Post on 25-Dec-2015
Approximately 75% of recently emerging infectious diseases affecting humans are diseases of animal origin; approximately 60% of all human pathogens are zoonotic.
Zoonoses and Veterinary Public Health
DVM, PHD, OKAMOTO KarokuProf. Veterinary Public Health, Dep. Veterinary Medicine,
Fac. Agriculture, Kagoshima University
Quoted from CDC, USA
SARS2003
palm civet et.al
HPAI H5N11997/2003Water birdBSE
1986/1993Cow
West Nile1999
Bird/Mosquito
H1N1 Pandemic2009
Swine/Bird
Nipah virus1998
Megabat/Swine
Ebola1976
Monkey
HPS1993
Rodentia
Hendra virus1994
Megabat/Horse
Lassa1969
Rodentia BzHF1994
RodentiaVzHF1991
Rodentia
E. Coli O1571982
Cow/Food
Examples of emerging infectious disease(Pathogen, Year, Natural reservoir)
HPS: Hantavirus Pulmonary SyndromeSARS: Severe Acute Respiratory Syndrome
Venezuelan & Brazilian Hemorrhagic Fever
Annex 2 Decision instrument for the assessment and notification of eventsInternational Health Regulations(2005): IHR 2005
Event detected by national surveillance systemNational IHR Focal Point
Event shall be notified to WHO under the International Health Regulations
● Small pox● Poliomyelitis(wild type)● Influenza(new subtype)● Severe acute respiratory syndrome (SARS)
● Cholera● Plague● Yellow fever● Viral haemorrhagic fevers(Ebola, Lassa, Marburg)● West Nile fever● Others(Dengue fever, Rift Valley fever)
DOES THE EVENT MEET AT LEAST TWO OF THE FOLLOWING CRITERIA?I. Is the public health impact of the event serious?II. Is the event unusual or unexpected?III. Is there a significant risk of international spread?IV. Is there a significant risk of international travel or trade restrictions?
Each State Party shall notify WHO within 24 hours of assessment.
Diseases in the red are zoonoses.
Many of zoonoses have the potential to spread through various means over long distances and to become global problems. Calvin W. Schwabe(1927 – 2006)
Veterinary Epidemiology, UC Davis
Classification of ZoonosesDr. Schwabe provided the following classification system of
zoonoses based on the type of life cycle of the pathogen.
Direct zoonoses are transmitted from an infected vertebrate host to another host by direct contact, fomite or mechanical vector. The pathogen does not undergo developmental change or propagation during the transmission.
Cyclozoonosis requires more than one vertebrate host but no invertebrate host is needed. An example is echinococcosis.
Metazoonoses does require an invertebrate host where the pathogen multiples or develops before it can infect a vertebrate host.
Saprozoonoses are diseases transferred through a non-animal reservoir, such as a plant, or through the abiotic environment, such as through water or soil.
Cyclozoonosis
Metazoonoses
Direct zoonoses
Saprozoonoses
an vertebrate host
Avian influenza, Rabies, Hantavirus, Psittacosis, Bovine tuberculosis, Brucellosis, E. coli O157, Anthrax
an invertebrate host
West Nile fever, Yellow fever , Rift Valley fever , Plague, Anisakiasis
more than one vertebrate host
Echinococcosis, Cysticercosis , Toxoplasmosis, Trichiniasis
non-animal reservoir
Tetanus, Botulism , Aspergillosis , Histoplasmosis , Toxocariasis , Fascioliasis, Anthrax
Calvin Schwabe One Health ProjectA CENTER OF EXCELLENCE AT THE INTERSECTION OF HUMAN,
ANIMAL, AND ENVIRONMENTAL HEALTH
Our MissionTo strengthen the UC Davis School of Veterinary Medicine's commitment to the One World-One Health movement by educating veterinarians of the future to integrate human, animal, and ecosystem protection into their professional lives.
