Public Health Preparedness at a National Special Security Event: Epidemiology, Food Safety and Food Defense at the 2012 Democratic National Convention: Tuesday, April 8th

This past week we heard from Mr. Larry Michael of the NC Department of Health and Human Services and Ms. Donna Wanucha or the regional office of the FDA. Their unexpectedly fascinating joint lecture was on the preparedness for NSSE—National Special Security Events, particularly food security.  Their thorough description of the planning for the available food and food preparation of the democratic national convention was unexpected in that I would have never considered food to be a vulnerable point for national events. Yet, when they described calling back all 2,000 lunch boxes for the security teams due to potentially “bad” chicken, it was not difficult to see how easily an entire event could be compromised by a little salmonella.

While the talk opened my eyes to all the potential threats that well trained FDA and Public Health officials deal with daily, I found myself thinking of my pet cat, Chui. I have the choice to only frequent establishments with high safety grades and I trust the local and federal government have tracked the food sources sufficiently that I will not get ill from my food. However, my cat does not have this luxury. As recent as 2007, pet food was recalled from over 100 brands contaminated from imported vegetable proteins from China (Roth, Tsay, Pullman, & Gray, 2008). Though we stringently regulate “farm to fork” production of human food, animal nutrition has fallen by the wayside. This does not pose a direct health concern to humans. Any food-born illness is not transferable to human pet owners, unless they are consuming the pet food themselves. However, especially in America, we have great time, money, and emotional investment in our companion animals.  It is estimated that Americans will spend over 22 billion USD on companion animal food in 2014 alone ("Pet Industry Market Size & Ownership Statistics,"). Despite this investment, comparatively poor consideration is given to the supply chain of pet food. Though this does not directly impede on human health, I believe it is a One Health issue as the emotional and financial burden on humans is great. We are becoming accustomed to thinking so carefully about our own food sources; it is time we give as much consideration to the food for our best friends. 

Pet Industry Market Size & Ownership Statistics. from    http://www.americanpetproducts.org/press_industrytrends.asp

           

Roth, A. V., Tsay, A. A., Pullman, M. E., & Gray, J. V. (2008). UNRAVELING THE FOOD SUPPLY CHAIN: STRATEGIC INSIGHTS FROM CHINA AND THE 2007 RECALLS*. Journal of Supply Chain Management, 44(1), 22-39. 

Authored by Chrissy Dideriksen

Black Bear Habitat Fragmentation Leads to more Human Conflicts in Florida

This week, human-black bear interaction in residential areas between Ocala National Forest and Orlando, FL made headlines after a bear bit a woman in her garage.  This problem is not new.  Both bear and human populations in Florida have been growing since the 1970s, and poor housing development plans have fragmented the bears’ habitats as building expands ever closer to Ocala National Forest.  Conflicts have increased because of misunderstandings that could benefit from a One Health approach.  Experts on bear behavior from the Bear Management Program for the Florida Fish and Wildlife Conservation Commission advise maintaining a contiguous habitat for the bears and that bears are easily habituated to humans.  Public education campaigns to advise residents against approaching bears, feeding bears, or failing to secure garbage from bears should be reinforced.

http://news.nationalgeographic.com/news/2014/04/140415-black-bear-florida-attack-habitat-wildlife-conservation/

Paige Meier

Duke University

Impacts of Improved Cookstoves on Environmental Health and Human Health: Tuesday, April 1st

On April 1, the One Health Intellectual Exchange’s session consisted of presentations from Jessica Lewis and Marc Jeuland that concerned the impacts of cookstoves on air pollution, health, and fuel.  Jessica Lewis is a third year PhD student in the Nicholas School of the Environment at Duke University and is an EPA STAR Doctoral Fellow.  She studies household energy and health and focuses on traditional cooking in developing countries.  Marc Jeuland, PhD is an Assistant Professor of Public Policy, Global Health, Environment, and Civil and Environmental Engineering at the Sanford School of Public Policy at Duke University.  In the past, Dr. Jeuland worked with the World Bank and volunteered with the Peace Corps for projects related to water sanitation.  His research includes economic implications of climate change, management of trans-boundary water resources, water sanitation, and environmental health. 

Ms. Lewis began with an overview of traditional and improved cookstoves and then highlighted her study in Odisha, India.  Importance of research on cooking methods and their impacts includes the following reasons:  forty percent of the world relies on solid fuel for cooking and heating, and air pollution is responsible for one out of seven deaths, in which household air pollution (HAP) contributes.  HAP includes substances such as particulate matter, black carbon, carbon monoxide, and carcinogenic materials.  Disadvantages of traditional cookstoves and solid fuels are high pollution risk, increased fuel wood use, deforestation, and impacts on health and climate.  Therefore, improved cookstoves are being introduced to improve its efficiency and reduce emissions in order to ultimately achieve health and environmental gains. 

The study in Odisha, India included an extensive baseline survey from five hundred households to assess firewood use, personal air pollution, household air pollution, and health implications.  Monitors were worn by some individuals to measure personal air pollution.  Factors such as household education and fuel prices significantly affect the choice of using improved cookstoves.  The improved cookstove significantly reduced firewood use, household air pollution, and personal air pollution.  Stove “stacking” was common in the village, as multiple stove types were used by households, and only twenty-five percent of households own only one stove.  Further research could determine the length of cookstove use by households, the age of cookstove users, and the health history of cookstove users.  These further questions could indicate additional health implications from cookstove use.  Ms. Lewis also directed the group to visit dukeenergyhealth.org.

