preparing for the next disease: the human-wildlife connection marguerite pappaioanou, dvm, phd...
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Preparing for the Next Disease:The Human-Wildlife Connection
Marguerite Pappaioanou, DVM, PhDCenters for Disease Control and Prevention
The Centers for Disease Control and Prevention
Protects the health and safety of the people of the United States- at home and abroad
Provides credible information to enhance health decisions
Promotes health through strong partnerships
Develops and applies disease prevention and control, environmental health, and health promotion and education activities
Emerging and re-emerging Zoonoses, 1996–2003 (Source: WHO and Pappaioanou)
Nipah Virus
Hendra virus
Multidrug resistant Salmonella
Lyme Borreliosis
West Nile
Cryptosporidiosis
Reston virus
Venezuelan Equine Encephalitis
E.coli O157
E.coli O157
Lassa fever
Yellow fever Ebola
Monkeypox
Influenza A(H5N1)
Rift valley Fever
NV-CJD
Ross River virusEquine
morbillivirus
Nv-CJDE.coli non-O157
West Nile Virus
Reston Virus
Brucellosis
Hantavirus pulmonary syndrome
Leptospirosis
Recent outbreaksInfluenza / Madagascar
West Nile / USA, CanadaEbola / Gabon, CongoMonkeypox / DRC/ US
CCHF / Afghanistan, IranTularemia / USA, KosovoYellow fever / Ivory Coast
Brucellosis / MongoliaE. coli 0157 / Canada
Hantavirus / USBSE-vCJD/ UK
Nipah virus / MalaysiaAvian Influenza / Hong Kong
SARS / Global
Wildlife EID
DomesticAnimal EID Human EID
Translocation
Human encroachmentEx situ contactEcological manipulationHuman behaviors
Global travelUrbanizationBiomedicalmanipulation
Food processing/distributionTechnology andIndustry
AgriculturalIntensification
EncroachmentIntroduction“Spill over” &“Spill back”
Transmission of Emerging Infectious Diseases
Dasazak P. et.al.Science 2000 287:443
Factors Promoting Transmission of Infectious Diseases from Animals to Humans
• Rapidly Increasing Human Population 6.1 Billion people 6.1 Billion people
in 2000in 2000 ~9.4 to 11.2 Billion in 2050~9.4 to 11.2 Billion in 2050
Source: United Nations, World Population Prospects, The 1998 Revision; and estimates by the Population Reference Bureau.
Factors Promoting Transmission of Infectious Diseases from Animals to Humans
Human population expanding into changing and overlapping wildlife habitat
Increasing human interaction with domestic and wild/exotic animals
Factors Promoting Transmission of Infectious Diseases from Animals to Humans
• Changing climates and ecosystems• Increases in arthropod vector populations and
their resistance to insecticides
Factors Promoting Transmission of Infectious Diseases from Animals to Humans
• Increasing international travel and trade, civil wars, political unrest, famines, human-made and natural disasters
• Increasing movement of people and animals
Factors Promoting Transmission of Infectious Diseases from Animals to Humans
• Globalization of the food supply
• Centralized processing of food
Factors Promoting Transmission of Infectious Diseases from Animals to Humans
• Human behaviors Consumption of bushmeat/wildlife Wild animal game ranches Exotic wildlife as pets Feed stations to increase wildlife populations for hunting
Early disease detection; rapid, timely reporting
Ongoing disease surveillance
Rapid laboratory diagnosis/confirmationRapid laboratory diagnosis/confirmation
Rapid epidemiologic investigationsRapid epidemiologic investigations
Timely and effective public health interventions
Public health research
Partnerships and communications
Infrastructure/capacity building
Public Health Detection, Prevention, ControlEmerging Infectious Diseases
Early Detection—Begins on the Front Line at the Local Level
Clinical Labs, State & Local Public Health Labs, Military Labs, Veterinary Labs, Agricultural, Water & Food-Testing Labs, APHL & ASM, FDA, NIH, & International Labs, FBI, DoD, DOE, USDA, EPA
Rapid Laboratory Diagnosis
Laboratory Response Network
Agent-Specific ProtocolsStandardized Reagents & ControlsLab Referral DirectorySecure Communications & Electronic Laboratory ReportingTraining & Technology TransferProficiency TestingAppropriate Vaccinations for Lab Workers
LRN Partnership with Veterinary Diagnostic Laboratories
1999: National Veterinary Services Laboratory/USDA (Ames) and U. of Texas Veterinary Laboratories LRN members
2002: LRN state public health labs propose funding for 8 veterinary laboratories for membership
2002: CDC/NCID proposes phased collaboration to address concerns with zoonotic diseases, build LRN infrastructure capacity, link animal and human health
2003 - University of Minnesota Veterinary Diagnostic Laboratory joins LRN National Testing Site to screen for monekypox in animals
West Nile Virus, 1999
West Nile Virus leads to New Approaches for Disease Surveillance
Epidemic/Epizootic West Nile Virus in the United States: Revised Guidelines for Surveillance, Prevention, and Control, 2003 Humans, birds, horses, mosquitoes Multidisciplinary
ArboNET National Zoo Surveillance System
CDC – ArboNET (9/8/03)
Partnerships on West Nile Virus Activities in the United States
State and Local Health DeptsState and Local VeterinariansState and Local Wildlife Veterinarians and BiologistsState and Local Mosquito ControlCDCUS Geological SurveyUSDADepartment of DefenseEPA
Weekly
September 5, 2003 / 52(35);845-846
West Nile Virus Activity --- United States, August 28--September 3, 2003 This report summarizes West Nile virus (WNV) surveillance data reported to CDC through ArboNET as of 3 a.m., Mountain Daylight Time, September 3, 2003.
