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09/14/2012
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Wildlife, the Environment, and Biodiversity: The Wild Cards in the One Health Game
Christine Ellis DVM MPH
Colorado State University, Animal Population Health Institute, College of Veterinary Medicine
National Wildlife Research Center
Fort Collins, CO
Kurt VerCauteren PhD
National Wildlife Research Center
Fort Collins, CO
Mo Salman BVMS, PhD, FACE
Colorado State University
Animal Population Health Institute
Fort Collins, CO
Statistics
57 million global deaths globally annually
– 25% caused by microbes
1415 human pathogens
– 217 viruses & prions
– 538 bacteria & rickettsia
– 307 fungi
– 287 helminths
– 66 protozoa
868 (62%) are zoonoses
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Statistics
868 zoonoses
– 3% human origin
– 71.8% wildlife origin
Ungulates
> 250 human pathogens
> 50 emerging and re-emerging pathogens
Human EIDs over the last 30 years
~ 75.0% are zoonotic
~ 22.8% are vector-borne
SARS
– $40 billion worldwide
– Thousands of people quarantined
– 50-70% drop in international travel
– 60% drop in hotel occupancy
– Businesses failed
– Some large production facilities suspended operations
Economic Impacts of Zoonotic EIDs
– Lee & McKibbin. Estimating the Global Cost of SARS. In: Learning from SARS: Preparing for the Next Disease Outbreak
– WHO. The World Health Report
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“One Medicine”
The study of health and disease regardless of species differences between human and animals, focusing on the commonality of human and veterinary medicine.
A clinical definition
– Insufficiently reflects interactionsbetween human and animal health
– Does not fully consider external factors
– societal dimensions
– public health
– environment
– ecology
“
“One Health”
“The health of animals, people and the environment are inextricably linked”
A worldwide strategy to expand interdisciplinary collaborations and communications in all aspects of
health care for humans, animals and the environment
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“Ecosystem Health”
The “World” and “Environment” are “Ecosystems”
“One Health/ One World/ One Environment”
EcosystemWellness
Humans & AnimalWellness
“Ecosystem Health”
Requires integrated approaches to human and animal health and their respective social and
environmental contexts
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What Makes a Disease Emerge?
Disease Occurrence
Wildlife
HumansDomestic animals
Infectious organisms
Potential Disease
Occurrence
Potential Disease
Occurrence
What Makes a Disease Emerge?
Disease Occurrence
Wildlife
HumansDomestic animals
Infectious organisms
EnvironmentPotential Disease
Occurrence
Potential Disease
Occurrence
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Causes of Disease Emergence
Disease Occurrence
Disease Occurrence
Wildlife
HumansDomestic animals
Infectious organisms
Environment
What Makes a Disease Emerge?
Human Population Density
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What Makes a Disease Emerge?
1: Changes in land use or agricultural practices
2: Changes in human demographics and society
3: Poor population health
4: Hospitals / Medical procedures
5: Pathogen evolution
6: Contamination of food sources or water supplies
7: International travel
8: Failure of public health programs
9: International trade
10: Climate changes
Zoonoses
Zoonoses
Woolhouse and Gowtage-Sequeria 2005
Causes of Emergence
18%
13%26%
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Causes of Emergence: Agriculture & Land Use
Occupies ~ 38% of Earth’s surface
Crop production increased 47% between 1985-2006
Worldwide agriculture has cleared or converted
– 70% of grasslands
– 50% of savannas
– 45% of temperate deciduous forests
– 37% of tropical forest biomes
Irrigated cropland doubled in the past 50 years
~ 70% of global freshwater devoted to irrigation
Global fertilizer use increased by 500% (>800% for nitrogen)
October 1998 – May 1999
> 265 cases human encephalitis
• 105 deaths
• Disproportionate number of farmers
Nipah Virus
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Anthropogenic Factors: Movement of Animals
Anthropogenic Factors: Movement of Animals
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Establishing and maintaining a ORV Zone = $58 - 148 Million
Avoided cost or net benefits = $48 - 496 Million
TX
MT
NM
COIL
WY
KS
IANE
SDMN
ND
OK
FL
WI
MO
AL GA
AR
MI
IN
LA
NY
NC
PA
TN
MS
VAKY
OH
SC
ME
TX
MT
NM
COIL
WY
KS
IANE
SDMN
ND
OK
FL
WI
MO
AL GA
AR
MI
IN
LA
NY
NC
PA
TN
MS
VAKY
OH
SC
ME
What Makes a Disease Emerge?