Dr. Jeuland followed with a presentation about why people choose to cook with an improved cookstove.  Beginning with background information, Dr. Jeuland explained that people may choose not to cook with an improved cookstove because of cost, lack of knowledge, no preference, being risk averse, and conformism.  In theory, people adopt environmental health technologies because of rationality, costs, time, and interventions.  However, people often do not adopt environmental health technologies, and “free stove” studies may not be successful despite their cheapness and efficiency.

Dr. Jeuland’s presentation then focused on his study in India.  The study aimed to find improved cookstove adoption determinants, collect evaluations of their impacts, and conduct marketing studies.  First, the study evaluated baseline cooking and fuel behaviors, knowledge and perception of cookstoves, and cookstove design preferences through a baseline survey.  The surveys showed that people preferred cheaper cookstoves that emit less smoke, decrease the needed amount of fuel, and increased the number of cooking surfaces.  After the baseline survey, pilots were conducted in which a cookstove was offered to people along with a payment plan and advertised by social marketing.  Some people bought natural draft or electric stoves, and selling in poor, rural areas were difficult.  Following pilot studies, intervention occurred.  Information about cookstoves was distributed via fact sheets, and demonstrations for using cookstoves were performed in communities.  The people paid three installments, and a random rebate was offered.  According to the study, rebates encouraged cookstove purchases and use.  Electrical stoves were most used, but the users also had to pay for electricity.  Fuel savings were largest for households in the NGOs stratum, and fuel expenses increased with rebates, most likely due to electricity costs.  Dr. Jeuland summarized that supply of cookstoves is needed, as the study shows a demand for cookstoves.

Discussion and questions followed the presentation.  Questions included the following topics:

• Practicality and effects of fixing a traditional cookstove instead of introducing a new cookstove
• Children’s health impacted by cookstove use
• Efficiency of a biogas stove
• The need of proof for improved cookstove health impacts
• The household member that decides to buy a cookstove
• The use of a community stove
• How taste is changed from using improved cookstoves versus traditional cookstoves

Post Authored by Erin Beasley, NC State University

“Demon Dogs” or Panicked Public?: A History of Breed Scares Through the Ages: Tuesday, March 25th

On March 25^th the One Health Intellectual Exchange welcomed Browen Dickey, a contributing editor of The Oxford American to discuss “’Demon dogs’ or panicked public? A history of breed scares through the ages.”

Ms. Dickey states that through her research she found breed scares are often cyclic, relative to current society, and often not necessarily about the breeds themselves but potential tension between different social groups. Breed scares/bans began as early as 1066 with the Mastiff. This was when royalty did not want those of lower social cast owning these dogs due to the potential of hunting on land owned by the king. Through her research she found that often breed scares could be pin pointed to certain events, such as the St. Bernard and the release of the movie Cujo or guard dog breeds with the increase of crime rates.

The current breed scare? The Pit Bull.  This “bully” breeds is beginning to be banned by apartment complexes and making it into certain state legislations. Starting in 1974 when dog fighting in certain rings became a popular topic. A media blitz came to bring the breed into the forefront, with reporters and journalists relying on the general public and dog fighters for information on this breed. Ms. Dickey has carried out an effort to interview owners nationwide to gain a better understanding of the Pit Bull breed. She found that that these dogs are often like any other breed, have a bad rap. They are often sweet, kind, and loyal to the owner.

Ms. Dickey made two points about breed panic that stuck out the most: it can lead to exacerbating the problem and letting human’s off the hook. So what will be the next breed to cause panic? Only time will tell.

Authored by Jessica Vasquez

Food Safety from Farm to Fork to Physician: Moving Towards a One Health Approach: Tuesday, March 4th

In this week's session, Barbara Kowalcyk, Ph.D. and CEO of the Center for Foodborne Illness Research and Prevention (CFI), a national non-profit organization that prevent foodborne disease by advancing a stronger, science-based food safety system, was our honored guest at the North Carolina One Health Intellectual Exchange Group. She received her master's degree in Applied Statistics from the University of Pittsburgh and a Doctorates in Environmental Health with a focus in Epidemiology and Bio-statistics from the University of Cincinnati. Although she began her career as a Statistician at a pharmaceutical company, her passion shifted to foodborne illnesses and food safety, due to a tragic personal event. Since then, her research has focused on the microbial aspect of foodborne pathogens and a system to improve epidemiology surveillance and awareness to prevent a pandemic outbreak.

Dr. Kowalcyk began her discussion by describing food safety and food security along with reasons why it should be a main priority and concern in people's lives. Statistics show approximately 48 million people contract illnesses, 128 thousand are hospitalized and 3 thousand deaths occur globally due to foodborne pathogens. The numbers are so high and increasing from the high transmission rate through food, people, water systems and petting zoos. The most vulnerable populations are pregnant women, senior citizens and children. Dr. Kowalcyk emphasizes the concerns of the under-analyzed effects of foodborne diseases globally, which inhibits the improvements of surveillance. Pathogens, including Norovirus, Salmonella, and E. coli 0157:H7, are continually evolving into new strains of antibiotic resistance that will cause a public health crisis in the 21st century.

Food companies, or the 'producers', have recently been the blame for the spread of foodborne illnesses instead on the consumers. Due to concerns of the spread of these pathogens, they have caused the CDC to implement sterilization procedures, like irradiation (a simple disinfecting process from a  UV light to kill the microbes growing in the food) and systematic preventive programs, like FoodNet, PulseNet, and Hazard Analysis Critical Control Point (HCCP), to food processing companies. Also, in 2011, Congress enacted the Food Safety Modernization Act (FSMA), a food safety law to mandate new risk-based approaches to the FDA's oversight of foodborne illness. This law will ensure the quality and amount of detection of bacteria to monitor the spread around the country. Fortunately, over the years, there has been an increasing amount of attention to improve the surveillance of foodborne diseases and to attempt to prevent sporadic outbreaks from occurring.

