MESSAGE FROM THE CHAIR When we first discussed the topic of “The Global Threat of Infectious Disease Outbreaks”” as a publication team, we expected our members to write about outbreaks in animals. But suddenly, COVID-19 appeared in our lives and has made this topic more relevant, and all the more interesting to write about. An overwhelming number of articles were being submitted, and while we were excited by the enthusiastic response, our team faced difficulties in processing and reviewing all of the submissions. The articles were not only numerous, but they were delightfully diverse: topics ranged from outbreaks of animal diseases, to those of human diseases, all the way to emerging and re-emerging outbreaks and the outbreak we are all currently experiencing today. That being said, it’s important to remember that similar outbreaks are happening in the animal world. At the current rate of things, our environment also faces the same destructive fate. We have to learn how each field of science can tackle these situations, and how collaboration can help solve problems. Together, we can prevent future threats to our planet, the animals we share it with, and ultimately, ourselves. We just have to keep trying. Although COVID-19 brings more than its share of despair and definitely makes our lives more challenging nowadays, there are some important lessons we can take away from this shared experience. First, we have to work as One!! We are only working against ourselves… and this clearly does not lead to good results. Second, the main thing that allows us to live happy, productive lives is our Health!! Not the health of a single person or country, but the health of everyone. Right now may be the best time to understand the One Health idea, and really take it to heart. In this very important edition, you will find a lot of information and we hope that you can gain some real knowledge and insight on this topic. There is a large range of articles, and we put them together here, in one place, for you to learn. We are also extremely happy to have an article from Purina, which gives another, welcomed, tone to our edition. Now, let’s all take this first step to gain as much knowledge as we can, so we can be ready to act together, as one, when we are called upon to do so. Many thanks to everyone who submitted an article for inclusion in this edition. Congratulations to every writer featured, and to the SCOH members for their great work.
With Love,
Pappas Andreas
WORDS FROM THE PUBLICATIONS Dear IVSA family,
Greetings from Greece. Another journal is complete and ready for you to discover it. For the last three months our world has been shocked by COVID-19. But it is not the first time humanity faces something like this. With this magazine you will remember some of the latest pandemics and how we succeed to overcome them. Also, I want to thank everyone who has submitted their articles for the 17th edition of the Veterinary Public Health Journal. So enjoy the journal and stay inside, stay safe and protect yourselves.
With kindest regards, Karachristos Konstantinos, SCOH Publication Team
EDITOR’S NOTE Hello IVSA, Welcome to VPHJ#17 with the theme of “ The Global Threat of Infectious Disease Outbreaks” regarding with the present and upcoming threats to global health due to emerging and re-emerging Infectious disease. We wanted to give you a broader sense of knowledge and information about the role of One Health to fight against the threats of the infectious disease in present and upcoming days. In recognition of the growing importance of knowledge about infectious disease, This edition features great contribution articles from IVSA Nepal, IVSA Macedonia, IVSA Germany, IVSA Bangladesh, IVSA Cyprus, IVSA Egypt,IVSA Pakistan ,IVSA South Africa as well as from the PURINA Institute .In this issue you will also get to know about SCOH Activites, Events and News regarding 1st One Health Conference, OIE Junior Ambassadors, results of Tuberculosis Challenge. Currently the globe has been struck with another devastating pandemic named as COVID-19 which is listed among the disease with the huge threat to tne mankind. Most of the countries are in lockdown and the daily life has been more challenging. The Health Personnels are doing their best to save lives. The concept of the One Health says everyone under it’s umbrella to try their their best to win the battle against infectious disease. This pandemic serves as a good example of the concept of One Health.Don’t forget to read the letter by the Professors from the Italy (A country highly affected by COVID-19) which is for the readers and students. I request all the readers to open and have a look to the file IFMSA created (by pressing the button given at the page with description of WHSA) in which you can find much information and all new updates about COVID-19 and the pandemic. You can also find promotional materials to share with your classmates, your families and the general public about the prevention and the steps that we should follow. Don’t forget to try out the crossword puzzle that we included in this issue to make the readers mind play with the terms related to the One health relating with the theme of the VPHJ#17. Try to solve the puzzle, it’s for you and it is surely going be fun!! Thank you for the contributions in this editions and Congratulations to all of the featured articles. We hope you enjoy the read.
Suraj Bhandari
Publications Team Standing Committee on One Health(SCOH) International Veterinary Student Association(IVSA)
TABLE OF CONTENT CROSSWORD PUZZLE...................................................................................................1 LETTER FROM ITALY....................................................................................................2 ARTICLES 1.Purina Reveals A Revolutionary Approach To Managing A Major Cat Allergen......7 2.The Global Threat of Infectious Diseases Outbreaks.................................................10 3.How Infectious Disease Outbreaks Are Shaping Our World & Vice Versa..............12 4.Pandemics! Are We Ready?..........................................................................................15 5.Hantavirus: Threat of Infectious Disease by Rodents................................................16 6.Global Health & Infectious Disease Outbreak............................................................19 7.I AM BECAUSE WE ARE: The South African Foot and Mouth Disease Outbreak as Practical Illustration of One Health Viability..........................21 8.The Global Threat of Infectious Disease Outbreaks...................................................24 9.Biological Warfare & Bioterrorism: Global Threats of Infectious Disease Outbreaks.....................................................................26 10.Infectious Disease Threats In Twenty First Century................................................30 11.The Effect of COVID-19 On The Earth.....................................................................33 12.Namaste: An Etiquette For Disease Control.............................................................35 13.Is The Record Of The Most Mortal Outbreak About To Be Broken........................38 14.Novel Coronavirus (2019-nCoV) Infection..............................................................41 15.Global Threat Of Infectious Disease Outbreak.........................................................45 16.COVID-19 - Global Matter Of Concern at Present..................................................46 17.Ecology Of Zoonotic Disease.....................................................................................49 18.Global Threat Of Infectious Diseases Over Time....................................................52 19.Back To The Past: Outbreak of an Infectious Disease Ebola ..................................58 20.Combat Against Serious Infectious Disease: Rabies in Nepal................................60
SCOH NEWS........................................................................................................ 63 GALLERY..........................................................................................................................68
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Brain Games
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Crossword Puzzle 1.
2. 3. 4.
5.
6. 7.
1
8. 9.
10.
Clues:
Down
Across
4.Transmissible by direct or indirect contact with infected ones.
1.An infection or disease that is transmissible between animals and humans.
5. A sudden rise in the incidence of a disease. 7. Presenting no symptoms of disease. 8. An object contaminated with infectious organisms and serve in their transmission. 9. A virulent contagious febrile disease that is caused by a bacterium (Yersinia pestis). 10. A pathogenic microorganism and esp. bacterium that has developed resistance to the medications normally used against it.
2. Terrorism involving the use of biological weapons. 3. An infectious disease spread among wild animals living in forests. 6. Disease occurring over a wide geographical area and affecting an exceptionally high proportion of the population.
YOU CAN FIND THE ANSWERS IN THE PAGE NO:69
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April 2020
LETTER FROM ITALY
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Dear Students, As virologists at the Department of Veterinary Sciences we feel the responsibility to express and let you know our opinion regarding what is going on in our Country. Those who have already attended our virology lessons know the approach we use when we talk about epidemic infections and about the strategies used by the viruses to survive within an animal population. We are talking about an RNA virus, with a strong propension to mutation and adaptation. Its origin is for sure from animals and bats are the most likely specie that could be considered as reservoir (they host several betacoronavirus, for example SARS virus took origin from those). It is likely that it passed on to humans a while ago and along this time it ‘learned’ through mutations how to succeed in a human to human transmission. The cross-species transmission guarantees to any new virus an advantage towards the susceptible population. Mankind is a wonderful opportunity because it is huge in number, mixed and naïve by immunological point of view.
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Coronavirus is usually involved in seasonal cold are alphacoronaviruses and they have very little in common with COVID-19 as far as cross-protection is concerned. Therefore, we are not expecting a reduction in virulence soon. Only when population immunity will get to a certain point, then the virus will start to be transmitted less efficiently and light symptoms or chronic or asymptomatic will become more common. These already exist in most of the infected population, but 15- 20% of cases who develop the infection still need hospitalization.We are not talking about the plague, but it is not a simple flu either.The common seasonal flu has a case fatality rate of approximately 0,1%, not so low, but most of the population is immune (due to previous infections, partly cross – protective ones towards the new one and due to vaccinations). In such a situation flu virus is maintained within the population, but only infects a minority of the population without heavy consequences on the working population of a Country SARS CoV2 is a new virus. We don’t have neither immunological memory nor heard immunity. In such a case the virus, without effective control measures, would have an epidemic growth, involving a high percentage of the susceptible population, before starting to slow down the progression. This means that without severe pathologies, a big part of the working population would be stopped for weeks with devastating consequences on National economy. This is why we DO NEED the current restriction measures in order to at least control the major epidemic outbreaks. COVID-19 causes severe symptoms that can lead to hospitalization in 15% of the cases. We are talking about pneumonias that need for healing an intensive care for about 20 days, with the assistance of artificial breathing. So, the matter is not the fact that the population at risk is the over 70 one, we all the due respect to our elders. People in their forties or fifties (a quite big percentage of working strength) would need the same therapy. How many beds for intensive care do we have here in Italy? How many of those are already full of patients who had other traumas? Therefore, we need to apply every useful measure to control the spread of epidemic outbreaks, even though they may be felt as excessive. Dear students, you already have a sensibility and VetPubHealth Journal ISSUE 17
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knowledge regarding the fight towards animal diseases. Your knowledge is a treasure and you may be an active part in risk communication, without any excessive alarmism but not even by underestimating the risk. You have probably noticed that not all virologists daily in media have the same ideas. This is absolutely normal (science is democratic AMONG SCIENTISTS and different approaches are necessary for a scientific debate). Nobody knows how and when this will end. The prevention approach, if applied the right way, will never be appreciated enough because the sanitary issue then doesn’t take place. Whereas an underestimation of the risk, in a situation of uncontrolled epidemy, could lead to a revolution. The tough part of making the right decision in how narrow the border is between to opposite extremes. Sincerely, Prof. Dr.Sergio Rosati & Prof. Dr.Luigi Bertolotti Infectious Diseases Section of the Veterinary Sciences Department of the University of Turin (Italy)
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Dear Students, The media popularity that followed our first letter touched us a lot. We don’t like being the center of attention, but we must thank you all for your contribution by sharing the message. This time, Veterinary Medicine spoke out. We enthusiastically accept the challenge, sure that you can help, we can give a good service to everybody, to make the perception of the social engagement of your future profession grow. We thought about maintaining a direct connection with you by writing a second letter. The aim is always the same, enrich your knowledge to become smart and well prepared communicators. The current idea, with a ‘One Health’ approach is to better define the original fault, which means the conditions at the origin of the main epidemy of last years. THE ORIGINAL SIN
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We still are in the middle of the emergency and already looking for a guilt, the one that risks putting down the global economy. We talk about delay in communication of the information to the international community; about viruses escaped from laboratories, developed for unknown reasons; about what could have been done and what shouldn’t have been done; about an artificial emergency created just to spread panic. We are living in a globalized, hyper technological world, that suddenly discovers its weak side, that shows himself armless facing the oldest menaces (diseases). We are virologists and as virologists we speak, leaving to others the duty of search for anthropological aspects. We found our guilt: the wet market, from which most of pandemic viruses of the last decades took origin. In wet markets, typically Asians, you can find livestock, wild animals that are kept together, slaughtered in unsure hygienic conditions and sold raw or cooked. Something similar happens in central Africa, where bats and monkeys are hunted and eaten by locals. As we will see in the insight, these environments represent a wonderful occasion for viruses and their mutations, enabling the cross-species transmission. It is likely that some habit takes their origin in traditions for some populations. In the past, this led to small epidemic outbreaks that quickly came to an end. The selfextinction of these outbreaks is of course an unlikely event for a virus, especially for the most pathogens, because by killing the new host, they can’t guarantee the species’ survival. The host dies and the virus beside that is not able to do anything else. The self-extinction can also occur for less pathogenic viruses, because of the population immunity, as the number of people that successfully overcame the infection increases, the epidemy slows down till it stops. Of course, the lowest the number of people is, the quicker this result is obtained. This used to happen a long time ago, in isolated Chinese villages or in small African villages. From the 70ties we become part of the progressive migration of populations towards large urban areas. Highly populated, bringing together with this food habits and connected risks. Several Ebola virus epidemies, new types of flu virus and coronavirus related to severe respiratory syndromes became therefore present in complex demographic situations in which contention measures require a huge effort. Every change in human lifestyle, domestic animals and wildlife, that nowadays occurs more and more rapidly will lead to consequences that are now hard to imagine. We hope that in the future we will have some more element to think about the society model that we chose. VetPubHealth Journal ISSUE 17
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INSIGHT Coronaviruses, such as flu viruses, have RNA genome. A common characteristic is their incredible ability to mutate very quickly because of the low precision of their replication enzymes. During replication some viruses can mutate so much that more than 70% of viral particles are defective (not working). What seems to be a handicap is a real advantage because it allows to the pathogen to adapt to new tissues, new hosts and to elude the immune defenses. Genetic mutations can be reflected to amino acid substitutions, changing the viral proteins that are necessary for the first part of the viral replication, the adhesion to the host cell. Furthermore, viruses with segmented genome such as the flu virus, can mutate in an even more drastic and quick way by swapping complete segments of their genome. This process is called reassortment and is the background for flu epidemies. Usually a wild animal is the principal host, these viruses coevolve with him, often without causing any severe symptom (they usually replicate in the intestinal tract, without a major involvement of the immune response). This is a consequence of long periods of cohabitation and adaptation, from the virus side and from the host side too. this aspect lead to a genetic stability, without any selection pressure from the immune system. Beside that being used to a host does not prevent the virus from mutation: if we add different actors in the natural cycle, these can represent new host for the mutated variants. This is what reasonably happened at the beginning of Covid-19: betacoronaviruses usually infect bats. The melting pot with other animal species enabled what is technically known as “spillover� which means the cross species jump. A virus can hardly directly pass from a bat to humans, or, like what happens with flu, from a bird to humans (with a few exceptions). Viruses need to adapt to more similar species from a genetic point of view, so that small mutations can be sufficient to pass on to a new host and, with time, to be efficiently transmitted among the new host. This is where we find animals such as the zibet (a wild carnivore), camels, or pigs and boars for some flu viruses. Small jumps, but they lead the virus to be transmitted to humans and most of all to get into the interhuman transmission cycle. The best way to enhance this mechanism is to augment contact probability and wet markets are the best epidemiological center. Sincerely, Prof. Dr.Sergio Rosati & Prof. Dr.Luigi Bertolotti Infectious Diseases Section of the Veterinary Sciences Department of the University of Turin (Italy)
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Dear students, The question that is now pressing the veterinary world is: can SARS-co2 infect animals? I’m used to tell the students: if you want to know a virus and predict its moves you have to imagine that it’s a thinking being and to try to think like it… "I lived in the intestine of a bat. What a …. though life! Then one day, after several attempts and asking for a lift to intermediate species, I managed to get in a human body. At the beginning it was tough, but then, thanks to my imperfect enzymes, I improved the replicative skills and earned the right to invade his respiratory tract.
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This new specie is amazing: it’s huge, it travels fast and moves around the world. Humans live in very large groups, millions of individuals under domes of smog. They love promiscuity, from time to time they organize gatherings of tens of thousands of individuals around a rectangle of grass, shouting out loud for an hour and a half and dispersing billions of droplets of saliva. It’s an unwise, selfish specie, and it doesn’t seem to have a very developed survival instinct. Its immune system only knows me since a very short time and it couldn’t bother me less. So why would I leave them, to infect cats and dogs and start all over again? I’ll think about it later." Hoping to see you all soon. Best wishes
Prof. Dr.Sergio Rosati & Prof. Dr.Luigi Bertolotti Infectious Diseases Section of the Veterinary Sciences Department of the University of Turin (Italy)
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ARTICLES
A Global Threat of Infectious Disease Outbreaks
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Institute Advancing Sciences for Pet Health
PURINA REVEALS A REVOLUTIONARY APPROACH TO MANAGING A MAJOR CAT ALLERGEN THE SCIENCE BEHIND REDUCING ACTIVE FEL D 1 AT ITS SOURCE IN CATS’ SALIVA
7 As many as 1 in 5 adults, worldwide, suffer from sensitivities to cat allergens.1,2 The main recommendation for people with these sensitivities is to avoid cats.3 Now, after more than 10 years of research, Purina scientists discovered a new approach that can give people and cats a chance to stay closer together. This safe and proven approach uses cat food coated with an egg product that neutralizes the major cat allergen, Fel d 1, at its source in cats’ saliva before the allergen gets into the environment.4,5 This offers people sensitized to cat allergens a way to reduce their exposure to the allergen, not the cat.
Allergies to cats affect approximately 1 in1 5 adults worldwide.
A common problem for people and cats Cat allergens can impair quality of life for allergy sufferers by interfering with daily activities.6,7 They also limit interactions between the allergic person and cats. Allergy to cats is a common reason for relinquishment to shelters,8-13 as well as a bar-
Fel d 1 is the major cat allergen Fel d 1 is produced primarily in cats’ salivary and sebaceous glands, spread throughout the hair coat during grooming, and shed into the environment with hair and dander.15,17 All cats produce Fel d 1 regardless of breed, sex, age, hair length, hair color, or body weight.3,7,15,17-21 The function of Fel d 1 is not yet known, but studies suggest a pheromone or chemical signaling role.2,15,22 VetPubHealth Journal ISSUE 17
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April 2020
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A new approach to allergen management Most methods of allergen management are effort-intensive, costly, and focus on managing exposure to the allergen in the environment.7,23 With Purina’s approach, the cat simply eats a nutritious food coated with an egg product containing anti-Fel d 1 antibodies.4,5 As the cat chews the kibble, the antibodies bind to active Fel d 1 in the cat’s saliva. Once bound, Fel d 1 is neutralized, and no longer recognized as an allergen. The neutralized Fel d 1 is transferred to the cat’s hair and dander during grooming, ultimately reducing active Fel d 1 levels in the environment. This approach does not stop a cat’s natural production of Fel d 1. A comprehensive safety study confirmed the ingredient is safe for cats.24
Proven science
Neutralized Fel d 1
Purina’s breakthrough maintains normal allergen production by the cat without affecting the cat’s overall physiology
In peer-reviewed, published studies4,5 cats showed significant reductions of active Fel d 1 in their saliva, and on their hair and dander, when fed a diet coated with an egg product containing anti-Fel d 1 antibodies. n 97% of cats showed reduced active Fel d 1 on their hair and dander.5 n 47% reduction, on average, of active Fel d 1 on cats’ hair beginning with the third week of feeding the diet.5 n 86% of cats had a reduction of at least 30% from baseline For more information levels.5 on this breakthrough, Reducing active allergen levels can have real and positive visit impacts.25,26 Cat-allergic people exposed to dander from cats fed www.PurinaInstitute.com this diet showed significant reductions in nasal allergy symptoms and some ocular symptoms.25 This revolutionary new approach reduces exposure to the allergen, not to the cat—bringing cats and people closer together. References: 1. Bousquet, P.-J., Chinn, S., Janson, C., Kogevinas, M., Burney, P. & Jarvis, D. (2007). Geographical variation in the prevalence of positive skin tests to environmental aeroallergens in the European Community Respiratory Health Survey I. Allergy, 62, 301-309. 2. Zahradnik, E. & Raulf, M. (2017). Respiratory allergens from furred mammals: environmental and occupational exposure. Veterinary Sciences 4, 38. doi: 10.3390/vetsci4030038 3. Dávila, I., Dominguez-Ortega, J., Navarro-Pulido, A., Alonso, A., Antolin-Amerigo, D., Gonzalez-Mancebo, E.,…Torrecillas, M. (2018). Consensus document on dog and cat allergy. Allergy, 73(6), 1206-1222. doi: 10.1111/all.13391 4. Satyaraj, E., Li, Q., Sun, P. & Sherrill, S. (2019).
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Anti-Fel d 1 immunoglobulin Y antibody-containing egg ingredient lowers allergen levels in cat saliva. Journal of Feline Medicine and Surgery, 21(10), 875-881. doi: 10.1177/1098612X19861218 5. Satyaraj, E., Gardner, C., Filipi, I., Cramer, K. & Sherrill, S. (2019). Reduction of active Fel d 1 from cats using an antiFel d 1 egg IgY antibody. Immunity, Inflammation & Disease, 7, 68-73. doi: 10.1002/ IID3.244 6. Leynaert, B., Neukirch, C., Liard, R., Bousquet, J. & Neukirch, F. (2000). Quality of life in allergic rhinitis and asthma: A population-based study of young adults. American Journal of Respiratory and Critical Care Medicine, 162, 1391-1396.
