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Understanding the Factors of Animal Disease Emergence: A World of One Health Brussels, Belgium October 17, 2008 Emerging Animal Diseases LONNIE J KING DVM, MS, MPA, DACVPM DIRECTOR, NATIONAL CENTER FOR ZOONOTIC, VECTOR--BORNE, & ENTERIC DISEASES CENTERS FOR DISEASE CONTROL & PREVENTION Convergence Model Genetic and Biological Factors Physical and Environmental Factors Animals EID Humans Wildlife Social, Political, and Economic Factors Ecological Factors Why Diseases Emerge Genetic and biological factors – Microbial adaptation and change – Human susceptibility to Infection Physical environmental factors – Climate and weather – Economic development and land use Ecological factors – Changing ecosystems – Human demographics and behavior Social, political, and economic factors – – – – – International Travel and commerce Poverty and Social inequity War and Famine Lack of political will Intent to harm Factors Contributing to Emerging Animal Diseases Movements of animals and people Disruption of the environment Crossing species boundaries Invasive Species Human lifestyle changes Husbandry and production systems Global food system Climate change Global Trends in Emerging Infection Diseases (EID) 335 EID events: 1940-2004 Steady increase with peak decade in 1980 20.9% drug-resistant microbes 22.8% vector-borne (28.8% in the last decade) Jones, K.E. et al Global trends in emerging infectious disease Nature 451:21 2/2008 Stages of Pathogen Evolution Source: Wolfe, ND, et al. Nature. May 2007. Foresight Analysis EID are the “New normal” Expect 3-4 new EID annually; 8-34 by 2015 87 new EID since 1980 - 58 viruses… 49 RNA - mostly zoonotic Found worldwide but proximity to animal populations or products is the key risk factor Change in the host-pathogen ecology will be the most important single driver The Convergence: A New Public Health Kaleidoscope Emphasizing One Health Human Health Animal Health Environmental Health ONE HEALTH One Health is the collaborative effort of multiple disciplines – working locally, nationally and globally - to attain optimal health of humans, animals and our environment. •Translocation •Encroachment •Introduction •“Spill over” & •“Spill back” •Wildlife •Domestic •Animal •Agricultural •Extensive Production Triple Threat— Infectious Diseases •Human •Human encroachment •Ex situ contact •Ecological manipulation •Human behaviors •Global travel •Urbanization •Biomedical •manipulation •Food processing/distribution •Technology and •After Daszak P. et.al. •Industry •Science 2000 287:443 Concepts of (Re)Emergence Microbes in search of disease “Spill-over” phenomenon Translocation Invasive species Anti-microbial resistance Pathogen pollution Signalment: microbial chatter The Convergence: A New Public Health Kaleidoscope Emphasizing One Health Human Health Animal Health Environmental Health Through the Lens of Human Health Trends in Global Population Global Population: 1950-2015 Total Less developed countries More developed countries Billions 8 7 6 5 4 3 2 1 0 1950 55 60 65 70 75 Source: US Bureau of the Census 80 85 90 95 2000 05 10 15 PNAS, 2004 Human Demographics Migration and Translocation is unparalleled Peri-Urban centers Immuno-compromised population Aging population- “baby boomers” Rapid growth in developing world Exposures to wildlife and vectors Recreational practices Shift to foods from animal-proteins Under-nutrition vs. Over-nutrition Healthcare vs. health promotion and prevention Health disparities and exposure bias The Convergence: A New Public Health Kaleidoscope Emphasizing One Health Human Health Animal Health Environmental Health Through the Lens of Animal Health Concentrated Animal Feeding Operations (CAFOs) Their Impact on Food Safety and Healthy Environments Livestock 2020 – The Next Food Revolution Global increase and demand for protein and food of animal origin Shift from poverty of 1-2 billion people to middle class “Westernization” of Asia and Latin America Concerns with sustainability Increases in emerging zoonoses through the concentration of people and animals Last year, over 21 billion food animals were produced to help feed a population of over 6 billion