Arabia. In 2000, a large outbreak of RVF in Saudi Arabia led to a ban of livestock imports from African countries where the disease is endemic, with huge economic losses to small pastoralists. Dr. Brown talked about an integrated approach to disease prevention involving trade groups, projects focused on increasing human capacity, and risk assessment training.

Since the majority of the semester focused on domestic health issues, Dr. Brown’s experience in the One Health field working across national boundaries provided a new perspective. We would like to thank Dr. Brown for her presentation to the One Health Intellectual Exchange, which was not only informative, but highly entertaining as well!

Animals as sentinels for disease

This week’s intellectual exchange featured guest lecturers Dr. Larry Glickman and Dr. William Stokes. Dr. Larry Glickman is a veterinarian and epidemiologist. He presented on some of his research on surveillance of companion animals as an indicator of disease. One case study he presented was on the transmission of Toxocara canis, or Dog Roundworm infection. The eggs of Toxocara are present in the environment and are extremely resilient, lasting for years without a host. Dogs are a natural host for Toxocara. By our exposure to dogs, people (especially young children), are at risk for acquiring the parasite. As humans are an unnatural host for Toxocara, we can experience debilitating symptoms as a result, including respiratory and eye health issues. Over twenty million children are infected at any one time. Although most cases are asymptomatic, 3000 cases of blindness are caused yearly due to the parasite traveling to the eye. In West Africa, Toxocara is also a serious issue. Due to the high prevalence of pica, or the consumption of earth, transmission of Toxocara is high. Dr. Glickman discussed further about using companion animals as sentinels for environmental exposure, and has constructed a novel database using a centralized medical records system which allows for the surveillance of animal diseases.

Dr. William Stokes, a Rear Admiral, veterinarian and Director of the U.S. National Toxicology Program’s Interagency Center for the Evaluation of Alternative Toxicological Methods (NICEATM) at the National Institute of Environmental Health Sciences (NIEHS), presented on the history of the United States Public Health Service Commissioned Corps. The Corps is an integrated group of veterinarians, physicians, and epidemiologists among other professions, and is one of seven uniformed services. It is tasked with the role of protecting, promoting, and advancing the health and safety of the nation. Dr. Stokes covered a variety of one health related issues that dealt specifically with the use of animals as sentinels for disease, and presented a unifying scientific framework for addressing environmental health hazards. Dr. Stokes noted that animals are particularly useful for surveillance because their exposures to environmental hazards may be greater than human exposures, resulting in development of adverse effects. Additionally, some species respond more quickly to environmental hazards due to increased susceptibility associated with shorter life spans, thus providing valuable information to the symptoms and consequences of environmental exposure. His presentation provided insight into how the U.S. Public Health Service Commissioned Corps integrates One Health concepts into national surveillance on environmental health.

Integrated Bio-preparedness (4-5)

Integrated Bio-preparedness

Bio-surveillance: “Active, data-gathering, analysis and interpretation of biosphere data related to disease activity and threats to human health and animal health to achieve early warning, detection and situational awareness”

Given the rising threat of zoonotic diseases, this collaborative exchange session explored the use of risk-based disease surveillance strategies from a One Health perspective. The session involved 4 panelists:

1. Dr. Dennis Carroll, Director of the U.S. Agency for International Development’s (USAID) Avian Influenza and other Emerging Threats Unit

2. Dr. Tom McGinn, Senior Health Advisor, North Carolina Bio-Preparedness Collaborative Program Manager, Office of Health Affairs, Department of Homeland Security

3. Dr. Megan Davies, State Epidemiologist and Chief of the Epidemiology Section, NC Department of Health and Human Services

4. Dr. Anna Waller, Research Associate Professor in Emergency Medicine, UNC School of Medicine

Per Dr. Carroll, the incidence of emerging infectious diseases is not an accidental or unique event, but consequence of events that continue to occur in an accelerated fashion. In fact, the threat from zoonotic diseases is intensifying: pathogen emergence expected to increase 5 fold from 2000-2030. The main drivers behind rising threat are population pressures, climate change, food security, economic growth, and globalization.

Dr. McGinn communicated that because disease emergence is proportionately a rare event, the ability to detect and control disease outbreak will rest on surveillance capability. From the One Health perspective, it is critically mportant to have the systems in place for early disease detection in animals as well as humans.

While disease surveillance occurs at geographic hotspots internationally (Amazon, congo basin, southeast asia, area around the Ganges river), Dr. Davies communicated the importance of surveillance at the state and local level. The scope of biosurveillance includes threats, exposures, adverse events, diseases and outbreaks.

Similarly, Dr. Waller reviewed the surveillance system in place in emergency departments in North Carolina. While most of this data is syndromic, it provides vital information to guide the public health response and can only be collected at the local level.

Overall, this session was both informative and collaborative, as all participants were able to not only recognize the components of surveillance in humans and animals, but also to ponder how the collected information could be used in global disease prediction strategies.

Human Metapneumovirus found in Gorillas in Rwanda

In 2009, the deaths of 2 mountain gorillas in the Virunga massif in Rwanda were confirmed to be caused by metapneumovirus, a human respiratory illness. With less than 800 mountain gorillas in the wild, illnesses passed from people is a serious concern given the frequency of gorilla contact with humans. With habitat destruction, these gorillas are limited to parks surrounded by dense human populations. Additionally, wildlife tourism brings many people to the region. Understanding how the transmission of diseases from humans to mountain gorillas occurs will be important in protecting this endangered species. As a result, The UC Davis Wildlife Health Center established the Mountain Gorilla One Health Program, which will work to protect gorillas by improving the health of humans and other animals in the surrounding area.

The research article on this topic, which recently appeared in the online edition of Emerging Infectious Diseases can be found here.