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de Leeuw E, Kickbusch I, Rüegg SR. A health promotion perspective on One Health. Can J Public Health 2024; 115:271-275. [PMID: 38478217 PMCID: PMC11006651 DOI: 10.17269/s41997-024-00872-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/12/2024] [Indexed: 04/11/2024]
Abstract
The One Health concept has acquired increasing attention due to the COVID-19 pandemic. We argue for a health promotion perspective that frames One Health in terms of positive health for people, animals, and ecosystems and includes a spiritual-cosmological dimension. This would enhance policy, research, and practice across disciplines and sectors for a more resilient and harmonious planet.
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Affiliation(s)
- Evelyne de Leeuw
- ESPUM, École de santé publique de l'Université de Montréal, Montreal, QC, Canada
- University of New South Wales, Sydney, Australia
- WHO European Regional Office Technical Advisory Group One Health, Copenhagen, Denmark
| | - Ilona Kickbusch
- WHO European Regional Office Technical Advisory Group One Health, Copenhagen, Denmark
- Global Health Centre at the Graduate Institute in Geneva, Le Grand-Saconnex, Switzerland
| | - Simon R Rüegg
- WHO European Regional Office Technical Advisory Group One Health, Copenhagen, Denmark.
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
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2
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Traore T, Shanks S, Haider N, Ahmed K, Jain V, Rüegg SR, Razavi A, Kock R, Erondu N, Rahman-Shepherd A, Yavlinsky A, Mboera L, Asogun D, McHugh TD, Elton L, Oyebanji O, Okunromade O, Ansumana R, Djingarey MH, Ali Ahmed Y, Diallo AB, Balde T, Talisuna A, Ntoumi F, Zumla A, Heymann D, Socé Fall I, Dar O. How prepared is the world? Identifying weaknesses in existing assessment frameworks for global health security through a One Health approach. Lancet 2023; 401:673-687. [PMID: 36682374 DOI: 10.1016/s0140-6736(22)01589-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023]
Abstract
The COVID-19 pandemic has exposed faults in the way we assess preparedness and response capacities for public health emergencies. Existing frameworks are limited in scope, and do not sufficiently consider complex social, economic, political, regulatory, and ecological factors. One Health, through its focus on the links among humans, animals, and ecosystems, is a valuable approach through which existing assessment frameworks can be analysed and new ways forward proposed. Although in the past few years advances have been made in assessment tools such as the International Health Regulations Joint External Evaluation, a rapid and radical increase in ambition is required. To sufficiently account for the range of complex systems in which health emergencies occur, assessments should consider how problems are defined across stakeholders and the wider sociopolitical environments in which structures and institutions operate. Current frameworks do little to consider anthropogenic factors in disease emergence or address the full array of health security hazards across the social-ecological system. A complex and interdependent set of challenges threaten human, animal, and ecosystem health, and we cannot afford to overlook important contextual factors, or the determinants of these shared threats. Health security assessment frameworks should therefore ensure that the process undertaken to prioritise and build capacity adheres to core One Health principles and that interventions and outcomes are assessed in terms of added value, trade-offs, and cobenefits across human, animal, and environmental health systems.
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Affiliation(s)
- Tieble Traore
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal.
| | - Sarah Shanks
- Institute of Zoology, Zoological Society of London, London, UK
| | - Najmul Haider
- Royal Veterinary College, University of London, London, UK; School of Life Sciences, Keele University, Keele, UK
| | - Kanza Ahmed
- Global Operations, UK Health Security Agency, London, UK
| | - Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Simon R Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ahmed Razavi
- Global Operations, UK Health Security Agency, London, UK
| | - Richard Kock
- Royal Veterinary College, University of London, London, UK
| | - Ngozi Erondu
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
| | | | - Alexei Yavlinsky
- Infectious Disease Informatics, Institute of Health Informatics, University College London, London, UK
| | - Leonard Mboera
- Southern African Centre for Infectious Disease Surveillance Foundation for One Health, Morogoro, Tanzania
| | - Danny Asogun
- Ekpoma and Irrua Specialist Teaching Hospital, Ambrose Alli University, Irrua, Nigeria
| | - Timothy D McHugh
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Linzy Elton
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Oyeronke Oyebanji
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Rashid Ansumana
- School of Community Health Sciences, Niala University, Bo Campus, Bo, Sierra Leone
| | - Mamoudou Harouna Djingarey
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Yahaya Ali Ahmed
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Amadou Bailo Diallo
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - Thierno Balde
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Ambrose Talisuna
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - David Heymann
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Osman Dar
- Global Operations, UK Health Security Agency, London, UK; Global Health Programme, Royal Institute of International Affairs, London, UK
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Elnaiem A, Mohamed-Ahmed O, Zumla A, Mecaskey J, Charron N, Abakar MF, Raji T, Bahalim A, Manikam L, Risk O, Okereke E, Squires N, Nkengasong J, Rüegg SR, Abdel Hamid MM, Osman AY, Kapata N, Alders R, Heymann DL, Kock R, Dar O. Global and regional governance of One Health and implications for global health security. Lancet 2023; 401:688-704. [PMID: 36682375 DOI: 10.1016/s0140-6736(22)01597-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/15/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023]
Abstract
The apparent failure of global health security to prevent or prepare for the COVID-19 pandemic has highlighted the need for closer cooperation between human, animal (domestic and wildlife), and environmental health sectors. However, the many institutions, processes, regulatory frameworks, and legal instruments with direct and indirect roles in the global governance of One Health have led to a fragmented, global, multilateral health security architecture. We explore four challenges: first, the sectoral, professional, and institutional silos and tensions existing between human, animal, and environmental health; second, the challenge that the international legal system, state sovereignty, and existing legal instruments pose for the governance of One Health; third, the power dynamics and asymmetry in power between countries represented in multilateral institutions and their impact on priority setting; and finally, the current financing mechanisms that predominantly focus on response to crises, and the chronic underinvestment for epidemic and emergency prevention, mitigation, and preparedness activities. We illustrate the global and regional dimensions to these four challenges and how they relate to national needs and priorities through three case studies on compulsory licensing, the governance of water resources in the Lake Chad Basin, and the desert locust infestation in east Africa. Finally, we propose 12 recommendations for the global community to address these challenges. Despite its broad and holistic agenda, One Health continues to be dominated by human and domestic animal health experts. Substantial efforts should be made to address the social-ecological drivers of health emergencies including outbreaks of emerging, re-emerging, and endemic infectious diseases. These drivers include climate change, biodiversity loss, and land-use change, and therefore require effective and enforceable legislation, investment, capacity building, and integration of other sectors and professionals beyond health.
