Public health threat of new, reemerging, and neglected zoonoses in the industrialized world

Where literature is scarce: observations and lessons learnt from four systematic reviews of zoonoses in African countries

The success of a systematic review depends on the availability, accessibility and quality of literature related to the review question. This paper presents the literature found in four systematic reviews conducted for a selection of zoonotic hazards in four livestock value chains in Africa, as well as setting out the challenges in conducting the reviews. The protocol was designed following international standards, and addressed four questions around prevalence, risk factors, control options and impact of various hazards and populations. Searches were conducted in four online databases. Articles were screened for relevance, and quality was assessed before data extraction. Literature on zoonotic hazards was in general scarce and access to full articles was limited. Overall, 25-40% of papers were considered poor quality. The diversity of approaches and designs in the studies compromised the ability to generate summarized estimates. We found that the emphasis of veterinary research has been on livestock problems rather than public health issues, although this seems to be shifting in the last decade; we also found there are limited studies on impact and control. While increasing literature is being published around zoonoses in Africa, this is still inadequate to appropriately inform policy and guide research efforts.

Knowledge, risk perception and mitigation measures towards Ebola virus disease by potentially exposed bushmeat handlers in north-central Nigeria: Any critical gap?

The bushmeat industry has been a topic of increasing importance among public health officials for its influence on zoonotic diseases transmission, such as Ebola virus disease (EVD), a rare and severe infectious disease of humans and non-human primates. This survey assessed knowledge/awareness, risk perceptions and mitigation practices towards EVD among bushmeat handlers in north-central Nigeria. These characteristics are premise to level of preparedness against appropriate risk prevention and control. A questionnaire-based cross-sectional study was conducted between January and December 2015 on 395 bushmeat handlers. Descriptive and analytical statistical analyses were performed using Epi-Info 3.5.3 software, and p < 0.05 was considered statistical significance in all analyses. Mean age of respondents was 40.9 ± 10.7 years, and most (30.4%) of them were in the age group 40-49 years. Majority (82.8%) of them were males, while most (47.9%) do not possess formal education. Bushmeat hunters, vendors and consumers constituted 17.2%, 28.1% and 54.7% of the respondents, respectively. A majority (85.6%) of the participants had heard about EVD. Bushmeat vendors were more likely (OR 1.96; 95% CI: 1.05-3.65) to have satisfactory knowledge than the hunters. Handlers with tertiary education were more likely (OR 3.22; 95% CI: 1.56-6.67) to possess significant satisfactory knowledge/awareness about EVD. Also, vendors were more likely (OR 1.85; 95% CI: 1.01-3.42) to practice satisfactory mitigation measures than the hunters. Only handlers with tertiary education were more likely (OR 2.48; 95% CI: 1.26-4.89) to significantly practice satisfactory mitigation measures against EVD. Although most of the handlers possessed significant knowledge/awareness about EVD, few applied mitigation measures against its infection, which is the challenging gap. There is a need for collaborations between the public health, veterinary and wildlife authorities in the provision of health information to bushmeat handlers on better management of emerging and re-emerging zoonotic viral diseases of wildlife origin.

High-throughput proteomics and the fight against pathogens

Pathogens pose a major threat to human and animal welfare. Understanding the interspecies host-pathogen protein-protein interactions could lead to the development of novel strategies to combat infectious diseases through the rapid development of new therapeutics. The first step in understanding the host-pathogen crosstalk is to identify interacting proteins in order to define crucial hot-spots in the host-pathogen interactome, such as the proposed pharmaceutical targets by means of high-throughput proteomic methodologies. In order to obtain holistic insight into the inter- and intra-species bimolecular interactions, apart from the proteomic approach, sophisticated in silico modeling is used to correlate the obtained large data sets with other omics data and clinical outcomes. Since the main focus in this area has been directed towards human medicine, it is time to extrapolate the existing expertise to a new emerging field: the 'systems veterinary medicine'. Therefore, this review addresses high-throughput mass spectrometry-based technology for monitoring protein-protein interactions in vitro and in vivo and discusses pathogen cultivation, model host cells and available bioinformatic tools employed in vaccine development.

Prevalence and risk factors of brucellosis among veterinary health care professionals

The study describes prevalence, clinical symptoms and risk factors for brucellosis in personnel engaged in veterinary health care in Karnataka, India. A total of 1050 sera samples were collected from animal handlers, veterinarians, veterinary students, para-veterinarians and persons engaged in artificial insemination of animals. The sera samples were tested for brucellosis by Rose Bengal plate test (RBPT), serum agglutination test (SAT), IgG and IgM indirect ELISA and PCR. Age, sex, clinical symptoms and risk factors were recorded in structured questionnaire. Of the 1050 samples tested, 6.76, 6.38, 3.90, 2.67 and 2.0% were positive by IgG ELISA, RBPT, SAT, IgM ELISA and PCR, respectively and overall prevalence recorded was 7.04%. The prominent clinical symptoms observed were intermittent fever (71.62%) followed by joint pain and body aches. A high degree of suspicion, awareness and multimodal diagnostic approach is suggested for early diagnosis, treatment and disease follow up.

Emerging Foodborne and Agriculture-Related Viruses

Viruses rapidly evolve and can emerge in unpredictable ways. Transmission pathways by which foodborne viruses may enter human populations and evolutionary mechanisms by which viruses can become virulent are discussed in this chapter. A majority of viruses emerge from zoonotic animal reservoirs, often by adapting and infecting intermediate hosts, such as domestic animals and livestock. Viruses that are known foodborne threats include hepatitis E virus, tick-borne encephalitis virus, enteroviruses, adenovirus, and astroviruses, among others. Viruses may potentially evolve and emerge as a result of modern agricultural practices which can concentrate livestock and bring them into contact with wild animals. Examples of viruses that have emerged in this manner are influenza, coronaviruses such as severe acute respiratory syndrome and Middle East respiratory syndrome, and the Nipah virus. The role of bats, bush meat, rodents, pigs, cattle, and poultry as reservoirs from which infectious pathogenic viruses emerge are discussed.