Dr. Kowalcyk then further argued the issues of people's assumption that foodborne diseases only result in acute illnesses, such as a 'tummy ache,’ as well as “it's something minor that is not necessary to visit or report to a physician.” In her paper, she describes the many long-term effects to numerous organ systems that people are unaware about the effects. Prominent sequelae of these infections include effects to the gastrointestinal, immune, nervous, respiratory, cardiovascular, endocrine and hepatic systems. Profuse diarrhea, another condition caused by foodborne infections, in children can cause deficits in cognition and development while in adults will make it more chronic [1]. The long-term consequences from the foodborne infections are detrimental to human health and must be taken with precaution. Dr. Kowalcyk wants to educate the people through CFI and provide a source of information about these pathogens, so that it is not something to be under-evaluated. 

Looking ahead towards the future, promising technology and procedures are being tested and formulated to eliminate the outbreaks of infections. An increase of epidemiology will drive preventive actions through the ability to constantly identify and detect the cluster of diseases that significantly harm people around the world. Dr. Kowalcyk quotes "surveillance goes beyond the detection of disease, but it is critical for prevention. There needs to be a surveillance shift from reactive to proactive action." The rise of antibiotic resistant pathogens and the continual difficulty of tracking the origin of the pathogens will force companies, farmers, and other countries to integrate to more cost effective surveillance protocols. Ultimately, the mission to prevent the spread of foodborne diseases is to advocate the necessity of funding for more studies and surveillance techniques to wealthy companies or governments as well as to educate the consumers on safe sterilization that will clean the foods from the burden of these pathogens. Lastly, Dr. Kowalcyk ends her discussion with a slide of children that have died or have severe complications of their lifestyle due to foodborne illnesses as a reminder of the true reason to promote proper surveillance and prevention of foodborne diseases.

[1] Batz, M. B., Henke, E., & Kowalcyk, B. (2013). Foodborne illness: Latest threats and emerging issues. Infectious Disease Clinics of North America, 27, 599-616.

Authored by Thanh-thao Thi Le

Microbial source tracking to evaluate links between human, animal and environmental health: Tuesday, February 25th

This past week’s One Health Intellectual Exchange Group’s topic focusing on microbial source tracking in bodies of water was presented by Dr. Jill Stewart.  As an Assistant Professor in the Department of Environmental Sciences and Engineering at the University of North Carolina, Dr. Stewart develops techniques to detect and track pathogens in water.  Dr. Stewart’s current research projects involve water quality evaluation associated with land application of waste products and water quality evaluation associated with urbanization on watersheds.  Her work with environmental sciences show how environmental impacts can affect human health.

During the presentation, Dr. Stewart addressed the following learning objectives:

• Name a standard indicator used to detect fecal pollution of surface waters.
• List three issues associated with the use of traditional fecal indicator bacteria to monitor water quality.
• Define microbial source tracking and name a marker that can be used to track human-source pollution in water.
• Describe how microbial source tracking can be used to mitigate water pollution.

The presentation began with an introduction on microbial pollution and microbial detection.  Dr. Stewart works with bacteria, viruses, and protozoa.  Microbial pollution on water and shellfish include various sources such as waste water treatment plants, marinas, wild and domestic animals, recreational use, and food (for example, oysters).  In order to detect the microbes, membrane filtration is performed and fecal coliform colonies are analyzed.  This technique is widely used; however, there are some drawbacks.  Disadvantages include time (it takes about twenty-four hours to complete), type of pathogen (it only works for bacteria), and determination of contamination source.  Microbial Source Tracking (MST) is the method to determine fecal pollution in water sources.  Molecular techniques such as PCR and assays are also incorporated.  Markers of fecal microorganisms are used for analysis.  Fecal indicator bacteria includes Escherichia coli.  Depending on the presence of markers, fecal pollution can be linked to land development or other human causes.

The remaining of the presentation focused on two of Dr. Stewart’s studies.  One of Dr. Stewart’s studies was conducted at Jordan Lake.  The purpose of the study was to determine storm water and land use effects on microbial contamination.  Water samples were collected at various types of area uses and different storm times.  The fecal indicator bacteria were compared at a regulatory threshold, and the markers used were Bacteroides sp. (HuBac) and Methanobrevibacter smithii (nifH).  There was a positive correlation between land development and microbial contamination.  Storms had more of a contaminant load, and loading occurred over the course of the storm.  Therefore, there was no difference in loading between dry conditions and stormy conditions.

A second study discussed by Dr. Stewart concerned fecal indicator bacteria and swine farms.  Eastern North Carolina has most of the state’s swine operations, and North Carolina is the nation’s second largest state in swine production.  To control swine fecal waste, common applications are swine lagoons and spraying fields.  Again, Dr. Stewart found that there were higher levels of fecal indicator bacteria with rain.  Swine genetic markers analyzed included pig-1-BAC, pig-2-BAC, and pig-BAC-2.  The markers pig-1-BAC and pig-2-BAC were found to be correlated with pig waste. 

In addition to her studies within North Carolina, Dr. Stewart also collaborates with researchers in the Galápagos Islands.  A few studies were conducted by measuring water quality around sewage pipes, which emptied into the ocean.  The water treatment plants also had fecal indicator bacteria.  Dr. Stewart along with students will continue research in the Galápagos Islands.

The presentation concluded with Dr. Stewart stressing that single-sample monitoring for water sources may be inadequate, and alternative indicators may be necessary.  These points are exemplified in her studies with land use and water contamination as well as storm water affects on water contamination.  Her presentation and studies support the One Health concept connecting environmental health and human health. 