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7. Cosme-Blanco, W., Arce-Ayala, Y., Malinow, I. & Nazario, S. (2018). Primary and Secondary Environmental Control Measures for Allergic Diseases. In Mahmoudi, M. (Ed.), Allergy and Asthma (pp. 1-36). Switzerland: Springer Nature. doi: 10.1007/978-3-319-58726-4_36-1 8. Eriksson, P., Loberg, J., & Andersson, M. (2009). A survey of cat shelters in Sweden. Animal Welfare, 18, 283-288. 9. American Humane Association. (2012). Keeping pets (dogs and cats) in homes: A three-phase retention study. Phase I: Reasons for not owning a dog or cat. Retrieved from American Humane Association website: https://www. americanhumane.org/app/uploads/2016/08/ahapetsmart- retention-study-phase-1.pdf 10. Coe, J. B., Young, I., Lambert, K., Dysart, L., Borden, L. N. & Rajic, A. (2014). A scoping review of published research on the relinquishment of companion animals. Journal of Applied Animal Welfare Science, 17, 253273.doi: 10.1080/10888705.2014.899910 11. Weiss, E., Gramann, S., Drain, N., Dolan, E., & Slater, M. (2015). Modification of the Feline-AlityTM Assessment and the ability to predict adopted cats’ behaviors in their new homes. Animals, 5, 71-88. doi: 10.3390/ANI5010071 12. Zito, S., Morton, J., Vankan, D., Paterson, M., Bennett, P. C., Rand, J., Phillips, C. J. C. (2016). Reasons people surrender unowned and owned cats to Australian animal shelters and barriers to assuming ownership of unowned cats. Journal of Applied Animal Welfare Science, 19, 303-319. doi: 10.1080/10888705.206.1141682 13. Svanes, C., Zock, J.-P., Anto, J., Dharmage, S., Norback, D., Wjst, M., & the Early Life Working Group of the European Community Respiratory Health Survey. (2006). Do asthma and allergy influence subsequent pet keeping? An analysis of childhood and adulthood. Journal of Allergy and Clinical Immunology, 118(3), 691-698. doi: 10.1016/J.JACI.2006.06.017 14. Bonnet, B., Messaoudi, K., Jacomet, F., Michaud, E. Fauquert, J. L., Caillaud, D., & Evrard, B. (2018). An update on molecular cat allergens: Fel D1 and what else? Chapter 1: Fel D1, the major cat allergen. Allergy, Asthma and Clinical Immunology, 14, 14. doi: 10.1186/S13223-0180239-8 15. Tsolakis, N., Malinovschi, A., Nordvall, L., Mattsson, L., Lidholm, J., Pedroletti, C.,...Alving, K. (2017). Sensitization to minor cat allergen components is associated with type-2 biomarkers in young asthmatics. Clinical and Experimental Allergy, 48(9), 1186-1194. doi: 10.1111/cea.13135
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16. Kelly, S. M., Karsh, J., Marcelo, J., Boeckh, D., Stepner, N., Litt, D.,...Yang, W. H. (2018). Fel D1 and Fel d4 levels in cat fur, saliva and urine. Journal of Allergy and Clinical Immunology, 142, 1990-1992.e3. doi: 10.1016/J.JACI.2018.07.033 17. Bastien, B., Gardner, C. & Satyaraj, E. (2019). Influence of time and phenotype on salivary Fel d 1 in domestic shorthair cats. Journal of Feline Medicine and Surgery, 21(10), 867-874. doi: 10.1177/1098612X19850973 18. Butt, A., Rashid, D., & Lockey, R. F. (2012)Do hypoallergenic dogs and cats exist? Annals of Allergy, Asthma & Immunology, 108, 74-76. doi: 10.1016/J. ANAI.2011.12.005 19. Salo, P. M., Cohn, R. D., & Zeldin, D. C. (2018). Bedroom allergen exposure beyond house dust mites. Current Allergy and Asthma Reports, 18, 52. doi: 10.1007/S11882-018-0805-7 20. Nicholas, C., Wegienka, G., Havstad, S., Ownby, D., & Johnson, C. C. (2008). Influence of cat characteristics on Fel D1 levels in the home. Annals of Allergy, Asthma & Immunology, 101, 47-50. 21. Durairaj, R., Pageat, P., & Bienboire-Frosini, C. (2018). Another cat and mouse game: deciphering the evolution of the SCGB superfamily and exploring the molecular singularity of major cat allergen Fel D1 and mouse ABP using Computational approaches. PLoS ONE, 13(5), E0197618; doi: 10.1371/journal.pone.0197618 22. BjĂśrnsdottir, U. S., Jakobinudottir, S., Runarsdottir, V. & Juliusson S. (2003). The effect of reducing levels of cat allergen (Fel D1) on clinical symptoms in patients with cat allergy. Annals of Allergy, Asthma and Immunology, 91, 189-194. 23. Matulka, R. A., Thompson, L., & Corley, D. (2020). Multi- level safety studies of anti Fel d 1 IgY ingredient in cat food. Frontiers in Veterinary Science, 6, 477. doi: 10.3389/ fvets.2019.00477 24. Wedner, J., Satyaraj, E., Gardner, C., Al-Hammadi, N., Sherrill, S. & Mantia, T. (2019, June) Pilot study to determine effect of feeding cat food made with egg product containing anti-Fel D1 antibodies to cats on human allergy symptoms. Presented at the annual meeting of the European Academy of Allergy and Clinical Immunology, Lisbon, Portugal. 25. Wickman, M., Egmar, A.-C., Emenius, G., Almqvist, C., Berglind, N., Larsson, P. & Van HageHamsten, M. (1999). Fel d 1 and Can F1 in settled dust and airborne Fel d 1 in allergen avoidance day-care centres for atopic children in relation to number of pet-owners, ventilation and general cleaning. Clinical and Experimental Allergy, 29, 626-632.
IVSA Standing Committe on One Health
April 2020
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The global threat of infectious diseases outbreaks As a public health emergency, coronavirus outbreak highlights need to address threats to ecosystem and wildlife. Veterinary medicine, along with other sciences, is actively involved in the complex health challenges of climate changes that humanity is facing. The emerging and re-emerging zoonoses, as well as the consequences of the so called neglected and not sufficiently researched diseases, especially in the wild animals, have resulted with serious health consequences for the people, animals, the environment, and also socioeconomic problems. This article highlights the importance of the veterinary medicine for an active involvement of the health and welfare of wild fauna. In the newly created conditions by the climate change, wildlife diseases occur with more intensity, morbidity, mortality, and new biological characteristics which mean high risk for public health. The veterinary medicine makes efforts to follow the continual changes through intense monitoring, emphasizing the need for implementation of the concept One Health and cooperation among all relevant disciplines, especially human medicine.
WILDLIFE PATHOGENS WITH ZOONOTIC POTENTIAL. Wild animals are an important reservoir of pathogenic microorganisms with zoonotic potential, which transmission is conducted by the free movement of the wild animals, as well as the international trade with wild animals and their products. The infectious diseases, around 60% of which are zoonotic, make a quarter of causes of death in humans. Most of them (>70%) are of wild animal origin, which shows a serious threat. (P.Lanfranchi et al., 2003, OIE, 2010).
, a k s v o s Ar ristovski Ivanfa. M .H Pro cedonia IVSA Ma
that can cause disease. Human diseases caused by wildlife zoonotic pathogens that became important in the past 60 years, includes: AIDS, Severe acute respiratory syndrome (SARS), Avian influenza, West Nile Virus, Leishmaniasis, Brucellosis, Tuberculosis, Ebola virus, Leptospirosis, Trichinellosis, Hanta Viruses etc. These outbreaks have served as examples of the potential seriousness of emerging zoonotic diseases to public health. For an example, AIDS viruses has adapted to people through genetic mutation and now are being transmitted between people, independent of their original source. (OIE, 2010) Currently, there is an outbreak of COVID-19 infections with scientific evidence that the virus has an animal origin. This emerging disease has pandemic potential with rapid geographic spread. Further research is needed to identify the source and the role of an animal reservoir in this disease. (OIE, 2020) Because of the concerns about COVID-19 transmission from wild animals to people and for better understanding the ecology of the disease, two species are suspsected for zoonotic transfer. Bats (Rhinolophus affinis) and Malayan pangolins (Manis javanica) contains coronaviruses similar to SARS-COV-2, although there are other species that are undersampled. This knowledge could help scientists to better understand the natural evolutionary process and how a virus with animal origin jumped species boundaries to infect humans. (Andersen et al., 2020)
Pathogens in wild animals may affect human health, animal health and wildlife ANTHROPOGENIC FACTOR – population. Wild animals can be direct or MAIN DRIVER FOR EMERGING indirect sources of infection for people DISEASES. VetPubHealth Journal ISSUE 17
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The world faces a crisis of extinction of species – the fastest disruption of the biodiversity in the history of planet Earth and these loses are related to the anthropogenic factor. Climate changes also affect the management of pathogens entering new environments with potential risk that leads to an emergence of a disease. The occurrence of wild animal diseases and their spreading, not only endangers particular species, but it is also a danger for disruption of the biodiversity and the ecosystems in nature. All these factors and processes that cause accelerated extinction of species and decrease in their populations, loss of genetic material and degradation of the ecosystems, can be considered threat to the biological diversity. The consequences of climate change to wildlife includes ecosystem changes, species interactions, human-wildlife conflict and diseases. (FAO, 2012). Major determinants that affect humananimal distribution of emerging diseases are ecological, environmental and socioeconomic.(Jones et al., 2008) The consequences of climate change on wildlife health and welfare are complex and includes mostly human behavioural factors: agriculture, infrastructure development, tourism/recreation, vehicle and train collision, trapping, poaching, illegal hunting, illegal wildlife trade, invasive species, deforestation, war/civil unrest, extraction of wood, fires, pollution etc. (Hristovski., 2001) Globalisation of human travel and (i) llegal wildlife trade address a public health concerns. These activities allows for infectious diseases to geographicaly spread very quickly, as was demonstrated during SARS outbreak in 2002/3 (Anderson et al., 2004) Social and cultural risk factors such as religious and ethics beliefs, law implementation, food habits and management patterns can also affect the emergence of zoonoses,
Wildlife health monitoring deals with limitation to a few study areas and species. This makes the identification of diseases in animal populations difficult, and important diseases remain undetected or not investigated at all. The specific host-pathogen relationship should be an area of interest, as identification is an essential part in maintaining wildlife disease status. (Sainsbury et al., 2001; Lanfranchi et al., 2003) Emerging and re-emerging zoonoses, with their constantly evolving nature and wide variety of wild animal species that act as reservoirs for zoonotic pathogens, represent a challenge for veterinary medicine and human medicine. Wild animal pathogen surveillance is essential to public health management. In 2010, for effective surveillance of zoonotic diseases and other public health threats, tripartite collaboration has been made between OIE, WHO and FAO. This international partnership provides multi-sectoral, One Health approach addressing health risks and provide guidance on how to reduce these risks. Each member country report the number of zoonoses to the Organizations, as a part of their annual report. Global effort is required for understanding the ecology of diseases. We must understand that every scientific discipline is equally important and can contribute for a complete One Health approach.
THE IMPORTANCE OF WILDLIFE HEALTH MONITORING: VetPubHealth Journal ISSUE 17
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How infectious disease outbreaks are shaping our world and vice versa? Over the past decades, the number of outbreaks caused by infections has been on the rise, causing severe damage to countries’ communities, economy and public health security . The main protagonists that have embodied the most recent outbreaks are amongst others Vibrio Cholerae, Ebolavirus, Influenzavirus, SARS-CoV and most recently the novel coronavirus SARSCoV-2. Be it bacteria or viruses, these deadly microorganisms are constantly proving us that the smallest entities often come up as the biggest threat. But what is the extent of the damage they are causing, and Are we heading towards the right direction to master future potential outbreaks? In 2020, approximately 200,000 years after the beginning of modern humankind , the menace of a pandemic is still pervading the world despite the astonishing medicinal, scientific and socio-economic progress we have made. One might argue that the challenge lies within the vast array of currently unknown infectious agents. In reality, our efforts to prevent future outbreaks of infections are not sufficient, in spite of knowledge of possible solutions. To make matters worse, re-emerging diseases that we considered to be on the decline – such as malaria and tuberculosis – have managed to make their comeback. Today’s reality shows that infectious diseases still remain one of the leading causes of deaths on a global scale .
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regard to the treatment of people in need of medical care for diverse health issues, that could become fatal if not treated properly and in due time. In addition, health workers are also at risk of contracting the diseases, thus potentially reducing the labor force in this important domain. Consequently, a single epidemic may aggravate other diseases that have so far been under control, substantially multiplying their fatality rate due to the fragile health care system we are relying upon. Besides medical aspects, outbreaks disrupt our everyday lives, leading to closures of educational institutions, commercial establishments, public services, and even borders. This state of “lockdown”, with the primary goal of breaking the chain of infection through social distancing, generates considerable damage to countries’ economies. Discontinuation of trade, decline in tourism, closure of businesses; all these elements can quickly lead to an important recession, for which a country would need years to recover from. To put it into numbers, the World Bank has estimated that a pandemic causing over 28 millions of deaths (for comparison, at least 50 million deaths have been recorded amidst the 1918 Influenza Pandemic ) could result in a loss of as much as 5% of global GDP . The UN has also projected a global economic slowdown, estimating a loss of at least 1 trillion USD in 2020 alone – corresponding to a deficit of 2% of global economy – as a consequence of the recent Covid-19 outbreak .
In the first instance, it is the health concerns that prevail in such an outbreak. But what we are really looking at is just the tip of the iceberg. It is fair to say that disease outbreaks have put us through multiple tests that have enabled us an auto-evaluation of our societies’ structure. The first victims of an outbreak are the affected community of individuals, and ultimately the complete health system. As the most recent Covid-19 outbreak has demonstrated, an important outbreak can easily overwhelm the nation’s health system without any major effort . This aspect particularly raises concerns with VetPubHealth Journal ISSUE 17 IVSA Standing Committe on One Health
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The evolution of pathogens, with antimicrobial resistance (AMR) in the front line, is also linked to our economy. In fact, AMR is responsible for higher morbidity and mortality rates in humans and livestock, therefore considerably hampering our industries’ success. Again, projections by the World Bank estimate a drop of as much as 3,8% in global GDP by 2050 due to AMR . Because of the augmented cost of newly conceived effective drugs, some developing countries are struggling to get access to these, making them vulnerable to a possible new outbreak. With increased resistance against medicines, along with constant mutations of pathogens in more deadly strains – as depicted by the Influenza virus – a more costly treatment combined with a longer treatment period are required. AMR and mutating microorganisms are therefore accountable for the health system overload, completing a vicious spiral.With nation’s economies being weakened, there is a huge political challenge lying ahead for world leaders, whose art of weathering the storm could prove decisive for their popularity. These economic blows often lead to an inevitable political crisis. In the US, the Covid-19 outbreak has even managed to redistribute the cards for the 2020 election. Almost overnight, the US’s remarkable economy has had to suffer an important financial setback, which could prove to be a blow for President Trump’s reelection. In times of distress during an outbreak, the political stakes are high, and fighting the virus becomes equally as important as maintaining a nation afloat.
of contamination. The Aedes aegypti mosquito, responsible for spreading diseases such as Dengue, Zika and yellow fever, is a perfect example to illustrate this. Moreover, increased rainfall also contributes in augmenting the mosquitoes’ breeding rate. Rising temperatures are likewise proving to be of importance. Studies have suggested that a slight incrementation of 2-3°C would lead to an additional 3 to 5% of the world population being potentially exposed malaria , corresponding to about 300 million people that are exposed to the infectious agent. It is safe to say that diseases considered specific to some areas are on the verge of spreading to other parts of the world. In terms of demographics, the important rise in population numbers – mainly in developing countries – is also playing its part. Because of the rapid population growth in countries at risk of infectious diseases possessing fragile healthcare systems, the inability to cope in time with an emerging outbreak is enhanced. With the majority of the world population now based in an urban environment , urbanization is another element to consider. Higher population density allows for an easier spread of diseases and often increased contact with wild animals, thus giving zoonoses a bigger opportunity to arise. The Lassa fever is a perfect example of urbanization’s detrimental consequences. In fact, as soon as urbanization was on the rise in West Africa, contact with the infectious agent’s host – a particular Today, it is obvious that the measures endemic rodent – was becoming more being taken are not adequate to prevent common, giving this particular disease a chance to emerge. another outbreak from happening. Mass migration, trade and travel are But the demographics’ influence doesn’t effectively helping accelerate the spread end here. Due to increased life expectancy, of an outbreak. In fact, the phenomenon senior communities are not considered of globalization contributes substantially an exception anymore, hence opening up more doors for pathogens’ introduction in to the emergence of outbreaks. But globalization is generating another a population as a result of the elderly’s major issue: climate change. There is biologically weaker immune system. undoubtedly a correlation between global With regard to research, arguments such as warming and the emergence of new laboratory-made catastrophes that could diseases. With rising temperatures and possibly occur – sometimes deliberately – shifting environments, we are witnessing while carrying out research about a deadly an expansion of disease-carrying vector’s pathogen are being raised. This reluctance habitats, leading to an increased risk to move forward is substantially impeding VetPubHealth Journal ISSUE 17 IVSA Standing Committe on One Health April 2020
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References: the fight against preventing diseases from emerging. Before conducting any research, it first needs to be labelled as economically profitable in order gain financial support from the pharmaceutical industries. In fact, while vaccines are often placed on top of the problem-solving list, they are barely profitable to the big manufacturing companies in comparison to standard drugs .Moreover, as the recently reported feud between German pharmaceutical giants CureVac and President Trump has demonstrated , it appears as if countries are more focused on selfishly winning the “race” by getting their hands first on the valuable remedy to the disease, rather than trying to cross the finish line together in order to find a more rapid, global solution that would come out as a success story resulting from international cooperation of powerful nations. There is no doubt that outbreaks will continue to emerge in the future, causing a lot of uncertainty and damage to our health, communities and economies. Still today, there is too much incoordination, lack of action and financing in order to prepare for our next pandemic. To quote the philanthropist Bill Gates in one of his speeches back in 2015: “if anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war.” . His vision and warning couldn’t have been more accurate, as we are desperately waiting today for a solution to help us combat this novel coronavirus pandemic. Additional investment in research, greater global cooperation, more thorough food safety controls… These are just few of the lacking measures that would contribute in preventing a new sanitary crisis. A more conscious approach to the problem, combined with a greater implication of the political, pharmaceutical and medical bodies would be an important step forward. Past outbreaks have unsuccessfully tried to remind us of how vulnerable we are, but that apparently wasn’t enough in order for us to take adequate measures. Now it is up to the young generations to point us in the right direction. VetPubHealth Journal ISSUE 17
KF Smith (2014). Global rise in human infectious disease outbreaks. https://www.ncbi.nlm.nih.gov/pubmed/25401184 J. Galway-Witham & Chris Stinger. (2018). How did Homo Sapiens evolve?. ScienceMag. https://science.sciencemag.org/content/360/6395/1296 World Health Organization (2018). The Top 10 causes of death. https://www.who.int/news-room/fact-sheets/detail/thetop-10-causes-of-death Denise Chow & Emanuelle Saliba (2020). Italy has a worldclass health system. The coronavirus has pushed it to the breaking point. NBC News. https://www.nbcnews.com/health/ health-news/italy-has-world-class-health-system-coronavirushas-pushed-it-n1162786 Center for Disease Control and Prevention. (2018). Influenza (Flu). https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm The World Bank. (2018). World Development Indicators United nations. (2020). This is how much the coronavirus will cost the world’s economy. World economic Forum, https://www. weforum.org/agenda/2020/03/coronavirus-covid-19-cost-economy-2020-un-trade-economics-pandemic Adeyi O.O. et al. (2017). Drug-Resistant Infections : A Threat to our Economic Future, Vol. 2 : Final Report. The World Bank. http://documents.worldbank.org/curated/ en/455311493396671601/pdf/executive-summary.pdf W. Shao, X. Li, M.-U. Goraya, S. Wang, J.-L. Chen. (2017). Evolution of Influenza A Virus by mutation and re-assortment. International Journal of Molecular Sciences. J.A. Patz et al. (2003). Chapter 6-Climate change and infectious diseases. Climate change and human health-risks and responses. World Health Organization. https://www.who.int/globalchange/ climate/en/chapter6.pdf United Nations. (2017). World Population Prospects: The 2017 Revision. United Nations. (2018). World Urbanization Prospects: The 2018 Revision J Kay Richmond. (2003). Lassa fever: epidemiology, clinical features, and social consequences. The BMJ. https://www.ncbi.nlm. nih.gov/pmc/articles/PMC286250/ Ronald M. Atlas. (1999). Combating the threat of Biowarfare and Bioterrorism: Defending against biological weapons is critical to global security. Bioscience. https://academic.oup.com/bioscience/article/49/6/465/229529 M. Kremer & Christopher M. Snyder. (2003). Why are drugs more profitable than vaccines. Cambridge Massachusetts: National Bureau of Economic Research. https://www.nber.org/papers/w9833.pdf David E. Sanger et al. (2020). Search for Coronavirus vaccine becomes a global competition. The New York Times. https:// www.nytimes.com/2020/03/19/us/politics/coronavirus-vaccine-competition.html Bill Gates. (2015). Lessons from Ebola-We’re not ready for the next pandemic. GatesNotes. https://www.gatesnotes.com/Health/ We-Are-Not-Ready-for-the-Next-Epidemic
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Pandemics! Are we ready? A pandemic is a type of epidemic, an outbreak of a disease that occurss an exceptionally high proportion of the population. Today large scale of economical and trade interaction creates an open channel among different countries which generates more ways for pandemics.
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We feel proud to declare that we are now well equipped with better technologies. But the bigger question being whether all these technologies are capable of beating pandemic still stays. The recent COVID-19 pandemic shows us even though we are a developed country, epidemic can still reach us. As time goes on microorganisms also get going through. They get mutation among them which creates a challenge towards our healthcare society. So what can we do? If we want to stop the transmission of zoonotic diseases or diseases originated from animals we need to be extra careful. Wild animal trafficking and using wild animal as a source of food must be prevented. We need to be more wiser because there is a wise saying that “ Prevention is better than
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cure”. To prevent infectious diseases we need to stop the route of infection. It can’t be done by a single person or by a single country. The whole world must be united against pandemics. How can it be done? A wide range of robust health policies should be introduced. Trade policy should be revised. The established health rules from WHO and OIE should be maintained strictly. The race between human civilization and diseases can’t be avoided. The more modernized the society is the more powerful the organisms are. We need to stay together to fight against this issue. It’s a demand that we should truly focus on “One Health”now if we want ourselves to get ready against the next pandemic.
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Hantavirus:Threat of Infectious Disease by Rodents
Everyone is in fear, everywhere there is lock down, every sector is in silence and this is how the threat of disease is like. Like COVID-19 in this crucial year 2020, there was a threat of disease named Hantavirus( Orthohantavirus) in 1993. It is a single stranded, enveloped, negative sense RNAVirus which normally infect rodents, but do not cause disease in them.