Serological and Molecular Detection of Toxoplasma gondii and Babesia microti in the Blood of Rescued Wild Animals in Gangwon-do (Province), Korea

Infections of Toxoplasma gondii and Babesia microti are reported in many wild animals worldwide, but information on their incidence and molecular detection in Korean wild fields is limited. In this study, the prevalence of T. gondii and B. microti infection in blood samples of 5 animal species (37 Chinese water deer, 23 raccoon dogs, 6 roe deer, 1 wild boar, and 3 Eurasian badgers) was examined during 2008–2009 in Gangwon-do (Province), the Republic of Korea (=Korea) by using serological and molecular tests. The overall seropositivity of T. gondii was 8.6% (6/70); 10.8% in Chinese water deer, 4.3% in raccoon dogs, and 16.7% in roe deer. PCR revealed only 1 case of T. gondii infection in Chinese water deer, and phylogenic analysis showed that the positive isolate was practically identical to the highly pathogenetic strain type I. In B. microti PCR, the positive rate was 5.7% (4/70), including 2 Chinese water deer and 2 Eurasian badgers. Phylogenetic analysis results of 18S rRNA and the β-tubulin gene showed that all positive isolates were US-type B. microti. To our knowledge, this is the first report of B. microti detected in Chinese water deer and Eurasian badger from Korea. These results indicate a potentially high prevalence of T. gondii and B. microti in wild animals of Gangwon-do, Korea. Furthermore, Chinese water deer might act as a reservoir for parasite infections of domestic animals.

Building the road to a regional zoonoses strategy: A survey of zoonoses programmes in the Americas

Background

In recent years, global public health security has been threatened by zoonotic disease emergence as exemplified by outbreaks of H5N1 and H1N1 influenza, SARS, and most recently Ebola and Zika. Additionally, endemic zoonoses, such as rabies, burden countries year after year, placing demands on limited finances and personnel. To survey the baseline status of the emerging and endemic zoonoses programmes of the Latin American and the Caribbean (LAC) countries, the Pan American Health Organization (PAHO) conducted a survey of priority emerging and endemic zoonoses, countries´ prioritization criteria and methodologies, and suggestions to strengthen countries capacities and regional approaches to zoonoses control.

Methods

A fillable online questionnaire was sent to the zoonoses programme managers of the Ministries of Health (MOH) and Ministries of Agriculture (MAg) of 33 LAC countries from January to April of 2015. The questionnaire comprised 36 single, multiple choice and open-ended questions to inform the objectives of the survey. A descriptive exploratory analysis was completed.

Results

Fifty-four ministries (26 MOH, 25 MAg, and 3 combined responses) in 31 LAC countries responded to the survey. Within the ministries, 22 (85%) MOH, 5 (20%) MAg, and 2 (67%) combined entities indicated they had specialized zoonoses units. For endemic zoonoses, 32 of 54 ministries responded that they conduct formal prioritization exercises, most of them annually (69%). The three priority endemic zoonoses for the MOHs were leptospirosis, rabies, and brucellosis while the three priorities for the MAgs were brucellosis, rabies, and tuberculosis. Diagnosis for rabies and leptospirosis were cited as the capacities most in need of development. The most needed cross-cutting capacity was coordination between stakeholders. For emerging zoonoses, 28 ministries performed formal prioritization exercises. The top prioritization criteria were probability of introduction into the country and impact. The three priority emerging zoonoses for the MOHs were Ebola viral disease, avian influenza, and Chikungunya while for the MAgs were avian influenza, bovine spongiform encephalopathy and West Nile virus disease. Surveillance for avian influenza and Ebola, and diagnosis for BSE were quoted as the capacities most needed. For all zoonoses, the majority of respondents (69%) ranked their relationship with the other Ministry as productive or very productive, and 31% minimally productive. Many countries requested a formal regional network, better regional communication and collaboration, and integrated surveillance.

Conclusions

The survey is the first comprehensive effort to date to inform the status of zoonoses programmes in LAC. The information collected here will be used to develop a regional strategy for zoonoses (both endemic and emerging), increase efforts, advocacy, and promote prompt identification and management of EIDs and improvement of endemic programmes.

Potential Pathogens Reported in Species of the Family Viverridae and Their Implications for Human and Animal Health

The Viverridae is a family of nocturnal carnivores including civets, genets and African linsangs. While a list of known organisms isolated from a species is an essential tool for population management, this review represents the first attempt to collate published reports of organisms isolated from viverrids. A wide range of organisms, including 11 viruses, eight bacterial species, one internal arthropod species, representatives from eight genera of protozoan, 21 genera of nematode, seven genera of cestode, eight genera of trematode and six genera of external arthropod (mites, ticks and louse), have been reported in literature spanning over a century of research. Many of these are capable of infecting multiple hosts, including humans. This is of concern given the anthropogenic factors that bring humans and domestic species into close contact with viverrids, facilitating transmission and spillover of organisms between groups. These factors include trade in viverrids for human consumption, captive management in zoos, rescue centres or on commercial breeding farms, and the increasing overlap of free-ranging viverrid distribution and human settlement.

Wildlife Pathology Studies and How They Can Inform Public Health

Emerging zoonoses have had a serious impact on human and animal health in recent decades. More often than not, these disease outbreaks have taken public health by surprise because we have failed to shift the epidemiological curve to the far left and detect zoonoses in animal populations prior to spillover to people. Not only can animals serve as valuable sentinels for emerging zoonoses but also much can be gained by the study of the animals themselves.

One Health

One Health is defined as an approach of integrating animal, human, and environmental health to mitigate diseases. One Health promotes public health by studying all factors, such as agriculture, food, and water security, mechanisms of toxicity and pathogenesis of acute and chronic diseases, sociology, economics, and ecosystem health (to name a few). Such an approach is essential because human, animal, and ecosystem health are inextricably linked; therefore, with this One Health approach, we are called to work together to promote, improve, and defend the health and well-being of all by enhancing cooperation and collaboration between physicians, veterinarians social scientists, economists, psychologists, legal professionals, philosophers, and other scientific health and environmental professionals. As such, the One Health movement and approach is a growing vision in global health and is gaining increasing recognition by national and international institutions, organizations, stakeholders, NGOs, and health policymakers. Likewise, the role of world-class universities is pivotal in discovering One Health scientific knowledge and translating them to policy and evidence-based practices. Universities have responsibilities to train future professionals capable of solving global health issues through interdisciplinary scientific knowledge, integrative approaches to teaching, research collaboration, community linkages, and leadership. This chapter discusses the importance of One Health and the role of higher education institutions’ One Health partnerships to improve global health.

A Generic Quantitative Risk Assessment Framework for the Entry of Bat-Borne Zoonotic Viruses into the European Union

Bat-borne viruses have been linked to a number of zoonotic diseases; in 2014 there have been human cases of Nipah virus (NiV) in Bangladesh and Ebola virus in West and Central Africa. Here we describe a model designed to provide initial quantitative predictions of the risk of entry of such viruses to European Union (EU) Member States (MSs) through four routes: human travel, legal trade (e.g. fruit and animal products), live animal movements and illegal importation of bushmeat. The model utilises available datasets to assess the movement via these routes between individual countries of the world and EU MSs. These data are combined with virus specific data to assess the relative risk of entry between EU MSs. As a case study, the model was parameterised for NiV. Scenario analyses showed that the selection of exporting countries with NiV and potentially contaminated trade products were essential to the accuracy of all model outputs. Uncertainty analyses of other model parameters identified that the model expected number of years to an introduction event within the EU was highly susceptible to the prevalence of NiV in bats. The relative rankings of the MSs and routes, however, were more robust. The UK, the Netherlands and Germany were consistently the most likely points of entry and the ranking of most MSs varied by no more than three places (maximum variation five places). Legal trade was consistently the most likely route of entry, only falling below human travel when the estimate of the prevalence of NiV in bats was particularly low. Any model-based calculation is dependent on the data available to feed into the model and there are distinct gaps in our knowledge, particularly in regard to various pathogen/virus as well as host/bat characteristics. However, the strengths of this model lie in the provision of relative comparisons of risk among routes and MSs. The potential for expansion of the model to include other routes and viruses and the possibility of rapid parameterisation demonstrates its potential for use in an outbreak situation.

