Published on February 14, 2008
Slide1: Nina Marano DVM MPH Dipl ACVPM Division of Global Migration and Quarantine One Medicine, Actually Slide2: Zoonotic & Vectorborne Diseases Zoonoses: “Those diseases and infections which are naturally transmitted between vertebrate animals and man.” Emerging zoonoses may include Old diseases, new hosts Old diseases, new areas New diseases Ref: The Emergence of Zoonotic Diseases, Workshop Summary. Institute of Medicine report, National Academy Press, 2002 Slide3: Risk Factors for Human Disease Emergence 1415 species of infectious agents reported to cause disease in humans Viruses, prions, bacteria, rickettsia, fungi, protozoa, helminths 868/1415 (61%) zoonotic 175 emerging infectious diseases 132/175 (75%) emerging zoonoses 37/132 (28%) emerging vectorborne diseases Taylor et al. Risk factors for disease emergence. 2001, Philosophical Transactions, The Royal Society, London Slide4: A wide variety of animal species carry microbes that infect humans Carnivores 43% Domestic Livestock 39% Rodents 23% Other primates 13% Birds 10% Marine Mammals 5% Bats 2% Slide5: Paleolithic Age Nomadic, small populations Shift from herbivorous diet Parasitic infections Humans as Hunters and Gatherers Adapted from “Beasts of the Earth: Animals Humans and Disease” E. Fuller Torrey MD and Robert Yolken MD Slide6: 10,000 years ago New social order due to agriculture Zoonoses through animal domestication Increases in infectious diseases Epidemics in non-immune populations Humans as Farmers Adapted from “Beasts of the Earth: Animals Humans and Disease” E. Fuller Torrey MD and Robert Yolken MD Humans as Traders: Microbes Get Passports: Humans as Traders: Microbes Get Passports Increasing trade and travel by shipping Warfare and resettlement Unprecedented human movement led to pathogen dispersal and spread of Yellow Fever, smallpox, tuberculosis Rodent-borne diseases - plague Adapted from “Beasts of the Earth: Animals Humans and Disease” E. Fuller Torrey MD and Robert Yolken MD Slide8: Humans as Warriors: Animal Origins of Bioterrorism Brucellosis Q Fever Tularemia Glanders Anthrax Plague Aerosolizable, hardy, capable of infecting humans and a wide variety of animals Adapted from “Beasts of the Earth: Animals Humans and Disease” E. Fuller Torrey MD and Robert Yolken MD History of Biological Warfare: History of Biological Warfare 1346: Tartars lob cadavers of bubonic plague victims into the Crimean city of Kaffa Humans as Pet Owners: Humans as Pet Owners Adapted from “Beasts of the Earth: Animals Humans and Disease” E. Fuller Torrey MD and Robert Yolken MD Pet Ownership and Utilization of Veterinary Services in the US: Pet Ownership and Utilization of Veterinary Services in the US Owning dogs: 36% Owning cats: 31% Owning horses: 2.9% Owning birds: 4.6% Owners using services of veterinarian in previous two years: Dog: 88.7% Cat: 72.9% Horse: 66.3% Bird: 15.8% Source: AVMA, U.S. Pet Ownership & Demographics Sourcebook, 2002 Vectorborne Infections: Public Health Implications April 2007 EID Theme Issue : Vectorborne Infections: Public Health Implications April 2007 EID Theme Issue Zoonotic Diseases of Concern in the Americas*: Zoonotic Diseases of Concern in the Americas* Current: West Nile fever, bat and wildlife rabies, equine encephalitis, hantavirus, monkeypox, avian influenza, q-fever, plague, anthrax, lyme, leptospirosis, bartonellosis, leishmaniasis, echinococcus, BSE, coccidiomycosis Future: Yellow fever, SARS, hepatitis E, poxviruses, Rift Valley Fever, meliodosis, potential for tranmission of Chronic Wasting Disease *As identified by Regional Surveillance Working Group from WHO/FAO/OIE Consultation on Emerging Zoonoses Slide15: Exhibition at zoos Education and research Scientific conservation programs Incidental/Accidental Use as food and products Tourism and Immigration Commercial pet trade Emerging Zoonotic Diseases: The Role of Commerce Slide16: Live Animal Importation - 2005 87,991 mammals including 29 species of rodents 259,000 birds 1.3 million reptiles 5.1 million amphibians 203 million fish U.S. Fish & Wildlife Service Data Emerging Zoonotic Diseases and Commercial Pet Trade Slide17: Emerging Zoonotic Diseases: The Role of Humans Humans are ultimately responsible for most patterns of zoonotic disease emergence Human population growth land use, habitat destruction Human interactions with wildlife food, sport, pet trade Global transportation increases speed with which pathogens are disseminated High speed air travel Movement of animals and arthropod vectors Slide18: Speed of Global Travel in Relation to World Population Growth From: Murphy and Nathanson. Semin. Virol. 