ORIGIN: There is place known as “The Four Corners” in southwestern United States, in an area shared b y Arizona, New Mexico, Colorado and Utah where in May 1993 a young , physically healthy Navajo man suffering from shortness of breath was rushed to a hospital in New Mexico and died rapidly. Going thoroughly to the case it was found that the young man’s fiancée had died a few days ago showing similar symptoms which became a piece of information that proved key to discovering the disease. As more people were found in later days who all had died after acute respiratory failure , an investigation combing the entire Four Corners region was launched by the New Mexico Office of Medical Investigations (OMI) from which mixture of symptoms and clinical findings pointed it is a new type of influenza and towards some type of virus. From a deep narrow test at molecular level, virologist were able to link the pulmonary syndrome with a virus, in particular a previously unknown type of hantavirus. As researchers had known that all other hantavirus were transmitted to people by rodents, such as mice and rats, they started to trap all rodents during which they decided not to wear protective clothing or masks which could scare the people. But later 1700 rodents being trapped, respirators and protective clothing were worn as they were dissecting them to prepare sample analysis at CDC. In November 1993, the specific hantavirus that caused the Four Corners outbreak was isolated from deer mouse(Peromyscusmaniculatus) .The new virs was called Muerto Canyon VetPubHealth Journal ISSUE 17
l a k a h D Rabin virus-later changed to Sin Nombre virus (SNV) which means nameless virus and the new disease caused by the virus was named hantavirus pulmonary syndrome, or HPS. Since 1993, researchers have discovered several hantavirus i.e. Bayou virus, linked to a carrier, the rice rat (Oryzomyspalustris) and Creek Canal virus, whose carrier is cotton rat.
(source:www.cdc.gov) Hantavirus is named for the Hantan River area in South Korea where early outbreak was observed and was first isolated in 1976.
Transmission:
Basic course of transmission Source: Possibilistic.org
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Human is infected through contact with rodents urine, saliva or feces. Some strains cause potentially fatal diseases in humans, such as fatal hemorrhagic fever with the renal syndrome (HPS), also known as hantavirus cardiopulmonary syndrome (HCPS) which is associated with the inhalation of aerosolized rodent excreta (urine and faces) contaminated by hantavirus particles.
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GENOME: Orthohantavirus are enveloped viruses with a genome that consists of three singlestranded, negative-sense RNA segments designated S (small), M(medium) and L(large).
• The L RNA encodes a nucleocapsid (N) protein. • The M RNA encodes a polyprotein that SIGNS & SYMPTOMS: is cotranslationally cleaved to yield the envelope glycoproteins Gn(formerly G1) •Hemorrhagic fever with renal and Gc(formerly G2). syndrome. • The L RNA encodes the L protein, It is also called as Korean hemorrhagic which functions as the viral transcriptase\ fever, epidemic hemorrhagic fever and replicase. nephropathiaepidemica. Its incubation time is two to four weeks in humans PREVENTION: before symptoms develop. Their severity depends on the viral load. • Eliminate or minimize contact with rodents in the home, workplace or campsite •Hantavirus pulmonary syndrome. as the virus can be transmitted by rodent It was found in North, Central and South saliva, excretions, and bite. America. the causative agent is yhe • Control rats and mice in areas Sin Nombre virus carried by deer mice. frequented by humans. Prodormal symptoms include flu-like • Dispose rodents nests, sealing any symptoms such as fever, cough, muscle cracks and holes in homes. pain, headache, and lethary which is • Vaccine characterized by a sudden onset of shortness As of 2016, there is no FDA-approved, of breath with rapidly pulmonary edema commercially available vaccine against that is often fatal despite intervention hantavirus. A vaccine known as hantavax with mechanical ventilation and potent has been under study since 1990. diuretics. The fatality rate is 36%. •Kidney failure, hemorrhage and shock.
EPIDEMIOLOGY:
generalized
TREATMENT:
• Ribavirin drug for HPS and HCPS but its effectiveness remains unknown.
• Oxygen and mechanical ventilation Hantavirus infections have been reported during acute pulmonary stage with severe from all continents expect Australia. respiratory distress. • An outbreak of hemorrhagic fever • Administration of immunotherapy among American and Korean soldiers for neutralizing antibodies during acute during the Korean War (1950-1953) was phases of Hantavirus. caused by Hantavirus infections. • Limited transmission via human-tohuman contact has since been shown in Argentina. • In late medieval England a mysterious sweating sickness swept through the country in 1485 for which several scientists theorized that the virus may have been cause of the disease. VetPubHealth Journal ISSUE 17 IVSA Standing Committe on One Health April 2020
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References: • “Virus Taxonomy: 2018b Release” (html). International Committee on Taxonomy of Viruses (ICTV). March 2019. Retrieved 18 March 2019. ^ “ICTV Taxonomy history: Orthohantavirus”. International Committee on Taxonomy of Viruses (ICTV). Retrieved 28 January 2019. • ^ a b “Rodent-borne diseases”. European Centre for Disease Prevention and Control. Retrieved 201806-04. • ^ a b c d Drebot,, Jones S.; Grolla, A.; Safronetz, D.; Strong, J. E.; Kobinger, G.; Lindsay, R. L. (4 June 2015). Hantavirus pulmonary syndrome in Canada: An overview of clinical features, diagnostics, epidemiology and prevention. Canada Communicable Disease Report (Report). Vector-borne diseases in Canada. 4106. Winnipeg, MB: National Microbiology Laboratory, Public Health Agency of Canada. p. 40. ISSN 1481-8531. • ^ a b c Martinez VP, Bellomo C, San Juan J, Pinna D, Forlenza R, Elder M, Padula PJ (2005). “Personto-person transmission of Andes virus”. Emerging Infectious Diseases. 11 (12): 1848– 1853. doi:10.3201/eid1112.050501. PMC 3367635. PMID 16485469. • ^ “ICTV 9th Report (2011) – Negative Sense RNA Viruses – Bunyaviridae”. International Committee on Taxonomy of Viruses (ICTV). Retrieved 31 January 2019. Hanta: from Hantaan, river in South Korea near where type virus was isolated. • ^ “What is hemorrhagic fever with renal syndrome?”. CDC Gov. • ^ Yi J, Xu Z, Zhuang R, Wang J, Zhang Y, Ma Y, Liu B, Zhang Y, Zhang C, Yan G, Zhang F, Xu Z, Yang A, Jin B (2013). “Hantaan virus RNA load in patients having hemorrhagic fever with renal syndrome: correlation with disease severity”. J. Infect. Dis. 207 (9): 1457– 1461. doi:10.1093/infdis/jis475. PMID 22869912. • ^ “CDC – Hantavirus Pulmonary Syndrome (HPS) – Hantavirus”. Cdc.gov. 2 June 2013. Retrieved 3 April 2013. • ^ “Reported Cases of HPS: HPS in the United States”. Centers for Disease Control and Prevention (CDC). 21 April 2014. Retrieved 4 August 2014. • ^ “Death at the Corners”. DiscoverMagazine. com. 1 December 1993. Retrieved 2013-03-25. • ^ a b c Plyusnin A, Vapalahti O, Vaheri A (1996). “Hantaviruses: genome structure, expression and evolution”. J. Gen. Virol. 77 (11): 2677–2687. doi:10.1099/0022-1317-77-11-2677. PMID 8922460. • ^ a b Jonsson CB, Figueiredo LT, Vapalahti O (2010). “A Global Perspective on Hantavirus Ecology, Epidemiology, and Disease”. Clinical Microbiology Reviews. 23 (2): 412–441. doi:10.1128/CMR.00062VetPubHealth Journal ISSUE 17
09. PMC 2863364. PMID 20375360. • ^ Elliott RM (1990). “Molecular biology of the Bunyaviridae”. The Journal of General Virology. 71(3): 501– 522. doi:10.1099/0022-1317-71-3-501. PMID 2179464. • ^ Mir MA, Panganiban AT (2005). “The Hantavirus Nucleocapsid Protein Recognizes Specific Features of the Viral RNA Panhandle and is Altered in Conformation upon RNA Binding”. Journal of Virology. 79 (3): 1824– 1835. doi:10.1128/JVI.79.3.18241835.2005. PMC 544099. PMID 15650206. • ^ Garcin, D.; Lezzi, M.; Dobbs, M.; Elliott, R. M.; Schmaljohn, C.; Kang, C. Y.; Kolakofsky, D. (September 1995). “The 5’ ends of Hantaan virus (Bunyaviridae) RNAs suggest a prime-and-realign mechanism for the initiation of RNA synthesis”. Journal of Virology. 69 (9): 5754–5762. doi:10.1128/JVI.69.9.5754-5762.1995. ISSN 0022-538X. PMC 189436. PMID 7637020. • ^ a b c “Hantavirus: Canadian Lung Association”. Canadian Lung Association. 26 November 2015. Archived from the original on 2 March 2011. Retrieved 23 April 2018. • ^ Peters, C.J. (2006). “Emerging Infections: Lessons from the Viral Hemorrhagic Fevers”. Transactions of the American Clinical and Climatological Association. 117: 189–197. PMC 1500910. PMID 18528473. • ^ Crowley, J.; Crusberg, T. “Ebola and Marburg Virus Genomic Structure, Comparative and Molecular Biology”. Dept. of Biology & Biotechnology, Worcester Polytechnic Institute. Archived from the original on 2013-10-15. • ^ Jackson AP, Charleston MA (2003). “A Cophylogenetic Perspective of RNA-Virus Evolution”. Molecular Biology and Evolution. 21 (1): 45–57. doi:10.1093/molbev/msg232. PMID 12949128. • ^ a b c d Ramsden C, Holmes EC, Charleston MA (2008). “Hantavirus Evolution in Relation to Its Rodent and Insectivore Hosts: No Evidence for Codivergence”. Molecular Biology and Evolution. 26(1): 143–153. doi:10.1093/molbev/msn234. PMID 18922760. • ^ Delfraro A, Tomé L, D’Elía G, Clara M, Achával F, Russi JC, ArbizaRodonz JR (2008). “Juquitibalike Hantavirus from 2 Nonrelated Rodent Species, Uruguay”. Emerging Infectious Diseases. 14 (9): 1447– 1451. doi:10.3201/eid1409.080455. PMC 2603116. PMID 18760017. • ^ Plyusnina A, Ibrahim IN, Plyusnin A (2009). “A newly recognized hantavirus in the Asian house rat (Rattustanezumi) in Indonesia”. Journal of General Virology. 90 (Pt 1): 205–209. doi:10.1099/Vir.0.006155-
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Global health & Infectious Disease Outbreak Introduction
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Global health is the health of the population in the global context. Koplan et al. define global health as: ‘an area for study, research, and practice that places a priority on improving health and achieving health equity for all people worldwide’. And there are many other definitions of global health and all together it is the health of all the populations not only human being but also health of the animals and environment too. All three health viz. human health, animal health and community or environmental health must be studied together so as to create a healthy relation between those essential components of the ecosystem. Infectious diseases are disorders caused by organisms such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They’re normally harmless or even helpful. But under certain conditions, some organisms may cause disease. Some infectious diseases can be passed from person to person. Some are transmitted by insects or other animals to humans . And human get others by consuming contaminated food or water or being exposed to organisms in the environment. Those diseases which transmit one individual to other individuals are more dangerous and they affect global health; HIV, MERS, SARS, Hepatitis etc are examples of those infectious disease.
What is an outbreak, epidemic and pandemic?
Outbreak is a sudden increase in occurrence of a disease in a particular time and place. It may affect a small or a large group of population. In another language an outbreak is a spike in the no. of cases of a disease. For example outbreak of COVID-19 was in Wuhan, China. When disease transmitted continuously from one individual to others it become epidemic after its outbreak in 2 or more cities or neighbouring nations. Epidemic is ongoing transmission of a disease, VetPubHealth Journal ISSUE 17
i d u a h h c l a Anish B with no clear endpoint. This is why we might hear ‘obesity epidemic’ or ‘opioid epidemics’. As an example let’s take the same example of COVID-19, it was epidemic in china when it was spread in other some cities of China. When the disease spread exponentially and crosses the intercontinental barrier then it becomes pandemic or global pandemic and as example COVID-19 is the global pandemic as it has been spread all over the world. Some infectious disease that became epidemic and pandemic (source:WHO 2020) : • Chikungunya • Cholera • Crimean-Congo haemorrhagic fever • Ebola virus disease • Hendra virus infection • Influenza • Lassa fever • Marburg virus disease • Meningitis • MERS-CoV • Monkeypox • Nipah virus infection • Novel coronavirus (2019-nCoV) • Plague • Rift Valley fever • SARS • Smallpox • Tularaemia • Yellow fever • Zika virus disease
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Threat of infectious diseases How to decrease the threat of on global health infectious disease? There are so many microorganism causing infectious diseases having resistant strain due to our uncontrolled and over use of antibiotics over the century. In normal population of microorganisms or bacteria they have 99% non resistant and 1% of resistant strain. But over use of antibiotic leads to the increment of resistant strain in the population as a result of selection pressure. Because of selection pressure there is more resistant strain of the microorganisms which is main threat to the global health. Tuberculosis, cholera, chicken pox etc have developd resistance strain which will may become the threat to global health soon. As in present scenario of COVID-19, a virus from corona virus family; corona virus is not new type of virus as more than 9 strains of corona virus are present in the world, but due to antigenic shift this corona virus became more stronger and new to the population as novel corona virus or COVID-19. Antigenic shift can be the result of a direct jump from an unknown animal strain to humans or a reassorment of two or more influenza virus within the same cell. For example genetic analysis of the COVID-19 virus shows that it is very similar to a coronavirus in bats but the receptor binding looks like the receptor for SARS, so antigenic shift in this novel corona virus is result of both jump of unknown strain from bat and reassortment with SARS within the human cell. Recently in China outbreak of a virus named hantavirus has been found and it is considered to be drifted from mouse or rat. Not only these viruses but also other infectious microorganisms are in the process of becoming more resistant to antibiotics and new to the human population which is main threat to the global health. This suggests that overuse of antibiotics, incomplete treatment or direct or indirect contact with animals are the main reasons to increase the threat of infectious disease to global health. VetPubHealth Journal ISSUE 17
Threat of infectious disease can be minimized or decreased by controlling the spread of infectious diseases and by proper and limited use of antibiotics so as to protect global health. The spread of infectious discan be controlled by : a. Building ethical principles into infectious disease legislation. b. Preventing the transmission of infectious disease. c. Compulsory treatment order. d. Limiting contact with infectious individuals.
References:
1. Centers for Disease Control and Prevention Frequently Asked Questions About SARS. (2012) URL:https://www.cdc.gov/sars/about/faq.html 2. World Health Organization SARS (Severe Acute Respiratory Syndrome). (2019) URL:https://www.who.int/ith/diseases/sars/en/ 3. URL:http://www.who.int/csr/don/en 4. URL:http://www.who.int/csr/en 5. URL:http://www.cdc.gov/outbreaks/index.html 6. Wolfe ND, Dunavan CP, Diamond J. Origins of major human infectious diseases 7. Murphy FA. New, emerging, and reemerging infectious diseases 8. Perlman S, Netland J. Coronaviruses post-SARS: update on replication and pathogenesis. Nat. Rev. Microbiol. 2009 Jun;7(6):439-50. 9. International health regulation 2005, 2nd edition Geneva: world health organization; 2008: article 6, annex 2. 10. World health organization/health systems. 11. National centre for biotechnology information/ PubMed.
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I am because we are:The South African Foot and Mouth Disease outbreak as practical illustration of One health viability. When one tugs at a single thing in nature, he finds it attached to the rest of the world. -John Muir
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Interspecies infection and interactions have historically been handled by veterinary and medical specialists only as far as it pertained to their respective fields but the modern threat of infectious diseases is often accompanied by a need for increased interdisciplinary cooperation and synergy. The rejection of this status quo is gaining momentum as the call for a shift toward One Health gains popularity. Interdependence of different species and the assumption that an inherent connection exists between man, animal and environment serves as the foundational premise that gave rise to the One Health concept. South Africa recently saw the resurgence of Foot and Mouth Disease in a December 2019 outbreak. The human animal interface in this infectious, nonzoonotic outbreak where 14 000 cattle were affected serves as a context for a community that illustrates the interconnected wellbeing as grounds for following a One Health approach. The ‘One Health’ concept flows from a growing idea that an interconnected global community should collectively take responsibility for not only the health but the wellbeing of members of said community in a unified attempt to take control of multifactorial medical challenges. Initially seen in the notion known as ‘One Medicine’, the potential of interdisciplinary collaboration for mutual benefit began to gain momentum in the early 2000’s. (LEE, 2013).
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obstacles facing both veterinary and medical professionals. (GIBBS, 2005). Largely a response to international fear during this wave of what appeared to be several serious epidemics, the ‘One Health’ concept is still in its infancy. (GIBBS E. P., 2002) . Although meant as a paradigm shift and commitment to wider interdisciplinary action that protects the wellbeing of society is often described as a hollow concept that has very little proven efficacy. (Okello, Paul , Gibbs, Vandersmissen, & Welburn, 2018). The idealistic nature of the rose-coloured interdisciplinary synergy is often met with scepticism that can only be proved or disproved through widespread operationalisation practical application that demonstrates the efficacy of this approach in improving global health and wellbeing. In an effort to debunk One Health scepticism the viability of the philosophy has to be either empirically proved or practically demonstrated. (HÄSLER, GILBERT, Jones, & PFEIFFER, 2012) The concept of One Health relies on the premise of co-dependence between the human race, animals and the environment. This serves as an attempt to illustrate the viability of One Health as concept by looking at a tangible example of intertwined human and animal livelihoods and the necessity of applying an interdisciplinary approach in order to preserve the wellbeing that medical and veterinary professionals are responsible for.
One health was born of, and fuelled by, fear. (Gibbs, 2014) The movement was triggered by several international zoonotic crises that made the codependency of different disciplines clear in the complex and multifactorial An effective way of demonstrating the VetPubHealth Journal ISSUE 17
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viability of One Health as philosophy and approach is the practical demonstration thereof. As much as this approach was born in response to an immediate threat, the “inextricable” connection of humans, animals and the environment often lacks tangibility and is only evident during zoonotic outbreaks.
farming communities, illustrating the scale of the interrelated wellbeing and tangible One Health in these communities (International Fund for Agricultural Development, 2001). These agricultural practices enable entire communities to survive under the breadline and the loss of this lifeline is part of the threat that infectious diseases pose to these Southern African agricultural landscape communities. is clearly divided into commercial and subsistence farming. The commercial These practices are ancient and forms farming community survives FMD part of engrained traditions and norms outbreaks and severe economic losses that stem from lifetimes of dependence as its productivity and financial security on animals and the environment. Cattle enables them to afford the necessary herds are also used as a bankable measures, vaccinations, quarantine asset that carries individuals through camps and drugs as well as the enormous unemployment, drought, disease and cost of the animals in affected herds that social disruptions (Van Averbeke & had to be culled. Khosa, 2007). The role of animals in these socio-economic landscapes is not Subsistence farmers, on the other hand, only one of income, direct food source are a far bigger and more vulnerable and means of survival, but a symbol of group of South African farmers. The prosperity and integral part of traditions FMD outbreak in the Molemole area and cultural practices (Scoones, 2009). directly impacted this subset of the The FMD outbreak, control measures South African farming community. and culling does thus not only pose a threat to the financial survival of rural Subsistence farming is defined communities but to the way of life that by Barnett et al. as: ‘farming and these communities have come to know. associated activities which together This exemplifies practical One Health form a livelihood strategy where the and, in absence of worldwide empirical main output is consumed directly, where proof through operationalisation of this there are few if any purchased inputs approach, the tangibleinextricable bond and where only a minor proportion of between man, animal and environment output is marketed.’’ (Barnett, 1997) demonstrates One Health in a patent and practical way. These communities are markedly affected by FMD outbreaks, control The global threat of infectious disease measures and culling as livestock is outbreaks is gaining relevance in this directly responsible for the survival of day and age. The importance of this families that are unable to make ends specific example, however, is the meet with their nonfarm employment. illustration of the threat that not only Although the FMD outbreak does not links human and animal health through constitute a traditional One Health issue transmission of an infectious disease, with classical zoonotic considerations, but through the disruption of a synergy the wellbeing of subsistence farming that constitutes the backbone of communities is directly linked to that of subsistence farming communities. animals (Morton, 2007). Seventy-five percent of the world’s 1.2 billion poor The demonstration of One Health (defined as consuming less than one principles as part of the natural dynamic purchasing-power adjusted dollar per of human animal interaction proves the day) work and live in rural subsistence viability and necessity thereof by VetPubHealth Journal ISSUE 17
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Bibliography: confirming the livelihood shared by man and animal is inherently interconnected. The destruction of the status quo in these communities illustrates theoretical concepts in a practical and tangible manner. This shows not only the viability but the necessity of One Health as approach to and component of global prosperity.
GIBBS, E. P. (2005). Emerging zoonotic epidemics in the interconnected global community. Veterinary Record 157, 673-679. GIBBS, E. P. (2002). The domestic animal/wildlife interface: issues for disease control, conservation, sustainable food production and emerging diseases. Annals of the New York Academy of Sciences, 969. Okello, A. L., Paul , E., Gibbs, J., Vandersmissen, A., & Welburn, S. (2018). One Health and the neglected zoonoses: turning rhetoric into reality. Vet Record, 169. LEE, K. &. (2013). Operationalizing the One Health approach: the global governance challenges. Health Policy and Planning , 778-785 .