Distribution and characteristics of rodent picornaviruses in China

Rodents are important reservoir hosts of many important zoonotic viruses. The family Picornaviridae contains clinically important pathogens that infect humans and animals, and increasing numbers of rodent picornaviruses have recently been associated with zoonoses. We collected 574 pharyngeal and anal swab specimens from 287 rodents of 10 different species from eight representative regions of China from October 2013 to July 2015. Seven representative sequences identified from six rodent species were amplified as full genomes and classified into four lineages. Three lineage 1 viruses belonged to a novel genus of picornaviruses and was more closely related to Hepatovirus than to others genera of picornaviruses based on aa homology. Lineage 2, lineage 3, and lineage 4 viruses belonged to the genera Rosavirus, Hunnivirus, and Enterovirus, respectively, representing new species. According to both phylogenetic and identity analyses, Lineage 2 viruses had a close relationship with rosavirus 2 which was recovered from the feces of a child in Gambia and Lineage 3 viruses had a close relationship with domestic animal Hunnivirus. Lineage 4 viruses provide the first evidence of these enteroviruses and their evolution in rodent hosts in China.

Prevalence of Escherichia Coli O157:H7 and Enterobacteriaceae on Hands of Workers in Halal Cattle Abattoirs in Peninsular Malaysia

BACKGROUND

Several occupational diseases of multiple origins are encountered among abattoir workers. Presence of indicator microorganisms (coliforms) on hands of workers can be used a gauge for hygienic practices.

METHODS

A cross-sectional study was performed to assess the prevalence of E.coli and enterobacteriaceae among Halal abattoir workers in some government halal abattoirs of Malaysia. A total of one hundred and sixty-five hand swab samples were collected from workers of Halal abattoirs in Malaysia. The samples were subjected to microbiological analysis for characterisation and serotyping.

RESULTS

The results have shown that no Escherichia coli O157:H7 was isolated on the hands of abattoir workers before and after work. However, a total prevalence of 9.7% was recorded for all samples during work. For non-O157:H7, total prevalence of 33.3% during work and 13% after work were obtained. High prevalence was recorded in sample taken during work from Tampin, Jasin and Kemaman (100% each) while low prevalence where observed in Shah Alam, Banting and Ipoh (20% each).

CONCLUSIONS

Based on the findings the hygienic practices of hand washing among the workers in few locations was found to be low especially after work.

Time Lags between Exanthematous Illness Attributed to Zika Virus, Guillain-Barré Syndrome, and Microcephaly, Salvador, Brazil

Zika virus infection emerged as a public health emergency after increasing evidence for its association with neurologic disorders and congenital malformations. In Salvador, Brazil, outbreaks of acute exanthematous illness (AEI) attributed to Zika virus, Guillain-Barré syndrome (GBS), and microcephaly occurred in 2015. We investigated temporal correlations and time lags between these outbreaks to identify a common link between them by using epidemic curves and time series cross-correlations. Number of GBS cases peaked after a lag of 5-9 weeks from the AEI peak. Number of suspected cases of microcephaly peaked after a lag of 30-33 weeks from the AEI peak, which corresponded to time of potential infections of pregnant mothers during the first trimester. These findings support the association of GBS and microcephaly with Zika virus infection and provide evidence for a temporal relationship between timing of arboviral infection of pregnant women during the first trimester and birth outcome.

Neurological Manifestations of Brucellosis in an Indian Population

Brucellosis is a zoonotic disease causing serious public health problems in countries of the Middle-East and developing countries like India. Neurobrucellosis is one of the devastating complications of this re-emerging zoonosis. The objective of this review was to identify the neurological manifestations of Brucellosis in an Indian population and bring into light the effective modalities used for treating neurobrucellosis. A systematic review of the scientific literature reported in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines was conducted. Three databases (PubMed, IndMed, and ScienceDirect) were used to analyze retrospectively case reports of sufficient quality for data extraction (from the last 15 years, 2002-2016), and relevant literature was reviewed. Most of the cases had a definite history of exposure to Brucella through occupational contact with cattle, drinking raw milk, or living near unhygienic abattoir or even trips to epidemic areas outside India. The common presentations include fever, meningitis, brisk deep-tendon reflexes, extensor plantars, sensory deficit usually below the twelfth thoracic vertebral level, weakness of lower limbs, ocular signs of papilledema, and retrobulbar neuritis. The usual systemic findings associated were hepatosplenomegaly and weight-loss. Neurobrucellosis needs to be kept in mind in the differential diagnosis of fever of unknown origin involving neurological symptoms and systemic involvement. Prognosis is good if there is a combination of antibiotics, each with different mechanisms of action given in full dose. Suitable measures for its prevention are also suggested.

Seoul virus in the Brown Rat ( Rattus norvegicus ) from Ürümqi, Xinjiang, Northwest of China

Hantavirus infections among human populations are linked to the geographic distribution of the host rodents that carry the viruses. To determine the presence and distribution of hantaviruses in the northern region of Xinjiang Uygur Autonomous Region (XUAR), northwestern China, 844 rodents were captured from five locations in four dissimilar habitats during 2010-14 and examined for Hantavirus infection. Hantavirus nucleic acids were firstly detected in the brown rat ( Rattus norvegicus ) from Ürümqi, China, indicating that the Hantavirus was transmitted into Ürümqi in XUAR and circulated by the brown rat. Our results suggest that the brown rat may act as a natural reservoir for the virus in XUAR.

Zoonotic and Vector-Borne Infections Among Urban Homeless and Marginalized People in the United States and Europe, 1990-2014

INTRODUCTION

In high-income countries, homeless individuals in urban areas often live in crowded conditions with limited sanitation and personal hygiene. The environment of homelessness in high-income countries may result in intensified exposure to ectoparasites and urban wildlife, which can transmit infections. To date, there have been no systematic evaluations of the published literature to assess vector-borne and zoonotic disease risk to these populations.

OBJECTIVES

The primary objectives of this study were to identify diversity, prevalence, and risk factors for vector-borne and zoonotic infections among people experiencing homelessness and extreme poverty in urban areas of high-income countries.