Discussion and questions followed the presentation.  Questions included the following topics:

• The affect of tides and timing on the analysis of storm water leaving sewage pipes in the Galápagos Islands
• Analyzing antibiotics directly in samples
• Water pollution by tour boats in the Galápagos Islands
• Collaborative work with Engineers Without Borders in the Galápagos Islands
• The difference between indicators and pathogens
• Costs for molecular techniques
• The use of caffeine as an indicator

Post Authored by Erin Beasley

NC State University

Feedbacks between shallow water coastal ecosystems and human well-being: Tuesday, February 25th

On Tuesday, February 25^th the North Carolina One Health Collaboration welcomed two speakers for the evening’s Intellectual Exchange Group meeting.

Dr. Mike Piehler is dually appointed as an Associate Professor at the UNC Chapel Hill Institute of Marine Sciences in Morehead City, NC and as Head of the Program in Estuarine Ecology and Human Health and the UNC Coastal Studies Institute in Manteo, NC.  He is also the Director of Graduate Studies for the Curriculum for the Environment and Ecology at UNC Chapel Hill.  Dr. Piehler drove up from the coast last Tuesday to share his expertise and current research on microbially mediated processes in coastal land-water interfaces and their links to human health with the NC One Health Intellectual Exchange Group. 

Dr. Piehler explained the importance of maintaining coastal shallow water ecosystems as “transition zones” between land based and fresh water areas and marine environments.  These areas mediate the contents of rivers feeding into the sea that are increasingly bringing excess nutrients and pollutants from sources such as fertilized fields or wastewater treatment facilities.  Without these zones, the excess nutrients can facilitate harmful algal blooms, which then deplete oxygen levels in the water as they decay, causing fish and plant-life kills. 

Currently, the world has lost between fifty and seventy percent of its flatland estuaries and nearly ninety percent of its oyster reefs.  Damage to coastal shallow water ecosystems increases globally as human population density in those ecosystems increases.  Dr. Piehler showed that these transition ecosystems are crucial for maintaining a balance to the influx of nutrients, sediments, and salinity in the water in such a complex way that alternate human interventions are hard-pressed to be as comprehensive or effective.

Nitrogen

Dr. Piehler has focused on nitrogen fluctuation in studying the importance of wetland ecosystems at the UNC Costal Studies Institute and at the Camp Lejeune military base in eastern North Carolina.  Nitrogen is key to limiting primary productivity at the intersection of fresh and salt water.  A healthy nitrogen cycle is threatened by augmentation of nitrogen in the water sourced mainly from fertilizers in the form of nitrite or ammonium. 

More is not always better in the case of ecological nitrogen levels.  There is a threshold for the amount of fixed nitrogen that is a beneficial to human, animal, and environmental health (Figure 1).¹ Beyond this levels instances of pollution and disease are increased.

Camp Lejeune DCERP Study

With funding from the Defense Coastal/Estuarine Research Program (DCERP), Dr. Piehler and colleagues studied the footprint of a military base on an estuary at Marine Corps Base Camp Lejeune.  An increase in nitrogen levels and in total suspended solid load was visible in the five streams tested as increases in development were seen.  The relationship of ammonium levels to development was not as clear.  In all cases more loading was seen during storms.  Currently, laws to control high levels of nutrients and pollutants entering streams and estuaries as a result of storms are of a small scale and are poorly monitored/ enforced.  Using regression modeling the researchers were able to predict loading in areas with various amounts of development.

Importance of Wetland Restoration

Dr. Piehler estimates that the cost to remove excess nitrogen if not done by oyster reefs is $1600 per year, per hectacre.  Oyster Reefs have among the highest denitrification potential and thus if restored can rebalance eutrophication areas. Subtidal flats, although they have lower rates of denitrification, are just as important because they cover a large area.  Wetlands provide numerous services under four different categories outlined by Dr. Piehler: Provisioning, Regulating, Cultural, and Supporting.  While Dr. Piehler does acknowledge that there are drawbacks to wetlands, such as competition for land for development or the potential for infectious diseases to breed in these areas, he demonstrates that the services provided by wetlands make them extremely valuable and that they should be restored and protected.

Future Concerns

The effects of global warming, drought, rising sea levels, and natural disasters are all concerns for the future of wetland ecosystems.  Dr. Piehler noted many ways these effects could be predicted and buffered through research on topics including:

• The impact of intense wet periods and protracted dry periods on river and wetland life
• The impact of changing tide ranges on coastal shallow water life as overall sea levels change
• The change in patterns of natural disasters and storms and their effects

As Dr. Piehler and his colleagues believe, the number one “eutrophication commandment” is to protect costal ecosystems for biodiversity services.

Figure Reference:

1) Townsend, Alan R., et al.  “Human health effects of a changing global nitrogen cycle.” Frontiers in Ecology and the Environment 1.5 (2003): 240-246.

Paige Meier

Duke University

Water contamination associated with shale gas exploration and hydraulic fracturing in the U.S.: Wednesday, February 19th

Dr. Vengosh is a Professor of Geochemistry and Water Quality at the Nicholas School of Environment in Duke University.  He also is appointed at the Department of Civil and Environmental Engineering at Duke University.  Dr. Vengosh received his BS and MS from the Hebrew University of Jerusalem, Israel and his PhD from the Research School of Earth Sciences, Australian National University, Canberra, Australia.

Currently Dr. Vengosh’s research includes the energy industry’s impact on water quality, environmental health related to human exposure of naturally occurring contaminants in drinking water and the salinization of water resources from human activities and climate change.

