| Author Keywords | Keywords Plus | Abstract |
| One Health; Experiential learning; Interprofessional education; Professional development; Competency-based curriculum; Program evaluation | MEDICAL-EDUCATION; PROFESSIONALS | The One Health approach has gained support across a range of disciplines; however, training opportunities for professionals seeking to operationalize the interdisciplinary approach are limited. Academic institutions, through the development of high-quality, experiential training programs that focus on the application of professional competencies, can increase accessibility to One Health education. TheRx One Health Summer Institute, jointly led by US and East African partners, provides a model for such a program. In 2017, 21 participants representing five countries completed theRx One Healthprogram in East Africa. Participants worked collaboratively with communities neighboring wildlife areas to better understand issues impacting human and animal health and welfare, livelihoods, and conservation. One Health topics were explored through community engagement and role-playing exercises, field-based health surveillance activities, laboratories, and discussions with local experts. Educational assessments reflected improvements in participants’ ability to apply the One Health approach to health and disease problem solving, as well as anticipate cross-sectoral challenges to its implementation. The experiential learning method, specifically the opportunity to engage with local communities, proved to be impactful on participants’ cultural awareness. TheRx One Health Summer Institutetraining model may provide an effective and implementable strategy by which to contribute to the development of a global One Health workforce. |
| one health; veterinary medicine; veterinary ethics; veterinary education interdependence; pedagogy; moral agency; mindfulness | ONE WELFARE; MINDFULNESS; WILDLIFE; ECOLOGY; IMPACT; EBOLA | Simple Summary The idea of One Health acknowledges the interdependence of human and non-human animal health against the backdrop of a shared environment. This requires collaboration across disciplines to tackle complex health problems. How does One Health affect the education of veterinary ethics, traditionally restricted to both animal and professional ethics? First, veterinary ethics education provides an opportunity within the curriculum for students to engage with the meaning and implication of One Health, so as to develop their own viewpoint. Similarly, One Health can enrich veterinary ethics. It does so by introducing relevant ethical fields and other cultural perspectives, as well as promoting ways of teaching that motivate and sensitize students to become aware of the underlying interdependency and complexity of health issues while at the same time fostering their capacity for ethical problem solving. Abstract What does One Health imply for veterinary ethics education? In order to answer this question, we will first have to establish what One Health itself involves. The meaning and scope of One Health, however, cannot be established without reference to its values-whose health matters? Veterinary ethics education is well equipped to facilitate such an open-ended inquiry into multispecies health. One Health also widens the scope of veterinary ethics by making salient, among other fields, environmental ethics, global health justice, and non-Western approaches to ethics. Finally, One Health requires students to engage with interdependence. Discussing three levels of interdependence, we argue that veterinary ethics stands to benefit from a more contemplative pedagogy. |
| One Health; Tanzania; subnational; health service; multisectoral | WEST-AFRICA; EBOLA | In 2018, Tanzania Launched the One Health Coordination Desk (OHCD) in a country that operates a centralized public health system with Limited privatization. In contrast, the animal health system is decentralized, with huge reliance on privatization. Subnational Level implementation of health services are sometimes at odds with national-Level planning due to inherent challenges. To bridge these gaps, One Health rapid response teams (OHRRTs) were set up and pilot tested in selected districts and regions of Tanzania. These teams serve the community directly through the delivery of community-oriented One Health activities. We discuss the OHRRT set-up process as an example of good practice for adoption in developing economies. |
| One health; Multidisciplinary; Training; Workforce development; Professional development; Uganda | GLOBAL HEALTH; SECURITY; LESSONS | The interconnections of humans, domestic animals, wildlife and the environment have increasingly become complex, requiring innovative and collaborative approaches (One Health approach) for addressing global health challenges. One Health is a multidisciplinary and multi-sectoral collaborative approach to human, animal, plant and environmental health. The role of academia in training professionals oriented in One Health is critical in building a global workforce capable of enhancing synergies of various sectors in improving health. Makerere University, Uganda has implemented pre-service capacity building initiatives aimed to foster One Health competencies among students who are future practitioners. In addition to incorporating the One Health concept in didactic curricula, Student One Health Innovation Clubs, undergraduate field placements in 11 demonstration sites, graduate fellowships, small grants to support research and innovations, and cross-college collaborative training approaches have greatly aided the assimilation of One Health into the fabric of university offerings. Partnerships with government ministries, private sector and international agencies were initiated to benefit the students, as well as chart a path for experiential learning and in-service offerings in the future. One major challenge, however, has been the tendency to focus on infectious diseases, especially zoonoses, with less consideration of other health issues. The opportunity for improvement, nonetheless, lies in the increasing emerging and re-emerging health concerns including epidemics, environmental pollution and related challenges which justify the need for countries and institutions to focus on building and strengthening multidisciplinary health systems. |
| One health; Orang Asli; Indigenous; Field training; Multidisciplinary | ORANG ASLI; EDUCATION; SEROPREVALENCE; MEDICINE; HYGIENE; PEOPLES | Background This paper describes the result of workshops conducted to increase the knowledge and awareness of university students using a multidisciplinary, collaborative, multisectoral and trans-disciplinary approach concerning One Health and the indigenous people of peninsular Malaysia called the Orang Asli. Methods A non-experimental pre and post-test intervention study was carried out among medical, veterinary and allied health students from six public and private universities who attended workshops on One Heath in two Orang Asli communities living by the Temenggor lake in Malaysia as part of the Malaysia One Health University Network (MYOHUN) efforts in training future and present One Health workforce. Results There was a significant increase in various aspects of knowledge and interest concerning One Health and the Orang Asli. The mean knowledge scores of One Health (p < 0.001) and Orang Asli (p < 0.001) increased significantly post workshop. A repeated measures ANOVA with a Greenhouse-Geisser correction showed the mean scores of knowledge of One Health F (1, 166) = 127.198, p < 0.001) and Orang Asli F (1, 166) = 214.757, p < 0.001) differed statistically significantly between the two time points. The test revealed that the score differences for knowledge on One Health (mean difference = 1.796, p < 0.001) and Orang Asli (mean difference = 4.940, p < 0.001) were statistically significant. Repeated measures ANOVA showed a significant difference in the knowledge on Orang Asli between the students of different courses F (4,166) = 3.734, p-0.006. The difference in the One Health knowledge scores between the students of different courses was not statistically significant F (4,166) = 0.998, p = 0.410. Conclusions Emphasis on field training in relation to One health can provide university students greater levels of preparedness to combat zoonotic diseases. |
| One Health; Antimicrobial resistance; Community Network Integration; Health alignment | | |
| biosecurity; One Health; zoonotic diseases; antimicrobial resistance; animal agriculture | INFLUENZA; SWINE; PIGS; VIRUS; H1N1 | The One Health approach has received widespread international endorsements from professional, academic, and governmental organizations as the way forward in tackling complex interdisciplinary problems, such as emerging zoonotic diseases, antimicrobial resistance, and food safety. Yet conspicuously absent from US One Health training or research activities are the animal agricultural industries. Their absence is likely due to multiple factors, including the lack of appreciation for their potential problem-solving roles, as well as the industries’ business-oriented fears that such engagement could cause them to suffer economic damage. As demands on the swine, poultry, egg, beef, and dairy production industries are closely linked to the above-mentioned complex problems, we must find new, nonthreatening ways to better engage and win animal agriculture’s collaboration into One Health training and research partnerships for successful health problem solving. Without animal agricultural industries’ improved cooperation, One Health’s efforts to control these complex problems are not likely to succeed. |
| One Health; One Health framework; One Health Huduma Centre; Turkana County; Integrated service delivery; Grounded theory | ANIMAL VACCINATION DELIVERY; NOMADIC PASTORALISTS | Pastoralists in sub-Saharan Africa have limited access to public services due to their mobile lifestyle, economic and political marginalization, and the limited health infrastructure that is common to arid and semi-arid lands (ASALs) where they primarily reside. This often results in poor health outcomes, including increased rates of maternal, neonatal, and under-5 mortality. One Health approaches that integrate human and animal health service delivery can help to improve pastoralists’ health through increased vaccine coverage and improved access to services. Kenya has institutionalized One Health at the national level; however, progress at the subnational level has been limited due to sustainability concerns, competing priorities, and insufficient coordination platforms. To address this gap, this paper presents a One Health framework (OHF) to aid in the implementation of integrated human and animal health policies in Turkana County, which can act as a model for other ASALs. Utilizing a grounded theory design, we conducted semi-structured interviews and focus group discussions with human health, animal health, and pastoralist stakeholders. Inadequate engagement with the public sector was identified as a major limitation by community members. Factors that contributed to this include distance to health facilities and restricted department capacities such as availability of vehicles, personnel, and cold chain maintenance. Our proposed OHF harnesses the existing structure of service delivery in Turkana and establishes an official coordination mechanism to implement One Health activities, through the form of mobile One Health Huduma Centres, offering a range of public services. This innovative framework is supported by stakeholders in Turkana and can improve service delivery constraints thereby improving the health of Turkana pastoralists. |
| SARS-CoV-2; One Health; infectious disease epidemiology; collaborative networks; community network integration; knowledge integration | BIOSECURITY | 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. |
| One health; Global health; Zoonoses; East Africa; Assemblage | SOCIAL-SCIENCE; ONE WORLD; COLONIAL KENYA; DISEASE; ELIMINATION; ECOLOGY; ACCESS; LAND | One Health perspectives are growing in influence in global health. One Health is presented as being inherently interdisciplinary and integrative, drawing together human, animal and environmental health into a single gaze. Closer inspection, however, reveals that this presentation of entanglement is dependent upon an apolitical understanding of three pre-existing separate conceptual spaces that are brought to a point of connection. Drawing on research with livestock keepers in northern Tanzania, in the context of the history of livestock policy in colonial and postcolonial East Africa, this demonstrates what an extended model of One Health – one that moves from bounded human, animal and environmental sectors to co-constitutive assemblages – can do to create a flexible space that is inclusive of the multiplicity of health. |
| Zoonotic disease control; One Health; Decision-making; Ethics | PRECAUTIONARY PRINCIPLE; PERSPECTIVES | To tackle zoonotic disease threats, a One Health approach is currently commonplace and generally understood as an integrated effort of multiple disciplines to promote the health of humans, animals and the environment. To implement One Health strategies in zoonotic disease control, many countries set up early warning systems, in which human and veterinary health professionals cooperate. These systems, like the Dutch Zoonoses Structure, can be successful to detect emerging disease threats. However, these systems are not well equipped to handle moral dilemmas that can arise in zoonotic disease control, like the culling of healthy animals. This research studies the role of normative presuppositions of professionals involved in zoonotic disease control policies in the Netherlands. We found that these professionals in general adhered to a holistic view of the One Health concept, however, in practice an anthropocentric approach was dominant. Public health was identified as the trumping moral value, which reveals an inherent field of tension with the core of One Health thinking. The lack of ethical expertise in control systems for zoonotic diseases can lead to misconception of ethical principles, like the precautionary principle which is frequently evoked to justify disease control measures. |
| One health; Animal; Environmental; Human; Interprofessional education | ONE MEDICINE | Today’s collaborations across fields of health and wellness are insufficient to meet societies’ challenges in combating disease and maintaining the ecosystem and public health. In this article, we present a One Health curriculum model designed to encourage undergraduate students of varying disciplines to value the connectedness of animals, humans, and the environment and to think innovatively about solutions to priority global health issues. We present the design and implementation of a course that brought together multiple faculty from different fields of study, including the dental, medical, nutrition, and veterinary schools, in a curriculum designed for undergraduates primarily from Arts & Sciences fields. The curriculum was collaboratively designed around four key One Health categories: 1) Infectious zoonotic diseases and global health, 2) Naturally occurring shared disease in companion animals that can serve as models for human disease, 3) Human-animal interactions, and 4) Impact of environmental health on human and animal health. We show this course successfully deepened students’ understandings of One Health, its role in addressing high priority health issues and the overall benefits of a One Health approach to tackling societal problems. We also report a positive experience by the faculty working in collaboration to implement the curriculum model and the overall enthusiasm of students for the course, all of whom would recommend it to their peers. We conclude by proposing the potential of the curriculum model underlying this course to fill the need for One Health Curricula in programs preparing future health professionals. |
| cellulitis; immunosuppression; One Health; Streptococcus canis | INFECTIONS; CHILDREN; SCM | Background: One Health is a biomedical approach that aims to optimize the health of humans, animals, and the environment through interdisciplinary collaboration. Cellulitis is an infection of the dermis and subcutaneous fat that may be caused by zoonotic streptococci species. Case Report: We report a case of cellulitis caused by Streptococcus canis in a woman who was taking Etanercept. We frame the presentation within a One Health approach and urge emergency physicians to collaborate with veterinarians in the management of patients with zoonotic diseases who are discharged home. Why Should an Emergency Physician Be Aware of This?: Pets are a source for zoonotic diseases, including resistant bacteria, that pose particular risk to immunocompromised patients. Emergency physicians often discharge patients with potential zoonotic infections such as cellulitis home without a long-term, holistic care plan, according to a One Health approach. Physicians should then collaborate with veterinarians in caring for humans and animals. (C) 2019 Elsevier Inc. All rights reserved. |
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| One Health; Global Health; MOOC; Blended learning; Project-based learning; Refugee camp | CHOLERA | Today, the world counts millions of refugees but only a fraction of them have access to higher education. Despite the multiple public health problems in refugee camps and the need to build local capacities to prevent and combat them, University level courses in public health are largely unavailable for refugees. This paper describes the development, implementation and evaluation of an innovative two-module blended-learning programme on One Health in Kakuma refugee camp (Kenya). This programme combines: (I) Interdisciplinary and multi-expert MOOC on Global Health at the Human-Animal-Ecosystem interface; (II) peer-to-peer learning involving students from University of Geneva Master of science in Global Health and research collaborations around specific and locally-relevant problems; (III) online mentoring and lecturing by experts from the Institute of Global Health of the University of Geneva in Kakuma. A total of 67 refugees applied to Module 1; 15 started the Module 1 in October 2017, of these 14 completed it and 6 passed the exams, finally five students started the Module 2 in October 2018 which they all passed in February 2019. Five student-led collaborative projects were developed focusing on the conception of a community-based monitoring system for prevalent diseases in the camp. With such a pedagogic approach, the programme provides an overview on Global Health challenges at the human-animal-ecosystem interface and the importance of the One Health approach, and introduces students to scientific research through interdisciplinary and international collaborations and innovation. The high number of applicants and positive feedback from students in Kakuma show the interest in One Health education in the camp. This learning experience ultimately aims at building local knowledge and capacity fostering One Health champions to reinforce local and national health system. This framework for One Health education could be potentially scaled up to other camps in Africa and the world. |
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| PUBLIC-HEALTH; POLICY; RISK; H1N1; PERSPECTIVES; PREPAREDNESS; DISCOURSE; BENEFITS; DISEASES; LESSONS | A One Health approach holds great promise for attenuating the risk and burdens of emerging infectious diseases (EIDs) in both human and animal populations. Because the course and costs of EID outbreaks are difficult to predict, One Health policies must deal with scientific uncertainty, whilst addressing the political, economic and ethical dimensions of communication and intervention strategies. Drawing on the outcomes of parallel Delphi surveys conducted with policymakers in Singapore and Australia, we explore the normative dimensions of two different precautionary approaches to EID decision-making-which we call regimes of risk management and organizing uncertainty, respectively. The imperative to act cautiously can be seen as either an epistemic rule or as a decision rule, which has implications for how EID uncertainty is managed. The normative features of each regime, and their implications for One Health approaches to infectious disease risks and outbreaks, are described. As One Health attempts to move upstream to prevent rather than react to emergence of EIDs in humans, we show how the approaches to uncertainty, taken by experts and decision-makers, and their choices about the content and quality of evidence, have implications for who pays the price of precaution, and, thereby, social and global justice. |
| ESCHERICHIA-COLI; ENTEROBACTERIACEAE; MICROBIOMES; PATHOGEN; THREAT | |
| Whole genome sequencing; Foodborne pathogen isolates; Data sharing; Ontology; Genetic diversity; Outbreak detection; Contamination | ANTIMICROBIAL RESISTANCE; SALMONELLA-ENTERICA | This article describes the potential for one health surveillance of foodborne pathogens and disease using the revolutionary methodologies of whole genome sequencing. Whole genome sequencing of viral and bacterial pathogens is a natural fit to a one health perspective because these pathogens reside and are shared by humans, animals, and the environment and their genomes are compared easily regardless of where or from what host the pathogen was isolated. A genome provides a huge amount of data that can be analyzed for numerous applications. Sharing data coordinates surveillance efforts across the various disciplines. |
| transdisciplinary research; case studies; co-creation of knowledge; risk maps; risk communication; epidemiology; one health; veterinary research | RISK-ASSESSMENT; ZEBRA MUSSELS; CO-CREATION; KNOWLEDGE; SCIENCE; EPIDEMIOLOGY; DISEASE; PARATUBERCULOSIS; ANIMALS; IMPACTS | Stakeholder engagement in research is widely advocated as a tool to integrate diverse knowledge and perspectives in the management of health threats while addressing potential conflicts of interest. Although guidelines for stakeholder engagement exist in public health and environmental sciences, the feasibility of actionable decisions based on scientific analyses and the lessons learned from the stakeholder engagement in the process co-creation of knowledge have been rarely discussed in One Health literature and veterinary sciences. Risk maps and risk regionalization using spatiotemporal epidemiological/analytical tools are known to improve risk perception and communication. Risk maps are useful when informing policy and management decisions on quarantine, vaccination, and surveillance intended to prevent or control threats to human, animal, or environmental health interface (i.e., One Health). We hypothesized that researcher-stakeholder engagement throughout the research process could enhance the utility of risk maps; while identifying opportunities to improve data collection, analysis, interpretation, and, ultimately, implementation of scientific/evidence-based management and policy measures. Three case studies were conducted to test this process of co-creation of scientific knowledge, using spatiotemporal epidemiological approaches, all related to One Health problems affecting Minnesota. Our interpretation of the opportunities, challenges, and lessons learned from the process are summarized from both researcher and stakeholder perspectives. By sharing our experience we intend to provide an understanding of the expectations, realizations, and good practices we learned through this slow-moving iterative process of co-creation of knowledge. We hope this contribution benefits the planning of future transdisciplinary research related to risk map-based management of One Health problems. |
| One Health; zoonotic parasites; non-zoonotic parasites; collaborative research; Taenia solium; Giardia; Theileria; Babesia; Neospora; Toxoplasma | TAENIA-SOLIUM CYSTICERCOSIS; BABESIA-GIBSONI INFECTIONS; TOXOPLASMA-GONDII OOCYSTS; EASTERN CAPE PROVINCE; PORCINE CYSTICERCOSIS; THEILERIA-PARVA; GIARDIA-DUODENALIS; NEOSPORA INFECTION; WASHINGTON-STATE; CANINE BABESIA | The One Health approach recognizes the interconnectedness of human, animal, and ecosystem health and en-courages collaboration between diverse disciplines to address complex health problems. In this paper, 3 academics, with diverse training, experience and backgrounds who each work on different pathogenic parasites, will share their stories of tackling parasitic challenges by applying a One Health approach. The pathogenic parasites to be discussed include the helminth Taenia solium and protozoans Giardia, Theileria, Babesia, Neospora and Toxoplasma species. The 3 narratives focus on research and clinical case-based challenges and illustrate where collaboration between human, animal, and environmental health scientists either has or could lead to improved control of human and animal health as well as important research discoveries. The need for better evaluation of interventions and scientific evidence to support changes in clinical practice and encourage enhanced collaboration between human and veterinary clinicians, as well as new governmental policies to improve public and wildlife health, are described. The need for a range of evidence-based metrics to monitor the success and impact of the One Health approach to veterinary parasitology is also discussed. |
| Health security; Emerging infectious disease; Antimicrobial resistance; One health; Transdisciplinary collaboration; China | | The Second International Symposium on One Health Research (ISOHR) was held in Guangzhou city, China on 23-24 November 2019. A transdisciplinary collaborative approach, One Health (OH), was the central theme of the symposium which brought together more than 260 experts, scholars and emerging researchers from human health, veterinary health, food safety, environmental health and related disciplines and sectors. More than 50 organizations including World Health Organization, Centers for Disease Control (USA), and Queensland Government (Australia) participated in the symposium. Scholars, experts and emerging researchers, policy-makers and practitioners in their respective fields delivered over 50 presentations at the symposium, highlighting the collective vulnerability to some of the emerging health challenges the region was combating. These included emerging infectious diseases, antimicrobial resistance, climate change, food safety and the growing burden of non-communicable diseases. ThePearl River Declaration, emanated from the symposium, called for establishing a One Health Cooperation Network in the Southeast Asia-Pacific region with a vision to strengthen regional health security through sharing each other’s knowledge and experience, and making investments in workforce development, scientific innovations such as vaccine research and development, sharing epidemic intelligence, risk identification, risk communication and appropriate response measures against emerging health threats. |
| ONE HEALTH; COLLECTIONS | |
| One Health; Zoonotic disease; Brucellosis; Emerging and re-emerging infections; Systematic review | | Background Brucellosis is the most significant and common bacterial zoonosis and is recognized as a re-emerging and neglected disease. Tackling zoonosis is very important for the health and the economy. One Health is an approach characterized by the integration of human and animal health, plants, and ecosystems and encourages joining local, national, and global multidisciplinary efforts to achieve optimal levels of health and collaboration among different disciplines to address complex health problems. Objectives The present study aimed to review published scientific literature related to the use of the One Health approach to tackle human brucellosis. Methods Web of Science (WoS), PubMed, Scopus, The Cochrane Library, and Embase databases were searched from inception until 30 January 2020. The reference lists of all relevant papers were hand-searched. Two authors extracted data from published studies independently. The Joanna Briggs Institute tool was used to assess the quality of studies. Results Of 2297 studies, 10 studies were deemed eligible, which were conducted between 2013 and 2019. Studies were performed in Uganda, Malta, Serbia, Greece, Mongolia, Azerbaijan, Israel, India, Ethiopia, and the USA. All studies suggested that brucellosis is still a major public health problem and that the most important aspect of the One Health approach is the interdependence of humans, ecosystems, and animals .Some studies have focused on livestock vaccination as the most effective way to prevent disease, and others have focused on the biology ofBrucellainfection and its transmission patterns. Some studies have pointed to the effectiveness of the One Health approach in all the phases of disease management as well as to its role in reducing health costs. Conclusion The success of the approach depends on the willingness of the decision-makers to implement the necessary policies. Due to the heterogeneity of current practices, and organizations involved in One Health approach-based programs, it will be incomplete without proper planning. To better implement the approach, strategies should be appraised and disseminated by experts and relevant stakeholders. |
| CORONAVIRUS; ANTIBODIES; INFECTION | |
| SARS-CoV; SARS-CoV-2; CoVID-19; MERS-CoV; Coronavirus; Outbreak; One health; Bats; Animal; Reservoir | ACUTE RESPIRATORY SYNDROME; LIVE POULTRY MARKETS; SARS-CORONAVIRUS; AVIAN INFLUENZA; MERS CORONAVIRUS; COV; VIRUS; TRANSMISSION; ENVIRONMENT; EVOLUTION | The severe acute respiratory syndrome cornavirus (SARS-CoV-2) is a new human coronavirus candidate recently detected in China that is now reported in people on inhabited continents. The virus shares a high level of identity with some bat coronaviruses and is recognised as a potentially zoonotic virus. We are utilizing the One Health concept to understand the emergence of the virus, as well as to point to some possible control strategies that might reduce the spread of the virus across the globe; thus, containment of such virus would be possible. |
| apiculture; bio-economic; eco-economic; management; one health | | One health concept aims to achieve and develop a competent bio-economic and eco-economic beekeeping management, based on scientific principles. It is an activity of national interest, useful for preserving a natural and healthy environment, ecological system and agriculture, in general, intended to ensure natural pollination of honey plants and bee species biological diversity, and in particular for the national genetic background in Romanian bee breed – Apis mellifera carpatica – as autochthonous bee population specific for the Romanian bio-apiculture areas. Concerning the importance of bees in human and humankind, Albert Einstein quoted .If the bee disappeared off the surface of the globe, then man would have only four years of life left. The famous physician referred to bees role as crop pollinators and also in achieving significant agricultural yields, that would not be possible in absence of pollinators, and their lack would have devastating impact on food procurement. The present paper overview one health points for a sustainable management in apiculture. |
| Antibiotic resistance; Antimicrobial resistance; One health; Qualitative research; Pork value chain | ANTIBIOTIC-RESISTANCE; MEKONG DELTA; FOOD; SALMONELLA; BACTERIA; RESIDUES; FARMS; PIG | BackgroundThe One Health concept promotes the enhancement of human, animal and ecosystem health through multi-sectorial governance support and policies to combat health security threats. In Vietnam, antimicrobial resistance (AMR) in animal and human health settings poses a significant threat, but one that could be minimised by adopting a One Health approach to AMR surveillance. To advance understanding of the willingness and abilities of the human and animal health sectors to undertake investigations of AMR with a One Health approach, we explored the perceptions and experiences of those tasked with investigating AMR in Vietnam, and the benefits a multi-sectorial approach offers.MethodsThis study used qualitative methodology to provide key informants’ perspectives from the animal and human health sectors. Two scenarios of food-borne AMR bacteria found within the pork value chain were used as case studies to investigate challenges and opportunities for improving collaboration across different stakeholders and to understand benefits offered by a One Health approach surveillance system. Fifteen semi-structured interviews with 11 participants from the animal and six from the human health sectors at the central level in Hanoi and the provincial level in Thai Nguyen were conducted.ResultsEight themes emerged from the transcripts of the interviews. From the participants perspectives on the benefits of a One Health approach: (1) Communication and multi-sectorial collaboration; (2) Building comprehensive knowledge; (3) Improving likelihood of success. Five themes emerged from participants views of the challenges to investigate AMR: (4) Diagnostic capacity; (5) Availability and access to antibiotics (6) Tracing ability within the Vietnamese food chain; (7) Personal benefits and (8) Managing the system.ConclusionThe findings of this study suggest that there is potential to strengthen multi-sectorial collaboration between the animal and human health sectors by building upon existing informal networks. Based on these results, we recommend an inclusive approach to multi-sectorial communication supported by government network activities to facilitate partnerships and create cross-disciplinary awareness and participation. The themes relating to diagnostic capacity show that both sectors are facing challenges to undertake investigations in AMR. Our results indicate that the need to strengthen the animal health sector is more pronounced. |
| Brucella; one health; outbreak | | We report aBrucellaoutbreak with seven cases in the Northern Region of Portugal in 2018-2019, associated with the consumption of fresh cheese. This outbreak has implications for risk assessment in Portuguese migrants related to this area, and it is an example of cooperation between public institutions, in a One Health based approach. |
| Epidemiologic-economic models; Cystic echinococcosis; Leishmaniasis; Neglected zoonosis; Epidemiology of parasitic zoonoses; Health economics; Animal health economics; One health economics | CYSTIC ECHINOCOCCOSIS; CANINE LEISHMANIASIS; SURVEILLANCE; TRANSMISSION; POLICY | Epidemiology and health economics have systemic interdependencies. The identification of the economic outcomes of any disease is operated by overlapping its epidemiology with the economic functions of the impacted entities. This communication presents two epidemiologic-economic models designed to evaluate the economic burden of cystic echinococcosis and leishmaniasis in Veneto (Northeastern Italy). Following a One Health approach, the research integrates expertise from different disciplines and institutions and fulfilled its first stage by defining the relevant cost categories and the data collection strategy for the two diseases in the study area. The two models identify the relevant epidemiological factors and the economic outcomes of infections in both animals and humans. The results, visualized in flow charts indicating the types of costs associated with these zoonoses, will guide data collection and the epidemiologic and economic assessment in the next research stages. This experience shows that One Health methods, although still innovative or unusual in many scientific and professional contexts, can be applied by using relatively limited resources and already available professional skills. |
| birds; faeces; norovirus; One Health; social media; water | RECREATIONAL WATER; ENTEROVIRUSES; INFECTION; GEESE; FECES; BIRDS | Norovirus constitutes the most frequently identified infectious cause of disease outbreaks associated with untreated recreational water. When investigating outbreaks related to surface water, a One Health approach is insightful. Historically, there has been a focus on potential contamination of recreational water by bird droppings and a recent publication demonstrating human noroviruses in bird faeces suggested this should be investigated in future water-related norovirus outbreaks. Here, we describe a One Health approach investigating a norovirus outbreak in a natural playground. On social media, a large amount of waterfowl were reported to defecate near these playground premises leading to speculations about their potential involvement. Surface water, as well as human and bird faecal specimens, was tested for human noroviruses. Norovirus was found to be the most likely cause of the outbreak but there was no evidence for transmission via waterfowl. Cases had become known on social media prior to notification to the public health service underscoring the potential of online media as an early warning system. In view of known risk factors, advice was given for future outbreak investigations and natural playground design. |
| INFLUENZA; TRANSMISSION; VIRUS; WUHAN; CHINA | Human coronaviruses continue to pose a threat to human health. The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 which causes coronavirus disease-2019 (COVID-19), an acute respiratory disease marked the third introduction of a highly pathogenic coronavirus into the human population in the twenty-first century. This recent emergence of a previously unknown coronavirus in China leads to huge impacts on humans globally. Covid-19 is a challenge to global public health. Here, we discuss the COVID-19 outbreak in a one health context, highlighting the need for the implementation of one health measures and practices to improve human health and reduce the emergence of pandemic viruses. |
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| interdiscipinary studies; social values; research design; veterinary medicine; social sciences | AVIAN INFLUENZA; PUBLIC DELIBERATION; ONE WORLD; BIOSECURITY; PEOPLE; POLICY; COMMUNITIES; KNOWLEDGE; AWARENESS; ZOONOSES | The One Health concept has inspired a rich vein of applied research and scholarly reflection over the past decade, yet with little influence from qualitative methodologists. With this overview, we describe the underpinning assumptions, purposes, and potential pitfalls of data collection techniques and methods of data analysis in key qualitative research methodologies. Our aim is to enhance One Health collaborations involving qualitative researchers, veterinary epidemiologists, and veterinary economists. There exist several distinct traditions of qualitative research, from which we draw selectively for illustrative purposes. Notwithstanding important distinctions, we emphasize commonalities and the potential for collaborative impact. The most important commonality is a shared focus on contextualizing human behavior and experience-culturally, economically, historically, and socially. We demonstrate that in-depth attention to context can assist veterinary economists and epidemiologists in drawing lessons from the implementation of policies and programs. In other words, qualitative researchers can assist One Health teams in distilling insights from success stories, but also from adverse events and unintended consequences. As a result, qualitative researchers can contribute to One Health research and policy discussions by formulating more accurate and contextually-relevant parameters for future quantitative studies. When performed well, qualitative methodologies can help veterinary economists and epidemiologists to develop impactful research questions, to create more accurate and contextually-relevant parameters for quantitative studies, and to develop policy recommendations and interventions that are attuned to the political and socio-cultural context of their implementation. In sketching out the properties and features of influential methodologies, we underscore the value of working with seasoned qualitative researchers to incorporate questions about what, how, and why in mixed-methods research designs. |
| Probiotics; Bacillus; Toxins; Antimicrobial resistance; One Health | EMETIC TOXIN; CEREUS; ASSOCIATION | Probiotic microbes conferring health benefits to the hosts have attracted great attention. However, the safety of probiotics is not guaranteed, although the increasing widespread use of probiotics with excellent overall safety records. Here, we performed a systematic evaluation of the safety of commercial Bacillus probiotics intended for usage in humans, animals, plants, aquaculture and environment in China. Nearly half of the 65 isolated Bacillus spp. strains from these commercial probiotic products were capable of producing hazardous toxins. Infections with the representative isolates could cause sepsis, intestinal inflammation and liver injury in different mouse models. Additionally, these isolates harbor multiple antimicrobial resistance genes coupled with mobile genetic elements. Collectively, the capability for producing various toxins and harboring mobile antimicrobial resistance genes in Bacillus probiotics indicates a potential risk for One Health. |
| ecosystem health; food safety and security; human health; microbiome; soil health | PEST-MANAGEMENT; BRONZE BUG; RESISTANCE; SPP.; PATHOGENICITY; EXPRESSION; VIRULENCE; SELECTION; DYNAMICS; URUGUAY | The concept of one health is gaining strength at a global scale. The term summarizes a notion that has been known for more than a century: human and animal health are interdependent and linked to the ecosystems in which they coexist. In the International Year of Plant Health (2020), it is crucial that the agricultural sciences call attention for the need to consider the health of plants and their microbiome as a whole within the one health concept, closely linked to the health of the soil, the environment, animals and humans. In the context of agroecological production based on the sustainable management of natural resources, integrated pest management has been promoted to reduce the use of pesticides and mitigate negative effects on human and environmental health. The combination of genetic resistance with cultural and biological control have contributed to achieving this goal. The management of the microbiome offers also the possibility of addressing plant nutritional issues and the continuum between environmental, plant, animal and human health. With its strategic plan and long-term vision, INIA plays an essential role in the generation of knowledge and technologies, acting in accordance to the one health approach. |
| animal health; emerging zoonoses; forefront; infectious diseases control; public health | DISEASE; ORIGIN | |
| One Health; COVID-19; Public health events; outbreaks; Public policy | | Background: In December 2019, new coronavirus pneumonia (COVID – 19) was found in Wuhan, China. The current epidemic is spreading in China and even the world. The virus has the characteristics of strong infectivity, long incubation period, mainly spread by droplets, close contact. So far there is no specific drug treatment. There are nearly 100,000 confirmed cases worldwide. Methods: In the current severe situation of the epidemic, this paper uses the methods of literature, investigation and logical and so on. Results: According to the special environment of China, the concept of One Health is proposed for prevention and control. Under the leadership of the government, multiple functional departments and disciplines cooperate to exchange information, forming a working mechanism of efficient coordination, seamless connection, a combination of prevention and control, and coordination among the masses. Conclusion: The government should set up a department of One Health to promote the coordination and cooperation between multiple departments and disciplines. It is suggested: 1. Strengthening infectious disease medical personnel training and public health research; 2. To intervene in the psychological crisis of different groups;3. Provide security and logistic support for medical staff; 4. Guarantee the reserve of protective and medical materials; 5. Vigilance and prevention and control of the weak period of the epidemic;6. International opinion dominates. |
| honeybee; Apis mellifera; One-Health; nexus; landscape; beekeeper; pathogens | COLONY COLLAPSE DISORDER; VARROA-DESTRUCTOR; AGRICULTURAL LANDSCAPES; CROP POLLINATION; CITIZEN SCIENCE; ONE WORLD; BEES; KNOWLEDGE; CONSERVATION; BIODIVERSITY | Global insect decline impacts ecosystem resilience; pollinators such as honeybees (Apis mellifera L.) have suffered extensive losses over the last decade, threatening food security. Research has focused discretely on in-hive threats (e.g., Nosema and Varroa destructor) and broader external causes of decline (e.g., agrochemicals, habitat loss). This has notably failed to translate into successful reversal of bee declines. Working at the interdisciplinary nexus of entomological, social and ecological research, we posit that veterinary research needs to adopt a One-Health approach to address the scope of crises facing pollinators. We demonstrate that reversing declines will require integration of hive-specific solutions, a reappraisal of engagement with the many stakeholders whose actions affect bee health, and recontextualising both of these within landscape scale efforts. Other publications within this special issue explore novel technologies, emergent diseases and management approaches; our aim is to place these within the One-Health context as a pathway to securing honeybee health. Governmental policy reform offers a particularly timely pathway to achieving this goal. Acknowledging that healthy honeybees need an interdisciplinary approach to their management will enhance the contributions of veterinary research in delivering systemic improvements in bee health. |
| antimicrobial resistance; antimicrobial stewardship; community health workers; health practitioners; infection prevention and control; multidisciplinary; one health; Uganda; UK | | Antimicrobial stewardship (AMS), as one of the global strategies to promote responsible use of antimicrobials to prevent antimicrobial resistance (AMR), remains poor in many low-and middle-income countries (LMICs). We implemented a project aimed at strengthening AMS in Wakiso district, Uganda using a One Health approach. A total of 86 health practitioners (HPs), including animal health workers, and 227 community health workers (CHWs) participated in training workshops, and over 300 pupils from primary schools were sensitized on AMR, AMS, and infection prevention and control (IPC). We further established two multidisciplinary online communities of practice (CoPs) for health professionals and students, with a current membership of 321 and 162, respectively. In addition, a Medicine and Therapeutics Committee (MTC) was set up at Entebbe Regional Referral Hospital. The project evaluation, conducted three months after training, revealed that the majority of the HPs (92.2%) and CHWs (90.3%) reported enhanced practices, including improved hand washing (57.3% and 81.0%, respectively). In addition, 51.5% of the HPs reported a reduction in the quantity of unnecessary antibiotics given per patient. This project demonstrates that AMS interventions using a One Health approach can promote understanding of the prudent use of antimicrobials and improve practices at health facilities and in communities. |
| One Health; Gender; Zoonotic disease; Survey; Risk factor; Mixed methods | EPIDEMIOLOGY; COMMUNITY; OUTBREAK; DISEASES; ANTHRAX; VIRUSES; FEVER | Gender sensitivity in health promotion has been widely recommended, yet attention to gender roles and gender-disaggregated studies is often lacking in disease research and public health intervention planning. In the rural Mnisi community of Mpumalanga, South Africa, where zoonotic pathogens are known to contribute to acute febrile illness, community and household tasks may increase an individual’s risk of exposure, and these tasks are likely to be influenced by gender. This study described the roles and responsibilities of community residents, specifically those that have been identified as critical control points for infectious pathogen exposure, by gender. Male gender-typed tasks included those associated with livestock and poultry husbandry, hunting and slaughtering wildlife, and rodent control. Female gender-typed tasks included animal-sourced food preparation, domestic cleaning and maintenance, and caregiving to children and ill family members. Given the gender-specific nature of these tasks, potential pathogen exposure and transmission patterns of infectious diseases may be also gender specific. These data can inform the development and revision of health promotion strategies, such as the community-based One Health Training and Leadership program, prioritizing outcomes for male and female participants alike. Gender-disaggregated analysis is recommended for effective risk mitigation and community-wide health promotion using a One Health approach. |