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Gibbs, E. P. (2014). The evolution of One Health: a decade of progress and challenges for the future. Veterinary Record, 85. HĂ„SLER, B., GILBERT, W., Jones, B., & PFEIFFER, D. (2012). The economic value of One Health in relation to the mitigation of zoonotic disease risks. Current Topics in Microbiology and Immunology, 127-151. Barnett, A. (1997). AIDS Briefs: Subsistence Agriculture. USAID Health and Human Resources Analysis and Research for Africa Project. Morton, J. F. (2007). The impact of climate change on smallholder and subsistence agriculture. PNAS, 19683. International Fund for Agricultural Development. (2001). Rural Poverty Report 2001: The Challenge of Ending Rural Poverty. Rome: IFAD. Van Averbeke, W., & Khosa, T. (2007). The contribution of smallholder agriculture to the nutrition of rural households in a semi-arid environment in South Africa. Water SA, 413-418. Scoones, I. W. (2009). Introduction: Livelihoods in Crisis: Challenges for Rural Development in Southern Africa. IDS Bulletin, 341. VetPubHealth Journal ISSUE 17
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The Global Threat of Infectious Disease Outbreaks Infectious diseases are caused by pathogenic microorganisms, such as d bacteria, viruses, parasites or fungi a w a J a are the factors responsible of various amz H pur l a w a diseases. Zoonotic diseases are infectious h , Ba n a t s i k a diseases of animals that can cause disease SA P V I when transmitted to humans. Many new and existing infectious microorganisms are serious threats to health and food that the concentration of pathogenic security. It is very much necessary to infectious diseases called the latitudinal identify causative organism, to save the species diversity gradient in human mankind from different diseases globally. pathogens is increasing toward the Apart from the region, country, and race, equator, which is mostly attributable to harmful microorganism are making life factors like population density, overuse continuously in danger also. Emerging of antibiotics, improper agricultural infectious diseases (EIDs) are defined practices and environmental disturbances. as ‘‘infections that have newly appeared The occurrence of emerging and in a population or existing before but reemerging infectious diseases can be are rapidly increasing in incidence or a grim situation for third world nations geographic range.’’ This causes burden such as Pakistan. This region has been on the health of public and national hit by several epidemics. According to the economy. It can affect ecological, WHO, there is risk for many outbreaks environmental, and socioeconomic in the future because of inadequate condition of nations. Food markets, primary health care, improper sanitation, human behavioral changes, changes overcrowded cities, an insufficient number in agriculture and livestock practices, of medical practitioners and insufficient climate alteration, and environmental medications, contaminated water, lack degradation have allowed new and of awareness among the public about easy passage for infectious agents to hygienic conditions, meager attention reemerge and appear in previously non by the government, a large number of endemic areas. Often such incidents refugees and internally displaced people, are followed by a global response that religious misconceptions, and resource entails divert developmental funds. limitations. Pakistan as a developing After having been in a state of denial country faces many challenges because for a few decades, the world community of limited resources and financial has recognized the potential threats of constraints. According to recent data, emerging and reemerging infectious Pakistan spends 4.7% of its total budget diseases, which is evident by the resolve on health care, which is not enough for in the Sustainable Development Goals a populous country like Pakistan. There (SDG) to combat infectious diseases like are estimated to be 2 primary healthcare malaria and acquired immunodeficiency units per 10,000 people in the country. syndrome explain (AIDS) and to support The maternal mortality ratio is 170 out of the global movement to wipe out such 100,000 people (Khalil et al.,2017). Even diseases from the face of earth (. Many after massive technical advancements, serious efforts, in the form of the Global our knowledge about infectious diseases is Health Security Agenda (GHSA), the not sufficient. This is a greater concern for Global Health Initiative (GHI), and the underdeveloped countries because they Cooperative Threat Reduction (CTR), all lack the technological capacity to deal with of which aim to build robust, collective, such issues effectively. There is a great sustainable, and globally integrated need for global partnerships to provide health management systems that are a collaborative and multidisciplinary safe and secure. Previous studies indicate approach to deal with these issues. Because VetPubHealth Journal ISSUE 17 IVSA Standing Committe on One Health April 2020
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of the flaws in healthcare practices and the environmental conditions, epidemics always find a way to spread in the local population. The failure to achieve a good healthcare system has resulted in Pakistan being a reservoir for infectious diseases, like polio, which have elsewhere been wiped from the face of the earth. Besides the endemic entities, there is a global threat of Ebola virus that demands serious and dedicated efforts to be undertaken at federal and provincial levels, with effective participation from civil society and religious scholars. Zika virus is among the heavily debated issues across the world. Recent statements by the health ministry and WHO indicated that the risk of a Zika virus outbreak is insignificant. Even if there is a low risk, there is a great need to monitor the virus globally and respond immediately if a suspected Zika case is found in the country. An outbreak response and implementation strategy should be immediately developed against pathogens like Ebola, Zika, and MERS. At present, Pakistan may not have the capacity to deal with these issues by itself, so efforts are required by the international community to reduce the existing threat of emerging infectious diseases (Khalil et al., 2017). The emergency response teams should be properly trained and equipped to respond to any event. Biosecurity issues must be taken care of. A dedicated, well-planned, integrated effort at all levels of society is needed to cope with the menace of infectious diseases. The Institute of Medicine’s 2003 report Microbial Threats to Health stresses that the United States should enhance the global capacity for responding to infectious disease threats and should take a leadership role in promoting a comprehensive, global, real-time infectious disease surveillance system.
health threats is recognized in the revised International Health Regulations (IHR [2005]) with its all-hazards approach to assessing serious public health threats. These regulations are designed to prevent the international spread of diseases, while minimizing interruption of world travel and trade. They encourage countries to work together to share information about known diseases and public health events of international concern. (www.healthypeople.gov) Nowadays, coronavirus pandemic outbreak is affecting all the countries around the globe. The day by day increase in the number of positive cases and deaths is a threat alarm for the health professionals and government bodies. Therefore, it is need of time to develop vaccine and proper treatment to limit the spread of infections. New policies and measures are required to stop further transmission of diseases across different regions. The role of veterinary professionals is also crucial in controlling such infectious diseases. They contribute in improvement of human and public health by improving agriculture and food systems, advancing biomedical and comparative medical research, preventing and addressing zoonotic diseases, enhancing environmental and ecosystem health, and helping manage 21st century public health. Considering the current scenario, the collaborative efforts of government officials, policy makers, health professionals, veterinarians and general public is the only solution to combat with the emerging and re-emerging infectious diseases.
References:
Khalil, A. T., Ali, M., Tanveer, F., Ovais, M., Idrees, M., Shinwari, Z. K., & Hollenbeck, J. E. (2017). Rapid identification and control of Emerging viral infections in Pakistan: issues, conemerging infectious diseases helps: cerns, and future prospects. Health security, 15(3), -Promote health abroad 268-281. -Prevent the international spread of https://www.healDthypeople.gov/2020/topics-objecdisease tives/topic/global-health -Protect the health of the U.S. population
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Biological warfare & Bioterrorism: Global Threats of Infectious Disease Outbreaks Bioterrorism is a term used for intentional use of pathogenic strains of microbes to cause disease or death in living things and/or to give harm to environment. The aim of bioterrorism is not only to cause mortality and morbidity, but also to lead to social and political breakdown. Since it is a threat of the 21st century, it is important to be aware of the biological features of the instruments of the war [1]. The act of bioterrorism can range from a simple hoax to the actual use of these biological weapons, also referred to as agents. A number of nations have or are seeking to acquire biological warfare agents, and there are concerns that terrorist groups or individuals may acquire the technologies and expertise to use these destructive agents. Biological agents may be used for an isolated assassination, as well as to cause incapacitation or death to thousands. If the environment is contaminated, a long-term threat to the population could be created [2]
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and dying plague victims into the city in an attempt to spread the disease. Armies polluted the water by throwing dead animals into water supplies. The incident was reported by an Italian, Gabriele de’ Mussi, who probably based his narrative on eyewitness accounts of survivors of the attack who fled Kaffa [5]. the plague pandemic also known as the “Black Death” which rapidly extended through Europe and North Africa initiated following migration of refugees from the defeated city [6]. During the French and Indian War in the 18th century AD, British forces under History of Biological Warfare: the direction of Sir Jeffrey Amherst Pre-History to the Present gave blankets that had been used by smallpox victims to the Native Americans Biological warfare may have originated in in a plan to spread the disease. [7] prehistory, although that is not certain. Archaeologists believe that poisons were used widely for fishing, hunting, World War I and warfare by nomadic and primitive By the time of The Great War, the germ tribal societies, although direct evidence theory of disease was well established; is scanty for the prehistoric period. scientists grasped how microbes such The poisons were toxins obtained from as bacteria and viruses transmit illness. readily available plants or animals. In During the war, German scientists some cases, however, primitive peoples and military officials applied this contaminated arrows in ways that knowledge in a widespread campaign of seemed likely to introduce pathogens. [3] biological destruction. Their target was livestock—the horses, mules, sheep, and cattle being shipped from neutral Ancient Biological Warfare: countries to the Allies. The diseases The potential impact of infectious they cultivated as weapons were diseases on people and armies has ganders and anthrax, both known to been recognized since 600 BC regarding ravage populations of grazing animals Biological Warfare.[4] During the siege of in natural epidemics. By infecting just Kaffa (now Ethiopia), Feodosiya, Ukraine, a few animals, through needle injection the Tartars (Mongols), who attacked and pouring bacteria cultures on Kaffa in the 14th century, tossed dead animal feed, German operators hoped VetPubHealth Journal ISSUE 17
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to spark devastating epidemics. [8]
World War II
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While Germany struggled with biological weapons in World War I, the Japanese military practiced bio warfare on a mass scale in the years leading up to and throughout World War II. In occupied Manchuria, starting around 1936, Japanese scientists used scores of human subjects to test the lethality of various disease agents, including anthrax, cholera, typhoid, and plague. As many as 10,000 people were killed. In active military campaigns, several hundred thousand people mostly Chinese civilians were victim. In October 1940, the Japanese dropped paper bags filled with plague-infested fleas over the cities of Ningbo and Qu Zhou in Zhejiang province. Other attacks involved contaminating wells and distributing poisoned foods. The Japanese army never succeeded, though, in producing advanced biological munitions, such as pathogen-laced bombs. By the end of WWII, the Americans and Soviets were far along on their own paths in developing biological weapons. [8]
Bio-Warfare Programs developed in the various Countries The United Kingdom: The British initiated an offensive Bio Weap on program in 1940. Prior to the war, press reports suggesting that the Germans had an offensive BW program attracted high-level official attention. The British program explored several biological weapons options but developed only a few. The focus was the Mark I, a modification of the Type-F cluster munition originally intended for use with high explosives and chemical agents. Field tests demonstrated that it could disseminate B. anthracis from liquid slurry, although it was highly inefficient in generating aerosols. The British were unable to produce the bulk agent required to fill these munitions and intended to rely on the United States to VetPubHealth Journal ISSUE 17
do so. The planned U.S. facility was not completed before the war ended, and the munitions were never fielded. The British did produce large quantities of cattle cakes impregnated with anthrax for bomber delivery. The intended targets were German cattle herds. [9]
The United States:
The United States initiated a Bio Weapon program in 1942. By that time, it was known that the Japanese were using biological agents in China, although it is unclear whether defence planners in Washington fully understood this. President Franklin D. Roosevelt, fearing that the Germans or Japanese might employ biological weapons against the United States, considered the BW program as a requirement. The U.S. Army organized a substantial effort, ultimately spending roughly $60 million and research efforts were highly successful, demonstrating that it was possible to transmit certain pathogens through the air in aerosol clouds. At least 18 different biological agents were studied, including some intended for use against crops and animals. The primary focus was on B. anthracis and botulinum toxin as antipersonnel agents. The program made much less progress in the development of biological weapons and in the mass production of biological agents. [10]
Hungary:
The Hungarians organized a small Bio Weapon program. Although authorized in 1936, it was not until August 1938 that it became active. The program reportedly employed only six technicians but supposedly made considerable progress before the facility was destroyed during a bombing raid in April 1944. The Hungarians researched Bacillus anthracis, Clostridium perfringens, Salmonella paratyphoid, and Shigella dysenteriae. They also explored various dissemination techniques, including glass bombs capable of carrying 1 to 50 kilograms of a biological
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agent (either wet or dry). [11]
France:
The French had a small BW program during the period between the two world wars. They benefited from the contributions of André Trillat. One of the world’s leading experts on dissemination of disease through the air, he published seminal articles on the topic in 1918 and 1920. The program was active from 1921 to 1927 and then went dormant, but efforts resumed in 1935.The French effort had both defensive and offensive elements. On the one hand, the French were trying to understand the potential threat better. They began researching dissemination technologies and techniques, even to the extent of re-leasing microorganisms in the Paris subway to determine the degree to which they would disperse. They studied botulinum toxin and determined that it could survive the destructive forces of an exploding artillery shell. Similarly, they researched dissemination of animal diseases. They also tried to implement some defensive measures, including the production of anti-anthrax sera [12].
South Africa:
South Africa developed a chemical and biological weapons program in the 1980s. Much of its work was focused on the development of toxins intended for assassinations. In addition, the South Africans created small stocks of biological agents for use against regime opponents, including B. anthracis (which causes various forms of anthrax), botulinum toxin, Brucella melitensis (which causes brucellosis), Salmonella typhimurium (which causes food poisoning), and Vibrio cholerae (which causes cholera).[13] VetPubHealth Journal ISSUE 17
Other Countries:
North Korea, Israel, Iraq, China, Canada, Egypt, Iran and many other countries were having the Bio Warfare Programs in the History. [14]
Bioterrorism
Some terrorist organizations, including Al-Qaeda, have explored the use of biological agents. In 2001, letters containing anthrax spores were mailed to a television news anchor, US senator, and others. These letters led to the death of a few people and hospitalization of a few others [15]. It is also known that the peoples are experimented with botulin toxin, anthrax, cholera, and Q fever. They have also sent healthcare providers to Africa on a mission; however, their main purpose was to bring back Ebola virus samples to use as a biological weapon [16].
Defence
Preparedness is the most potent defence against possible bioterrorist events. During the recent decade, a remarkable progress in the detection, protection, and decontamination of biological warfare agents has emerged since various and sophisticated detection and decontamination methods have been developed and implemented [17]. In case of an attack, many people can be affected in a short period of time and great chaos may occur on the healthcare system [18]. In order to avoid the logistical problems and insufficiency of medications and resources, the US Centres for Disease Control (CDC) encourages healthcare professionals to be familiar with warfare agents, and in association with governmental organizations have implemented a “Bioterrorism Preparedness and Response Program” to detect and appropriately respond to a potential bioterrorist attack, immediately [19].
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References:
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1. Kasdorf B. EPUB 3: Not Your Father’s EPUB. 11. 95 Gábor Faludi, “Challenges of BW Information Standards Quarterly. 2011;23(2):p. Control and Defense During Arms Reduction,” 4. doi: 10.3789/isqv23n2.2011.02. in Conversion of Former BTW Facilities, ed. Erhard Geissler, Lajos Gazsó, and Ernst Buder, 2.URL:https://www.emedicinehealth.com/ NATO Science Series 21 (Dordrecht: Springer biological_warfare/article_em.htm#what_is_ Netherlands, 1998), 67–70; Lajos Rózsa and the_history_of_biological_w arfare, Biological Kathryn Nixdorff, “Biological Weapons in NonWarfare, Medical Author: Edmond Hooker, MD, Soviet Pact Countries,” in Deadly Cultures: DrPH, Medical Editor: William C. Shiel Jr., MD, Biological Weapons since 1945, ed. Mark L. FACP, FACR Wheelis, Lajos Rózsa, and Malcolm R. Dando (Cambridge: Harvard University Press, 2006), 3. Émile Perrot and Émile Vogt, “Poisons de 158–160 Flèches et Poisons D’épreuve” (Paris: Vigot Freres, 1913); H.D. Neuwinger, “Alkaloids in 12. Lepick, “French Activities Related to Arrow Poisons,” in Alkaloids, ed. Margaret F. Biological Warfare, 1919–45.” Roberts and Michael Wink (New York: Springer US, 1998), 45–84; David E. Jones, Poison Arrows: 13. 160 Gould and Folb, Project Coast. North American Indian Hunting and Warfare (Austin: University of Texas Press, 2007). 14. A Short History of Biological Warfare: From Pre-History to the 21st Century W. Seth Carus 4. Stefan R. Biological warfare and bioterrorism: a historical review Proc. Bayl Univ Med Cent. 15. 7. Stefan R. Biological warfare and 2004;17(4):400–406. bioterrorism: a historical review Proc. Bayl Univ Med Cent. 2004;17(4):400–406. 5. Christopher G. W., Cieslak T. J., Pavlin J. A., Eitzen E. M., Jr. Biological warfare: A historical 16. Olson K. B. Aum Shinrikyo: Once and perspective. Journal of the American Medical future threat? Emerging Infectious Diseases. Association. 1997;278(5):412–417. doi: 10.1001/ 1999;5(4):513–516 jama.1997.03550050074036. 17. Vatansever F., Ferraresi C., de Sousa M. V. P., et al. Can biowarfare agents be defeated with light? 6. Kasdorf B. EPUB 3: Not Your Father’s EPUB. Virulence. 2013;4(8) doi: 10.4161/viru.26475. Information Standards Quarterly. 2011;23(2):p. 4. doi: 10.3789/isqv23n2.2011.02. 18.Keim M., Kaufmann A. F. Principles for emergency response to bioterrorism. Annals of 7.URL:https://www.emedicinehealth.com/ Emergency Medicine. 1999;34(2):177–182. doi: biological_warfare/article_em.htm#what_is_the_ 10.1016/S0196-0644(99)70227-1 history_of_biological_warfare 19.Emergency Preparedness and Response. 8. URL: https://www.pbs.org/wgbh/nova/ Atlanta, GA, USA: Centers for Disease Control bioterror/hist_nf.html and Prevention; 2011 9. G.P. Gladstone, B.C.J.G. Knight, and Graham Wilson, “Paul Gordon Fildes, 1882–1971,” Biographical Memoirs of Fellows of the Royal Society 19 (1973), 317–347 10. John Ellis van Courtland Moon, “U.S. Biological Warfare Planning and Prepared-ness: The Dilemmas of Policy,” in Geissler and Moon, 215–254 VetPubHealth Journal ISSUE 17
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Infectious Disease Threats in the Twenty-First Century
Abstract
Recently we are facing global pandemic of CoViD-19. It has kneeled down all the people in the world. It has first seen in Wuhan p rovince of China. Researchers has suggested that it is zoonotic and it is transmitted to human from bat and it is contagious. Till now it has affected almost 440 thousand population of world and death tolls reaches to 19000 whereas 112 thousand people have already recovered and living normal life. COVID-19 shows the symptoms similar to general flu. The present condition of people suggests that we people are not ready to face such type of outbreaks till now and more efforts need to be done to cope with such types of outbreaks in coming future.
INFECTIOUS DISEASE AND WE
Infectious disease are caused by pathogenic micro-organisms, such as bacteria, viruses’ parasites or fungi. It can spread directly or indirectly from one person to another. Likewise zoonotic disease are infectious of animals that can cause disease when transmitted to human. Human have been ruling this planet since long time. Being the most intelligent creature on earth human have failed to move along with nature, thus nature played its part. Our national interest are inevitably linked to the health of people throughout the world. Health, like education, is an investment in human capital that can help break cycles of poverty and political instability and is of fundamental importance is shaping and stability and well-being of a nation or region. The tragedy of all the outbreaks till now has deeply scarred large regions of the continent and it threatens to undermine economic progress, institutional strength and the survival of family units. Although less visible than the other outbreaks the human toll of economic hardships and social instability in Russia has resulted in a 10-year decrease in birth rate from the mid-80sto the mid-90s, far lower than the replacement rate needed VetPubHealth Journal ISSUE 17
a h t s e r h S n Sachi standard of living. These are only 2 examples of global health events that could threaten peace, prosperity and international relationships in the decades to come. The global reach of emerging infectious issuance of ‘Microbial Threats to Health Emergence, Detection and Response’ (2003), the SARS epidemic pandemic can emerge with astonishing speed and spread globally in matter of weeks. Shortly thereafter Bovine Encephalopathy (Mad Cow Disease) and Monkey pox emerged for the first time in the Americas. The Institute of Medicine (IOM) contributes to improved global health through studies that advise on how to reduce the burden of disease and disability in developing countries, that illuminate emerging threats to international and global health and that emphasize infectious disease the most truly global threat to health.
How infectious disease start?
Infectious disease today ignore geographic and political boundaries, and thus constitute a global threat that places every nation and every person at risk. Food products, livestock, exotic pets and material goods and the microbes they carry are exchanged as culture from every region of the world are explored.Microbial Threats to Health, 2003 Microbial Threats to Health: Emergence, Detection and Response (2003) concludes that the public health and medical communities are inadequately prepared to deal effectively with infectious disease. Many reports on infectious disease describes scientific, social and political
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trends that have influenced infection and disease emergence and control over the past decades. New or previously unrecognized diseases (such as SARS) have emerged and known disease that thought to be virtually eradicated have reappeared, occasionally in epidemic proportion. WHO has been working together with all the countries in the globe to cope with all the epidemic. Observing the present condition of the world we can say that we are not yet ready to face the epidemic. Unlike viruses and microorganisms the agents of most known infectious disease prions are an abnormally shaped form of a normal mammalian protein. Identified in 1982, prions appears to be associated with a group of uniformly fatal neurodegenerative disease called Transmissible Spongiform Encephalopathies (TSEs), which include ‘Mad Cow’s Disease’ conventional method used to diagnose most infectious disease fail to detect TSEs. There is no cure, prophylaxis or fail-safe ante mortem diagnostic test for TSEs. A decade worth of attempts of develop effective prion detection tests have failed. Effective treatment for TSEs fails because of lack of proper funding, investigators, lab facilities. International collaboration offers opportunities to expand that capacity. Today’s superpower countries have been spending its fund only to aircrafts, missiles and weapons. Recent CoVid-19 outbreak have shown that being supremacy on weapons is not enough. One need to provide enough look to proper research and health facilities.