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Affiliation(s)
- Azza Elnaiem
- Royal Free London NHS Foundation Trust, London, UK
| | - Olaa Mohamed-Ahmed
- UK Health Security Agency, London, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | | | - Tajudeen Raji
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Ammad Bahalim
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Logan Manikam
- Global Health Programme, Royal Institute of International Affairs, London, UK
| | - Omar Risk
- Department of Population, Policy and Practice, University College London Great Ormond Street Institute of Child Health, London, UK
| | | | | | - John Nkengasong
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Simon R Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | | | - Nathan Kapata
- Zambia National Public Health Institute, Ministry of Health, Lusaka, Zambia
| | - Robyn Alders
- Global Health Programme, Royal Institute of International Affairs, London, UK; Development Policy Centre, Australian National University, Canberra, ACT, Australia
| | - David L Heymann
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard Kock
- Royal Veterinary College, University of London, London, UK
| | - Osman Dar
- Global Operations, London, UK; Global Health Programme, Royal Institute of International Affairs, London, UK
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Charypkhan D, Rüegg SR. One Health evaluation of brucellosis control in Kazakhstan. PLoS One 2022; 17:e0277118. [PMID: 36322602 PMCID: PMC9629608 DOI: 10.1371/journal.pone.0277118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/20/2022] [Indexed: 01/24/2023] Open
Abstract
Brucellosis is one of the main livestock disease risks in Kazakhstan. It's been endemic there since 1930, accounting for over 1300 human cases per annum. The economic loss was 45 million USD in 2015 alone. Since 1952, Kazakhstan has implemented various control strategies with little success. One Health approaches have been suggested to tackle brucellosis, however, there is a lack of evidence for best practices to operationalise One Health in the literature, and methods for implementation are not established. The intention of this study was to introduce the One Health approach during the evaluation phase of the policy cycle. A two-day workshop was organized by the authors to familiarize participants with the evaluation methodology. Twenty-one specialists representing veterinary and public health sector, together with researchers, took part in this study. For two weeks following the workshop, first author conducted individual interviews with workshop participants to obtain individual scorings to assess knowledge integration capacity (One Health-ness). The evaluation results show that there is a lack of knowledge about the perceived damage caused by brucellosis to animal owners and other stakeholders. There is insufficient data available about farmers' practices, interests and motivations, and also data is missing for important transmission processes such as the amount of unsafe dairy consumption. The absence of such data illustrates the extent of the uncertainty to which decision-makers are exposed despite well-elaborated transmission models and supports the importance of co-producing solutions with participatory methods. The results suggest the need for broader involvement of stakeholders. Outputs of this study could help navigate the initial stages of One Health operationalization.
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Affiliation(s)
- Duriya Charypkhan
- Vetsuisse Faculty, Section of Epidemiology, University of Zurich, Zurich, Switzerland
- Laboratory of Brucellosis, Kazakh Scientific Research Veterinary Institute, Almaty, Kazakhstan
- * E-mail:
| | - Simon R. Rüegg
- Vetsuisse Faculty, Section of Epidemiology, University of Zurich, Zurich, Switzerland
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Noguera Z. LP, Charypkhan D, Hartnack S, Torgerson PR, Rüegg SR. The dual burden of animal and human zoonoses: A systematic review. PLoS Negl Trop Dis 2022; 16:e0010540. [PMID: 36240240 PMCID: PMC9605338 DOI: 10.1371/journal.pntd.0010540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/26/2022] [Accepted: 10/02/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Zoonoses can cause a substantial burden on both human and animal health. Globally, estimates of the dual (human and animal) burden of zoonoses are scarce. Therefore, this study aims to quantify the dual burden of zoonoses using a comparable metric, "zoonosis Disability Adjusted Life Years" (zDALY). METHODOLOGY We systematically reviewed studies that quantify in the same article zoonoses in animals, through monetary losses, and in humans in terms of Disability Adjusted Life Years (DALYs). We searched EMBASE, Web of Science, Scopus, PubMed, and Google Scholar. We excluded articles that did not provide the data to estimate the zDALY or those for which full text was not available. This study was registered at PROSPERO, CRD42022313081. PRINCIPAL FINDINGS/SIGNIFICANCE We identified 512 potentially eligible records. After deduplication and screening of the title and abstract, 23 records were assessed for full-text review. Fourteen studies were included in this systematic review. The data contains estimates from 10 countries, a study at continental level (Asia and Africa), and 2 studies on a global scale. Rabies was the most frequently reported zoonosis where zDALYs were calculated, based on the following included studies: for Kazakhstan 457 (95% CI 342-597), Viet Nam 5316 (95% CI 4382-6244), Asia 1,145,287 (90% CI 388,592-1,902,310), Africa 837,158 (90% CI 283,087-1,388,963), and worldwide rabies 5,920,014 (95% CI 1,547,860-10,290,815). This was followed by echinococcosis, the zDALYs in Peru were 2238 (95% CI 1931-2546), in China 1490 (95% CI 1442-1537), and worldwide cystic echinococcosis 5,935,463 (95% CI 4,497,316-7,377,636). Then, the zDALYs on cysticercosis for Mozambique were 2075 (95% CI 1476-2809), Cameroon 59,540 (95% CR 16,896-101,803), and Tanzania 34,455 (95% CI 12,993-76,193). Brucellosis in Kazakhstan were 2443 zDALYs (95% CI 2391-2496), and brucellosis and anthrax in Turkey 3538 zDALYs (95% CI 2567-6706). Finally, zDALYs on leptospirosis in New Zealand were 196, and Q fever in Netherlands 2843 (95% CI 1071-4603). The animal burden was superior to the human burden in the following studies: worldwide cystic echinococcosis (83%), brucellosis in Kazakhstan (71%), leptospirosis in New Zealand (91%), and brucellosis, and anthrax in Turkey (52%). Countries priorities on zoonoses can change if animal populations are taken into consideration.
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Affiliation(s)
- Liz P. Noguera Z.
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
- Epidemiology and Biostatistics, Life Science Zurich Graduate School, University of Zurich, Zurich, Switzerland
- * E-mail: ,
| | - Duriya Charypkhan
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
- Epidemiology and Biostatistics, Life Science Zurich Graduate School, University of Zurich, Zurich, Switzerland
| | - Sonja Hartnack
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Simon R. Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
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Sousa FM, Berezowski J, Rüegg SR. No clear trends in expatriation of non-human primate research from -Switzerland between 2004 and 2017. SCHWEIZ ARCH TIERH 2021; 163:553-563. [PMID: 34465559 DOI: 10.17236/sat00313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Animal experimentation is commonly practiced in scientific research worldwide. However, there are no globally accepted standards for regulating the ethical boundaries and accepted practices for animal experimentation. Large differences exist between countries. A report suggested that some researchers, especially from countries with more stringent animal experimentation regulations, may be relocating experimental research to countries with less stringent regulations. We followed a systematic literature review approach to identity publications and determine whether there is an increasing trend in expatriation of non-human primate experimentation by researchers based in Switzerland. We used the Projects People Publications database, which contains projects funded by the Swiss National Science Foundation, to identify researchers conducting experiments using non-human primates. This list of names, together with terms referring to non-human primates were used to search the Web of Science. Publications without an author affiliated to a Swiss institution, no living or only with free non-human primates, and non-original research were excluded. For each publication, we recorded the place of experimentation, funding source, number of animals, species and the statement of ethical approval. We retained 120 publications, involving more than 2,429 non-human primates. Macaca mulatta and Macaca fascicularis were the most common species. We could not confirm an increasing trend in expatriation of non-human primate experimentation outside of Switzerland. Over time, publications appeared to report the ethical approval number more consistently. These results should be interpreted with caution because the sample included only studies that were: 1) published and 2) reported in the Web of Science. Consequently, studies with insignificant results may have been excluded because these studies are rarely published, and studies of poor quality may have been excluded because they are often published in lower quality journals, not indexed by the Web of Science.