| staphylococci; slaughterhouse; genes of resistance; pcr; sus scroffa domesticus; one health | AUREUS | |
| complex thinking; coronavirus pandemic; multilevel causes; non‐ linearity; One Health | ONE HEALTH; EMERGENCE | Complex crises like the coronavirus pandemic are showing us that modern societies are becoming increasingly unable to live in equilibrium with nature. These crises are the result of multiple causes, which interact at different scales and across different domains. Therefore, investigating their proximate causes is not enough to fully understand them. It is also crucial to take into account the structural factors involved. As concerns the global pandemic, I suggest four levels of analysis: (i) the surface or proximate level of the crisis; (ii) the human-environment-animal interface, as pointed out by the One Health approach; (iii) the broader socioeconomic context; and (iv) the deeper or worldview level. Furthermore, I argue that there is the need for a mindset shift if we want to properly trace causality. Much more attention must be given to the study of multilevel connecting patterns and nonlinear mechanisms as the producers of emergent global effects. |
| pandemic; zoonoses; emerging diseases; wildlife; bushmeat; one health | AVIAN INFLUENZA; FRUIT BATS; VIRUS; BUSHMEAT; EBOLA; RESERVOIRS; WILDLIFE; HEALTH; EMERGENCE; INSIGHTS | |
| One health; Livelihood; Bougainville; Cocoa; Productivity; Poverty; Farmer; Transdisciplinary | TRANSDISCIPLINARY RESEARCH; ONE MEDICINE; SCIENCE | Cocoa production is the major contributor to livelihoods for farming families that constitute nearly two-thirds of the population of the Autonomous Region of Bougainville, a Province in Papua New Guinea (PNG). These families, living mostly in subsistence poverty as a result of the Bougainville Civil War (1988-98), have significantly reduced cocoa production. Efforts to rebuild the industry have not been realised, due to known agricultural factors such as labour shortages, pests and diseases, poor support for farmers from trained agricultural extension officers and inefficient cocoa supply chains. But cocoa production involves factors other than agricultural ones. This article describes how we applied One Health methods to design and undertake a 6-year research project in Bougainville to improve cocoa productivity. Maximising the health and wellbeing of farming families and increasing agricultural productivity we argue, requires an in-depth understanding of the non-linear interactions between health, labour, household decision-making, yields and incomes. |
| avian influenza viruses; infectious aerosol; one health; phylogenetic analysis; poultry market | AVIAN INFLUENZA; POULTRY MARKETS; H9N2; INFECTION | |
| epidemic; pathogens; One Health; outbreak; zoonosis; spillover; transmission | HENDRA VIRUS; INFECTION; ZOONOSES; RISK | Zoonotic diseases pass between humans and other animals and are a major global health challenge. Lyme disease, SAPS, swine flu, and Ebola are all examples of diseases spilling over to humans from other animals. Students may hear about these outbreaks in the news but learn very little about them in the classroom. We describe an activity designed to teach high school or college students about zoonotic disease outbreaks. This case-based lesson also introduces how habitat disruption can lead to far-reaching impacts on livestock and humans, often indirectly. Collaborative problem solving is used to explore the One Health concept and a real-world spillover event involving Hendra virus. Active learning using a jigsaw format to model the value of multiple stakeholders engages students in tracing the path of transmission for a pathogen. The scenario and class activity demonstrate how scientists and health professionals routinely work together to figure out the chain of transmission for a novel pathogen and use this information to limit the spread of disease. |
| | The COVID-19 pandemic has spread worldwide since the outbreak in Wuhan (China) in December 2019, currently infecting over 25 million people and causing more than 800.000 deaths. In Ecuador, up to the 30th of August 2020, overall 113.648 confirmed cases and 6.555 deaths have been declared. Besides overloading of hospital, capacity for molecular diagnosis of SARS-CoV-2 by the Ministry of Public Health was quickly overwhelmed. In this context, emergency authorization for SARS-CoV-2 RT-qPCR diagnosis was granted to other institutions, like the Agencia de Regulaci ‘ on y Control para la Bioseguridad y Cuarentena de Gal ‘ apagos (ABG), that implemented LabGal with support of One Health Research Group from Universidad de Las Ame ‘ ricas (UDLA). The previous experience of ABG and the One Health Research Group in conducting massive surveillance of zoonotic diseases on livestock was crucial to the success on the control of COVID-19 outbreak at Galapagos Islands by the end of May 2020, when Latin American countries were leading the spread of the pandemic. |
| Salmonella; serovar distribution; One-Health; humans; foods; animals | SALMONELLA-ENTERICA SEROVAR; OUTBREAK; TYPHIMURIUM; WELTEVREDEN; PREVALENCE; POULTRY; MEAT; VEGETABLES; RESISTANCE; STRAINS | We analyzed the epidemiological distribution ofSalmonellaserovars in humans, foods, animals and the environment as a One-Health step towards identifying risk factors for human salmonellosis. Throughout the 2012-2016 period,Salmonellaser. Enteritidis was consistently the predominating serovar attributing to >20.0% of isolates in humans. Other most common serovars in humans includeSalmonellaser. Stanley,Salmonellaser. Weltevreden,Salmonellaser. Typhimurium andSalmonellaser. 4,5,12:b:-(dT+).S.Enteritidis was also the most frequent serovar found among the isolates from chicken/chicken products (28.5%) and eggs/egg products (61.5%) during the same period. In contrast,S.Typhimurium (35.2%) andSalmonellaser. Derby (18.8%) were prevalent in pork/pork products.S. Weltevreden was more frequent in seafood (19.2%) than others (<= 3.0%). Most isolates (>80.0%) from farms, companion and wildlife animals belonged to serovars other thanS. Enteritidis orS. Typhimurium. Findings demonstrate the significance of a One-Health investigative approach to understand the epidemiologySalmonellafor more effective and integrated surveillance systems. |
| climate change; One Health; Candida auris; COVID 19; emerging pathogens; antimicrobial resistance | AEDES-AEGYPTI DIPTERA; GLOBAL CLIMATE; DISEASES; TEMPERATURE; SURVIVAL | Climate change has become a controversial topic in today’s media despite decades of warnings from climate scientists and has influenced human health significantly with the increasing prevalence of infectious pathogens and contribution to antimicrobial resistance. Elevated temperatures lead to rising sea and carbon dioxide levels, changing environments and interactions between humans and other species. These changes have led to the emergence and reemergence of infectious pathogens that have already developed significant antimicrobial resistance. Although these new infectious pathogens are alarming, we can still reduce the burden of infectious diseases in the era of climate change if we focus on One Health strategies. This approach aims at the simultaneous protection of humans, animals and environment from climate change and antimicrobial impacts. Once these relationships are better understood, these models can be created, but the support of our legislative and health system partnerships are critical to helping with strengthening education and awareness. |
| Q fever; vaccination; animal science; veterinary; One Health; Australia | RISK-FACTORS; INFECTION; PREVALENCE | Unvaccinated animal science and veterinary students are at risk of Q fever, a vaccine-preventable zoonotic disease transmitted from animals to humans. We investigated students’ perspectives on Q fever prevention using a One Health approach combining animal, human and environmental health. Animal science and veterinary students enrolled at the University of Adelaide in 2019 were invited to participate in an online survey to explore their perceptions about Q fever and prevention strategies. We undertook descriptive analysis and logistic regression. Overall, 46% of students reported little to no knowledge of Q fever. Over three-quarters of students reported transmission of Q fever via aerosol inhalation and animal culling, whilst other modes including sexual transmission between humans (7%) was poorly identified. The majority of students reported exposure to cattle, sheep and goats. Of those who reported vaccination status, 5% veterinary and 61% animal science students were unvaccinated for Q fever. Challenges concerning vaccination included cost, time and access to healthcare with strategies aimed at promoting awareness, improving healthcare access and subsidized and mass vaccination. Knowledge of Q fever among respondents, particularly about disease transmission was suboptimal. As a key principle to One Health approach, adherence to biosecurity guidelines during contact with animals could potentially reduce zoonoses including Q fever transmission. Improving access to Q fever vaccine for unvaccinated students is a priority. Findings underscore that university policy for Q fever vaccination needs to consider subsidized vaccination for both animal science and veterinary students. |
| Brucellosis; Neglected zoonosis; One health | EPIDEMIOLOGY | Brucellosis is a neglected zoonosis. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioeconomic impact. Over the past two decades, improvements have been made to better understand the various aspects of human and animal brucellosis. Meanwhile, especially in the developing world, immense challenges that remain in controlling and eradicating brucellosis are novel diagnostics tools and efficacious vaccines. Here, we will focus on the remarkable issues on epidemiological survey, as well as the priority and challenge of brucellosis in China. Brucellosis will be controlled with meaningful collaboration between local and public partnerships effectively applying a One Health framework. |
| aquaculture; COVID-19; fisheries; one health; SARS-CoV-2 | FOOD | The COVID-19 pandemic, caused by the SARS-CoV-2, has presented itself as a wicked problem where both the disease and its containment measures have caused significant human suffering. The pandemic has also affected every aspect of aquaculture and capture fisheries. Zoonotic origin of the SARS-CoV-2 and its containment measures, such as restrictions on the mobility of people, social distancing and ban on public gathering, have disrupted fish production, supply chain, consumer behaviour and perception for fish as a food item. The debilitating effect of COVID-19 on the global economy has also left people with less dispensable income, which can translate to poor fish sales in the upcoming years. Therefore, the effects of COVID-19 on society are not only a medical issue but have more profound and long-lasting socioeconomic consequences. The current article reviews the existing literature across multiple disciplines to determine the effects of the COVID-19 pandemic on multiple aspects of the aquaculture and fishing industry; aquaculture and capture fishery, post-harvest processing of fish, supply chain and consumer behaviour. The article also provides recommendations for making different aspects of aquaculture and fisheries resilient to a future pandemic-like situation. The recommendations are inspired by the principles of One Health that range from biological to socioeconomic aspects of the sector. A One Health approach is a collaborative effort from professionals belonging, but not limited, to the disciplines of medicine, veterinary, environment, economics, education and social sciences to make policy-level interventions for problems that can be difficult to address using conventional approach. |
| One Health approach; Traditional Milk Production; sustainability; Healthy Choices; SDGs | | The production of milk and cheese assumes activities in the field of agricultural production, veterinary health, and the use of milk and dairy products has public health significance, and can be viewed through the one health concept. The aim of the paper is to underline public health and sustainability significance of interconnection among agriculture, veterinary and technology. Production of hard cheese with added value from milk produced in organic and self-sustaining systems research the risks, advantages and possibilities of traditional cheese production and focused on creating conditions for organic milk and hard cheese with added value production, with precisely defined conditions: isolating land plots, livestock farms and processing facilities from possible sources of pollution, water quality, harmonized development of plant and animal production and the capability of producers for organic agriculture with the obligation to constantly innovate knowledge. The new products ensure the employment and livelihood of people in the countryside, the economic prosperity of small family farms, link the activities in the field of veterinary health and agricultural production, contribute to the development of risk-management technology, healthy chooses and compatible with SDGs. |
| Animal Coronaviruses; COVID-19; One Health; SARS-CoV-2 | ACUTE-RESPIRATORY-SYNDROME; MERS-COV; INFECTION; OUTBREAK; PATHOGENESIS; PNEUMONIA; EMERGENCE; VIRUS; SARS; SUSCEPTIBILITY | Coronaviruses are a group of enveloped, single-stranded, positive-sense RNA viruses that are broadly classified into alpha, beta, gamma, and delta coronavirus genera based on the viral genome. Coronavirus was not thought to be a significant problem in humans until the outbreak of severe acute respiratory syndrome in 2002, but infections in animals, including pigs, cats, dogs, and poultry, have been problematic for a long time. The outbreak of coronavirus disease 2019 in December 2019 in Wuhan, China, drew special attention towards this virus once again. The intermediate host of this novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is yet to be determined, but it has a very close genomic relationship with the bat coronavirus (Bat-CoV), RaTG13 strain and the pangolin coronaviruses. As veterinary medicine has a long-term experience dealing with coronaviruses, this could be helpful in better understanding and detecting the origin of SARS-CoV-2 and drive human medicine towards the development of vaccines and antiviral drugs through the collaborative and tansdisciplinary approaches of One Health. |
| Brucella; Pakistan; One Health | | Brucellosis is a zoonotic disease; endemic but neglected in the South Asian countries including Pakistan. It causes economic loss to the livestock sector and leads to systemic infection in humans. Brucellosis was neglected in Pakistan since long. According to the Staged Tool for the Elimination of Brucellosis (STEB), Pakistan carries a grim landscape of the disease with no structured control activities. This article describes the five-year national brucellosis control strategic plan (2018-2023) formulated by the government of Pakistan using the one-health approach for the prevention and control of disease across the country. The plan incorporates components of surveillance, research, diagnostic capacity, awareness and vaccination using a multi- disciplinary approach. |
| Epidemics; Emergence; Livestock; MERS-CoV; One Health; Pandemic; SARS-CoV-2 | RISK-FACTORS; HEALTH; OUTBREAK; SARS; MERS | Many emerging and re-emerging zoonotic infectious diseases occur in Africa. These are projected to increase as human-animal host contact increases owing to increasing environmental degradation that shrinks nature habitats for wildlife over the continent. The current outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) responsible for causing coronavirus disease in 2019 (COVID-19) has reinvigorated discourse on the disruptiveness of the zoonotic emerging infectious diseases, owing to their transboundary character. Even as the world focuses on the COVID-19 sweeping pandemic, the Middle East respiratory syndrome coronavirus (MERS)-CoV re-emerged in Saudi Arabia infecting 18 people with five deaths; this has barely received any attention. This outbreak is particularly of concern to the pastoralists in the Horn of Africa, a region that has in recent past seen an increase in camel trade with the Gulf States, especially Yemen and Saudi Arabia. Emerging and re-emerging zoonotic infectious diseases are complex, depend on human-animal-environment interaction and pose a strain on public health systems. There is a need to address these diseases dynamically through a synergistic approach, drawing on expertise from diverse sectors. One Health approach has distinguished itself as an integrative action able to bring together multiple actors on a global, national and local scale to advance the attainment of optimal health outcomes for people, animals and the environment. One Health works by strengthening the preparedness, response, mitigation and monitoring of zoonotic infectious disease risks collaboratively. We opine that as zoonotic emerging and re-emerging infectious diseases continue to rise over pastoral Africa, comprehensive implementation of the One Health approach will be urgently required. |
| COVID-19; SARS-CoV-2; coronavirus; zoonosis; transmission; one health; animal model; veterinarian | SARS-COV-2 | A novel coronavirus emerged in human populations and spread rapidly to cause the global coronavirus disease 2019 pandemic. Although the origin of the associated virus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) remains unclear, genetic evidence suggests that bats are a reservoir host of the virus, and pangolins are a probable intermediate. SARS-CoV-2 has crossed the species barrier to infect humans and other animal species, and infected humans can facilitate reverse-zoonotic transmission to animals. Considering the rapidly changing interconnections among people, animals, and ecosystems, traditional roles of veterinarians should evolve to include transdisciplinary roles. |
| avian influenza; avian influenza A virus; Bangladesh; influenza in birds; live bird market; pathogen transmission | H5N1; POULTRY | In response to unusual crow die-offs from avian influenza A(H5N1) virus infection during January-February 2017 in Dhaka, Bangladesh, a One Health team assessed potential infection risks in live bird markets (LBMs). Evidence of aerosolized avian influenza A viruses was detected in LBMs and in the respiratory tracts of market workers, indicating exposure and potential for infection. This study highlighted the importance of surveillance platforms with a coordinated One Health strategy to investigate and mitigate zoonotic risk. |
| clinician-scientist; graduate education; veterinary medical education; investigative pathologist; veterinary specialty; veterinary pathology; DVM/PhD; comparative medicine; predictive translational modeling; NIH intramural research training award (IRTA); NCI cancer research training award (CRTA) | VIRUS | Limitations in workforce size and access to resources remain perennial challenges to greater progress in academic veterinary medicine and engagement between human and veterinary medicine (One Health). Ongoing resource constraints occur in part due to limited public understanding of the role veterinarians play in improving human health. One Health interactions, particularly through interdisciplinary collaborations in biomedical research, present constructive opportunities to inform resource policies and advance health care. To this end, inter-institutional partnerships between individual veterinary medical education programs (VMEPs) and several National Institutes of Health (NIH) intramural research programs have created synergies beyond those provided by individual programs. In the NIH Comparative Biomedical Scientist Training Program (CBSTP), interdisciplinary cross-training of veterinarians consisting of specialty veterinary medicine coupled with training in human disease research leading to a PhD, occurs collaboratively on both VMEP and NIH campuses. Pre-doctoral veterinary student research opportunities have also been made available. Through the CBSTP, NIH investigators and national biomedical science policy makers gain access to veterinary perspective and expertise, while veterinarians obtain additional opportunities for NIH-funded research training. CBSTP Fellows serve as de facto ambassadors enhancing visibility for the profession while in residence at NIH, and subsequently through a variety of university, industry, and government research appointments, as graduates. Thus, the CBSTP represents an inter-institutional opportunity that not only addresses critical needs for veterinarian-scientists in the biomedical workforce, but also simultaneously exposes national policy makers to veterinarian-scientists’ specialized training, leading to more effective realization of One Health goals to benefit human and animal health. |
| Ebola; One health; Infectious disease control; Democratic Republic of Congo | | The Democratic Republic of Congo (DRC) is facing its tenth outbreak of Ebola virus disease (EVD), in North-Kivu and Ituri provinces. This is the second most deadly EVD outbreak in history, after the one that occurred in West Africa in 2014. The DRC Ministry of Health (MoH), supported by the World Health Organization (WHO) and a range of regional and international partners, are implementing EVD response plans in these affected areas such as screening of suspect cases at points of entry, case detection, contact tracing, laboratory testing, case management and infection prevention and control, safe and dignified burials, ring vaccination (this involves vaccination of infected individuals, direct contacts of infected individuals and contacts of their contacts), and therapeutics, community mobilization and free access to healthcare services. Despite these efforts, there has been a sharp rise in the number of confirmed cases within the identified affected areas, and due to a number of challenges unique to DRC, there has been an expansion in the geographical extent of transmission. The significance of the proximity of these regions to wildlife and the Virunga National Park is questionable in the EVD transmission dynamics. The close interaction between human, animal, and environmental factors, in combination with high population movement due to regular rebel attacks in these regions, suggest the need for the integration of the One Health approach in the holistic response plans for control and prevention of EVD. This paper seeks to highlight the implications and importance of a One Health-based approach into the infectious diseases control program implementation in DRC. |
| Antimicrobial resistance; Surveillance; One health; Antibiotics | STAPHYLOCOCCUS-AUREUS; FOOD ANIMALS; INFECTIONS; PREVALENCE; PATTERNS | Antimicrobial Resistance is threatening to upset much of the progress that developing countries have made in the healthcare domain over the last few decades. Though there are issues with the projected morbidity and mortality figures, there is a general agreement that the data collection processes need to be strengthened, especially in the context of developing countries of Asia, Africa and Latin America. The high burden of disease associated with communicable diseases in Africa, increases the overall antibiotic use and weakens the healthcare system of the continent. Even though the scale of antibiotic use may be lower than in some other regional contexts, the high burden of infectious disease makes antimicrobial resistance a priority in the continental context. In human health sector, antibiotic resistance is becoming a problem in community acquired infections as well as healthcare associated infections. This situation is fuelled by the rampant misuse of antibiotics across the African countries; and the surveillance efforts have been quite weak in this regard. Antibiotic use is increasing in food animal production too, as the continent is moving towards various intensification methods to improve productivity. Therefore the surveillance of antimicrobial resistance patterns in animal health and food animal production, has a lot of significance in understanding the potential threats to human health and food security. But for any surveillance system to be effective, especially in the context of AMR, it needs to be truly ‘One Health’ in its approach. The division between animal health and human health is not scientific, but cultural in its character. This has to be broken down to create a proper ‘One Health’ surveillance system with data integration possible at different levels. |
| One-health; Sleeping sickness; Elimination; Zoonotic; UTCC stakeholders; TIBA | | Elimination of sleeping sickness from endemic countries like Uganda is key if the affected communities are to exploit the potential of the available human and livestock resources (production and productivity). Trypanosoma brucei rhodesiense, the parasite that causes acute sleeping sickness in humans, is transmitted by tsetse flies and co-exists in non-human animal reservoirs. Uganda by Act of Parliament in 1992 decided to handle the complex approach to control of sleeping sickness and animal trypanosomiasis by establishing the Uganda Trypanosomiasis Control Council (UTCC) and its secretariat the Coordinating Office for the Control of Trypanosomiasis in Uganda (COCTU). The Institutional arrangement aimed to promote engagement with key stakeholders across nine key ministries and the community, all vital for control of zoonotic sleeping sickness, creating a One Health platform, long before such practice was common. From 2006, approaches by the Public Private Partnership, Stamp Out Sleeping Sickness (SOS) have required involvement of stakeholders in the promotion of insecticide treated cattle as live tsetse baits, targeting elimination of zoonotic sleeping sickness. Experiences in promoting sustainability of these interventions have been captured in this study as part of the Tackling Infections to Benefit Africa (TIBA) partnership. Meeting transcripts, focus group discussions and questionnaires were used to collect data from the different stakeholders involved in a rapid impact live bait study over 12 months from Dec 2017. The study provides unprecedented insights into the stakeholders involved in the application of a One health approach for control of zoonotic sleeping sickness across the most important active human African trypanosomiasis focus in East Africa. This unique study is fundamental in guiding multi-stakeholder engagement if the goal to eliminate zoonotic sleeping sickness is to be realised. A major challenge is timely feedback to the community as regards human and animal disease status; rapid diagnostic services that can be delivered from facilities established in close proximity to the affected communities and well equipped in-country reference laboratories are key to delivering effective control and best One Health Approach. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of World Federation of Parasitologists. |
| Human-animal bond; one-health; Rasch analysis; homeless | PET EVACUATION FAILURE; LEXINGTON ATTACHMENT; OWNERSHIP; BEHAVIORS; SCALE; RELINQUISHMENT; CHILDREN; BENEFITS; YOUTH; ME | In response to a gap in veterinary care for low-income, under-served populations, the Student Health Outreach for Wellness (SHOW) Clinic in Phoenix, AZ took a One-Health initiative to establish a pilot veterinary care program to serve the veterinary needs of the local homeless pet owners receiving human medical care at the clinic. The study examines the pilot program through the lens of the human-animal bond (HAB) and focuses specifically on the attachment dimension of the bond as measured by the Lexington Attachment to Pets Scale (LAPS). Data was collected from the homeless pet owners, and Rasch modeling was used to investigate the importance of various factors of the owner attachment to pet as described in LAPS items. The results demonstrate the perceptions of the homeless pet owners of ownership. The findings also provide psychometric evidence for revising the LAPS to better serve future research on human-animal relationships. Limitations and possible extensions of the research as related to the HAB and owner attachment to pets are discussed and enhancements proposed for the pilot program to better serve the local homeless people. |
| arbovirus; early warning; integrated surveillance; One Health | RIFT-VALLEY FEVER; AEDES-AEGYPTI; EPIDEMIOLOGY; OUTBREAK; DRIVEN; KENYA; MODEL | Emerging and re-emerging infectious diseases and zoonoses indicate the importance of the One Health (OH) approach for early warning. At present, even when surveillance data are available, they are infrequently timeously shared between the health sectors. In the context of the MediLabSecure (MLS) Project, we investigated the collection of a set of surveillance indicators able to provide data for the implementation of integrated early warning systems in the 22 MLS countries of the Mediterranean, Black Sea and Sahel regions. We used an online questionnaire (covering vector, human, and animal sectors), focusing on seven relevant arboviruses, that was submitted to 110 officially appointed experts. Results showed that West Nile virus was perceived as the most relevant zoonotic pathogen, while Dengue virus was the most relevant non-zoonotic pathogen in the study area. Data collection of early warning indicators is in place at a different level for all the investigated pathogens and in almost all the MLS Countries. Further assessments on the reliability of the collection in place and on the feasibility of piloting an integrated early warning system for arbovirus could verify if integrated early warning really represents the Achilles’ heel of OH. |
| 16S rRNA gene; cow rumen; DNA extraction; high-throughput sequencing; human gut; microbiome; One Health; plant root; soil | EXTRACTION; ARCHAEA; DNA; BACTERIA; PLANT | The ‘One Health’ framework emphasizes the ecological relationships between soil, plant, animal and human health. Microbiomes play important roles in these relationships, as they modify the health and performance of the different compartments and influence the transfer of energy, matter and chemicals between them. Standardized methods to characterize microbiomes along food chains are, however, currently lacking. To address this methodological gap, we evaluated the performance of DNA extraction kits and commonly recommended primer pairs targeting different hypervariable regions (V3-V4, V4, V5-V6, V5-V6-V7) of the 16S rRNA gene, on microbiome samples along a model food chain, including soils, maize roots, cattle rumen, and cattle and human faeces. We also included faeces from gnotobiotic mice colonized with defined bacterial taxa and mock communities to confirm the robustness of our molecular and bioinformatic approaches on these defined low microbial diversity samples. Based on Amplicon Sequence Variants, the primer pair 515F-806R led to the highest estimates of species richness and diversity in all sample types and offered maximum diversity coverage of reference databases in in silico primer analysis. The influence of the DNA extraction kits was negligible compared to the influence of the choice of primer pairs. Comparing microbiomes using 515F-806R revealed that soil and root samples have the highest estimates of species richness, while lowest richness was observed in human faeces. Primer pair choice directly influenced the estimation of community changes within and across compartments and may give rise to preferential detection of specific taxa. This work demonstrates why a standardized approach is necessary to analyse microbiomes within and between source compartments along food chains in the context of the One Health framework. |
| bovine tuberculosis; dairy farmworker; Mycobacterium bovis; One Health; zoonotic disease | MYCOBACTERIUM-BOVIS; UNITED-STATES; DISEASE; EPIDEMIOLOGY; TRANSMISSION | Bovine tuberculosis is caused byMycobacterium bovis (M. bovis), which infects both humans and cattle. In 2018, a dairy farm in Wisconsin was affected byM. bovis, including a farmworker with exposure to the affected herd. Largely eradicated by effective public health strategies in the United States, most cases are now associated with risk factors including occupational hazards, food consumption, and iatrogenic infections.M. boviscontinues to cause disease worldwide affecting certain at-risk populations in the United States. Infections more often result in extrapulmonary sequelae and resistance to pyrazinamide is universal. Thus, successful treatment depends on early and correct identification of the mycobacterium species. A One Health approach to control this re-emerging disease is crucial. |
| Preparedness; West Nile virus; After action reviews; Epidemics; Outbreaks; Infectious disease; Mosquito-borne disease | | Background After Action Reviews (AAR) with a One Health perspective were performed in Slovenia, Italy, Serbia and Greece following a severe West Nile virus (WNV) transmission season in 2018. A protocol combining traditional techniques and organizational process analysis was developed and then implemented in each country. Results In 2018, response to the unusually intense transmission season of WNV in Slovenia, Italy, Serbia and Greece took place through routine response mechanisms. None of the four countries declared a national or subnational emergency. We found a very strong consensus on the strengths identified in responding to this event. All countries indicated the availability of One Health Plans for surveillance and response; very high laboratory diagnostic capacity in the human, veterinary and entomology sectors and strong inter-sectoral collaboration with strong commitment of engaged institutions as critical in the management of the event. Finally, countries implementing One Health surveillance for WNV (in terms of early warning and early activation of prevention measures) consistently reported a positive impact on their activities, in particular when combining mosquito and bird surveillance with surveillance of cases in humans and equids. Recurring priority areas for improvement included: increasing knowledge on vector-control measures, ensuring the sustainability of vector monitoring and surveillance, and improving capacity to manage media pressure. Conclusions The AARs presented here demonstrate the benefit of cross-sectoral and cross-disciplinary approaches to preparedness for West Nile virus outbreaks in Europe. In the coming years, priorities include fostering and strengthening arrangements that: enable coordinated One Health surveillance and response during WNV transmission seasons; ensure adequate laboratory capacities; strengthen risk communication; and fund longer-term research to address the knowledge gaps identified in this study. |
| COVID-19; SARS-CoV2; companion animal; zoo animal; One Health; comparative medicine; Remdesivir (RDV; GS-5734) | CANINE CORONAVIRUS | The COVID-19 pandemic in 2020 has stimulated open collaboration between different scientific and clinical disciplines like never before. Public and private partnerships continue to form in order to tackle this unprecedented global challenge. This paper highlights the importance of open collaboration and cooperation between the disciplines of medicine, veterinary medicine, and animal health sciences in the fight against COVID-19. Since the pandemic took the whole world by surprise, many existing drugs were rapidly repurposed and tested in COVID-19 clinical trials and some of the trials are revealing promising results, it is clear that the long-term solution will come in the form of vaccines. While vaccines are being developed, the antiviral agent Remdesivir (RDV, GS-5734) is being repurposed for use in human clinical trials but this is being done without acknowledging the significant efforts that went into development for treating cats with feline infectious peritonitis (FIP), a highly fatal immune-mediated vasculitis in cats which is caused by a feline coronavirus. There are many other antiviral drugs and immune modulating treatments that are currently being trialed that have animal health origins in terms of discovery and clinical development. Closer collaboration between the animal health and human health sectors is likely to accelerate progress in the fight against COVID-19. There is much that we do not yet know about COVID-19 and its causative agent SARS-CoV-2 but we will learn and progress much faster if we increase interdisciplinary collaboration and communication between human and animal health researchers and taking a genuine One Health approach to this and other emerging viral pathogens. Enhanced knowledge of zoonotic coronaviruses can significantly enhance our ability to fight current and future emerging coronaviruses. This article highlights the acute need for One Health and comparative medicine and the crucial importance of building on and recognizing veterinary research for addressing future human pandemics. |
| | Since 2001, more than 3.3 million US service members have been deployed to operations Iraqi Freedom, Enduring Freedom, New Dawn, Inherent Resolve and Freedom’s Sentinel. Visible and invisible war wounds from direct combat experiences, coupled with environmental exposures to harmful substances, can complicate veterans’ health throughout their lifespan. While promoting a holistic view of health, health professionals should be attentive for potential risks associated with environmental or animal exposures (One Health concept). During deployment, infectious and non-infectious environmental exposures and harmful substances in the air, on the land and in the water may result in immediate- or long-term health effects. Veterans can also face psychosocial health risks when home that may impact their concentration, emotional responses and social interactions. To strengthen health professions education, the authors recommend that curricula incorporate a comprehensive overview of veterans’ physical and psychosocial health risks as a result of their deployment. They describe four specific curriculum topics, competencies and didactic methods that can reinforce veteran-specific content for clinical education and training. By applying the One Health concept, health professionals can document harmful environmental exposures during deployment, report gaps in clinical practice, and provide support for veterans’ physical and psychosocial health needs when returning to civilian life. Military service experience, overseas deployment and post-deployment reintegration to civilian life are recognised chapters in the lives of military service members |
| COVID-19; biosecurity; One health; animal health; social science | ANIMAL-DISEASE; ONE WORLD; 2001 FOOT; SCIENCE; CONSEQUENCES; NARRATIVES; AUSTRALIA; TRUST | Whatever we read about Covid-19, the word unprecedented is not far away: whether in describing policy choices, the daily death tolls, the scale of upheaval, or the challenges that await a readjusting world. This paper takes an alternative view: if not unpredictable, the crisis unfolding in the United Kingdom (UK) is not unprecedented. Rather, it is foretold in accounts of successive animal health crises. Social studies of biosecurity and animal disease management provide an anticipatory logic – a mirror to the unfolding human catastrophe of Covid-19, providing few surprises. And yet, these accounts appear to be routinely ignored in the narrative of Covid-19. Do social studies of animal disease really have no value when it comes to guiding and assessing responses to Covid-19? To answer this question, we describe the narrative arc of the UK’s approach to managing Covid-19. We then overlay findings from social studies of animal disease to reveal the warnings they provided for a pandemic like Covid-19. We conclude by reflecting on the reasons why these studies have been paid minimal attention and the extent to which the failure to learn from these lessons of animal health management signals a failure of the One Health agenda. |
| ANTIBIOTIC-RESISTANCE; GENE; FAECIUM; FAECALIS; MACROLIDE; IDENTIFICATION; EPIDEMIOLOGY; VIRULENCE; HOMOLOG; CONTAMINATION | For a One-Health investigation of antimicrobial resistance (AMR) in Enterococcus spp., isolates from humans and beef cattle along with abattoirs, manured fields, natural streams, and wastewater from both urban and cattle feedlot sources were collected over two years. Species identification of Enterococcus revealed distinct associations across the continuum. Of the 8430 isolates collected, Enterococcus faecium and Enterococcus faecalis were the main species in urban wastewater (90%) and clinical human isolates (99%); Enterococcus hirae predominated in cattle (92%) and feedlot catch-basins (60%), whereas natural streams harbored environmental Enterococcus spp. Whole-genome sequencing of E. faecalis (n=366 isolates) and E. faecium (n=342 isolates), revealed source clustering of isolates, indicative of distinct adaptation to their respective environments. Phenotypic resistance to tetracyclines and macrolides encoded by tet(M) and erm(B) respectively, was prevalent among Enterococcus spp. regardless of source. For E. faecium from cattle, resistance to beta -lactams and quinolones was observed among 3% and 8% of isolates respectively, compared to 76% and 70% of human clinical isolates. Clinical vancomycin-resistant E. faecium exhibited high rates of multi-drug resistance, with resistance to all beta -lactam, macrolides, and quinolones tested. Differences in the AMR profiles among isolates reflected antimicrobial use practices in each sector of the One-Health continuum. |
| Integrated surveillance-response; One health; Pandemics; Transdisciplinarity; Zoonoses | ONE HEALTH; RABIES CONTROL; TRANSMISSION; BRUCELLOSIS; ELIMINATION; DYNAMICS | Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs. The transmission of such pathogens to humans may lead to self-sustaining chains of transmission. These pathogens represent the highest risk for future pandemics. For their prevention, the transmission over the species barrier – although rare – should, by all means, be avoided. In the current COVID-19 pandemic, surprisingly though, most of the current research concentrates on the control by drugs and vaccines, while comparatively little scientific inquiry focuses on future prevention. Already in 2012, the World Bank recommended to engage in a systemic One Health approach for zoonoses control, considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons. First examples, like integrated West Nile virus surveillance in mosquitos, wild birds, horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors. Provided a zoonotic origin can be ascertained for the COVID-19 pandemic, integrated wildlife, domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks. In conclusion, the earlier a zoonotic pathogen can be detected in the environment, in wildlife or in domestic animals; and the better human, animal and environmental surveillance communicate with each other to prevent an outbreak, the lower are the cumulative costs. |
| | This commentary places the Coronavirus Disease pandemic in the context of research approaches such as ‘Ecohealth,’ ‘One Health,’ and ‘Planetary Health.’ It argues that systemic analysis of the underlying drivers of the pandemic is called for and that this is a time when transdisciplinarity is needed more than ever. |
| Burkholderia mallei; glanders; zoonoses; one health | GLANDERS | Glanders is a fatal bacterial infection of equids caused byBurkholderia mallei. The infection can be transmitted to humans through prolonged direct contact with glanderous equids. Recently, reemergence of equine glanders has been reported in many countries. To investigate zoonotic transmission ofB malleiinfection, sera were collected from 538 humans including equine handlers and veterinary professionals exposed to glanderous equids. Samples were tested by ELISA (enzyme-linked immunosorbent assay) and complement fixation test and found negative forB mallei-specific antibodies. Even though there was no incidence of human glanders during this survey period, occupational exposure will continue to remain a serious concern and a key risk factor. Therefore, we emphasize the need for intersectoral collaboration and coordination among veterinary, human, and public health authorities for continuous surveillance and monitoring of human glanders under one health concept. |
| Avian influenza A; One Health; A(H9N2); Virus infection; Oman | EVOLUTION | Following the detection of the first human case of avian influenza A subtype H9N2 in 1998, more than 40 cases were diagnosed worldwide. However, the spread of the virus has been more remarkable and significant in global poultry populations, causing notable economic losses despite its low pathogenicity. Many surveillance studies and activities conducted in several countries have shown the predominance of this virus subtype. We present the case of a 14-month-old female in Oman with an A(H9N2) virus infection. This is the first human case of A(H9N2) reported from Oman and the Gulf Cooperation Countries, and Oman is the second country outside of southern and eastern Asia to report a case (cases have also been detected in Egypt). The patient had bronchial asthma and presented with a high-grade temperature and symptoms of lower respiratory tract infection that necessitated admission to a high dependency unit in a tertiary care hospital. It is of urgency that a multisector One Health approach be established to combat the threat of avian influenza at the animal-human interface. In addition to enhancements of surveillance and control in poultry, there is a need to develop screening and preventive programs for high-risk occupations. (c) 2019 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. |
| Aboriginal community; animal health; remote; One Health; dogs; cats; population management | INDIGENOUS COMMUNITIES; VETERINARY SERVICES; DOG; BITE | Simple Summary Many remote Australian Aboriginal communities face barriers in accessing animal health care for their pets. A community that faces these barriers implemented a community-driven program with the objective of improving animal health and population management. The program was evaluated by comparing the percentage of animals desexed, the body and hair condition of dogs, and the presentations at the health clinic for dog bites before versus after 12 months of program implementation. Results show improved animal health measures and no measurable change in human presentations for dog bites. This program, with One Health considerations, could be suitable for other communities facing similar animal health care barriers. This study evaluated a community-driven animal health and management program in the remote community of Wadeye, Northern Territory. This evaluation used a pre-post design to assess changes in animal and human health outcomes over a 12-month period of program implementation, from June 2018 to June 2019. The evaluation assessed the program by comparing animal health outcomes before versus one year after program implementation and comparing human health outcomes before versus during the first 12 months of the program. Outcome measures included the desexing status of dogs and cats, body condition and hair score of dogs, and rates of people presenting to the health clinic for a dog bite. Animal health outcomes significantly improved after program implementation. From pre to post program, there was a 77% increase in the prevalence of good body condition score among dogs and a 9% increase in the prevalence of good hair score among dogs, and the prevalence of desexed dogs and cats more than doubled. There was no significant change in the number of people presenting to the health clinic for a dog bite. Consideration on how to further incorporate human and environmental health aspects into the program could be useful for future One Health programs. |