After a snow delay Dr. Vengosh spoke to the One Health Intellectual Exchange beginning with an introduction to sources of energy in the USA.  He explained that Natural Gas has recently overtaken Coal as the most produced energy in the US.  Here’s a table of the percent of energy produced in the US.

Natural Gas        31%

Coal                     26%

Crude Oil            21%

Nuclear               10%

Renewables        16%  which include wind, solar, hydropower, biomass etc.

It is projected that as natural gas production increases the use of oil will decrease a bit.  Other sources will stay about the same.  As the US produces more natural gas, we will begin to export it to Mexico and Canada which may increase prices.

Water quality is affected by several of the different energy industries such as mountaintop and sub-surface coal mining, shale gas fracking, coal ash disposal sites, tar sands etc.

What is myth and what is reality?  Several mainstream movies such as Gasland and The Promise Land have stirred the public’s interest (and opposition) to fracking.  Dr. Vengosh explains that there are lots of other chemicals used in energy harvesting which are just as bad but receive no press or protest.

Why is gas so important?  Natural gas is everywhere in the United States and around the world.  Using more natural gas would cause a decrease of wood burning as a fuel source.

What is fracking? 

What are the environmental risks of fracking?

• methane emissions in the air and water- methane causes more build-up of greenhouse gases
• 7-15 million liters of water per well is used- this is an issue where water is scarce.  The industry is moving towards 100% water recycling.  (Forty per cent of water used in the US is in coal and nuclear plants.)
• fracking chemical spills contaminate the immediate area
• air and water pollution at different stages of gas production
• disposal of the fracking fluids and the waste water
• health implications on quality of life

Of the above mentioned risks, 99% of the issues are with the waste water disposal.  Waste water is state regulated, not federally regulated.  There is a question if the states have proper regulations to monitor deep injection wells or is the waste water moved to another state?  He adds that earthquakes are not a major issue.

Some results from his studies:

1.       Stray gas contamination is real.  Meaning that water does catch on fire, but not always.

2.       Need to establish tools to detect fracking fluids in the environment.

3.       Disposal of shale gas waste water results in contamination and with radioactivity build up.

Water becomes contaminated from gas leaking from well casings, surface spills and waste water treatment and storage.  It is determined that living close (<1km) to a drill site will increase the per cent of methane (also ethane and propane) in the water.  Living > 10km away reduces this risk.  There has been no evidence of fracking fluids found in active wells.

What are fracking fluids?  They are proprietary chemicals but they do contain high salinity, Bromide, Strontium, NORM (Naturally Occurring Radioactive Materials) and organics including benzene, toluene, ethlybenzene, xylene and many other chemicals.

How/where can we treat fracking fluids?

• Municipal treatment facility- these are inadequate since the fluids will affect the domestic waste water.  Bromide in the water causes carcinogenic byproducts.
• Brine treatment facility-inadequate for halogens and radioactivity
• Deep well injection- this may induce seismicity
• Recycle to fracking- limited by water chemistry causing scaling and radioactivity

What are the solutions?

• Blend acid mine drainage and fracking fluids.  The SO4 from the acid will react with the Br, Sr and Rn capturing the radioactivity.
• Completely recycle the fracking fluids.
•  Must have a private well >1 km from a drilling site.

Submitted by Barbara A. Wujciak, OD

Farming for Food Safety

This past week Veterinary Record published Dr. Patrick Wall’s article “One Health and the food chain: maintaining safety in a globalized industry”[2] discussing the relationship between herd and farm animals with human health. Dr. Wall argues that the current “farm to fork” consumer’s mantra is ‘naive’ and he presents an alternate ‘maze’-like image of the food chain where even a slice from the local pizzeria has been impacted by legislation as far away as China--a main distributed of vitamins for animal rations.

                                                                                                   [1]

                                                                                             

Dr. Wall further argues that the “final objective” for the agri-food sector should be human health and that we should look to veterinarians and plant and animal geneticists for future food health interventions. Though many of his ideas are quite reasonable--no one can argue that diseased animals should not enter the food chain, he seems to be precariously close to calling out the so-called organic and small farm industry whose popularity is spreading beyond the affluent. Even a diet consisting of only home-raised animals will be touched by the animal feed industry.  On the one hand, more hands in the pot of production leaves more opportunity for contamination. On the other hand, careful involvement by veterinarians and scientists can lead to healthier a “final product”--for example, meat with naturally less saturated fat.

Is the future of food locally grown organics or carefully bred, monitored, and enhanced animals and plants?

---

[1] http://www.ineffableisland.com/2010/06/eu-funded-moniqa-tracks-edible-safety.html

[2] http://veterinaryrecord.bmj.com/content/174/8/189.full

Authored by Chrissy Dideriksen

Hemotropic Mycoplasmas: Insight into reservoirs and new species: Tuesday, February 18th

The North Carolina One Health Intellectual Exchange Group was pleased to host Ricardo Maggi, MS, Ph.D., a well-travelled and highly respected researcher of microbiology and vector borne pathogens.  Dr. Maggi earned his Doctorate from the University of Puerto Rico, where he researched the development of regulated gene expression systems in certain yeasts for biotechnological applications.  Although Dr. Maggi’s research has taken him to very scenic locations such as Milan, he now calls North Carolina home.  Currently, Professor Maggi is Co-Director of the Vector Borne Diseases Diagnostic Laboratory at North Carolina State University’s College of Veterinary Medicine.  There Dr. Maggi and his team aim to develop and implement cutting edge methods and technologies to improve the diagnosis of vector-borne pathogens. 