METHODS

We conducted a systematic review and narrative synthesis of published epidemiologic studies of zoonotic and vector-borne infections among urban homeless and very poor people in the United States and Europe from 1990 to 2014.

RESULTS

Thirty-one observational studies and 14 case studies were identified (n = 45). Seroprevalence to the human louse-borne pathogen Bartonella quintana (seroprevalence range: 0-37.5%) was identified most frequently, with clinical disease specifically observed among HIV-positive individuals. Seropositivity to Bartonella henselae (range: 0-10.3%) and Rickettsia akari (range: 0-16.2%) was noted in multiple studies. Serological evidence of exposure to Rickettsia typhi, Rickettsia prowazekii, Bartonella elizabethae, West Nile virus, Borellia recurrentis, lymphocytic choriomeningitis virus, Wohlfartiimonas chitiniclastica, Seoul hantavirus (SEOV), and Leptospira species was also identified in published studies, with SEOV associated with chronic renal disease later in life. HIV infection, injection drug use, and heavy drinking were noted across multiple studies as risk factors for infection with vector-borne and zoonotic pathogens.

CONCLUSIONS

B. quintana was the most frequently reported vector-borne infection identified in our article. Delousing efforts and active surveillance among HIV-positive individuals, who are at elevated risk of complication from B. quintana infection, are advised to reduce morbidity. Given documented exposure to rodent-borne zoonoses among urban homeless and marginalized people, reducing human contact with rodents remains an important public health priority.

Emerging infectious diseases: Focus on infection control issues for novel coronaviruses (Severe Acute Respiratory Syndrome-CoV and Middle East Respiratory Syndrome-CoV), hemorrhagic fever viruses (Lassa and Ebola), and highly pathogenic avian influenza viruses, A(H5N1) and A(H7N9)

Over the past several decades, we have witnessed the emergence of many new infectious agents, some of which are major public threats. New and emerging infectious diseases which are both transmissible from patient-to-patient and virulent with a high mortality include novel coronaviruses (SARS-CoV, MERS-CV), hemorrhagic fever viruses (Lassa, Ebola), and highly pathogenic avian influenza A viruses, A(H5N1) and A(H7N9). All healthcare facilities need to have policies and plans in place for early identification of patients with a highly communicable diseases which are highly virulent, ability to immediately isolate such patients, and provide proper management (e.g., training and availability of personal protective equipment) to prevent transmission to healthcare personnel, other patients and visitors to the healthcare facility.

Characterization of Viral Communities of Biting Midges and Identification of Novel Thogotovirus Species and Rhabdovirus Genus

More than two thirds of emerging viruses are of zoonotic origin, and among them RNA viruses represent the majority. Ceratopogonidae (genus Culicoides) are well-known vectors of several viruses responsible for epizooties (bluetongue, epizootic haemorrhagic disease, etc.). They are also vectors of the only known virus infecting humans: the Oropouche virus. Female midges usually feed on a variety of hosts, leading to possible transmission of emerging viruses from animals to humans. In this context, we report here the analysis of RNA viral communities of Senegalese biting midges using next-generation sequencing techniques as a preliminary step toward the identification of potential viral biohazards. Sequencing of the RNA virome of three pools of Culicoides revealed the presence of a significant diversity of viruses infecting plants, insects and mammals. Several novel viruses were detected, including a novel Thogotovirus species, related but genetically distant from previously described tick-borne thogotoviruses. Novel rhabdoviruses were also detected, possibly constituting a novel Rhabdoviridae genus, and putatively restricted to insects. Sequences related to the major viruses transmitted by Culicoides, i.e., African horse sickness, bluetongue and epizootic haemorrhagic disease viruses were also detected. This study highlights the interest in monitoring the emergence and circulation of zoonoses and epizooties using their arthropod vectors.

Taking forward the World TB Day 2016 theme 'Unite to End Tuberculosis' for the WHO Africa Region

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Tuberculosis (TB) has remained a global emergency ever since it was declared as such by the World Health Organization (WHO) in 1993.

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Of the 9.6 million people who developed TB in 2014, 28% were in the WHO Africa Region, where the case rate was 281 per 100 000 population.

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An estimated 1.2 million (12%) TB cases were HIV-positive and the Africa Region accounted for 74% of these cases.

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The global spread of multidrug-resistant TB (MDR-TB) is now a major public health challenge.

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Scientific, political, and funder communities seriously need to ‘Unite to End TB’, the theme of the 2016 World TB Day.

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TB control programs in Africa can only succeed if mechanisms for close engagement of developing country scientists, healthcare workers, patient groups, governments, and policy-makers are ensured by funding and donor agencies.

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Several funder, political, and community initiatives provide hope for achieving the goals of the WHO post-2015 TB strategy.

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TB activities and funder investments in Africa need to be aligned in parallel with international efforts at improving social and living conditions and with the ‘one health’ initiative.

Tuberculosis (TB) remains a global emergency, with an estimated 9.6 million new TB cases worldwide reported in 2014. Twenty-eight percent of these cases were in the World Health Organization (WHO) Africa Region, where the annual case detection rate was 281 per 100 000 population—more than double the global average of 133 per 100 000. Of the 9.6 million people who developed TB, an estimated 1.2 million (12%) were HIV-positive, and the Africa Region accounted for 74% of these cases. Three million people with TB remain undiagnosed and untreated. Globally, an estimated 480 000 had multidrug-resistant TB (MDR-TB). Whilst of the African countries, only South Africa has reported a high prevalence of MDR-TB, it is likely that all of Sub-Saharan Africa has an unreported high load of drug-resistant TB. Tragically, in 2014, only 48% of individuals diagnosed with MDR-TB had successful treatment and an estimated 190 000 people died of MDR-TB. Of the global TB funding gap of US$ 0.8 billion, the largest funding gap was in the Africa Region, amounting to US$ 0.4 billion in 2015. The MDR-TB pandemic in particular now threatens to devastate entire regions and may fundamentally alter the life-expectancy and demographic profile of many countries in Sub-Saharan Africa. The theme designated for this year's World TB Day, March 24, 2016, is ‘Unite to End TB’. From the Africa Region, there is an urgent need to seriously address the political, economic, and social factors that influence host–Mycobacterium tuberculosis interactions and result in disease. Recent political and funder initiatives that provide renewed hope for the alleviation of Africa's TB and TB/HIV problems are discussed.