| Active learning; Education; Inter-professional education; One World, One Health; Surveys; Veterinary students | MEDICAL-STUDENTS; PROFESSIONS; ATTITUDES | The increasingly acknowledged One Word, One Health (OH) concept studies the collaborative multi-disciplinary approaches for the assessment of human and animal health and the environment. This study provides information about a module of activities created to teach the OH concept to undergraduate veterinary students. The module consisted of three different activities: theoretical classes, teamwork for the preparation of different concepts and practical examples related to OH, and public presentations of the students of these practical cases. This module was evaluated by two questionnaires’ consisting of online surveys, which were filled in before (questionnaire 1, Q1) and after (questionnaire 2, Q2) the module about OH. Before the course, 80% of students recognized to have a poor or very poor knowledge about OH, and a 71% failed to include the three main items of the OH concept (humans, animals and environment) in their answers. After the course, the general knowledge about OH was improved and most students evaluated the course positively, although the lack of time and the high number of students per group were pointed out as the main drawbacks. In conclusion, the module of activities described in this report contributed to the increase of OH knowledge by veterinary students and could be a resource for future advances to improve the teaching of the OH concept in the curricula at University level in Veterinary and other Degrees related with OH. |
| general practitioners; One Health; veterinarians; zoonoses | HENDRA VIRUS; ZOONOTIC DISEASES; PHYSICIANS; INFECTION; COLLABORATION; QUEENSLAND; PREVENTION; EDUCATION | General medical practitioners (GPs) and veterinarians have different but complementary knowledge and skills, with potential to enhance clinical management of zoonoses in human and animal patients through taking a One Health approach that promotes cross-professional collaboration. Ability and willingness to engage within this framework is contingent on knowledge of endemic zoonoses and an understanding of the diversity of professional roles; however, previous research suggests that this is lacking. A unique parallel survey of Australian GPs and veterinarians was implemented to ascertain clinician experience, concern, confidence and current practices regarding zoonoses management as well as willingness to engage in cross-professional collaboration where it is beneficial to overall health outcomes. Responses from 528 GPs and 605 veterinarians were analysed. Veterinarians in clinical practice were found to more frequently diagnose zoonoses; have greater concern about zoonoses; be more confident in diagnosing, managing and giving advice about the prevention of zoonoses; more likely to give advice about managing the risk of zoonoses; and more likely to initiate cross-professional referral compared to GPs (p < .001 in all areas, adjusted for other factors). The findings of this study indicate a need for change in both clinical and continuing professional education, especially for GPs, in order to better equip them in the area of zoonoses management. Exploration of pathways to encourage and facilitate cross-professional referral and collaboration will further improve clinical outcomes for both human and animal patients. |
| ExPEC pathotypes; extraintestinal-pathogenic E. coli; India; one health; poultry | EXTENDED VIRULENCE GENOTYPES; MOLECULAR CHARACTERIZATION; ANTIMICROBIAL RESISTANCE; ESCHETICHIA-COLI; CHICKEN MEAT; PHYLOGENY; IDENTIFICATION; EXPRESSION; LINK | Aim: In-depth ‘One Health’ risk assessment of extraintestinal pathogenic Escherichia coli (ExPEC) strains carrying the traits of urinary tract infection, sepsis, meningitis and avian colibacillosis in poultry of India. Methods and Results: A total of 230 E. coli isolates were recovered from chicken samples representing the different sources (faeces vs caeca), stages (poultry farms vs retails butcher shop) or environments (rural vs urban) of poultry in India. Among all poultry-origin E. coli isolates, 49 (21.1%) strains were identified as ExPEC possessing multiple virulence determinants regardless of their association with any specific phylogenetic lineages. Of particular, potentially virulent ExPEC pathotypes, that is, uropathogenic E.coli (UPEC, 20.4%), avian pathogenic E. coli (APEC, 34.6%), septicaemia-associated E. coli (SEPEC, 47.0%) and neonatal meningitis-causing E.39 coli (NMEC, 2.0%) were also detected among all ExPEC strains. Conclusions: Our study is the first to assess ExPEC strains circulating in the different settings of poultry in India and significantly demonstrates their potential ability to cause multiple extraintestinal infections both in humans and animals. Significance and Impact of the Study: The data of our study are in favour of the possibility that poultry-origin putative virulent ExPEC pathotypes consequently constitute a threat risk to ‘One Health’ or for food safety and a great concern for poultry production of India. |
| biosecurity; climate change impact; One Health; genome; sequencing; infectious disease | ADAPTATION | Changes in the Earth’s climate and weather continue to impact the planet’s ecosystems, including the interface of infectious disease agents with their hosts and vectors. Environmental disasters, natural and human-made activities raise risk factors that indirectly facilitate infectious disease outbreaks. Subsequently, changes in habitat, displaced populations, and environmental stresses that affect the survival of species are amplified over time. The recurrence and spread of vector-borne (e.g., mosquito, tick, aphid) human, animal, and plant pathogens to new geographic locations are also influenced by climate change. The distribution and range of humans, agricultural animals and plants, wildlife and native plants, as well as vectors, parasites, and microbes that cause neglected diseases of the tropics as well as other global regions are also impacted. In addition, genomic sequencing can now be applied to detect signatures of infectious pathogens as they move into new regions. Molecular detection assays complement metagenomic sequencing to help us understand the microbial community found within the microbiomes of hosts and vectors, and help us uncover mechanistic relationships between climate variability and pathogen transmission. Our understanding of, and responses to, such complex dynamics and their impacts can be enhanced through effective, multi-sectoral One Health engagement coupled with applications of both traditional and novel technologies. Concerted efforts are needed to further harness and leverage technology that can identify and track these impacts of climate changes in order to mitigate and adapt to their effects. |
| AZA; conservation medicine; multidisciplinary; One Health; zoos | | Zoo veterinarians and allied professionals have been contributing to conservation medicine (CM) and One Health (OH) activities for more than two decades. Although the Association of Zoos and Aquariums (AZA) considers conservation a key part of its mission, little published material exists about the extent of AZA work in CM/OH or the challenges and opportunities associated with these endeavors. To better understand the current scope of CM/OH in zoos, we surveyed 53 AZA-accredited institutions from April through October of 2016. We obtained information on CM/OH infrastructure, support for expansion in this area, and strategies to overcome perceived obstacles hindering CM/OH from becoming a core AZA activity. Survey results revealed that while most zoos favor greater investment in CM/OH programs, awareness, and understanding of CM/OH across the broader zoo community and public is lacking. The majority of respondents stated that overcoming this challenge is paramount to attaining support for CM/OH initiatives. In spite of these obstacles, survey respondents highlighted many positive developments in CM/OH. We found that 84% of zoos surveyed are actively engaged in CM/OH activities, and 12% house formal CM/OH programs. Another 8% of respondents said their institutions were developing CM/OH programs. Perhaps most noteworthy, we found that zoo size did not have a significant bearing on the financial amount allocated toward an institution’s CM/OH activities. This suggests that all zoos, regardless of size, can make meaningful contributions to the growing movement of CM/OH and help redefine the role of zoos within this movement. |
| PCR RIBOTYPES; SURVEILLANCE | The One Health concept recognises that the health of humans is interconnected to the health of animals and the environment. It encourages multidisciplinary communication and collaboration with the aim of enhancing surveillance and research and developing integrative policy frameworks. Clostridium difficile (also known as Clostridioides difficile) infection (CDI) has long been viewed as a hospital-associated (HA) enteric disease mainly linked to the use of broad-spectrum antimicrobials that cause dysbiosis in the gut and loss of ‘colonisation resistance’. However, since the early 2000s, the rate of community-associated CDI (CA-CDI) has increased to similar to 15% in Europe, similar to 30% in Australia and similar to 40% in theUSAin populations often without obvious risk factors. Since the 1990s, it has become apparent that food animals are now a major reservoir and amplification host for C. difficile, including lineages of clinical importance. Cephalosporin antimicrobials, to which C. difficile is intrinsically resistant, were licensed for animal use in North America in 1990. By the second decade of the 21st century, there were reports of C. difficile contamination of food and the environment in general. Using whole-genome sequencing (WGS) and high-resolution typing, C. difficile isolates from humans, animals, food and the environment were proven to be genetically closely related and, in some cases, indistinguishable. This suggests possible zoonoses and/or anthroponoses, with contaminated food and the environment acting as the conduit for transmission between animals and humans. This paper summarises the key evidence that demonstrates the One Health importance of C. difficile. |
| FISH CONSUMPTION; CARBON FOOTPRINT; FOOD; IMPACTS; SYSTEMS; FISHERIES | By 2050, the majority of aquatic dietary protein will be produced by the aquaculture sector. A set of 15 metrics are presented here to guide the industry sustainably through the rapid growth and development it is experiencing. Aquaculture is predicted to supply the majority of aquatic dietary protein by 2050. For aquaculture to deliver significantly enhanced volumes of food in a sustainable manner, appropriate account needs to be taken of its impacts on environmental integrity, farmed organism health and welfare, and human health. Here, we explore increased aquaculture production through the One Health lens and define a set of success metrics – underpinned by evidence, policy and legislation – that must be embedded into aquaculture sustainability. We provide a framework for defining, monitoring and averting potential negative impacts of enhanced production – and consider interactions with land-based food systems. These metrics will inform national and international science and policy strategies to support improved aquatic food system design. |
| human fascioliasis hyperendemic; One Health; donkey; Fasciola hepatica; Galba truncatula experimental transmission; field epidemiology; reservoir role; Bolivia | NORTHERN BOLIVIAN ALTIPLANO; HEPATICA INFECTION; HOST; EGGS; REGION; RISK; POPULATIONS; PREVALENCE; CHILDREN; PATTERNS | A One Health initiative has been implemented for fascioliasis control in a human hyperendemic area for the first time. The area selected for this multidisciplinary approach is the Northern Bolivian Altiplano, where the highest prevalences and intensities in humans have been reported. Within the strategic intervention axis of control activities concerning animal reservoirs, complete experimental studies, and field surveys have been performed to assess the fascioliasis transmission capacity and epidemiological role of the donkey for the first time. Laboratory studies with altiplanic donkey-infecting Fasciola hepatica and altiplanic Galba truncatula snail vector isolates demonstrate that the donkey assures the viability of the whole fasciolid life cycle. Several aspects indicate, however, that F. hepatica does not reach, in the donkey, the level of adaptation it shows in sheep and cattle in this high altitude hyperendemic area. This is illustrated by a few-day delay in egg embryonation, longer prepatent period despite similar miracidial infectivity and shorter patent period in the intramolluscan development, lower cercarial production per snail, different cercarial chronobiology, shorter snail survival after shedding end, shorter longevity of shedding snails, and lower metacercarial infectivity in Wistar rats. Thus, the role of the donkey in the disease transmission should be considered secondary. Field survey results proved that liver fluke prevalence and intensity in donkeys are similar to those of the main reservoirs sheep and cattle in this area. Fasciolid egg shedding by a donkey individual contributes to the environment contamination at a rate similar to sheep and cattle. In this endemic area, the pronounced lower number of donkeys when compared to sheep and cattle indicates that the epidemiological reservoir role of the donkey is also secondary. However, the donkey plays an important epidemiological role in the disease spread because of its use by Aymara inhabitants for good transport, movements, and travel from one locality/zone to another, a repercussion to be considered in the present geographical spread of fascioliasis in the Altiplano due to climate change. Donkey transport of parasite and vector, including movements inside the zone under control and potential introduction from outside that zone, poses a problem for the One Health initiative. |
| ANTIBIOTIC-RESISTANCE; BARRIERS | Improving evidence for action is cnicial to tackle antimicrobial resistance. The number of interventions for antimicrobial resistance is increasing but current research has major limitations in terms of efforts, methods, scope, quality, and reporting. Moving the agenda forwards requires an improved understanding of the diversity of interventions, their feasibility and cost benefit, the implementation factors that shape and underpin their effectiveness, and the ways in which individual interventions might interact synergistically or antagonistically to influence actions against antimicrobial resistance in different contexts. Within the efforts to strengthen the global governance of antimicrobial resistance, we advocate for the creation of an international One Health platform for online learning. The platform will synthesise the evidence for actions on antimicrobial resistance into a fully accessible database; generate new scientific insights into the design, implementation, evaluation, and reporting of the broad range of interventions relevant to addressing antimicrobial resistance; and ultimately contribute to the goal of building societal resilience to this central challenge of the 21st century. |
| Antimicrobial resistance; Environment; Research activity; One health | ONE-HEALTH; ANTIBIOTIC-RESISTANCE; SUSTAINABLE DEVELOPMENT; BACTERIA; CHINA; LINKS | Background Antimicrobial resistance (AMR) is a global health threat that requires a One Health approach. Of the One Health triad, the environmental component is the most dynamic and most neglected. Therefore, the objective of the current study was to assess and analyze global research activity on AMR in the environment. Methods This was a bibliometric descriptive study of publications on AMR in the environment. Publications were retrieved using SciVerse Scopus for the study period from 2000 to 2019. The search query was developed using terms and phrases related to the topic. The retrieved publications were analyzed for specific bibliometric indicators including annual growth, citation analysis, key players, research output for each world regions, research themes, and occurrences of different drug classes of antimicrobials. Visualization maps including research collaboration were created using VOSviewer program. The Hirsch (h) index was used to assess scientific impact. Results There were 2611 research articles based on the implemented research query. The retrieved documents had an average of 22 citations per document and anh-index of 122. The annual number of publications showed a steep increase from 2011 to 2019. The major research themes in the field were (1) dissemination and abundance of antibiotic-resistant genes and (2) detection of bacterial strains or antibiotic residues in various environmental isolates. The bulk of the retrieved articles (n = 899; 34.4%) originated from the European region. China led with 598 (22.9%) documents. Four of the top 10 active institutions were in China. The top 10 active countries had relatively inadequate international research collaboration. The most commonly encountered antibiotic drug classes in the retrieved articles were penicillin/cephalosporin (n = 1152 occurrences). The most frequently encountered pathogen in the retrieved publications wasE. coli(n = 666). TheScience of the Total Environmentjournal was the most prolific journal with 139 (5.3%) publications. Conclusion Scientific literature on the AMR in the environment has witnessed a steep growth lately with a leading role of China and Chinese institutions. Data on AMR in the environment need to be collected from all world regions including the Eastern Mediterranean and African regions through research collaboration and funding of research in this field. |
| Antibiotics; Antimicrobials; Bacteria; Horses; One Health | ESCHERICHIA-COLI; STREPTOCOCCUS-EQUI; PREVALENCE; PROFILE | Lately, bacterial drug resistance has become an important worldwide problem in one health, where bacteria have undergone mutation becoming increasingly resistant. The major problem of bacterial drug resistance is the difficulty with eliminating microorganisms from different wounds and infected patients, and the therapeutic option is most often ineffective as a result of the repeated and inappropriate use of antimicrobials. The objective of this work was to detect and identify enterobacteria, to evaluate their resistance profile and the production of extended-spectrum beta-lactamases in draft horse isolates from the municipality of Umuarama, Parana, Brazil. A nasal, oral, and ear cavity swab was collected from 38 horses (used for animal traction) for isolation and bacterial identification, phenotypic antibiotic susceptibility testing, and the phenotypic test for the detection of extended-spectrum beta-lactamases-producing strains. In 12 swabs bacterial isolation was possible. Strains of Escherichia coli, Serratia rubidaea, Citrobacterdiversus, Kluyvera species, and Providenciaalcalifaciens were isolated. One hundred percent multidrug resistance was detected, and the antimicrobials that encountered the highest resistance were ertapenem (100%), cefotaxime (100%), cefoxitin (100%), ampicillin (100%), amoxicillin (100%), chloramphenicol (100%), and aztreonam (91.67%) and no extended-spectrum beta-lactamases -producing strain was detected. The results of this work reveal the presence of strains of the Enterobacteriaceae family associated with high bacterial resistance in horses used for animal traction in the municipality of Umuarama, State of Parana, Brazil, and these results confirm that these horses can be considered reservoirs of multidrug-resistant microorganisms. This situation can be considered an important problem of one health. |
| canine leishmaniasis; correlation; cryptic leishmaniasis; incidence; Leishmania infantum; One Health approach; Phlebotomus perniciosus; southern Spain; spatiotemporal trends | LOCALIZED MUCOSAL LEISHMANIASIS; RABBITS ORYCTOLAGUS-CUNICULUS; CANINE LEISHMANIASIS; VISCERAL LEISHMANIASIS; PHLEBOTOMUS-PERNICIOSUS; CUTANEOUS LEISHMANIASIS; RISK-FACTORS; INFECTION; REGION; SEROPREVALENCE | The aim of this study was to explore Leishmania infantum epidemiology through a One Health approach that promotes a better estimation of leishmaniasis burden and a deeper understanding of the spatial distribution of the key actors of the parasite life cycle (vectors, reservoirs and humans). We conducted a 14-year mixed retrospective and prospective study of leishmaniasis cases in an endemic area in southern Spain (Granada province), to estimate the human incidence and its association with the vector presence, cryptic leishmaniasis rates and canine leishmaniasis prevalence. We found an annual linear increase in the incidence that cannot be fully explained by active case surveillance and the improvement of PCR diagnostic techniques. 49.4% of cases were not reported to the surveillance system. Approximately half of the human cases correspond to the visceral form that occurred more frequently in men; cutaneous, mucosal and cryptic forms were also detected. Leishmaniasis is no longer a disease of young children, accounting for a quarter of immunocompetent patients and most infected people remained asymptomatic. Human and canine leishmaniasis, cryptic or symptomatic, are present in the whole province, where there is a medium/high risk of the presence of Phlebotomus perniciosus, the main vector. We found association between the incidence of human leishmaniasis and the presence of the vector, but not with the prevalence of canine leishmaniasis and cryptic human leishmaniasis. A potential hot spot was also found, where high leishmaniasis incidence may be associated to the involvement of host species other than dogs. |
| Hygiene practices; knowledge level; One-Health; zoonotic diseases | | Introduction: Globally, India is the largest milk producer with highest population of cattle i.e., 134 million cows and 124 million buffalos, with women accounting for 93 per cent of total employment in dairy production. The Indian subcontinent is one of the four global hot-spots at increased risk for emergence of zoonotic diseases. Health hazards occurring due to lack of awareness about the causes and impact of zoonosis on the public health are significant. In addition, fewer efforts are seen in One-Health programs in India. Objective: To assess the knowledge level regarding the risk of zoonoses and hygiene practices among rural female population with livestock. And also to assess the actual status of practices adopted in the small holder dairy farm. Materials and Methods: A cross-sectional study was conducted among 60 female populations in peri-urban area of Najafgarh, New Delhi. A structured questionnaire and checklist for observing practicing gaps were used for data collection; Knowledge level was calculated with the help of knowledge scores. Snowball sampling was used. The analysis was done with SPSS-(22). Descriptive statistics, one sample t-test, cross tabulation and Chi-square test were used. Results: Out of total score (28), the respondents got a maximum mean score of 11. Majority of respondents (75%) had low knowledge of specific zoonotic diseases and there was an observed gap in practice. Conclusion: 75% of the respondents had low knowledge on specific zoonotic diseases, hence importance should be given on increasing knowledge about the correct handling of the livestock especially in female population through national-programs and strengthening One-Health efforts. |
| trematodiasis; xenomonitoring; One Health; barcoding; artificial lake; integrative taxonomy; taxonomic impediment; parasitology | FRESH-WATER SNAILS; FASCIOLA-GIGANTICA; DNA-SEQUENCE; SCHISTOSOMIASIS; IDENTIFICATION; DIVERSITY; TREMATODA; TAXONOMY; AMPLIFICATION; TRANSMISSION | Trematodes are snail-borne parasites of major zoonotic importance that infect millions of people and animals worldwide and frequently hybridize with closely related species. Therefore, it is desirable to study trematodiases in a One Health framework, where human and animal trematodes are considered equally important. It is within this framework that we set out to study the snail and trematode communities in four artificial lakes and an abattoir in Zimbabwe. Trematode infections in snails were detected through multiplex PCR protocols. Subsequently, we identified snails by sequencing a partial mitochondrial cytochrome c oxidase subunit I (COI) fragment, and trematodes (adults from the abattoir and larval stages detected in snails) using COI and nuclear rDNA markers. Of the 1,674 collected snails, 699 were molecularly analyzed, in which we identified 12 snail and 19 trematode species. Additionally, three parasite species were sampled from the abattoir. Merely four trematode species were identified to species level through COI-based barcoding. Moreover, identification of members of the superfamilies Opisthorchioidea and Plagiorchioidea required a phylogenetic inference using the highly conserved 18S rDNA marker, as no related COI reference sequences were present in public databases. These barcoding challenges demonstrate a severe barcoding void in the available databases, which can be attributed to the neglected status of trematodiases. Adding to this, many available sequences cannot be used as different studies use different markers. To fill this gap, more studies on African trematodes, using a standardized COI barcoding region, are desperately needed. |
| AMERICAN-COLLEGE; CLINICAL ENDOCRINOLOGISTS; PRACTICE GUIDELINES; MEDICAL-CARE; OBESITY; ASSOCIATION; TECHNOLOGY; OVERWEIGHT | Background Some guidelines state that in-person weight management interventions are more efficacious than those delivered digitally. However, digital programs are more scalable and accessible. We hypothesized that one-on-one health coaching via app-based video chat would simulate an in-person experience and help achieve outcomes comparable to those of in-person interventions. Methods A 12-month digital weight management intervention was provided to overweight or obese adults recruited from a large technology company. One-on-one health coaching sessions were offered during a 24-week intensive phase as well as subsequent maintenance phase. Focused on sustainable changes in activity and diet, the intervention incorporates SMART goals, in-app food and activity logs, Fitbit integration, as well as optional sleep and stress modules. Self-Determination Theory and the Transtheoretical Model are incorporated to drive behavior change. Multilevel mixed-effects models were used to analyze weight changes retrospectively. Results Six hundred eighty-three participants reported 29,051 weights. At 12 months, mean percent changes in body weight were -7.2% and -7.6% for overweight and obese groups, respectively. A weight change of -5% is commonly targeted for in-person weight management interventions. Observed weight loss exceeded this target by 2.2% (95% CI, 0.7% to 3.8%; P < .01) for the overweight group and 2.6% (95% CI, 1.4% to 3.9%; P < .01) for the obese group. Conclusions Further research is needed with randomization to in-person or digital interventions. Though limited by an observational, retrospective design, preliminary results suggest that some digital weight management programs with one-on-one coaching may achieve outcomes comparable to those of robust, in-person interventions. |
| educational workshop; simulation; experiential learning; outbreak investigation | CUTANEOUS LEISHMANIASIS; PREPAREDNESS | Issues in the fields of wildlife disease and One Health are often difficult to address by single research groups because of the many disciplines and areas of expertise required to effectively solve complex problems.Although collaborations are becoming increasingly prevalent in the professional realm, many undergraduate, graduate, and professional students are merely introduced to the idea of collaboration without fully understanding how team-based approaches function. In this report, we describe the framework for a one-day workshop hosted by the Colorado State University student chapter of the Wildlife Disease Association (CSU WDA), where we gathered students and professionals to collectively investigate a simulated wildlife disease outbreak. CSU WDA student members designed the workshop and recruited professionals who are experts in their respective fields to run an outbreak simulation during the event. Based on pre- and post-event evaluation responses, this workshop was effective in increasing participants’ knowledge of disease ecology, pathology, genetics, and microbiology, as well as the importance of collaboration among disciplines as it pertains to wildlife disease outbreaks. |
| Human fascioliasis; Lymnaeids; Galba truncatula; rDNA; mtDNA; Geographical spread; Habitat modifications; One Health; Northern Bolivian Altiplano | LINKED-IMMUNOSORBENT-ASSAY; INTERMEDIATE HOSTS; ANIMAL FASCIOLIASIS; CLIMATE-CHANGE; HIGH-ALTITUDE; LIVER FLUKES; HEPATICA; TRANSMISSION; GASTROPODA; SNAILS | Background Fascioliasis is a snail-borne zoonotic trematodiasis emerging due to climate changes, anthropogenic environment modifications, and livestock movements. Many areas where Fasciola hepatica is endemic in humans have been described in Latin America altitude areas. Highest prevalences and intensities were reported from four provinces of the northern Bolivian Altiplano, where preventive chemotherapy is ongoing. New strategies are now incorporated to decrease infection/re-infection risk, assessment of human infection sources to enable efficient prevention measures, and additionally a One Health initiative in a selected zone. Subsequent extension of these pilot interventions to the remaining Altiplano is key. Methods To verify reproducibility throughout, 133 specimens from 25 lymnaeid populations representative of the whole Altiplano, and 11 used for population dynamics studies, were analyzed by rDNA ITS2 and ITS1 and mtDNA cox1 and 16S sequencing to assess their classification, variability and geographical spread. Results Lymnaeid populations proved to belong to a monomorphic group, Galba truncatula. Only a single cox1 mutation was found in a local population. Two cox1 haplotypes were new. Comparisons of transmission foci data from the 1990’s with those of 2018 demonstrated an endemic area expansion. Altitudinal, northward and southward expansions suggest movements of livestock transporting G. truncatula snails, with increasing temperatures transforming previously unsuitable habitats into suitable transmission areas. Transmission foci appear to be stable when compared to past field observations, except for those modified by human activities, including construction of new roads or control measures undertaken in relation to fascioliasis. Conclusions For a One Health initiative, the control of only one Fasciola species and snail vector species simplifies efforts because of the lower transmission complexity. Vector monomorphism suggests uniformity of vector population responses after control measure implementation. Hyperendemic area outer boundary instability suggests a climate change impact. All populations outside previously known boundaries were close to villages, human dwellings and/or schools, and should therefore be considered during disease control planning. The remarkable southward expansion implies that a fifth province, Aroma, should now be included within preventive chemotherapy programmes. This study highlights the need for lymnaeid molecular identification, transmission foci stability monitoring, and potential vector spread assessment. |
| NURSES | Precepting is a demanding but important role for successful onboarding in healthcare institutions. However, preceptors face many challenges, including inconsistent formal training, selection, and evaluation. One health system took a unique approach to this challenge by developing a transition to practice preceptor program through the institution’s professional governance culture. Program components include clearly outlined selection criteria, formal initial preparation, competency verification, resources, and recognition for preceptors. |
| COVID-19; Public health; Greater horn of Africa; Community one health teams; Food security; Livelihood security; Gender | PATHOGENIC AVIAN INFLUENZA; CAMEL MILK; SURVEILLANCE; VACCINATION; H5N1 | COVID-19 is a global pandemic that continues to spread around the world, including to Africa where cases are steadily increasing. The African Centres for Disease Control and Prevention is leading the pandemic response in Africa, with direction from the World Health Organization guidelines for critical preparedness, readiness, and response actions. These are written for national governments, lacking nuance for population and local differences. In the greater Horn of Africa, conditions unique to pastoralists such as inherent mobility and limited health and service infrastructure will influence the dynamics of COVID-19. In this paper, we present a One Health approach to the pandemic, consisting of interdisciplinary and intersectoral collaboration focused on the determinants of health and health outcomes amongst pastoralists. Our contextualized public health strategy includes community One Health teams and suggestions for where to implement targeted public health measures. We also analyse the interaction of COVID-19 impacts, including those caused directly by the disease and those that result from control efforts, with ongoing shocks and vulnerabilities in the region (e.g. desert locusts, livestock disease outbreaks, floods, conflict, and development displacement). We give recommendations on how to prepare for and respond to the COVID-19 pandemic and its secondary impacts on pastoral areas. Given that the full impact of COVID-19 on pastoral areas is unknown currently, our health recommendations focus on disease prevention and understanding disease epidemiology. We emphasize targeting pastoral toponymies with public health measures to secure market access and mobility while combating the direct health impacts of COVID-19. A contextualized approach for the COVID-19 public health response in pastoral areas in the Greater Horn of Africa, including how the pandemic will interact with existing shocks and vulnerabilities, is required for an effective response, while protecting pastoral livelihoods and food, income, and nutrition security. |
| Amblyomma; Coxiella burnetii; Coxiella-like endosymbionts; One Health; Sao Tome and Principe; spotted fever group rickettsiae | TICK-BORNE RICKETTSIOSES; PHYLOGENETIC ANALYSIS; COXIELLA-BURNETII; GENUS RICKETTSIA; DISEASES; IDENTIFICATION; INFECTION; SEQUENCES; DIAGNOSIS; WORLD | Spotted fever group rickettsiae (SFGR) andCoxiella burnetiiare intracellular bacteria that cause potentially life-threatening tick-borne rickettsioses and Q fever respectively. Sao Tome and Principe (STP), small islands located in the Gulf of Guinea, recently experienced a dramatic reduction in the incidence of malaria owing to international collaborative efforts. However, unexplained febrile illnesses persist. A One Health approach was adopted to investigate exposure to SFGR andC. burnetiiin humans and examine the diversity of these bacteria in ticks parasitizing domestic ruminants. A cross-sectional human serological study was conducted in Agua Grande district in Sao Tome Island from January to March 2016, and ticks were collected from farmed domestic ruminants in 2012 and 2016. In total, 240 individuals varying in age were randomly screened for exposure to SFGR andC. burnetiiby indirect immunofluorescence assay. Twenty of 240 individuals (8.3%) were seropositive for SFGR (4 forRickettsia africaeand 16 forR. conorii) and 16 (6.7%) were seropositive forC. burnetii.Amblyomma astrionwere collected exclusively in 2012, as wereA. variegatumin 2016 andRickettsiaspp. were detected in 22/42 (52.4%) and 49/60 (81.7%) respectively. Sequence analysis of multiple gene targets fromRickettsiaspp. detected in ticks suggests the presence of a single divergentR. africaestrain (Sao Tome). While no ticks were found positive forC. burnetii,Coxiella-like endosymbionts were detected in nearly all ticks. This is the first study in STP to provide serological evidence in humans of SFGR andC. burnetiiand additional molecular evidence in ticks for SFGR, which may be responsible for some of the unexplained febrile illnesses that persist despite the control of malaria. Future epidemiological studies are needed to confirm the occurrence and risk factors associated with SFG rickettsioses and Q fever in both humans and animals. |
| One Health; extended spectrum Beta-lactamase producing E. coli; antimicrobial resistance; whole genome sequencing; comparative genomics | ANTIMICROBIAL RESISTANCE GENES; SALMONELLA-ENTERICA; MOLECULAR CHARACTERIZATION; MULTIDRUG-RESISTANT; BIOFILM FORMATION; PLASMIDS; ANIMALS; PREVALENCE; ELEMENTS; STRAINS | Antimicrobial resistance (AMR) has important implications for the continued use of antibiotics to control infectious diseases in both beef cattle and humans. AMR along the One Health continuum of the beef production system is largely unknown. Here, whole genomes of presumptive extended-spectrum beta-lactamase E. coli (ESBL-EC) from cattle feces (n = 40), feedlot catch basins (n = 42), surrounding streams (n = 21), a beef processing plant (n = 4), municipal sewage (n = 30), and clinical patients (n = 25) are described. ESBL-EC were isolated from ceftriaxone selective plates and subcultured on ampicillin selective plates. Agreement of genotype-phenotype prediction of AMR ranged from 93.2% for ampicillin to 100% for neomycin, trimethoprim/sulfamethoxazole, and enrofloxacin resistance. Overall, beta-lactam (100%; bla(EC), bla(TEM-1), bla(SHV), bla(OXA), bla(CTX-M-)), tetracycline (90.1%; tet(A), tet(B)) and folate synthesis (sul2) antimicrobial resistance genes (ARGs) were most prevalent. The ARGs tet(C), tet(M), tet(32), bla(CTX-M-1), bla(CTX-M-14), bla(OXA-1), dfrA18, dfrA19, catB3, and catB4 were exclusive to human sources, while bla(TEM-150), bla(SHV-11-12), dfrA12, cmlA1, and cmlA5 were exclusive to beef cattle sources. Frequently encountered virulence factors across all sources included adhesion and type II and III secretion systems, while IncFIB(AP001918) and IncFII plasmids were also common. Specificity and prevalence of ARGs between cattle-sourced and human-sourced presumptive ESBL-EC likely reflect differences in antimicrobial use in cattle and humans. Comparative genomics revealed phylogenetically distinct clusters for isolates from human vs. cattle sources, implying that human infections caused by ESBL-EC in this region might not originate from beef production sources. |
| One Health; COVID-19; One Welfare; Pets; Companion animals; Healthcare | ATTACHMENT; MEMBERS; SCALE | There is evidence that prioritizing pets’ welfare can impact the health and well-being of their owners, especially when pet owners have a strong bond with their pet. This carries public health implications, particularly in a global public health emergency such as COVID-19. The study objective was to understand pet owners’ consideration of their pets’ welfare when making personal healthcare decisions specific to COVID-19. A large sample (n = 1356) of adult pet owners in the U.S. completed an online survey in April and May of 2020, coinciding with the onset of social distancing measures to prevent the spread of COVID-19. Respondents were asked if they would delay or avoid testing or treatment for COVID-19 due to concern for their pets’ welfare, and a follow-up question asked them to elaborate. Multinomial logistic regression models showed that attachment to pets and socioeconomic resources were important factors in pet owners’ hypothetical decisions regarding testing and treatment for COVID-19. Qualitative analysis of responses to the follow-up question revealed explanations across three themes: (1) the need to find pet accommodation prior to seeking healthcare; (2) pet-related concerns; and, (3) human-related concerns. Pet owners often cited concern for their pets’ welfare as a factor contributing to their decision making; participants’ lack of a concrete plan for pet care was most commonly cited as the reason for their delay in seeking healthcare. Results from this study indicate that pet owners experience unique obstacles to accessing healthcare related to COVID-19, which has implications for future public health emergencies. Increased disease spread and prevalence of poor health outcomes could result if pet owners delay or avoid testing or treatment. Communities can benefit from a One Health/One Welfare approach to collaboration between human and animal health and service providers to reduce COVID-19 spread and secure the well-being of people and their pets. |
| Coronavirus; National response preparedness; Nigeria; SARS-CoV-2; Pandemic | RESIDENTS; KNOWLEDGE | Background: Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) is the causative agent of COVID-19. This study aimed to assess the preventive behavior, and responses to national preparedness and response readiness to the COVID-19 outbreak by Healthcare workers in Nigeria. Methods: A cross-sectional survey of 1200 HCW was carried out, three hundred and forty-six (346) responded to the online questionnaire on demographic characteristics, national preparedness, and preventive behavior towards COVID-19 by HCWs. Descriptive analysis of variables in the form of tables and graphs was carried out. A binary logistic regression analysis was applied and expressed as odds ratio (OR) at a 95% confidence interval (C.I) and p-value of 0.05 as significant values. Results: Of the (346) HCWs, 249 (72.0%) were males, 214 (61.8%) belong to the age group 30-39 years, age group of between 20 and 49 years were more likely to be anxious about been infected of SARS-CoV-2. HCWs in the S.E. region were 35 times more likely to use a face mask (OR 35.0; 95% C.I 3.48-370.41; P = 0.0003), and 140 (40.5%) of the HCWs supported one health approach for containing the spread of COVID-19. HCWs were anxious (OR = 5.885; 95% C.I: 1.634-20.973; p = 0.007) about their families becoming infected with SARS-CoV-2 because of their occupation. Conclusion: The national preparedness and response to the COVID-19 outbreak in Nigeria were below expectations. Healthcare workers were worried about infection with SARS-CoV-2. One health approach is recommended for the fight against the infectious disease of animal origin like COVID-19. |
| COVID-19; SARS-CoV-2; Epidemiology; Wuhan; Fangcang | TRANSMISSION | In February 2020, the exponential growth of COVID-19 cases in Wuhan city posed a huge economic burden to local medical systems. Consequently, Wuhan established Fangcang Shelter hospitals as a One Health approach for responding to and containing the COVID-19 outbreak by isolating and caring for mild-to-moderate cases. However, it is unclear to what degree the hospitals contained COVID-19. This study performed an interrupted time series analysis to compare the number of new confirmed cases of COVID-19 before and after the operation of Fangcang Shelter hospitals. The initial number of confirmed cases in Wuhan increased significantly by 68.54 cases per day prior to February 4, 2020. Compared with the number of cases noted 20 days before the use of Fangcang Shelter hospitals, a sustained reduction in the number of confirmed cases (trend change, -125.57; P < 0.0001) was noted 41 days after the use of the hospitals. Immediate-level changes were observed for confirmed cases (level change, 725.97; P = 0.025). These changes led to an estimated 5148 fewer confirmed cases (P < 0.0001). According to the mean confirmed cases of 395.71 per day before the intervention, we estimated that Wuhan had advanced the terminal phase of COVID-19 by 13 days. Furthermore, immediately after introduction of Fangcang Shelter Hospitals on February 5, the reproduction number dropped rapidly, from a pre-introduction rate of 4.0 to 2.0. The Fangcang Shelter hospitals most likely to reversed the epidemic trend of COVID-19 while a containment strategy was implemented in Wuhan. In a One Health perspective, Fangcang Shelter hospitals, with their functions of isolation and treatment of confirmed COVID-19 patients, engaging professionals from many disciplines, such as medicine, engineering, architecture, psychology, environmental health, and social sciences. The results of this study provide a valuable reference for health policy makers in other countries. |
| Acquisition; antibiotic resistance; Asia; exposure assessment; health risk assessment; Monte‐ Carlo simulation; One‐ Health; transmission summary for social media | ANTIMICROBIAL RESISTANCE; ESCHERICHIA-COLI; WASTE-WATER; ANIMALS; PREVALENCE; BACTERIA; MEAT; ENVIRONMENT; PRODUCTS | Antimicrobial resistance (AMR) has become a major threat worldwide, especially in countries with inadequate sanitation and low antibiotic regulation. However, adequately prioritizing AMR interventions in such settings requires a quantification of the relative impacts of environmental, animal, and human sources in a One-Health perspective. Here, we propose a stochastic quantitative risk assessment model for the different components at interplay in AMR selection and spread. The model computes the incidence of AMR colonization in humans from five different sources: water or food consumption, contacts with livestock, and interhuman contacts in hospitals or the community, and combines these incidences into a per-year acquisition risk. Using data from the literature and Monte-Carlo simulations, we apply the model to hypothetical Asian-like settings, focusing on resistant bacteria that may cause infections in humans. In both scenarios A, illustrative of low-income countries, and B, illustrative of high-income countries, the overall individual risk of becoming colonized with resistant bacteria at least once per year is high. However, the average predicted incidence of colonization was lower in scenario B at 0.82 (CrI [0.13, 5.1]) acquisitions/person/year, versus 1.69 (CrI [0.66, 11.13]) acquisitions/person/year for scenario A. A high percentage of population with no access to improved water on premises and a high percentage of population involved in husbandry are shown to strongly increase the AMR acquisition risk. The One-Health AMR risk assessment framework we developed may prove useful to policymakers throughout Asia, as it can easily be parameterized to realistically reproduce conditions in a given country, provided data are available. |
| HEMORRHAGIC-FEVER; SURVEILLANCE | Background. One Health is receiving attention for arbovirus infection prevention and control and for defining national intersectoral priorities. Increasing awareness of intersectoral priorities through multisectorial risk assessments (MRA) is promising, where data are not systematically shared between sectors. Towards this aim, the MediLabSecure project organized three MRA exercises (hereby called exercises): one on West Nile virus, one on Crimean-Congo haemorrhagic fever, and one on Rift Valley fever, assessing the added value of this approach. Methods. The exercises relied on RA methodologies of international organisations. Country representatives of the human and animal virology, medical entomology, and public health sectors (hereby called sectors) involved in the surveillance of vector-borne diseases participated in the exercises. Background documentation was provided before each exercise, and a guide was developed for the facilitators. All three exercises included technical and methodological presentations and a guided RA directed at bringing into play the different sectors involved. To assess the added value of the approach, each participant was asked to rank the level of perceived benefit of the multisectoral collaboration for each risk question included in the exercises. Results. In total, 195 participants from 19 non-EU countries in the Mediterranean and Black Sea regions took part in the exercises. The participants assessed the multisectoral approach as valuable in analysing comprehensively the situation by having access to information and knowledge provided by each of the sectors involved. Sharing of information and discussion facilitated reaching a consensus on the level of risk in each country. Conclusions. Increasing awareness of intersectoral priorities, including cross-border ones, through MRA is relevant to reduce gaps due to unavailability of shared data and information. Given that six out of the ten threats to global health listed by WHO are occurring at the human-animal-environmental interfaces, comprehensive regional RA with a One Health approach made by national authorities can be a relevant added value for the global health security. |