Dr. Maggi related with the audience the importance of conducting research on hemotrophic mycoplasmas, and their relevance in combating pathogenic potential in both animals and humans.  Hemotrophic mycoplasmas are epierythrocytic obligate bacteria, so evolutionary pressures have given these bacteria the opportunity to spread with the employ of arthropods as vectors.  While the ticks feed on their host, the hemoplasmas have been provided a route to another more suitable host.  Dr. Maggi explained to the Exchange Group how infections with hemoplasmas are often regarded as chronic and largely asymptomatic, so the optimal method of detecting infection would be through serology.  Cytological examination of stained blood smears under light microscopy had been the primary method of detecting hemoplasmas in veterinary medicine, although there were limitations such as the proper categorization of the many mycoplasma varieties.  Dr. Maggi and his research team have developed methods to categorize hemoplasmas based on their genetic makeup.  The polymerase chain reaction (PCR), a biochemical technique used to amplify targeted sections of DNA, has proven to be a viable analytical tool in the proper identification of hemoplasmas. 

The gene sequences recognized and used by Dr. Maggi’s research team in the analysis and identification of hemoplasma subclusters is 16S rRNA.  These sequences are present in the Mycoplasma suis and Mycoplasma hemofelis groups.  This was an important step in the organization of the bacteria because what was found was the tip of the hemoplasma ice burg.  Dr. Maggi then explained to the Exchange how the M. suis and M. haemofelis subcluster included varietals that affected many animals that humans have established domestic or other relationships with.  Because of the genetic similarities of the 16S rRNA gene sequence similarities within the members of the two aforementioned subclusters, the bacteria may be best categorized by the host that it has invaded. 

Noting the breadth of research in the proper analysis of mycoplasmas, Dr. Maggi spoke about the prevalence of the bacterial infections in many species.  The test subjects were sourced from many regions of the world on location.  Some of these animals and respective regions included dogs from Greece and domestic cats from the United States.  Although many animals did not display any signs of infection, in some animals hemoplasma infection was associated with hemolytic anemia of variable degrees of severity.  Comparative immunology was also evaluated between selected primates and humans.  In all, research suggests that hemotrophic mycoplasmas are very adaptable organisms.  They have the ability to change to fit the physiological profiles of their respective hosts.  For this reason Dr. Maggi expressed the importance of recognizing mycoplasmas as emerging zoonotic pathogens. 

The challenge in researching the pathogen lies in the lack of “respect” for these tick-borne pathogens in the greater healthcare and government institutions.  Because ticks are largely isolated in heavily-wooded areas, the potential for human infection is greatly reduced.  This is especially so in urban areas, where ticks typically do not inhabit except through the means of a travelling host.  Dr. Maggi stressed the importance of educating the larger community of the dangers of tick-borne mycoplasmas, and the role researchers in many disciplines may play in combating the pathogen.  This includes creative means of attracting the proper funding to control the spread of the tick-borne diseases.  Ticks are very slow moving in nature, and do not travel great distances from their native regions except by latching on to a host or through other artificial transit modes. 

Another important point brought up in discussion was the growing trend to globalize markets.  Many livestock and other goods are transported to different countries, and a consequence may also be the transport of ticks and other organisms carrying pathogens.  The education of animal handlers and health workers in the proper detection and removal of ticks is essential in combating hemoplasmas.  More importantly, once the obvious obligate has been identified, it is essential to properly screen the inhabitants for the presence of hemoplasmas.  Dr. Maggi concluded his discussion with the students of One Health with a charge to expand on the research already done on mycoplasmas, a largely underappreciated pathogen with the potential to harm many species.  Perhaps comparative immunology may provide perspective on a species that is resistant to the bacteria, and may provide a vaccine.  Perhaps there may be an arthropod species that resists the invasion.  Dr. Maggi stresses the constant transparency and collaboration between human and veterinary medical disciplines, along with the cooperation of environmental and governmental agencies in identifying risk factors associated with mycoplasmas, and measures to prevent infection of a silent pathogen.

Cedric Harvey

NCSU

Senior, Biological Sciences-Human Biology

Primates and their Parasites: Disease Ecology in a Changing World: Tuesday, February 11th

The North Carolina One Health Collaborate was honored to host Charles Nunn, Ph.D., a Professor of Evolutionary Anthropology and Global Health at Duke University’s Trinity College of Arts and Sciences, as this week’s keynote speaker. Dr. Nunn, who received his Ph.D. from Duke in 1999, left his position at Harvard University this past year to return to the Research Triangle. Prior to his work at Harvard, he held various positions at the Berkeley and Davis campuses of the University of California, the Max Planck Institute for Evolutionary Anthropology, and the University of Virginia.

Dr. Nunn currently leads the Comparative Primatology and Research Group at Duke where his lab focuses on the ecology and evolution of infectious diseases in wildlife, particularly among primates and other mammals. His work addresses basic questions about wildlife diseases as well as zoonotic disease risks and the conservation of biodiversity. He conducts large-scale studies on parasites that infect mammals to understand patterns of disease risk in natural systems, especially at the ecological interface between humans and wildlife. Through statistical analysis and modeling, he studies the spread of infectious agents in wildlife populations.

Dr. Nunn began his talk by comparing the number of parasites found in wild primates to those found in humans. The data was staggeringly clear: humans are afflicted with a substantially higher rate of parasites. Interestingly, early humans faced rates comparable to those of modern day wild primates. Dr. Nunn addressed this difference by discussing the changes in our lifestyles, activity levels, as well as the impacts of the agricultural revolution and its influence on the spillover of diseases between humans and animals.