5, 87, 1994 Slide19: Immigrant and Refugee Arrivals = 437,864 Traveler Visits Abroad > 1 night =63,502,000 International Passenger Arrivals = 49,401,528 Wild Mammals Imported = 88,000 (Photo Delta Sky Mag.) Slide20: Wildlife EID Domestic Animal EID Human EID Translocation Human encroachment Ex situ contact Ecological manipulation Global travel Urbanization Biomedical manipulation Technology and Industry Agricultural Intensification Encroachment Introduction “Spill over” & “Spill back” Emerging Infectious Diseases Daszak P. et.al. Science 2000 287:443 Slide21: Early Detection--Front Line Response Expecting the Unexpected West Nile Virus, 1999 Undetected entry of infected human, bird, mosquito: West Nile Virus, 1999 Undetected entry of infected human, bird, mosquito Time Line to Confirmation of WNV, 1999: Time Line to Confirmation of WNV, 1999 1st patient admitted to hospital, Queens human sera tested positive for SLE Veterinary pathologist suspects human and bird epidemics linked CDC confirms WNV Introduction Early Detection: Early Detection There is a history of people serving as sentinels for disease in animal populations There is a desire to reverse this situation Slide25: Time (days) No. Affected Seek Care Symptoms Infectious Disease Outbreak Source: Minnesota Dept of Health Slide26: Emerging Zoonotic Diseases: The Role of Diagnosis and Surveillance Diseases may appear different in humans than animals - Nipah – respiratory disease in pigs, encephalitis in humans - Time delay in association may result in more cases or outbreak Human and animal surveillance systems often not linked - West Nile virus emergence Rare diseases may not be high on differential Bat-associated rabies virus infection in humans May lead to further spread (such as transplant- associated cases) Global Warming: Impact on Malaria: Global Warming: Impact on Malaria Slide29: The World’s Most Dangerous Animal Vectorborne Disease Precautions & Advice to Travelers: Vectorborne Disease Precautions & Advice to Travelers Avoid exposure Appropriate clothing Bed nets Fans/screens Tick removal Insect repellents Antimalarials Vaccines CDC in 1946: CDC in 1946 Communicable Disease Center opens in the Office of Malaria Control in War Areas We are making progress: We are making progress Raise awareness of emerging and reemerging diseases at home and abroad International Meeting on Emerging Diseases Feb ’07 World Rabies Day Sept 8 2007 Train the future vectorborne disease workforce Skills needed: Medical entomologists, vector biologists, mammologists, ornithologists Engage academia - American Schools of Public Health/American Association of Veterinary Medical Schools Symposium April ’07 CDC Veterinary Student Day ‘06 & ‘08 We are making progress: We are making progress Train the US veterinary/medical workforce to recognize emerging diseases Travelers’ health – incorporate travel medicine into medical school curricula and into primary care practice Plum Island – foreign animal disease training Animals in commerce - Partner with industry Pet Zoonoses Coalition Pets in the home - Improve veterinary-medical clinical collaborations & teamwork Kids, Docs, Pets, Vets Campaigns Invest in veterinary public health infrastructure abroad Stipends for veterinarians for Field Epi Training Programs USAID, USDA & HHS funding for avian influenza response Look for opportunities to engage in collaborative research Southeastern Center for Emerging Biologic Threats Slide34: Major American Epidemics of Yellow Fever, 1793-1905 From “The Great Fever” www.pbs.org CDC in 2007 The National Center for Zoonotic, Vectorborne and Enteric Diseases: CDC in 2007 The National Center for Zoonotic, Vectorborne and Enteric Diseases “ There is a blurring of boundaries, disciplines, and biological systems found in our environment and animal and human populations that hold great promise and need for our future understanding, control, and prevention of infectious diseases.” Dr. Lonnie King, Director NCZVED Acknowledgements: Acknowledgements CDC Jennifer McQuiston DVM MS Paul Arguin MD MPH Lonnie King DVM PhD Tracee Treadwell DVM Heather Bair-Brake DVM Richard Meyer PhD Emory University Jim Hughes MD University of Minnesota Marguerite Pappiaoanou DVM PhD The findings and conclusions in this presentation are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.