| Participatory epidemiology; Zoonoses; Infectious disease control; Power relationship; Interdisciplinary research | DISEASE SURVEILLANCE; MANAGEMENT; EBOLA | The use of Participatory Epidemiology in veterinary research intends to include livestock keepers and other local stakeholders in research processes and the development of solutions to animal health problems, including potentially zoonotic diseases. It can also be an attempt to bring some of the methods and insights of social science into a discipline largely shaped by natural science methods and ways of seeing the world. The introduction of participatory methodologies to veterinary epidemiology and disease surveillance follows a wider movement in development thinking, questioning the top-down nature of much post-second world war development efforts directed from the Global North towards the Global South. In the best cases, participatory methods can help to empower the poor and marginalised to participate in and have some control over research and interventions which affect them. Compiled from experience in multi-disciplinary One Health projects, this paper briefly traces the rise of participatory epidemiology before examining some of the limitations observed in its implementation and steps that might be taken to alleviate the problems observed. The three areas in which the operationalisation of Participatory Epidemiology in veterinary and One Health research could be improved are identified as: broadening the focus of engagement with communities beyond quantitative data extraction; taking note of the wider power structures in which research takes place, and questioning who speaks for a community when participatory methods are used. In particular, the focus falls on how researchers from different disciplines, including veterinary medicine and the social sciences, can work together to ensure that participatory epidemiology is employed in such a way that it improves the quality of life of both people and animals around the world. |
| birds; antimicrobial resistance; bacteria; risk; public health; One Health | WILD BIRDS; BACTERIA | Antimicrobial resistance is a public health concern worldwide and it is largely attributed to the horizontal exchange of transferable genetic elements such as plasmids carrying integrons. Several studies have been conducted on livestock showing a correlation between the systemic use of antibiotics and the onset of resistant bacterial strains. In contrast, although companion birds are historically considered as an important reservoir for human health threats, little information on the antimicrobial resistance in these species is available in the literature. Therefore, this study was aimed at evaluating the antimicrobial resistance of Escherichia coli and Pseudomonas aeruginosa isolated from 755 companion birds. Cloacal samples were processed for E. coli and P. aeruginosa isolation and then all isolates were submitted to antimicrobial susceptibility testing. P. aeruginosa was isolated in 59/755 (7.8%) samples, whereas E. coli was isolated in 231/755 (30.7%) samples. Most strains showed multidrug resistance. This study highlights that companion birds may act as substantial reservoirs carrying antimicrobial resistance genes which could transfer directly or indirectly to humans and animals, and from a One Health perspective this risk should not be underestimated. |
| One Health; Political Sociology; Science studies; Watchword | ONE WORLD; SURVEILLANCE; EMERGENCE; INFLUENZA; POLITICS; HISTORY; RISKS | This paper discusses the relationship between One Health (OH) and the social sciences. Using a comparison between three narratives of the history of OH, it is argued that OH can be studied as a social phenomenon. The narrative of OH by its promoters (folk narratives) emphasizes two dimensions: OH as a renewal of veterinary medicine and OH as an institutional response to global health crises. Narratives from empirical social science work explore similar dimensions, but make them more complex. For political sociology, OH is the result of negotiations between the three international organisations (WHO, OIE and FAO), in a context of a global health crisis, which led to the reconfiguration of their respective mandates and scope of action: OH is a response to an institutional crisis. For the sociology of science, OH testifies to the evolution of the profession and veterinary science, enabling it to position itself as a promoter of interdisciplinarity, in a context of convergence between research and policy. In the Discussion section, I propose an approach to OH as an epistemic watchword: a concept whose objective is to make several actors work together (watchword), in a particular direction, that of the production of knowledge (epistemic). Cet article aborde les rapports entre One Health (OH – << une sante >> en francais) et les sciences sociales. L’idee que OH peut etre etudie comme un phenomene social est defendue, au moyen d’une comparaison entre trois narrations de l’histoire de OH. La narration de OH par ses promoteurs (narrations indigenes) insiste sur deux dimensions : OH comme renouveau de la medecine veterinaire et OH comme reponse institutionnelle a des crises sanitaires. Les narrations issues de travaux empiriques en sciences sociales explorent des dimensions similaires, mais les rendent plus complexes. Pour la sociologie politique, OH est le resultat d’une negociation entre les trois organisations internationales (OMS, OIE et FAO), dans un contexte de crise sanitaire globale, ayant amene a reconfigurer leurs mandats et leurs perimetres d’action respectifs : OH est une reponse a une crise institutionnelle. Pour la sociologie des sciences, OH temoigne des evolutions de la profession et de la science veterinaire, permettant a celle-ci de se placer en position de promotrice de l’interdisciplinarite, dans un contexte de rapprochement entre recherche et action publique. Dans la partie << discussion >>, je proposerai d’aborder OH comme un << mot d’ordre epistemique >> : un concept dont l’objectif est de faire travailler plusieurs acteurs ensemble (mot d’ordre), dans un sens particulier, celui de la production de savoirs (epistemique). |
| bacterial infection; antibiotics resistance; sentinel surveillance; drug prescriptions; One Health; India | SEWAGE-TREATMENT PLANTS; ESCHERICHIA-COLI; ANTIMICROBIAL RESISTANCE; BETA-LACTAMASE; STAPHYLOCOCCUS-AUREUS; ANTIBIOTIC-RESISTANCE; CHICKEN MEAT; PREVALENCE; SALMONELLA; CATTLE | Background: India has the largest burden of drug-resistant organisms compared with other countries around the world, including multiresistant and extremely drug-resistant tuberculosis and resistant Gram-negative and Gram-positive bacteria. Antibiotic resistant bacteria are found in all living hosts and in the environment and move between hosts and ecosystems. An intricate interplay of infections, exposure to antibiotics, and disinfectants at individual and community levels among humans, animals, birds, and fishes triggers evolution and spread of resistance. The One Health framework proposes addressing antibiotic resistance as a complex multidisciplinary problem. However, the evidence base in the Indian context is limited. Objective: This multisectoral, trans-species surveillance project aims to document the infection and resistance patterns of 7 resistant-priority bacteria and the risk factors for resistance following the One Health framework and geospatial epidemiology. Methods: This hospital- and community-based surveillance adopts a cross-sectional design with mixed methodology (quantitative, qualitative, and spatial) data collection. This study is being conducted at 6 microbiology laboratories and communities in Khurda district, Odisha, India. The laboratory surveillance collects data on bacteria isolates from different hosts and their resistance patterns. The hosts for infection surveillance include humans, animals (livestock, food chain, and pet animals), birds (poultry), and freshwater fishes (not crustaceans). For eligible patients, animals, birds and fishes, detailed data from their households or farms on health care seeking (for animals, birds and fishes, the illness, and care seeking of the caretakers), antibiotic use, disinfection practices, and neighborhood exposure to infection risks will be collected. Antibiotic prescription and use patterns at hospitals and clinics, and therapeutic and nontherapeutic antibiotic and disinfectant use in farms will also be collected. Interviews with key informants from animal breeding, agriculture, and food processing will explore the perceptions, attitudes, and practices related to antibiotic use. The data analysis will follow quantitative (descriptive and analytical), qualitative, and geospatial epidemiology principles. Results: The study was funded in May 2019 and approved by Institute Ethics Committees in March 2019. The data collection started in September 2019 and shall continue till March 2021. As of June 2020, data for 56 humans, 30 animals and birds, and fishes from 10 ponds have been collected. Data analysis is yet to be done. Conclusions: This study will inform about the bacterial infection and resistance epidemiology among different hosts, the risk factors for infection, and resistance transmission. In addition, it will identify the potential triggers and levers for further exploration and action. |
| One Health; Yakutia; zooanthroponosis; zoonoses; climate change | | Population growth, socio-cultural and economic changes as well as technological progress have an immediate impact on the environment and human health in particular. Our steadily rising needs of resources increase the pressure on the environment and narrow down untainted habitats for plants and wild animals. Balance and resilience of ecosystems are further threatened by climate change, as temperature and seasonal shifts increase the pressure for all species to find successful survival strategies. Arctic and subarctic regions are especially vulnerable to climate change, as thawing of permafrost significantly transforms soil structures, vegetation and habitats. With rising temperature, the risk of zoonotic diseases in the Republic of Sakha (Yakutia) has also increased. As vegetation periods prolong and habitats broaden, zoonotic pathogens and their vectors find more favourable living conditions. Moreover, permafrost degradation may expose historic burial grounds and allow for reviving the vectors of deadly infections from the past. To assess the current state of knowledge and emerging risks in the light of the One Health concept, a German-Russian Symposium took place on 13 August 2018 in Yakutsk, Russian Federation. This symposium report presents the main findings generated from presentations and discussions. |
| antimicrobial resistance bacteria; environmental surveillance; One Health; transmission pathway; wastewater treatment; water environment | WASTE-WATER; PSEUDOMONAS-AERUGINOSA; ANTIBIOTIC-RESISTANCE; ENVIRONMENT | The emergence and spread of antimicrobial resistance (AMR), including clinically relevant antimicrobial-resistant bacteria, genetic resistance elements, and antibiotic residues, presents a significant threat to human health. Reducing the incidence of infection by improving water, sanitation, and hygiene (WASH) is one of five objectives in the World Health Organization’s (WHO) Global Action Plan on AMR. In September 2019, WHO and the Health-Related Water Microbiology specialist group (HRWM-SG) of the International Water Association (IWA) organized its third workshop on AMR, focusing on the following three main issues: environmental pathways of AMR transmission, environmental surveillance, and removal from human waste. The workshop concluded that despite an increase in scientific evidence that the environment may play a significant role, especially in low-resource settings, the exact relative role of the environment is still unclear. Given many antibiotic-resistant bacteria (ARB) can be part of the normal gut flora, it can be assumed that for environmental transmission, the burden of fecal-oral transmission of AMR in a geographical area follows that of WASH-related infections. There are some uncertainties as to the potential for the propagation of particular resistance genes within wastewater treatment plants (WWTPs), but there is no doubt that the reduction in viable microbes (with or without resistance genes) available for transmission via the environment is one of the goals of human waste management. Although progress has been made in the past years with respect to quantifying environmental AMR transmission potential, still more data on the spread of environmental AMR within human communities is needed. Even though evidence on AMR in WWTPs has increased, the reduction in the emergence and spread of AMR by basic sanitation methods is yet unresolved. In order to contribute to the generation of harmonized One Health surveillance data, WHO has initiated an integrated One Health surveillance strategy that includes the environment. The main challenge lies in rolling it out globally including to the poorest regions. |
| One Health; intersectoral collaboration; actors; health system; India | PUBLIC-HEALTH; VETERINARY-MEDICINE; GOVERNANCE; COLLABORATION; DISEASES; OPPORTUNITIES; PARTNERSHIPS; INTEGRATION | The surging trend of (re)emerging diseases urges for the early detection, prevention, and control of zoonotic infections through the One Health (OH) approach. The operationalization of the OH approach depends on the contextual setting, the presence of the actors across the domains of OH, and the extent of their involvement. In the absence of national operational guidelines for OH in India, this study aims to identify potential actors with an attempt to understand the current health system network strength (during an outbreak and non-outbreak situations) at the local health system of Ahmedabad, India. This case study adopted a sequential mixed methods design conducted in two phases. First, potential actors who have been involved directly or indirectly in zoonoses prevention and control were identified through in-depth interviews. A network study was conducted as part of the second phase through a structured network questionnaire. Interest and influence matrix, average degree, network density, and degree of centralization were calculated through Atlas.Ti (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany), UCINET (Analytic Technologies, Lexington, KY, USA) software. The identified actors were categorized based on power, administrative level (either at the city or district level), and their level of action: administrative (policy planners, managers), providers (physicians, veterinarians), and community (health workers, community leaders). The matrix indicated that administrative actors from the district level were ‘context setters’ and the actors from the city level were either ‘players’ or ‘subjects’. The network density showed a strength of 0.328 during the last outbreak of H5N1, which decreased to 0.163 during the non-outbreak situation. Overall, there was low collaboration observed in this study, which ranged from communication (during non-outbreaks) to coordination (during outbreaks). The private and non-governmental actors were not integrated into collaborative activities. This study concludes that not only collaboration is needed for OH among the sectors pertaining to the human and the animal health system but also better structured (‘inter-level’) collaboration across the governance levels for effective implementation. |
| next-generation sequencing; one health; shotgun metagenomic sequencing; porcine viruses; targeted sequence capture; viral metagenomics; virome | IDENTIFICATION | Shotgun metagenomic sequencing (SMg) enables the simultaneous detection and characterization of viruses in human, animal and environmental samples. However, lack of sensitivity still poses a challenge and may lead to poor detection and data acquisition for detailed analysis. To improve sensitivity, we assessed a broad scope targeted sequence capture (TSC) panel (ViroCap) in both human and animal samples. Moreover, we adjusted TSC for the Oxford Nanopore MinION and compared the performance to an SMg approach. TSC on the Illumina NextSeq served as the gold standard. Overall, TSC increased the viral read count significantly in challenging human samples, with the highest genome coverage achieved using the TSC on the MinION. TSC also improved the genome coverage and sequencing depth in clinically relevant viruses in the animal samples, such as influenza A virus. However, SMg was shown to be adequate for characterizing a highly diverse animal virome. TSC on the MinION was comparable to the NextSeq and can provide a valuable alternative, offering longer reads, portability and lower initial cost. Developing new viral enrichment approaches to detect and characterize significant human and animal viruses is essential for the One Health Initiative. |
| Leishmaniasis; Spatial epidemiology; One health | VISCERAL LEISHMANIASIS; PHLEBOTOMUS-PERNICIOSUS; CANINE LEISHMANIASIS; RESERVOIR; DIPTERA; BIOLOGY; VECTOR | Introduction: Historically, leishmaniasis in Italy was constrained to areas with Mediterranean climate. In the last 20 years, sand fly vectors (Phlebotomus perniciosus), cases of canine leishmaniasis (CanL) and cases of human visceral leishmaniasis (VL) have been observed in Northern Italian regions, traditionally classified as cold areas unsuitable for sand fly survival. Aim: We aim to evaluate through a One-Health approach the risk of endemic transmission of Leishmania infantum in the Piedmont Region, Northern Italy. Methods: We collected environmental, entomological, animal, and human data. We applied a geostatistical binomial model to map the probability of P. perniciosus presence in the study area, using selected environmental parameters as predictors. We evaluated the spatial relationship between the probability of P. perniciosus presence and the geographical distribution of CanL and VL cases observed between 1999 and 2013. Results: Between 1999 and 2003, 142 sampling sets (17%) out of 839 resulted positive for P. perniciosus. Elevation, degree of slope, normalized difference vegetation index (NDVI) and summer temperatures were associated with positive sampling sets. During the study period, 164 (13.6%) of Piedmont municipalities reported at least one autochthonous case of CanL, while 89 VL cases were observed in 54 municipalities (4.5%). We observed an association between municipalities affected by autochthonous CanL cases and the estimated probability of P. perniciosus presence (Odds Ratio for 10% increase of probability: 2.66; 95% confidence intervals (CI): 2.16-3.37). We found that human VL incident cases were positively associated with the probability of the municipality of residence of being endemic for CanL (Incidence Rate Ratio for 10% increase of probability: 1.49; 95% CI 1.02-2.16). Conclusions: Using a One-Health approach, we quantified the spatial association between the distribution of P. perniciosus, municipalities endemic for CanL and incident cases of human VL, suggesting that the disease has become endemic in the Piedmont region. |
| colistin; dog; E; coli; mcr-1; One Health; plasmid | COMPANION ANIMALS; INCI2 PLASMIDS; FOOD ANIMALS; GENE MCR-1; SALMONELLA; ENTEROBACTERIACEAE; LIVESTOCK | We studied the presence of the mobile colistin resistance gene mcr-1 in Escherichia coli isolates recovered from fecal and urine samples of companion animals, that were collected from South Korea in 2018 and 2019. The mcr-1 gene was detected in one colistin-resistant E. coli isolated from a diarrheic dog. The isolate exhibited additional resistance to multiple antimicrobials, including fluoroquinolones and third-generation cephalosporins. The mcr-1 carrying isolate belonged to ST160. The pulsed-field gel electrophoresis pattern of our strain differed from those ST160 E. coli strains previously identified from chickens in Korea. The mcr-1 gene was identified in the IncI2 plasmid. It was also transferred to E. coli J53 recipient strain, with a conjugation efficiency of 2.8 x 10(-4). Average nucleotide identity analysis demonstrated that the mcr-1-carrying plasmid in this study was closely related to those from patients in Korea. To the best of our knowledge, this is the first report of mcr-1 carrying E. coli from a companion animal in South Korea. Our findings support One Health approach is necessary to prevent the dissemination of this high-risk gene. |
| animal welfare; animal behavior; sentience; zoonoses; sustainability | POSITIVE WELFARE; FEATHER-PECKING; CLIMATE-CHANGE; HEAT-STRESS; CATTLE; FARM; CASTRATION; BEHAVIOR; POULTRY; PIGLETS | Simple Summary In a situation where human actions are damaging much of the life of the world, it is important to remember that the basic concepts of biology, welfare, and health are the same for humans and all other animals. Human actions have wide consequences and we need to change the way we interact with other living beings. An understanding of the concepts of one health, one welfare, one biology, and their application to daily decisions about production systems, public policies, markets, and consumers could mitigate current negative impacts. In particular, an understanding of human relationships with animals used for food, work, or company helps in dealing with challenges concerning their use and system sustainability, including the animal’s welfare. Animal welfare should always be considered in our relationships with animals, not only for direct impacts, e.g., manipulations, but also for indirect effects, e.g., on the environment, disease spread, natural resource availability, culture, and society. Abstract Excessive human population growth, uncontrolled use of natural resources, including deforestation, mining, wasteful systems, biodiversity reduction by agriculture, and damaging climate change affect the existence of all animals, including humans. This discussion is now urgent and people are rethinking their links with the animals we use for clothing, food, work, companionship, entertainment, and research. The concepts of one health, one welfare, and one biology are discussed as a background to driving global change. Nothing should be exploited without considering the ethics of the action and the consequences. This review concerns domesticated animals, including those used for human consumption of meat, eggs, and milk; horses kept for work; and dogs kept for company. Animal welfare includes health, emotional state, and comfort while moving and resting, and is affected by possibilities to show behavior and relationships with others of the same species or with humans. We show some examples of the relations between humans and domesticated animals in the environmental context, including zoonotic diseases, and consider the consequences and the new paradigms resulting from current awareness. |
| COVID-19; Severe acute respiratory syndrome coronavirus 2; Pandemics; Coronavirus infections; zoonoses | | SARS-CoV-2 is a zoonotic virus that has achieved community spread among humans and become a pandemic. Transmission from humans to dogs, domestic cats, tigers, and lions has occurred. Pigs, cats, ferrets, and primates have been identified as good candidates for susceptibility to SARS-CoV-2. The potential implications indicate the need for One Health surveillance, intervention, and management strategies to mitigate the effects on animal populations and prevent a second preparedness failure during this health emergency. |
| RESIDENCY PROGRAMS; SAFETY-EDUCATION; WORK ENGAGEMENT; RETENTION; SATISFACTION; WORKFORCE; MAGNET(R); TURNOVER; QUALITY | The complexity and growth of healthcare systems provide nurse leaders an opportunity to recognize and facilitate professional development for experienced frontline clinicians and to create formal structures that give expert direct care nurses a stronger voice. The purpose of this article is to describe how one health system developed and implemented an innovative Distinguished Nurse Clinician Academy. This elite academy demonstrates the longitudinal impact of a health systems’ Magnet(R) culture. |
| SARS-CoV-2; COVID-19; Pets; Seroprevalence; One health; Luminex; Neutralization assay | FELINE CORONAVIRUS; SEROPREVALENCE; CATS | In a survey of household cats and dogs of laboratory-confirmed COVID-19 patients, we found a high seroprevalence of SARS-CoV-2 antibodies, ranging from 21% to 53%, depending on the positivity criteria chosen. Seropositivity was significantly greater among pets from COVID-19+ households compared to those with owners of unknown status. Our results highlight the potential role of pets in the spread of the epidemic. |
| Kinetoplastida; Trypanosomatidae; Italy; Lazio region; leishmaniasis; lizard; molecular detection; one health; zoonosis | PHLEBOTOMINE SAND FLIES; CANINE LEISHMANIASIS; NATURAL INFECTION; SERGENTOMYIA-MINUTA; INFANTUM; IDENTIFICATION; RNA; DNA; PERNICIOSUS; DIAGNOSIS | The detection of atypical Kinetoplastida in vertebrate hosts and vectors might suggest unexpected host-parasite contacts. Aside to major vectors ofLeishmania (Leishmania) infantumin Italy (e.g.Phlebotomus perniciosusandPhlebotomus perfiliewi), the sand fly fauna also includesSergentomyia minuta, herpetophilic and proven vector ofLeishmania (Sauroleishmania) tarentolae, in which records of blood meal on mammals and detection ofL. infantumDNA are increasing. This study was conducted in Central Italy aiming to molecularly detect potential atypicalLeishmaniahost-vector contacts. Detection ofLeishmaniaspp. DNA was performed by polymerase chain reaction (SSU rRNA, ITS1 targets) on field-collected sand fly females (N = 344), blood samples from humans (N = 185) and dogs (N = 125). Blood meal identification was also performed on engorged sand flies.Leishmaniaspp. DNA was found in 13.1% sand flies, 3.7% humans and 14.4% dogs. Sequence analysis identifiedL. infantuminS. minuta(4.4%),P. perniciosus(9.1%), humans (2.2%) and dogs (14.4%).Leishmania tarentolaewas detected inS. minuta(12.6%),P. perfiliewi(6.6%) and human (1.6%) samples. Of 28S. minutaexamined for blood meal, 3.6 and 21.4% scored positive for human and lizard DNA, respectively. These results indicate the importance of one-health approach to explore new potential routes of transmission of leishmaniasis involvingS. minuta. |
| curriculum; educational methods; student affairs; student partnership; leadership; outcomes | PERCEPTIONS | As central members of the veterinary education community, students are well placed to highlight current problems in veterinary education. Motivated by the lack of current formal student involvement, the largest global veterinary student association, the International Veterinary Students’ Association (IVSA), realized the necessity for students to express their opinions within the veterinary education field. Thus, two standing committees related to veterinary education were created: the Standing Committee on One Health in 2013 and the Standing Committee on Veterinary Education in 2014. For 7 years, veterinary students have been acting in a four-dimensional plane to involve students in (a) electronic educational resources and e-learning, (b) interdisciplinary collaboration and One Health, (c) curriculum involvement, and (d) vocational guidance.Through multiple projects, such as student and tutor interaction, idea exchanges, development of e-resources, and curriculum development campaigns, IVSA has managed to increase awareness to students and schools of the important role students play within veterinary education.This article highlights students’ ability to work together to help other students learn and succeed within their veterinary studies, as well as the necessity for student engagement in curricular renewal and development. Consequently, IVSA’s projects and achievements are described, highlighting a from students-to students approach to promote active student involvement in veterinary education and curricula globally. |
| Strongyloides stercoralis; soil-transmitted helminths; hookworms; zoonotic parasites; Australian remote communities; One Health | ANCYLOSTOMA-CEYLANICUM; HELMINTH INFECTIONS; EOSINOPHILIC ENTERITIS; PCR; EPIDEMIOLOGY; PREVALENCE; DISEASES; CANINUM; TOOLS | Both Strongyloides stercoralis and hookworms are common soil-transmitted helminths in remote Australian communities. In addition to infecting humans, S. stercoralis and some species of hookworms infect canids and therefore present both environmental and zoonotic sources of transmission to humans. Currently, there is limited information available on the prevalence of hookworms and S. stercoralis infections in dogs living in communities across the Northern Territory in Australia. In this study, 274 dog faecal samples and 11 faecal samples of unknown origin were collected from the environment and directly from animals across 27 remote communities in Northern and Central Australia. Samples were examined using real-time polymerase chain reaction (PCR) analysis for the presence of S. stercoralis and four hookworm species: Ancylostoma caninum, Ancylostoma ceylanicum, Ancylostoma braziliense and Uncinaria stenocephala. The prevalence of S. stercoralis in dogs was found to be 21.9% (60/274). A. caninum was the only hookworm detected in the dog samples, with a prevalence of 31.4% (86/274). This study provides an insight into the prevalence of S. stercoralis and hookworms in dogs and informs future intervention and prevention strategies aimed at controlling these parasites in both dogs and humans. A One Health approach is crucial for the prevention of these diseases in Australia. |
| ovine toxoplasmosis; nanoparticle; nasal vaccination; adjuvant free; one-health approach | GONDII INFECTION; KILLED VACCINE; SEROPREVALENCE; DELIVERY; MECHANISMS; CHALLENGE; RESPONSES; ABORTIONS; IMMUNITY; COLONY | Toxoplasma gondiiis a parasitic protozoan of worldwide distribution, able to infect all warm-blooded animals, but particularly sheep. Primary infection in pregnant sheep leads to millions of abortions and significant economic losses for the livestock industry. Moreover, infected animals constitute the main parasitic reservoir for humans. Therefore, the development of a One-health vaccine seems the best prevention strategy. Following earlier work, a vaccine constituted of total extract ofToxoplasma gondiiproteins (TE) associated with maltodextrin nanoparticles (DGNP) was developed in rodents. In this study we evaluated the ability of this vaccine candidate to protect against latent and congenital toxoplasmosis in sheep. After two immunizations by either intranasal or intradermal route, DGNP/TE vaccine generated specific Th1-cellular immune response, mediated by APC-secretion of IFN-gamma and IL-12. Secretion of IL-10 appeared to regulate this Th1 response for intradermally vaccinated sheep but was absent in intranasally-vaccinated animals. Finally, protection against latent toxoplasmosis and transplacental transmission were explored. Intranasal vaccination led to a marked decrease of brain cysts compared with the non-vaccinated group. This DGNP/TE vaccine administered intranasally conferred a high level of protection against latent toxoplasmosis and its transplacental transmission in sheep, highlighting the potential for development of such a vaccine for studies in other species. |
| Salmonella; drug resistance; chicken; feces; One Health | OUTBREAKS | The widespread usage of antimicrobials due to continued misuse, overuse, or even assimilation in products has prompted the emergence and development of antimicrobial resistance in bacteria in the recent decades. Most common recipients of antimicrobial resistant bacteria are animals which then transmit these bacteria to humans via consumption. Salmonella enterica, an enteric pathogen, can be acquired from consumption of contaminated or undercooked food, particularly chicken. Salmonellosis, the infection of Salmonella enterica, causes gastroenteritis and although frequently self-limiting, it can nonetheless be fatal to humans in cases of systemic infections. This disease is estimated to affect millions of humans annually and causing thousands of deaths globally. This study aims to detect the presence of antimicrobial resistant Salmonella enterica from broiler feces and determine its susceptibility profile.Thirty fecal samples from broilers were collected from a selected farm in Nueva Ecija and were subjected to traditional culture methods. A total of 40 bacterial isolates were detected and their antimicrobial susceptibility profiles identified using the VITEK (R) 2 system. Only one (1) of the 30 fecal samples was identified to be Salmonella enterica (3.3%) but is found to be multi-drug resistant. This finding poses a significant threat to public health and emphasizes the need for intensified surveillance and interventions aimed towards One Health. |
| housing; public health; refugees | MULTI-MORBIDITY | Background This cross-sectional study explores the relationship between housing, social wellbeing, access to services and health among a population of Syrian refugee children in Lebanon. Methods We surveyed 1902 Syrian refugee households living in informal tented settlements in Lebanon in 2017. Logistic regressions assessed relationships between housing problems, socioeconomic deprivation, social environment and health. Results Of the 8284 children in the study, 33.0% had at least one health problem. A considerable number of households (43.1%) had > 8 housing problems. Children in these households had higher odds to have three or more health problems compared to children in households with < 6 housing problems (adjusted odds ratio [AOR], 2.39; confidence interval [CI], 1.50-3.81). Nearly three-quarters (74.3%) of households were severely food insecure. Children in these households had higher odds to have one health problem than those in food secure households (AOR, 1.75; CI, 1.11-2.76). There was a significant positive association between households that reported being unhappy with their neighbourhood and the number of children with health problems in those households. Conclusions This study highlights the association between the physical and social living conditions and refugee children’s health. Without multidimensional interventions that consider improvements to living conditions, the health of young Syrian refugees will continue to worsen. |
| INDIGENOUS COMMUNITIES; PUBLIC-HEALTH; DOMESTIC DOGS; POPULATIONS; OWNERSHIP; PETS | Community perspectives are rarely sought or integrated into dog management policy and practice. Dog management in remote communities in Australia has focused on reducing the number of dogs, which is often implemented by visiting veterinarians, despite widely-held opinions that fly-in-fly-out services provide only temporary solutions. We conducted participatory research in a group of remote communities in northern Australia to explore how dog-related problems arise and are managed, and explain their impacts from a One Health perspective. Over the course of a year, 53 residents from a range of backgrounds contributed through in-depth interviews with key community service providers, and informal semi-structured discussions with community residents. Free-roaming dogs have broader impacts on canine and human health than previously documented. Dog-keeping norms that enable free-roaming can enhance human and dog wellbeing and intra-family connectivity. This can also cause disengagement and conflict with other residents, leading to resentment and occasionally violence towards dogs. Dog-related problems are underpinned by constraints associated with remote-living, governance and differing sociocultural norms. Focusing on dog population reduction detracts from the welfare benefits and sociocultural value of free-roaming dogs and undermines community-determined management that can overcome constraints to support local values and co-promote canine and human wellbeing. |
| Culex; Eichhornia crassipes; invasive species; glyphosate; One Health; vector control | THURINGIENSIS VAR ISRAELENSIS; CULEX-QUINQUEFASCIATUS; EICHHORNIA-CRASSIPES; OVIPOSITION SITE; AEDES-AEGYPTI; ONE HEALTH; QUALITY; MANAGEMENT; CALIFORNIA; LARVICIDE | Invasive aquatic weeds are managed with herbicides to reduce their negative impacts on waterways in many areas, including the California Delta Region. Herbicides create a dynamic environment of living and decomposing plant matter that could affect larval mosquitoes and other invertebrates, such as their predators and competitors. Our objective was to compare the number of larval mosquitoes in water or water hyacinth, before and after an herbicide treatment. We created replicated pond mesocosms with water hyacinth, water hyacinth treated with glyphosate and an oil adjuvant, open water, and water with glyphosate plus adjuvant. We sampled for larval mosquitoes and other aquatic invertebrates. Before herbicide addition, there was a trend for more larval mosquitoes in open water tanks than in tanks with water hyacinth. Herbicide application resulted in an immediate decrease of larval mosquitoes. As decay progressed, larval mosquitoes became most abundant in mesocosms with herbicide-treated hyacinth and very few larval mosquitoes were found in other habitat treatments. Although the numbers of predatory and competitor insects had some variation between treatments, no clear pattern emerged. This information on how invasive weed management with herbicides affects larval mosquitoes will allow control practices for larval mosquitoes and invasive weeds to be better integrated. |
| soil-transmitted helminths; zoonoses; parasiticide fungi; one health | EGGS; PELLETS | Soil-transmitted helminths (STHs) are parasites transmitted through contact with soil contaminated with their infective eggs/larvae. People are infected by exposure to human-specific species or animal species (zoonotic agents). Fecal samples containing eggs of Ascaris suum or Lemurostrongylus sp. were sprayed with spores of the soil saprophytic filamentous fungi Clonostachys rosea (CR) and Trichoderma atrobrunneum (TA). The antagonistic effect was assessed by estimating the viability of eggs and their developmental rate. Compared to the controls (unexposed to fungi), the viability of the eggs of A. suum was halved in CR and decreased by two thirds in TA, while the viability of the eggs of Lemurostrongylus sp. was reduced by one quarter and one third in CR and TA treatments, respectively. The Soil Contamination Index (SCI), defined as the viable eggs that attained the infective stage, reached the highest percentages for A. suum in the controls after four weeks (66%), with 21% in CL and 11% in TA. For Lemurostrongylus sp., the values were 80%, 49%, and 41% for control, CR and TA treatments, respectively. We concluded that spreading spores of C. rosea or T. atrobrunneum directly onto the feces of animal species represents a sustainable approach under a One Health context to potentially reduce the risk of zoonotic STHs in humans. |
| Pandemic; New coronavirus; COVID-19; Active random surveillance | DEMONSTRATING FREEDOM | The pandemic of new coronavirus disease COVID-19 is threatening our health, economy and life style. Collaborations across countries and sectors as a One Health World could be a milestone. We propose a general protocol, for setting timely active random surveillance of COVID-19, at the human community level, with systematic repeated detection efforts. Strengths and limitations are discussed. If considered applicable by public health, the protocol could evaluate the status of COVID-19 epidemics consistently and objectively. |
| SARS-CoV-2; COVID-19; Molecular characterization; Next generation sequencing; Mutations; Variants; One health; Veterinarians | SEQUENCE | The current pandemic is caused by a novel coronavirus (CoV) called SARS-CoV-2 (species Severe acute respiratory syndrome-related coronavirus, subgenus Sarbecovirus, genus Betacoronavirus, family Coronaviridae). In Italy, up to the 2nd of April 2020, overall 139,422 confirmed cases and 17,669 deaths have been notified, while 26,491 people have recovered. Besides the overloading of hospitals, another issue to face was the capacity to perform thousands of tests per day. In this perspective, to support the National Health Care System and to minimize the impact of this rapidly spreading virus, the Italian Ministry of Health involved the Istituti Zooprofilattici Sperimentali (IZSs), Veterinary Public Health Institutes, in the diagnosis of SARS-CoV-2 by testing human samples. The Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise is currently testing more than 600 samples per day and performing whole genome sequencing from positive samples. Sequence analysis of these samples suggested that different viral variants may be circulating in Italy, and so in Abruzzo region. CoVs, and related diseases, are well known to veterinarians since decades. The experience that veterinarians operating within the Public Health system gained in the control and characterization of previous health issues of livestock and poultry including avian flu, bluetongue, foot and mouth disease, responsible for huge economic losses, is certainly of great help to minimize the impact of this global crisis. |
| Animal health; Climate change; Disaster risk reduction; Health security; One Health approach; Preparedness; Sustainable development; Zoonosis | | In recent times, there has been an increased focus on animal health and zoonotic diseases that have the potential to trigger epidemics or pandemics that disproportionately affect the poor and most vulnerable. The recent Ebola, Zika and COVID-19 outbreaks demonstrate the devastating human, social and economic impacts of such diseases if they are not prevented or controlled, ideally at source. The risk drivers for zoonoses, which are complex and often interdependent, include climate change and related disasters, antimicrobial resistance, and anthropogenic drivers such as land-use changes and animal production practices. Understanding these drivers requires a better understanding of the ecology of zoonotic diseases at the human-animal-environment interface. Biosecurity and biosafety are critical for reducing the risk of accidental or deliberate release and should be included in risk management strategies. International frameworks for sustainable development, climate change, and disaster risk reduction have all integrated health as one of the core areas of work, calling for better preparedness and response to biological hazards and increased health system resilience. To improve their ability to prevent, prepare for, and respond to emerging and re-emerging threats, countries should address these risk drivers, taking a multidisciplinary One Health approach that involves the animal and human health and environment sectors. Cross-border cooperation is also vital, as diseases know no boundaries. |
| CLIMATE-CHANGE; ONE HEALTH | Leptospirosis is a human and veterinary illness caused by spirochete bacteria in the genus Leptospira. Insymptomatic infection the clinical presentation ranges from non-specific febrile illness to fulminant organ system failure with a high case fatality rate. Leptospires are excreted in the urine of infected mammals with rodents being the main source for human exposures. Leptospires can survive for months in urine-contaminated water and moist soil and humans can acquire infection via direct exposure to urine from infected animals or indirectly though contact with urine-contaminated water and wet soil. While leptospirosis occurs worldwide, it is more common in tropical and sub-tropical climates where it is estimated to cause more than a million illnesses and result in almost 60 000 deaths annually. Flood-related leptospirosis outbreaks have been documented in many settings, including Australia, and are expected to increase with climate change. The largest outbreak of human leptospirosis in Australia occurred in 2018 when 84 cases where identified among workers on a berry farm in New South Wales. In 2019 unprecedented clusters of fatal canine leptospirosis occurred in urban areas of Sydney and Melbourne. It is not yet known whether the recent leptospirosis outbreaks among dogs and humans are an aberration or herald a growing threat to public and veterinary health in Australia. A One Health approach is critical to understanding the emergence of leptospirosis in an era of climate change, population growth, changes to agricultural practices, increased travel and urbanisation, both in Australia and abroad. |
| Antimicrobial resistance; Joint external evaluation; One health | | Background Antimicrobial resistance (AMR) is of growing concern globally and AMR status in sub-Saharan Africa (SSA) is undefined due to a lack of real-time data recording, surveillance and regulation. World Health Organization (WHO) Joint External Evaluation (JEE) reports are voluntary, collaborative processes to assess country capacities and preparedness to prevent, detect and rapidly respond to public health risks, including AMR. The data from SSA JEE reports were analysed to gain an overview of how SSA is working towards AMR preparedness and where strengths and weaknesses lie. Methods SSA country JEE AMR preparedness scores were analysed. A cumulative mean of all the SSA country AMR preparedness scores was calculated and compared to the overall mean SSA JEE score. AMR preparedness indicators were analysed, and data were weighted by region. Findings The mean SSA AMR preparedness score was 53% less than the overall mean SSA JEE score. East Africa had the highest percentage of countries reporting having AMR National Action Plans in place, as well as human and animal pathogen AMR surveillance programmes. Southern Africa reported the highest percentage of countries with training programmes and antimicrobial stewardship. Conclusions The low mean AMR preparedness score compared to overall JEE score, along with the majority of countries lacking implemented National Action Plans, suggests that until now AMR has not been a priority for most SSA countries. By identifying regional and One Health strengths, AMR preparedness can be fortified across SSA with a multisectoral approach. |
| One Health; Zoonoses; Herder; Animal husbandry; Sanitation; Hygiene | ANIMAL FECES; EXPOSURE; HEALTH; WATER; RISK; BRUCELLOSIS; STRATEGIES; MANAGEMENT; HAZARDS; HERDERS | The strong bond between herder and livestock was forged centuries ago in rural Mongolia and remains an element of national pride and a cornerstone to the economy. However, semi-nomadic herders frequently live at the edge of human health care, veterinary services, and municipal infrastructure like water and sanitation. This study examined zoonotic risk factors and disease perceptions among 150 rural herding households. Less than half of the participating households used an improved drinking water source (43.3%), and the majority of herding families did not use an improved sanitation service (68.5%). Almost half of the study population practise open defaecation (49.7%). Hand washing occurs after animal contact (78%) but not after defaecation/urination (76.6%). Domestic animal ownership and/or presence was reported at every household, and exposure risks varied by the gender of the household member. Most households had knowledge about zoonotic disease transmission (74%) but far less recognized the risk of reverse zoonoses, or human-to-animal disease transmission (53.3%). Few survey respondents believed that animal contact is a risk factor for diarrhoeal disease (8.7%). This study highlights zoonotic disease exposure risks from animal husbandry practices and inadequate water, sanitation, and hygiene access and behaviours among rural herding households. Zoonotic disease prevention among Mongolian herders should be implemented using a One Health framework to simultaneously address human, animal, and environmental health concerns of rural herding households. |