Zoonotic Pathogen “Weediness”
– Makes certain pathogens adept at taking advantage of new epidemiologic opportunities
Pathogens are “smart”Exploit any change in ecology that provides new
opportunities
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Causes of Emergence: Climate
Highest concentration of EID events per 1 million km2 land
30
60
90
0
- 30
- 60
- 90
Hotspots: NE US western EuropeJapan, SE Australia
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Invader
– fastest spreading mosquito in the world
Aggressive daytime biter
Transmits
– Dengue, WNV, Encephalitis viruses
Ross River fever Rift Valley fever
An Integrated Systems Approach to Pathogens
Aedes Albopictus (“Asian Tiger Mosquito)
Aedes albopictus
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Aedes albopictus
Present predicted distribution, native range in Asia
Aedes albopictus: Invasion risk map
Invasion Risk Map
– Used ecological data from the Asian niche
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Aedes albopictus: USA invasion
Causes of Emergence: Biodiversity Loss
“The variety of species, the diversity of their genetic make-up, and the natural communities in which they occur”
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Biodiversity and Pathogen Emergence
What role does biodiversity have in the processes by which pathogens emerge?
Biodiversity may act as a source pool
A large number of potential pathogens
Biodiversity may PREVENT exposure
Pathogen transmission is reduced
Schistosoma mansoni
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Shistosoma mansoni
West Nile Virus in the US
Low bird diversity = increased human risk or incidence
Communities with low avian diversity
– dominated by species that amplify the virus
Communities with high avian diversity
– contain many species that are less competent hosts
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Northeast New York hantavirus
West & Central Sin Nombre
FloridaBlack Creek Canal virus
Texas Muleshoe virus
SoutheastBayou Virus
Hantavirus
Lyme Disease
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How many of you learned this stuff in school, or in your professional training?
This is why including wildlife biologists, ecologists, environmental scientists in discussions of One
Health is important
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One Health Approach to Rabies
Ancient Greeks called it “Lyssa” or “Lytta”
Present on all continents except Antarctica
• 100 countries
• 3 billion people at risk
• 55,000 human deaths annually *
– 50% children < 15 years
Rabies in the United States
Prior to 1947:
– Canine rabies was predominant variant
– Incidence in domestic canines > wildlife
– ~ 100 human deaths / year
1947:
– Efficacious canine rabies vaccines developed
– National Rabies Control effort
• Local & National Education campaigns
• Urban field operations (domestic pets)
• Rural field operations (livestock, wildlife)
1957:
– Domestic dog cases > wildlife for the first time
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Rabies in the US – 2009
Enzootic Rabies is present in the continental US & Puerto Rico
Skunk:24% total cases26% wildlife cases
Fox:7% total cases 8% wildlife cases
Raccoon:35% total cases38% wildlife cases
Bat: 24% total cases, 26% wildlife cases
Puerto Rico:43 cases 79% Mongoose
Source: CDC
Rabies and One Health
Factors affecting occurrence:
Humans & Domestic Animalspopulation dynamicshealthagricultural practicesanimal translocation
Wildlife population biologyspecies interactionmovementhealthsusceptibility
Rabies Virusvariant proclivitiesspecies specificitymutation
Environmentclimate changeencroachmentdegradationpollutionfragmentation
Rabies
wildlife
humansdomestic animals
rabies virus
environment
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Introduced in 1800’s
High reproductive index
Bad attitude
Eats everything
Negative environmental impact
~ 70% may be infected with rabies?
Rabies in Puerto Rico
Rabies in Puerto Rico
Human Population: 3,706,690
Mongoose Population: ~ 2,000,000
Mongoose Density: 2-9 / ha (1-4 / acre)
~ 25 people/day exposed
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A One Health Experience Waiting to Happen!
Human Health
– Education
– PEP
Veterinary Medicine
– Large feral dog & cat populations
– Livestock
Wildlife Sciences
Ecology
Vaccine Research
Economists
Rabies in Puerto Rico
Wildlife Emerging Infectious Diseases
Historically, wildlife diseases have been considered important only when human health or agriculture have been threatened
Parallels between human and wildlife EIDS – Domestic animals introduce their own suites of
pathogens
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Bovine Tuberculosis in Michigan
1979: Michigan declared free of bovine TB
1994: A hunter-killed deer discovered with bTB
1995-2011: 1-4% deer (+)
Other animals reported
– Elk
– Captive cervid facility
– Domestic cattle
• (9 beef, 2 dairy)
– Carnivores
1917
The most prevalent infectious disease in livestock– Cattle: ~ 5% prevalence – Swine: ~15% prevalence
– Carcasses inspected: < 10 million
– Carcasses retained: ~ 200,000
Humans: 20% of cases causedby M bovis
Last 10 years
– Cattle: <0.001% prevalence
– Swine – eradicated
– Carcasses inspected:
36 billion
– Carcasses retained:
~ 1300
Human cases: 1-6 / year
(11,182 TB cases in 2010)
Bovine Tuberculosis
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Bovine Tuberculosis
Bovine Tuberculosis in Michigan
Spill over infection from cattle
Human Intervention:
– Hunt Clubs
– increase in prevalence appears to be associated with escalation of feeding and baiting in the 1980-90s
Data from the 1950s
– deer were exceeding the natural carrying capacity of the habitat
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Bovine Tuberculosis in Michigan
Bovine Tuberculosis and One Health
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Bovine Tuberculosis and One Health
Breath analysis as a potential diagnostic tool for tuberculosisKolk et al (2012)
International Journal of Tuberculosis and Lung Disease June 16(6): 777-82
Volatile biomarkers of pulmonary tuberculosis in the breathPhillips M. et al (2007) Tuberculosis 87: 44-52
One Health & Bovine Tuberculosis
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Summary
“One Health/ One World/ One Environment”
– Improved communication, cooperation and collaboration across disciplines and institutions is essential to safeguard the health of humans, animals and the environment
But . . .