Screening for Viral Pathogens in African Simian Bushmeat Seized at A French Airport

Illegal bushmeat traffic is an important threat to biodiversity conservation of several endangered species and may contribute to the emergence and spread of infectious diseases in humans. The hunting, manipulation and consumption of wildlife‐based products, especially those of primate origin, may be a threat to human health; however, few studies have investigated the role of bushmeat trade and consumption as a potential source of human infections to date. In this study, we report the screening of viral pathogens in African simian game seized by French customs at Toulouse Blagnac Airport. Epifluorescence microscopy revealed the presence of virus‐like particles in the samples, and further metagenomic sequencing of the DNA and RNA viromes confirmed the presence of sequences related to the Siphoviridae, Myoviridae and Podoviridae bacteriophage families; some of them infecting bacterial hosts that could be potentially pathogenic for humans. To increase the sensitivity of detection, twelve pan‐generic PCRs targeting several viral zoonoses were performed, but no positive signal was detected. A large‐scale inventory of bacteria, viruses and parasites is urgently needed to globally assess the risk for human health of the trade, manipulation and consumption of wildlife‐related bushmeat.

Serological evidence of H9N2 avian influenza virus exposure among poultry workers from Fars province of Iran

BACKGROUND

Since the 1990s, influenza A viruses of the H9N2 subtype have been causing infections in the poultry population around the globe. This influenza subtype is widely circulating in poultry and human cases of AI H9N2 have been sporadically reported in countries where this virus is endemic in domestic birds. The wide circulation of H9N2 viruses throughout Europe and Asia along with their ability to cause direct infection in mammals and humans, raises public health concerns. H9N2 AI was reported for the first time in Iran in 1998 and at present it is endemic in poultry. This study was carried out to evaluate the exposure to H9N2 AI viruses among poultry workers from the Fars province.

METHODS

100 poultry workers and 100 healthy individuals with no professional exposure to poultry took part in this study. Serum samples were tested for antibodies against two distinct H9N2 avian influenza viruses, which showed different phylogenetic clustering and important molecular differences, such as at the amino acid (aa) position 226 (Q/L) (H3 numbering), using haemagglutination inhibition (HI) and microneutralization (MN) assays.

RESULTS

Results showed that 17 % of the poultry workers were positive for the A/chicken/Iran/10VIR/854-5/2008 virus in MN test and 12 % in HI test using the titer ≥40 as positive cut-off value. Only 2 % of the poultry workers were positive for the A/chicken/Iran/12VIR/9630/1998 virus. Seroprevalence of non exposed individuals for both H9N2 strains was below 3 % by both tests. Statistical analyses models showed that exposure to poultry significantly increases the risk of infection with H9N2 virus.

CONCLUSIONS

The results have demonstrated that exposure to avian H9N2 viruses had occurred among poultry workers in the Fars province of Iran. Continuous surveillance programmes should be implemented to monitor the presence of avian influenza infections in humans and to evaluate their potential threat to poultry workers and public health.

Poverty, Health and Livelihoods

Developing countries, especially those in the tropical regions of the world, are known for poverty and infectious diseases (ID). People in developing countries carry on their day-to-day living amongst these two challenges. Between the years 1940–2004, over 300 emerging human ID have been reported worldwide. Infectious diseases have resulted in high mortality and morbidity in developing countries. Affecting more than 1 billion of the world’s population, neglected tropical diseases (NTD) are a group of infectious diseases that are endemic in the poorest regions of the world. Most of the affected populations live in rural areas with very minimal resources but at high risk of disease due to their livelihood. Non-communicable diseases are also on the increase in developing countries, further exacerbating public health challenges in these regions. With nearly 15 million people dying each year as a result of ID, most of them living in developing countries, there is need to find solutions to prevent and tackle infectious diseases in these communities. This book is devoted to infectious diseases and livelihoods in developing countries.

Review of Climate Change and Health in Ethiopia: Status and Gap Analysis

BACKGROUND

This review assessed Ethiopia's existing situation on issues related to the environment, climate change and health, and identifies gaps and needs that can be addressed through research, training, and capacity building.

METHODS

The research was conducted through a comprehensive review of available secondary data and interviewing key informants in various national organizations involved in climate change adaptation and mitigation activities.

RESULTS

Climate change-related health problems, such as mortality and morbidity due to floods and heat waves, vector-borne diseases, water-borne diseases, meningitis, and air pollution-related respiratory diseases are increasing in Ethiopia. Sensitive systems such as agriculture, health, and water have been affected, and the effects of climate change will continue to magnify without the right adaptation and mitigation measures. Currently, research on climate change and health is not adequately developed in Ethiopia. Research and other activities appear to be fragmented and uncoordinated. As a result, very few spatially detailed and methodologically consistent studies have been made to assess the impact of climate in the country. There has often been a lack of sufficient collaboration among organizations on the planning and execution of climate change and health activities, and the lack of trained professionals who can perform climate change and health-related research activities at various levels.

CONCLUSION

Firstly, there is a lack of organized structure in the various organizations. Secondly, there is inadequate level of inter-sectoral collaboration and poor coordination and communication among different stakeholders. Thirdly, there are no reliable policy guidelines and programs among organizations, agencies and offices that target climate change and health. Fourth, the existing policies fail to consider the gender and community-related dimensions of climate change. Fifth, the monitoring and evaluation efforts exerted on climate change and health activities are not strong enough to address the climate change and health issues in the country.

The consequences of human actions on risks for infectious diseases: a review

The human population is growing, requiring more space for food production, and needing more animals to feed it. Emerging infectious diseases are increasing, causing losses in both human and animal lives, as well as large costs to society. Many factors are contributing to disease emergence, including climate change, globalization and urbanization, and most of these factors are to some extent caused by humans. Pathogens may be more or less prone to emergence in themselves, and rapidly mutating viruses are more common among the emerging pathogens. The climate-sensitive vector-borne diseases are likely to be emerging due to climate changes and environmental changes, such as increased irrigation. This review lists the factors within pathogens that make them prone to emergence, and the modes of transmission that are affected. The anthropogenic changes contributing to disease emergence are described, as well as how they directly and indirectly cause either increased numbers of susceptible or exposed individuals, or cause increased infectivity. Many actions may have multiple direct or indirect effects, and it may be difficult to assess what the consequences may be. In addition, most anthropogenic drivers are related to desired activities, such as logging, irrigation, trade, and travelling, which the society is requiring. It is important to research more about the indirect and direct effects of the different actions to understand both the benefits and the risks.

Introducing One Health to the Ethical Debate About Zoonotic Diseases in Southeast Asia

Pandemic plans recommend phases of response to an emergent infectious disease (EID) outbreak, and are primarily aimed at preventing and mitigating human-to-human transmission. These plans carry presumptive weight and are increasingly being operationalized at the national, regional and international level with the support of the World Health Organization (WHO). The conventional focus of pandemic preparedness for EIDs of zoonotic origin has been on public health and human welfare. However, this focus on human populations has resulted in strategically important disciplinary silos. As the risks of zoonotic diseases have implications that reach across many domains outside traditional public health, including anthropological, environmental, and veterinary fora, a more inclusive ecological perspective is paramount for an effective response to future outbreaks.