| microbial evolution; public health; symbiosis; drug resistance; hologenome; AMR; allergy; anthropocene; plantationocene | GUT MICROBIOTA; ANTIMICROBIAL RESISTANCE; INTESTINAL EPITHELIUM; BRAIN-DEVELOPMENT; BACTERIA; VIRUSES; DOXYCYCLINE; CHALLENGES; DYSBIOSIS; EVOLUTION | Microbes evolve in complex environments that are often fashioned, in part, by human desires. In a global perspective, public health has played major roles in structuring how microbes are perceived, cultivated, and destroyed. The germ theory of disease cast microbes as enemies of the body and the body politic. Antibiotics have altered microbial development by providing stringent natural selection on bacterial species, and this has led to the formation of antibiotic-resistant bacterial strains. Public health perspectives such as Precision Public Health and One Health have recently been proposed to further manage microbial populations. However, neither of these take into account the symbiotic relationships that exist between bacterial species and between bacteria, viruses, and their eukaryotic hosts. We propose a perspective on public health that recognizes microbial evolution through symbiotic associations (the hologenome theory) and through lateral gene transfer. This perspective has the advantage of including both the pathogenic and beneficial interactions of humans with bacteria, as well as combining the outlook of the One Health model with the genomic methodologies utilized in the Precision Public Health model. In the Anthropocene, the conditions for microbial evolution have been altered by human interventions, and public health initiatives must recognize both the beneficial (indeed, necessary) interactions of microbes with their hosts as well as their pathogenic interactions. |
| health education; health literacy; teaching experiences; teacher preparation; teaching skills; Whole School; Whole Community; Whole Child | MENTAL-HEALTH; SCHOOL; LITERACY; FOCUS | BACKGROUND In this study, we explore how a health education course may play a role in pre-service teachers’ perceptions in teaching and integrating health education activities to nurture K-8 students’ health literacy. METHODS We used mixed methods to examine the effect of a health education course in a teacher education program. Of 55 pre-service teachers, 41voluntarily participated in the study. Quantitative data were obtained through an online questionnaire administered to participants at the beginning and end of the course. We conducted 6 focus groups at the end of the course. RESULTS The inferential analysis from a series of analysis of variance with repeated measures revealed significant differences in health knowledge (F = 113.39, p < .01, eta(2) = 0.74), preparedness (F = 104.74, p < .01, eta(2) = 0.73), attitudes (F = 15.02, p < .01, eta(2) = 0.28), and beliefs (F = 8.87, p < .01, eta(2) = 0.19) between time points. Qualitative data led to the conclusion that where one health education course is insufficient, such a course is the first step into future curriculum development and implementation. CONCLUSION One health education course might be beneficial for general education teachers to increase their knowledge and preparation to teaching school health. On-going training is needed for program success. |
| antimicrobial resistance; ESBL; One Health; E; coli; phylotyping; plasmid replicon typing; isolate association | ANTIBIOTIC-RESISTANCE; BETA-LACTAMASES; PLASMIDS; PATTERNS; GENES | Antimicrobial resistance (AMR) is a prevalent global health problem across human and veterinary medicine. The One Health approach to AMR is necessary to mitigate transmission between sources of resistance and decrease the spread of resistant bacteria among humans, animals, and the environment. Our primary goal was to identify associations in resistance traits between Escherichia coli isolated from clinical (n = 103), dairy manure (n = 65), and freshwater ecosystem (n = 64) environments within the same geographic location and timeframe. Clinical E. coli isolates showed the most phenotypic resistance (47.5%), followed by environmental isolates (15.6%) and manure isolates (7.7%), with the most common resistances to ampicillin, ampicillin-sulbactam, and cefotaxime antibiotics. An isolate subset was screened for extended spectrum beta-lactamase (ESBL) production resulting in the identification of 35 ESBL producers. The most common ESBL gene identified was bla(TEM-1). Additionally, we found nine different plasmid replicon types including IncFIA-FIB, which were frequently associated with ESBL producer isolates. Molecular phylotyping revealed a significant portion of clinical E. coli were associated with phylotype B2, whereas manure and environmental isolates were more diverse. Manure and environmental isolates were significantly different from clinical isolates based on analyzed traits, suggesting more transmission occurs between these two sources in the sampled environment. |
| antimicrobial resistance; extended-spectrum beta-lactamase (ESBL); one health; beef; sewage | CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE; GRAM-NEGATIVE BACTERIA; ESCHERICHIA-COLI; BETA-LACTAMASE; ANTIBIOTIC-RESISTANCE; UNITED-STATES; LABORATORY SURVEILLANCE; MOLECULAR EPIDEMIOLOGY; KLEBSIELLA-PNEUMONIAE; COMPANION ANIMALS | This study aimed to compare antimicrobial resistance (AMR) in extended-spectrum cephalosporin-resistant and genericEscherichia colifrom a One Health continuum of the beef production system in Alberta, Canada. A total of 705 extended-spectrum cephalosporin-resistantE. coli(ESC(R)) were obtained from: cattle feces (CFeces,n= 382), catch basins (CBasins,n= 137), surrounding streams (SStreams,n= 59), beef processing plants (BProcessing,n= 4), municipal sewage (MSewage;n= 98) and human clinical specimens (CHumans,n= 25). Generic isolates (663) included: CFeces (n= 142), CBasins (n= 185), SStreams (n= 81), BProcessing (n= 159) and MSewage (n= 96). All isolates were screened for antimicrobial susceptibility to 9 antimicrobials and two clavulanic acid combinations. In ESC(R),oxytetracycline (87.7%), ampicillin (84.4%) and streptomycin (73.8%) resistance phenotypes were the most common, with source influencing AMR prevalence (p< 0.001). In genericE. coli,oxytetracycline (51.1%), streptomycin (22.6%), ampicillin (22.5%) and sulfisoxazole (14.3%) resistance were most common. Overall, 88.8% of ESC(R), and 26.7% of generic isolates exhibited multi-drug resistance (MDR). MDR in ESC(R)was high from all sources: CFeces (97.1%), MSewage (96.9%), CHumans (96%), BProcessing (100%), CBasins (70.5%) and SStreams (61.4%). MDR in genericE. coliwas lower with CFeces (45.1%), CBasins (34.6%), SStreams (23.5%), MSewage (13.6%) and BProcessing (10.7%). ESBL phenotypes were confirmed in 24.7% (n= 174) ESC(R)and 0.6% of genericE. coli. Prevalence ofblagenes in ESC(R)werebla(CTXM)(30.1%),bla(CTXM-1)(21.6%),bla(TEM)(20%),bla(CTXM-9)(7.9%),bla(OXA)(3.0%),bla(CTXM-2)(6.4%),bla(SHV)(1.4%) and AmpC beta-lactamasebla(CMY)(81.3%). The lower AMR in ESC(R)from SStreams and BProcessing and higher AMR in CHumans and CFeces likely reflects antimicrobial use in these environments. Although MDR levels were higher in ESC(R)as compared to genericE. coli, AMR to the same antimicrobials ranked high in both ESC(R)and genericE. colisub-populations. This suggests that both sub-populations reflect similar AMR trends and are equally useful for AMR surveillance. Considering that MDR ESC(R)MSewage isolates were obtained without enrichment, while those from CFeces were obtained with enrichment, MSewage may serve as a hot spot for MDR emergence and dissemination. |
| Fasciola hepatica; sheep and cattle; reservoirs; transmission; epidemiology; human hyperendemic; very high altitude; Bolivia | LINKED-IMMUNOSORBENT-ASSAY; HEPATICA INFECTION; FLUID BALANCE; HIGH-ALTITUDE; LIVER FLUKES; SNAIL HOST; ALTIPLANO; POPULATIONS; RISK; CAJAMARCA | The Northern Bolivian Altiplano is the human fascioliasis hyperendemic area where the highest prevalences and intensities of infection by Fasciola hepatica in humans have been reported. Four animal species are the reservoir species for F. hepatica in this area, namely, sheep, cattle, pigs, and donkeys. Livestock for the Aymara inhabitants is crucial because vegetable cultures are not viable due to the inhospitality of the very high altitude of 3,820-4,100 m. A One Health initiative has been implemented in this area in recent years, as the first such control action in a human endemic area ever. Among the different control axes included, special focus is devoted to the two main reservoirs sheep and cattle. Egg embryonation, miracidial infectivity, intramolluscan development, cercarial production, infected snail survival, and metacercarial infectivity were experimentally studied in altiplanic sheep and cattle isolates. These laboratory studies were performed using altiplanic isolates of the lymnaeid species Galba truncatula, the only vector present in the hyperendemic area. Experiments were made at constant 12 h day/12 h night and varying 20/20 degrees C and 22/5 degrees C photoperiods. Infections were implemented using mono-, bi-, and trimiracidial doses. Results demonstrate that sheep and cattle have the capacity to assure F. hepatica transmission in this very high-altitude area. Field surveys included prevalence studies by coprology on fecal samples from 1,202 sheep and 2,690 cattle collected from different zones of the Northern Bolivian Altiplano. Prevalences were pronouncedly higher and more homogeneous in sheep (63.1%; range: 38.9-68.5%) than in cattle (20.6%; range: 8.2-43.3%) in each one of the different zones. Although similarities between the prevalences in sheep and cattle appeared in the zones of the highest and lowest infection rates, this disappeared in the other zones due to cattle treatments. Comparison with past surveys demonstrates that this hyperendemic area is stable from the disease transmission point of view. Therefore, the control design should prioritize sheep and cattle within the One Health action. Studies performed in the Bolivian Altiplano furnish a baseline for future initiatives to assess the transmission and epidemiological characteristics of fascioliasis in the way for its control in other high altitude Andean endemic areas. |
| ANTIMICROBIAL RESISTANCE; ANTIBIOTIC-RESISTANCE; MOLECULAR EPIDEMIOLOGY; GENETIC LINEAGES; CLINICAL-SAMPLES; FECAL SAMPLES; SPP.; UNIVERSITY; SUSCEPTIBILITY; FAECIUM | Vancomycin-resistant enterococci are a global challenge currently as reported by the World Health Organization. It is also important to recognize that combating antimicrobial resistance needs to recognize the interconnections between people, animals, plants and their shared environment in creating public health, the so-called One Health approach. Although the presence of VRE has been described in many regions of the world, there is a lack of comprehensive data indicating their prevalence of in Africa. Therefore, this study aimed to aggregate the result of studies describing VRE reported across multiple regions in Africa. A literature search was conducted on PubMed, Google scholar, and Hinari with the term Vancomycin resistance enterococcus in Africa on August 1-3, 2019. All available articles were downloaded to Endnote version 7.1 then to Microsoft Word 2013. Articles determined to meet our criteria for the review was extracted to Microsoft Excel 2013. Those articles that reported the prevalence of vancomycin resistance Enterococcus obtained from all sample types and published from 2010 to 2019 in the English language were included for the review. A meta-analysis was conducted with OpenMetaAnalyst version R.3.1.0 software. The effect size was determined using a binary random effect model and statically significant considered when p<0.05. Heterogeneity determined with the inconsistency index. A leave one out analysis used to perform the sensitivity analysis. There were 151 articles identified from the database searches; of this, 36 articles included after extensive review with two independent authors. Out of 4073 samples collected, 1488 isolates identified with an overall pooled prevalence of VRE 26.8% (95% CI; 10.7-43.0%) in Africa with a one-health perspective. The analysis showed that considerable heterogeneity among the studies (I-2=99.97%; p<0.001). Subgroup analysis in-country, African region, laboratory method, year of publication, and sample source showed that a high prevalence was identified from South Africa (74.8%), South African regions (74.8%), PCR (959.2%), 2010-2015 years (30.3%) and environmental (52.2%), respectively. This meta-analysis indicates that there was a high-pooled prevalence of vancomycin-resistant enterococci in African. A lot should be done to prevent and control the transmission of vancomycin resistance enterococci to a human being from the environment in the continent. |
| Catalytic philanthropy; systems change; health | FOUNDATION | In 2014, the Medical College of Wisconsin’s Advancing a Healthier Wisconsin Endowment made a significant shift in focus to supporting adaptive rather than programmatic solutions to address critical health issues. The endowment’s new approach emphasized engagement with key stakeholders, recognizing the importance of contribution over attribution and requiring a long-term perspective on outcomes. This article discusses how the endowment experimented with a new model of creating change, ultimately translating new knowledge from national thought leaders and aligning it with its own experiences to guide the endowment’s work. |
| antimicrobial use; antimicrobial resistance; companion animals; critically important antimicrobials; colistin resistance; one health | ESCHERICHIA-COLI; STAPHYLOCOCCUS-AUREUS; ANTIBIOTIC-RESISTANCE; HOUSEHOLD TRANSMISSION; VETERINARY PRACTICES; MULTIDRUG-RESISTANT; PIG PRODUCTION; PET ANIMALS; DOGS; PATTERNS | Companion animals have been described as potential reservoirs of antimicrobial resistance (AMR), however data remain scarce. Therefore, the objectives were to describe antimicrobial usage (AMU) in dogs and cats in three European countries (Belgium, Italy, and The Netherlands) and to investigate phenotypic AMR. A questionnaire and one fecal sample per animal (n = 303) were collected over one year and AMU was quantified using treatment incidence (TI). Phenotypic resistance profiles of 282 Escherichia coli isolates were determined. Nineteen percent of the animals received at least one antimicrobial treatment six months preceding sampling. On average, cats and dogs were treated with a standard daily dose of antimicrobials for 1.8 and 3.3 days over one year, respectively. The most frequently used antimicrobial was amoxicillin-clavulanate (27%). Broad-spectrum antimicrobials and critically important antimicrobials for human medicine represented 83% and 71% of the total number of treatments, respectively. Resistance of E. coli to at least one antimicrobial agent was found in 27% of the isolates. The most common resistance was to ampicillin (18%). Thirteen percent was identified as multidrug resistant isolates. No association between AMU and AMR was found in the investigated samples. The issue to address, regarding AMU in companion animal, lies within the quality of use, not the quantity. Especially from a One-Health perspective, companion animals might be a source of transmission of resistance genes and/or resistant bacteria to humans. |
| biodiversity; Amazon; virus jumping; plants; animals; anthropogenic pressures | VIRUS | Biodiversity is much more than what we see. Biodiversity also includes a number of microorganisms, such as bacteria, fungi and viruses, many of which cause disease in animals, plants and man. In the Amazon, many of these organisms live in the body of repository animals that are in the forest and can jump to humans, with the potential to cause new epidemics and pandemics. In the region, we cannot discard plants as repositories for these microorganisms too. It is necessary to reduce deforestation, mining, cattle ranching at the heart of the forest and strive for One Health approach, improving social organization, including policies, legislation and science. |
| surveilance; metagenomics; MOOC; antimicrobial resistance; one health | ANTIBIOTIC-RESISTANCE; FOOD; NORMALIZATION; GENOMES; PCR; DNA | One Health surveillance of antimicrobial resistance (AMR) depends on a harmonized method for detection of AMR. Metagenomics-based surveillance offers the possibility to compare resistomes within and between different target populations. Its potential to be embedded into policy in the future calls for a timely and integrated knowledge dissemination strategy. We developed a blended training (e-learning and a workshop) on the use of metagenomics in surveillance of pathogens and AMR. The objectives were to highlight the potential of metagenomics in the context of integrated surveillance, to demonstrate its applicability through hands-on training and to raise awareness to bias factors(1). The target participants included staff of competent authorities responsible for AMR monitoring and academic staff. The training was organized in modules covering the workflow, requirements, benefits and challenges of surveillance by metagenomics. The training had 41 participants. The face-to-face workshop was essential to understand the expectations of the participants about the transition to metagenomics-based surveillance. After revision of the e-learning, we released it as a Massive Open Online Course (MOOC), now available at https://www.coursera.org/learn/metagenomics. This course has run in more than 20 sessions, with more than 3,000 learners enrolled, from more than 120 countries. Blended learning and MOOCs are useful tools to deliver knowledge globally and across disciplines. The released MOOC can be a reference knowledge source for international players in the application of metagenomics in surveillance. |
| agriculture; antimicrobial resistance; enteric pathogen; food animal; One Health; zoonoses | HEPATITIS-E-VIRUS; RATS RATTUS-NORVEGICUS; CLOSTRIDIUM-DIFFICILE INFECTION; MICE PEROMYSCUS-MANICULATUS; MAJOR AGRICULTURAL REGION; WILD SMALL MAMMALS; ESCHERICHIA-COLI; LISTERIA-MONOCYTOGENES; COXIELLA-BURNETII; FRANCISELLA-TULARENSIS | Although rodents are well-known reservoirs and vectors for a number of zoonoses, the functional role that peridomestic rodents serve in the amplification and transmission of foodborne pathogens is likely underappreciated. Clear links have been identified between commensal rodents and outbreaks of foodborne pathogens throughout Europe and Asia; however, comparatively little research has been devoted to studying this relationship in the United States. In particular, regional studies focused on specific rodent species and their foodborne pathogen reservoir status across the diverse agricultural landscapes of the United States are lacking. We posit that both native and invasive species of rodents associated with food-production pipelines are likely sources of seasonal outbreaks of foodborne pathogens throughout the United States. In this study, we review the evidence that identifies peridomestic rodents as reservoirs for foodborne pathogens, and we call for novel research focused on the metagenomic communities residing at the rodent-agriculture interface. Such data will likely result in the identification of new reservoirs for foodborne pathogens and species-specific demographic traits that might underlie seasonal enteric disease outbreaks. Moreover, we anticipate that a One Health metagenomic research approach will result in the discovery of new strains of zoonotic pathogens circulating in peridomestic rodents. Data resulting from such research efforts would directly inform and improve upon biosecurity efforts, ultimately serving to protect our food supply. |
| animals; Candida albicans; Candida tropicalis; azole resistance; efflux-pumps; epidemiological cutoff values | EPIDEMIOLOGIC CUTOFF VALUES; COCKATIELS NYMPHICUS-HOLLANDICUS; ANTIFUNGAL SUSCEPTIBILITY; MACROBRACHIUM-AMAZONICUM; PARAPSILOSIS COMPLEX; MIC DISTRIBUTIONS; VIRULENCE FACTORS; CROSS-RESISTANCE; YEAST MICROBIOTA; ALBICANS | This study initially aimed at investigating the occurrence of azole resistance among Candida spp. from animals and analyzing the involvement of efflux pumps in the resistance phenomenon. Then, the dynamics of antifungal resistance was assessed, by comparing the antifungal epidemiological cutoff values (ECVs) against C. albicans and C. tropicalis from humans and animals. Fifty azole-resistant isolates (24 C. albicans, 24 C. tropicalis; 2 C. parapsilosis sensu lato) were submitted to the efflux pump inhibition assay with promethazine and significant MIC reductions were observed for fluconazole (2 to 250-fold) and itraconazole (16 to 4000-fold). Then, the antifungal ECVs against C. albicans and C. tropicalis from human and animal isolates were compared. Fluconazole, itraconazole and voriconazole ECVs against human isolates were lower than those against animal isolates. Based on the antifungal ECVs against human isolates, only 33.73%, 50.39% and 63.53% of C. albicans and 52.23%, 61.85% and 55.17% of C. tropicalis from animals were classified as wild-type for fluconazole, itraconazole and voriconazole, respectively. Therefore, efflux-mediated mechanisms are involved in azole resistance among Candida spp. from animals and this phenomenon seems to emerge in animal-associated niches, pointing to the existence of environmental drivers of resistance and highlighting the importance of the One Health approach to control it. |
| Campylobacter; zoonotic; cytotoxicity; pathogenicity; virulence; campylobacteriosis; foodborne; livestock; PCR; one-health | MULTIPLEX PCR; JEJUNI; COLI; RESISTANCE; IDENTIFICATION; PREVALENCE; BROILER; STRAINS; SPP.; PATHOGENESIS | Campylobacter species are a major cause of foodborne bacterial infections in both developed and developing countries worldwide. Campylobacter jejuni is responsible for the majority of infections. This study was conducted to identify virulence associated genes in Campylobacter species isolated from livestock production systems in South Africa. A total of 250 fecal samples consisting of cattle (n=50), chickens (n=50), goats (n=50), sheep (n=50) and pigs (n=50) were randomly collected from livestock in Eastern Cape and KwaZulu-Natal provinces of South Africa between April and October 2018. The samples were analyzed for the presence of virulence genes in Campylobacter species using molecular PCR-based methods. It was found that 77 and 23% of Campylobacter jejuni and Campylobacter coli respectively were isolated from all the livestock samples. There were positive significant (P<0.05) correlations amongst all the virulence genes that were investigated. Chisquare and Fisher’s exact tests were implemented to test for the effect of livestock species on the presence or absence of virulence genes. The study demonstrated that most of livestock species can potentially cause zoonotic infections and food poisoning due to the high prevalence of Campylobacter. The high prevalence of virulence genes highlights the significance of Campylobacter in livestock production systems in South Africa. This requires the implementation of one-health approaches to reduce the impact of foodborne and zoonotic diseases for the welfare of human and animal health. |
| Covid19; Food safety; Food systems; Biosecurity; Policy | VIRUS TRANSMISSION; ESCHERICHIA-COLI; CLIMATE-CHANGE; NIPAH VIRUS; ONE HEALTH; EMERGENCE; STANDARDS; WILDLIFE; ANIMALS; DRIVERS | Recent large-scale pandemics such as the covid19, H1N1, Swine flu, Ebola and the Nipah virus, which impacted human health and livelihoods, have come about due to inadequate food systems safeguards to detect, trace and eliminate threats arising from zoonotic diseases. Such diseases are transmitted to humans through their interaction with animals in the food value chain including through the consumption of bush meat. Climate change has also facilitated the emergence of new zoonotic diseases. The lack of adequately enforced food-safety standards in managed agricultural production systems creates the necessary conditions for diseases to mutate into highly contagious strains. The lack of food safety measures in handling, packaging and sales of food increases risks of cross-species contamination. Finally, increasing anti-microbial resistance, combined with rapid urbanization and global interconnectedness allows diseases to spread rapidly among humans. Thus, part of the reconstruction efforts, post covid19, should include prioritizing proactive investments in food safety. The key to stave off another such pandemic lies in integrating one-health knowledge on zoonotic diseases along with food safety measures along the food value chain. Refocusing policy priorities from disease control to prevention will improve international coordination efforts in pandemic prevention. Implementing such proactive actions will cost a very small fraction of the reconstruction budgets. However, the expected benefits of the food-safety approach will include preventing global economic losses due to pandemics. |
| virome; Pecari tajacu; Betacoronavirus; zoonoses; one health | MIDDLE-EAST; CORONAVIRUS | In an enclosure with nine collared peccaries (Pecari tajacu) from the Rio de Janeiro city Zoo, Brazil, one specimen was found dead and two others developed prostration, apathy and dehydration, resulting on its death. Necropsy of two animals pointed to pulmonary and renal damage. Histological examination revealed vasculitis in spleen from both P. tajacu, suggesting a systemic viral infection. Lungs from one specimen showed fibrinoid vasculitis, alveolar damage with hyaline membrane, and interstitial lymphocytes infiltration. Virome analysis in anal wash samples from the latter two animals revealed a new type of Betacoronavirus, lineage A, provisionally named Ptajacu-CoV. |
| hydatid cyst; veterinary medicine; operational research; abattoir survey; livestock | ECHINOCOCCOSIS | Introduction: Zoonotic parasitic infections such as echinococcosis affect cattle, sheep and goats by lowering quality of meat and hides as well as decreasing milk production. The burden of such diseases among humans is usually underestimated as they are difficult to diagnose. We used abattoir data to estimate the prevalence of zoonotic parasitic infections in animals. Methodology: Data from 2005-2018 was used from the registry of an abattoir in Northwest Ethiopia. Frequencies, proportions and trends over time were analyzed. Meat inspection was conducted by visualization, palpation and incision. Results: A total of 58,787 animals were slaughtered in the abattoir during the study period. These included 51,956 (88 %) cattle, 5,890 (10%) sheep and 941 (2%) goats. The detected parasites included Echinococcus in 12,334/58,787 (21%) and Fasciola in 10,551/58,787 (18%) animals. Echinococcus infection was highest among goats (267/941, 28%), followed by cattle (11,591/51,956, 22%) and sheep (476/5,890, 8%). Fasciolosis was detected in 9,877/51,956 (19%) cattle and 178/941 (19%) goats. The number of animals slaughtered strongly decreased over time from 8,405 in 2006 to 1,605 in 2018. However, the proportion of parasitic infections remained high with some fluctuations over the study period. Conclusions: Echinococcosis and fasciolosis were very common with one out of five animals slaughtered infected. This is of public health concern and needs urgent multi-sectorial efforts from stakeholders at the national and regional level for control of these diseases. One health program approaches may warrant the control of transmission to humans. |
| | In early 2020, hospitals faced unprecedented patient volumes resulting from the COVID-19 outbreak. Nurse executives at a faith-based, not-for-profit health care system quickly responded to ensure safe staffing, conservation of personal protective equipment, and implementation of infection prevention strategies. A significant challenge was safe staffing for the expected patient surge. To address this, a team of nurse executives utilized the ADKAR change model to guide a transition from primary to team nursing. The processes varied between hospitals, but core principles and implementation strategies were the same. This article discusses the quick, but methodical, journey one health care system experienced. |
| | The health care industry, a major contributor to greenhouse gas emissions and landfill waste, must focus on sustainable efforts. The American Nurses Association (ANA) Scope and Standards of Practice deems nurses accountable to achieve sustainable goals in the workplace. This article shows how the chief nursing officer (CNO) council of one health care system partnered with the organization’s sustainability department to integrate sustainability efforts into daily operations across the system. Each CNO was tasked to determine key performance indicators for their location, identify facility champions, and support sustainability efforts. Some joint initiatives included education, waste reduction and diversion, 501(c)3 donation, and device reprocessing. |
| COVID-19; food security; One Health; Planetary Health; SARS-CoV-2; food safety; animal production | HEALTH; NUTRITION; IMPACTS | We present scientific perspectives on the impact of the COVID-19 pandemic and global food security. International organizations and current evidence based on other respiratory viruses suggests COVID-19 is not a food safety issue, i.e., there is no evidence associating food or food packaging with the transmission of the virus causing COVID-19 (SARS-CoV-2), yet an abundance of precaution for this exposure route seems appropriate. The pandemic, however, has had a dramatic impact on the food system, with direct and indirect consequences on lives and livelihoods of people, plants, and animals. Given the complexity of the system at risk, it is likely that some of these consequences are still to emerge over time. To date, the direct and indirect consequences of the pandemic have been substantial including restrictions on agricultural workers, planting, current and future harvests; shifts in agricultural livelihoods and food availability; food safety; plant and animal health and animal welfare; human nutrition and health; along with changes in public policies. All aspects are crucial to food security that would require One Health approaches as the concept may be able to manage risks in a cost-effective way with cross-sectoral, coordinated investments in human, environmental, and animal health. Like climate change, the effects of the COVID-19 pandemic will be most acutely felt by the poorest and most vulnerable countries and communities. Ultimately, to prepare for future outbreaks or threats to food systems, we must take into account the Sustainable Development Goals of the United Nations and a Planetary Health perspective. |
| Klebsiella pneumonia; One Health; genomics; antimicrobial resistance; surveillance | ESCHERICHIA-COLI; ENTEROBACTERIACEAE; EPIDEMIOLOGY; RESISTANCE; RESERVOIR; HUMANS; FRANCE; SPP.; FARM | Background. Klebsiella pneumoniae is a human, animal, and environmental commensal and a leading cause of nosocomial infections, which are often caused by multiresistant strains. We evaluate putative sources of K. pneumoniae that are carried by and infect hospital patients. Methods. We conducted a 6-month survey on 2 hematology wards at Addenbrooke’s Hospital, Cambridge, United Kingdom, in 2015 to isolate K. pneumoniae from stool, blood, and the environment. We conducted cross-sectional surveys of K. pneumoniae from 29 livestock farms, 97 meat products, the hospital sewer, and 20 municipal wastewater treatment plants in the East of England between 2014 and 2015. Isolates were sequenced and their genomes compared. Results. Klebsiella pneumoniae was isolated from stool of 17/149 (11%) patients and 18/922 swabs of their environment, together with 1 bloodstream infection during the study and 4 others over a 24-month period. Each patient carried 1 or more lineages that was unique to them, but 2 broad environmental contamination events and patient-environment transmission were identified. Klebsiella pneumoniae was isolated from cattle, poultry, hospital sewage, and 12/20 wastewater treatment plants. There was low genetic relatedness between isolates from patients/their hospital environment vs isolates from elsewhere. Identical genes encoding cephalosporin resistance were carried by isolates from humans/environment and elsewhere but were carried on different plasmids. Conclusion. We identified no patient-to-patient transmission and no evidence for livestock as a source of K. pneumoniae infecting humans. However, our findings reaffirm the importance of the hospital environment as a source of K. pneumoniae associated with serious human infection. |
| Rift Valley fever; modeling; epidemics; spillover; One Health | CULEX-PIPIENS; TEMPERATURE; OUTBREAKS; EGYPT; MODEL | Rift Valley fever (RVF) is an emerging, zoonotic, arboviral hemorrhagic fever threatening livestock and humans mainly in Africa. RVF is of global concern, having expanded its geographical range over the last decades. The impact of control measures on epidemic dynamics using empirical data has not been assessed. Here, we fitted a mathematical model to seroprevalence livestock and human RVF case data from the 2018-2019 epidemic in Mayotte to estimate viral transmission among livestock, and spillover from livestock to humans through both direct contact and vector-mediated routes. Model simulations were used to assess the impact of vaccination on reducing the epidemic size. The rate of spillover by direct contact was about twice as high as vector transmission. Assuming 30% of the population were farmers, each transmission route contributed to 45% and 55% of the number of human infections, respectively. Reactive vaccination immunizing 20% of the livestock population reduced the number of human cases by 30%. Vaccinating 1 mo later required using 50% more vaccine doses for a similar reduction. Vaccinating only farmers required 10 times as more vaccine doses for a similar reduction in human cases. Finally, with 52.0% (95% credible interval [CrI] [42.9-59.4]) of livestock immune at the end of the epidemic wave, viral reemergence in the next rainy season (2019-2020) is unlikely. Coordinated human and animal health surveillance, and timely livestock vaccination appear to be key to controlling RVF in this setting. We furthermore demonstrate the value of a One Health quantitative approach to surveillance and control of zoonotic infectious diseases. |
| COVID-19; SARS-CoV-2; Environment; Pollutants; Environmental impacts; One health | PARTICULATE AIR-POLLUTION; RISK-ASSESSMENT; PHARMACEUTICALS; MEGACITIES; CHEMICALS; WILDLIFE; AGENTS; HEALTH; CHILE; WATER | Coronavirus disease 2019 (COVID-19) has become a global pandemic. Its relationship with environmental factors is an issue that has attracted the attention of scientists and governments. This article aims to deal with a possible association between COVID-19 and environmental factors and provide some recommendations for adequately controlling future epidemic threats. Environmental management through ecosystem services has a relevant role in exposing and spreading infectious diseases, reduction of pollutants, and control of climatic factors. Pollutants and viruses (such as COVID-19) produce negative immunological responses and share similar mechanisms of action. Therefore, they can have an additive and enhancing role in viral diseases. Significant associations between air pollution and COVID-19 have been reported. Particulate matter (PM2.5, PM10) can obstruct the airway, exacerbating cases of COVID-19. Some climatic factors have been shown to affect SARS-CoV-2 transmission. Yet, it is not well established if climatic factors might have a cause-effect relationship to the spreading of SARS-CoV-2. So far, positive as well as negative indirect environmental impacts have been reported, with negative impacts greater and more persistent. Too little is known about the current pandemic to evaluate whether there is an association between environment and positive COVID-19 cases. We recommend smart technology to collect data remotely, the implementation of one health approach between public health physicians and veterinarians, and the use of biodegradable medical supplies in future epidemic threats. (C) 2020 Elsevier B.V. All rights reserved. |
| SPONGIFORM ENCEPHALOPATHY; DISEASE; MORBILLIVIRUS; BATS | The CSIRO Australian Animal Health Laboratory (AAHL) was officially opened on 1 April 1985. After that day the laboratory switched to secure mode and has operated as such ever since. AAHL was constructed to be the primary national diagnostic facility for exotic animal diseases but has expanded its role to become a national and international reference laboratory for many diseases. AAHL has supported disease control within the region by providing training, reagents and proficiency testing, both within Australia and internationally. AAHL’s role has evolved even further to include a focus on one-health which resulted in AAHL being renamed the Australian Centre for Disease Preparedness (ACDP) in March 2020. |
| ANTIBIOTIC-RESISTANCE; ESCHERICHIA-COLI; HEALTH; METRICS | Background: The JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks have joined efforts to formulate a set of target actions to link the surveillance of antimicrobial usage (AMU) and antimicrobial resistance (AMR) with antimicrobial stewardship (AMS) activities in four different settings. This White Paper focuses on the veterinary setting and embraces the One Health approach. Methods: A review of the literature was carried out addressing research questions in three areas: AMS leadership and accountability; AMU surveillance and AMS; and AMR surveillance and AMS. Consensus on target actions was reached through a RAND-modified Delphi process involving over 40 experts in infectious diseases, clinical microbiology, AMS, veterinary medicine and public health, from 18 countries. Results/discussion: Forty-six target actions were developed and qualified as essential or desirable. Essential actions included the setup of AMS teams in all veterinary settings, building government-supported AMS programmes and following specific requirements on the production, collection and communication of AMU and AMR data. Activities of AMS teams should be tailored to the local situation and capacities, and be linked to local or national surveillance systems and infection control programmes. Several research priorities were also identified, such as the need to develop more clinical breakpoints in veterinary medicine. Conclusions: This White Paper offers a practical tool to veterinary practitioners and policy makers to improve AMS in the One Health approach, thanks to surveillance data generated in the veterinary setting. This work may also be useful to medical doctors wishing to better understand the specificities of the veterinary setting and facilitate cross-sectoral collaborations. |
| bronchial/lung respiratory disease; bronchoalveolar lavage; indoor air pollution; one health; pet dog and cat; PM2.5 and VOC | BRONCHOALVEOLAR LAVAGE FLUID; PULMONARY-DISEASE; DIESEL EXHAUST; EXPOSURE; DOGS; INFLAMMATION; METHYLATION; ASTHMA; SMOKE; RISK | Background: Indoor air pollution (IAP) is an emerging issue for both human and veterinary patients under the concept of ‘One Health’. The association between IAP and respiratory disease in companion animals has been reported. Objectives: The present study investigated the relationship between quantifiable indoor air quality and clinical characteristics of naturally acquired bronchial/lung disease in pet dogs and cats. Methods: A total of 36 clinical cases (20 dogs and 16 cats) with naturally acquired bronchial/lung disease were prospectively recruited. Lower airway samples were collected and analysed, and clinical signs and the information from pulmonary function testing were examined. Indoor air quality was estimated by the average concentration of particles measuring <= 2.5 mu m (PM2.5, mu g/m(3)) and volatile organic compounds (VOC, ppm) in the animals’ domestic microenvironments. Results: Exposure to IAP was not found to be correlated with the severity of clinical signs, pulmonary function changes or bronchoalveolar lavage fluid cytology in cats with bronchial/lung disease. However, a hypercellular response in canine lower airways was found to be associated with poor indoor air quality, including unacceptable indoor PM2.5 levels (>35 mu g/m(3)) or increases in VOC concentration (>1 ppm) in places most commonly frequented by the dogs in the home. Conclusions: Poor indoor air quality may exacerbate airway disease in pets and should not be ignored in modern society. |
| One health; Hantavirus emergence; Predator diversity; Species richness | PULMONARY SYNDROME; BIODIVERSITY; TRANSMISSION; PREVALENCE; RESERVOIRS; DIVERSITY; RODENTS; HEALTH | Hantavirus infection is a rodent-borne disease (RBD) transmitted by urine or feces (as the natural reservoirs) with an annual estimated worldwide incidence of-150,000 cases. Previous ecological studies suggested that higher species richness of rodents could decrease the risk of RBDs in humans, because the regulatory pressure of predators could reduce contact among rodents, and between humans and rodents. Using surveillance data, we investigated the association of predator species richness with hantavirus infection emergence in 5562 Brazilian inland municipalities between 2007 and 2017. Multivariable logistic regression models were used for the analyses. Diurnal and non-diurnal predator species were independent explanatory variables in the models. Rodent species richness and demographic, socioeconomic, and environmental factors were used as covariates. During the study period, 1084 cases were reported in 429 municipalities. The results showed a reverse-U-shaped association between diurnal predator species richness and hantavirus infection emergence (odds ratio [OR] 0.463, 0.688, and 0.553 for the first [lowest], third, and fourth [highest] quartiles, respectively, using the second quartile as a reference), while higher non-diurnal predator species richness tended to be associated with higher emergence risk (OR 0.134, 1.065, and 2.708 for the first, third, and fourth quartiles, respectively). The difference in these associations illustrates the complexity of the effects of predator species richness on human RBDs, which require further investigation in follow-up studies. The results showed a close link between environmental factors and public health, emphasizing that the One Health concept should be employed to understand the dynamics of RBDs. |
| cart horse; socio-economic; One Health; demographics; community; spatial epidemiology | HEALTH | In the Cape Flats townships, Cape Town, South Africa, there are more than 250 working cart horses. They serve the community with scrap metal and garden refuse removal, human transport and the selling of goods. A questionnaire was undertaken to understand the social and economic impacts of a horse and cart in the Cape Flats on individual owners and/or drivers, their households and the community. A mixture of classical quantitative questions combined with qualitative participatory technique questions were used. A total of 100 participants took part in the questionnaire, who cart with 163 horses between them. The majority (89%) identified the cart horse income as their primary income source. Apart from the participants, an additional 716 people were supported financially through this income, where the mean number of children supported was 2.9 (95% confidence interval [CI]: +/- 0.42) per interviewed participant. Scrap metal transportation was the most common work and the season (winter) had a negative impact on their ability to work. The spatial extent to which a cart horses work was determined and related back to the impact on the horse and participant of the survey. It was demonstrated that the cart horse industry had an impact not only on those who worked in the industry, but also on the surrounding residents, either through their work or through supporting others with their income. This study revealed that the concepts of ‘One Health’ and ‘Health in Social-Ecological Systems’, in action as horse and human health within the Cape Flats are closely intertwined. |
| community-based participatory research; Hendra virus; One health; syndromic surveillance; vaccines; Zoonoses | HEALTH-POLICY; EQUINE | Background Hendra virus (HeV) is endemic in Australian flying foxes, posing a threat to equine and human health. Equine vaccination remains the most effective risk mitigation strategy. Many horses remain unvaccinated – even in higher-risk regions. Debate surrounding the vaccine’s use is characterised by conflicting perspectives, misunderstanding and mistrust. Private veterinary practitioners are critical to early identification of public health risk through recognition, sampling and management of suspect-equine-HeV-cases. However, managing such cases can be burdensome, with some veterinarians opting not to attend unvaccinated horses or to abandon equine practice because of risk posed by HeV disease and liability. Objective Ascertain the perspectives of informed citizens on what obligations (if any) private veterinarians have to attend unvaccinated horses with HeV or HeV-like disease. Methods Three citizens’ juries were tasked with considering approaches to managing HeV risk in Australia, including (reported here) roles and obligations of private veterinarians in responding to HeV-suspect-cases. Results Jurors acknowledged that HeV management posed an important challenge for private veterinarians. A clear majority (27 of 31 jurors) voted that veterinarians should not be obliged to attend unvaccinated horses. All recognised that greater support for veterinarians should be a priority. Conclusions When informed of HeV risks and strategies for control and management, citizens appreciated the need to support veterinarians performing this critical ‘One Health’ role for public benefit. The current governance framework within which zoonotic disease recognition and response operates limits the contingency and scope for increasing support and efficacy of these important veterinary public health practices. |
| Rabies; Knowledge; Attitude; Professionals; Human-health; Animal-health; Zoonosis; One health; Uganda | EPIDEMIOLOGY; PHYSICIANS; AFRICA; BURDEN | Objective To assess the knowledge, attitude and practices (KAP) of animal and human health professionals towards rabies management and also to establish the level of relationship between KAP. Methods A cross-sectional study was conducted between December 2012 and March 2013 among 147 randomly selected animal and human health professionals in Mbale District. Of these, only 16 were animal health professionals. Quantitative data was obtained using a semi-structured questionnaire while qualitative data was obtained from 4 Focus Group Discussions (FGDs) and 2 Key Informant (KI) interviews. Quantitative data was entered into EpiInfo version 3.5.1 and proportions computed while qualitative data was summarised into themes and sub-themes resulting from content analysis of interview scripts. Findings Of all the respondents, only 44% (65/147) had sufficient knowledge about rabies while 25% (37/147) had positive attitude towards rabies management. A half of the respondents (50%, 73/147) had limited good practices. Respondents knowledgeable about rabies were more likely to have positive attitude towards rabies management (OR = 3.65; 95% CI: 1.60-8.3) while respondents with positive attitudes, were more likely to have good practices towards rabies management (OR: 2.22; 95% CI: 1.01-4.86). Conclusion Respondents had low knowledge, negative attitude and limited good practices of rabies management. Regular refresher trainings about rabies to broaden staff knowledge and improve their attitudes and hence practices of rabies management should be conducted by the District leaders. Harnessing multi-sectoral and multi-disciplinary collaborative efforts (One Health approach) for rabies control should be instituted to reduce the incidence of the disease in the District. |
