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One Health: the small animal dimension
M. J. Day
Veterinary Record 2010 167: 847-849
doi: 10.1136/vr.c6492
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Feature
one medicine
One Health: the small animal
dimension
Earlier this year, the World Small Animal Veterinary Association (WSAVA) established a One Health committee with the remit of
positioning small companion animals in the global One Health framework. Here, Michael Day, the chairman of that committee,
explains how companion animals fit within the One Health concept
‘One Health’ or ‘One Medicine’ proposes
the unification of the medical and veterinary
professions with the establishment of
collaborative ventures in clinical care,
surveillance and control of cross-species
disease, education, and research into disease
pathogenesis, diagnosis, therapy and
vaccination. The concept encompasses the
human population, domestic animals and
wildlife, and the impact that environmental
changes (‘environmental health’) such
as global warming will have on these
populations (Monath and others 2010).
The concept is not a new one as
a number of enlightened individuals
historically practised One Health and are
regarded as the initiators of this field. In
2011, we celebrate the 250th anniversary
of the foundation of the first veterinary
school in Lyon by Claude Bourgelat, who
wrote ‘We have realised the intimacy of the
relation which exists between the human
and the animal machines; this relation is
such that either medicine will mutually
enlighten and perfect the other when we
discard a derisory, harmful prejudice.’
The greats of 19th century medical
research, Louis Pasteur (1822-1895), Robert
Koch (1843-1910) and Rudolph Virchow
(1821-1902), all investigated animal disease,
with Virchow stating ‘Between animal and
human medicine there is no dividing line –
nor should there be. The object is different
but the experience obtained constitutes the
basis of all medicine.’
In the UK, an early proponent of One
Health was Sir John McFadyean (18531941) who was dually qualified as both a
veterinary surgeon and medical physician
and undertook research into major zoonotic
diseases, largely at the Royal Veterinary
M. J. Day, BSc, BVMS, PhD, DSc, DiplECVP, FASM,
FRCPath, FRCVS,
School of Veterinary Sciences, University of Bristol,
Bristol BS40 5DU
E-mail: [email protected]
The close relationship
between pet animals
and people – the humancompanion animal bond – is
just one aspect of activity in
the small animal field that is
relevant to the One Health
concept
College in London (Pattison 1988). Sir
John also founded the Journal of Comparative
Pathology (in 1888), which remains an
important vehicle for dissemination of such
research (Day 2008).
Rediscovering One Health
The ‘rediscovery’ of the One Health concept
is widely attributed to the veterinary
epidemiologist Calvin W. Schwabe (Cardiff
and others 2008). Academia, government
and industry now well recognise the value
of collaboration between human and
veterinary physicians and scientists for the
benefit of both man and animals in areas as
diverse as experimental medical research,
public health, food and environmental
science, and bioterrorism. Numerous
recent initiatives have occurred in this area.
In 2005 the British Medical Association
and the British Veterinary Association
co-published complementary volumes of
the British Medical Journal and the Veterinary
Record, highlighting the links between the
professions (Alder and Easton 2005). The
theme of the 2007 American Veterinary
Medical Association (AVMA) convention
was One Health, following from the liaison
established in 2006 between the AVMA and
the American Medical Association (AMA)
(Enserink 2007). The keynote lecture at
the 2008 forum of the American College of
Veterinary Internal Medicine was entitled
‘One Health, One Medicine: a common
pathway for veterinary and human
medicine’, and One Health was a recurrent
theme at the 2008 International Conference
on Emerging Infectious Diseases.
The UK Comparative Clinical Science
Foundation has been established to
promote and fund research into diseases
affecting both man and animals (www.
onemedicine.org.uk) and in 2009 this group
hosted a symposium in London attended
by over 100 UK medical and veterinary
researchers (Anon 2009a). In Europe,
major European Union funding has been
allocated to the LUPA project, a genomic
study of canine diseases that may model
equivalent human disorders (Pennisi 2007)
(www.eurolupa.org), and the Federation
of Veterinarians of Europe (FVE) and
the World Small Animal Veterinary
Association (WSAVA) have both adopted
the One Health theme.
The most significant recent initiative
has been the focus on One Health by a
consortium of the World Organisation
for Animal Health (OIE), the World
Health Organization (WHO), the Food
and Agriculture Organization (FAO), the
United Nations Children’s Fund, the United
November 27, 2010 | Veterinary Record | 847
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Nations System Influenza Coordinator and
the World Bank. This group produced a
document on the coordination of medical
and veterinary health policies that was
adopted at a meeting of more than 100
country representatives in October 2008
(Anon 2009b). In April 2010, a tripartite
concept note on One Health was produced
by the OIE, WHO and FAO (Anon 2010a).