Epidemiological surveillance of capybaras and ticks on warning area for Brazilian spotted fever

Aim:

The vulnerability of tropical developing countries to the emerging disease constitutes a critical phenomenon in which the invasion of wild niches by human hosts, contributes to expansion of zoonotic diseases, such as the Brazilian spotted fever (BSF). This study performed a diagnosis of species occurrence of their hosts (Hydrochoerus hydrochaeris) and vectors (Amblyomma sculptum and Amblyomma dubitatum) on the warning area for this reemerging disease in Brazil.

Materials and Methods:

The study was conducted in a warning area for BSF in the city of Americana, São Paulo state. The occurrence of capybaras was registered by use of binoculars and GPS equipment and 24 acarological researches were performed through 180 CO2 traps. Samples of adult ticks were dissected for salivary glands removal, DNA extraction, and evaluation by polymerase chain reaction (PCR) being tested by initial gltA-PCR, ompA-PCR, and Rickettsia bellii-specific PCR, with the positive samples subjected to sequencing.

Results:

Eleven clusters of capybaras (total of 71 individuals), were observed along the riparian of Ribeirão Quilombo and 7,114 specimens of A. sculptum and 7,198 specimens of A. dubitatum were collected in this same area. About 568 samples of adult ticks were dissected for salivary glands removal, DNA extraction and evaluation by gltA-PCR, with results of 1.94% (11/568) of positive samples. Results for the initial gltA-PCR indicated none positive sample to Rickettsia species into A. sculptum and 11 positive samples to A. dubitatum. These samples were negative to the ompA-PCR and positive to the Rickettsia bellii-specific PCR protocol and subjected to DNA sequencing, whose result indicated 100% similarity to Rickettsia bellii. The distribution of tick species A. sculptum and A. dubitatum was configured regarding to the biotic potential of the riparian areas, measuring the risks for BSF in peri-urban areas of Americana.

Conclusion:

These results confirmed a status of epidemiological warning with a strong association of the amplifiers hosts of Rickettsia and tick vectors for the transmission of BSF to humans in this region.

Shedding of Infectious Borna Disease Virus-1 in Living Bicolored White-Toothed Shrews

BACKGROUND

Many RNA viruses arise from animal reservoirs, namely bats, rodents and insectivores but mechanisms of virus maintenance and transmission still need to be addressed. The bicolored white-toothed shrew (Crocidura leucodon) has recently been identified as reservoir of the neurotropic Borna disease virus 1 (BoDV-1).

PRINCIPAL FINDINGS

Six out of eleven wild living bicoloured white-toothed shrews were trapped and revealed to be naturally infected with BoDV-1. All shrews were monitored in captivity in a long-term study over a time period up to 600 days that differed between the individual shrews. Interestingly, all six animals showed an asymptomatic course of infection despite virus shedding via various routes indicating a highly adapted host-pathogen interaction. Infectious virus and viral RNA were demonstrated in saliva, urine, skin swabs, lacrimal fluid and faeces, both during the first 8 weeks of the investigation period and for long time shedding after more than 250 days in captivity.

CONCLUSIONS

The various ways of shedding ensure successful virus maintenance in the reservoir population but also transmission to accidental hosts such as horses and sheep. Naturally BoDV-1-infected living shrews serve as excellent tool to unravel host and pathogen factors responsible for persistent viral co-existence in reservoir species while maintaining their physiological integrity despite high viral load in many organ systems.

Human attacks by large felid carnivores in captivity and in the wild

Whereas those who live in the native ranges of the large feline carnivores are well aware of the risks of cat and human encounters, North Americans and Europeans are increasingly exposed to exotic animals through travel, ecotourism, leisure pursuits in rural areas, occupational exposure, zoo and animal park visits, wild habitat encroachment at the urban-wildlands interface, and contact with exotic pets. In encounters during which persons have been severely injured, lapses in animal management protocols, lack of appropriate adult supervision, and intoxication have been reported. Unlike common domestic pets that have lived in close association with humans for thousands of years, no matter where individual large felines may have been raised, they remain wild carnivores with strong prey-drive and territorial instincts. The emergency management of large felid attacks is similar to that of other major trauma: stabilization; management of significant orthopedic, neurologic, vascular, and soft tissue injuries; antibiotic coverage provided for the number of organisms that inhabit their mouths and the potential for tetanus and rabies; and early management in survivors of likely posttraumatic stress disorder. We must actively explore responsible measures globally that can be taken to ensure biologically appropriate, ethical, safe, and sustainable conservation of these large carnivores in both their natural habitats and captivity.

Systematic review of surveillance systems and methods for early detection of exotic, new and re-emerging diseases in animal populations

In this globalized world, the spread of new, exotic and re-emerging diseases has become one of the most important threats to animal production and public health. This systematic review analyses conventional and novel early detection methods applied to surveillance. In all, 125 scientific documents were considered for this study. Exotic (n = 49) and re-emerging (n = 27) diseases constituted the most frequently represented health threats. In addition, the majority of studies were related to zoonoses (n = 66). The approaches found in the review could be divided in surveillance modalities, both active (n = 23) and passive (n = 5); and tools and methodologies that support surveillance activities (n = 57). Combinations of surveillance modalities and tools (n = 40) were also found. Risk-based approaches were very common (n = 60), especially in the papers describing tools and methodologies (n = 50). The main applications, benefits and limitations of each approach were extracted from the papers. This information will be very useful for informing the development of tools to facilitate the design of cost-effective surveillance strategies. Thus, the current literature review provides key information about the advantages, disadvantages, limitations and potential application of methodologies for the early detection of new, exotic and re-emerging diseases.

A scoping review of the role of wildlife in the transmission of bacterial pathogens and antimicrobial resistance to the food Chain

Wildlife can contribute to environmental contamination with bacterial pathogens and their transfer to the human food chain. Global usage and frequent misuse of antimicrobials contribute to emergence of new antimicrobial resistant (AMR) strains of foodborne pathogens. We conducted a scoping review of published research to identify and characterize the evidence on wildlife's role in transmission of AMR and/or bacterial pathogens to the food chain. An advisory group (AG) of 13 North American experts from diverse disciplines was surveyed to solicit insight in the review scope, priority topics and research characteristics. A pre-tested search strategy was implemented in seven bibliographic databases (1990 to January 2013). Citations were relevance screened, and key characteristics on priority topics extracted independently by two reviewers. Analysis identified topic areas with solid evidence and main knowledge gaps. North America reported 30% of 866 relevant articles. The prevalence of five targeted bacterial pathogens and/or AMR in any pathogen in wildlife was reported in 582 articles. Transmission risk factors for selected bacteria or AMR in any bacteria were reported in 300. Interventions to control transmission were discussed in 124 articles and formally evaluated in 50. The majority of primary research investigated birds, cervids, rodents, feral pigs, opossums, E. coli (n = 329), Salmonella (n = 293) and Campylobacter (n = 124). An association between wildlife and transmission of bacterial pathogens and/or AMR to the food chain was supported in 122 studies. The scoping review identified a significant body of research on the role of wild birds in the prevalence and transmission of E. coli, Salmonella and Campylobacter. There was little research employing molecular methods contributing to the evidence concerning the importance and direction of transmission of wildlife/pathogen combinations. Given the advancements of these methods, future research should focus in this area to help prioritize future intervention studies and risk mitigation strategies.