| homelessness; homeless youth; pet ownership; companion animals; One Health; housing policy; service delivery; access to care; Housing First; veterinary medicine | DROP-IN CENTER; SEVERE MENTAL-ILLNESS; ONE HEALTH; COMPANION ANIMALS; HOUSING 1ST; COMMUNITY INTEGRATION; SHELTER LINKAGE; DOG OWNERSHIP; DRUG-USE; YOUTH | Simple Summary Approximately one in 10 people experiencing homelessness have pets. Despite pets having psychosocial benefits for their owners, pets can also present challenges for people experiencing homelessness related to meeting their basic needs and obtaining housing. This article proposes a framework of policy, public, and service interventions for improving the health and well-being of pet owners experiencing homelessness. At the policy level, the framework proposes an increase of pet-friendly emergency shelters, access to market rental housing and veterinary medicine, and the use of a Housing First approach. At the public level, educational interventions are needed to improve knowledge and reduce stigma about the relationship between homelessness and pet ownership. At the service delivery level, direct service providers can support pet owners experiencing homelessness by recognizing their strengths, connecting them to community services, being aware of the risks associated with pet loss, providing harm reduction strategies, documenting animals as emotional support animals, and engaging in advocacy. By targeting policies and service approaches that exacerbate the hardships faced by pet owners experiencing homelessness, the framework is a set of deliberate actions to better support this vulnerable group. Approximately one in 10 people experiencing homelessness have pets. Despite the psychosocial benefits derived from pet ownership, systemic and structural barriers can prevent this group from meeting their basic needs and exiting homelessness. A multilevel framework is proposed for improving the health and well-being of pet owners experiencing homelessness. Informed by a One Health approach, the framework identifies interventions at the policy, public, and direct service delivery levels. Policy interventions are proposed to increase the supply of pet-friendly emergency shelters, access to market rental housing and veterinary medicine, and the use of a Housing First approach. At the public level, educational interventions are needed to improve knowledge and reduce stigma about the relationship between homelessness and pet ownership. Direct service providers can support pet owners experiencing homelessness by recognizing their strengths, connecting them to community services, being aware of the risks associated with pet loss, providing harm reduction strategies, documenting animals as emotional support animals, and engaging in advocacy. By targeting policies and service approaches that exacerbate the hardships faced by pet owners experiencing homelessness, the framework is a set of deliberate actions to better support a group that is often overlooked or unaccommodated in efforts to end homelessness. |
| animal control; policy; one health; one welfare; humane communities; social justice; access to care; underserved communities; companion animals | | Simple Summary: The current emphasis on enforcement and punishment in animal control policy has disproportionately negative impacts on low-income communities in the United States (US), particularly people of color. In this way, animal protection efforts are perpetuating many of the same inequities under examination in the human social justice movement. Reallocating the resources that have historically gone towards enforcement in communities to efforts that provide support in addressing the root causes of animal welfare concerns is needed to improve outcomes for pets in historically underserved communities. Due to inherent and systemic biases, animal control policies in the US are over-enforced in low-income communities and communities of color, resulting in worse health outcomes for the pets in these communities. These outcomes are exemplified by higher confiscation, relinquishment, and euthanasia rates, lower return to owner rates, and extended lengths of stay in animal shelters. The Humane Communities framework operationalizes One Health and One Welfare concepts to comprehensively address issues of inequity at both the individual and structural levels to improve animal control policy and outcomes. Person-centered and culturally competent policies and programs that focus resources on addressing root causes of pet health and welfare issues as opposed to an emphasis on code enforcement can create more positive, scalable, and sustainable improvements in human, other animal, and environmental health and welfare outcomes. This shift from punishment-oriented approaches to support-based models of animal control aligns the animal welfare field with the modern human social justice movement. |
| Antimicrobial resistance; Feces; Farm environment; Mobilome; One health; Sustainable farming; Swine | ESCHERICHIA-COLI; RESISTANCE; INTEGRONS; FEED; IDENTIFICATION; ENTEROCOCCI; ALIGNMENT; COMMON; CFR | Background: The global threat of antimicrobial resistance (AMR) is a One Health problem impacted by antimicrobial use (AMU) for human and livestock applications. Extensive Iberian swine production is based on a more sustainable and eco-friendly management system, providing an excellent opportunity to evaluate how sustained differences in AMU impact the resistome, not only in the animals but also on the farm environment. Here, we evaluate the resistome footprint of an extensive pig farming system, maintained for decades, as compared to that of industrialized intensive pig farming by analyzing 105 fecal, environmental and slurry metagenomes from 38 farms. Results: Our results evidence a significantly higher abundance of antimicrobial resistance genes (ARGs) on intensive farms and a link between AMU and AMR to certain antimicrobial classes. We observed differences in the resistome across sample types, with a higher richness and dispersion of ARGs within environmental samples than on those from feces or slurry. Indeed, a deeper analysis revealed that differences among the three sample types were defined by taxa-ARGs associations. Interestingly, mobilome analyses revealed that the observed AMR differences between intensive and extensive farms could be linked to differences in the abundance of mobile genetic elements (MGEs). Thus, while there were no differences in the abundance of chromosomal-associated ARGs between intensive and extensive herds, a significantly higher abundance of integrons in the environment and plasmids, regardless of the sample type, was detected on intensive farms. Conclusions: Overall, this study shows how AMU, production system, and sample type influence, mainly through MGEs, the profile and dispersion of ARGs in pig production. |
| hawai’i; disease; behavior change; biology; invasive species; endemic; anthropogenic impact; conservation; one health; ecology | METROSIDEROS-POLYMORPHA | ‘Ohi’a lehua is a species of tree endemic to the islands of Hawaii. Its existence is vital to the survival of many pollinator insects and endangered bird species and to the integrity of multiple islands’ watersheds. Rapid ‘Ohi’a Death (ROD) is an emerging fungal disease that poses a significant health risk for these trees and is spread by human traffic, ambrosia beetles, and wind dispersal. Loss of ‘ohi’a forests will negatively affect Hawai’i’s economy and ecology and will have detrimental impacts on Hawaiian culture, particularly because of the role of lehua flowers in hula. While transmission of ROD Death is not yet fully understood, human activity is currently considered the main proponent of its spread. Hawai’i’s economy is largely built on the tourism industry; however, tourists are often unaware of the disease and the practices implemented to contain the current outbreak while visiting the Hawaiian Islands. ROD is a conservation issue that connects humans with the environment and must be addressed using a one-health perspective. This article aims to elucidate the anthropogenic factors contributing to the depletion of ‘ohi’a lehua through the spread of ROD and to propose prevention measures that can be adopted by citizens and visitors. At the end of this case study, readers will understand the cultural, ecological, and economic significance of ‘ohi’a lehua. Readers will also be able to identify important stakeholders and examine the complexity of behavior change in conservation issues. |
| Biodiversity; Conservation; Disease; One Health; Reporting; Species stress; Threat; Wildlife; World Organisation for Animal Health | | Disease is an increasingly recognised threat to wild animal populations and the conservation of endangered species. The World Organisation for Animal Health (OIE) Worldwide Monitoring System for Wild Animal Diseases (WAHIS-Wild) serves as the main global information portal for wildlife disease events, compiled via voluntary reporting by countries on non-OIE-listed diseases. The first decade of reports to WAHIS-Wild were analysed to identify trends and examine their relevance for conservation. Between 2008 and 2018, a total of 4,229 wildlife disease events were reported, with the majority from the European continent. When standardised for nomenclature changes, 54 unique previous or current non-OIE-listed diseases were reported. The most common disease events (collectively representing > 50% of reports) were chemical poisoning (12.5% of events reported), infection with low pathogenic avian influenza viruses (11.9%), infection with Salmonella enterica (10.8%), infection with Pasteurella spp. (8.4%) and infection with Trichomonas spp. in birds and reptiles (7.5%). Reports indicated disease in 501 unique species, 19.2% of which are listed as endangered species based on the International Union for Conservation of Nature (IUCN) Red List of Threatened Species, and 30.7% of which are protected under the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). The findings suggest reporting gaps, including likely geographical area and other biases. More systematic reporting of wildlife disease and use of this information in biodiversity assessment and decision-making would result in better animal health and conservation coordination in a One Health context. |
| PREVENTION | Introduction Cervical cancer is one of the most common causes of morbidity and mortality among women in developing countries including Ethiopia. Unlike other types of cancers, the grave outcomes of cervical cancer could be prevented if detected at its early stage. However, in Ethiopia, awareness about the disease and the availability of screening and treatment services is limited. This study aims to determine the role of health education on cervical cancer screening uptake in selected health facilities in Addis Ababa. Methods Two-pronged clustered randomized controlled trial was conducted in 2018 at eight public health centers that provide cervical cancer screening services using visual inspection with acetic acid (VIA) in Addis Ababa, Ethiopia. Each of the eight health centers were randomly assigned to serve as either an intervention or a control center. A two-pronged clustered randomized controlled trial was conducted in eight public health care centers. All the selected facilities provided cervical cancer screening services using visual inspection with acetic acid (VIA). Four health centers were randomly assigned to the intervention and control arms. The study participants were women aged 30-49 years who sought care at maternal and child health clinics but who had never been screened for cervical cancer. In the intervention health centers, all eligible women received one-to-one health education and educational brochures about cervical cancer and cervical cancer screening. In the control health centers, participants received standard care. Baseline data were collected at recruitment and follow-up data were collected two months after the baseline. For the follow-up data collection, participants (both in the intervention and control arms) were interviewed over the phone to check whether they were screened for cervical cancer. Result From the 2,140 women who participated in the study, 215 (10%) screened for cervical cancer, where 152(71%) were from the intervention health centers. Seventy-four percent of these participants reported that they learned about the benefits of screening from the one-to-one health education or the brochure. Women from the intervention health centers had higher odds of getting screened (AOR = 2.43,95% CI;1.58-2.90) than the controls. Women with the educational status of the first degree and those who have a history of sexually transmitted infections (STIs) had higher odds of getting screened (AOR = 2.03,95% CI;(1.15-2.58) and (AOR = 1.55,95% CI;1.01-2.36), respectively. Conclusion and recommendation Providing focused health education supported by printed educational materials increased the uptake of cervical cancer screening services. Integrating one-to-one health education and providing a take-home educational material into the existing maternal and child health services can help increase cervical cancer screening uptake. |
| Chaplain; documentation; interdisciplinary; medical record | | Medical record documentation by hospital chaplains is an under-researched and under-published field. Because documentation serves both as a register of chaplain interventions and as a collaborative tool for interdisciplinary communication, it should be written in a way that is clear, concise, and consistent. As chaplains continue to integrate with other medical professions in interdisciplinary care, careful attention should be given to the way in which communication of the chaplain role, functioning, and patient information obtained is conveyed. This quality improvement project standardized chaplain documentation in one health system of 15 medical centers, provides insights and resources devised from the project, and offers considerations for other systems contemplating future changes toward standardizing documentation. |
| MRSA CC398; SCCmec IV; Wild animals; Antimicrobial resistance; WGS | RESISTANT STAPHYLOCOCCUS-AUREUS; TRIMETHOPRIM RESISTANCE; QUINOLONE RESISTANCE; ANTIMICROBIAL RESISTANCE; SEQUENCE; GENE; MUTATIONS; NORA; ALGORITHM; EVOLUTION | A methicillin-resistant Staphylococcus aureus CC398 was recovered from a wild female boar (Sus scrofa) in the north of Portugal, in 2013 (Sousa et al. 2017). Whole genome sequencing (WGS) revealed this strain carries a new variant of a mecA-containing staphylococcal chromosomal gene cassette (SCCmec) type IV with an uncommon J3 region. WGS studies can facilitate surveillance and provide more detailed characterization of bacterial clones circulating in the wild, reinforcing the need for a one health perspective to better understand and control antimicrobial resistance. (C) 2020 Elsevier B.V. All rights reserved. |
| IncHI2; wildlife; gull; AMR; plasmid; XDR; Salmonella; Agona; ESBL; IncX; MDR; One Health; blaCTX | ANTIMICROBIAL RESISTANCE; ESCHERICHIA-COLI; ANTIBIOTIC-RESISTANCE; ISLAND 1; PATHOGENICITY; OUTBREAK; DATABASE; FOOD; ENTEROBACTERIACEAE; PREVALENCE | Although most of the approximately 94 million annual human cases of gastroenteritis due to Salmonella enterica resolve without medical intervention, antimicrobial therapy is recommended for patients with severe disease. Wild birds can be natural hosts of Salmonella that pose a threat to human health; however, multiple-drug-resistant serovars of S. enterica have rarely been described. In 2012, silver gull (Chroicocephalus novaehollandiae) chicks at a major breeding colony were shown to host Salmonella, most isolates of which were susceptible to antibiotics. However, multiple-drug-resistant (MDR) Escherichia coli with resistance to carbapenems, ceftazidime, and fluoroquinolones was reported from this breeding colony. In this paper, we describe a novel MDR Salmonella strain subsequently isolated from the same breeding colony. SG17-135, an isolate of S. enterica with phenotypic resistance to 12 individual antibiotics but only nine antibiotic classes including penicillins, cephalosporins, monobactams, macrolides, fluoroquinolones, aminoglycosides, dihydrofolate reductase inhibitors (trimethoprim), sulfonamides, and glycylcyclines was recovered from a gull chick in 2017. Wholegenome sequence (WGS) analysis of SG17-135 identified it as Salmonella enterica serovar Agona (S. Agona) with a chromosome comprising 4,813,284 bp, an IncHI2 ST2 plasmid (pSG17-135-HI2) of 311,615 bp, and an IncX1 plasmid ( pSG17-135-X) of 27,511 bp. pSG17-135-HI2 housed a complex resistance region comprising 16 antimicrobial resistance genes including blaCTX- M-55. The acquisition of MDR plasmids by S. enterica described here poses a serious threat to human health. Our study highlights the importance of taking a One Health approach to identify environmental reservoirs of drug-resistant pathogens and MDR plasmids. IMPORTANCE Defining environmental reservoirs hosting mobile genetic elements that shuttle critically important antibiotic resistance genes is key to understanding antimicrobial resistance (AMR) from a One Health perspective. Gulls frequent public amenities, parklands, and sewage and other waste disposal sites and carry drug-resistant Escherichia coli. Here, we report on SG17-135, a strain of Salmonella enterica serovar Agona isolated from the cloaca of a silver gull chick nesting on an island in geographic proximity to the greater metropolitan area of Sydney, Australia. SG17-135 is closely related to pathogenic strains of S. Agona, displays resistance to nine antimicrobial classes, and carries important virulence gene cargo. Most of the antibiotic resistance genes hosted by SG17-135 are clustered on a large IncHI2 plasmid and are flanked by copies of IS26. Wild birds represent an important link in the evolution and transmission of resistance plasmids, and an understanding of their behavior is needed to expose the interplay between clinical and environmental microbial communities. |
| animal welfare; animal health; veterinary ethics; One Health; welfare technology and systems; veterinary education | PRECISION LIVESTOCK; ONE HEALTH; EBOLA; RESISTANCE; MULTIPLE; CONTEXT | Simple Summary This article emphasizes the importance of educating veterinarians and veterinary students in animal welfare science and veterinary ethics, so that they can ably advance pertinent scientific knowledge and promote ethical thinking as trusted animal advocates in the 2020s. In light of this public expectation, a number of challenges are raised for veterinarians and the veterinary profession. These challenges involve: (1) re-envisioning the nature of disease treatment that goes beyond traditional conceptions of health or clinical matters, and which include animal welfare; (2) re-imagining disease prevention at the intersection of animal-human-ecosystem health; (3) developing core competencies in animal welfare science and ethics in order to provide professional leadership in animal welfare; and (4) taking a more active role in the development of novel networked devices, monitoring technologies and automated animal welfare solutions, and understanding their effects on the welfare of animals, human-animal relationships, and the veterinary profession in general. Abstract What should leading discourses and innovation regarding animal welfare look like for the veterinary profession in the 2020s? This essay considers four main challenges into which veterinarians are increasingly being drawn, as they respond to increasing public expectation for them to be scientific and moral authorities in animal welfare in addition to their traditional role as trusted health experts. They include: (1) to go beyond traditional conceptions of health by adopting a holistic view that also considers animal welfare, not only disease treatment; (2) to reimagine their professional duties when it comes to disease prevention at the intersection of animal-human-ecosystem health; (3) to develop core competencies/proficiency in animal welfare science and ethics in order to navigate discourses concerning competing priorities and socio-political ideologies and to provide professional leadership in animal welfare; (4) to provide feedback on novel networked devices, monitoring technologies and automated animal welfare solutions and their impact on animals’ welfare. To competently navigate the intricacies of the socio-political and connected world as trusted authorities and conduits for innovation in and through animal welfare, veterinarians and veterinary students are encouraged to: (a) develop core competencies in veterinary ethics, animal welfare science and deliberative capacities that are well-informed by current multidisciplinary frameworks, such as One Health; (b) engage interested parties in more effective collaboration and ethical decision-making in order to address animal welfare related concerns within their immediate sphere of influence (e.g., in a given community); and (c) participate in the process of engineering and technological design that incorporates animals’ welfare data (such as their preferences) for real-time animal monitoring through adding animal scientific and values-aware evidence in information technology systems. In order to tackle these challenges, four pillars are suggested to help guide veterinarians and the veterinary profession. They are: Collaboration, Critical Engagement, Centeredness on Research, and Continuous Self-Critique. |
| FAMILY CHLAMYDIACEAE; INFECTIONS; PROPOSAL; GENUS | Chlamydiae are obligate intracellular bacterial pathogens of humans. Infections in animals are also widespread with some species, such as Chlamydia psittaci, long recognised as a serious threat to human health. Critical to the public health response of any zoonotic disease outbreaks is reliable and up-to-date information on the epidemiology of the target pathogen. Aided by advances in the use of quantitative PCR, molecular typing and culture-independent genomic studies, significant recent work has highlighted an expanded diversity and host range of chlamydial pathogens in animals. New and unexpected cases of chlamydial zoonoses have now been recently documented in Australia and elsewhere, emphasising the importance of multi-disciplinary ‘One Health’ collaboration and the use of standardised methods to detect and characterise chlamydial pathogens in humans and animals. |
| AMR; AMU; food-producing animals; harmonization; monitoring; surveillance | SURVEILLANCE | Introduction: Antimicrobial resistance (AMR), associated with antimicrobial use (AMU), is a major public concern. Surveillance and monitoring systems are essential to assess and control the trends in AMU and AMR. However, differences in the surveillance and monitoring systems between countries and sectors make comparisons challenging. The purpose of this article is to describe all surveillance and monitoring systems for AMU and AMR in the human and livestock sectors, as well as national surveillance and monitoring systems for AMR in food, in six European countries (Spain, Germany, France, the Netherlands, the United Kingdom and Norway) as a baseline for developing suggestions to overcome current limitations in comparing AMU and AMR data. Methods: A literature search in 2018 was performed to identify relevant peer-reviewed articles and national and European grey reports as well as AMU/AMR databases. Results: Comparison of AMU and AMR systems across the six countries showed a lack of standardization and harmonization with different AMU data sources (prescription vs sales data) and units of AMU and AMR being used. The AMR data varied by sample type (clinical/non-clinical), laboratory method (disk diffusion, microdilution, and VITEK, among others), data type, ie quantitative (minimum inhibition concentration (MIC) in mg/ L/inhibition zone (IZ) in mm) vs qualitative data (susceptible-intermediate-resistant (SIR)), the standards used (EUCAST/CLSI among others), and/or the evaluation criteria adopted (epidemiological or clinical). Discussion: A One Health approach for AMU and AMR requires harmonization in various aspects between human, animal and food systems at national and international levels. Additionally, some overlap between systems of AMU and AMR has been encountered. Efforts should be made to improve standardization and harmonization and allow more meaningful analyses of AMR and AMU surveillance data under a One Health approach. |
| Control; Knowledge; One Health; Sustainable Development Goal; Transmission; Water | SUB-SAHARAN AFRICA | This Special Issue (SI) was conceptualized on the basis that success in tackling foodborne and waterborne parasites (FBP and WBP) will contribute to achievement of seven of the United Nation’s Sustainable Development Goals (SDGs). We chose to take a closer look at research on FBP and WBP in Africa, given that attaining these SDGs may be particularly challenging there. In this SI we present 7 articles that provide particular insights into FBP and WBP from different regions in Africa. The articles take different approaches. Three papers are reviews addressing occurrence (either widely, in terms of parasite and/or geography, or with focus on a specific parasite genus at a more regional level); all 3 articles emphasise the importance of a One Health approach regarding control and prevention of FBP and WBP, and the need for further research to fulfil the information gaps identified. Two articles then report on investigations regarding the knowledge and understanding of different communities in Africa regarding various FBP and WBP. These articles highlight lack of awareness among communities at risk, and also, perhaps of greater relevance, gaps in the knowledge of health workers regarding some FBP and WBP of public health importance. The final two articles are research articles regarding prevalence and occurrence of specific WBP, both as infections and in the environment. This SI, while limited in depth and scope, provides insights into some of the current challenges associated with FBP and WBP in Africa that might result in a lack of success regarding attainment of the previously mentioned seven SDGs. We anticipate significant advances in research on FBP and WBP in Africa, and hope that a future SI on the same topic may present a more positive picture regarding the current status and research achievements. (C) 2020 The Author(s). Published by Elsevier Inc. on behalf of International Association of Food and Waterborne Parasitology. |
| Escherichia coli; dogs; virulence genes; antibiotic resistance; WGS; ST372; clonal structure | CTX-M-15-PRODUCING ESCHERICHIA-COLI; SPECTRUM BETA-LACTAMASES; EXTENDED-SPECTRUM; FLUOROQUINOLONE-RESISTANT; COMPANION ANIMALS; RISK-FACTORS; ANTIMICROBIAL RESISTANCE; VIRULENCE GENOTYPES; HIGH PREVALENCE; CATS | Under a one health perspective and the worldwide antimicrobial resistance concern, we investigated extraintestinal pathogenic Escherichia coli (ExPEC), uropathogenic E. coli (UPEC), and multidrug resistant (MDR) E. coli from 197 isolates recovered from healthy dogs in Spain between 2013 and 2017. A total of 91 (46.2%) isolates were molecularly classified as ExPEC and/or UPEC, including 50 clones, among which (i) four clones were dominant (B2-CH14-180-ST127, B2-CH52-14-ST141, B2-CH103-9-ST372 and F-CH4-58-ST648) and (ii) 15 had been identified among isolates causing extraintestinal infections in Spanish and French humans in 2015 and 2016. A total of 28 (14.2%) isolates were classified as MDR, associated with B1, D, and E phylogroups, and included 24 clones, of which eight had also been identified among the human clinical isolates. We selected 23 ST372 strains, 21 from healthy dogs, and two from human clinical isolates for whole genome sequencing and built an SNP-tree with these 23 genomes and 174 genomes (128 from canine strains and 46 from human strains) obtained from public databases. These 197 genomes were segregated into six clusters. Cluster 1 comprised 74.6% of the strain genomes, mostly composed of canine strain genomes (p < 0.00001). Clusters 4 and 6 also included canine strain genomes, while clusters 2, 3, and 5 were significantly associated with human strain genomes. Finding several common clones and clone-related serotypes in dogs and humans suggests a potentially bidirectional clone transfer that argues for the one health perspective. |
| one health; pet food; pet snack; food safety | CONTAMINATED DRY DOG; LISTERIA-MONOCYTOGENES; ESCHERICHIA-COLI; SALMONELLA; FOOD; OUTBREAK; MEAT | Recent foodborne pathogen outbreaks associated with dry pet food and treats have focused the attention on these products as vehicles of pathogens for both pets and their owners. This study investigates the purchasing habits of dog owners and determines if and in what form pet snacks can be potentially dangerous for humans, especially for children. For these purposes, questionnaires collected from 406 dog owners were evaluated and microbiological analyses were performed on 120 dry pet snacks. The shape of the pet snack affects the purchase (median score, Mdn = 6.4) and the star bone was the preferred one (Mdn = 7.1). Most of the participants (76.0%; p < 0.001) stated that snacks are attractive to their children and that the possibility for children to get in contact with pet snacks is rare, but not implausible (Mdn = 3.1). Indeed, more than 6% of respondents admitted that there had been incidents of involuntary ingestion of pet snacks, with fever and gastrointestinal manifestations. Microbiological analyses showed that 119 dry pet snacks analyzed of a total of 120 (99.2%) were in good sanitary condition except for one sample where the presence of Listeria ivanovii was confirmed. The upward trend in the presence of pets in households and the strong and continuous growth in value and volume of the pet food market led researchers to analyze possible public health issues. Children and infants in particular are the most exposed subjects as they are more likely to come into contact with pet snacks, attracted by a shape similar to that of a toy. For this reason, although our findings did not highlight important microbiological contamination of pet snacks, it would be useful to standardize food safety criteria with those for human food from a One Health perspective. |
| All-hazard plan; Animal health; National emergency management plan; Veterinary Services; Zoonotic; Zootic | ONE HEALTH; ONE WORLD; FOOD; PREPAREDNESS | With human population growth, rapid urbanisation, increasing globalisation, and climate change, the interdependency of human health and animal health is mounting. Therefore, the importance of national emergency management plans (N EM Ps) for the mitigation of, and preparedness for, all hazards, including disease epidemics, both zoonotic and zootic, is ever increasing. The authors decided to take a One Health approach by assessing the inclusion of Veterinary Services and animal health in NEMPs, based on geographical region, the date of the NEMP, national income status, and the proportion of the agricultural sector in national gross domestic product (GDP). To carry out the assessment, the authors analysed the publicly available NEMPs of 86 Members of the World Organisation for Animal Health. Of the 86 NEMPs reviewed, only a third expressly mentioned Veterinary Services, almost 60% mentioned zoonotic and/or zootic diseases, and about two-thirds mentioned animals to some extent. The highest correlating factor to the inclusion of animal health in NEMPs was the level of the agricultural sector’s contributions to the national GDP. Fisheries and aquaculture were not a major consideration in any of the reviewed NEMPs, especially not in relation to diseases. Based on region, Latin America and the Caribbean, exhibited the lowest inclusion rate of animal health in NEMPs. The results demonstrate that the omission of animal health is still a problem. A multi-disciplinary approach that includes veterinary medicine as well as human medicine is vital in the construction and/or revision of NEMPs. Future studies should consider whether or not there is a connection between countries’ veterinary capacities and the inclusion of Veterinary Services in their NEMPs and whether or not they have the infrastructure and human resources to put into operation the roles of Veterinary Services as identified in their NEMPs. |
| CSF; Bhutan; Low; and middle-income countries; Outbreak; Epidemiology; One health | EFFICACY; VACCINE | Given the importance of pork in the Bhutanese diet and to enhance food security, the Government of Bhutan has generated policies to promote development of the swine sector in the country. One of the main threats to swine farming is classical swine fever (CSF), a transboundary disease of wild and domestic swine thought to be enzootic in the country. In 2018, three outbreaks of CSF were notified in Bhutan. The type of animals, their vaccine status, and the aftermath of these outbreaks highlight the interplay of epidemiological and context-specific factors that may result in CSF undermining the emerging Bhutanese swine sector. This communication reports on the CSF outbreaks of 2018, discusses some of the challenges posed by these events, and proposes some research priorities. |
| DEFORESTATION; IMPACTS; HEALTH; LAND; BANS | The current COVID-19 pandemics is having a major impact on our global health and economies. There is widespread recognition that ecosystem disruption, including land-use change and illegal wildlife trade, is linked to the increasing emergence of zoonotic diseases. Here, we emphasize that protected areas play a fundamental role in buffering against novel disease outbreaks by maintaining ecosystem integrity. However, protected areas worldwide are facing increasing human pressures, which are being amplified by the unfolding COVID-19 crisis. Increased resources are thus urgently needed to mainstream a One Health approach to protected area management, focusing specifically on i) monitoring illegal wildlife trade, ii) biodiversity trends and iii) surveillance of zoonotic pathogens. Improving integration of public health into global biodiversity conservation policies should be a top priority to reduce the risk of future pandemics. |
| AUSTRALIAN BAT LYSSAVIRUS; CANINE-RABIES; ONE HEALTH; ELIMINATION; COMMUNITIES; RISK | It is unacceptable that as we advance into the 21st century rabies is still a threat to humans and animals alike. Given public health interventions that focus solely on disease prevention in humans have no effect on the reduction of infection in the reservoir hosts, themost effective way to combat human rabies infection is to control thedisease transmission by mass vaccination of the animal source, e.g. dogs and wildlife1. This short communication focuses on the global strategic target to end human deaths from dog-mediated rabies by 20302 in line with the Sustainable Development Goals by providing recent updates on World Health Organization (WHO) and OIE guidelines(3-5) and recommendations as well as highlighting Australian rabies research activities to prevent an incursion of rabies into the country. |
| medical school | EDUCATION | The University of New England College of Osteopathic Medicine (UNE COM) was founded by a group of osteopathic physicians who wanted to ensure that the practice of Osteopathic Medicine would endure in northern New England and that patients in the region would continue to receive the best health care possible. UNECOM merged with St. Francis College in 1978 to form the University of New England (UNE).(1) UNE has grown and developed over the years, building on the shared Franciscan and osteopathic traditions of integrating philosophy and intellect. Following the 1996 merger with Westbrook College in Portland, Maine, UNE now comprises 3 campuses, 13 additional health profession programs, 6 Centers of Excellence in Research, and strong undergraduate programs that link the environment, people, and community in a One Health concept. |
| Zoonosis; Equine; Henipaviruses; Hendra virus | VIRUS-INFECTION; FLYING FOXES; SPILLOVER | In June 2019 the first equine case of Hendra virus in the Hunter Valley, New South Wales, Australia was detected. An urgent human and animal health response took place, involving biosecurity measures, contact tracing, promotion of equine vaccinations and investigation of flying fox activity in the area. No human or additional animal cases occurred. Equine vaccination uptake increased by over 30-fold in the surrounding region in the three months following the case. Black flying fox and grey-headed flying fox species were detected in the Valley. The incident prompted review of Hendra virus resources at local and national levels. This event near the horse capital of Australia, is the southernmost known equine Hendra case. Management of the event was facilitated by interagency collaboration involving human and animal health experts. Ongoing One Health partnerships are essential for successful responses to future zoonotic events. |
| antimicrobial stewardship; antibiotic prescribing; antimicrobial resistance; One Health; industry | | Rising levels of antimicrobial resistance pose serious dangers to patients, population health, food security, and economic stability worldwide. In response to this threat, the United Nations and the World Health Organization have called for multisectoral, multidisciplinary action, recognizing that human, animal, and environmental health are interdependent. Although the pharmaceutical industry clearly has a leading role in developing novel antimicrobials and vaccines, it is also active in many areas supporting antimicrobial stewardship. This article describes why pharmaceutical companies invest in antimicrobial stewardship, outlines why they are well suited to help address this issue, and provides examples of how the pharmaceutical industry can support the responsible use of antimicrobials. Merck & Co., Inc. (Kenilworth, NJ, USA), a large, globally operating pharmaceutical company that develops and markets both human and veterinary antimicrobials and vaccines is used as a case study for illustrating industry involvement in antimicrobial stewardship efforts. |
| zoonosis; human-animal interface; COVID-19; SARS-CoV-1; outbreak; virus; transmission; pathogen; emergence; reservoir | INFECTIOUS-DISEASES; SARS-CORONAVIRUS; ONE HEALTH; VIRUS; CHALLENGES; EVOLUTION; EPIDEMIC; ORIGINS; BATS | The COVID-19 pandemic has affected all sectors of society, from health and economics to socialization and travel. The level and extent of this impact are unprecedented. Although the cause of COVID-19 was quickly identified to be a new coronavirus (SARS-CoV-2), the world was poorly prepared for preventing its spread. One important pillar of preparedness is surveillance of the sources of emerging pathogens and responding appropriately to prevent their spread in the human population. The ever-increasing interaction between humans and animals is one leading factor in facilitating the emergence of new pathogens. In this viewpoint, we discuss the possibility of the zoonotic origin of SARS-CoV-2, highlight the importance of understanding human-animal interaction to improve preparedness for future outbreaks, and outline recommendations for prevention. |
| Feline Coronavirus; Feline Infectious Peritonitis; Seroepidemiology; Clinicopathology; SARS CoV-2; COVID-19 | RESPIRATORY SYNDROME CORONAVIRUS; CATS; TESTS; PERSISTENCE; PREVALENCE; ANTIBODIES; ISTANBUL; EFFICACY; DIARRHEA; MUTANTS | Feline coronavirus 176 seropositive cats were examined in 2014-2019. Seroepidemiological, serological, clinical, haematological and biochemical data were analysed with IBM-SPSS Statistics. Clinicopathological signs were typical with enteric form in 125 cats (71%) and FIPV in 51 cats (29%). Fever, depression, dullness, weight loss, vomitus, growth retardation, diarrhoea, ocular and neurological symptoms were findings. 40 cats (23%) were died, 17 had pleural effusion, 19 had ascites, and 16 Rivalta tests were positive. Post-mortem FIP confirmation was at 8 cats. Of the FCoV seropositive cats, 22 (12.5%) had FIV antibodies, 7 (3.9%) were positive for FLV antigens, 2 (1.1%) were positive for FCoV, FIV and FLV, and 2 (1.1%) were FmopV RNA positive. FCoV, canine enteric CoV, human CoV-229E and CoV-NL63 belong to Alphacoronavirus, and canine respiratory CoV, Human CoV-OC43, CoV-HKU1, SARS, MERS and COVID-19 belong to Betacoronavirus genus, originated from bat gene pool and is of animal origin cause zoonotic infections. Covid-19 pathogenesis is not fully understood and data’s focused on case fatality rates. Covid-19 was reported as anthropozoonosis infecting cats, dogs, tigers and lions. The panthropism risk should be investigated. In particular, the clinicopathology and treatment modalities of feline coronavirus and COVID-19 infections are having similarities such as GS-441524 as the main metabolite of remdesivir prodrug and dexamethazone responses, and both can cause resident and persistent infections in many organs, including the eyes and brain, of varying severity. The obtained data have been evaluated in the ‘One Health’ approach to better understand the aetiology, pathogenesis and clinicopathology of coronavirus infections, and presenting valuable findings to help the control of COVID-19 epidemic. Veterinary medicine will help to multidisciplinary collaboration to develop effective vaccines and drugs with many years of coronavirus experiences. |
| environment; ecotoxicity; resistance; antiparasitic drug; ivermectin | RESISTANCE; BEHAVIOR; DRUG | It is worldwide recognized that the use of pharmaceuticals for human and veterinary purposes could lead to unsustainable effects on the environment. A strategy to reduce the impact of pharmaceuticals on the environment has been recently established at European level, where guidelines to evaluate the impacts of veterinary drugs used to treat animal diseases are in place. The aim of this article is to focus on the worldwide used antiparasitic drug ivermectin (IVM) and its potential impact on the environment. A specific section is related to the IVM resistance that the massive use of this drug could generate enhancing the risk scenarios also for human health. The application of stringent measures for the veterinary use of this substance, in line with the recommendations provided by International frameworks such as One Health and EcoHealth, is recommended. |
| Q fever; Spatial; Occupational; Livestock; South Australia; One Health | VACCINATION; EPIDEMIOLOGY; NOTIFICATIONS; SURVEILLANCE; NETHERLANDS; VICTORIA; EXPOSURE; PROGRAM | Background: The burden of Qfever on at risk population groups in Australia is substantial, despite the availability of a vaccine. Our objectives were to: (a) describe the epidemiology of notified Qfever cases in South Australia (SA), (b) identify if Qfever infection is associated with occupational exposure, and (c) detect the possible spatial and temporal association of Qfever with livestock density. Methods: Laboratory confirmed Q-fever notifications from January 2007 to December 2017 were obtained from the SA Health Department. Q fever notification rates and incidence rate ratios were calculated for gender, notification year, age group, occupation category, and primary exposure suburb. Spatial mapping and analysis of Q fever notifications was undertaken using livestock data, and abattoirs and saleyards located in SA. Results: During the study period 167 Qfever cases were notified. Males predominated (72%), with higher rates observed in the 21-40 year age group (1.52/100,000), and eight cases (5%) reported prior Qfever vaccination. Most frequently listed occupation categories were livestock farmers (35%), and abattoir workers (20%), but in 15% of cases, there was no known occupational risk. Highest notifications (22%) were recorded in the suburb containing an abattoir. The number of goats, cattle and sheep was not associated with Qfever notifications. Conclusions: Qfever predominance among males in their twenties and thirties may indicate vaccination under-coverage among the young workforce possibly due to high turnover of workers. Q fever among those vaccinated raises concerns about vaccine efficacy or potential waning immunity. Our findings are consistent with previous studies highlighting abattoir workers as a high-risk occupational group because of its transient workforce, and low vaccination coverage. Q fever notifications in SA may be unrelated with spatial livestock density. Further One Health research involving veterinary, public health and environmental data is required. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. |
| Microfluidics; Screening system; Surface tension; Viscosity; Tuberculosis; Anemia | SURFACE-TENSION; VISCOSITY; RHEOLOGY; PLASMA; SHEAR; SERUM | Introduction: A key feature of the ‘One Health’ concept pertains to the design of novel point of care systems for largescale screening of health of the population residing in resource-limited areas of low- and middle-income countries with a view to obtaining data at a community level as a rationale to achieve better public health outcomes. The physical properties of blood are different for different samples. Our study involved the development of an innovative system architecture based upon the physical properties of blood using automated classifiers to enable large-scale screening of the health of the population living in resource-limited settings. Methods: The proposed system consisted of a simple, robust and low-cost sensor with capabilities to sense and measure even the minute changes in the physical properties of blood samples. In this system, the viscosity of blood was derived from a power-law model coupled with the Rabinowitsch-Mooney correction for non-Newtonian shear rates developed in a steady laminar Poiseuille flow. Surface tension was measured by solving the Young-Laplace equation for pendant drop shape hanging on a vertical needle. An anticipated outcome of this study would be the development of a novel automated classifier based upon the rheological attributes of blood. This automated classifier would have potential application in evaluating the health status of a population at regional and global levels. Results: The proposed system was used to measure the physical properties of various samples like normal, tuberculous and anemic blood samples. The results showed that the physical properties of these samples were different as compared to normal blood samples. The major advantage of this system was low-cost, as well as its simplicity and portability. Conclusion: In this work, we proposed making a case for the validation of a low-cost version of a microfluidic system capable of scanning large populations for a variety of diseases as per the WHO mandate of One Health. |
| | Human perturbation of natural systems is accelerating the emergence of infectious diseases, mandating integration of disease and ecological research. Bats have been associated with recent zoonoses, but our bibliometric analysis of coauthor relationships identified a separation of bat ecologists and infectious disease researchers with few cross-disciplinary relationships. Of 5,645 papers, true interdisciplinary collaborations occurred primarily in research focused on White Nose Syndrome (WNS). This finding is important because it illustrates how research with outcomes favoring both bat conservation and disease mitigation promotes domain integration and network connectivity. We advocate for increased engagement between ecology and infectious researchers to address such common causes and suggest that efforts focus on leveraging existing activities, building interdisciplinary projects, and networking individuals and networks to integrate domains and coordinate resources. We provide specific opportunities for pursuing these strategies through the Bat One Health Research Network (BOHRN). |
| Amoebae; Chlamydiales; drinking water; environment; one health; Waddlia chondrophila | FREE-LIVING AMEBA; CHLAMYDIA-LIKE BACTERIA; MYCOBACTERIA; ASSOCIATION; TRACHOMATIS; SERVE | Waddlia chondrophila is an emerging pathogen belonging to the order of Chlamydiales. This obligate intracellular bacterium was initially isolated from an aborted bovine fetus and is associated with adverse pregnancy outcomes in women. The ability of W. chondrophila to reside and replicate within a range of free-living amoebae implies a possible widespread environmental presence. Potential hosts of W. chondrophila are present in Dutch drinking water. This study therefore investigated the presence of W. chondrophila DNA in drinking water by analysing 59 samples from ten drinking water systems throughout the Netherlands. Samples were taken at three distances from the treatment plant, during both summer and winter. Twelve of the samples were positive, originating from two of the treatment plants, of which three samples were quantifiable. (c) 2019 The Author(s). Published by Elsevier Ltd. |