More recently, the establishment
of the One Health Commission in
the USA has been announced (www.
onehealthcommission.org). This is a
collaboration involving eight professional
organisations including the AVMA and
AMA that emerged from the AVMA One
Health Initiative Task Force (King and others
2008).
In addition to One Health there is also
widespread discussion of ‘One Pathology’,
which seeks to promote greater integration
of medical and veterinary pathology,
particularly on the research front and
specifically in the characterisation of
genetically engineered mice where it is
predicted that major advances will be made
in the future (Cardiff and others 2008,
Sundberg and Schofield 2009).
In February 2011, the First International
One Health Conference will be held in
Melbourne, Australia (www.onehealth2011.
com/index.php), bringing together all of
the groups with an interest in this rapidly
emerging discipline.
Small companion animals and
One Health
The initiatives described above relate to
efforts to improve human and animal health
in the context of shared environment.
Much of the focus is currently on diseases
and zoonotic diseases that occur in
production animals and wildlife, improved
environmental management and integrated
laboratory research. There are, however,
numerous specific examples of major
human diseases in which small companion
animals play an integral role in transmission
or by acting as reservoirs of infection. The
two most immediate of these are rabies and
leishmaniosis.
Rabies remains a major disease of man
and is often considered a neglected disease.
Two-thirds of the world’s population lives
in a rabies endemic area and over 55,000
human deaths occur each year, mostly in
Africa and Asia. The vaccination of dogs
and control of stray dogs is crucial to rabies
control. Recent initiatives in this area have
been summarised in an editorial in Veterinary
Record (Anon 2009c) and include:
n World Rabies Day supported by the OIE,
WHO and the US Centers for Disease
Control and Prevention (CDC) and others.
n European Veterinary Week with the
theme of ‘Animals + Humans = One
Health’.
848 | Veterinary Record | November 27, 2010
n The award of US$10 million by
the Gates Foundation to the WHO
Department of Control of Neglected
Tropical Diseases for a study of rabies
control focusing on elimination of the
disease in the dog.
Leishmaniosis is a similarly significant
human disease endemic in many countries
and for which the domestic dog is the
major reservoir of infection. Although
not accorded the same significance as
rabies, control of the disease in the canine
population (by vaccination and stray dog
control) is crucial. First generation Leishmania
vaccines are now available in Brazil and
appear effective in the field (Palatnik-deSousa and others 2009). The WHO also
regards leishmaniosis as a neglected disease.
The disease is present in 88 countries (72 of
them are developing nations) and there are
an estimated two million new human cases
each year, with an estimated 12 million
people currently infected.
Rabies and leishmaniosis are also
excellent examples of the interaction
between domestic pet animals and wildlife,
with the urban fox having a niche as a
reservoir of both infections.
Although these provide two clear
examples of small companion animal
diseases of global significance, the close
relationship between pet animals and man
creates potential for transmission of many
diseases.
Many emerging infectious diseases
might potentially cross species barriers
into dogs and cats and these animals may
become a focus for disease control. Examples
of the potential of this scenario are provided
by the susceptibility of cats to infection
with the SARS coronavirus (van den Brand
and others 2008) and emergent strains of
influenza including highly pathogenic
H5N1 (Kuiken and others 2004, Marschall
and Hartmann 2008) and H1N1 (Lohr
and others 2010). Companion animals are
also susceptible to infection by West Nile
virus, Nipah virus, Hendra virus and others.
The full range of small companion animal
zoonotic infectious diseases is reviewed in
an excellent new textbook devoted to this
subject (Rabinowitz and Conti 2010).
The risk of emergent zoonotic infection
in companion animals is now compounded
by the unprecedented increase in the
global movement of these species through
international pet travel schemes (Brown
2010). For example, the cumulative total
of cat, dog and ferret movement under the
UK Pet Travel Scheme since its introduction
in 2000 was 717,965 to the end of August
2010 (Anon 2010b). Companion animal
veterinarians must therefore be vigilant in
disease surveillance in these species.
In developed nations a further example
of disease that has attracted much attention
is meticillin-resistant Staphylococcus aureus
(MRSA) infection and the realisation
that these resistant organisms may infect
companion animals (generally considered a
transmission from man to animal).
Apart from these examples of direct
interaction between human and small
companion animal health, another major
aspect of One Health is the integration of
research efforts. It is widely recognised that
the study of spontaneously arising canine
and feline diseases holds great potential for
understanding the human counterparts.