After his introduction, Dr. Nunn’s presentation narrowed and shifted in focus to explicitly illustrate how research that integrates theoretical modeling and broad evolutionary comparisons is providing new insights to infectious disease ecology. Ultimately, it is his hope that these studies and comparisons will continue to increase our understanding of human disease risk, an idea elaborated upon by discussing the details of parasite sharing in wild primates and what this information can tell us about our own infections. Dr. Nunn went on to discuss how population group size influences parasitism in the wild and then explained the intricacies of the various meta-analysis techniques employable for this purpose. These kinds of meta-analysis techniques were also used to determine what the consequences (in terms of disease risk) are when humans disrupt natural ecological communities, another idea brought up by Dr. Nunn. Audience questions focused on these complex meta-analyses and their methodology and application.

Although often overly dramatized in science fiction thriller novels and films, infectious diseases pose a real threat to humans worldwide. If we reduce our focus to just zoonotic diseases, we see the Bas-Congo virus in the Democratic Republic of the Congo, the Novel Coronavirus in the Middle East, and the Hantavirus in Yosemite, among others, as present real-life examples of infectious diseases affecting various parts of the world. The pages of history have shown what a profound impact these kinds of diseases and other infectious diseases can have on the cultures, prosperity, and survival of entire population groups. As we look forward toward the remainder of the 21^st century, we must reflect on lessons from the past and acknowledge that infectious diseases will inevitably (and unfortunately) continue to help steer the present direction of our lives and future as a species.

This new century also brings with it novel considerations and unforeseen challenges for us to tackle. The effects of climate change threaten to result in the emersion of new disease vectors that will exacerbate transmission and infection among humans. Furthermore, as bacteria become resistant to our traditional antibiotic treatments, we will be forced to adapt and alter how we practice both veterinarian and human medicine. Ultimately, understanding ecology and evolution will be essential on our path toward addressing problems like these. As shown by Dr. Nunn, adopting a multiple disciplinary perspective might lead to additional insight that will help us discover resolutions.

Post authored by Thomas Woo, a junior majoring in biological sciences (human biology concentration) at North Carolina State University. 

The Link Between Domestic Violence and Animal Abuse

Recently Ohio.com published an article entitled “Animal abuse often signals domestic violence; Canton rescue group fills the need for fearful victims.” ^[1] The article details the work of Peace for Pets (peaceforpets.org) who provide a place for people who are fleeing abusive relationships to find a safe place for their pets without leaving them behind. So, why is this important?

                There are three reasons to focus on pets when it comes to domestic violence. The first is that animal abuse can be a sign of domestic violence in a home. Women in shelters were 11 times more likely to report the animal abuse then to report the abuse they themselves were experiencing.^[2]  The second is that the animal abuse is also abuse on the people. Most shelter women and children reported that seeing the animal abused added to the distress they were feeling in this situations.^[2] The last reason is the crux of what Peace for Pets is doing; women who were abused said that concern for the pet prevented them from leaving their abusers.^[2]

Authored by Chris Pierson

References

• Antoniotti, Kathy. 2013. “Animal Abuse often signals domestic violence; Canton rescue group fills the need for fearful victims.” Ohio.com. January 2014. http://www.ohio.com/news/animal-abuse-often-signals-domestic-violence-canton-rescue-group-fills-need-for-fearful-victims-1.462792
• Ascione, FR, CV Weber, TM Thompson, J Heath, M Maruyama, K Hayashi. 2007. “Battered Pets and Domestic Violence: Animal Abuse Reported by Women Experiencing Intimate Violence and by Nonabused Women.” Violence Against Women [Internet]. 13:354. (Apr 2007). Accessed 11 Feb 2014. http://vaw.sagepub.com/content/13/4/354.full.pdf+html

One Health, One Welfare: Supporting human livelihoods through improved health and welfare of working animals: Tuesday, February 4th

Andy Stringer, BVSc PhD MRCVS is Director of Veterinary Programmes for SPANA (Society for the Protection of Animals Abroad) where he directs SPANA’s global veterinary programs. SPANA (www.spana.org) is a British charity that works to improve the health and welfare of working animals worldwide, and thereby support the livelihoods of those who depend on them. Dr. Stringer also holds a position as an Honorary Lecturer in International Animal Health at the Institute of Infection and Global Health, University of Liverpool where he is involved in teaching and research.

SPANA’s primary objective to improve the health and welfare of working animals worldwide can be reached through a multifaceted approach that includes providing direct veterinary care through clinics and field work, improving and supporting the training and capacity building of vet professionals and paraprofessionals, supporting teaching institutions in country, providing community education, and conducting research programs and evaluations of all of the above.  In addition SPANA provides limited response to emergency situations encompassing both environmental disasters and conflict related emergency care of equine work animals. 

Work animals can include the span of horses, camels, oxen, and donkeys (most common). These animals are at risk for misuse and abuse because they are largely absent from protection within agricultural and research regulations and therefore the ownership and treatment of these animals varies and is often attached to more to cultural values rather than ethical values.

Dr. Stringer delved into the discussion of the sustainable livelihoods approach (SLA), which is a way to improve understanding of the livelihoods of poor people.  By building assets including human, social, natural, physical, and financial capital, individuals and households develop their capacity to cope with the challenges they encounter and to meet their needs on a sustained basis. Dr. Stringer mentions a quote that was told to him by a villager:

“If you have a healthy working animal you can be the King of a village, if you have no animal you can be the King of poverty”

Dr. Stringer encourages a holistic approach to help animals.  The relief of suffering, which can include heat exposure, potential for injury, overworked conditions, inadequate diets, and inadequate handling equipment, is crucial for the longevity of the animals.  Among the major issues is one of inadequate veterinary care where animals lack appropriate treatment for infections, foreign body ingestion, and wounds caused by poor harnesses (abscesses), traffic accidents and poor home remedies including burning.  