Most infectious disease research still emphasizes an etiologically based, disciplinary approach
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Walking the Talk
A gap exists between knowledge and its applications
– Rabies
• cases increase despite well-established knowledge of effective control
– TB:
• we still don’t have better vaccines
The next research paradigm…must be collaborative Biological Sciences Ecology Climatology Sociology Political Science Medicine Wildlife Sciences Environmental Toxicology
A complex-system view of health
– integrated surveillance and research
– use of project management models
Wildlifesciences
Human Medicine
Veterinary Medicine
Environmental Sciences
Biodiversity Studies
Walking the Talk
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Recognize Our Strengths and Weaknesses
Veterinary Medicine
Population health
Food safety
Preventive medicine
Individual animal health
Public health/ Zoonosis
Wildlife Sciences
Population health
Wildlife - Domestic Animal Interface
Ecology
Individual animal health
Public health/ Zoonosis
Human Medicine
Population health
Food safety
Preventive medicine
Individual health
Public health/ Zoonosis
Infectious Disease
Chronic Disease
BioDiversity Sciences
Climate studies
Environmental Studies
Ecology
Evolutionary impact
Public health/ Zoonosis
Adopt an integrated, “holistic” approach that reflects both our interdependence and the realization that we are part of a larger ecological system
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Acknowledgements
Kurt VerCauteren PhD, USDA-APHIS-WS-NWRC, Fort Collins, CO
Mo Salman, APHI, CSU, Fort Collins, CO
Pauline Nol DVM PhD, USDA-APHIS-VS-WILDIT, Fort Collins, CO
Jack Rhyan MS DVM, USDA-APHIS-VS-WILDIT, Fort Collins, CO
Ray Waters DVM PhD, USDA-APHIS-ARS, NADC, Ames, IA
Mitch Palmer DVM PhD, USDA-APHIS-ARS, NADC, Ames, IA
Town Peterson PhD, University of Kansas
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Zoonotic pathogens
~ 25% have limited person-to-person transmission
– Do not persist without repeated reintroductions from a non-human reservoir
Do not cause major epidemics
A small minority spread almost exclusively from person to person
An Integrated Systems Approach to Pathogens
For pathogens that emerge by switching host species
– Land use change
– Underlying biodiversity patterns
– Surveillance of endemic wildlife and wildlife pathogens
– Preserve / Protecting intact habitats in these hotspots
• a simple, direct way of reducing human-animal contact and
• reduces the likelihood of emergence of new pathogens
– Manage potential emergence hotspots
• reduce the probability that pathogens become established and transmissible within a new host population
– Husbandry management of high-density monocultures of domestic animals
• surveillance for disease presence
• employ measures to decrease contact with wildlife
Managing potential emergence hotspots by attempting to eliminate them is not likely to work.
The species most resilient to habitat destruction and degradation may be those that amplify the pathogen transmission
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Zoonotic Pathogens
Monkey escapes
Monkey infects a kid
Kid infects family
Family infects town
Humanity in peril !!!
Intrepid epidemiologist catches monkey
Antibody harvested from monkey
All of humanity saved !!!
Walking the Talk -- Literature Search (Anholt et al 2012)
Strategies for Collaboration in the Interdisciplinary Field of Emerging Zoonotic Diseases
Anholt R. M., Stephen C., Copes R.
Zoonosis and Public Health 2012, 59: 229-240
Conducted a literature search looking at results of collaborations built in health partnerships, health research knowledge transfer and exchange, business knowledge management and system design engineering to identify key attributes of successful interdisciplinary collaboration.
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Opportunities exist, but are not without challenges
Characteristics of the people
Degree to which the task is a shared goal
Policy, practices, and resources of the workplace(s)
Personal relationships built on trust and respect are needed.
Financial
“It is necessary to move beyond the belief that collaborations are simply a “good thing” to demonstrate ID collaboration results in improved outcomes.”
“There was a dearth of publications providing evidence of improved outcomes arising from such collaborations.”
Walking the Talk -- Literature Search (Anholt et al 2012)
But . . .
Our ability to protect, improve, and advance health cannot be based on strategies and mindsets in the past
Isolated silo thinking and actions persist
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Integrated Systems Approach
A complex-system view of health
– integrated surveillance and research
– use of project management models