Examining the Elephant: Many Views of One Health

Gary Vroegindewey, DVM, MSS, DACVPM

Director, Global Health Initiatives

Center for Public and Corporate Veterinary Medicine

Virginia Maryland Regional College of Veterinary Medicine

One Health Definition

One Health has been defined as "the collaborative effort of multiple disciplines — working locally, nationally, and globally — to attain optimal health for people, animals and the environment"

https://www.avma.org/KB/Resources/Reference/Pages/One-Health94.aspx

Unites the entire spectrum of medical expertise with the goal of improving and protecting animals and public

health worldwide

One Health

One Health HistoryThe recognition that environmental factors can impact human health can be traced as far back as to the Greek physician Hippocrates (c. 460 BCE – c. 370 BCE) in his text "On Airs, Waters, and Place".

He promoted the concept that public health depended on a clean environment.

Hippocrates

One Health HistoryLucius Junis Moderatus Columella wrote a work Segregation and Quarantine, which was an early text on agriculture and lead to a basic form of One Health, in that it advised people and animals to be kept separate on farms.

One Health History

Rudolph Carl Virchow (1821 – 1902)

“Between animal and human medicine there is no dividing line-nor should there be.

The object is different but the experience obtained constitutes the basis of all medicine."

COLUMBIA VETERINARY COLLEGE (1877-1884)

“It is desired to have graduate not only a horse-doctor or a cow-doctor, but a man qualified to give medical advice upon the diseases of all domestic animals; to make him, in fact, a doctor of comparative medicine”.

Professor Bates (Dean)

Langdon Frothingham

1889

Harvard, 1882-1901

New York-American Veterinary College, within the NYU School of Medicine 1899-1922

NYC, East 26th Street, 1924

“The medico in an Australian sheep district not only has to prescribe for his patients both man and beast, but has to act as his own dispenser and, in fact, combines the duties of a doctor, veterinary surgeon and a chemist.”   

Courtesy: C. Trenton Boyd,BS, MA, AHIP, FMLA

One Health History

Calvin Schwabe, DVM

One Health Commission

One Health Initiative

Conferences

Courses and Degrees

Courses

One Health Library Guide created by Duke Global Health Librarian Duke Global Health librarian, Diane Harvey, immediately reached out to the One Health course organizers to get involved. She has put together a fantastic resource for the course and our students, a One Health LibGuide.

This guide will be very helpful in researching case studies and learning more about One Health. Diane has been working with her counterparts at UNC, Mellanye Lackey, and NC State, to provide resources to the students.

Libraries

One Health References

“The threat to human health will persist as long as the problem persists in animals.”

Dr. Peter HorbyWorld Health OrganizationViet Nam

Greater progress in prevention and control of infectious diseases requires a more directed effort focusing on the complex interplay between human health, the health of animals, and the environment.

Are We Truly One Health?

One Health Group Hug

The One Health Elephant in the Room

Barriers to One Health in Operation

Barriers to Effective One Health•Legal Authority•Funding• Institutional Culture•Processes•Terminology•Facilities• Infrastructure• Information technology

DoD Lyme Disease Example

US Army Center forHealth Promotionand Preventive Medicine

US Army Veterinary Command

US Army Medical Centers

Avian Influenza

Avian Influenza

Disease Surveillance

Terminology/Information Technology

ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO).

It codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.

The US ICD-10 CM, for instance, has some 68,000 codes. The US also has ICD-10 PCS a procedure code system not used by other countries that contains 76,000 codes

ICD-10 Example

Veterinary Terms in Human Databases

Sample of pink salmon infected with Henneguya salminicola, caught off the Queen Charlotte Islands, Western Canada in 2009

Informatics

One Health Through Multiple Lenses

"Blind monks examining an elephant“ an ukiyo-e print by Hanabusa Itchō (1652–1724).

One Health Lenses

Translational and Comparative Medicine

What can we learn from one species that can be translatedinto another species

Example:

Al-Mashhadi and colleagues created a large animal model of familial hypercholesterolemia FH by genetically altering Yucatan minipigs.

These animals reproduce features of the human disease, and could thus be used for translational atherosclerosis research into new drugs and imaging agents.

CREDIT: J. RAIS/AARHUS UNIVERSITY

Comparative Medicine

One Health Lenses

Zoonotic Diseases

Disease transmitted fromanimals to people

RabiesEbolaMonkey poxSalmonellaE. coli

Cardinal Albrecht of Brandenburg as St. JeromeLucas Cranach the Elder (1472-1553)

FMD

Emerging Infectious Diseases

Monkeypox

Hanta virus

Plague

Ebola virus

Nipah virus

Rift Valley Fever

West Nile

Anthrax

One Health Lenses

World Bank- People, Pathogens and our Planet

Narrow to Holistic

Holistic One Health

The Peaceable Kingdom- Edward Hicks 1780-1849

Acknowledgements

C. Trenton Boyd,BS, MA, AHIP, FMLA Distinguished Librarian Curator of the Medical and Veterinary Historical Collections University of Missouri

Don Smith, DVM, DACVSProfessor of Surgery and Dean EmeritusCornell University College of Veterinary Medicine

Gary Vroegindewey, DVM, MSS, DACVPMDirector, Global Health InitiativesVirginia-Maryland Regional College of Veterinary MedicineMaryland Campus8075 Greenmead DriveCollege Park, MD  20742-3711301.314.6821 gvroeg@umd.edu

Discussion