MAJOR DISEASE OUTBREAK IN HUMAN HISTORY
We human have faced many disease outbreak in history. At past there was no proper care thus it becomes more difficult eradicate disease. Likewise superstition had also enraged the condition at past. The pandemic emerged at past remained at only one region but at present due to vast development of transportation facilities disease seen in one region takes VetPubHealth Journal ISSUE 17
no longer time to reach every nook and corner of the country. Major disease outbreaks; 1.Prehistoric epidemic: Circa 3000 B.C 2.Plague of Athens:430 B.C 3.Antonine Plague:165-180 A.D 4.Plague of Cyprian:250-271 A.D 5.Plague of Justinian:541-542 A.D 6.The Black Death:1346-1353 A.D 7.Cocoliztli Epidemic:1545-1548 A.D 8.The American Plague:16th century 9.Great plague London:1665-1666 A.D 10. Plague of Marseille: 1720-1723 A.D 11. Russian Plague: 1770-1772 A.D 12. Philadelphia Yellow Fever : 1793 13. Flu Pandemic: 1889-1890 A.D 14. American Polio Epidemic: 1916 15. Spanish Flu: 1918-1920 16. Asian Flu: 1957-1958 17. AIDS Pandemic : 1981-Present 18. Swine Flu Pandemic: 2014-1016 A.D 19. Ebola Epidemic: 2014-2016 A.D 20. Zika Virus: 2015-present 21. COVID-2019-Present These pandemic have infected billions of population and caused death of millions of population. Human need to learn from these outbreaks to prevent the future epidemic. The superpower countries need to invest more on research and health facilities than on weapons. The organizations working in the betterment of the human health all over the world need to take all the countries in hand to hand to control the future outbreaks. Table:Leading Infectious Causes of Death Worldwide,
Cause
Rank
Respiratory infection HIV/AIDS Diarrheal disease Tuberculosis Malaria Measles Pertussis Tetanus Meningitis Syphilis
1 2 3 4 5 6 7 8 9 10
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Estimated number of death 3871000 2866000 2001000 1644000 1124000 745000 285000 282000 173000 167000 Source: WHO 2002 April 2020
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References: 1. Patterson KD, Pyle GF. The geography and mortality of the 1918 influenza pandemic. Bull Hist Med. (1991) 65:4–21. [PubMed] [Google Scholar] 2. Johnson N P, Mueller J. Updating the accounts: global mortality of the 1918-1920 “Spanish” influenza pandemic. Bull Hist Med. (2002) 76:105–15. 10.1353/bhm.2002.0022 [PubMed] [CrossRef] [Google Scholar] 3. A deadly touch of flu Economist. (2018) 428:75–7. [Google Scholar] 4. United Nations Department of Economic and Social Affairs PD World Population Prospects: The 2017 Revision, DVD Edition. (2017). [Google Scholar] 5. Foreman KJ, Marquez N, Dolgert A, Fukutaki K, Fullman N, McGaughey M, et al. . Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 201640 for 195 countries and territories. Lancet. (2018) 392:2052– 90. 10.1016/S0140-6736(18)31694-5 [PMC free article] [PubMed] [CrossRef] [Google Scholar] 6. Taubenberger JK, Morens DM. 1918 Influenza: the mother of all pandemics. Emerg Infect Dis. (2006) 12:15–22. 10.3201/ eid1209.05-0979 [PMC free article] [PubMed] [CrossRef] [Google Scholar] 7. Saunders-Hastings PR, Krewski D. Reviewing the history of pandemic influenza: understanding patterns of emergence and transmission. Pathogens. (2016) 5:66. 10.3390/ pathogens5040066 [PMC free article] [PubMed] [CrossRef] [Google Scholar] 8. World Health Organization Global Health Observatory (GHO) Data: HIV/AIDS. (2019). Available online at: https:// www.who.int/gho/hiv/en/ (accessed February 12, 2019). 9. Zhu T, Korber BT, Nahmias AJ, Hooper E, Sharp PM, Ho DD. An African HIV-1 sequence from 1959 and implications for the origin of the epidemic. Nature. (1998) 391:594–7. 10.1038/35400 [PubMed] [CrossRef] [Google Scholar] 10. Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, et al. . Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science. (1983) 220:868–71. 10.1126/ science.6189183 [PubMed] [CrossRef] [Google Scholar] 11. World Health Organization Cholera (2019). Available online at: https://www.who.int/news-room/fact-sheets/detail/ cholera (accessed February 7, 2019). 12. Camacho A, Bouhenia M, Alyusfi R, Alkohlani A, Naji MAM, de Radiguès X, et al. . Cholera epidemic in Yemen, 2016-18: an analysis of surveillance data. Lancet Glob Health. (2018) 6:e680–90. 10.1016/S2214-109X(18)30230-4 [PMC free article] [PubMed] [CrossRef] [Google Scholar] 13. Weinraub B. Smallpox grows in India; worst over, officials say. New York Times. (1974). p. 3. Available online at: https:// www.nytimes.com/1974/07/16/archives/smallpox-grows-inindia-worst-over-officials-say-about-26000-deaths.html 14. Centers for Disease Control and Prevention International notes update: human plague – India, 1994. Morb Mortal Wkly
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Rep. (1994) 43:761–2. [PubMed] [Google Scholar] 15. Post T, Clifton T. The plague of panic. Newsweek. (1994) 124:40–2. [Google Scholar] 16. Centers for Disease Control and Prevention Frequently Asked Questions About SARS. (2012). Available online at: https://www.cdc.gov/sars/about/faq.html (accessed February 12, 2019). 17. Olsen SJ, Chang H-L, Cheung TY-Y, Tang AF-Y, Fisk TL, Ooi SP-L, et al. . Transmission of the severe acute respiratory syndrome on aircraft. N Engl J Med. (2003) 349:2416–22. 10.1056/NEJMoa031349 [PubMed] [CrossRef] [Google Scholar] 18. Dawood FS, Iuliano AD, Reed C, Meltzer MI, Shay DK, Cheng P-Y, et al. . Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modelling study. Lancet Infect Dis. (2012) 12:687–95. 10.1016/S1473-3099(12)70121-4 [PubMed] [CrossRef] [Google Scholar] 19. Carroll R, Tuckman J. Swine flu: Mexico braces for unprecedented lockdown. Guard. (2009). Available online at: https://www.theguardian.com/world/2009/apr/30/swine-flumexico-government-lockdown 20. Welch C. Inaccurate “Swine” Flu Label Hurts Industry, Pork Producers Say. CNN; (2009). Available online at: http:// www.cnn.com/2009/HEALTH/04/30/pork.industry.impact/ [Google Scholar] 21. Centers for Disease Control and Prevention 2014-2016 Ebola Outbreak in West Africa. (2017). Available online at: https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/ index.html (accessed February 12, 2019). 22. Gavi The Vaccine Alliance Ebola Vaccine Purchasing Commitment from Gavi to Prepare for Future Outbreaks. (2016). Available online at: https://www.gavi.org/library/ news/press-releases/2016/ebola-vaccine-purchasingcommitment-from-gavi-to-prepare-for-future-outbreaks/ 23. Partlow J. As Zika virus spreads, El Salvador asks women not to get pregnant until 2018. Washington Post. (2016). [Google Scholar] 24. Institute for Health Metrics and Evaluation GBD Results Tool. (2019). Available online at: http://ghdx.healthdata.org/ gbd-results-tool (Accessed February 12, 2019). 25. World Health Organization Plague Outbreak Madagascar: External Situation Report 14. (2017). Available online at: https://apps.who.int/iris/bitstream/handle/10665/259556/ Ex-PlagueMadagascar04122017.pdf?sequence=1 26. World Health Organization An R& D Blueprint for Action to Prevent Epidemics: Plan of Action. Geneva: WHO Press; (2016). Available online at: https://www.who.int/blueprint/ about/r_d_blueprint_plan_of_action.pdf [Google Scholar] 27. World Health Organization Crimean-Congo Haemorrhagic Fever. (2013). Available online at: https://www.who.int/newsroom/fact-sheets/detail/crimean-congo-haemorrhagic-fever (Accessed February 7, 2019).
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The effect of COVID-19 on the Earth
COVID-19 is the century’s recent concern. Doctors and scientists all around the world are struggling to contain this virus, and to find an effective vaccine for it. Regardless of the fact that the coronavirus does not kill everyone infected with it, it is a major threat to humanity due to its rapid expansion. The outbreak started in China and rapidly spread throughout many other countries like Italy and Iran. The panic that rose between people around the world and the fast spread of the virus, pushed the governments to take serious measures in this issue. Everyone was shortly aware of the concerns of the spread on the global economy, but only few saw the bigger picture and the effect of the outbreak on the earth.
In most countries, including China and 33 Italy, communities were quarantined. All forms of work, manufacturing, education and entertainment were shut. Borders and airports will closed until the governments decide to open them. The use of vehicles for transportation enormously decreased due to the quarantine. In China for example, the daily passenger traffic dropped from 85% at January 10 to 20% at February 17. Moreover the manufacturing purchasing manager’s index decreased from 50.0 to 35.7 from January to February. In addition, china’s export index also dropped from 48.7 to 28.7, same as imports decreased from 49.0 to 31.9. As Ren explains:” The economy experienced huge negative growth in February, the trough has been reached, the duration of the impact should be monitored in the next step.” (Ren, 2020) It was obviously clear to the world that the economy dropped in China and many other countries due to all these interruptions. But the thing that was not visible for the world, is the effect of these interruptions on the earth itself. The earth suffered from all forms of pollution throughout the previous years. Could the effects of COVID-19 actually be beneficial for the health of the earth?
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problem generated by coronavirus is not exactly a problem to the earth itself. Many scientists see it as a break for the earth from all the pollution caused to it throughout the previous years. Air pollution in the world was mostly caused by the emission of NO2 gas by vehicles, factories and basically all types of machines that burn fossil fuels. Due to the coronavirus outbreak, many factories were shut down or at least decreased the time of their activity. Also as mentioned before the activity of vehicles especially airplanes have dropped in the past two months. In China specifically, which is one of the most important manufacturing countries in the world, the density of NO2 decreased enormously by 25% during the quarantine period, due to the shutting down of many of its factories.Fei said:” This is the first time I have seen such a dramatic dropoff over such a wide area for a specific event.”(Fei, 2020). This change did not only occur in China, but also in countries such as Italy where there was also a pause of the economic and social life. Claus explains:” The decline in nitrogen dioxide emissions over the Po Valley in northern Italy is particularly evident.” (Claus, 2020). Air pollution was not the only thing that decreased, but also water pollution. The lockdown in Italy and the shutting down of the airport, lead to the decrease of tourism in Italy, especially Venice. The canals in Venice that were always full of cruise ships are becoming clearer than ever.
One of the scientists have suggested Many scientists believe that the that although there was numbers of
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deaths caused by coronavirus, but this virus is also saving lives in progress. Marshall suggested:” Given the huge amount of evidence that breathing dirty air contributes heavily to premature mortality, a natural - if admittedly strange - question is whether the lives saved from this reduction in pollution caused by economic disruption from COVID-19 exceeds the death toll from the virus itself.” (Marshall, 2020). “Even under very conservative assumptions, I think the answer is a clear ‘yes’.” It is proven that 2 months of pollution reduction saved 4,000 children under 5, and 73,000 adults over 70 in China. All of these lives saved exceed the number of deaths caused by coronavirus in China. After all, the negative effects of COVID-19 are not deniable, but the benefits of the quarantine are also clearly visible on the earth. Some people see this outbreak as a disaster on humanity, but in fact it is the savor that allowed the earth to have a break from humanmade dilemmas. It is now possible to say that the lockdown of humans from the earth’s resources is giving the earth a chance to renew itself without our help. And even though the lockdown will shortly be over as the coronavirus starts to fade, but this short period of rest for nature is enough for it to heal itself and keep giving us, humans, what we might not deserve.
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References: 1.Zeping, Ren. (February 2020). Coronavirus: China’s factory activity plunges to all-time low, worse than global financial crisis, February data show. Publisher: Andrew Mullen and Orange Wang https://www.scmp.com/economy/china-economy/ article/3052985/coronavirus-chinas-factories-activity-plunges-all-time-low 2. Zehner, Claus. (2020). Air pollution has fallen in northern Italy following lockdown https://airqualitynews.com/2020/03/16/air-pollution-has-fallen-in-northern-italy-following-lockdown/ 3. Burke, Marshall. (March 2020). New Evidence Shows How COVID-19 Has Affected Global Air Pollution. Publisher: Jacinta Bowler. https://www.sciencealert.com/here-s-what-covid-19-is-doing-to-ourpollution-levels
34 4. Lin, Fei.(2020). NASA says COVID-19 lockdown ‘slashes air pollution’ in China. Publisher:Jonny Bairstow https://www.energylivenews.com/2020/03/17/ nasa-says-covid-19-lockdown-slashes-air-pollutionin-china/
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Namaste:An Etiquette for Disease Control
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Travel patterns and ages of exploration refer to period between 15th to 17th centuries. A new height was gained by technological advancement along with new products and new discoveries of land around the world.During this time, different people from societies around the globe began to integrate that resulted emergence of new diseases. The Earth is now a global village. We can travel from Australia to Ireland which is 9680 miles apart in 17.29 hours. Land, sea and air transport routes and networks are expanding day by day. Number of passengers and amount of goods that are being transported from place to place is increasing. With this the pathogens and their vectors are moving in large number further faster than ever. Global travel has resulted more new diseases than ever before in last five centuries before becoming potential pandemics. Human mobility has increased by 1000 fold in high income countries since 1880 (Wilson,1995, 2003).As world economy continues to grow aviation in particular has expanded. Global passenger number has grown by nearly 9% per annum since 1960. Moving from place to place makes people meet new people. Meeting someone after long time or in a new place with different situation compels a person to show respect towards the next person. We generally show respect and generate a level of etiquette to greet other people. There’s an amazing diversity of greetings customs around the world. In Tibet sticking out your tongue can be way of welcoming people. In some part of New Zealand, Mori greet each other by touching noses. In most of the western countries including Europe, people hug or kiss on cheek as their norms. It depends upon religion, culture and ethnicity. But, it all comes to handshaking habit of human beings in case of greetings. We often do handshakes while meeting other people. It’s considered as a gesture of peace. From life of a normal VetPubHealth Journal ISSUE 17
i r a k i h d A Aashish
person to a high diplomatic person, handshake is very popular. We students go to college and hand shake, a leader from one country visits another country, meets some leaders and shakes hand with them during a formal meet. A celebrity attends a ceremony, meets other celebrities of his kind and shakes hand. In fact handshake is everywhere, from our home to school, college, offices, ceremonies, etc. It’s so ubiquitous that you may never have thought about why people shake hands. The history of the handshake dates back to the 5th century B.C in Greece. It was a symbol of peace, showing that neither person was carrying a weapon. During the Roman era, handshake was actually more of an arm grab. It involved grabbing each other’s forearms to check that neither man had a knife hidden up his sleeve. Some say that the shaking gesture of the handshake started in Medieval Europe. Knights would shake the hand of others in an attempt to shake loose any hidden weapons. But with the gradual change in the modern times, this culture is considered unsafe in case of hygiene. During handshake two persons grip each other’s palm accompanied by brief up and down movement, which develops direct contact between persons by the means of hand. According to several research studies, almost 80% of pathogens can transfer during a normal handshake from one person to another depending upon relative humidity. The number of microorganisms on intact areas of skin in the same person can vary from 100-
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106/cm2 (Jumaa 2005). Inanimate surfaces found in day care centers, schools, office buildings, homes, public areas or hospitals can be reservoir for secondary mode of transmission with contaminated hands playing a critical role as route of exposure. If a person’s hand is well sanitized but shakes hand with another can cause serious problems of transmission of harmful microorganisms and can result infection. Spores of Clostridium difficile have been shown to be transferred via handshaking as have Enterobacteriaceae, Pseudomonas and Staphylococcus aureus. Inanimate objects, or fomites, are a potential reservoir in the transmission of pathogens either directly, by surfaceto-mouth contact, or indirectly, by contamination of fingers and subsequent hand-to-mouth, hand-to-eye, or handto-nose contact. Many people don’t take hand wash into consideration in day to day, even by health workers. This is resulting as a global threat to transmit infectious diseases from person to person especially; air borne. So, the handshake is such a terrible idea from an infectious disease standpoint.
At the end of November 2019, total of 2494 laboratory confirmed cases of MERS including 818 associated deaths were reported globally, majority of cases in Saudi Arabia (WHO 2019). Swine Influenza also caused pandemic condition in 2009-2010 in almost 80 countries with more than 4100 death out of more than 340,000 confirmed cases. This influenza has caused problems several times since this pandemic condition by changing its antigenic properties. The causative agent of this influenza is considered to be new strain of Spanish Flu; H1N1 strain (WHO 2009). And now Novel Corona Virus has caused a global pandemic condition with a disease named Covid-19. It started from city of Wuhan, Central China and has reached 195 countries causing 16,231 deaths till this article was prepared out of 372,757 confirmed cases (WHO, 2020). The antidote for this disease is not discovered yet. These are some of the examples. There are many other outbreaks in the history that has caused chaos transmitting from person to person. Some are vector borne while many are air borne. There is no any alternative than taking measures to Discussing about the history of air prevent such chaos from each and every borne epidemics and pandemics, 1889- sector. 90 flu pandemic (also called Asiatic or Russian Flu) which lasted till 1995 in So to control infectious diseases which four different stages due to transmission are mainly air borne, alternatives for killed one million people worldwide. handshake should be kept in mind at Spanish Influenza Pandemic of 1918- first which can be a simple but big step 1919 AD commonly known as ‘Spanish in preventing transmission of disease. Flu’ is considered as the mother of all We can prefer doing ''Namaste', a pandemics which lasted from 1918 to South Asian culture to greet people December 1919. It affected one third of around you. It is a typical way to greet world’s population; nearly 500 million. and respect people joining two palms Total death was estimated around 50 in front of third eye, bowing head and million and were arguably as high as 100 bringing hand together down to chest. million (Taubenberger & Morens, 2006). This is good tradition to show respect Likewise, Severe Acute Respiratory joining hands at the level of chest. It's Syndrome (SARS) came as an epidemic quite easy and has many benefits over disease in 2002-2003 that affected 26 handshake. In this context of global countries mainly China which caused threat of infectious disease, Namaste 770 death out of more than 8000 (WHO can be a useful replacement which 2020). Middle East Respiratory Syndrome transfers 0% microorganisms. There is (MERS) is another infectious disease, no any contact between persons and a viral respiratory infection caused by we can do it maintaining considerable MERS-corona virus in September 2012. distance. Spiritual meaning of Namaste VetPubHealth Journal ISSUE 17
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conveys 'the divine in me respectfully References: recognizes the divine in you’. P.A. Jumaa (2005). Hand hygiene: simple and comToday the world is in chaos caused by plex. International Journal of Infectious Diseases, infectious disease like Covid-19. Novel 9(1), 3-14. doi. 10.1016/j.ijid.2004.05.005 Corona Virus has caused a havoc situation all around the globe with possible mutation Taubenberger, J. K. & Morens, D. M. (2006). in coming days. Human encroachment in 1918 influenza: The mother of all pandemics. wildlife and disturbances in ecosystem Emerging Infectious Disease, 17(1), 69-79. doi. has result many infectious diseases. 10.3201%2Feid1201.050979. In this situation, handshake must be avoided from our daily habit. Instead, WHO (2020). Coronavirus disease 2019 (COVID-19) 'Namaste' culture can be adopted. Today Situation Report – 62. Retrieved from: https://www. leaders around the globe are adopting who.int/docs/default-source/coronaviruse/situaNamaste as a greeting culture instead tion-reports/20200322-sitrep-62-covid-19 of handshake to avoid possible danger caused by infectious diseases. Success WHO (2020). International travel and health disagainst disasters is not possible unless ease information on SARS. Retreived from: https:// we don't think wisely and realize that www.who.int/ith/diseases/sars change starts from a small step. WHO (2009). Weekly epidemiological record. Retreived from: https://www.who.int/wer/2009/ wer8447 WHO (2009). MERS monthly summary November 2019. Retreived from: https://www.who.int/emergencies/mers-cov Wilson, M.E. (1995). Travel and the emergence of infectious diseases. Emerging Infectious Diseases 1, 39-46 Wilson, M.E. (2003). The traveler and emerging infections: sentinel, courier, transmitter. Journal of Applied Microbiology 94, 1S–11S.
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Is the record of the most mortal outbreak about to be broken? In 1918, a strain of influenza known as Spanish flu caused a global pandemic, spreading rapidly and killing indiscriminately. Young, old, sick and otherwise-healthy people all became infected, and at least 10% of patients died. Estimates vary on the exact number of deaths caused by the disease, but it is thought to have infected a third of the world’s population and killed at least 50 million people making it the deadliest pandemic in modern history. Although at the time it gained the nickname “Spanish flu,” it’s unlikely that the virus originated in Spain. THE CAUSE OF THE SPANISH FLU: The outbreak began in 1918, during the final months of World War I, and historians now believe that the conflict may have been partly responsible for spreading the virus. On the Western Front, soldiers living in cramped, dirty and damp conditions became ill. This was a direct result of weakened immune systems from malnourishment. Their illnesses, which were known as “la grippe,” were infectious, and spread among the ranks. Within around three days of becoming ill, many soldiers started to feel better, but not all were able to make it. During the summer of 1918, as troops began to return home on leave, they brought with them the undetected virus that had made them ill. The virus did spread across cities, towns and villages in the soldiers’ home countries. Many of those infected, both soldiers and civilians, did not recover rapidly. The virus was hardest on young adults between the ages of 20 and 30 who had previously been healthy.
MODE OF TRANSMISSION:
Through inhalation of the respiratory droplets whish are transmitted from the infected person through the air
SYMPTOMS:
The first wave of the 1918 pandemic occurred in the spring and was generally mild. The sick, who experienced such typical flu symptoms as chills, fever and VetPubHealth Journal ISSUE 17
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fatigue, usually recovered after several days, and the number of reported deaths was low. However, a second, highly contagious wave of influenza appeared with a vengeance in the fall of that same year. Victims died within hours or days of developing symptoms, their skin turning blue and their lungs filling with fluid that caused them to suffocate.
REACTION OF THE WORLD TOWARD THE OUTBREAK:
The city closed saloons, theatres and schools, and public gatherings were banned. Hospitals in some areas were so overloaded with flu patients. Thus, schools, private homes and other buildings had to be converted into makeshift hospitals, some of which were staffed by medical students. People were advised to avoid shaking hands and to stay indoors. Libraries put a halt on lending books, and regulations were passed banning spitting the transmission of the flu by ordering businesses to open and close on staggered shifts to avoid overcrowding on the subways Treat
TREATMENTment
Unlike today, there were no effective vaccines or antiviral drugs that treat the flu, the first licensed flu vaccine appeared in America in the 1940s. The treatment was largely symptomatic, aiming to reduce fever or pain. Aspirin, or acetylsalicylic acid was a common remedy. For secondary pneumonia, doses of epinephrin were given. To combat the cyanosis, physicians gave oxygen by mask or some injected it subcutaneously. Salicin was used to
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reduce pain, discomfort and fever and claimed to reduce the infectivity of the patient. Another popular remedy was cinnamon in powder or oil form with milk to reduce the higher temperature. Finally, salt of quinine was suggested as a treatment. Most physicians agreed that the patient should be kept in bed. With that was the advice of plenty of fluids and nourishment. The application of cold to the head, with warm packs or warm drinks was also advised. Warm baths were used as a hydrotherapeutic method in hospitals but were discarded for /lack of success.
CONTROL
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With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly.