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Affiliation(s)
- F M Sousa
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern
| | - J Berezowski
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern
| | - S R Rüegg
- Section of Epidemiology, Vetsuisse-Faculty, University of Zurich
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Hitziger M, Berezowski J, Dürr S, Falzon LC, Léchenne M, Lushasi K, Markosyan T, Mbilo C, Momanyi KN, Özçelik R, Prejit N, Zinsstag J, Rüegg SR. System Thinking and Citizen Participation Is Still Missing in One Health Initiatives - Lessons From Fifteen Evaluations. Front Public Health 2021; 9:653398. [PMID: 34150701 PMCID: PMC8211880 DOI: 10.3389/fpubh.2021.653398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/29/2021] [Indexed: 11/24/2022] Open
Abstract
Tackling complex public health challenges requires integrated approaches to health, such as One Health (OH). A key element of these approaches is the integration of knowledge across sectors, disciplines and stakeholders. It is not yet clear which elements of knowledge integration need endorsement to achieve best outcomes. This paper assesses 15 OH initiatives in 16 African, Asian and European countries to identify opportunities to improve knowledge integration and to investigate geographic influences on knowledge integration capacities. Two related evaluation tools, both relying on semi-quantitative questionnaires, were applied to two sets of case studies. In one tool, the questions relate to operations and infrastructure, while the other assigns questions to the three phases of “design,” “implementation,” and “evaluation” of the project life cycle. In both, the question scores are aggregated using medians. For analysis, extreme values were identified to highlight strengths and weaknesses. Seven initiatives were assessed by a single evaluator external to the initiative, and the other eight initiatives were jointly assessed by several internal and external evaluators. The knowledge integration capacity was greatest during the project implementation stage, and lowest during the evaluation stage. The main weaknesses pointing towards concrete potential for improvement were identified to be a lack of consideration of systemic characteristics, missing engagement of external stakeholders and poor bridging of knowledge, amplified by the absence of opportunities to learn and evolve in a collective process. Most users were unfamiliar with the systems approach to evaluation and found the use of the tools challenging, but they appreciated the new perspective and saw benefits in the ensuing reflections. We conclude that systems thinking and associated practises for OH require not only specific education in OH core competencies, but also methodological and institutional measures to endorse broad participation. To facilitate meta-analyses and generic improvement of integrated approaches to health we suggest including knowledge integration processes as elements to report according to the COHERE guidelines.
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Affiliation(s)
- Martin Hitziger
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zurich, Switzerland
| | - John Berezowski
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Salome Dürr
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Laura C Falzon
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Monique Léchenne
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Kennedy Lushasi
- Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Tigran Markosyan
- Scientific Center for Risk Assessment and Analysis in Food Safety Area, Yerevan, Armenia
| | - Céline Mbilo
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Ranya Özçelik
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Nambiar Prejit
- Centre for One Health Education, Advocacy, Research and Training, Kerala Veterinary and Animal Sciences University, Wayanad, India
| | - Jakob Zinsstag
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Simon R Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zurich, Switzerland
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8
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Häsler B, Bazeyo W, Byrne AW, Hernandez-Jover M, More SJ, Rüegg SR, Schwarzmann O, Wilson J, Yawe A. Reflecting on One Health in Action During the COVID-19 Response. Front Vet Sci 2020; 7:578649. [PMID: 33195585 PMCID: PMC7661772 DOI: 10.3389/fvets.2020.578649] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/10/2020] [Indexed: 11/26/2022] Open
Abstract
The COVID-19 pandemic, a singular disruptive event in recent human history, has required rapid, innovative, coordinated and collaborative approaches to manage and ameliorate its worst impacts. However, the threat remains, and learning from initial efforts may benefit the response management in the future. One Health approaches to managing health challenges through multi-stakeholder engagement are underscored by an enabling environment. Here we describe three case studies from state (New South Wales, Australia), national (Ireland), and international (sub-Saharan Africa) scales which illustrate different aspects of One Health in action in response to the COVID-19 pandemic. In Ireland, a One Health team was assembled to help parameterise complex mathematical and resource models. In New South Wales, state authorities engaged collaboratively with animal health veterinarians and epidemiologists to leverage disease outbreak knowledge, expertise and technical and support structures for application to the COVID-19 emergency. The African One Health University Network linked members from health institutions and universities from eight countries to provide a virtual platform knowledge exchange on COVID-19 to support the response. Themes common to successful experiences included a shared resource base, interdisciplinary engagement, communication network strategies, and looking global to address local need. The One Health approaches used, particularly shared responsibility and knowledge integration, are benefiting the management of this pandemic and future One Health global challenges.
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Affiliation(s)
- Barbara Häsler
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Veterinary Epidemiology Economics and Public Health Group, Hatfield, United Kingdom
| | - William Bazeyo
- Africa One Health University Network (AFROHUN), Makerere University, Kampala, Uganda
| | - Andrew W. Byrne
- One-Health Scientific Support Unit, Department of Agriculture, Food, and The Marine, Government of Ireland, Celbridge, Ireland
| | - Marta Hernandez-Jover
- Faculty of Science, School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
- Graham Centre for Agricultural Innovation (NSW Department of Primary Industries and Charles Sturt University), Wagga Wagga, NSW, Australia
| | - Simon J. More
- Centre for Veterinary Epidemiology and Risk Analysis, School of Veterinary Medicine, University College Dublin (UCD), Dublin, Ireland
| | - Simon R. Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ofir Schwarzmann
- Biosecurity and Food Safety, New South Wales Department of Primary Industries, Orange, NSW, Australia
| | - Jeff Wilson
- Novometrix Research Inc., Moffat, ON, Canada
| | - Agnes Yawe
- Africa One Health University Network (AFROHUN), Makerere University, Kampala, Uganda
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9
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Rüegg SR, Buttigieg SC, Goutard FL, Binot A, Morand S, Thys S, Keune H. Editorial: Concepts and Experiences in Framing, Integration and Evaluation of One Health and EcoHealth. Front Vet Sci 2019; 6:155. [PMID: 31214602 PMCID: PMC6544039 DOI: 10.3389/fvets.2019.00155] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/07/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Simon R Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Flavie L Goutard
- Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), Montpellier, France
| | - Aurélie Binot
- Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD), Montpellier, France
| | - Serge Morand
- Centre National de la Recherche Scientifique (CNRS), Paris, France
| | - Séverine Thys
- Department of Virology, Parasitology, and Immunology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Hans Keune
- Belgian Biodiversity Platform - Research Institute Nature & Forest (INBO), Brussels, Belgium.,Department of Primary and Interdisciplinary Care Antwerp, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Abstract
Many new and highly variable data are currently being produced by the many participants in farmed animal productions systems. These data hold the promise of new information with potential value for animal health surveillance. The current analytical paradigm for dealing with these new data is to implement syndromic surveillance systems, which focus mainly on univariate event detection methods applied to individual time series, with the goal of identifying epidemics in the population. This approach is relatively limited in the scope and not well-suited for extracting much of the additional information that is contained within these data. These approaches have value and should not be abandoned. However, an additional, new analytical paradigm will be needed if surveillance and disease control agencies wish to extract additional information from these data. We propose a more holistic analytical approach borrowed from complex system science that considers animal disease to be a product of the complex interactions between the many individuals, organizations and other factors that are involved in, or influence food production systems. We will discuss the characteristics of farmed animal food production systems that make them complex adaptive systems and propose practical applications of methods borrowed from complex system science to help animal health surveillance practitioners extract additional information from these new data.