During the reporting week of August 28--September 3, a total of 414 human cases of WNV infection were reported from 22 states (Alabama, Georgia, Iowa, Kansas, Kentucky, Louisiana, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, Ohio, Oklahoma, Pennsylvania, South Dakota, Tennessee, Texas, Virginia, and Wyoming), including 16 fatal cases from eight states (Iowa, Missouri, Nebraska, New Mexico, New York, South Dakota, Texas, and Wyoming). During the same period, WNV infections were reported in 975 dead birds, 252 horses, one dog, one squirrel, two unidentified animal species, and 532 mosquito pools.
Additional information about WNV activity
is available from CDC at http://www.cdc.gov/ncidod/dvbid/westnile/index.htm and
http://westnilemaps.usgs.gov
What Everyone Should Know
· Fight the Bite! · What You Need To Know · Questions & Answers · Case Count Specific Topics
· Maps & Human Cases · Clinical Guidance · Laboratory Guidance · Background · Ecology/Virology · Education/Training Resources
· Press and Media · Publications · Conferences · Links · State and Local
Government Sites
West Nile Virus Home > Statistics, Surveillance, and Control Current Case Count
Statistics, Surveillance, and Control Maps and Data | Surveillance Program | Guidelines | Case Definition | See Also
Maps and Data
Human case and virus activity data and maps are available from several sources:
2003 Human Case Count
U.S. Maps Updated
Maps & County-Level
Data* Click here to view the
2002 Case Count Table.
Click here to view U.S. Maps
representing the spread of WNV.
Click here to go to the U.S. Geological Survey to view weekly maps
and tables of data collected.
*The data reported by USGS reflect surveillance information reported and verified to CDC through the Arbonet surveillance.
USGS/CDC – Wild Birds (9/3/03)
USGS/CDC – Mosquitoes (9/3/03)
USGS/CDC- Veterinary (9/3/03)
USGS/CDC – Humans (9/3/03)
Rapid Epidemiologic Investigation
Weekly
June 13, 2003 / 52(23);537-540
Multistate Outbreak of Monkeypox --- Illinois, Indiana, and Wisconsin, 2003 CDC has received reports of patients with a febrile rash illness who had close contact with pet prairie dogs and other animals. The Marshfield Clinic, Marshfield, Wisconsin, identified a virus morphologically consistent with a poxvirus by electron microscopy of skin lesion tissue from a patient, lymph node tissue from the patient's pet prairie dog, and isolates of virus from culture of these tissues. Additional laboratory testing at CDC indicated that the causative agent is a monkeypox virus, a member of the orthopoxvirus group. This report summarizes initial descriptive epidemiologic, clinical, and laboratory data, interim infection-control guidance, and new animal import regulations.
Investigation
Of Human
Cases
Animal
Trace back
and
Trace forward
Public Health Strategies to Control Epidemic
FDA-CDC joint order banning importation and prohibiting movement of implicated exotic animalsState enacted measures to further restrict intrastate animal shipment and tradePremise quarantineAnimal euthanasiaPre- and post-exposure vaccination of potentially exposed persons with small pox vaccine
Preventing and Controlling Zoonoses – Wildlife Connection
Vaccination of humans and animalsRegulation of importation and movement of exotic animalsControl of feral/stray populationsRegulation of bush meat tradeTesting and culling infected wildlifeOther
Preparing for the Next Disease:The Human-Wildlife Connection
Expect the unexpectedForm and strengthen human-animal health partnershipsLink human and animal surveillance Disease reporting; laboratory networks Communication Coordinate evidence-based public health action
Develop multidisciplinary infectious disease centers Conduct research, e.g., ecology of diseases, risk factors for
human exposure
Develop, test, implement plans for integrated disease detection and response Roles, responsibilities, actions, coordination
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