SPANISH ENDS
FLU
are circulating in animals that have not yet infected humans. Recently, novel coronavirus was detected in China in December 2019, it is named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), while the disease associated with it is referred to as COVID-19. Coronaviruses are viruses that transmitted among animals but some of them are also known to affect humans. After they have infected animals, they can eventually be transmitted to humans. The current COVID-19 outbreak caused around 10, 000 reported cases in China during the first month of the outbreak, with additional cases subsequently being detected in Europe and other countries. On February 13, official statistics reported that China had 15, 141 new cases of COVID-19, which represented the single largest number of cases reported on one day since the start of the epidemic .Till now, number of cases reached 524,010, while the number of deaths is 23, 670. 123,322 cases were reported as recovered.
MODE OF TRANSMISSION
PANDEMIC The virus is thought to spread mainly
from person-to-person, between people By the summer of 1919, the Spanish flu who are in close contact with one pandemic came to an end, as those that another (within about 6 feet) through the were infected either died or developed respiratory droplets that are produced immunity. when an infected person coughs or sneezes. About the new outbreak that may break Spanish flu record as the most SYMPTOMS mortal outbreak 1-The most common symptom is fever, Coronaviruses (CoV) are a large family abnormal elevation in body temperature of viruses that cause illness ranging is noticed. from the common cold to more severe 2-we could say that dry cough is the diseases, such as Middle East Respiratory most important second symptom as Syndrome (MERS-CoV) and Severe corona virus attacks lower respiratory Acute Respiratory Syndrome (SARS- system, begins with lungs that cause CoV). A novel coronavirus (nCoV) is a destruction in alveoli then blockage of new strain that has not been previously respiratory tracts. identified in humans. Corona viruses are 3- Runny nose is also observed. zoonotic, meaning they are transmitted 4- General fatigue in all of body organs between animals and people. Detailed 5- Sometimes, it accompanies with investigations found that SARS-CoV was severe diarrhea. transmitted from civet cats to humans 6- Vomiting can be a signal that the and MERS-CoV from dromedary camels person is attacked by COVID-19. to humans. Several known coronaviruses VetPubHealth Journal ISSUE 17
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THE REACTION OF THE WORLD TOWARD THE OUTBREAK
Stopping all international trips between countries, postponing all exams for all stages of education and applying the e- learning via using different online applications, increasing the awareness of the public through the media, in addition to adding restrictions and regulations that people should follow; by wearing protective clothes as face mask and gloves and by staying at home.
TREATMENT
There is no approved drug to prevent or treat coronavirus disease (COVID-19). Thus, people may need supportive care to help them breathe. The World Health Organization (WHO) announced a large global trial, called SOLIDARITY, to find out whether any can treat infections with the new coronavirus for the dangerous respiratory disease. The study, which could include many thousands of patients in dozens of countries, has been designed to be as simple as possible so that even hospitals overwhelmed by an onslaught of COVID-19 patients can participate. WHO is focusing on what it says are the four most promising therapies: an experimental antiviral compound called remdesivir; the malaria medications chloroquine and hydroxychloroquine; a combination of two HIV drugs, lopinavir and ritonavir; same combination plus interferon-beta,(an immune system messenger that can help cripple viruses).
HOW LONG THIS OUTBREAK WILL LAST?
References: (1)Chodosh, Sara (18 March 2020). “What the 1918 flu pandemic can teach us about COVID-19, in four charts”. PopSci. Retrieved 20 March 2020. (2)Crossley, B. M., Mock, R. E., Callison, S. A., & Hietala, S. K. (2012). Identification and characterization of a novel alpaca respiratory coronavirus most closely related to the human coronavirus 229E. Viruses, 4(12), 3689-3700. (3)Cui, J., Han, N., Streicker, D., Li, G., Tang, X., Shi, Z., ... & Wang, L. (2007). Evolutionary relationships between bat coronaviruses and their hosts. Emerging infectious diseases, 13(10), 1526. (4)Geller, C., Varbanov, M., & Duval, R. E. (2012). Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses, 4(11), 3044-3068. (5)Gouilh, M. A., Puechmaille, S. J., Gonzalez, J. P., Teeling, E., Kittayapong, P., & Manuguerra, J. C. (2011). SARS-Coronavirus ancestor’s foot-prints in South-East Asian bat colonies and the refuge theory. Infection, Genetics and Evolution, 11(7), 1690-1702.. (6)Langford, C. (2005). Did the 1918–19 influenza pandemic originate in China?. Population and Development Review, 31(3), 473-505. (7)Phillips, H., & Killingray, D. (Eds.). (2011). The Spanish influenza pandemic of 1918-1919: New perspectives. Routledge. (8)Shanks, G. D. (2016). No evidence of 1918 influenza pandemic origin in Chinese laborers/soldiers in France. Journal of the Chinese Medical Association, 79(1), 4648. (9)Spreeuwenberg, P., Kroneman, M., & Paget, J. (2018). Reassessing the global mortality burden of the 1918 influenza pandemic. American journal of epidemiology, 187(12), 2561-2567. (10)Worobey, M., Cox, J., & Gill, D. (2019). The origins of the great pandemic. Evolution, medicine, and public health, 2019(1), 18-25.
-Unfortunately, it is not possible to predict how long the outbreak will last and how the epidemic will evolve overall. We are dealing with a new virus and therefore a lot of uncertainty remains. For instance, it is unknown whether transmission will decrease during the summer, as what is observed for seasonal influenza.
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Novel coronavirus (2019-nCoV) infection
ABSTRACT
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In recent study in 2019-2020, many patients with pneumonia of unknown cause were associated to a seafood wholesale market in China in Wuhan city. Through the use of unbiased sequencing in samples from patients with pneumonia betacoronavirus was discovered. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV. This virus form a clade within the subgenus sarbecovirus and Orthocoronavirinae subfamily. It is different from both Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus MERS-CoV, Novel Corona Virus-2019 (2019-nCoV) is the seventh member of the family of coronaviruses that infect humans. Further investigation and enhanced surveillance are still going on.1
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areas. Screening of travelers was done in other countries and quarantine measures were taken under certain circumstances. Novel coronaviruses have emerged as human pathogens in the past, notably associated with outbreaks of SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome). 3
CAUSE
Infection due to 2019-nCoV (2019 novel coronavirus)
CLINICAL PRESENTATION
INTRODUCTION
Pathogen is a betacoronavirus, similar to the agents of SARS (severe acute respiratory syndrome)and MERS (Middle East respiratory syndrome).2 In December, 2019 China notified the World Health Organization (WHO) about the several cases of human respiratory illness. These cases were found in the open seafood and livestock market in the city of Wuhan. The infecting agent identified as a novel coronavirus, now called SARS-CoV-2 (initially called 2019nCoV). Novel Coronavirus associated infection is called as COVID-19. The virus is presumed mostly zoonotic in origin. The pandemic disease or correct have been reported in China and also in other countries throughout the world. Outbreaks involve large numbers of people are infecting in USA, Italy, Spain, Germany, France, Iran, South Korea, and local transmission is occurring on a small level in other countries. Travel restrictions and quarantine measures have been adopted in some affected VetPubHealth Journal ISSUE 17
l u G d a z Ahm
The incubation period is 2 to 14 days including the major Symptoms such as fever (may be absent in person at extremes of age or with compromise immune system), cough and dyspnea. In Chest radiography bilateral infiltrates are seen. Clinical illness varies from mild to severe; about 25 percent of confirmed cases have been classified as severe, with up to 32 percent requiring intensive care for respiratory support.3 Some reports suggest worsening during the second week of illness. In early cases, mortality was associated with advanced age. Asymptomatic infection has also been described. a.In symptomatic patients, illness may occur over the course of a week or longer, begin with mild symptoms that progress to dyspnea and shock 4 b.Fever and cough (may or may not be productive) 4, 5 c.Myalgia and fatigue 4 d.Moderate to severe disease complain of dyspnea 4
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e.Hemoptysis can occurred in a small percentage of patients 4 f.Pleuritic chest pain 6 g.Upper respiratory tract symptoms are
than 2 seconds) or warm vasodilation and bounding pulses VIII. Tachypnea IX. Mottled skin with hemorrhage’s like unusual e.g. rhinorrhea, sneezing, sore petechial, or purpura. throat 4, 5 X. Oliguria h. Headache and gastrointestinal XI. Hyperthermia or hypothermia. symptoms are uncommon but may occur e.g. nausea, vomiting and diarrhea 4
DIAGNOSIS
The US Centers for Disease Control (CDC) and World Health Organization (WHO) developed criteria for whom to test, and these criteria have been modified continually. With significant outbreaks in several countries as well as wider availability of diagnostic test kits, both organizations have broadened recommendations for testing. The US Centers for Disease Control (CDC) now recommends that clinicians use their judgment, informed by knowledge Figure 1. Chest Radiographs of novel coronavirus of local COVID-19 activity as well as infected patient. travel history and other risk factors, to determine the need for testing in Shown are chest radiographs from Patient 2 on days patients with a compatible clinical 8 and 11 after the onset of illness. The trachea was illness. World Health Organization intubated and mechanical ventilation instituted in the (WHO) defines a suspect case as follows period between the acquisitions of the two images. (for whom testing is recommended): 7 Bilateral fluffy opacities are present in both images but are increased in density, profusion, and confluence he second image; these changes are most marked in the lower lung fields. Changes consistent with the accumulation of pleural liquid are also visible in the second image.
I. Patients with severe disease may appear quite ill, with tachypnea and labored respirations. Fever is usual, often exceeding 39°C. II. Patients with extremes of age or having immunodeficiency may not develop fever 4 III. Hypotension and tachycardia IV. In children, hypotension plus 2 or 3 of the following criteria: 6 V. Altered mental status VI. Tachycardia (heart rate more than 160 beats per minute in infants or 150 in older children) or bradycardia (heartrate less than 90 in infants or 70 in older children). VII. Prolonged capillary refill (more VetPubHealth Journal ISSUE 17
1) A patient with acute respiratory illness and a history of travel to or residence in an area reporting local transmission of COVID-19 during the 14 days prior to symptom onset. 2) Patient with acute respiratory illness and contact with a confirmed or probable COVID-19 case in the last 14 days. 7 3) A patient with severe acute respiratory infection without other explanatory etiology7 4) If a patient with suspected COVID-2019 infection tests positive for another respiratory pathogen, after clinical, they may not be considered under investigation. 7
TREATMENT AND CONTROL MEASURE
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1) Standard, contact, and airborne precautions should be implemented 9 2) Patient must be provided with a face mask. 3) Place the patient in a closed room 4) No specific antiviral agent is approved for this infection. 5) Lopinavir-ritonavir is FDA-approved for HIV infection and used for other coronavirus infections; it was used empirically for SARS 10 and is being studied in the treatment of MERS 11 i. Chinese health authorities planned to use the combination of this conjunction with interferon alfa for treatment of infection due to 2019-nCoV 12 6) Treatment is largely supportive like oxygen supplementation and conservative fluid support 6 7) Corticosteroid therapy is not recommended 6 8) Until a diagnosis of 2019-nCoV is confirmed, appropriate antiviral or antimicrobial therapy for other viral pathogens (e.g., influenza virus) or bacterial pathogens should be administered 6 9) Management of septic shock must be done which includes cautious fluid resuscitation and use of vasopressors if fluid administration does not restore adequate perfusion. 6 10) Nondrug and supportive care 1 . WHO provides specific guidance for oxygenation, ventilation, and fluid management .6 11) Oxygenation and ventilation.
I II. High-flow nasal oxygen or noninvasive ventilation may be necessary to achieve adequate oxygenation in some patients. IV. Mechanical ventilation may be necessary for patients in whom oxygenation targets cannot be met with less invasive measures or who cannot maintain the work of breathing; - Recommended settings are tidal volume of 4 to 8 mL/kg and inspiratory pressures less than 30 cm H2O V. Use of PEEP may be necessary in patients with acute respiratory distress syndrome. VI. For patients with severe acute respiratory distress syndrome, prone positioning is recommended. VII. Extracorporeal membrane oxygenation has been used 8 in severely ill patients, and it can be considered if resources and expertise are available 12) Fluid management I. Overhydration should be avoided, because it may precipitate or exacerbate acute repiratory distress syndrome.
II. In patients with shock: a) Administration of crystalloids I. Nasal cannula at 5 L/minute, (i.e. saline or lactated Ringer solution) titrated to target peripheral is recommended. oxygen saturation: Adults: total of 30 mL/kg over -SpO2 of 90% or higher in non- the first 3 hours; goal is mean arterial pregnant adults; 92% or higher in pressure of at least 65 mm Hg (if invasive pregnant patients. pressure monitoring is available). II. In most children the target b) Children: 20 mL/kg bolus and SpO2 is 90% or greater; for up to 40 or even 60 mL/kg over the first those who require urgent resuscitation hour. (e.g., those with apnea or obstructed breathing, severe respiratory distress, central cyanosis, shock, seizures, or coma), a target SpO2 of 94% or higher is recommended VetPubHealth Journal ISSUE 17
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References:
1 . h t t p s : / / w w w. n c b i . n l m . n i h . g o v / m / p u b m e d/31978945/ A Novel Coronavirus from Patients with Pneumonia in China, 2019. Zhu N, et al. N Engl J Med. 2020. Zhu N1, Zhang D1, Wang W1, Li X1, Yang B1, Song J1, Zhao X1, Huang B1, ShiW1, Lu R1, Niu P1, Zhan F1, Ma X1, Wang D1, Xu W1, Wu G1, Gao GF1, Tan W1; China Novel Coronavirus Investigating and Research Team. From the NHC Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (N.Z., W.W., J.S., X.Z., B.H., R.L., P.N., X.M., D.W., W.X., G.W., G.F.G., W.T.), and the Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University (X.L.) - both in Beijing; Wuhan Jinyintan Hospital (D.Z.), the Division for Viral Disease.
management. She has been with Elsevier since 2010 and is currently Director,Point of Care. http://www.elsevier.com/connect/coronavirus-information-center 8. Huang C et al: Clinical features of patients infected with the 2019 novelcoronavirus in Wuhan, China. Lancet. ePub, 2020 9. CDC: 2019 Novel Coronavirus: Interim Infection Prevention and Control Recommendations for Patients with Confirmed 2019 Novel Coronavirus (2019- nCoV) or Patients Under Investigation for 2019nCoV in Healthcare Settings. CDC website. Updated February 3, 2020. Reviewed february 3, 2020. Accessed February 3, 2020. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/infection-control.html
2. Zhu N et al: A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. ePub, 2020 10. Arabi YM et al: Treatment of Middle East respiratory syndrome with a combination of lopinavir-ritona3. Margaret Trexler Hessen, MD, Director, Point of vir and interferon-β1b (MIRACLE trial): study Care, Elsevier | Updated March 2, 2020 Margaret protocol for a randomized controlled trial. Trials. Trexler Hessen, MD, is an infectious disease specialist 19(1):81, 2018 with 20 years of clinical practice experience and public health service, including outbreak management. She 11. Bloomberg News: China Names HIV Drugs in has been with Elsevier since 2010 and is currently Di- Treatment Plan for New Virus. Bloomberg News webrector, Point of Care. site. Published January 26, 2020. Accessed February 3, http://www.elsevier.com/connect/coronavirus-infor- 2020. mation-center h t t p s : / / w w w. b l o o m b e r g . c o m / n e w s / a r t i cles/2020-01-26/china-names-abbvie-s-hiv-drugs-in4. Huang C et al: Clinical features of patients infected treatment-plan-for-new-virus with the 2019 novel coronavirus in Wuhan, China. Lancet.ePub, 2020 12. Bloomberg News: China Names HIV Drugs in Treatment Plan for New Virus. Bloomberg News web5. Chen N et al: Epidemiological andclinical characte site. Published January 26, 2020. Accessed February 3, istics of 99 cases of 2020. 2019 novel coronaviruspneumonia in Wuhan, China: h t t p s : / / w w w . b l o o m b e r g . c o m / n e w s / a r t i a descriptive study. Lancet. ePub, 2020 cles/2020-01-26/china-names-abbvie-shiv-drugs-in-treatment-plan-for-new6. WHO: Clinical Management of Severe Acute Respi- virus ratory Infection When Novel Coronavirus (nCoV) Infection Is Suspected: Interim Guidance. WHO website. Updated January 28, 2020. Accessed February 3, 2020.https://www.who.int/publications-detail/clinical-management-of-severe-acuterespiratory-infection-when-novel- coronavirus-(ncov)-infection-issuspected 7. Margaret Trexler Hessen, MD, is an infectious disease specialist with 20 years of clinical practice experience and public health service, including outbreak VetPubHealth Journal ISSUE 17
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Global Threat of Infectious Diseases outbreak Abstract
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Infectious disease means disease caused by microorganism and destroy the living cells and when the disease occurrence increases exponentially in a very short time within in a limited area is called outbreak. From the very beginning, infectious disease has a great threat to life, economy, environment etc at the level of local, regional, national, global. The global health system as currently constituted can provide effectively protection against dynamic array of infectious disease. It has been called into question by recent outbreaks “Ebola, Zica, Dengue, Middle east respiratory syndrome, Severe acute respiratory syndrome, and most alarming Covid19 at present. In past century, Spanish flu(1918-1920),Asian flue(1957-1958), Cholera(1961), Plague (1994) simultaneously caused 30-1000million, 1-2million, 21000, 143000 death. And in this century, SARS (2002-2003), Influenza (2009), Ebola(2014-2016) simultaneously caused 774,284000,11325,38000 death. At present situation the corona virus has already affected 200 countries in the world and killed about 500000 around the world. They all have great impact on economy also. With respect tp outbreak, there are obvious costs to the health system in terms of medical treatments, PPE, and other stuffs. GDP growth decline 8% point 2013-2014 during Ebola outbreak. Now a days the most alarming situation ‘Covid19’ are leading us in a uncertain earth. Drastically fall of economy can be seen.
a z n i S m a l Sadia Is ltural
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disease like TB and Malaria endemic most area but in a steady burden. The graph (fig 1) shows that the infection of Covid19 may remain till August 2020, and about 2200000 people on US can be affected.
Impact on Industry
The TVs, video game, smart phones, note book, smart watch can be reduced simultaneously 4.5%,10.1%,12.1%,12.3%,16%.
Threat in economy
At recent study estimated per annum cost of pandemic influenza at roughly 500 billion us dollar (0.6% global income). The covid19 can cause dramatically economic fall it is thought.
Social Risk
As with the outbreak, the economic risk of AMR begins with increase cost to the health system. Resistance infection demand use of more expensive line of treatment. If resistance infection grows the cost will grow.
Conclusion
Infectious diseases are very much threat for life, economy, industry ect. It In 1920 pandemic Spanish flu killed 30- has the power to shake and change the 100 million people. The two world war killed 77 million combined. Infectious disease and associated mortality have References: abated , they remain a significant threat through out the world. In twenty 1.Pratham alo paper first century we continue to fight old 2.Paper published by David E.Bloom, Dept of pathogen like plague. Some infectious Global health and population, Havard. VetPubHealth Journal ISSUE 17
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COVID 19- Global Matter of Concern at present. ABSTRACT
Corona virus disease-2019 (COVID19); a zoonotic virus today, being a global matter of concern after its outbreak on 31st December 2019, first notified in Wuhan, China. World Health Organization(WHO) made the assessment that COVID19 can be characterized as a pandemic on March 11,2020 after its huge outbreak outside the China and many countries. Though, virus itself is not too dangerous observing the previous history, it is threat because no vaccines are made till date for both human and animals and are on trails.