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Affiliation(s)
- John Berezowski
- Vetsuisse Faculty, Veterinary Public Health Institute, University of Bern, Bern, Switzerland
| | - Simon R. Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Céline Faverjon
- Vetsuisse Faculty, Veterinary Public Health Institute, University of Bern, Bern, Switzerland
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11
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Tröndle U, Steinmetz HW, Rüegg SR, Müller A, Liesegang A. UV-light and dietary vitamin D and their effects on ionized calcium and 25-OH-D plasma concentrations in captive gentoo penguins (Pygoscelis papua). J Anim Physiol Anim Nutr (Berl) 2018; 102:1419-1428. [PMID: 29971838 DOI: 10.1111/jpn.12941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 05/07/2018] [Accepted: 05/25/2018] [Indexed: 11/29/2022]
Abstract
In this study, the effect of ultraviolet (UV) light and dietary vitamin D on calcium metabolism in permanently indoor-housed gentoo penguins (Pygoscelis papua) was investigated. The study consisted of three periods, each completed with blood samples to analyse plasma concentrations of 25-OH-D, 1,25-(OH)2 -D, ionized (iCa) and total calcium (tCa). During the first study period (D), animals were housed under routine conditions without UV-light and fed a diet of different fish species, supplemented with 1,000 IU vitamin D per animal and day. The following study period (Baseline) of 28-day duration consisted of the same diet without any vitamin D supplementation and without UV-light. During the study period (UVB) artificial UV-light was added for 3 weeks. The vitamin D content of fish was measured by high-performance liquid chromatography. It varied between fish species and between facilities, ranging from no measurable content in capelin (Mallotus villosus) to 7,340 IU vitamin D/kg original matter (OM) in herring (Clupea spp). The average dietary vitamin D content was 311 IU/kg OM at facility 1 and 6,325 IU/kg OM at facility 2, resulting in a vitamin D intake per animal and day without supplementation of 130 IU (25.5 IU/kg body weight BW) and 2,454 IU (438.2 IU/kg BW) respectively. The supplementation of vitamin D elevated significantly the plasma concentrations of 25-OH-D by an intraindividual difference of 15 (range -2 to 59) nmol/L and tCa by 0.1 (0.0-0.3) mmol/L only at facility 2. The exposure to UV-light raised the blood concentrations of tCa at facility 2 by 0.15 (0.1-0.2) mmol/L, and of iCa and tCa for females at facility 1 by 0.23 (0.13-0.41) mmol/L and 1.8 (1.1-2.5) mmol/L respectively. No significant influence of the study periods (D) and (UVB) was found for the concentrations of 1,25-(OH)2 -D at both facilities.
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Affiliation(s)
- Ursina Tröndle
- Vetsuisse Faculty, Institute of Animal Nutrition, University of Zurich, Zurich, Switzerland
| | | | - Simon R Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Anja Müller
- IDEXX Laboratories, Vet Med Labor GmbH, Ludwigsburg, Germany
| | - Annette Liesegang
- Vetsuisse Faculty, Institute of Animal Nutrition, University of Zurich, Zurich, Switzerland
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12
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Hanin MCE, Queenan K, Savic S, Karimuribo E, Rüegg SR, Häsler B. A One Health Evaluation of the Southern African Centre for Infectious Disease Surveillance. Front Vet Sci 2018; 5:33. [PMID: 29616227 PMCID: PMC5864892 DOI: 10.3389/fvets.2018.00033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/16/2018] [Indexed: 11/13/2022] Open
Abstract
Rooted in the recognition that emerging infectious diseases occur at the interface of human, animal, and ecosystem health, the Southern African Centre for Infectious Disease Surveillance (SACIDS) initiative aims to promote a trans-sectoral approach to address better infectious disease risk management in five countries of the Southern African Development Community. Nine years after SACIDS’ inception, this study aimed to evaluate the program by applying a One Health (OH) evaluation framework developed by the Network for Evaluation of One Health (NEOH). The evaluation included a description of the context and the initiative, illustration of the theory of change, identification of outputs and outcomes, and assessment of the One Healthness. The latter is the sum of characteristics that defines an integrated approach and includes OH thinking, OH planning, OH working, sharing infrastructure, learning infrastructure, and systemic organization. The protocols made available by NEOH were used to develop data collection protocols and identify the study design. The framework relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative evaluation (scoring). Data for the analysis were gathered during a document review, in group and individual interviews and in an online survey. Operational aspects (i.e., OH thinking, planning, and working) were found to be balanced overall with the highest score in the planning dimension, whereas the infrastructure (learning infrastructure, systemic organization, and sharing infrastructure) was high for the first two dimensions, but low for sharing. The OH index calculated was 0.359, and the OH ratio calculated was 1.495. The program was praised for its great innovative energy in a difficult landscape dominated by poor infrastructure and its ability to create awareness for OH and enthuse people for the concept; training of people and networking. Shortcomings were identified regarding the balance of contributions, funds and activities across member countries in the South, lack of data sharing, unequal allocation of resources, top-down management structures, and limited horizontal collaboration. Despite these challenges, SACIDS is perceived to be an effective agent in tackling infectious diseases in an integrated manner.