The Calvin Schwabe One Health Project fosters a diverse and sustainable planet, with the goal of encouraging a new generation of veterinary expertise in the integration of better health for humans, animals, and their environment. To that end, One Health expands career pathways for veterinary students in disciplines such as public practice, wildlife and ecosystem health, food safety, herd health, disaster preparedness, rural health, and zoonotic disease threats.
The World Health Organization Expert Committee on Zoonoses came up with the classification system of zoonoses provided by Dr. Schwabe.
BirdMosquito
Other animals
Equine
Human
1.WNV is spread by the bite of an infected mosquito (vector). 2.Mosquitoes become infected when they feed on infected birds(Reservoir).3.WNV can cause most clinical cases in humans and horses that does generally not allow transmission to others(Dead-end host).
Metazoonoses West Nile fever
Life cycle of West Nile virus (WNV)
Dead-end host
Reservoir host
Vector
Many of zoonoses have the potential to spread through various means over long distances and to become global problems.
Endemic area of Japanese encephalitis and West Nile fever
West Nile fever suddenly occurred in the New York in 1999 .
A mosquito traveled by air?
★
WNV Positive mosquito
Human case
Spread of West Nile virus in New York City in 1999
WNV Positive ratio of dead birds
Kennedy International AirportA mosquito arrived at this terminal.
Newark Liberty International Airport
0
2000
4000
6000
8000
10000
19992000
20012002
20032004
20052006
20072008
No. of patients
fatality rate(%)
02468
101214161820
62 2166
Progression of West Nile fever in USA(1)
Initial high fatality rate may due to the following reasons. 1. Diagnostic and treatment system were not prepared.2. The number of patients in mild was increased with the progression of surveillance. 3. Acquisition of immunity.
WNV amplification between birds and mosquitoes took three years.
0
50
100
150
200
250
300
19992000
20012002
20032004
20052006
20072008
No. of death No. of State affected
0
10
20
30
40
50
60Why the number of death in 2002 was more than in 2003 when the number of patients peaked.
WNF occurred in almost all Sates in 2002, and many people acquired immunity.
Progression of West Nile fever in USA(2)
Small pox Smallpox is an infectious disease unique to humans(not zoonosis), caused by Variola virus. The fatality rate for flat-type is 90% or greater and nearly 100% is observed in cases of hemorrhagic smallpox.
Smallpox is believed to have emerged in human populations about 10,000 BC. In the early 1950s an estimated 50 million cases of smallpox occurred in the world each year.
To eradicate smallpox, each outbreak had to be stopped from spreading, by isolation of cases and vaccination of everyone who lived
close by. This process is known as "ring vaccination".
The global program on smallpox eradication initiated by WHO in 1958 and intensified since
1967. The global eradication of smallpox was certified by a commission of eminent scientists on December 1979.
Hemorrhagic-type smallpox.
Family: Poxviridae
Subfamily: ChordopoxvirinaeGenus: Orthopoxvirus
Camelpox virusCowpox virusEctromelia virus Monkeypox virusRaccoonpox virusTaterapox virusVaccinia virusVariola virusVolepox virus
Genus: ParapoxvirusBovine papular stomatitis virusOrf virusParapoxvirus of red deer in New ZealandPseudocowpox virus
Virus families not assigned to an order(65 Families)
Orthopoxvirus is a genus of poxviruses that includes many species isolated from mammals. Although Variola virus infects only human, some Orthopoxviruses have the ability to infect non-host species, such as monkeypox virus.
I now offer a few topics related with small pox eradication.
Monkeypox
Monkeypox was first found in 1958 in laboratory monkeys. African squirrels might be the common host for the disease. Rats, mice, and rabbits can get monkeypox, too.
Direct zoonoses
Seven years old girl in Republic of Zaire
Human monkeypox
Monkeypox is an exotic infectious disease caused by the monkeypox virus, and is usually transmitted to humans from rodents, pets, and primates through contact with the animal's blood or through a bite.