| ESBL Escherichia coli; dairy cattle; milk; ESBL genes; farm environment | CTX-M; MOLECULAR CHARACTERIZATION; MULTIDRUG-RESISTANT; PREVALENCE; BACTERIA; CTX-M-15 | The emergence and spread of antimicrobial resistance genes and resistant bacteria do not recognize animal, human, or geographic boundaries. Addressing this threat requires a multidisciplinary approach involving human, animal, and environmental health (One Health) sectors. This is because antimicrobial agents used in veterinary medicine have been reported to be the same or similar to those in human medicine use. Extended-spectrum beta-lactamase (ESBL) E. coli is a growing public health problem worldwide, and the agri-food industry is increasingly becoming a source of clinically important ESBL bacteria. Accordingly, the aim of this study was to investigate the occurrence and characteristics of ESBL-producing E. coli from dairy cattle, milk, and the farm environment. E. coli isolates were identified by their 16sRNA, and their ESBL production was confirmed using ESBL-CHROMagar media and the double disk diffusion method. Genotypes of ESBL producers were characterized using multiplex polymerase chain reaction (mPCR) assay. It was found that 18 (4.8%) of the total samples were positive for ESBL-producing E. coli. Of these, 66.7% were from milk, and 27.8% and 5.5% were from the farm environment and faecal samples, respectively. Predominant ESBL genotypes identified were a combination of both TEM and CTX-M in eight out of 18 (44.4%) isolates. Four (22.2%) isolates produced the CTX-M gene, two (11.1%) isolates produced the TEM gene, and four (22.2%) remaining isolates produced the ESBL genes other than TEM, SHV, CTX-M, and OXA. The SHV and OXA gene were not detected in all 18 isolates. In all, there were four profiles of genetic similarity. The occurrence of these genotypes in indicator organisms from dairy cattle, milk, and the farm environment further re-enforced the potential of food-animals as sources of ESBL-producing E. coli infection in humans via the food chain. Thus, there is the need for the adoption of a tripartite One Health approach in surveillance and monitoring to control antimicrobial resistance. |
| antibiotic resistance; antimicrobial resistance; poultry; chicken; ampicillin; erythromycin; Escherichia coli; food reservoir; retail meat; One Health | ANTIMICROBIAL RESISTANCE; VETERINARY ANTIBIOTICS; INTESTINAL FLORA; POULTRY; AGRICULTURE; PREVALENCE; CAMPYLOBACTER; MICROBIOME; HEALTH; SWINE | Simple Summary While it is well known that antibiotics administered for either therapeutic or non-therapeutic purposes in livestock farms promote the development of antibiotic resistance in bacteria through selective pressure, there are conflicting findings in the literature with regard to the influence of production strategies on antibiotic resistance in bacteria isolated from commercially-available chicken. In this work, we tested the hypothesis that there would be differences in antibiotic resistance in E. coli isolated from three categories of production methods: Conventional, No Antibiotics, and Humane Family Owned. In this work, it was found that for both ampicillin and erythromycin, there was no significant difference (p > 0.05) between Conventional and USDA-certified No Antibiotics chicken, which is in line with some previous work. The novel finding in this work is that we observed a statistically significant difference between both of the previously mentioned groups and chicken from Humane Family Owned production schemes. To our knowledge, this is the first time E. coli from Humane Family Owned chicken has been studied for antibiotic resistance. This work contributes to a better understanding of a potential strategy of chicken production for the overall benefit of human health, in line with the One Health approach implemented by the World Health Organization. The use of antibiotics for therapeutic and especially non-therapeutic purposes in livestock farms promotes the development of antibiotic resistance in previously susceptible bacteria through selective pressure. In this work, we examined E. coli isolates using the standard Kirby-Bauer disk diffusion susceptibility protocol and the CLSI standards. Companies selling retail chicken products in Los Angeles, California were grouped into three production groupings-Conventional, No Antibiotics, and Humane Family Owned. Humane Family Owned is not a federally regulated category in the United States, but shows the reader that the chicken is incubated, hatched, raised, slaughtered, and packaged by one party, ensuring that the use of antibiotics in the entire production of the chicken is known and understood. We then examined the antibiotic resistance of the E. coli isolates (n = 325) by exposing them to seven common antibiotics, and resistance was seen to two of the antibiotics, ampicillin and erythromycin. As has been shown previously, it was found that for both ampicillin and erythromycin, there was no significant difference (p > 0.05) between Conventional and USDA (United States Department of Agriculture)-certified No Antibiotics chicken. Unique to this work, we additionally found that Humane Family Owned chicken had fewer (p <= 0.05) antibiotic-resistant E. coli isolates than both of the previous. Although not considered directly clinically relevant, we chose to test erythromycin because of its ecological significance to the environmental antibiotic resistome, which is not generally done. To our knowledge, Humane Family Owned consumer chicken has not previously been studied for its antibiotic resistance. This work contributes to a better understanding of a potential strategy of chicken production for the overall benefit of human health, giving evidentiary support to the One Health approach implemented by the World Health Organization. |
| avian influenza virus; endemic disease; epidemiology; virus surveillance; Lebanon | HUMAN INFECTION; VIRUS; ECOLOGY; BIRDS; H9N2 | Background: Avian influenza viruses (AIVs) cause severe diseases in poultry and humans. In Lebanon, AIV H9N2 was detected in 2006 and 2010 and H5N1 was detected in 2016. Aim: To evaluate the current circulating AIVs in Lebanon at the human-animal interface. Methods: A total of 1000 swabs were collected from poultry from 7 Lebanese governorates between March and June 2017. Swabs were screened for influenza infection. Haemagglutinin and neuraminidase AIV subtypes were determined for positive samples. Gene segments were cloned and sequenced. Blood was collected from 69 exposed individuals. Serological studies were performed to test sera for antibodies against AIV. Results: In chickens, 0.6% were positive for AIV H9N2. Sequences obtained clustered tightly with those of Israeli origin as well as Lebanese H9N2 viruses from 2010. All human samples tested negative. Conclusion: We recommend regular surveillance for AIVs in poultry using a One Health approach. |
| antibiotic resistance; horizontal gene transfer; treated wastewater; rhizosphere; root colonization; E; coligenomes; One Health | ANTIBIOTIC-RESISTANCE GENES; ESCHERICHIA-COLI O157H7; PLASMID TRANSFORMATION; WASTE-WATER; SEASONAL OCCURRENCE; GENOMIC ISLANDS; SEQUENCE; REMOVAL; PHARMACEUTICALS; EVOLUTION | The diffusion of antibiotic resistance determinants in different environments, e.g., soil and water, has become a public concern for global health and food safety and many efforts are currently devoted to clarify this complex ecological and evolutionary issue. Horizontal gene transfer (HGT) has an important role in the spread of antibiotic resistance genes (ARGs). However, among the different HGT mechanisms, the capacity of environmental bacteria to acquire naked exogenous DNA by natural competence is still poorly investigated. This study aimed to characterize the ability of the environmentalEscherichia colistrain ED1, isolated from the crustaceanDaphniasp., to acquire exogenous DNA by natural competence. Transformation experiments were carried out varying different parameters, i.e., cell growth phase, amount of exogenous DNA and exposition to artificial lake water (ALW) and treated wastewater to mimic environmental-like conditions that may be encountered in the agri-food system. Results were compared with those showed by the laboratoryE. colistrain DH5 alpha. Our experimental data, supported by genomic sequencing, showed that, when exposed to pure water, ED1 strain was able to acquire exogenous DNA with frequencies (10(-8)-10(-9)) statistically higher than the ones observed for DH5 alpha strain (10(-10)). Interestingly, higher values were retrieved for ED1 than DH5 alpha strains exposed to ALW (10(-7)vs. 10(-9), respectively) or treated wastewater (10(-8)vs. 10(-10), respectively). We tested, therefore, ED1 strain ability to colonize the rhizosphere of lettuce, a model plant representative of raw-consumed vegetables of high economic importance in the ready-to-eat food industry. Results showed that ED1 strain was able to efficiently colonize lettuce rhizosphere, revealing a stable colonization for 14 days-long period. In conclusion, ED1 strain ability to acquire exogenous DNA in environmental-like conditions by natural competence, combined with its ability to efficiently and stably colonize plant rhizosphere, poses the attention to food and human safety showing a possible route of diffusion of antibiotic resistance in the agri-food system, sustaining the One Health warnings related to the antibiotic spread. |
| blowflies; Calliphoridae; Cochliomyia hominivorax; eradication; genetic control; myiasis; sterile insect technique (SIT) | COCHLIOMYIA-HOMINIVORAX; MYIASIS; RELIGION | In the One Health scenario, a deep understanding of the dynamics potentially threatening the development and implementation of useful pest and vector management tools is of key importance. The New World screwworm fly, Cochliomyia hominivorax (Coquerel) (Diptera: Calliphoridae), is characterized by a wide host range. It acts as an important agent of myiasis in humans and warm-blooded animals in the Neotropics, and has been eliminated from a wide region through genetic methods. Of note, Serebrovsky had already proposed in 1940 the principles of autocidal control by the translocation of segments between two chromosomes, but his work was negated by Lysenko, based on the negation of Mendelian genetics. This entomological case study emphasizes the danger of politics interfering with science, a still contemporary hot issue. The negation of global warming or current pandemics are further examples of this noxious influence. |
| pediatrics; patient portal; health information technology | CARE; ENROLLMENT; OUTCOMES | Objective: The study sought to assess, for children in one large health system, (1) characteristics of active users of the patient portal (>= 1 use in prior 12 months), (2) portal use by adolescents, and (3) variations in pediatric patient portal use. Materials and Methods: We analyzed data from the electronic health record regarding pediatric portal use during 2017-2018 across a health system (39 871 pediatric patients). Results: Altogether, 63.5% of pediatric patients were active portal users. Children (proxies) who were boys, privately insured, white, and spoke English were more likely to be active users. Common uses involved messaging with physicians, medications, allergies, letters, and laboratory results. By 15 years of age, > 50% of adolescents used the portal by themselves (without a proxy). Pediatric portal use varied widely across practices. Discussion: Pediatric or adolescent portal use is quite high, but large variations exist. Conclusion: Use of the portal for pediatric care may reflect varying pediatric patient engagement. |
| Shiga toxin-producing Escherichia coli; antimicrobial resistance; one health | DIARRHEAL DISEASE; READ ALIGNMENT; EPIDEMIOLOGY; PROFILES | Introduction. Despite many ongoing surveillance projects and the recent focus on the veterinary and clinical ‘One Health’ aspects of antimicrobial resistance (AMR), evidence of the extent of any public health risk posed by animal reservoirs with respect to the transmission of resistant strains of Escherichia coli to humans remains varied and contentious. In the UK, the main zoonotic reservoir for the foodborne pathogen Shiga toxin-producing E. coli (STEC) is cattle and sheep. In this study, we adopt an alternative approach to the risk assessment of transmission of AMR E. coli from animals to humans, involving monitoring AMR in isolates of STEC, an established zoonotic, foodborne pathogen, from human cases of gastrointestinal disease. Aim. The aim of this study was to determine the genome-derived AMR profiles for STEC from human cases to assess the risk of transmission of multidrug-resistant STEC from ruminants to humans. Methodology. STEC belonging to 10 different clonal complexes (CCs) (n=457) isolated from human faecal specimens were sequenced and genome-derived AMR profiles were determined. Phenotypic susceptibility testing was undertaken on all isolates (n=100) predicted to be resistant to at least one class of antimicrobial. Results. Of the 457 isolates, 332 (72.7 %) lacked identifiable resistance genes and were predicted to be fully susceptible to 11 classes of antimicrobials; 125/332 (27.3 %) carried 1 or more resistance genes, of which 83/125 (66.4%) were resistant to 3 or more classes of antibiotic. The percentage of isolates harbouring AMR determinants varied between CCs, from 4% in CC25 to 100% in CC504. Forty-six different AMR genes were detected, which conferred resistance to eight different antibiotic classes. Resistance to ampicillin, streptomycin, tetracyclines and sulphonamides was most commonly detected. Four isolates were identified as extended-spectrum beta-lactamase producers. An overall concordance of 97.7% (n=1075/1100) was demonstrated between the phenotypic and genotypic methods. Conclusion. This analysis provided an indirect assessment of the risk of transmission of AMR gastrointestinal pathogens from animals to humans, and revealed a subset of human isolates of the zoonotic pathogen STEC were resistant to the antimicrobials used in animal husbandry. However, this proportion has not increased over the last three decades, and thismay provide evidence that guidancepromoting responsible practice has been effective. |
| animal model; bone marrow concentrate; horse; interleukin-1 receptor antagonist protein; mesenchymal stem cell; platelet rich plasma; stem cell | MESENCHYMAL STEM-CELLS; DIGITAL FLEXOR TENDON; PLATELET-RICH PLASMA; MARROW-DERIVED CELLS; BONE-MARROW; STROMAL CELLS; IMMUNOMODULATORY PROPERTIES; PROGENITOR CELLS; EQUINE TENDON; DIFFERENTIATION | Regenerative medicine is commonly used in human and equine athletes. Potential therapies include culture expanded stem cells, stromal vascular fraction of adipose tissue, platelet-rich plasma, bone marrow concentrate, or autologous conditioned serum. The purpose of this manuscript is to disseminate findings from a workshop on the development of translational regenerative medicine in the equine field. Five themes emerged: stem cell characterization and tenogenic differentiation; interactions between mesenchymal stem cells, other cells and the environment; scaffolds and cell packaging; blood- and bone marrow-based regenerative medicines; clinical use of regenerative therapies. Evidence gained through the use of regenerative medicine applications in the horse should continue to translate to the human patient, bringing novel regenerative therapies to both humans and horses. |
| case detection; domestic dog; dog-mediated rabies; elimination; patient management; post-exposure prophylaxis; surveillance; zoonosis | SURVEILLANCE | Rabies is a neglected zoonotic disease that causes an estimated 59,000 human deaths worldwide annually, mostly in Africa and Asia. A target of zero human deaths from dog-mediated rabies has been set for 2030, and large-scale control programs are now advocated. However, in most low-income endemic countries surveillance to guide rabies control is weak and few cases of rabies are recorded. There is an urgent need to enhance surveillance to improve timely case detection and inform rabies control and prevention, by operationalizing a One Health approach. Here we present data from a study piloting Integrated Bite Case Management (IBCM) to support intersectoral collaboration between health and veterinary workers in Tanzania. We trained government staff to implement IBCM, comprising risk assessments of bite patients by health workers, investigations by livestock field officers to diagnose rabid animals, and use of a mobile phone application to support integration. IBCM was introduced across 20 districts in four regions of Tanzania and results reported after 1 year of implementation. Numbers of bite patient presentations to health facilities varied across regions, but following the introduction of IBCM reporting of bite patients at high-risk for rabies more than doubled in all regions. Over 800 high-risk investigations were carried out, with 49% assessed as probable dog rabies cases on the basis of clinical signs, animal outcome, and rapid diagnostic testing. The status of a further 20% of biting animals could not be determined but rabies could not be ruled out. Livestock field officers reported that use of rapid diagnostic tests (RDTs) were useful for confirming rabies occurrence. Overall, our study provides further evidence that IBCM is a practical approach that can improve rabies detection in endemic countries, and be used to monitor the impact of mass dog vaccinations, including potential to verify rabies freedom. However, the main challenges to implementation are limited training of health workers in rabies, perceived burden of real-time recording and limited resources for livestock field officers to undertake investigations. Nonetheless, IBCM dramatically improved case detection and communication between sectors and we recommend further implementation research to establish best practice and applicability to other settings. |
| ANTIBIOTIC-RESISTANCE; ONE HEALTH; DOGS; EFFICACY; INHIBITION; RECEPTOR; GROWTH; COMBINATION; INDUCTION; INJECTION | The FDA Green Book is a list of all drug products that have been approved by the FDA for use in veterinary medicine. The Green Book, as published, lacks structural information corresponding to approved drugs. To address this gap, we have compiled the structural data for all FDA Green Book drugs approved through the end of 2019. Herein we discuss the relevance of this data set to human drugs in the context of structural classes and physicochemical properties. Analysis reveals that physicochemical properties are highly optimized and consistent with a high probability of favorable drug metabolism and pharmacokinetic properties, including good oral bioavailability for most compounds. We provide a detailed analysis of this data set organized on the basis of structure and function. Slightly over half (51%) of vet drugs are also approved in human medicine. Combination drugs are biologics are also discussed. |
| blaZ; Buffaloes; Human; Mastitis; mecA; Nasal carriage; Nilli Ravi; S. aureus | ANTIBIOTIC-RESISTANCE | Rise of antibiotic resistant Staphylococcus aureus is a higher risk and great concern to global health. Zoonotic transfer of such strains is well documented. Present study evaluated the presence of resistant S. aureus from mastitic Nilli Ravi buffaloes and nasal carriage of milkers. Phenotypic profile of S. aureus isolates was conducted against penicillin, ampicillin, and cefoxitin. PCR analysis revealed presence of blaZ gene and mecA gene from S. aureus isolated from milk and milkers samples. Sequence and phylogenetic analysis depicts the divergence of mecA gene originated from bovine and human but for the blaZ gene, no divergence was detected. The high degree of genetic relatedness among blaZ and mecA genes in bovine and human S. aureus isolates from same farm suggests the potential transfer of antimicrobial resistance genes between buffaloes and milkers, highlighting the importance of one-health approach to promote global health. (C) 2020 PVJ. All rights reserved |
| yeast; antifungal resistance; environment; pesticides; opportunistic fungi; one health | RESISTANT ASPERGILLUS-FUMIGATUS; AZOLE RESISTANCE; CANDIDA; EPIDEMIOLOGY; ALBICANS | Opulente et al. (Opulente DA, Langdon QK, Buh KV et al. Pathogenic budding yeasts isolated outside of clinical settings. FEMS Yeast Res 2019;19:foz032) published early this year a study aiming to investigate the diversity of wild yeast species, by collecting 1000 environmental samples coming from different substrates across the United States of America. The main finding of this work is the recovery of 54 strains of budding yeasts of which several are having a pathogenic potential in the clinical setting, such as Candida albicans, C. parapsilosis, C. tropicalis, Nakaseomyces glabrata and Pichia kudriavzevii. These findings, discussed here in light of other recent studies highlighting the role of fungicides in the rise of antifungal resistance in the clinical setting or the emergence of Candida auris, demonstrate that our environment can represent an alternative niche for several opportunistic fungal pathogens that can be a concern for human health. |
| Antimicrobial resistance; Cost; One health | STEWARDSHIP | Objectives/purpose The costs attributable to antimicrobial resistance (AMR) remain theoretical and largely unspecified. Current figures fail to capture the full health and economic burden caused by AMR across human, animal, and environmental health; historically many studies have considered only direct costs associated with human infection from a hospital perspective, primarily from high-income countries. The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ONeuro) network has developed a framework to help guide AMR costing exercises in any part of the world as a first step towards more comprehensive analyses for comparing AMR interventions at the local level as well as more harmonized analyses for quantifying the full economic burden attributable to AMR at the global level. Methods GAP-ONeuro (funded under the JPIAMR 8th call (Virtual Research Institute) is composed of 19 international networks and institutions active in the field of AMR. For this project, the Network operated by means of Delphi rounds, teleconferences and face-to-face meetings. The resulting costing framework takes a bottom-up approach to incorporate all relevant costs imposed by an AMR bacterial microbe in a patient, in an animal, or in the environment up through to the societal level. Results The framework itemizes the epidemiological data as well as the direct and indirect cost components needed to build a realistic cost picture for AMR. While the framework lists a large number of relevant pathogens for which this framework could be used to explore the costs, the framework is sufficiently generic to facilitate the costing of other resistant pathogens, including those of other aetiologies. Conclusion In order to conduct cost-effectiveness analyses to choose amongst different AMR-related interventions at local level, the costing of AMR should be done according to local epidemiological priorities and local health service norms. Yet the use of a common framework across settings allows for the results of such studies to contribute to cumulative estimates that can serve as the basis of broader policy decisions at the international level such as how to steer R&D funding and how to prioritize AMR amongst other issues. Indeed, it is only by building a realistic cost picture that we can make informed decisions on how best to tackle major health threats. |
| Chiropterans; One health; Proteobacteria; South America; Vector-borne; Zoonosis | BARTONELLA SPP.; COXIELLA-BURNETII; SPOTTED-FEVER; INFECTION; DIVERSITY; RESERVOIR; FLEAS | Intracellular pathogens were investigated for the first time in 55 Chilean bats belonging to six species. Using a conventional PCR protocol targeting a fragment of the ITS region, 21 bats (38 %) were positive for DNA of Bartonella sp. Molecular characterization of fragments of the gltA, rpoB and fstZ genes and subsequent phylogenetic analysis indicated the presence of diverse genotypes related to Bartonella from bats worldwide. DNA from C. burnetii was investigated using a real-time PCR (qPCR) protocol targeting the IS1111 gene and yielded positive results for 5 individuals (9%), being the first report of C. burnetii in wildlife in Chile. All bats were negative for Rickettsia sp., evaluated by qPCR for the gltA gene, confirming that bats do not act as important reservoirs for Rickettsia. This preliminary survey calls for more comprehensive studies on the epidemiology of these agents, including larger sample sizes, the evaluation of potential transmission routes and spillover potential. |
| indigenous; toxoplasmosis; outbreak; rainforest (Amazon forest); parasitology | SEVERE ACQUIRED TOXOPLASMOSIS; GONDII INFECTION; WATERBORNE TOXOPLASMOSIS; SEROPREVALENCE; SEROEPIDEMIOLOGY; PEOPLE; TRANSMISSION; OOCYSTS; STRAIN; BRAZIL | Background:Toxoplasma gondiiis a parasite of worldwide importance but its burden in indigenous communities remains unclear. In French Guiana, atypical strains ofT. gondiioriginating from a complex rainforest cycle involving wild felids have been linked to severe infections in humans. These cases of Amazonian toxoplasmosis are sporadic and outbreaks are rarely described. We report on the investigation of an outbreak of acute toxoplasmosis in a remote Amerindian village. We discuss the causes and consequences of this emergence. Methods:In May 2017, during the rainy season and following an episode of flooding, four simultaneous cases of acute toxoplasmosis were serologically confirmed in two families living the village. Other non-diagnosed cases were then actively screened by a medical team along with epidemiological investigations. Inhabitants from nine households were tested forT. gondiiantibodies and parasite DNA by PCR when appropriate. Samples of water, cat feces and cat rectal swabs, soil, and meat were tested forT. gondiiDNA by PCR. Positive PCR samples with sufficient DNA amounts were genotyped using 15 microsatellite markers. Results:Between early May and early July 2017, out of 54 tested inhabitants, 20 cases were serologically confirmed. A fetus infected at gestational week 10 died but other cases were mild. Four patients tested positive for parasite DNA and two identical strains belonging to an atypical genotype could be isolated from unrelated patients. While domestic cats had recently appeared in the vicinity, most families drank water from unsafe sources. Parasite DNA was recovered from one water sample and nine soil samples. Three meat samples tested positive, including wild and industrial meat. Conclusions:The emergence of toxoplasmosis in such a community living in close contact with the Amazon rainforest is probably multifactorial. Sedentary settlements have been built in the last few decades without providing safe water sources, increasing the risk of parasite circulation in cases of dangerous new habits such as cat domestication. Public health actions should be implemented in these communities such as safe water supply, health recommendations, and epidemiological surveillance of acute toxoplasmosis. A One Health strategy of research involving medical anthropology, veterinary medicine, and public health needs to be pursued for a better understanding of the transmission routes and the emergence of this zoonosis. |
| PIG PRODUCTION; INTERVENTIONS; USAGE; MYTH | Antimicrobial stewardship in veterinary practice and animal production is important from a One Health perspective. The ADKAR (R) change management model is a well-known strategy to implement behavioral change in people and small businesses. The objective of this study was to adapt the existing ADKAR (R) change management model to enable herd veterinarians to profile farmers with regard to antimicrobial stewardship. Therefore, an antimicrobial stewardship related scoring scale was defined. Subsequently, ADKAR (R) profiles of 26 poultry and 28 pig farmers from Belgium and the Netherlands were determined. For 57% of the farmers, perception and/or motivation were expected to limit successful change. For 70% of the farmers, knowledge and for 52% of the farmers, a lack of ability were the limiting factor. The ADKAR (R) model proved useful for identifying the key elements that prevent successful behavioral change in farmers to reduce the use of antibiotics in farm animals. |
| antimicrobial resistance; CA-MRSA; LA-MRSA; livestock; methicillin-resistant Staphylococcus aureus; one health; pigs; public health; ST398; ST93 | LIVESTOCK-ASSOCIATED MRSA; STAPHYLOCOCCUS-AUREUS ST398; REAL-TIME PCR; STRAINS; CARRIAGE; PATTERNS; PIGLETS; HERDS; CC398 | This observational study aimed to determine MRSA prevalence using strain-specific real-time PCR at the pig level, stratified by age groupings, within a pig enterprise. A total of 658 samples were collected from individual pigs (n = 618) and the piggery environment (n = 40), distributed amongst five different pig age groups. Presumptive MRSA isolates were confirmed by the presence of mecA, and MALDI-TOF was performed for species verification. All isolates were tested against 18 different antimicrobials. MRSA was isolated from 75.2% (95% CI 71.8-78.6) of samples collected from pigs, and 71% of the MRSA isolates from this source were identified as community-associated (CA)-MRSA ST93, while the remainder were livestock-associated (LA)-MRSA ST398. Amongst environmental isolates, 80% (CI 64.3-95.7) were ST93 and the remainder ST398. All MRSA isolates from pigs and the environment were susceptible to ciprofloxacin, gentamicin, linezolid, mupirocin, rifampicin, sulfamethoxazole-trimethoprim, teicoplanin and vancomycin. Phenotypic rates of resistance were penicillin (100%), clindamycin (97.6%), erythromycin (96.3%), ceftiofur (93.7%), chloramphenicol (81.2%), tetracycline (63.1%) and amoxicillin-clavulanate (63.9%). A low prevalence of resistance (9.2%) was observed against neomycin and quinupristin-dalfopristin. The probability of MRSA carriage in dry sows (42.2%) was found to be significantly lower (p < .001) when compared to other age groups: farrowing sows (76.8%, RR1.82), weaners (97.8%, RR 2.32), growers (94.2%, RR 2.23) and finishers (98.3%, RR 2.33). Amongst different production age groups, a significant difference was also found in antimicrobial resistance for amoxicillin-clavulanate, neomycin, chloramphenicol and tetracycline. Using the RT-PCR assay adopted in this study, filtering of highly prevalent ST93 and non-ST93 isolates was performed at high throughput and low cost. In conclusion, this study found that weaner pigs presented a higher risk for CA-MRSA and antimicrobial resistance compared to other age groups. These findings have major implications for how investigations of MRSA outbreaks should be approached under the One-Health context. |
| Rabies; Education; Knowledge; Veterinary worker; Human health worker; Chad | POSTEXPOSURE PROPHYLAXIS; PUBLIC-HEALTH; PREVENTION; AWARENESS; NORTHERN; AFRICA; DEATHS | To prevent human rabies deaths close communication between the veterinary and human health sector is needed for timely and adequate treatment after a bite exposure. Good practice treatment and efficient One Health communication depends heavily on the knowledge and practices (KP) of both human health and veterinary workers. We have evaluated the level of KP of both these sectors during a one-day joint training program to kick start a large scale rabies burden and vaccine demand study in selected regions of Chad. Participants were evaluated through a questionnaire before and after training to get insight into the basic knowledge of rabies and the improvement of this knowledge after the training session. In addition to 20 questions on rabies derived from the educational platform of the Global Alliance for Rabies Control, the questionnaires included a pre-training knowledge self-evaluation and a post-training evaluation of the course. Overall 247 workshop participants with varied level of educational background responded to at least one questionnaire. Around 75% of respondents were from the human health sector and 20% from the veterinary sector. Knowledge level did not differ significantly between the two sectors nor between rural or urban working backgrounds. Respondents with a university degree scored significantly higher in pre-and post-training questionnaire compared to respondents with high school level degree or lower. Knowledge was also dependent on study region and sex of the respondent. In general, the importance of a One Health approaches, such as vaccination of dogs to prevent human rabies, is well understood in both sectors. Regarding treatment, many participants did not know the adequate number of doses required for a full course of PEP, but through the training, this knowledge improved. Detailed knowledge of atypical transmission routes and pathophysiology (neurotropism of the virus) was generally lacking and did not significantly improve through the training. The study revealed considerable deficiencies and challenges in the knowledge level of both veterinary and human health workers in Chad. Rabies control programs need to anticipate these challenges to implementation and provide sufficient time and funds for training workshops and follow-up. |
| | Irish Travellers are a small indigenous minority group with a distinctive lifestyle and culture which sets them apart from the general population. Travellers are vulnerable to significant mental distress which is exacerbated by the social disadvantage that they experience. A Traveller Mental Health Liaison Nurse (TMHLN) was introduced in one health care region in Ireland to provide support for Travellers and increase their access to mental health services. The aim of this paper is to present the findings from an evaluation which explored Travellers access to and reasons for accessing the TMHLN, the interventions provided and their experiences of and perceptions of the role of the TMHLN. A descriptive qualitative approach was used. Ten Travellers who used the service were interviewed. Following data analysis, three themes emerged: factors affecting Traveller mental health; accessing the TMHLN and the Travellers experiences and perceptions of the TMHLN. The participants were extremely positive about the TMHLN and valued the support provided. The findings highlight how the interpersonal skills associated with mental health nursing set against recovery orientated and culturally congruent practices are suitable approaches when working with Travellers. |
| Enterobacterales; ESBL; Food; qnrE1; Resistome | | A multidrug-resistant CTX-M-15-producing Klebsiella pneumoniae (KpP1 strain) was isolated from a native Amazonian fish (Brachyplatystoma filamentosum) at the Brazilian Amazon. The strain was identified by MALDI-TOF. The genome was extracted, purified and a Nextera DNA Flex library was prepared and sequenced by Illumina platform. The sequenced genome was de novo assembled using Unicycler and in silico prediction accomplished by curated bioinformatics tools. The size of the genome is 5.6 Mb with 5715 genes. Whole-genome sequencing analysis revealed the presence of wide resistome, with genes conferring resistance to clinically relevant antibiotics, heavy metals and disinfectants. The KpP1 strain was assigned to the sequence type ST3827, KL111 (wzi113) and O3b locus. Native freshwater fish sold in wet markets of the Amazonian region could be an important vehicle for transmission of multidrug-resistant bacteria to humans. This study may give genomic insights on the spread of critical-priority WHO pathogens in a One Health context. |
| Spirochetes; Diagnosis; Leptospirosis; Ruminants; One Health | PARANA; STATE | The aim of this study was to investigate the antibodies and DNA of Leptospira spp. isolated from infected cattle in a small rural dairy farm in a border region between Brazil and Paraguay. Blood and urine samples were collected from 50 Holstein cows aged between 1 and 15 years. The diagnostic tests performed were microscopic serum agglutination for antibody detection and polymerase chain reaction for Leptospira spp. detection. Out of the samples analyzed, 48% were MAT positive with titers ranging from 100 to 400, and the most prevalent antibody was to the serovar Hardjo. One serum sample was amplified to 549 bp for the sec y gene, and sequencing identified it as L. interrogans. This is the first report from northwestern Parana (PR) State of L. interrogans identification in naturally infected milk cattle. Thus, based on these results, to enhance production efficiency, new serological and molecular studies on dairy cattle from border regions are required to characterize the epidemiology of possible genotypes and their consequences in affected herds. |
| PROGRAMMED DNA ELIMINATION; MITOCHONDRIAL-DNA; HELMINTH INFECTIONS; TRICHURIS-TRICHIURA; FILARIAL PARASITE; GENETIC-VARIATION; GENOME ANALYSIS; READ ALIGNMENT; DISEASE BURDEN; DRAFT GENOME | Human ascariasis is a major neglected tropical disease caused by the nematode Ascaris lumbricoides. We report a 296 megabase (Mb) reference-quality genome comprised of 17,902 protein-coding genes derived from a single, representative Ascaris worm. An additional 68 worms were collected from 60 human hosts in Kenyan villages where pig husbandry is rare. Notably, the majority of these worms (63/68) possessed mitochondrial genomes that clustered closer to the pig parasite Ascaris suum than to A. lumbricoides. Comparative phylogenomic analyses identified over 11 million nuclear-encoded SNPs but just two distinct genetic types that had recombined across the genomes analyzed. The nuclear genomes had extensive heterozygosity, and all samples existed as genetic mosaics with either A. suum-like or A. lumbricoides-like inheritance patterns supporting a highly interbred Ascaris species genetic complex. As no barriers appear to exist for anthroponotic transmission of these ‘hybrid’ worms, a one-health approach to control the spread of human ascariasis will be necessary. |
| one health; COVID-19; SARS-CoV-2; disease determinants; public health; vertebrate hosts; epidemics | RESPIRATORY SYNDROME CORONAVIRUS; SARS-CORONAVIRUS; ENVIRONMENTAL DETERMINANTS; DROMEDARY CAMELS; INFLUENZA-VIRUS; BAT ORIGIN; TRANSMISSION; RECOMBINATION; SARS-COV-2; EPIDEMIOLOGY | The knowledge of disease determinants is a pre-requisite for disease prevention. Infectious diseases determinants can be classified in three ways, as: primary or secondary; intrinsic or extrinsic; and associated with host, agent, or environment. In the specific case of COVID-19 several of these determinants are currently unknown leading to difficulties in public health approach to this disease. In this paper, we attempt to address several of the current gaps on COVID-19 using a systematic analysis on recent findings and some preliminary knowledge on animal coronaviruses. A discussion on the impact of COVID-19 determinants in disease prevention and control will be based on the Environmental Change and Infectious Disease (EnVID) systemic framework to address several challenges that may affect the control of the SARS- CoV-2 pandemic spread both in industrialized and in developing Countries. |
| Apis mellifera; bees; biomarkers for health; parasites; pathogens; ecophysiology | VARROA-DESTRUCTOR ACARI; HONEY-BEE HYMENOPTERA; APIS-MELLIFERA; OXIDATIVE STRESS; GUT MICROBIOTA; COLONY GROWTH; GENOTYPIC DIVERSITY; ECTOPARASITIC MITE; BOMBUS-TERRESTRIS; WILD | Evidence for global bee population declines has catalyzed a rapidly evolving area of research that aims to identify the causal factors and to effectively assess the status of pollinator populations. The term pollinator health emerged through efforts to understand causes of bee decline and colony losses, but it lacks a formal definition. In this review, we propose a definition for pollinator health and synthesize the available literature on the application of standardized biomarkers to assess health at the individual, colony, and population levels. We focus on biomarkers in honey bees, a model species, but extrapolate the potential application of these approaches to monitor the health status of wild bee populations. Biomarker-guided health measures can inform beekeeper management decisions, wild bee conservation efforts, and environmental policies. We conclude by addressing challenges to pollinator health from a One Health perspective that emphasizes the interplay between environmental quality and human, animal, and bee health. |
| Antibiotic resistance; ABR; Antimicrobial resistance; AMR; Chloramphenicol; Wastewater; Stereochemistry; Chirality | WASTE-WATER TREATMENT; SPECTRUM BETA-LACTAMASE; 23S RIBOSOMAL-RNA; CHLORAMPHENICOL-RESISTANCE; ESCHERICHIA-COLI; FLORFENICOL RESISTANCE; AQUATIC ENVIRONMENT; TREATMENT PLANTS; ANTIMICROBIAL RESISTANCE; FUNCTIONALIZED BIOCHAR | Antibiotic resistance (ABR) is now recognised as a serious global health and economic threat that is most efficiently managed via a ‘one health’ approach incorporating environmental risk assessment. Although the environmental dimension of ABR has been largely overlooked, recent studies have underlined the importance of non-clinical settings in the emergence and spread of resistant strains. Despite this, several research gaps remain in regard to the development of a robust and fit-for-purpose environmental risk assessment for ABR drivers such as antibiotics (ABs). Here we explore the role the environment plays in the dissemination of ABR within the context of stereochemistry and its particular form, enantiomerism. Taking chloramphenicol as a proof of principle, we argue that stereoisomerism of ABs impacts on biological properties and the mechanisms of resistance and we discuss more broadly the importance of stereochemistry (enantiomerism in particular) with respect to antimicrobial potency and range of action. |
| MODIS; EO data; phenological metrics (NDVI; EOS; SOS; MAXVI); remote sensing; evapotranspiration; climate change; Google Earth Engine (GEE); Chamois Rupicapra r; rupicapra; infectious keratocongiuntivis (Mycoplasma conjunctivae); one health | MYCOPLASMA-CONJUNCTIVAE; ALPINE CHAMOIS; TIME-SERIES; GRASSLAND; CLIMATE; ALPS; EVAPOTRANSPIRATION; BIODIVERSITY; RUPICAPRA; HABITAT | Geomatics and satellite remote sensing offer useful analysis tools for several technical-scientific fields. This work, with reference to a regional case of study, investigates remote sensing potentialities for describing relationships between environment and diseases affecting wildlife at landscape level in the light of climate change effects onto vegetation. Specifically, the infectious keratoconjunctivitis (IKC) of chamois (Rupicapra rupicapra L.) in Aosta Valley (NW Italy) was investigated at the regional level. IKC (Mycoplasma conjunctivae) is a contagious disease for domestic and wild ruminants (Caprinae and Ovinae). Two types of analysis were performed: one aimed at exploring by remotely sensed data phenological metrics (PMs) and evapotranspiration (ET) trends of vegetation in the area; one investigating the correlation between PMs and ET, versus IKC prevalence. The analysis was based on TERRA MODIS image time series ranging from 2000 to 2019. Ground data about IKC were available for a shorter time range: 2009-2019. Consequently, PMs and ET trend investigations were focused on the whole times range (2000-2019); conversely, correlation analysis was achieved with reference to the reduced 2009-2019 period. The whole study was based on freely available data from public archives. MODIS products, namely MOD13Q1 v.6 and MOD16A2, were used to derive PM and ET trends, respectively. Shuttle Radar Topography Mission (SRTM) Digital Terrain Model (DTM) was used to describe local topography; CORINE Land Cover map was adopted to describe land use classes. PMs and ET (as derivable from EO data) proved to significantly changed their values in the last 20 years, with a continuous progressive trend. As far as correlation analysis was concerned, ET and some PMs (specifically, End of Season (EOS) and Length of Season (LOS) proved significantly condition IKC prevalence. According to results, the proposed methodology can be retained as an effective tool for supporting public health and eco-pathological sectors. Specifically, it can be intended for a continuous monitoring of effects that climatic dynamics determine onto wild animals in the Alpine area, included diseases and zoonosis, moving future environmental management and planning towards the One Health perspective. |
| Apiculture; Biosecurity measures; BPRACTICES; Europe; Honey bee | | Emerging pathogens of honey bees represent an important threat to the development of the beekeeping sector. The implementation of biosecurity measures in beekeeping (BMBs) plays an essential role in supporting honey bee health within the beekeeping sector. A group of experts, in collaboration with the BPRACTICES (Grant Agreement No. 696231, European Research Area on Sustainable Animal Production Systems [ERA-Net SusAn]) project partners, has provided the definition of BMBs. Thus, BMBs are all those operational activities implemented to control the risk of introduction and spread of specific honey bee disease agents. In this paper, the BMBs in the European beekeeping context are identified for the most relevant honey bee diseases in Europe: varroosis, American foulbrood (AFB), European foulbrood (EFB), nosemosis and aethinosis. Moreover, BMBs were classified in `categories’ adapted to consider productivity and the `One Health’ approach: human health, honey bee health and protection of the environment. The 84 BMBs described by the panel of experts were ranked according to the priority score attributed. The implementation of BMBs represents an essential step forwards to increase the resilience and sustainability of European beekeeping. |
| diffuse large B cell lymphoma; dog; animal model; gene expression; metabolism; oxidative phosphorylation | GERMINAL CENTER; CANCER; SUBTYPES; TRANSFORMATION; SURVIVAL; S100A8 | Gene expression profiling has revealed molecular heterogeneity of diffuse large B cell lymphoma (DLBCL) in both humans and dogs. Two DLBCL subtypes based on cell of origin are generally recognized, germinal center B (GCB)-like and activated B cell (ABC)-like. A pilot study to characterize the transcriptomic phenotype of 11 dogs with multicentric BCL yielded two molecular subtypes distinguished on the basis of genes important in oxidative phosphorylation. We propose a metabolic classification of canine BCL that transcends cell of origin and shows parallels to a similar molecular phenotype in human DLBCL. We thus confirm the validity of this classification scheme across widely divergent mammalian taxa and add to the growing body of literature suggesting cellular and molecular similarities between human and canine non-Hodgkin lymphoma. Our data support a One Health approach to the study of DLBCL, including the advancement of novel therapies of relevance to both canine and human health. |
| Cryptosporidiosis; Outbreaks; Veterinary; Public health | N. SP APICOMPLEXA; HIV-INFECTED PATIENTS; SEQUENCE TYPING TOOL; PIG GENOTYPE II; PROTOZOAN PARASITES; MOLECULAR CHARACTERIZATION; DAIRY-CATTLE; CLINICAL-MANIFESTATIONS; HALOFUGINONE-LACTATE; PARVUM GENOTYPE | Cryptosporidiosis, caused by parasite species of the genus Cryptosporidium, is a major diarrhoeal disease in both people and animals globally, with C. hominis and C. parvum the main species infecting humans. Environmentally robust oocysts which are shed in high numbers in the faeces of infected individuals are resistant to disinfectants, including levels of chlorine normally used in drinking water. As a result, Cryptosporidium is a major cause of waterborne and foodborne outbreaks. Interestingly, C. hominis is responsible for the majority of waterborne outbreaks typed to date with C. parvum responsible for the majority of foodborne outbreaks. No vaccine and few treatments are currently available, which has greatly limited control of this disease to date. Livestock are both an important reservoir and source of human infections and improved husbandry and management practices as well as a One Health integrated molecular typing approach across both veterinary and public health systems are essential to improve our ability to control this disease. |