Fecal virome analysis of three carnivores reveals a novel nodavirus and multiple gemycircularviruses

BACKGROUND

More knowledge about viral populations in wild animals is needed in order to better understand and assess the risk of zoonotic diseases. In this study we performed viral metagenomic analysis of fecal samples from three healthy carnivores: a badger (Meles meles), a mongoose (Herpestes ichneumon) and an otter (Lutra lutra) from Portugal.

RESULTS

We detected the presence of novel highly divergent viruses in the fecal material of the carnivores analyzed, such as five gemycircularviruses. Four of these gemycircularviruses were found in the mongoose and one in the badger. In addition we also identified an RNA-dependent RNA polymerase gene from a putative novel member of the Nodaviridae family in the fecal material of the otter.

CONCLUSIONS

Together these results underline that many novel viruses are yet to be discovered and that fecal associated viruses are not always related to disease. Our study expands the knowledge of viral species present in the gut, although the interpretation of the true host species of such novel viruses needs to be reviewed with great caution.

Understanding West Nile virus ecology in Europe: Culex pipiens host feeding preference in a hotspot of virus emergence

BACKGROUND

Understanding wildlife disease ecology is becoming an urgent need due to the continuous emergence and spread of several wildlife zoonotic diseases. West Nile Virus (WNV) is the most widespread arthropod-borne virus in the world, and in recent decades there has been an increase both in geographic range, and in the frequency of symptomatic infections in humans and wildlife. The principal vector for WNV in Europe is the common house Culex pipiens mosquito, which feeds on a wide variety of vertebrate host species. Variation in mosquito feeding preference has been described as one of the most influential parameters driving intensity and timing of WNV infection in the United States, but feeding preferences for this species have been little studied in Europe.

METHODS

Here, we estimated feeding preference for wild Cx. pipiens in northern Italy, using molecular analysis to identify the origin of blood meals, and avian census to control host abundance variations. Additionally, we used host bird odour extracts to test experimentally mosquito preferences in the absence of environmental variations.

RESULTS

For the first time, we demonstrate a clear feeding preference for the common blackbird (Turdus merula), both for wild collected specimens and in the lab, suggesting a potential important role for this species in the WNV epidemiology in Europe. A seasonal decrease in abundance of blackbirds is associated with increased feeding on Eurasian magpies (Pica pica), and this may be linked to seasonal emergence of WNV in humans. Feeding preferences on blackbirds are more marked in rural areas, while preference for magpies is higher in peridomestic areas. Other species, such as the house sparrow (Passer domesticus) appear to be selected by mosquitoes opportunistically in relation to its abundance.

CONCLUSIONS

Our findings provide new insights into the ecology of Cx. pipiens in Europe and may give useful indications in terms of implementing targeted WNV surveillance plans. However, a clearer understanding of spatio-temporal variations of Cx. pipiens feeding preferences, and targeted studies on reservoir competence for WNV for these species are therefore now urgently needed as this is essential to describe disease dynamics and quantify virus transmission risk.

Viral and vector zoonotic exploitation of a homo-sociome memetic complex

As most newly characterized emerging infectious diseases are considered to be zoonotic, a modern pre-eminence ascribed within this classification lies clearly within the viral taxonomic realm. In particular, RNA viruses deserve special concern given their documented impact on conservation biology, veterinary medicine and public health, with an unprecedented ability to promote an evolutionary host–pathogen arms race from the ultimate infection and immunity perspective. However, besides the requisite molecular/gross anatomical and physiological bases for infectious diseases to transmit from one host to another, both viral pathogens and their reservoirs/vectors exploit a complex anthropological, cultural, historical, psychological and social suite that specifically defines the phylodynamics within Homo sapiens, unlike any other species. Some of these variables include the ecological benefits of living in groups, decisions on hunting and foraging behaviours and dietary preferences, myths and religious doctrines, health economics, travel destinations, population planning, political decisions on agricultural product bans and many others, in a homo-sociome memetic complex. Taken to an extreme, such complexities elucidate the underpinnings of explanations as to why certain viral zoonoses reside in neglected people, places and things, whereas others are chosen selectively and prioritized for active mitigation. Canine-transmitted rabies serves as one prime example of how a neglected viral zoonosis may transition to greater attention on the basis of renewed advocacy, social media, local champions and vested international community engagement. In contrast, certain bat-associated and arboviral diseases suffer from basic ignorance and perpetuated misunderstanding of fundamental reservoir and vector ecology tenets, translated into failed control policies that only exacerbate the underlying environmental conditions of concern. Beyond applied biomedical knowledge, epidemiological skills and biotechnical abilities alone, if a homo-sociome memetic complex approach is also entertained in a modern transdisciplinary context, neglected viral zoonosis may be better understood, controlled, prevented and possibly eliminated, in a more holistic One Health context.

Neglected fungal zoonoses: hidden threats to man and animals

Zoonotic fungi can be naturally transmitted between animals and humans, and in some cases cause significant public health problems. A number of mycoses associated with zoonotic transmission are among the group of the most common fungal diseases, worldwide. It is, however, notable that some fungal diseases with zoonotic potential have lacked adequate attention in international public health efforts, leading to insufficient attention on their preventive strategies. This review aims to highlight some mycoses whose zoonotic potential received less attention, including infections caused by Talaromyces (Penicillium) marneffei, Lacazia loboi, Emmonsia spp., Basidiobolus ranarum, Conidiobolus spp. and Paracoccidioides brasiliensis.

Jet set pets: examining the zoonosis risk in animal import and travel across the European Union

Ownership of companion animals or pets is popular throughout the world. Unfortunately, such animals are susceptible to and potential reservoirs of zoonotic pathogens. Close proximity to and contact with pets can lead to human infections. The distribution of zoonotic diseases associated with companion animals such as dogs and cats is not uniform around the world, and moving animals between regions, countries, and continents carries with it the risk of relocating the pathogens they might harbor. Critical among these zoonotic diseases are rabies, echinococcosis, and leishmania. In addition, the protozoan parasites, Toxoplasma gondii and Giardia duodenalis, are also significant agents for human disease of pet origin. Considerable effort is applied to controlling movements of companion animals, particularly dogs, into the European Union. However, free movement of people and their pets within the European Union is a risk factor for the translocation of diseases and their vectors. This review considers the current distribution of some of these diseases, the risks associated with pet travel, and the controls implemented within Europe to prevent the free movement of zoonotic pathogens.