Human monkey pox can be difficult to distinguish clinically from smallpox. Case-fatality ratios in Africa have ranged from 1% to 10%.
It is assumed that vaccination against smallpox would provide protection against human monkeypox infection. Since the eradication of smallpox in 1979, human case increase gradually.
Six months later, she healed but many pockmark remained.
Distribution of 52 confirmed cases of human monkeypox.
Endemic Human Monkeypox, Democratic Republic of Congo, 2001–2004Emerg Infect Dis. 2007
Monkeypox positive/No. cases investigated
Age
<45–14
15–2425–34>35
Total
male
8/1212/225/172/91/6
28/66
female
7/219/198/130/81/7
24/68
Age and sex distribution of patients with monkeypox
Among 136 patients, 51 (37.5%) had laboratory-confirmed MPX infection, 61 (44.8%) had laboratory-confirmed chickenpox virus infection, and 1 (0.7%) had coinfection.
Movement of imported African rodents to pet shops and distribution of prairie dogs from a pet shop associated with
human cases of monkeypox, in 2003 USA.
All 35 human cases of monkeypox were associated with prairie dogs.
African rodents were resell to Japan, but 15 already dead before arrival and lived two rodents was not infected.
MMWR 2003Rodents and prairie dogs contacted with each other.
762 rodents
Cowpox and Pseudocowpox virusIn 1796, Dr Edward Jenner used “cowpox
virus” to inoculate a patient to prevent them from contracting smallpox. Discovery of virus is in 1892(tobacco mosaic disease), so it is not as clear what virus he used for vaccine 100 years ago. In fact, milker's nodule is usally caused by a parapox virus(Pseudocowpox), not by cowpox virus.
Milker's nodules
Nowadays, cowpox is a rare disease. It mostly occurs in Great Britain and some European countries. Cows are no longer the main carrier of the virus; instead woodland rodents are the natural hosts of the virus who then pass it on to domestic cats. Feline cowpox virus infection
What is cowpox?
Cowpox Virus Transmission from Pet Rats to Humans
16 years old boy
Germany: Outbreak including 5 patients caused by infected pet rats from the same litter in 2009. Human cowpox infections seem to be increasing. One obvious reason for an increase might be the fading cross-protective immunity to cowpox after the cessation of small pox vaccination.
Human cowpox is a disease of young people, with half of all cases occurring in individuals younger than 18 years, because of their not having been vaccinated for smallpox, which may confer some protection against cowpox.
VARV: Variola virus
VACV: vaccinia virus
CPXV: cowpox virus
VACV species imported to Brazil in 1804, when human vaccine arrived at a port on the arms of slaves returning from Portugal. The species was maintained in this manner(arm to arm) and in 1887 the first animal vaccine was produced in calves. In 1963, Brazilian VACVs(Group 1, 2) was isolated from the blood of a rice rat captured near the edge of Amazon rain forest. Since then, those virus were naturally isolated from a wild rodent. In 1999, exanthematous outbreaks affecting dairy cattle and their handlers were reported.
Brazilian VACVs existed before the beginning of the WHO smallpox eradication vaccination campaigns.
Original animal vaccine strein imported in 1887
Brazilian Vaccinia Viruses and Their Origins
The virus that Dr. Edward Jenner used for vaccination derived from milker's nodule in 1796 may be Brazilian VACVs.
Voyages of Christopher Columbus(1492-1504)
Cyclozoonosis Echinococcosis(Hydatid Disease)
Skunk, liver. The inner surface of the cyst is lined by hydatid sand, and the cyst is surrounded by a thick capsule of fibrous connective tissue
Human, liver. Multiple thin-walled hydatid cysts project from the capsular surface of the liver.Iowa Sate Univ.: CFSPH
Humans are accidental intermediate hosts and are not able to transmit the disease. There are areas of high endemicity in southern South America, Mediterranean coast, southern part of Russia, Middle East, south-western Asia, northern Africa, Australia, Kenya, New Zealand and Uganda.