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Affiliation(s)
- Marie C E Hanin
- Department of Pathobiology and Population Sciences, Veterinary Epidemiology Economics and Public Health Group, Royal Veterinary College, London, United Kingdom
| | - Kevin Queenan
- Department of Pathobiology and Population Sciences, Veterinary Epidemiology Economics and Public Health Group, Royal Veterinary College, London, United Kingdom
| | - Sara Savic
- Scientific Veterinary Institute Novi Sad, Novi Sad, Serbia
| | | | - Simon R Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Barbara Häsler
- Department of Pathobiology and Population Sciences, Veterinary Epidemiology Economics and Public Health Group, Royal Veterinary College, London, United Kingdom
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13
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Rüegg SR, Nielsen LR, Buttigieg SC, Santa M, Aragrande M, Canali M, Ehlinger T, Chantziaras I, Boriani E, Radeski M, Bruce M, Queenan K, Häsler B. A Systems Approach to Evaluate One Health Initiatives. Front Vet Sci 2018; 5:23. [PMID: 29594154 PMCID: PMC5854661 DOI: 10.3389/fvets.2018.00023] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 02/05/2018] [Indexed: 11/13/2022] Open
Abstract
Challenges calling for integrated approaches to health, such as the One Health (OH) approach, typically arise from the intertwined spheres of humans, animals, and ecosystems constituting their environment. Initiatives addressing such wicked problems commonly consist of complex structures and dynamics. As a result of the EU COST Action (TD 1404) "Network for Evaluation of One Health" (NEOH), we propose an evaluation framework anchored in systems theory to address the intrinsic complexity of OH initiatives and regard them as subsystems of the context within which they operate. Typically, they intend to influence a system with a view to improve human, animal, and environmental health. The NEOH evaluation framework consists of four overarching elements, namely: (1) the definition of the initiative and its context, (2) the description of the theory of change with an assessment of expected and unexpected outcomes, (3) the process evaluation of operational and supporting infrastructures (the "OH-ness"), and (4) an assessment of the association(s) between the process evaluation and the outcomes produced. It relies on a mixed methods approach by combining a descriptive and qualitative assessment with a semi-quantitative scoring for the evaluation of the degree and structural balance of "OH-ness" (summarised in an OH-index and OH-ratio, respectively) and conventional metrics for different outcomes in a multi-criteria-decision-analysis. Here, we focus on the methodology for Elements (1) and (3) including ready-to-use Microsoft Excel spreadsheets for the assessment of the "OH-ness". We also provide an overview of Element (2), and refer to the NEOH handbook for further details, also regarding Element (4) (http://neoh.onehealthglobal.net). The presented approach helps researchers, practitioners, and evaluators to conceptualise and conduct evaluations of integrated approaches to health and facilitates comparison and learning across different OH activities thereby facilitating decisions on resource allocation. The application of the framework has been described in eight case studies in the same Frontiers research topic and provides first data on OH-index and OH-ratio, which is an important step towards their validation and the creation of a dataset for future benchmarking, and to demonstrate under which circumstances OH initiatives provide added value compared to disciplinary or conventional health initiatives.
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Affiliation(s)
- Simon R. Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | | | - Mijalche Santa
- Faculty of Economics—Skopje, Saints Cyril and Methodius University of Skopje, Skopje, Macedonia
| | - Maurizio Aragrande
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Massimo Canali
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Timothy Ehlinger
- Center for Global Health Equity, University of Wisconsin Milwaukee, Milwaukee, WI, United States
| | | | - Elena Boriani
- Global Decision Support Initiative (GDSI), Technical University of Denmark, Kongens Lyngby, Denmark
- National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Miroslav Radeski
- Faculty of Veterinary Medicine, Saints Cyril and Methodius University of Skopje, Skopje, Macedonia
| | - Mieghan Bruce
- School of Veterinary and Life Science, Murdoch University, Perth, WA, Australia
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14
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Hitziger M, Esposito R, Canali M, Aragrande M, Häsler B, Rüegg SR. Knowledge integration in One Health policy formulation, implementation and evaluation. Bull World Health Organ 2018. [PMID: 29531420 PMCID: PMC5840631 DOI: 10.2471/blt.17.202705] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The One Health concept covers the interrelationship between human, animal and environmental health and requires multistakeholder collaboration across many cultural, disciplinary, institutional and sectoral boundaries. Yet, the implementation of the One Health approach appears hampered by shortcomings in the global framework for health governance. Knowledge integration approaches, at all stages of policy development, could help to address these shortcomings. The identification of key objectives, the resolving of trade-offs and the creation of a common vision and a common direction can be supported by multicriteria analyses. Evidence-based decision-making and transformation of observations into narratives detailing how situations emerge and might unfold in the future can be achieved by systems thinking. Finally, transdisciplinary approaches can be used both to improve the effectiveness of existing systems and to develop novel networks for collective action. To strengthen One Health governance, we propose that knowledge integration becomes a key feature of all stages in the development of related policies. We suggest several ways in which such integration could be promoted.
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Affiliation(s)
- Martin Hitziger
- Epidemiology Section, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, 8057 Zürich, Switzerland
| | - Roberto Esposito
- External Relation Office, National Institute of Health, Rome, Italy
| | - Massimo Canali
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Aragrande
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Barbara Häsler
- Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Simon R Rüegg
- Epidemiology Section, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, 8057 Zürich, Switzerland
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15
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Boriani E, Esposito R, Frazzoli C, Fantke P, Hald T, Rüegg SR. Framework to Define Structure and Boundaries of Complex Health Intervention Systems: The ALERT Project. Front Public Health 2017; 5:182. [PMID: 28804707 PMCID: PMC5532392 DOI: 10.3389/fpubh.2017.00182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 07/06/2017] [Indexed: 11/16/2022] Open
Abstract
Health intervention systems are complex and subject to multiple variables in different phases of implementation. This constitutes a concrete challenge for the application of translational science in real life. Complex systems as health-oriented interventions call for interdisciplinary approaches with carefully defined system boundaries. Exploring individual components of such systems from different viewpoints gives a wide overview and helps to understand the elements and the relationships that drive actions and consequences within the system. In this study, we present an application and assessment of a framework with focus on systems and system boundaries of interdisciplinary projects. As an example on how to apply our framework, we analyzed ALERT [an integrated sensors and biosensors’ system (BEST) aimed at monitoring the quality, health, and traceability of the chain of the bovine milk], a multidisciplinary and interdisciplinary project based on the application of measurable biomarkers at strategic points of the milk chain for improved food security (including safety), human, and ecosystem health (1). In fact, the European food safety framework calls for science-based support to the primary producers’ mandate for legal, scientific, and ethical responsibility in food supply. Because of its multidisciplinary and interdisciplinary approach involving human, animal, and ecosystem health, ALERT can be considered as a One Health project. Within the ALERT context, we identified the need to take into account the main actors, interactions, and relationships of stakeholders to depict a simplified skeleton of the system. The framework can provide elements to highlight how and where to improve the project development when project evaluations are required.