Dogs and cats develop a wide range of
infectious, neoplastic, inflammatory and
immune-mediated diseases that are close
mimics of disorders of man. The availability
of the canine genome has allowed rapid
progress to be made in recent years in such
research and we are beginning to see the
publication of ‘genome-wide association
studies’ characterising the precise genetic
basis for canine diseases with human
correlates (Mellersch 2008, Wilbe and others
2010). Many of these diseases, in both man
and dogs, are multifactorial with increasing
recognition of the role of lifestyle and
environmental influences. As both species
intimately share a domestic environment,
there are further aspects of comparative
research that are ripe for investigation
(Bernstein and Shanahan 2008). Probably
the most important health issue of man
and pets in western countries is the shared
epidemic of obesity that is often directly
related to aspects of this shared lifestyle.
The final aspect of One Health with
direct relevance to small companion animals
involves the very important and widely
discussed area of the ‘human-companion
animal bond’. The direct benefit to human
health and wellbeing from association with
pet animals is now well established in areas
as diverse as child rearing, recuperation from
chronic disease and care of the elderly.
WSAVA One Health committee
Given this clear significance of small
companion animals for human health, it is
surprising that many One Health platforms
focus almost entirely on the interaction
between man, production animals and
wildlife species. In order to redress this
balance the WSAVA has recently established
a One Health Committee, which has as
its major remit the positioning of small
companion animals within the global One
Health framework.
The WSAVA is a unique organisation
that is a point of contact for almost
80 national small animal veterinary
associations representing almost 80,000
small animal practitioners throughout
the world. The fundamental remit of the
organisation is in scientific education, which
it achieves through an annual congress and
by taking a programme of education into
developing nations. The delivery of such
education can already be regarded as a major
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contribution to One Health as practitioners
in developing nations are on the front line
when it comes to existing and emerging
infectious diseases that cross species barriers.
The WSAVA is therefore uniquely
positioned to be able to rapidly contact and
coordinate the efforts of the global small
animal veterinary community, particularly
those practitioners working in developing
nations. For example, many of the WSAVA
member nations are countries in which
rabies and leishmaniosis are endemic
diseases. The single most important role
that the WSAVA might play in the arena of
One Health would be to establish a really
strong and effective global communications
network. This might serve as an effective
means of rapidly disseminating scientific
information (for example, in the case
of a global disease pandemic involving
companion animals), or initiating new
disease control programmes, and could be of
great benefit to organisations such as OIE.
The global communication of scientific
information in this way has been proved
through the international adoption of new
guidelines for canine and feline vaccination
produced by the WSAVA Vaccination
Guidelines Group (Day and others 2010).
Given appropriate funding, it would
also be feasible for the WSAVA to coordinate
global small companion animal infectious
disease surveillance through sentinel
practices or diagnostic laboratories in
member nations contributing data to a
central database.
A second activity of increasing
importance for the WSAVA has been in
coordinating scientific progress through its
standardisation groups. The diseases that
are the current subject of these activities
involve the liver, gastrointestinal tract and
kidney, and in all of these areas there are
canine and feline disorders that provide
excellent spontaneously arising models
of human disease (Day and others 2008).
While the WSAVA supports only clinical
(rather than experimental) research, there is
enormous scope for greater integration of
human and veterinary clinical research. As
a direct example of this, the WSAVA Liver
Standardization Group included among its
membership a human hepatologist. The
WSAVA has now established a standalone
Foundation which will allow development
of such shared scientific knowledge.
The WSAVA recognises the significance
of One Health and actively supports all
of the current initiatives that are in play.
The association believes that it has a
potential role as global coordinator for
small companion animal veterinarians to
expand and promote their role in the One
Health concept. For this reason, the WSAVA
adopted One Health as a key focus during its
recent 50th anniversary year.
The association has now established a
One Health Committee (Table 1) that will
commence a three-year cycle of activity
with an inaugural meeting in January
2011. This work has been generously
supported through the WSAVA Foundation
by a consortium of industry sponsors. The
foundation members of the committee have
internationally recognised expertise in small
companion animal zoonotic infectious
disease, vaccinology and comparative
research. The committee includes
representatives from the OIE and CDC and
is in discussion with the WHO at the time
of writing. These organisations have all
recognised the potential that lies within the
WSAVA global network for redressing the
omission of small companion animals from
the One Health concept.
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Michael J. Day (Chair)
UK
Chairman WSAVA Scientific Advisory Committee
Chairman WSAVA Vaccination Guidelines Group
Comparative research
Sarah Cleaveland
UK
Rabies in domestic dogs and wildlife
Chand Khanna
USA
Comparative research, National Institutes for Health
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Michael Lappin
USA
Feline zoonoses
Clarisa Palatnik-de-Sousa
Brazil
Leishmaniosis
Carol Rubin
USA
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Diane Sheahan
Australia
WSAVA Board and first opinion small animal practitioner
Alex Theirmann
France
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Ed Breitschwerdt (affiliate member)
USA
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