Relate to wool industry
WHO: Echinococcosis
Oral intake
Echinococcus granulosus
Echinococcus multilocularisDefinitive Host
Intermediate Host
Fox
Dog
E. multilocularis is found primarily in the northern hemisphere. It is widely distributed in continental Europe, and also occurs in much of northern and central Eurasia eastward to Japan (where it is found only on the island of Hokkaido), and in North America, where it primarily occurs in Canada, Alaska and the north central U.S. from Montana to central Ohio.
Cat
ingesting eggs shed in the
feces
Rodent
predatism
CFSPH: Echinococcosis
For the production of fur, red foxes were imported in Rebun island in 1924. First patient with hydatid cyst was detected in 1937, after a lapse of 2 years reaching 129 patients. Hokkaido authorities gave instructions to destroy all foxes and stray dogs.
Although the outbreak resolved, a hydatid patient was detected in east area of Hokkaido in 1965, and infection of Ezo red foxes were confirmed diffusely.
Nuber of points capturedNuber of foxes capturedNuber of positive foxesPositive rate(%)
Before1989-98
1995,157
3136.1
After2000-05
1483,840
180.5
Rebun island
Several monkeys, gorillas and orangutans died by hydatid desease in 2 zoological gardens in 1992 and 1994. By this circumstance, the Zoo were forced to shut.
in 1965
Since 1999, anthelmintic pellet including Praziquantel(Biltricide: effective against flatworms) were put in place widely where foxes are ranging.
Since then, about 10 patients each year continues to suffer the disease.
キツネの駆虫に関するガイドライン 参考資料
19661968
19701972
19741976
19781980
19821984
19861988
19901992
19941996
19982000
20022004
20062008
0
10
20
30
40
50
60
70
80
Progression of prevalence of Echinococcosis in the foxes and dogs at Hokkaido through 1966-2008.
No. of foxes captured: 25,358No. of hydatid foxes: 5,174
Positive rate: 20.4%
北海道におけるエキノコックス症対策の経緯
No. of stray dogs : 9,945No. of hydatid dogs: 99
Positive rate: 1.0%
8
7
6
5
4
3
2
1
0
Dog
Fox
Echinococcus specific PCR using Cox1 primer
19831984
19851986
19871988
19891990
19911992
19931994
19951996
19971998
19992000
20012002
20032004
20052006
20072008
0
0.05
0.1
0.15
0.2
0.25
0.3
北海道におけるエキノコックス症対策の経緯
Number of pigs slaughtered: 27,321,373Number of hydatid pigs: 31,253
Positive rate: 0.11%
Progression of prevalence of Echinococcosis in the pig slaughtered at Hokkaido through 1983-2008.
Saprozoonoses Anthrax
Pasteur's Vaccine of Anthrax in Australia: as a preventative against Cumberland Disease in sheep, cattle and horses.
The trial was held under the supervision of two graziers and three government officials at Junee Junction in Australia during September and October 1888. The trial was undertaken on 39 sheep and 6 cattle. It was a complete success: all vaccinated animals remained in very good health, whereas all 19 unprotected sheep and one of the two non-vaccinated cows died within a few days.
In May 1881 Louis Pasteur performed a public experiment to demonstrate his concept of vaccination.
When conditions are not conducive to growth and multiplication of the vegetative bacilli, B. anthracis tends to form spores. These spores are extremely resistant to inactivation by heat or chemicals, and can survive in the environment for decades.
Rain and other agents can disperse the spores to other locations. Heavy rains, alternating with dry periods, may concentrate the spores and result in outbreaks among grazing animals.
Spores and vegetative cells of B. anthracis
Capsulated B. anthracis in the blood of an animal that has died of anthrax.