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Affiliation(s)
- Elena Boriani
- Global Decision Support Initiative (GDSI), Technical University of Denmark, Kongens Lyngby, Denmark.,National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Roberto Esposito
- External Relations Office, Istituto Superiore di Sanità, Rome, Italy
| | - Chiara Frazzoli
- Department of Cardiovascular, Dysmetabolic and Aging-Associated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Peter Fantke
- Global Decision Support Initiative (GDSI), Technical University of Denmark, Kongens Lyngby, Denmark.,Quantitative Sustainability Assessment Division, Department of Management Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Tine Hald
- Global Decision Support Initiative (GDSI), Technical University of Denmark, Kongens Lyngby, Denmark.,National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Simon R Rüegg
- Vetsuisse Faculty, Section of Epidemiology, University of Zurich, Zurich, Switzerland
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16
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Jaeger S, Virchow F, Torgerson PR, Bischoff M, Biner B, Hartnack S, Rüegg SR. Test characteristics of milk amyloid A ELISA, somatic cell count, and bacteriological culture for detection of intramammary pathogens that cause subclinical mastitis. J Dairy Sci 2017. [PMID: 28647334 DOI: 10.3168/jds.2016-12446] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bovine mastitis is an important disease in the dairy industry, causing economic losses as a result of withheld milk and treatment costs. Several studies have suggested milk amyloid A (MAA) as a promising biomarker in the diagnosis of mastitis. In the absence of a gold standard for diagnosis of subclinical mastitis, we estimated the diagnostic test accuracy of a commercial MAA-ELISA, somatic cell count (SCC), and bacteriological culture using Bayesian latent class modeling. We divided intramammary infections into 2 classes: those caused by major pathogens (e.g., Escherichia coli, Staphylococcus aureus, streptococci, and lacto-/enterococci) and those caused by all pathogens (major pathogens plus Corynebacterium bovis, coagulase-negative staphylococci, Bacillus spp., Streptomyces spp.). We applied the 3 diagnostic tests to all samples. Of 433 composite milk samples included in this study, 275 (63.5%) contained at least 1 colony of any bacterial species; of those, 56 contained major pathogens and 219 contained minor pathogens. The remaining 158 samples (36.5%) were sterile. We determined 2 different thresholds for the MAA-ELISA using Bayesian latent class modeling: 3.9 µg/mL to detect mastitis caused by major pathogens and 1.6 µg/mL to detect mastitis caused by all pathogens. The optimal SCC threshold for identification of subclinical mastitis was 150,000 cells/mL; this threshold led to higher specificity (Sp) than 100,000 cells/mL. Test accuracy for major-pathogen intramammary infections was as follows: SCC, sensitivity (Se) 92.6% and Sp 72.9%; MAA-ELISA, Se 81.4% and Sp 93.4%; bacteriological culture, Se 23.8% and Sp 95.2%. Test accuracy for all-pathogen intramammary infections was as follows: SCC, sensitivity 90.3% and Sp 71.8%; MAA-ELISA, Se 88.0% and Sp 65.2%; bacteriological culture, Se 83.8% and Sp 54.8%. We suggest the use of SCC and MAA-ELISA as a combined screening procedure for situations such as a Staphylococcus aureus control program. With Bayesian latent class analysis, we were able to identify a more differentiated use of the 3 diagnostic tools. The MAA-ELISA is a valuable addition to existing tools for the diagnosis of subclinical mastitis.
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Affiliation(s)
- S Jaeger
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, 8057 Zurich, Switzerland; Clinica Alpina SA, Center for Veterinary Medicine, Buorna, 7550 Scuol, Switzerland
| | - F Virchow
- Clinica Alpina SA, Center for Veterinary Medicine, Buorna, 7550 Scuol, Switzerland
| | - P R Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, 8057 Zurich, Switzerland
| | - M Bischoff
- Clinica Alpina SA, Center for Veterinary Medicine, Buorna, 7550 Scuol, Switzerland
| | - B Biner
- Clinica Alpina SA, Center for Veterinary Medicine, Buorna, 7550 Scuol, Switzerland
| | - S Hartnack
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, 8057 Zurich, Switzerland
| | - S R Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 270, 8057 Zurich, Switzerland.
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17
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Machalaba C, Smith KM, Awada L, Berry K, Berthe F, Bouley TA, Bruce M, Cortiñas Abrahantes J, El Turabi A, Feferholtz Y, Flynn L, Fournié G, Andre A, Grace D, Jonas O, Kimani T, Le Gall F, Miranda JJ, Peyre M, Pinto J, Ross N, Rüegg SR, Salerno RH, Seifman R, Zambrana-Torrelio C, Karesh WB. One Health Economics to confront disease threats. Trans R Soc Trop Med Hyg 2017; 111:235-237. [PMID: 29044367 PMCID: PMC5914424 DOI: 10.1093/trstmh/trx039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 04/10/2017] [Accepted: 07/12/2017] [Indexed: 01/01/2023] Open
Abstract
Global economic impacts of epidemics suggest high return on investment in prevention and One Health capacity. However, such investments remain limited, contributing to persistent endemic diseases and vulnerability to emerging ones. An interdisciplinary workshop explored methods for country-level analysis of added value of One Health approaches to disease control. Key recommendations include: 1. systems thinking to identify risks and mitigation options for decision-making under uncertainty; 2. multisectoral economic impact assessment to identify wider relevance and possible resource-sharing, and 3. consistent integration of environmental considerations. Economic analysis offers a congruent measure of value complementing diverse impact metrics among sectors and contexts.
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Affiliation(s)
| | | | - Lina Awada
- World Organisation for Animal Health, Paris 75017, France
| | - Kevin Berry
- Institute of Social and Economic Research, University of Alaska-Anchorage, Anchorage 99508, USA
| | | | | | | | | | - Anas El Turabi
- Graduate School of Arts and Sciences, Harvard University, Cambridge 02138, USA
| | | | | | | | | | - Delia Grace
- International Livestock Research Institute, Nairobi 00100, Kenya
| | - Olga Jonas
- Global Health Institute, Harvard University, Cambridge 02138, USA
| | - Tabitha Kimani
- Emergency Centre for Transboundary Animal Diseases-Eastern Africa, Food and Agriculture Organization of the UN, Nairobi, Kenya
| | | | | | | | - Julio Pinto
- Animal Production and Health Division, Food and Agriculture Organization of the UN, Rome 00153, Italy
| | - Noam Ross
- EcoHealth Alliance, New York 10001, USA
| | - Simon R Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich CH-8057, Switzerland
| | | | | | | | - William B Karesh
- EcoHealth Alliance, New York 10001, USA
- World Organisation for Animal Health, Paris 75017, France
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18
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Rüegg SR, Machalaba C, McMahon BJ, Häsler B, Errecaborde KM, Pelican K, Kock R. Expectations for a new WHO Director General: health in a rapidly changing environment. Lancet Planet Health 2017; 1:e44-e45. [PMID: 29851574 DOI: 10.1016/s2542-5196(17)30022-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 01/09/2017] [Indexed: 06/08/2023]
Affiliation(s)
- Simon R Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich CH-8057, Switzerland.