people resulting in trillions of pounds of products distributed worldwide. Projections toward 2020 indicate that the demand for animal protein will increase by 50%, especially in developing countries. “Double, double toil and trouble; Fire burn, and caldron bubble.” William Shakespeare Commerce and Trade - A New Built Environment of Global Enterprises World of “collapsed space” – smaller, faster and progressively more interconnected Annual global trade (2006) - $12 trillion 6% annual growth projected 90% of global trade is between private corporations Of the top 100 global economies, over half are private international companies 6 million food shipments come into the U.S. each year with a small % inspected Global Meat Trade is Highly Concentrated Worldwide Ship Traffic Nipah Virus Virus Carriers Fruit bats Peri-urban Slums Human population density Poultry population density Source: FAO, WHO, Rimsa, Rimsa, Mexico City April 2005 Human and animal density 140 60 120 50 100 40 80 30 60 20 40 10 20 0 0 50 100 150 200 250 300 350 400 450 Distance to Bangkok (km) human population (nb/km2/10) soybean (10 tons/km2) maize (tons/km2) chicken (nb/km2/10) pigs (nb/km2/10) cassava (tons/km2/2) Source: Gerber and others 2005. 500 Mean normalized crop production Human and livestock densities, and main feed production areas as affected by the distance to Bangkok Microbial View Annual Global Trade in Exotic Animals 4 million birds 640,000 reptiles 40,000 primates Illegal trade unknown – estimate $4-6 billion Wildlife Conservation Society Foodborne illness Top 10 infections Image source: CDC/Google Campylobacter Salmonella Clostridium perfringens Giardia lamblia Staphylococcus Toxoplasma gondii Shigella Yersinia enterocolitica E coli O157:H7 Ecosystem • 1/3 of the world’s population lives in scarce fresh water areas. • By 2025 2/3 of the world’s population will live in scarce fresh water areas. • 70% of our planet’s surface represents total water resources yet only 2.5% is fresh water. • Every year more than 3.4 million people die as a result of water related diseases. • 4,000 children die every day of diseases from ingestion of filthy water. Ecotone The edge or transition zone between two adjacent ecological systems Man-made Ecotone Along Route 3 in Laos • Winding through rice paddies, tea plantation, and villages in Malaysia, Thailand, Laos, and China, the road mirrors an ancient trade route linking Southeast Asia to the southern branches of the Silk Road. Route 3 makes it possible to drive from Singapore to Beijing. The road rarely follows a straight line as it meanders through rice fields and tea plantations. Challenges of transboundary transmission of communicable diseases, environmental degradation, and illegal migration are being addressed. Photo: Justin Mott for The New York Times C. gattii on Vancouver Island* First detected in animals High incidence of human infection (27.9 cases per million per year) Isolated from numerous environmental samples Continues to infect wild (Including marine) and companion animals as well as humans Human Cases Animal Cases *http://www.bccdc.org/downloads/pdf/epid/reports/C.gattii%20Surveillance%20Summary% 20BC%201999-2006.pdf Threats to Biodiversity Sixth Mass Extinction: 4 Billion Yr? Human destruction of ecosytems Overexploitation of species Human overpopulation Spread of agriculture: animal agriculture is 70% of total carbon footprint Pollution National Ecological Observatory Network (NEON) A continental-scale research platform for discovering and understanding the impacts of climate change, land-use change, and invasive species on ecology. Gathers long-term data on ecological responses of the biosphere to changes in land use and climate, and on feedbacks with the geosphere, hydrosphere, and atmosphere. Nature watch: a network of stations will measure the impact of human activity and invasive species on ecosystems on a huge scale. Past Challenges: Lessons Learned West Nile virus H5N1 avian influenza Ebola virus in gorillas SARS Nipah virus Lyme disease Whirling disease Chytridicomycosis MRSA One Health Integration of Professionals: Multiple disciplines working together toward the goal of optimal health for all.