Virtually all mammals and some birds can contract anthrax, but susceptibility varies widely and most clinical cases occur in wild and domesticated herbivores. Cattle, sheep, and goats are considered to be highly susceptible; horses somewhat less so. Pigs, other omnivores, and carnivores are more resistant to disease, but they may become ill if the dose is high. Birds are highly resistant.
Bloody discharges from the nose, mouth, and anus
Enlarged spleen has a ‘blackberry jam’ consistency.
20,000-100,000 cases estimated globally/year
Louisiana State Univ.: World Anthrax Site
Human case rates for anthrax are highest in Africa and central and southern Asia. Where the disease is infrequent or rare in livestock, it is rarely seen in humans.
0
50
100
150
200
250
300
19081910
19121914
19161918
19201922
19241926
19281930
1932
Human
Equine
Cow
Occurrence of Anthrax in Kagoshima prefecture through 1908-1932
Nu
mb
er o
f ca
ses The bone meals imported from
China and Korea in Meiji period were contaminated with Anthrax spores.
It was revealed that the application of bone meal was very effective to crop growth in Kagoshima Prefecture consisting of volcanic ash soils in the middle of Edo period.
Numer of cattles with Anthrax in Japan, 1960-2000
0
10
20
30
40
50
6019
60
1964
1968
1972
1976
1980
1984
1988
1992
1996
2000
Nu
mb
er o
f ca
ses
In Japan, only one animal-Anthrax case in several years was reported recently. The spores still may be distributed in the soil, the number of them do not reach the onset dose.By the oral route, minimum infectious dose for sheep was 3.5 x 10 4 spores and that the dose needed to ensure lethal infection in sheep, horses and cattle was 5 x 108 spores.
WHO: Anthrax in humans and animals
Wood bison is designated as the Status of Endangered Wildlife in Canada
Number of bisons died of anthrax in Canada
0
50
100
150
200
250
300
350
400
1962
1963
1965
1967
1968
1971
1978
1991
1993
2000
2001
Nu
mb
er o
f d
eath
sDuring the first documented outbreak of anthrax, in the
summer of 1962, 281 bison died in the eastern Slave River Lowlands. Outbreaks soon became widespread,
extending during the course of the next few years to as far south as bison herds in the Sweet Grass area.
Wood Buffalo National ParkSlave River Lowlands Mackenzie BisonLiard River Valley (Nahanni)
450018001555
400
Number of Bisons in National Park
Wood Bison in the NWT
No cases of human anthrax have been diagnosed in the last two decades in Canada.
Distribution by decade of 75 cases of anthrax in humans in Texas, 1935 to 2001.
CDC: Epizootiology and Ecology of Anthrax
Cutaneous anthraxEarly 1900s: 200 cases annuallyLate 1900s: 6 cases annually
Inhalational anthrax20th century: 18 cases/16 fatal
Anthrax in U.S.
Outbreaks of anthrax in wild animals including bison were a public health threat in United States, formerly.
• 22 cases– 11 cutaneous– 11 inhalational
• 5 deaths (all inhalational)– Index case in Florida– 2 postal workers in Maryland– Hospital supply worker in New York City– Elderly farm woman in Connecticut
2001 anthrax attacks
Who did it for what purpose?The truth has not been revealed until now.
The second letter dated at 9 November
• Japanese religious cult• 1993
– Unsuccessful attempts at biological terrorism– Released anthrax from office building
• Vaccine strain used – not toxic– No human injuries
• Successful attempt in 1995– Sarin gas release in Tokyo subway– 1,000 injured – 12 deaths
Guru in the cult
Aum Shinrikyo
A group behaving fanatically would exist in any country. It is an unavoidable phenomenon resulting from the mentally suffering society.
The International Health Regulations (2005) provide not only the ability of the world community to cope with public health emergencies affecting more than one country, but they have important implications for biosecurity, including the response to transborder incidents involving the accidental or deliberate release of biological or chemical agents or radiological materials.