| | | | - Barry J McMahon
- UCD School of Agriculture & Food Science, University College Dublin, Dublin, Ireland
| | | | | | - Katharine Pelican
- College of Veterinary Medicine, University of Minnesota, Minneapolis, MN, USA
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19
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Rüegg SR, McMahon BJ, Häsler B, Esposito R, Nielsen LR, Ifejika Speranza C, Ehlinger T, Peyre M, Aragrande M, Zinsstag J, Davies P, Mihalca AD, Buttigieg SC, Rushton J, Carmo LP, De Meneghi D, Canali M, Filippitzi ME, Goutard FL, Ilieski V, Milićević D, O'Shea H, Radeski M, Kock R, Staines A, Lindberg A. A Blueprint to Evaluate One Health. Front Public Health 2017; 5:20. [PMID: 28261580 PMCID: PMC5311072 DOI: 10.3389/fpubh.2017.00020] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/30/2017] [Indexed: 11/13/2022] Open
Abstract
One Health (OH) positions health professionals as agents for change and provides a platform to manage determinants of health that are often not comprehensively captured in medicine or public health alone. However, due to the organization of societies and disciplines, and the sectoral allocation of resources, the development of transdisciplinary approaches requires effort and perseverance. Therefore, there is a need to provide evidence on the added value of OH for governments, researchers, funding bodies, and stakeholders. This paper outlines a conceptual framework of what OH approaches can encompass and the added values they can provide. The framework was developed during a workshop conducted by the “Network for Evaluation of One Health,” an Action funded by the European Cooperation in Science and Technology. By systematically describing the various aspects of OH, we provide the basis for measuring and monitoring the integration of disciplines, sectors, and stakeholders in health initiatives. The framework identifies the social, economic, and environmental drivers leading to integrated approaches to health and illustrates how these evoke characteristic OH operations, i.e., thinking, planning, and working, and require supporting infrastructures to allow learning, sharing, and systemic organization. It also describes the OH outcomes (i.e., sustainability, health and welfare, interspecies equity and stewardship, effectiveness, and efficiency), which are not possible to obtain through sectoral approaches alone, and their alignment with aspects of sustainable development based on society, environment, and economy.
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Affiliation(s)
- Simon R Rüegg
- Vetsuisse-Faculty, Section for Veterinary Epidemiology, University of Zurich , Zurich , Switzerland
| | - Barry J McMahon
- UCD School of Agriculture and Food Science, University College Dublin , Dublin , Ireland
| | | | | | | | - Chinwe Ifejika Speranza
- Institute of Geography and Centre for Development and Environment, University of Bern , Bern , Switzerland
| | | | | | - Maurizio Aragrande
- Agriculture and Food Science Department, University of Bologna , Bologna , Italy
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, University of Basel , Basel , Switzerland
| | | | - Andrei Daniel Mihalca
- Department of Parasitology and Parasitic Diseases, University of Agricultural Sciences and Veterinary Medicine , Cluj Napoca , Romania
| | | | - Jonathan Rushton
- Faculty of Health and Life Sciences, University of Liverpool , Liverpool , UK
| | - Luís P Carmo
- Veterinary Public Health Institute, University of Bern , Bern , Switzerland
| | - Daniele De Meneghi
- Department of Veterinary Sciences, University of Turin , Grugliasco-Turin , Italy
| | - Massimo Canali
- Agriculture and Food Science Department, University of Bologna , Bologna , Italy
| | - Maria E Filippitzi
- Veterinary Epidemiology Unit, Faculty of Veterinary Medicine, Ghent University , Ghent , Belgium
| | | | - Vlatko Ilieski
- Faculty of Veterinary Medicine, Ss Cyril and Methodius University , Skopje , Macedonia
| | | | | | - Miroslav Radeski
- Faculty of Veterinary Medicine, Ss Cyril and Methodius University , Skopje , Macedonia
| | | | - Anthony Staines
- School of Nursing & Human Sciences, Dublin City University , Dublin , Ireland
| | - Ann Lindberg
- National Veterinary Institute , Uppsala , Sweden
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20
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Otero-Abad B, Rüegg SR, Hegglin D, Deplazes P, Torgerson PR. Mathematical modelling of Echinococcus multilocularis abundance in foxes in Zurich, Switzerland. Parasit Vectors 2017; 10:21. [PMID: 28077161 PMCID: PMC5225524 DOI: 10.1186/s13071-016-1951-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 12/22/2016] [Indexed: 11/30/2022] Open
Abstract
Background In Europe, the red fox (Vulpes vulpes) is the main definitive host of Echinococcus multilocularis, the aetiological agent of a severe disease in humans called alveolar echinococcosis. The distribution of this zoonotic parasite among the fox population is remarkably aggregated with few heavily infected animals harbouring much of the parasite burdens and being responsible for most of the environmental parasitic egg contamination. Important research questions explored were: (i) spatial differences in parasite infection pressure related to the level of urbanization; (ii) temporal differences in parasite infection pressure in relation to time of the year; (iii) is herd immunity or an age-dependent infection pressure responsible for the observed parasite abundance; (iv) assuming E. multilocularis infection is a clumped process, how many parasites results from a regular infection insult. Methods By developing and comparing different transmission models we characterised the spatio-temporal variation of the infection pressure, in terms of numbers of parasites that foxes acquired after exposure per unit time, in foxes in Zurich (Switzerland). These included the variations in infection pressure with age of fox and season and the possible regulating effect of herd immunity on parasite abundance. Results The model fitting best to the observed data supported the existence of spatial and seasonal differences in infection pressure and the absence of parasite-induced host immunity. The periodic infection pressure had different amplitudes across urbanization zones with higher peaks during autumn and winter. In addition, the model indicated the existence of variations in infection pressure among age groups in foxes from the periurban zone. Conclusions These heterogeneities in infection exposure have strong implications for the implementation of targeted control interventions to lower the intensity of environmental contamination with parasite eggs and, ultimately, the infection risk to humans. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1951-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Belen Otero-Abad
- Section for Veterinary Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Simon R Rüegg
- Section for Veterinary Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Daniel Hegglin
- Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Paul R Torgerson
- Section for Veterinary Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
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Rüegg SR, Regenscheit N, Origgi FC, Kaiser C, Borel N. Detection of Chlamydia pneumoniae in a collection of captive snakes and response to treatment with marbofloxacin. Vet J 2015; 205:424-6. [PMID: 26049258 DOI: 10.1016/j.tvjl.2015.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 05/04/2015] [Accepted: 05/09/2015] [Indexed: 11/28/2022]
Abstract
In a collection of 58 snakes comprising predominantly Eurasian vipers in Switzerland, five snakes died unexpectedly during hibernation from 2009 to 2012. In one snake, organisms resembling chlamydiae were detected by immunohistochemistry in multiple histiocytic granulomas. Real-time quantitative PCR and microarray analysis were used to determine the presence of Chlamydia pneumoniae in tissue samples and cloacal/choanal swabs from snakes in the collection; 8/53 (15.1%) of the remaining snakes were positive. Although one infected snake had suppurative periglossitis, infection with C. pneumoniae did not appear to be associated with specific clinical signs in snakes. Of seven snakes treated with 5 mg/kg marbofloxacin IM once daily, five became PCR negative for C. pneumoniae following treatment, whereas one animal remained positive and one snake was lost to follow-up.