Host cell proteases: Critical determinants of coronavirus tropism and pathogenesis

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Coronavirus spike proteins can be cleaved by a multitude of host cell proteases.

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Proteolytic activation of spike is a crucial step to activate its fusogenicity.

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The spike protein can be cleaved at multiple sites.

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Modulation of spike cleavage can have profound effects on tropism and pathogenesis.

Coronaviruses are a large group of enveloped, single-stranded positive-sense RNA viruses that infect a wide range of avian and mammalian species, including humans. The emergence of deadly human coronaviruses, severe acute respiratory syndrome coronavirus (SARS-CoV), and Middle East respiratory syndrome coronavirus (MERS-CoV) have bolstered research in these viral and often zoonotic pathogens. While coronavirus cell and tissue tropism, host range, and pathogenesis are initially controlled by interactions between the spike envelope glycoprotein and host cell receptor, it is becoming increasingly apparent that proteolytic activation of spike by host cell proteases also plays a critical role. Coronavirus spike proteins are the main determinant of entry as they possess both receptor binding and fusion functions. Whereas binding to the host cell receptor is an essential first step in establishing infection, the proteolytic activation step is often critical for the fusion function of spike, as it allows for controlled release of the fusion peptide into target cellular membranes. Coronaviruses have evolved multiple strategies for proteolytic activation of spike, and a large number of host proteases have been shown to proteolytically process the spike protein. These include, but are not limited to, endosomal cathepsins, cell surface transmembrane protease/serine (TMPRSS) proteases, furin, and trypsin. This review focuses on the diversity of strategies coronaviruses have evolved to proteolytically activate their fusion protein during spike protein biosynthesis and the critical entry step of their life cycle, and highlights important findings on how proteolytic activation of coronavirus spike influences tissue and cell tropism, host range and pathogenicity.

Legal aspects of public health: difficulties in controlling vector-borne and zoonotic diseases in Brazil

In recent years, vector-borne and zoonotic diseases have become a major challenge for public health. Dengue fever and leptospirosis are the most important communicable diseases in Brazil based on their prevalence and the healthy life years lost from disability. The primary strategy for preventing human exposure to these diseases is effective insect and rodent control in and around the home. However, health authorities have difficulties in controlling vector-borne and zoonotic diseases because residents often refuse access to their homes. This study discusses aspects related to the activities performed by Brazilian health authorities to combat vector-borne and zoonotic diseases, particularly difficulties in relation to the legal aspect, which often impede the quick and effective actions of these professionals. How might it be possible to reconcile the need to preserve public health and the rule on the inviolability of the home, especially in the case of abandoned properties or illegal residents and the refusal of residents to allow the health authority access? Do residents have the right to hinder the performance of health workers even in the face of a significant and visible focus of disease transmission? This paper argues that a comprehensive legal plan aimed at the control of invasive vector-borne and zoonotic diseases including synanthropic animals of public health importance should be considered. In addition, this paper aims to bridge the gap between lawyers and public health professionals and to facilitate communication between them.

Environmental change and enteric zoonoses in New Zealand: a systematic review of the evidence

OBJECTIVE

To review the available evidence that examines the association between climatic and agricultural land use factors and the risks of enteric zoonoses in humans and consider information needs and possible pathways of intervention.

METHODS

The electronic databases PubMed, Web of Science and Embase and government websites were searched systematically for published literature that investigated the association of climatic and/or agricultural exposures with the incidence of the four most common enteric zoonotic diseases in New Zealand (campylobacteriosis, salmonellosis, cryptosporidiosis and giardiasis). Results The 16 studies in the review demonstrated significant associations between climate, agricultural land use and enteric disease occurrence. The evidence suggests that enteric disease risk from environmental reservoirs is pathogen specific. In some rural regions, environmental pathogen load is considerable, with multiple opportunities for zoonotic transmission.

CONCLUSIONS

Enteric disease occurrence in NZ is associated with climate variability and agricultural land use. However, these relationships interact with demographic factors to influence disease patterns.

IMPLICATIONS

Improved understanding of how environmental and social factors interact can inform effective public health interventions under scenarios of projected environmental change.

Time-series analysis on human brucellosis during 2004-2013 in Shandong Province, China

Human brucellosis is a re-emerging bacterial anthropozoonotic disease, which remains a public health concern in China with the growing number of cases and more widespread natural foci. The purpose of this study was to short-term forecast the incidence of human brucellosis with a prediction model. We collected the annual and monthly laboratory data of confirmed cases from January 2004 to December 2013 in Shandong Diseases Reporting Information System (SDRIS). Autoregressive integrated moving average (ARIMA) model was fitted based on the monthly human brucellosis incidence from 2004 to 2013. Finally, monthly brucellosis incidences in 2014 were short-term forecasted by the obtained model. The incidence of brucellosis was increasing from 2004 to 2013. For the ARIMA (0, 2, 1) model, the white noise diagnostic check (x(2) = 5.58 P = 0.35) for residuals obtained was revealed by the optimum goodness-of-fit test. The monthly incidences that fitted by ARIMA (0, 2, 1) model were closely consistent with the real incidence from 2004 to 2013. And forecasting incidences from January 2014 to December 2014 were, respectively, 0.101, 0.118, 0.143, 0.166, 0.160, 0.172, 0.169, 0.133, 0.122, 0.105, 0.103 and 0.079 per100 000 population, with standard error 0.011-0.019 and mean absolute percentage error (MAPE) of 58.79%.

Viral metagenomics on animals as a tool for the detection of zoonoses prior to human infection?

Many human viral infections have a zoonotic, i.e., wild or domestic animal, origin. Several zoonotic viruses are transmitted to humans directly via contact with an animal or indirectly via exposure to the urine or feces of infected animals or the bite of a bloodsucking arthropod. If a virus is able to adapt and replicate in its new human host, human-to-human transmissions may occur, possibly resulting in an epidemic, such as the A/H1N1 flu pandemic in 2009. Thus, predicting emerging zoonotic infections is an important challenge for public health officials in the coming decades. The recent development of viral metagenomics, i.e., the characterization of the complete viral diversity isolated from an organism or an environment using high-throughput sequencing technologies, is promising for the surveillance of such diseases and can be accomplished by analyzing the viromes of selected animals and arthropods that are closely in contact with humans. In this review, we summarize our current knowledge of viral diversity within such animals (in particular blood-feeding arthropods, wildlife and domestic animals) using metagenomics and present its possible future application for the surveillance of zoonotic and arboviral diseases.