i r t a h K a Ush
INTRODUCTION
Coronaviruses(CoV) are a large family of viruses that causes illness ranging from the common cold to more severe diseases. Coronavirus disease was first described in 1931, with the first coronavirus(HCoV-229E) isolated from humans in 1965. Until the outbreak of severe acute respiratory syndrome in late 2002, only two human coronaviruses(HCoV) were known-HCoVA-229E & HCoV-OC43. Once the Severe Acute Respiratory Syndrome (SARS) corona-virus(SARS-CoV) had been identified, two further human coronaviruses were identified. Three groups coronaviruses exist:
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Source: shutterstock.com
The SARS-CoV-2 is a beta-coronavirus, which is enveloped non-segmented positive-sense RNA virus.They have polycistronic plus-stranded RNA genomes (about 26-32 kilobases) long with 80x160 nm diameter, with 12-24 nm surface projections ( spikes ) that cause the corona (Latin: crown, appearGroup1(HCoV-229E and HCoV-NL63) ance) Group2(HCoVOC43 and HCoV-HKU1) S- spike Group3(no human CoVs as yet) E- envelope M- membrane But, the new coronavirus disease as an N- nucleocapsid outbreak of respiratory illness proved to be infected by a 2019 novel coronavirus, officially named Coronavirus Dis- ETIOLOGY The disease- COVID-1 is caused by inease 2019, notified in Wuhan, China. fection from the new coronavirus, SARSCoV-2, which is one of multiple coronaMORPHOLOGY OF VIRUS Coronaviruses(CoV) are divided into viruses that can infect humans. Other four genera, including α-/β-/gamma- examples includes SARS, MERS(Middle /δ-CoV. α- and β-CoVs are able to infect East Respiratory Syndrome). Both humammals, while gamma - and δ-CoV mans and animals are affected by the virus. The new kind of virus is mainly tend to infect birds. seen to be matched in the pangolins. VetPubHealth Journal ISSUE 17
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sin Converting Enzymes-2(ACE-2). The ACE-2 is present on the surface of the OUTBREAK The outbreak was first indentified in alveolar cells in the lung. Wuhan, Hubei, China, in 31st December, 2019. It is supposed to be spread There are 3 types of alveolar cells: via the biggest meat market in Wuhan. Type1: Responsible for gas exchange A number of cases were registered in Type2: Responsible for producing “surhospital of Wuhan related to respirar- factant” which is a mixture of proteins tory problems as pneumonia with un- and fats that reduce the surface tension known medications to solve the cases. of the alveoli. Thereafter, it spreads gradually to ex- Type3: Dust cell, which is macrophages. The ACE-2 is found on Type2 of these tent. cells. Corona virus envelop contains proteins called spikes and special (S-spike) HOST RANGE that helps the virus bind to ACE-2. The most likely ecological reservoirs for When the above association occurs, the SARS-CoV-2 are bats, but believed that genetic material of the virus enters the the virus jumped the species barrier cell and the cell is harnessed to produce to humans from another intermediate viral proteins, thus the virus multiplies animal host could be a domestic food and the cell dies. animal, a wild animal, or a domesticat- When( type2 alveolar cells)die, they ed wild animal which has not yet been release substances called specific inidentified. flammatory mediators. These substances stimulate the existing immune subSPREAD OF THE DISEASE stances called “cytokines” which are: COVID-19 is a new disease and there is Interleukin_1(IL_1) process of still learning how it spreads. Interleukin_6(IL_6) The observation since it outbreak had Tumor Necrosis Factor(TNF_α) shown such: These three substances, when they Person-to-person spread reach the bloodstream, cause the sympThe virus is thought to spread mainly toms associated with infection with Cofrom person-to-person. rona virus. Through respiratory droplets produced when an infected person coughs or INCUBATION PERIOD: sneezes. The entry of virus to the exposure of Between people who are in close con- symptoms varies from 5 days to 14 days. tact with one another (within about 6 feet) Those droplets can land in the mouths CLINICAL SYMPTOMS or noses of people who are nearby or A study led by Prof. Nan-Shan Zhong’s team, by sampling 1099 possibly be inhaled into lungs. cases, found Spread from contact with contaminated laboratory-confirmed that the common clinical manisurfaces or objects included fever(88.7%), It may be possible that a person can festations get COVID-19 by touching a surface or cough(67.8%), fatigue(38.1%), spuobject that has the virus on it and then tum production(33.4%), shortness of touching their own mouth, nose, or pos- breath(18.6%), sore throat(13.9%), sibly their eyes, but this is not thought and headache(13.6%). In addition, a to be the main way the virus spreads. part of patients manifested gastrointestinal symptoms, with diarrhea(3.8%) and vomiting(5.0%). PATHOGENESIS In laboratory examination results, most After the virus enters the body, it needs patients had normal or decreased white a special receptor to help it enter the blood cell counts, and lymphocytopecell. This receptor is called Angioten- nia. But in the severe patients, the neuVetPubHealth Journal ISSUE 17
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trophil count, D-dimer, blood urea, and Cover your nose and mouth with a discreatinine levels were higher and lym- posable tissue or flexed elbow when phocyte counts continued to decrease. you cough or sneeze. Avoid close contact ( 1 meter or 6 feet) with people who are unwell CURRENT SCENARIO The disease has been declared as Stay home and self-isolate from others pandemic by World Health Organiza- in the household if you feel unwell tion(WHO) on March 11, 2020, as the Social distancing is the must for to previrus is spreading day by day with high vent it’s spread. rate though the mortality rate is not Math behind social distancing and it’s much. There is no vaccines made till help to prevent spread disease is on date though many trials are on process. the figure. The disease is now the global matter of So many countries are being lockdown for many days. concern. Over 200 countries are being affected Don’t Touch your eyes, nose, or mouth if your hands are not clean. by the virus. The death toll is increasing day by day and becoming threat to the people ev- POSITIVE TO ENVIRONMENT ery moment. The people are in mental Though threat to human existence trauma due to the pandemic situation. COVID-19 has become boon to environment. Ozone layer is healing, and the cities and whole world look green PREVENTIVE MEASURES As prevention is better than cure and and happy. addition to this there is no any vaccines for the virus following measures should But we must do something to prevent the pandemic situation otherwise there be adopted to control the spread: Do Wash your hands regularly for 20 is for sure great loss of human civilizaseconds, with soap and water or alco- tion. Hope in future, human would learn hol-based hand rub. from such pandemic like this and will be ready from beginning. Now we can only pray for good with having faith and hope. References:
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1.Lu R, Zhao X, Li J, Niu P, Yang b, Wu H, et al. Genomic characterization and epidemiology of 2019 novel coronavirus 2.WHO. Coronavirus disease (COVID-19) situation reports 2020 3.Riou J, Althaus CL. Pattern of early humanto-human transmission of Wuhan 2019 novel coronavirus (2039-nCoV), December 2019 to Jan 2020 4.WHO Director – General’s Opening remarks at time media briefing on COVID-19 5.Coronavirus diseases (COVID-19) Outbreak – WHO/Euroope. 6.WEB PAGES 1.https://www.who.int. 2.www.euro.eho.int 3.https://www.sciencedirect.com 4.Mmrjournal.biomedcentral.com
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Ecology of Zoonotic Diseases ABSTRACT
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Zoonoses are those diseases and infection which are naturally transmitted between vertebrate animals and man. Zoonosis constitutes a diverse group of viral, bacterial, rickettsia, fungal, parasitic and prion disease with a variety of animal reservoirs, including wildlife, livestock, pet animals and birds. Zoonotic diseases impose significant economic losses in the livestock sector. Evolutionary response to changes in the environment, including anthropogenic factors such as new agricultural practices, urbanization, or globalization, as well as climate change causes disease emergence. Livestock pathogens are subjected to pressures resulting from the production, processing and retail environment which together alter host contact rate, population size and/or microbial traffic flows in the food chain. The basic principles of zoonosis prevention control and eradication involves reservoir neutralization, reducing contact potential and increasing host resistance.
e n a p u e N Sushil
Changes in pathogen and/or host ecology are primarily responsible for the majority of emerging diseases and that those resulting from evolutionary changes alone are comparatively rare. ‘Ecological changes’ embrace a number of very different processes under the same umbrella: changes in agricultural practices, urbanization, globalization or climate change. The latter is a factor of growing concern as it may affect the areas where primary agricultural production takes place, alter vector distribution and abundance, change the migration patterns of birds and other wildlife, and INTRODUCTION affect the survival time of pathogens Zoonoses is term defined as infectious outside the host. Disease emergence is diseases that are transmitted naturally the result of two sequential processes: between humans and wild or domestic #The adaptation of a pathogen animals. These diseases are important in the context of emerging infectious to a new host: Pathogen strains entering diseases of humans as the majority a new host population may initially have of these are of zoonotic origin. 1,415 an overall reproductive number of less species of infectious organisms known than one (R0 < 1) that leads to the to be pathogenic to humans, including extinction of the pathogens, but prior 217 viruses and prions, 538 bacteria and to extinction, some may evolve and rickettsia, 307 fungi, 66 protozoa and increase their virulence to give R0 > 1, 287 helminths. Out of these, 868 (61%) allowing them to persist and spread into were classified as zoonotic and 175 a new host population. #The spread of the pathogen pathogenic species were considered to be associated with emerging diseases. Of into the new population. this group of 175 emerging pathogens, Invasive alien species are defined as 132 (75%) were zoonotic. species introduced outside their natural, past or present, distribution. Generally FACTORS AFFECTING THE by human activities, these EMERGENCE OF ZOONOTIC introduced species have adverse effects on DISEASES indigenous fauna and are now considered VetPubHealth Journal ISSUE 17
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contaminating open land and water resources, and the spread of pathogens through giving feed of animal origin to live animals. Pathogens are also dispersed through food preparation and consumption and can also spread to water bodies via the sewage system. d) Factors relating to the innate biology of the pathogen: reproductive (r/K) strategy, host range, mode of transmission, virulence and infective period metapopulation, and the level of isolation of each subpopulation. Naturally, this also applies to the spread of emerging diseases. For example, the current global network of Following introduction and initial human populations meets all the basic ‘colonization’, the spread of disease requirements for a novel disease agent within the new host population will to turn into a pandemic. determine the success of an emerging pathogen in the newly invaded host. Zoonotic infections originating from Factors facilitating the spread into new wild animal reservoirs are generally populations are not specific to emerging associated with anthropogenic forces diseases and apply equally to any involving high contact rates with the epidemic disease. The spread mainly wild animal host (e.g. rodents can be depends on the overall reproductive host to several zoonotic diseases) or number being higher than one, which is biological invasions by vectors (e.g. subject to change as a consequence of West Nile virus, Lyme disease) or by the both a better adaptation to the host and pathogen itself (e.g. anthrax spores). changes in the spatial structure of the Many zoonotic diseases and human host population. Factors influencing the pathogens result from our intimate spread of zoonotic diseases, categorized contacts with domesticated animals, according to four main epidemiological a process that has continued since the early days of domestication. The domains: capture and controlled breeding of the a) Animal husbandry factors major animal domesticates was part concerning to feeding, breeding, housing/ of a suite of transformations in human animal movement management, society known as the Neolithic transition. and health protection practices are Identifying the processes underlying the responsible for the production structure. transformation of livestock production b ) Metapopulation, the ‘static’ and its intensification are thus central to animal host environment in which the an understanding of the forces affecting disease spread is taking place, made disease emergence and spread. up of the number and size of holdings, the spatial structure (clumping) of THE POTENTIAL FUTURE production units; the metapopulation ROLE OF DISEASE ECOLOGY fixes the possible microbial traffic within The study of the ecology of invasive the host population. diseases may arguably assist c ) Pathways external to the in identifying the links between host population are also important and environmental change, new forms include the flow of pathogens originating of disease and microbial adaptation, from live hosts passing into the food though the approach is still in its infancy. production-processing-distribution Lessons learned from epidemics of chain, germs in animal waste products to be the second most important cause of the global biodiversity crisis. They are also recognized as a clear threat to ecosystems, habitats or species, with severe economic and environmental consequences. In biological invasion ecology, it has long been recognized that successful invaders are generally those species which are able to maximize fitness in changing environments. Such organisms are generally characterized by a short generation time and high numbers of offspring and usually have efficient ways of dispersing to new habitats.
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existing pathogens have highlighted some of the factors associated with the spread of a disease within a population, and methodological tools are available to explore these patterns. In parallel, some of the processes of environmental change (e.g. demographic pressures, critical contacts with wildlife animals, the rate at which climate change or deforestation may occur, etc.) have also been quantified. The missing link is how pathogens currently restricted to wildlife or domestic animals will evolve toward humans in response to abrupt environmental changes. In this context, it may be helpful to consider the full spectrum of pathogens that affect animals and/or humans:
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#true animal pathogens #pathogens confined to an animal #reservoir but sometimes producing limited human infection. #well established multiple host and zoonotic pathogens. #pathogens increasingly affecting human populations but moving towards extinction. #Transient agents which evolve into human pathogens. #Full blown human pathogens. It is likely that new pandemics will occur in the future, that RNA viruses in animal reservoirs will be implicated and that food and agricultural practices will play an important role in the emergence of disease in human populations as well as in veterinary health and food safety hazards. Agricultural intensification will be fraught with structural problems such as unchecked land pressures and imbalances in socio-economic development. For all these reasons, it would perhaps be advisable to pay fuller attention to the inherent epidemiological instability that is caused by innate characteristics of livestock development and food chains in some parts of the world. Of particular concern is the progressive ‘urbanisation’ of animal production and processing. Not only does the enhanced contact of people with live animals, perishable meat and VetPubHealth Journal ISSUE 17
dairy commodities and waste products increase the number of occupational hazards, also the general public is at risk through the microbial contamination of water sources, food poisoning and of course flare-ups of zoonotic infections. Disease ecology shows us that disease spread and the emergence of zoonotics and other veterinary public health concerns are largely the product of human activity. Hence, the solution to these problems is also a matter of human choice.
References: 1.Anderson, R. M., Anderson, B., & May, R. M. (1992). Infectious diseases of humans: dynamics and control. Oxford university press. 2.Antia, R., Regoes, R. R., Koella, J. C., & Bergstrom, C. T. (2003). The role of evolution in the emergence of infectious diseases. Nature, 426(6967), 658-661. Heylighen, F. (2000). rK selection: the developmentreproduction trade-off. Principia Cybernetica Web. Website: http://pespmc1. vub. ac. be/RKSELECT. html (accessed on 29 July 2004). 3.Keeling, M. J. (1999). The effects of local spatial structure on epidemiological invasions. Proceedings of the Royal Society of London. Series B: Biological Sciences, 266(1421), 859-867. 4.May, R. M., Gupta, S., & McLean, A. R. (2001). Infectious disease dynamics: what characterizes a successful invader?. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences, 356(1410), 901910. 5.Sakai, A. K., Allendorf, F. W., Holt, J. S., Lodge, D. M., Molofsky, J., With, K. A., ... & McCauley, D. E. (2001). The population biology of invasive species. Annual review of ecology and systematics, 32(1), 305-332. 6.Schrag, S. J., & Wiener, P. (1995). Emerging infectious disease: what are the relative roles of ecology and evolution?. Trends in ecology & evolution, 10(8), 319-324. 7.Slingenbergh, J., Hendrickx, G., & Wint, W. (2002). Will the livestock revolution succeed. AgriWorld Vision, 2(4), 31-33. 8.Slingenbergh, J., Gilbert, M., Balogh, K. D., & Wint, W. (2004). Ecological sources of zoonotic diseases. Revue scientifique et technique-Office international des épizooties, 23(2), 467-484. 9.Schrag, S. J., & Wiener, P. (1995). Emerging infectious disease: what are the relative roles of ecology and evolution?. Trends in ecology & evolution, 10(8), 319-324.
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Global Threat of Infectious Diseases over time
Abstract
Since decades, infectious diseases have become the subject of major concern to global health. About 15 million (>25%) of 57 million annual mortality worldwide are estimated to be related directly to hrel k o P i b a infectious diseases. Emerging and reaadh M emerging infectious diseases like influenza, Spanish flu, Ebola, Bubonic plague, HIV, SARS have caused devastating effects in the past and some of these are again re-emerging like SARS-CoVID-2 and Hantavirus cases. Zoonosis, climate change, overpopulation, deforestation, etc. are the factors causing the emergence and spread of infectious diseases that have put global health in threat worsening the predicament every other day.Therefore, effective control measures are essential for prevention.
Introduction
Infectious diseases are threatening human health since ancient times and have caused incalculable misery and mortality. “THE BLACK DEATH”, also called the great Bubonic Plague, was a hazardous pandemic recorded in human history resulting in the death of about 75 to 200 million people in Eurasia, peaking in Europe from 1347 to 1351. Similarly, the “Spanish Flu” pandemic of 1918, was the deadliest in recent history, taking the lives of about 50 million people throughout the world. Smallpox is estimated to have killed 400,000 people per year in 18th century Europe and 300 million people in the 20th century. The “Asian Flu” in 1957 and “Hong Kong Flu” in 1968 caused the death of about 3 million people. In the same way, the re-emergence of influenza as “Swine Flu” swept up 18,500 lives. Similarly, the case of Novel Severe Acute Respiratory Syndrome Corona Virus (SARS-CoV) of 2002/2003 infected 8,000 people causing 774 deaths in 27 countries. Moreover, there have been 20206 reported cases with 7905 reported deaths during the re-emergence of Ebola in 2013-2014. Not only these diseases, but many of other global examples of emerging and re-emerging infectious diseases can also be seen in the figure below; Newly emerging diseases.
deliberately emerging disease.
Re-emerging diseases.
Source: David M. Morens, Gregory K. Folkers & Anthony S. Fauci.(2004). The challenge of emerging and re-emerging infectious diseases.
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Currently, the Novel Corona virus 2019, also designated as CoVID 2019 is the limelight with the beginning of the New Year 2020. Since December 2019, patients with unexplained pneumonia cases have been found in Wuhan city, Hubei province, China which has been continuing to spread around the world, resulting in several thousand reported cases in multiple countries. The pathogen in these cases is a new type of Corona virus. The World Health Organization confirmed this diagnosis and named the pathogen SARS – CoV-2. The disease caused by SARS-CoV-2 is called Corona virus disease (CoVId-2019).The infection with virus results in respiratory symptoms such as Flu, running nose, shortness of breath, cough which appear within 2-14 days of transmission from the infected individual through droplets or direct contact. Hantavirus; another recently re-emerged virus, is recently seen in an individual from Yunnan, China in March 2020. According to CDC, Hantavirus infection has a mortality rate of about 38%. Unlike CoVID– 19, the Hantavirus cannot spread from one person to another. A human can get the infection through rodents’ urine, feces, and saliva.
Responsible Factors for Emergence of Infectious Diseases
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•Zoonosis
The most important pathogens in parasites that affect the human population are of animal origin. It is estimated that zoonotic infectious agents contribute about 60% of the known human pathogens. This percentage increases to 73 -75% if only “emerging” or “re-emerging” diseases that have appeared in the last 30-40 years are considered. Ruminants, Carnivores, Rodents, Birds, and Primates are mainly seen animals that have transmitted infectious diseases for many years. List of zoonotic disease with animals involved is given below;
Disease
Pathogen(s)
Animals involved
Anthrax
Bacillus anthracis Influenza A virus subtype H5N1
commonly – grazing herbivores such as cattle, sheep, goats, camels, horses, and pigs
African sleeping sickness
Bird flu
Trypanosoma brucei rhodesiense
range of wild animals and domestic livestock
wild birds, domesticated birds such as chickens
Bovine spongiform encephalopathy Prions
Cattle
Brucellosis
cattle, goats
Brucella spp.
Bubonic plague, Pneumonic plague, Yersinia pestis Septicemic plague, Sylvatic plague Trypanosoma Chagas disease cruzi Taenia solium, Cysticercosis and Taenia asiatica, taeniasis Taenia saginata VetPubHealth Journal ISSUE 17
rabbits, hares, rodents, ferrets, goats, sheep, camels armadillos, Triatominae (kissing bug) commonly – pigs and cattle
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Ebola virus disease (a haemorrhagic fever) Other haemorrhagic fevers:Dengue, Lassa, Marburg viral haemorrhagic, Rift Valley fever Echinococcosis
Fasciolosis Giardiasis
Ebolavirus spp.
chimpanzees, gorillas, orangutans, fruit bats, monkeys, shrews, forest antelope and porcupines
Varies – commonly viruses
varies (sometimes unknown) – commonly camels, rabbits, hares, hedgehogs, cattle, sheep, goats, horses and swine
Echinococcus spp. Fasciola hepatica, Fasciola gigantica Giardia lamblia
commonly – dogs, foxes, jackals, wolves, coyotes, sheep, pigs, rodents sheep, cattle, buffaloes beavers, other rodents, raccoons, deer, cattle, goats, sheep, dogs, cats
Hantavirus
Hantavirus spp.
Influenza
Influenza A virus
Japanese encephalitis
Japanese encephalitis virus
Leishmaniasis
Leishmania spp.
Leprosy
Mycobacterium leprae, Mycobacterium lepromatosis
armadillos, monkeys, rabbits, mice
Lassa fever
Lassa fever virus
Rodents
Lyme disease
Borrelia burgdorferi
Middle Eastern Respiratory Syndrome
MERS coronavirus
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deer mice, cotton rats and other rodents horses, pigs, domestic and wild birds, wild aquatic mammals such as seals and whales, minks and farmed carnivores pigs, water birds dogs, rodents, other animals
deer, wolves, dogs, birds, rodents, rabbits, hares, reptiles bats, camels
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Monkeypox
Monkeypox virus
rodents, primates
Nipah virus infection
Nipah virus (NiV)
bats, pigs
Rabies
Rabies virus
Rift Valley fever
Phlebovirus
Rocky Mountain spotted fever
Rickettsia rickettsii
dogs, rodents
Severe acute respiratory syndrome
SARS coronavirus
Bats
Swine influenza
Trichinosis Tuberculosis West Nile fever Zika fever
commonly – dogs, bats, monkeys, raccoons, foxes, skunks, cattle, goats, sheep, wolves, coyotes, groundhogs, horses, mongooses and cats livestock, buffaloes, camels
any strain of the influenza virus endemic in pigs (excludes H1N1 Pigs swine flu, which is a human virus) Trichinella spp. rodents, pigs, horses, bears, walruses, dogs, foxes, crocodiles, birds Mycobacterium infected cattle, deer, llamas, pigs, bovis domestic cats, wild carnivores (foxes, coyotes) and omnivores (possums, mustelids and rodents) Flavivirus birds, horses Zika virus
chimpanzees, gorillas, orangutans, monkeys, baboons
• Increased contact between humans and animals. Animals and people often live close together throughout the developing world. People are especially dependent on livestock and poultry for food, clothing, fertilizer, drought power and an important degree of financial security. • Through the food linked to zoonotic contaminations Egg, seafood, meat, dairy which transfer the pathogens in food to the human VetPubHealth Journal ISSUE 17
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body. Another route for zoonosis is farming, ranching, and animal husbandry. Many disease causing pathogens can be transmitted from cattle, pig, chickens like Anthrax, Bovine TB, swine flu, avian flu, Spanish flu, etc. Similarly, pets can be another source for the transfer of diseases like rabies, cat-scratch disease which are especially dogs and cat origin. Hunting and bush meat in the past show to cause HIV through infected chimpanzees. Encroachment of human activity into a wilderness area or by the movement of the wild area or by the movement of wild animals into areas of human activity can also lead to infectious diseases for e.g. the outbreak of Nipah virus in peninsular Malaysia in 1999, when intensive pig farming, began on the habitat of infected fruit bats. And many rodents causing diseases (more than 35) such as Hantavirus pulmonary syndrome, Lassa fever, Rat-bite fever etc. can spread to a human through the handling of live or dead rodents faeces, urine or saliva and through rodent bites. â&#x20AC;˘ Other factors include a) Agricultural Development With the development of agriculture, people become closer to the natural environment and more susceptible to infectious diseases e.g. Hantavirus is a natural infection of the field mouse Apodemus agrarius. The rodents flourish in the rice field; people usually come in contact with the infected rodents to disease during the rice harvest. b) Changes in Human Demographics and Behavior Human behaviors such as sex and intravenous drug use has led to emergence of HIV which is still a hazardous disease. c) Travel and Commerce As people travel from one place to another/one country to another /one continent to another for travel ,commerce or war, there is high chance of transmission of infectious diseases e.g. trade between Asia and Europe; perhaps beginning with silk route and continuing with crusades brought one of its infection, the Bubonic Plague to Europe. d) Microbial adaption Due to pervasive antimicrobials in the environment, antimicrobial bacteria and drug-resistant parasites have evolved. Therefore, many viruses can rapidly evolve to yield new variants through high mutation. One of its classical examples is influenza. Regular annual epidemics are caused by antigenic drift in a previously circulating influenza. â&#x20AC;˘ Future prospect Though substantial fraction of well-identified mammalian viruses are responsible for human etiology, there are still more evolving viruses unknown to us that can cause infectious diseases. One of the responsible factors is deforestation. If the rate of deforestation continues in the same way, humans will be closer to wildlife and be at high risk of many new viral disease infection. Even the melting of ice in Antarctica is responsible for the emergence of infectious diseases in the future. Ice melts will release glacial microbes and viruses that have been trapped and preserved for tens to hundreds of thousands of years. Those viruses may create problems in the economic and health sectors shortly. Moreover, there may be re-emergence of many viruses in new forms in upcoming days as SARS â&#x20AC;&#x201C;CoVD-2, Hantavirus has re-emerged in present, and the whole world is in threat of infectious diseases in the future. Preventive Measures for Infectious diseases 1) As zoonosis is responsible for 60% of emerging infectious diseases, domestic VetPubHealth Journal ISSUE 17
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animals should be regularly vaccinated against rabies, FMD etc. Consumption of raw meat should be avoided and illegal hunting of wild animals should be banned. 2) Vaccination against viral infections such as Flu, Pneumonia, Chicken pox , HIV and other infections that could potentially lead to sepsis. 3) As the misuse and overuse of antibiotics can put patient at risk of contracting infections, antibiotics should be used rationally with the prescription of the doctor. 4) Use of clean and sterile drug injecting equipment (needle and syringes), surgical equipment (catheter) and other medical equipment. 5) There is an urgent need for public health and health care to develop adaptation strategies for the impact of climate change on infectious diseases (Ebi 2008; Lafferty 2009; Paaijamans et al. 2010; Zhang et al. 2008). Similarly, current policies and programs to control climate-sensitive infections including surveillance and interpretation of data related to the impact of climate change, outbreak investigation and response, regulations, education, enhancing partnership and conducting research (Frumkin et al. 2008; Semenza and Menne 2009).