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Affiliation(s)
- S R Rüegg
- Section of Veterinary Epidemiology, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 270, 8057 Zürich, Switzerland.
| | - N Regenscheit
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012 Bern, Switzerland
| | - F C Origgi
- Centre of Fish and Wildlife Health, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012 Bern, Switzerland
| | - C Kaiser
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 268, 8057 Zürich, Switzerland
| | - N Borel
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zürich, Winterthurerstrasse 268, 8057 Zürich, Switzerland
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Rüegg SR, Torgerson P, Deplazes P, Mathis A. Age-dependent dynamics of Theileria equi and Babesia caballi infections in southwest Mongolia based on IFAT and/or PCR prevalence data from domestic horses and ticks. Parasitology 2007; 134:939-47. [PMID: 17306055 DOI: 10.1017/s0031182007002405] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Epidemiological factors of tick-borne equine piroplasmoses, caused by Theileria equi and Babesia caballi, were investigated using logistic regression (GLM) and general additive models (GAM) based on the prevalences determined in 510 domestic horses and in ticks in S.W. Mongolia by indirect immunofluorescence antibody test (IFAT) and/or multiplex PCR. Prevalences of T. equi and B. caballi in horses were 66.5% (95% CI: 62.1-70.7) and 19.1% (15.6-22.9), respectively by PCR and 78.8% (74.9-82.3) and 65.7% (61.3-69.9) by IFAT. Of 166 ticks analysed from PCR- and IFAT-negative horses 1 was PCR positive for B. caballi and none for T. equi. GAM demonstrated non-linear increasing proportions of T. equi-PCR and -IFAT positive horses with age suggesting persistent infection. In contrast, the B. caballi-PCR prevalence decreased with age despite a concurrent increase in the proportion of IFAT-positive animals suggesting parasite elimination. The tick (Dermacentor nuttalli) burden of the horses increased with age and decreased with advancing season. Geldings were more likely to be infected with, and seroconvert to, T. equi. Neither herd affiliation, date of sample collection nor abundance of tick infestation had a significant influence on parasite prevalence.
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Affiliation(s)
- S R Rüegg
- Institute of Parasitology, University of Zurich, Winterthurerstrasse 266A, 8057 Zurich, Switzerland
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Rüegg SR, Torgerson PR, Doherr MG, Deplazes P, Böse R, Robert N, Walzer C. EQUINE PIROPLASMOSES AT THE REINTRODUCTION SITE OF THE PRZEWALSKI'S HORSE (EQUUS FERUS PRZEWALSKII) IN MONGOLIA. J Wildl Dis 2006; 42:518-26. [PMID: 17092882 DOI: 10.7589/0090-3558-42.3.518] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Piroplasmosis has been identified as a possible cause of mortality in reintroduced Przewalski's horses (Equus ferus przewalskii) in the Dsungarian Gobi (Mongolia). A cross-sectional and a longitudinal study were conducted in a representative sample (n = 141) of the resident domestic horse population and in 23 Przewalski's horses to assess the prevalence of Theileria equi and Babesia caballi. Piroplasms were detected in blood by light microscopy in 6.7% (95% confidence interval [CI]: 3.6-12.2%) of the domestic horse samples. Antibody prevalence was 88.6% (95% CI: 82.4-92.9%) for T. equi and 75.2% (95% CI: 67.4-81.6%) for B. caballi. Antibody prevalence did not change over time, but antibody prevalence for both piroplasms were significantly lower in animals less than 1 yr of age. For both piroplasms, the prevalence of presumably maternal antibodies (falling titers) in foals was 100%. Only one of 16 foals seroconverted against T. equi during the study period, despite that piroplasms were found in two other individuals. The incidence density (ID) of T. equi in foals was therefore 0.0012 seroconversions per horse day (95% CI: 0.00029-0.0057). In contrast, yearlings had an ID of 0.0080 (95% CI: 0.0049-0.010) for T. equi and 0.0064 (95% CI: 0.0036-0.0093) for B. caballi, and in seven individuals piroplasms were detected. The seroprevalence of both piroplasms rose from 20% in spring to 100% in autumn. Comparison of domestic and Przewalski's horses resulted in a standardized prevalence ratio (SPR) of 0.98 (95% CI: 0.80-1.24, not significant) for B. caballi; in contrast, the prevalence of T. equi in Przewalski's horses was significantly lower than expected (SPR = 0.51, 95% CI: 0.50-0.64).
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Affiliation(s)
- Simon R Rüegg
- Institute of Parasitology, University of Zürich, Winterthurstrasse 266A, CH-8057 Zürich, Switzerland
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Robert N, Walzer C, Rüegg SR, Kaczensky P, Ganbaatar O, Stauffer C. PATHOLOGIC FINDINGS IN REINTRODUCED PRZEWALSKI'S HORSES (EQUUS CABALLUS PRZEWALSKII) IN SOUTHWESTERN MONGOLIA. J Zoo Wildl Med 2005; 36:273-85. [PMID: 17323569 DOI: 10.1638/03-035.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The Przewalski's horse (Equus caballus przewalskii) was extinct in the wild by the mid 1960s. The species has survived because of captive breeding only. The Takhin Tal reintroduction project is run by the International Takhi Group; it is one of two projects reintroducing horses to the wild in Mongolia. In 1997 the first harem group was released. The first foals were successfully raised in the wild in 1999. Currently, 63 Przewalski's horses live in Takhin Tal. Little information exists on causes of mortality before the implementation of a disease-monitoring program in 1998. Since 1999, all dead horses recovered (n = 28) have been examined and samples collected and submitted for further investigation. Equine piroplasmosis, a tick-transmitted disease caused by Babesia caballi or Theileria equi, is endemic in Takhin Tal and was identified as the cause of death of four stallions and one stillborn foal. In December 2000, wolf predation was implicated in the loss of several Przewalski's horses. However, thorough clinical, pathologic, and bacteriologic investigations performed on dead and surviving horses of this group revealed lesions compatible with strangles. The extreme Mongolian winter of 2000-2001 is thought to have most probably weakened the horses, making them more susceptible to opportunistic infection and subsequent wolf predation. Other occasional causes of death since 1999 were trauma, exhaustion, wasting, urolithiasis, pneumonia, abortion, and stillbirth. The pathologic examination of the Przewalski's horses did not result in a definitive diagnosis in each case. Several disease factors were found to be important in the initial phase of the reintroduction, which could potentially jeopardize the establishment of a self-sustaining population.
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Affiliation(s)
- Nadia Robert
- Center for Fish and Wildlife Health, Institute of Animal Pathology, University of Berne, Länggass-Strasse 122, CH-3001 Berne, Switzerland
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