Examples of some of the projects being implemented were given:

• Changing harnesses for safer versions locally made to help prevent wounds
•  Reflective ear tags for animals to wear for reduction of night traffic accidents
• Providing proper saddles for transporting pregnant women from mountains which are also comfortable and ergonomically correct for animal use

Challenges of Interventions include how to sustainably change attitudes, knowledge, culture.

Dr Stringer entertained multiple questions from the audience include ones regarding:

•  Infection transmission between owners and animals which he answered as unknown because of limited available information
• Has there been a “mutual healer” training to address both human and animal needs? “no”
• How does SPANA help in communities of displaced people and their work animals?
• This is addressed with helping offload animals from their owners and then often gifting them back or selling them back for a reduced price which helps to keep the animals in a stable environment while the owners re-establish.  This is supported with a restocking with animals from the region as naïve animals that are brought in are susceptible to illness and people may have better knowledge of native species.

The presentation concluded with a quote from a recent article published about One Health:

“It is time to consider whether One Health will prove to be a short-lived response to a spate of emerging diseases that apparently threatened to engulf the world, or a paradigm shift that will lead to a wider and deeper commitment to interdisciplinary action addressing the protection and needs of society in the 21^st century”

– E. Paul J. Gibbs., BVSc, PhD, FRCVS

To which he responded that while he hopes it is the latter, he feels as though the interdisciplinary world is currently in a stage of doubt, but hopes it will be followed closely by acceptance. 

Authored by Christina Gonzalez

Cryptococcus gattii Spreading in North America

The Centers for Disease Control reported late last year that Cryptococcus gattii fungal infections were diagnosed in Alabama (1), California (13), Florida (1), Georgia (5), Hawaii (1), Michigan (1), Montana (1), and New Mexico (2) since 2009.  This is surprising because the fungus only first emerged in North America in British Columbia in 2009.  Shortly after, it spread to the Pacific Northwest, and it has now reached the North American East Coast.

C. gattii infections are contracted by inhalation of fungal spores after encountering areas of decaying forest matter or areas near pigeon droppings, which support the growth of the fungus2.  The resulting cryptococcosis infection can lead to pulmonary irritation/infection and potential pneumonia or, more seriously, central nervous system infection1.  Animals present symptoms similar to humans, and the wide array of species that have been affected includes cats, dogs, birds, ferrets, llamas, alpacas, goats, sheep, horses, and porpoises.2

Fungal infections have been known to generally threaten only immunocompromised humans and animals, and infections of this type have usually been associated with the opportunistic pathogen Cryptococcus neoformans rather than C. gattii.  These recent North American infections have been reported in otherwise clinically healthy people and animals, and the C. gattii infections have been more difficult treat than C. neoformans3.  According to microbiologists such as Joseph Heitman, Director for Center for Microbial Pathogenesis at Duke University Medical Center,4 these developments and the changes in geographic spread could be due to C. gattii participating in sexual reproduction and forming previously unseen and more virulent strains.  Additionally, global climate changes could be playing a role in providing new ideal environments for the fungus.  This is thought to be the case in British Columbia, where Douglas fir trees were discovered to be hosting the organism after several years during which the average temperature in the area was consistently one degree higher than normal3. The new North American cases were not always connected with travel to places in which the fungus is endemic within the expected incubation period of 2-13 months1.  Such instances could suggest that the C. gattii strains arrived years earlier from endemic regions, but are just now causing illnesses as the climates in their new habitats have become more favorable3.  

Authored by Paige Meier

References:

1. Harris JR, SR Lockhart, G Sondermeyer, DJ Vugia, MB Crist, MT D’Angelo, et al. 2013. “Cryptococcus gattii infections in multiple states outside the US Pacific Northwest.” Emerg Infect Dis [Internet]. 19.10 (Oct 2013). Accessed 20 Jan 2014. http://wwwnc.cdc.gov/eid/article/19/10/13-0441_article.htm 
2. Nielsen K, AL De Obaldia, J Heitman. 2007. “Cryptococcus neoformans mates on pigeon guano: implications for the realized ecological niche and globalization.” Eukaryot Cell. 6.6 (Jun 2007): 949-59. Accessed 20 Jan 2014. http://www.ncbi.nlm.nih.gov/pubmed/17449657
3. Frazer, J. 2013. “Fungi on the March.” Scientific American. 309(Nov 2013): 50-57. Accessed 20 Jan 2014. http://www.nature.com/scientificamerican/journal/v309/n6/full/scientificamerican1213-50.html.
4. Heitman, J. 2013. “Sexual reproduction and the emergence and evolution of microbial pathogens.” Duke University Medical Center for Microbial Pathogenesis. Accessed 20 Jan 2014. http://mgm.duke.edu/microbial/mycology/heitman/.
5.  Naureen I, EE DeBess, R Wohrle, B Sun, RJ nett, AM Ahlquist, T Chiller, SR Lockhart. 2009. “Correlation of genotype and in vitro susceptibilities of Cryptococcus gattii strains from the Pacific Northwest of the United States.” J. Clin. Micorobiol. 48.2 (Dec 2009): 539. Accessed 20 Jan 2014. http://jcm.asm.org/content/48/2/539.full.pdf+html.
6. Duncan CG, C Stephen, J Campbell. 2006. “Evaluation of risk factors for Cryptococcus gattii infection in dogs and cats.” J Am Vet Med Assoc. 228.3 (Feb 2006): 377-82. Accessed 20 Jan 2014. http://avmajournals.avma.org/doi/abs/10.2460/javma.228.3.377?prevSearch=allfield%253A%2528c.%2Bgatti%2529&searchHistoryKey.