References:
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Parvez M.K , Parveen S.(2017). Evolution and emergence of pathogenic viruses: Past, Present, and Future . URL:https://www.karger.com/Article/FullText/4787 2) David M. Morens, Gregory K. Folkers & Anthony S. Fauci.(2004). The challenge of emerging and re-emerging infectious diseases. URL:https://www.nature.com/articles/nature02759 3) World Health Organization . Infection prevention and control. URL:https://www.who.int/gpsc/ipc/en/ 4) Kristie L. Ebi & Elisabet Lindgren & Jonathan E. Suk & Jan C. Semenza.(2012). Adaptation to the infectious disease impacts of climate change. URL:https://ec.europa.eu/clima/sites/clima/files/adaptation/how/social/docs/infectious_disease_en.pdf 5) Peter Schelden .(2020).Hantavirus Death in China: How Likely Is a Coronavirus-Like Pandemic? URL:https://www.medicinenet.com/script/main/art.asp?articlekey=229363 6) World Health Organization .(2014). Ebola response roadmap situation report URL:https://apps.who.int/iris/bitstream/handle/10665/141468/roadmapsitrep_12Nov2014_eng.pdf
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Back to the past: Outbreak of an infectious Disease Ebola INTRODUCTION:
Ebola belongs to the Filoviridae family, comprising 3 genera: Cueva virus, Marburg virus, and Ebola virus. 5 species of Ebola virus are reported viz. Zaire, Sudan, Bundibugyo, Restron, and Tai forest. Within the genus Ebola, Zaire species of Ebola has the highest fatality rate followed by Sudan species. The disease was known as Ebola hemorrhagic fever but now referred as Ebola virus. The virus genome is a negatively single stranded RNA with ranging diameter from 80nm to 1400nm. West Africa was largest Ebola outbreak though the virus was first discovered in 1976. The outbreak started in Guinea and then moved across to Sierra Leone and Liberia. The 2014-16 outbreak in West Africa was largest Ebola outbreak since the virus was first discovered in 1976. Bats have been identified as likely reservoir for Ebola (Hayman et al. ,2013). Bats are only mammal that can fly and can harbor a large number of pathogen or disease. This posses a potential problem when they cross into another species. A virus evolved in a bat will not be affected by higher body temperature. Apes, man and other mammalian species are susceptible to Ebola virus infection.
ROUTE OF INFECTION:
Ebola virus enters the host through mucosal surfaces break, and penetration in the skin or by parental introduction. Human outbreaks seem to occur by direct contact with infected patient or cadavers. After Ebola’s glycoproteins binds the host cell, endothelial cells fibroblasts, hepatocytes, adrenal cortical cells, and several types of epithelial cell, all lend to support virus replication( Feldmann et al. ,2010). Reuse of contaminated needles, butchering of chimpanzee food, bodily fluid of infected animal or person are one of major cause of outbreaks. Those who care for sick person or bury someone who has died from disease often get it. The World Health Organization (WHO) declared it a “Public Health Emergency of International Concern” on Aug 7, 2014. VetPubHealth Journal ISSUE 17
e n a p u e N Saroj As of Feb-4, 2015, 22500 confirmed case of EVD and almost 9000 deaths have been reported. The disease is endemic in Central Africa. Health care workers can also be risk of Ebola if they do not prevent infection by wearing masks, gloves and goggles whenever they come into contact with people who may have Ebola. More than 800 health workers were infected and more than 500 are reported to be dead (Currie et al., 2016).
SYMPTOMS:
Ebola virus are characterized by immune supression and systemic inflammatory response that causes impairment of vascular coagulation and immune system leading to multiorgan failure and shock. However, symptoms show within 2-21 days after infection and usually include high fever, headache, joint and muscle ache, weakness, stomach pain and lack of appetite. If the disease gets worse, bleeding inside body as well as eyes, ears and nose, bloody vomiting and bloody diarrhoea are seen.
DIAGNOSIS:
Lab diagnosis of Ebola virus is achieved in two ways: measurement of host specific immune response to infection and detection of viral particles in infected individuals ( Feldmann et al. ,2010) . The diagnosis is done by antibody capture ELISA, antigen-capture detection test, reverse transciptase-PCR( RT-PCR) assay and electron microscopy. Treatment:
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Ebola viruses are bio safety level-4 pathogen and require special containment measures and barrier protection for health care workers. As the virus can survive in liquid or dried materials. they are inactivated by gamma-radiation, heating for 60 minutes at 60ºC or boiling for 5 minutes, and are sensitive to sodium hypochlorite ( bleach ) and other disinfectants( Rewar et al. ,2014). The following intervention, when used by doctors early, can improve chances of survival. 1.Providing intravenous fluids and balancing electrolytes ( body salts ) 2.Maintain oxygen status and blood pressure level. 3.Blood transfusion. 4.Inactivating virus by the use of gammaradiation from a cobalt-60 source. 5.Nucleic acid can be amplified by treating with guanidium isothiocyanate that denatures the protein of the virus and make it non- infectious. 6.In addition, health system should formulate proper plans for emergency case, ensuring adequate quarantine facilities, proper surveillance, case management and contact tracing. 7.Certain drugs like regeneron ( REGENEB3 ) and mAb114 can increase the survival. The local individuals can prevent the disease by maintaining personal hygiene, supporting infected person by taking them to proper health services in hospital. The government shouldn’t allow disrupt ecosystems and avoid the trade of wild animal marketing. Rodents and some bats thrive when we disrupt natural habitats. They are the most likely to promote transmission. The more we disturb the forest and habitants, the more danger we are in (Wolfe et al., 2007 ). It is rare but Ebola virus can stay in semen for three months even after recovery so we should avoid sex or use condom to keep safe from infecting others. Breast milk has also been found infectious for two weeks after recovery so at that time women should not breastfed. However the major preventive measure seems to be personal hygiene and sustaining VetPubHealth Journal ISSUE 17
ecological balance.
CONCLUSION:
The current epidemic of Ebola virus shows unpredictable nature of pathogen and importance of animal in ecology and emergence of vital strength. The simple behavioural precaution could reduce risk ( Morse et al. ,2013 ). The impact of this epidemic will last longer even after its end. Health systems needs to be rebuilt, surveillance systems be established, trust in health services and rebuilt economic losses restored. Over US, 7 billion dollar were for Ebola response. The epidemic was removed when the international mechanism act syngerstically with a strong local governance and health systems with a shared agenda. The field studies into the ecology of reservoir species and their infection status and shading mechanism should be carried out. Also the managed urbanization, protection of species can reduce to such epidemics. Education can eradicate all these problems.
References: Wolfe, N., Dunavan, C. & Diamond, J. (2007) Origins of major human infectious diseases. Nature 447, 279–283. https://doi.org/10.1038/nature05775 Paton, N., Walsh & Cotovio V. (2020), Bats are Not to Blame For Corona Virus, Humans are CNN. Hayman, D. T., Bowen, R. A., Cryan, P. M., McCracken, G. F., O’Shea, T. J., Peel, A. J., Gilbert, A., Webb, C. T., & Wood, J. L. (2013). Ecology of zoonotic infectious diseases in bats: current knowledge and future directions. Zoonoses and public health, 60(1), 2–21. https://doi.org/10.1111/ zph.12000 Falzarano, D., & Feldmann, H.(2015). Delineating Ebola Entry. Virology. Feldmann, H., & Geisbert, T.W.(2010). Ebola Haemorragic Fever Piot. P. (2014). Ebola’s Perfect Storm. American Association For the Advancement of Science Ghazanfar, H., Orooj, F., Abdullah M. A., & Ghazanfar A. (2015). Ebola,the Killer Virus. Infectious Disease of Poverty. Rewar, S., & Mirdha, D.(2014). Transmission of Ebola Virus Disease: An Overview. Annals of Global Health. Morse, Stephen & Mazet, Jonna & Woolhouse, Mark & Parrish, Colin & Carroll, Dennis & Karesh, W. & ZambranaTorrelio, Carlos & Lipkin, W & Daszak, Peter. (2012). Prediction and prevention of the next pandemic zoonosis.
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Combat against serious infectious disesase:Rabies in Nepal INTRODUCTION Infectious disease means that diseases which transmits from animals to humans or humans to animals. Rabies is an infectious disease that is caused by rabies virus when an rabies infected animal bites or scratches a human or other animal. Rabies is not only transmitted through biting of infected animals but also from saliva of an infected animal can also transmit rabies if saliva comes in contact with eyes, mouth, or nose. It enters the peripheral system directly and migrates to the brain. It causes inflammation of the brain in human and other mammals and even cause death if not treated properly. In human, rabies is mostly caused due to biting of rabies infected dogs. We also can hear many cases of biting of dogs in our locality. According to WHO, infection causes ten thousands death every year, mainly in Asia and Africa. 40%of people bitten by suspect rabies animals are children under 15 years of age. Rabies is present in all continents, except Antarctica.
Gaha n a h d u s u h Mad Cases of Rabies in Nepal Nepal is among the countries in the world suffering from neglected diseases. Per year, rabies is reported to kill about 100 livestock and 10â&#x20AC;&#x201C;100 humans, while about 1,000 livestock and 35,000 humans are reported to receive rabies post-exposure prophylaxis after animal bites. Despite Nepal committing to achieve the goal of eliminating cases of dogtransmitted rabies by 2030, a target set by the World Health Organization, hundreds of people are contracting the
Number of rabies outbreaks reported during 2005â&#x20AC;&#x201C;2014 to the Veterinary Epidemiology Center of the Directorate of Animal Health, Department of Livestock Services, Ministry of Agricultural Development. VetPubHealth Journal ISSUE 17
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coyote ,ferret, groundhog ,mongoose, skunks etc. People themselves are also responsible for this. People tease streets dogs, step on dogs tail , throw stone etc . Due to this type of behavior people are bitten by dogs too. Lack of knowledge about causes, symptoms, preventions and effect in uneducated people and underdeveloped people rabies is being a serious infectious disease in all over the world. Transmission of rabies in Nepal is mainly #Animal rabies cases and number of by the Dog bite(92%) and cases of cats vaccinated animals during 2005â&#x20AC;&#x201C;2014, bite and jackal bites are also recorded. virus in Kathmandu. According to Sukraraj Tropical and Infectious Disease Hospital, the only infectious disease hospital based in Teku, the number of dog bites in recent years has gone up sharply in Kathmandu. According to the hospital, it receives around 350 to 400 patients of dog bites every day. And every month 9,000 to 9,500 dog bite patients get anti-rabies vaccine administered from the hospital.
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Species Dog Cattle Buffalo Goat Sheep Horse Yak Pig TOTAL
Cases 374 442 315 122 9 14 1 21 1298
Vaccinated 141,303 4498 2857 2424 587 288 252 191 152,400
Source: Veterinary Epidemiology Center of the Directorate of Animal Health, Department of Livestock Services, Ministry of Agricultural Development of Nepal
TRANSMISSION Dogs are the main source of human rabies deaths contributing up to 99% of all rabies transmission to humans. Rabies is most common in countries where streets dogs are present in large number. It is passed on through saliva. Rabies can develop if a person receives a bite from an infected animal, if saliva from an infected animal gets into an open wound or through a mucous membrane , such as eyes, mouth , nose etc. It cannot pass through un broken skin. Any mammal can spread virus but smaller mammals such as rodents, rarely become infected or transmit rabies .rabbits are unlikely to spread rabies. The rabies animals are bats, racon , fox, VetPubHealth Journal ISSUE 17
SYMPTOMS Initial symptoms include a fever with pain and unusual or unexplained tingling, prickling, or burning sensation at wound. Later it include neurological problems and a fear of light and water. The incubation period ( i.e time before symptoms appear) is typically 2-3 months but may vary from 1 week to 1 year depending upon location of virus entry and virus load. The closer the bite to the brain, the sooner the effects are likely to appear. People should visit hospital at once without waiting for symptoms. Other symptoms are listed below; 1.Irratibility or aggressiveness. 2.Excessive movements or agitation . 3.Confusion, bizarre or strange thoughts or hallucination. 4.Muscle spasms and unusual postures. 5.Weakness 6.paralysis,seizures(convulsions) DIAGNOSIS In animals, rabies is diagnosed using the Direct Fluorescent Antibody(DFA) test., which looks for the presence of rabies virus antigen in brain tissue. Human rabies can be confirmed intra-vitam and post mortem by various diagnostic techniques that detect whole viruses, viral antigens or nucleic acids in infected tissues(brain, skin, urine, or saliva).
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TREATMENT
If a person is bitten or scratched by an animal that may have rabies or if the animal lick on wound, the individual should immediately wash any bites and scratches for 15 minutes with soapy water, povidone iodine, or detergent. This might minimize the number of viral particles. Then they must seek medical help at once. After exposure and before symptoms begin, a series of shots can prevent the virus from thriving. To prevent the virus from infecting the individual a fast acting dose of rabies immunoglobin is delivered. Part of this injection is given near the area where the animal bit person, as soon as possible after the bite. The series of rabies vaccines is injected into arm over the next 2 to 4 weeks to fight against virus. The patient receive 4 injection over 14 day.
PREVENTION
Rabies can be prevented by following ways; 1.vaccination of dogs and cats against rabies 2.Keeps dogs and cats under control 3.Washing animal bites or scratches immediately with soap and water 4.Spay or neuter your pets to reduce no of animals.
References: 1.URL:https://www.researchgate.net/ publication/294257272_Epidemiology_ Impact_and_Control_of_Rabies_in_Nepal_A_ Systematic_Review 2. Rabies control in Asia –Page 117 Betty Dodet 3. URL:https://www.boehringer-ingelheim.com/ animal-health/animal-health-news/nepal-ourefforts-fight-against-rabies-year-later 4..URL: https://myrepublica.nagariknetwork. com/news/upto-150-dogbite-cases-daily-at-tekuhospital/ 5. Rabies – Page 83 Thomas E.kienzle,I. EdwardAlcamo-2007 6..URL:https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC4752342/ 7.URL:https://kathmandupost.com/ national/2019/02/04/nepal-has-pledged-to-endrabies-by-2030-but-dog-bite-cases-are-rising 8.Handbook of Zoonoses E-Book ;Identification and Preventation, Joann Colville,David Berryhill-2007
Effort of Nepal to fight against Rabies: Prophylaxis . Production of ARV in Nepal started in 1970 and continues to date .ARV production is managed by the Rabies Vaccine Production Laboratory (RVPL), which fallsunder the DAH, DLS, Ministry of Agricultural Development Rabies control programmes. Over the past decades, various NGO’S Government,local authorities,INGO’s have been involved in rabies control activities in Nepal. VetPubHealth Journal ISSUE 17
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IVSA SCOH 1st One Health Conference to be held in Konya, Turkey has been postponed to further date due to the pandemia of the COVID-19 in the world. We will inform you soon about the new dates of our event. We look forward to meeting you in Konya. Stay Safe.
OH_Conference onehealth.conference@ivsa.org VetPubHealth Journal ISSUE 17
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OIE Ambassadors
to our new ambassadors of the 2nd Session. Member Organization
Name
University
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If your MO donâ&#x20AC;&#x2122;t have an ambassador you can contact us at ivsa.oieambassadors@gmail.com VetPubHealth Journal ISSUE 17
IVSA Standing Committe on One Health
April 2020
Veterinary Public Health Journal | Issue #17
Tuberculosis Challenge Results are out!!! IVSA SCOH The IVSA SCOH Team is happy to announce that the Winner of the Tuberculosis Challenge is
Irina Andoni
from IVSA Moldova, with the best overall score and entry about Tuberculosis in her country! Below is an excerpt from her entry: “While almost all countries are experiencing this disease, tuberculosis is a pressing problem of developing countries. There is a stereotype that is deep incarnated in people’s mentality: tuberculosis is considered the “disease of the poor” - getting sick with TB is not only awful, but also shameful. In Moldova, however, everyone is at risk for tuberculosis, regardless of income and social status because tuberculosis is a marker of the standard of living and of the situation of the society in general, that is the reason why the level of morbidity in Republic of Moldova (RM) is seven times higher than in the European Union. People often neglect the symptoms and/or refuse the treatment and are responsible for the contamination of another 5-15 people within their life span. According to the criteria of the World Health Organization, “tuberculosis does not present a public danger as long as one million inhabitants have a single bacterial eliminator.” The mortality indicator has stabilized and even dropped to 11 per 100,000 people in 2016 in RM. Nevertheless, The Republic of Moldova is among 18 countries of the European Region with a high rate of cases of tuberculosis and among 30 countries with the highest indicators in TB multidrug-resistant (TB MDR).” We had two IVSA members tied for Second place:
Bristy Dhar Nandita, IVSA Bangladesh and Hamza Jawad, IVSA Bahawalpur, IVSA Pakistan (National chapter). They all had really great answers for the questions, and directed us towards great case-studies on Tuberculosis in their home countries!
The IVSA SCOH Team would like to say a huge thank-you to everyone that took part in our Tuberculosis Challenge, and hope you all keep your eyes out for the next one! VetPubHealth Journal ISSUE 17
IVSA Standing Committe on One Health
April 2020
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Veterinary Public Health Journal | Issue #17
Press Release by W.H.S.A: CoronaVirus (Covid-19) #Stay_Safe #Covid_19 #WHSA The World Health Students’ Alliance (WHSA) is one of the largest interprofessional healthcare alliances representing over 1.8 million health students in more than 100 countries worldwide. The International Association of Dental Students (IADS), the International Federation of Medical Students Associations (IFMSA), the International Pharmaceutical Students’ Federation (IPSF), and the International Veterinary Students’ Association (IVSA).
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Coronavirus threatened the lives of many during the last period, and we all must help as health care students as long as individuals. We wish all our members to be safe and take all forms of precaution in their working place. Here is a file IFMSA created in which you can find much information and all new updates about COVID-19 and the pandemic. You can also find promotional materials to share with your classmates, your families and the general public about the prevention and the steps each individual should follow.
Press the Button : FILE We hope that these difficult days will end soon.
About the IADS:
The International Association of Dental Students (IADS) was formed in 1951, to unite the dental students of the world and allow them to exchange knowledge and experiences about dentistry at an international level. Representing the interests of more than 200,000 dental students in 50 countries worldwide and having its headquarters at the FDI World Dental Federation headquarters in Geneva (Switzerland), the Association strives for dental educational and scientific excellence throughout the international student projects and initiatives it manages.
VetPubHealth Journal ISSUE 17
IVSA Standing Committe on One Health
April 2020
Veterinary Public Health Journal | Issue #17
About the IFMSA: The International Federation of Medical Students Associations (IFMSA) envisions a world in which medical students unite for global health and are equipped with the knowledge, skills and values to take on health leadership roles locally and globally. Founded in 1951, it is one of the world’s oldest and largest student-run organisations. It represents, connects and engages every day with an inspiring and engaging network of 1.3 million medical students from 135 national member organisations in 125 countries around the globe. About the IPSF: The International Pharmaceutical Students’ Federation (IPSF) is the leading international advocacy organisation representing over 350,000 pharmacy students and recent graduates in more than 90 countries worldwide. IPSF promotes improved public health through the provision of information, education, and networking opportunities as well as a range of publications and professional development activities. IPSF also holds public health campaigns on social media and provides tools to their member organizations to develop their own campaigns at the national and local levels. Over the past year, over 100 student organizations worldwide collectively organized more than 300 public campaigns in their own nations and reached more than 150,000 individuals. IPSF continues to hold public health at the forefront of its initiatives. About the IVSA: The International Veterinary Students’ Association (IVSA) is a non- profit organisation for veterinary students across the globe. The association was founded in 1953 in Germany and has been voluntarily run by veterinary students since then. The mission of IVSA is to benefit the animals and people of the world, which is accomplished by promoting and enabling international application of veterinary skills, education and knowledge. IVSA has approximately 30.000 members, who study at more than one-hundred different universities in over fifty different countries, representing 6 different continents of the world.
VetPubHealth Journal ISSUE 17
IVSA Standing Committe on One Health
April 2020
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GALLERY
Veterinary Public Health Journal | Issue #17
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VetPubHealth Journal ISSUE 17
IVSA Standing Committe on One Health
April 2020
Veterinary Public Health Journal | Issue #17
Answers of the Puzzle Z O O N O 2. B S 3. I E S O U S Y T L E A K V R A R T O M A T I C R C I T E S M 1.
4.
C O N T A G I O U T B R
5.
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P 7 . A S Y M P T N 8. D F O M 9. P L A G U E M I C 10 . S U P E R B U G 6.
VetPubHealth Journal ISSUE 17
IVSA Standing Committe on One Health
April 2020
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