| Antimicrobial; Aminoglycosides; Ultra performance liquid chromatography-tandem mass spectrometry; Racehorse | CHROMATOGRAPHY; ANTIBIOTICS; HORSES; DRUGS | Ever since ‘One Health’ concept was introduced in early 2000s, judicious use of antimicrobials by veterinarians has become an issue of great concern. Recently, findings of anti-inflammatory effects in certain types of antimicrobials have raised a subject for discussion among racing authorities. Regulatory framework of antimicrobials in racing should be based on best interest of horse welfare and doping control perspective, but basic data on prevalence of antimicrobials are lacking. Analysis of 100 postrace urinary samples collected from 10 Japanese racecourses by targeting 21 antimicrobials using ultra performance liquid chromatography-tandem mass spectrometry resulted in detection of ceftiofur, cefalotin, cefalotin metabolite, dihydrostreptomycin, gentamicin, kanamycin, and oxytetracycline. Detection of antimicrobials critically important for resistance in human medicine was limited to a single sample. Oxytetracycline, which is known to possess anti-inflammatory effects, was detected in three samples. This may suggest the need for establishing a regulatory framework from doping control perspective and further studies to clarify pharmacologically relevant concentration of antimicrobials with such properties. (C) 2020 Elsevier Inc. All rights reserved. |
| oncolytic HSV (herpes simplex virus); checkpoint inhibition; Indoximod; IL-12; immunotherapy; canine (dog) glioma; one health; comparative oncology | HERPES-SIMPLEX-VIRUS; INDOLEAMINE 2,3-DIOXYGENASE; BRAIN-TUMORS; CANCER; G207; EPIDEMIOLOGY; CONSENSUS; TARGET; SAFETY; MUTANT | As the most common and deadly of primary brain tumors, malignant gliomas have earned their place within one of the most multifaceted and heavily-funded realms of medical research. Numerous avenues of pre-clinical investigation continue to provide valuable insight, but modeling the complex evolution and behavior of these tumors within a host under simulated circumstances may pose challenges to extrapolation of data. Remarkably, certain breeds of pet dogs spontaneously and sporadically develop high grade gliomas that follow similar incidence, treatment, and outcome patterns as their human glioma counterparts. The most malignant of these tumors have been refractory to limited treatment options despite aggressive treatment; outcomes are dismal with median survivals of just over 1 year in humans and 2 months in dogs. Novel treatments are greatly needed and combination therapies appear to hold promise. This clinical protocol, a dose-escalating phase I study in dogs with sporadic malignant glioma, represents a first in comparative oncology and combination immunotherapy. The trial will evaluate M032, an Interleukin-12 expressing Herpes Simplex virus, alone and combined with a checkpoint inhibitor, Indoximod. Extensive pre-clinical work has demonstrated safety of intracranial M032 administration in mice and non-human primates. M032 is currently being tested in humans with high-grade malignant gliomas. Thus, in a novel fashion, both canine and human trials will proceed concurrently allowing a direct head-to-head comparison of safety and efficacy. We expect this viral oncolytic therapy to be as safe as it is in human patients and M032 to (a) infect and kill glioma cells, producing a virus and tumor cell antigen-rich debris field; (b) provide an adjuvant effect due to liberation of viral DNA, which is rich in unmethylated CpG sequences that toggle TLR-9 receptors; and (c) express IL-12 locally, stimulating induction of TH1 lymphocytes. The resultant immune-mediated anti-viral responses should, through cross-epitope spreading, translate into a strong response to tumor antigens. The ability to compare human and dog responses in real time affords the most stringent test of suitability of the dog as an informative model of human brain tumors. Subsequent studies will allow canine trials to properly inform the design of human trials. |
| One Health; agriculture; antibiotic; antimicrobial resistance; gene transfer; host-microbe; microbiome; plant-microbe interactions | INTESTINAL COLONIZATION; BACTERIA; MICE; NEED | Agricultural use of antibiotics is recognized by the U.S. Centers for Disease Control and Prevention as a major contributor to antibiotic-resistant infections. While most One Health attention has been on the potential for antibiotic resistance transmission from livestock and contaminated meat products to people, plant foods are fundamental to the food chain for meat eaters and vegetarians alike. We hypothesized that environmental bacteria that colonize plant foods may serve as platforms for the persistence of antibiotic-resistant bacteria and for horizontal gene transfer of antibiotic-resistant genes. Donor Acinetobacter baylyi and recipient Escherichia coli were cocultured in vitro, in planta on lettuce, and in vivo in BALB/c mice. We showed that nonpathogenic, environmental A. baylyi is capable of transferring plasmids conferring antibiotic resistance to E. coli clinical isolates on lettuce leaf discs. Furthermore, transformant E. coli from the in planta assay could then colonize the mouse gut microbiome. The target antibiotic resistance plasmid was identified in mouse feces up to 5 days postinfection. We specifically identified in vivo transfer of the plasmid to resident Klebsiella pneumoniae in the mouse gut. Our findings highlight the potential for environmental bacteria exposed to antibiotics to transmit resistance genes to mammalian pathogens during ingestion of leafy greens. IMPORTANCE Previous efforts have correlated antibiotic-fed livestock and meat products with respective antibiotic resistance genes, but virtually no research has been conducted on the transmission of antibiotic resistance from plant foods to the mammalian gut (C. S. Holzel, J. L. Tetens, and K. Schwaiger, Pathog Dis 15:671-688, 2018, https://doi.org/10.1089/fpd.2018.2501; C. M. Liu et al., mBio 9:e00470-19, 2018, https://doi.org/10.1128/mBio.00470-18; B. Spellberg et al., NAM Perspectives, 2016, https://doi.org/10.31478/201606d; J. O’Neill, Antimicrobials in agriculture and the environment, 2015; Centers for Disease Control and Prevention, Antibiotic resistance threats in the United States, 2019). Here, we sought to determine if horizontal transmission of antibiotic resistance genes can occur between lettuce and the mammalian gut microbiome, using a mouse model. Furthermore, we have created a new model to study horizontal gene transfer on lettuce leaves using an antibiotic-resistant transformant of A. baylyi (Ab(zeoR)). |
| oral antibiotics; resistance genes; point-of-care; one health; dental practice | ANTIMICROBIAL RESISTANCE; INFECTIONS; DENTISTS; BACTERIAL; BIOFILMS; DISEASES; PCR | Antibiotic resistance poses a global threat, which is being acknowledged at several levels, including research, clinical implementation, regulation, as well as by the World Health Organization. In the field of oral health, however, the issue of antibiotic resistances, as well as of accurate diagnosis, is underrepresented. Oral diseases in general were ranked third in terms of expenditures among the EU-28 member states in 2015. Yet, the diagnosis and patient management of oral infections, in particular, still depend primarily on empiric means. On the contrary, on the global scale, the field of medical infections has more readily adopted the integration of molecular-based systems in the diagnostic, patient management, and antibiotic stewardship workflows. In this perspective review, we emphasize the clinical significance of supporting in the future antibiotic resistance screening in dental practice with novel integrated and point-of-care operating tools that can greatly support the rapid, accurate, and efficient administration of oral antibiotics. |
| economics; Ethiopia; rabies; public health; health policy | HEALTH; EPIDEMIOLOGY; STRATEGIES; LIVESTOCK; IMPACT | One Health disease-control programs are believed to be most effective when implemented within the population transmitting the disease. The World Health Organization (WHO) and partners have targeted the elimination of dog-mediated human rabies by 2030 primarily through mass dog vaccination. Mass vaccination, however, has been constrained by financial resource limitations. The current owner-charged dog vaccination strategy, used in most resource-limited countries like Ethiopia, has not reached the minimum coverage required to build population immunity. Dog vaccination is non-existing in most rural areas of Ethiopia, and coverage is <20% in urban areas. Although the health and economic benefits of rabies elimination outweigh the costs, the direct beneficiaries (public in general) and those who bear the costs (dog owners) are not necessarily the same. In this perspective paper, we aggregate evidence on the socioeconomic burden of rabies in Ethiopia as well as the implications for potential opportunities to control the disease and possibilities to obtain the required funding sources for evidence-based interventions in the control of rabies in Ethiopia. |
| rabies; lyssavirus; dog rabies; elimination program; Namibia | CANINE RABIES; RURAL AFRICA; VACCINATION; POPULATION; STRATEGIES; COVERAGE | The major part of the global burden of dog-mediated rabies falls on Africa and Asia, where still an estimated 60,000 people die of the disease annually. Like in many African countries, dog-mediated rabies is a major public health concern in Namibia, costing the country an estimated 242 human deaths during the past two decades, in particular in the Northern Communal Areas (NCAs). Consequently, under the One Health concept, the Namibian government adopted a National Rabies Control Strategy in 2015, which strives to contribute to the global goal of ending dog-mediated human rabies deaths by 2030. A key component of this strategy was the implementation a dog rabies elimination program in the NCAs in 2016, being designed as a stepwise regional rollout strategy by building on experience gained in a pilot project area. The area of implementation covers approximately 263,376 km(2) and 64 constituencies, with around 1.2 million inhabitants and estimated 93,000 dogs. |
| Influenza; AIV; A/H9N2; phylogeny; low pathogenicity | HUMAN INFECTION; H9N2; VIRUS; IDENTIFICATION | The H9N2 influenza virus has become one of the dominant subtypes of influenza virus circulating in poultry, wild birds, and can occasionally cross the mammalian species barrier. Here, we report the first human A/H9N2 in Sub-Saharan Africa. The patient was a child of 16 months’ old living in the South-West of Senegal. He had no influenza vaccination history and no other disease history. He had symptoms of fever with an auxiliary temperature of 39.1 degrees C. Respiratory symptoms were an intense cough, runny nose and pulmonary crackles. All eight genome segments belonged to the A/H9N2 AIV subtype and the strain characyerized as of low pathogenicity with a RSSR/GLF amino acids motif. Phylogenetic analysis of both complete HA and NA gene segments showed that the A/H9N2 subtype virus from Senegal belonged to the G1 lineage. This human case highlights the weakness of influenza surveillance in animals and the need for enhanced surveillance using a one-health approach. |
| WILDLIFE INTERFACE AREAS; RISK-FACTORS; BOVINE BRUCELLOSIS; DAIRY-CATTLE; CAPRINE BRUCELLOSIS; COMPETITIVE ELISA; SEROPREVALENCE; LIVESTOCK; SEROPOSITIVITY; PREVALENCE | Brucellosis is a bacterial zoonotic disease that has important veterinary and public health consequences as well as economic impact in sub Saharan Africa including Ethiopia. A cross-sectional study was conducted in four selected districts of Borena Pastoral setting in Southern Ethiopia from October 2017 to February 2018 to estimate the prevalence of brucellosis and assess associated risk factors in cattle, sheep, goats and occupationally associated humans. A total of 750 cattle, 882 sheep and goats and 341 human subjects were screened for evidence of brucellosis using the Rose Bengal Test (RBT) with positive results confirmed by Competitive-ELISA(c-ELISA). Structured questionnaires were used for collection of metadata from individual animals, herders and animal attendants to test the association between explanatory and outcome variables. The overall animal level prevalence was 2.4% (95% confidence interval, CI: 1.4-3.7) in cattle, 3.2% (95% CI: 2.1-4.6) in sheep and goats, and 2.6% (95% CI: 1.2-5) in humans occupationally linked to livestock production systems. Herd size, parity, and history of abortion were risk factors associated with Brucella seropositivity (P<0.05) in cattle whereas in sheep and goats the results showed that district, age group, flock size, and history of abortion were significantly associated risk factors with Brucella seropositivity (P<0.05). Assisting calving and presence of seropositive animals in a household (P<0.05) were significantly associated with Brucella seropositivity in humans. Evidence of brucellosis in various animal species and the associated human population illustrates the need for a coordinated One Health approach to controlling brucellosis so as to improve public health and livestock productivity. Author summary Brucellosis is a bacterial infectious disease with public health and economic importance mainly in low and middle-income countries (LMICs). The burden of this disease in livestock and its zoonotic importance in humans in sub-Saharan Africa including Ethiopia is poorly understood. In Ethiopia, although epidemiological studies were conducted in intensive dairy herds in high lands areas, there is shortage of data on the epidemiology and public health and impacts of brucellosis. This study was conducted to estimate the prevalence brucellosis in different species of livestock and pastoralists and thereafter to identify the potential risk factors affecting its occurrence and transmission. To this effect, a one health approach was used. |
| Mycoplasma spp.; Zoonoses; One health; Neotropical; Bats; Infectious diseases | PHYLOGENETIC ANALYSIS; INFECTION; WIDESPREAD; PATHOGENS; DNA | Hemotropic mycoplasmas (hemoplasmas) are bacteria distributed worldwide and affect domestic and wildlife animals and human beings. Hemoplasmas have been described infecting hematophagous and non-hematophagous bats; however, transmission risk and zoonotic potential in vampire bats remain to be fully established. This study aimed to evaluate the presence of hemotropic mycoplasma species in free-ranging bats from this area using a universal PCR protocol for hemoplasmas. Accordingly, ten blood samples were collected from six male common vampire bats (Desmodus rotundus), two male hairy-legged vampire bats (Diphylla ecaudata), and two female non-hematophagous Pallas’s mastiff bats (Molossus sp.) from the Curitiba’s region, Parana State, Southern Brazil. A total of eight (8/10) blood samples were positive byconventional PCR; five (5/6) Desmodus rotundus, two (2/2) Diphylla ecaudata, and one (1/2) Molossus sp. bats. The analyses of the partial sequence of the 16S rDNA gene suggest that the hemoplasma detected in Desmodus rotundus in South Brazil has a high identity compared to the hemoplasma circulating in vampire bats from Central and South America. |
| Companion animal; Horse; Integrated arthropod management; Livestock; Parasitic haematophagous arthropod; Veterinary hospital | | As reviewed in Part 1 of this publication series, numerous haematophagous arthropods have negative direct effects and are involved in the transmission of pathogens to either animals and/or humans in Western Europe. Their control is therefore essential to prevent vector-borne infections. Different control methods, either general or arthropod-specific, were presented in Part 2 of this publication series. Part 3 focuses on integrated management of arthropods and proposes a coherent and affordable plan for facilities housing sick animals in a veterinary faculty, i.e. small animals and large animals, with an educational farm. Control of arthropods should be part of a biosecurity plan, the effectiveness of which requires awareness raising and education of the different actors, i.e. staff, students and animal owners. The originality of the review lies in its specificity to a veterinary faculty and animal housing facilities, from a One Health point of view. As far as it could be ascertained, this is the first review focusing on arthropod control in this specific at-risk environment. |
| COVID-19; emerging disease; epidemic intelligence; one Health; online news; PADI-web | | Event-based surveillance (EBS) systems monitor a broad range of information sources to detect early signals of disease emergence, including new and unknown diseases. In December 2019, a newly identified coronavirus emerged in Wuhan (China), causing a global coronavirus disease (COVID-19) pandemic. A retrospective study was conducted to evaluate the capacity of three event-based surveillance (EBS) systems (ProMED, HealthMap and PADI-web) to detect early COVID-19 emergence signals. We focused on changes in online news vocabulary over the period before/after the identification of COVID-19, while also assessing its contagiousness and pandemic potential. ProMED was the timeliest EBS, detecting signals one day before the official notification. At this early stage, the specific vocabulary used was related to ‘pneumonia symptoms’ and ‘mystery illness’. Once COVID-19 was identified, the vocabulary changed to virus family and specific COVID-19 acronyms. Our results suggest that the three EBS systems are complementary regarding data sources, and all require timeliness improvements. EBS methods should be adapted to the different stages of disease emergence to enhance early detection of future unknown disease outbreaks. |
| | With the dramatic background of a newly emerged virus (SARS-CoV-2) spreading around the world, Coronavirus and other infectious health threats for the human and animal populations were illustrated and debated in excellent presentations at the IABS meeting 26-28 of February 2020. Historical evidence of pandemics and lessons learned from recent epidemics or epizootics caused by many pathogens (e.g., Ebola, Zika, and African Swine Fever viruses) illustrated the overarching need for close international cooperation. New and old technologies in vaccine development and their use were presented, resulting in a call for greater interaction between the human and the veterinary fields in order to leverage the expertise and knowledge in both human and animal medicine. The One Health concept was also emphasized for eliminating the 59,000 fatal human rabies cases annually attributed to unvaccinated dogs. For preventable, infectious diseases commonly spreading in the poorer regions of the world, a new regulatory approach and governance structure was called for to give access to affordable vaccines. Vaccines were touted as one of the most successful health invention ever introduced; on a similar level to health improvements due to clean water. |
| Metagenomics; Low anthropogenic impact; Namib desert; Mobile genetic element | HOST-RANGE PLASMIDS; ESCHERICHIA-COLI; METAL RESISTANCE; MOLECULAR CHARACTERIZATION; KLEBSIELLA-PNEUMONIAE; INDICATORS; BACTERIA; ENTEROBACTERIACEAE; ENVIRONMENT; ASSOCIATION | The exhaustive use of antibiotics in humans, animal farming and other agricultural practices has resulted in the frequent appearance of antibiotic resistant bacteria in human-impacted habitats. However, antibiotic resistance in natural (less-impacted) habitats is less understood. Using shotgun metagenomics we analysed soils from relatively low anthropogenic impact sites across the Namib Desert. We report the presence of a clinically significant extended spectrum D-lactamase (TEM-116), on a ColE1-like plasm id also carrying a metal resistance gene (arsC). The co-occurrence of resistance to antimicrobial drugs and metals encoded on a single mobile genetic element increases the probability of dissemination of these resistance determinants and the potential selection of multiple resistance mechanisms. In addition, the presence of a P7 entero-bacteriophage on the same plasmid, may represent a new vehicle for the propagation of TEM-116 in these soil communities. These findings highlight the role of the environment in the One Health initiative. (C) 2020 Elsevier B.V. All rights reserved. |
| One Health; Panthera leo; Panthera tigris; SARS-CoV-2; in situ hybridization; lion; rRT-PCR; tiger; virus isolation; whole-genome sequencing; zoo; zoonotic infection | NUCLEOCAPSID PROTEIN; HOST-RANGE; PERFORMANCE; PCR | Despite numerous barriers to transmission, zoonoses are the major cause of emerging infectious diseases in humans. Among these, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and ebolaviruses have killed thousands; the human immunodeficiency virus (HIV) has killed millions. Zoonoses and human-to-animal cross-species transmission are driven by human actions and have important management, conservation, and public health implications. The current SARS-CoV-2 pandemic, which presumably originated from an animal reservoir, has killed more than half a million people around the world and cases continue to rise. In March 2020, New York City was a global epicenter for SARS-CoV-2 infections. During this time, four tigers and three lions at the Bronx Zoo, NY, developed mild, abnormal respiratory signs. We detected SARS-CoV-2 RNA in respiratory secretions and/or feces from all seven animals, live virus in three, and colocalized viral RNA with cellular damage in one. We produced nine whole SARS-CoV-2 genomes from the animals and keepers and identified different SARS-CoV-2 genotypes in the tigers and lions. Epidemiologic and genomic data indicated human-to-tiger transmission. These were the first confirmed cases of natural SARS-CoV-2 animal infections in the United States and the first in nondomestic species in the world. We highlight disease transmission at a nontraditional interface and provide information that contributes to understanding SARS-CoV-2 transmission across species. IMPORTANCE The human-animal-environment interface of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important aspect of the coronavirus disease 2019 (COVID-19) pandemic that requires robust One Health-based investigations. Despite this, few reports describe natural infections in animals or directly link them to human infections using genomic data. In the present study, we describe the first cases of natural SARS-CoV-2 infection in tigers and lions in the United States and provide epidemiological and genetic evidence for human-to-animal transmission of the virus. Our data show that tigers and lions were infected with different genotypes of SARS-CoV-2, indicating two independent transmission events to the animals. Importantly, infected animals shed infectious virus in respiratory secretions and feces. A better understanding of the susceptibility of animal species to SARS-CoV-2 may help to elucidate transmission mechanisms and identify potential reservoirs and sources of infection that are important in both animal and human health. |
| Leptospira spp.; MAT; Leptospirosis; Wild animals; Conservation; Ecuador | HORSES; DOGS | Leptospirosis is a zoonotic disease of worldwide distribution that affects humans, domestic and wild animals. This study evaluates the frequency of anti- Leptospira spp. antibodies in companion, livestock and wild mammals from a mixed use rescue center on Guayaquil, the main city of Ecuador. Sera were collected from 23 domestic and 6 wild mammals. All animals tested were seropositive for Leptospira spp. using Microscopic Agglutination Test (MAT), most of them for multiple serovars. Leptospira interrogans serovars Canicola, Hardjo and Icterohaemorrhagiae were the most frequent ones. We conclude that the presence of domestic animals at this mixed use rescue center may cause the exposure of wild animals, considering the high frequency of Leptospira spp. seropositivity already reported for livestock and companion animals in Ecuador. This is the first serological survey for leptospirosis including wild animals rescued from illegal traffic in Ecuador and point out the urgent need of exclusive rescue and conservation units for wild species and the potential role as Leptospira spp. reservoir for wild mammals. |
| Discrete choice experiment; Schistosomiasis; Schistosoma mansoni; WASH; Non-monetary numeraires; Shadow wage rate; One health approach | WILLINGNESS-TO-PAY; PREFERENCES | Schistosomiasis is a serious health problem in many parts of Africa which is linked to poor water quality and limited sanitation resources. We administered a discrete choice experiment on water access and health education in rural Uganda, focussing on interventions designed to reduce cases of the disease. Unlike previous studies, we included a payment vehicle of both labour hours supplied per week and money paid per month within each choice set. We were thus able to elicit both willingness to pay and willingness to work for alternative interventions. Respondents exhibit high demand for new water sources. From the random parameter model, only households with knowledge about water-borne parasites are price sensitive and exhibit willingness to pay values. Through a latent class model specification, higher income respondents exhibit higher willingness to pay values for all programme attributes; however, lower income participants have higher willingness to work values for certain new water sources. We found a shadow wage rate of labour that is between 15 and 55% of the market wage rate. |
| medical microbiology; health policy; other study design | RESISTANCE | Little is known about the overall trend and prioritisations of past and current antimicrobial resistance (AMR) policies. Here we introduce a quantitative method to analyse AMR policies. The AMR-Policy Analysis Coding Toolkit (AMR-PACT) uses several categorical variables. Thirteen AMR action plans from five countries (China, Japan, Norway, the UK and the USA) were used to develop the tool and identify possible values for each variable. The scope and capability of AMR-PACT is demonstrated through the 2015 WHO’s Global Action Plan and 2017 Hong Kong AMR Action Plan (HKAP). Majority of policies were aimed at either human or animal sector with less attention given to the environment, plant or food sector. Both plans shared the same two strategic focus areas, namely the conservation of antibiotics and the improved surveillance of resistance. There were no policies dedicated to improving access to antibiotics in the HKAP. These empirical results provide useful insights into the priorities and gaps of AMR policies. The method proposed here can help understand countries’ priorities regarding AMR, support the creation of AMR policy database and foster innovative policymaking. |
| Amazon rainforest; biodiversity; emerging infectious disease; deforestation; pathogens; public health | VECTOR-BORNE DISEASES; LAND-USE CHANGE; BRAZILIAN-AMAZON; ENVIRONMENTAL-CHANGE; RISK-FACTORS; BIODIVERSITY CONSERVATION; DIARRHEAL DISEASES; ZOONOTIC SPILLOVER; PARASITIC DISEASES; EXTREME WEATHER | Amazonian biodiversity is increasingly threatened due to the weakening of policies for combating deforestation, especially in Brazil. Loss of animal and plant species, many not yet known to science, is just one among many negative consequences of Amazon deforestation. Deforestation affects indigenous communities, riverside as well as urban populations, and even planetary health. Amazonia has a prominent role in regulating the Earth’s climate, with forest loss contributing to rising regional and global temperatures and intensification of extreme weather events. These climatic conditions are important drivers of emerging infectious diseases, and activities associated with deforestation contribute to the spread of disease vectors. This review presents the main impacts of Amazon deforestation on infectious-disease dynamics and public health from a One Health perspective. Because Brazil holds the largest area of Amazon rainforest, emphasis is given to the Brazilian scenario. Finally, potential solutions to mitigate deforestation and emerging infectious diseases are presented from the perspectives of researchers in different fields. |
| musculoskeletal pain; health care utilization; chronic pain; pain prevalence; epidemiology | LOW-BACK-PAIN; CHRONIC WIDESPREAD PAIN; OLDER-ADULTS; RISK-FACTORS; PREVALENCE; EPIDEMIOLOGY; VALIDITY; CLASSIFICATION; FIBROMYALGIA; PATTERNS | Background and aims: Few studies have reported the long-term impact of chronic pain on health care utilization. The primary aim of this study was to investigate if chronic musculoskeletal pain was associated with health care utilization in the general population in a 21-year follow-up of a longitudinal cohort. The secondary aim was to identify and describe factors that characterize different long-term trajectories of health care utilization. Methods: A prospective cohort design with a baseline sample of 2,425 subjects (aged 20-74). Data were collected by self-reported questionnaires, and three time points (1995, 2007, and 2016) were included in the present 21-year follow up study. Data on health care utilization were dichotomized at each time point to either high or low health care utilization. High utilization was defined as >5 consultations with at least one health care provider, or >= 1 consultation with at least 3 different health care providers during the last 12 months. Low health care utilization was defined as <= 5 consultations with one health care provider and <3 consultations with different health care providers. The associations between baseline variables and health care utilization in 2016 were analyzed by multiple logistic regression. Five different trajectories for health care utilization were identified by visual analysis, whereof four of clinical relevance were included in the analyses. Results: Baseline predictors for high health care utilization at the 21-year follow-up in 2016 were chronic widespread pain (OR: 3.2, CI: 1.9 5.1), chronic regional pain (OR:1.8, CI: 1.2-2.6), female gender (OR: 2.0, CI: 1.4-3.0), and high age (OR: 1.6, CI:0.9-2.9). A stable high health care utilization trajectory group was characterized by high levels of health care utilization, and a high prevalence of chronic pain at baseline and female gender (n =23). A stable low health care utilization trajectory group (n=744) was characterized by low health care utilization, and low prevalence of chronic pain at baseline. The two remaining trajectories were: increasing trajectory group (n =108), characterized by increasing health care utilization, chronic pain at baseline and female gender, and decreasing trajectory group (n=107) characterized by decreasing health care utilization despite a stable high prevalence of chronic pain over time. Conclusions: The results suggest that chronic pain is related to long-term health care utilization in the general population. Stable high health care utilization was identified among a group characterized by female gender and a report of chronic widespread pain. |
| antimicrobial resistance; surveillance; whole genome sequencing | PUBLIC-HEALTH; SALMONELLA; WGS; SURVEILLANCE; PLASMIDS; SPREAD; GENES | The laboratory identification of antibacterial resistance is a cornerstone of infectious disease medicine. In vitro antimicrobial susceptibility testing has long been based on the growth response of organisms in pure culture to a defined concentration of antimicrobial agents. By comparing individual isolates to wild-type susceptibility patterns, strains with acquired resistance can be identified. Acquired resistance can also be detected genetically. After many decades of research, the inventory of genes underlying antimicrobial resistance is well known for several pathogenic genera including zoonotic enteric organisms such asSalmonellaandCampylobacterand continues to grow substantially for others. With the decline in costs for large scale DNA sequencing, it is now practicable to characterize bacteria using whole genome sequencing, including the carriage of resistance genes in individual microorganisms and those present in complex biological samples. With genomics, we can generate comprehensive, detailed information on the bacterium, the mechanisms of antibiotic resistance, clues to its source, and the nature of mobile DNA elements by which resistance spreads. These developments point to a new paradigm for antimicrobial resistance detection and tracking for both clinical and public health purposes. |
| surgical wound care; priorities workshop; clinicians; health consumers | NOMINAL GROUP TECHNIQUE; MANAGEMENT | Objective To identify the priorities and challenges related to surgical wound care from the perspectives of clinicians and health consumers / patients at a private hospital in Australia. Methods Twenty-five clinical questions related to five surgical wound management topics were developed a priori and presented to four clinicians at a workshop. Questions were ranked by participating clinicians using a consensus building approach to identify the top two research priorities. One health consumer who had experience with a surgical wound was interviewed. Transcripts from the workshop and the consumer interview were analysed using a deductive approach. Results The clinicians’ top priority questions focused on the importance of the consumer in their postoperative wound management, and the role of the wound care team in providing evidence-based care. The patient highlighted the vital role collaboration with clinicians played in the successful management of their surgical wound and continuity of care. Conclusion Strategies to partner with consumers in the prevention of surgical wound complications can be successfully incorporated into clinical practice. |
| antibiotics; ESBL; monkeys; resistance; zoonosis | ESCHERICHIA-COLI; ANTIBIOTIC-RESISTANCE; PARANA; STATE | The aim of this study was to evaluate the profile of antimicrobial resistance in members of the family Enterobacteriaceae and to detect strains of extended-spectrum beta-lactamases (ESBL) in free-living Sapajus nigritus. Oral and rectal swabs were collected from 15 primates to isolate and identify bacteria, conduct phenotypic tests to detect antimicrobial sensitivity and ESBL-producing strains, and calculate the multiple antimicrobial resistance index. The least effective antimicrobial was amoxicillin (72.72%) and ampicillin (57.57%), and the samples were considered as high risk for public health. No sample was positive for ESBL production. The results show that this study is relevant to One Health initiatives, considering the possibility of transmission of bacterial resistance and resistant genes originating from direct or indirect interaction of S. nigritus with parkgoers. However, these animals cannot be considered as the only reservoirs and transmitters of resistant bacteria as they can be contaminated by human-origin bacteria that can be extremely harmful and often prove lethal to them that play an important role in relationship to the ecology, spreading seeds and controlling insects. |
| Cryprosporidium; outbreak; zoonosis; One Health; diarrhea; cattle | PARVUM; OUTBREAK; SUBTYPES; GIARDIA; CATTLE; COHORT | An outbreak of cryptosporidiosis among veterinary students performing fetotomy exercises on euthanized calves took place in September 2018 in Denmark. A prospective cohort investigation was performed to identify risk factors and provide guidance for preventing outbreaks of cryptosporidiosis in this setting. Ninety-seven students attended the fetotomy exercises and completed a questionnaire about symptoms and potential risk behavior. Real-time PCR was used to detect Cryptosporidium spp. in stool samples from students and to quantify the fecal parasite load in the calves used for the exercises. gp60 subtyping was carried out for the Cryptosporidium-positive samples. Our case definition was based on participation in a fetotomy exercise, reported symptoms, and laboratory results. Eleven laboratoryconfirmed or probable cases (11%) were identified in two outbreaks during the prospective study period, with attack rates of 4/10 (40%) and 7/9 (78%), respectively. The risk factors for cryptosporidiosis we identified were performing the exercise on a diarrheic calf, reporting visible fecal contamination on the personal protective equipment (PPE), and reporting problems with PPE during the exercise. Cryptosporidium parvum IlaA15G2R1 was detected in both cases and calves. A significantly higher proportion of the calves aged 7 days old and above were positive compared with younger calves. Furthermore, a high fecal Cryptosporidium load in a calf was associated with a higher probability of an outbreak among the students. Based on our results, using noninfected calves for the exercises, appropriate use of PPE, and thorough hand hygiene are recommended to reduce the risk of contracting cryptosporidiosis in connection with fetotomy exercises. IMPORTANCE Cryptosporidium spp. can cause severe diarrhea in infected individuals. Cryptosporidium parvum is zoonotic, and cattle are the main reservoir. In several countries, outbreaks of cryptosporidiosis have occurred in veterinary students after handling calves. We carried out a 1-year-long prospective study to investigate the occurrence of these recurrent cryptosporidiosis outbreaks in Denmark. Our investigation used a One Health approach and combined comprehensive epidemiological approaches and laboratory methods applied to both students and calves in the setting of the fetotomy exercises. Two outbreaks took place during the study period; additionally, we retrospectively identified two more suspected outbreaks prior to the study period. The results illustrated a high risk of contracting cryptosporidiosis among veterinary students in the setting of the fetotomy exercises, especially when using calves with high fecal Cryptosporidium loads. Our data can be used to inform future efforts to prevent transmission of Cryptosporidium parvum to students during fetotomy exercises. |
| WASTE-WATER TREATMENT; HIGH PREVALENCE; INFECTION; EPIDEMIOLOGY; RESISTANCE; RIBOTYPES | With rates of community-associatedClostridium difficileinfection (CA-CDI) increasing worldwide, potential reservoirs/sources ofC. difficilein the community are being sought. SinceC. difficileis found in animal manure and human biosolids, which are composted for agricultural purposes, composted products could be a source. In this study, the presence ofC. difficilein composted products, and their genetic relatedness to other previously isolated strains from humans, root vegetables and the environment in Western Australia, was investigated. Overall,C. difficilewas found in 22.5% (16/71) of composted products [29.7% (11/37) of soil conditioners, 16.7% (2/12) of mulches and 13.6% (3/22) of garden mixes]. FifteenC. difficilePCR ribotypes (RTs) were identified, the most common toxigenic strains being RTs 020 and 056.Clostridium difficileRT 056 is commonly associated with CDI in humans and has also been isolated from cattle, root vegetables and the environment (veterinary clinics and lawn) in Australia. High-resolution core-genome analysis of 29C. difficileRT 056 strains revealed clonal relationships between isolates derived from humans, vegetables, composted products and the environment. These findings provide support for an intricate transmission network between human, food and the environment, further highlighting the importance of a ‘One Health’ approach for managing CDI. |
| CLPP; monensin; PLFA; respiration; soil bacteria | RESISTANT BACTERIA; RUMINAL BACTERIA; MICROBIAL COMMUNITIES; PHARMACEUTICALS; ANTIBIOTICS; DEGRADATION; MANURE; FATE; MANAGEMENT; LITTER | Monensin (MON) is a coccidiostat used as a growth promoter that can reach the environment through fertilization with manure from farm animals. To verify whether field-relevant concentrations of this drug negatively influence the structure and activity of tropical soil bacteria, plate counts, CO2 efflux measurements, phospholipid fatty acids (PLFA) and community-level physiological profiling (CLPP) profiles were obtained for soil microcosms exposed to 1 or 10 mg kg(-1) of MON across 11 days. Although 53% (1 mg kg(-1)) to 40% (10 mg kg(-1)) of the MON concentrations added to the microcosms dissipated within 5days, a subtle concentration-dependent decrease in the number of culturable bacteria (<1 log CFU g(-1)), reduced (-20 to -30%) or exacerbated (+25%) soil CO2 effluxes, a marked shift of non-bacterial fatty acids, and altered respiration of amines (1.22-fold decrease) and polymers (1.70-fold increase) were noted in some of the treatments. These results suggest that MON quickly killed some microorganisms and that the surviving populations were selected and metabolically stimulated. Consequently, MON should be monitored in agronomic and environmental systems as part of One Health efforts. |
| antimicrobial resistance; antimicrobial susceptibility test; veterinary; flow cytometry; one health concept | ANTIBIOTIC-THERAPY; SEPSIS | A rapid flow cytometric antimicrobial susceptibility test for bacteria isolated from companion animals – the FASTvetassay, developed by FASTinov(R), was evaluated. Bacterial strains isolated from different biological samples of companion animals with infectious diseases in progress were obtained from several veterinary clinical laboratories across the country. A total of 115 strains, comprising 65 Gram-negative and 50 Gram positive isolates, were incubated with 13 antimicrobial drugs (ampicillin, amoxicillin-clavulanic acid, piperacillin-tazobactam, cefpodoxime, imipenem, enrofloxacin, gentamicin, amikacin for Gram-negative; penicillin, cefoxitin, enrofloxacin, vancomycin and ampicillin for Gram-positive) at breakpoint concentrations following CLSI protocol (CLSI Vet 01, 2018) for 1 h and analyzed by flow cytometry. The overall categorical agreement was 95.6% in case of Gram-negative and of 96.7% in Gram-positive isolates when compared to microdilution. FASTvetkits contribute to reduce the turnaround time (2 vs. 24 h) with early determination of the antimicrobial susceptibility profile. The correct and rapid choice of the target antibiotic therapy, will have a positive impact on animal care, contributing for preventing antimicrobial resistance. In conclusion, FASTinov(R)vet kits showed an excellent performance, both for Gram-negative and Gram-positive isolates encouraging us to enlarge the sample size and planning multicentric studies. |
| Dog; Lyssavirus; Rabies; Prophylaxis; Vaccine; Zoonosis | VACCINE; PROGRAMS; FOXES | Rabies is a major neglected zoonotic disease and causes a substantial burden in the Asian region. Currently, Pacific Oceania is free of rabies but enzootic areas throughout southeast Asia represent a major risk of disease introduction to this region. On September 25-26, 2019, researchers, government officials and related stakeholders met at an IABS conference in Bangkok, Thailand to engage on the topic of human rabies mediated by dogs. The objective of the meeting was focused upon snowballing efforts towards achieving substantial progress in rabies prevention, control and elimination within Asia by 2030, and thereby to safeguard the Pacific region. Individual sessions focused upon domestic animal, wildlife and human vaccination; the production and evaluation of quality, safety and efficacy of existing rabies biologics; and the future development of new products. Participants reviewed the progress to date in eliminating canine rabies by mass vaccination, described supportive methods to parenteral administration by oral vaccine application, considered updated global and local approaches at human prophylaxis and discussed the considerable challenges ahead. Such opportunities provide continuous engagement on disease management among professionals at a trans-disciplinary level and promote new applied research collaborations in a modern One Health context. |
| VANCOMYCIN-RESISTANT ENTEROCOCCI; SALMONELLA-ENTERICA SEROTYPE; ESCHERICHIA-COLI O157-H7; ACID TOLERANCE RESPONSE; LISTERIA-MONOCYTOGENES; UNITED-STATES; ANTIMICROBIAL RESISTANCE; EUROPEAN-UNION; POULTRY MEAT; VIBRIO-VULNIFICUS | Microorganisms vehiculated by food might benefit health, cause minimal change within the equilibrium of the host microbial community or be associated with foodborne diseases. In this chapter we will focus on human pathogenic bacteria for which food is conclusively demonstrated as their transmission mode to human. We will describe the impact of foodborne diseases in public health, the reservoirs of foodborne pathogens (the environment, human and animals), the main bacterial pathogens and food vehicles causing human diseases, and the drivers for the transmission of foodborne diseases related to the food-chain, host or bacteria features. The implication of food-chain (foodborne pathogens and commensals) in the transmission of resistance to antibiotics relevant to the treatment of human infections is also evidenced. The multiplicity and interplay of drivers related to intensification, diversification and globalization of food production, consumer health status, preferences, lifestyles or behaviors, and bacteria adaptation to different challenges (stress tolerance and antimicrobial resistance) from farm to human, make the prevention of bacteria-food-human transmission a modern and continuous challenge. A global One Health approach is mandatory to better understand and minimize the transmission pathways of human pathogens, including multidrug-resistant pathogens and commensals, through food-chain. |
| emergency preparedness; syndromic surveillance; patient tracking; mass gathering | | Objective: In January 2017, Washington, DC, hosted the 58th United States presidential inauguration. The DC Department of Health leveraged multiple health surveillance approaches, including syndromic surveillance (human and animal) and medical aid station-based patient tracking, to detect disease and injury associated with this mass gathering. Methods: Patient data were collected from a regional syndromic surveillance system, medical aid stations, and an internet-based emergency department reporting system. Animal health data were collected from DC veterinary facilities. Results: Of 174 703 chief complaints from human syndromic data, there were 6 inauguration-related alerts. Inauguration attendees who visited aid stations (n = 162) and emergency departments (n = 180) most commonly reported feeling faint/dizzy (n = 29; 17.9%) and pain/cramps (n = 34;18.9%). In animals, of 533 clinical signs reported, most were gastrointestinal (n = 237; 44.5%) and occurred in canines (n = 374; 70.2%). Ten animals that presented dead on arrival were investigated; no significant threats were identified. Conclusion: Use of multiple surveillance systems allowed for near-real-time detection and monitoring of disease and injury syndromes in humans and domestic animals potentially associated with inaugural events and in local health care systems. |
| ANTIBIOTIC-RESISTANCE GENES; ANTIMICROBIAL RESISTANCE; CARBAPENEM-RESISTANCE; TREATMENT PLANTS; FOOD ANIMALS; DISSEMINATION; BACTERIA; EMERGENCE; EVOLUTION; ORIGINS | Determining the effect of wastewater treatment in water resistome is a topic of interest for water quality, mainly under re-use and One-Health perspectives. The resistome, the plasmidome, and the bacterial community composition of samples from influents and treated effluents from a wastewater treatment plant located in Northern Portugal were studied using metagenomic techniques. Wastewater treatment contributed to reduce the abundance of resistance genes and of plasmid replicons, coinciding with a decline in the number of intrinsic resistance genes from Enterobacteriaceae, as well as with a reduction in the relative abundance of Firmicutes and Proteobacteria after treatment. These taxons comprise bacterial pathogens, including those belonging to the ESKAPE group, which encompasses bacteria with the highest risk of acquiring antibiotic resistance, being the most relevant hosts of resistance genes acquired through horizontal gene transfer. Our results support that wastewater treatment efficiently removes the hosts of antibiotic resistance genes and, consequently, the harboured antibiotic resistance genes. Principal component analysis indicates that the resistome and the bacterial composition clustered together in influent samples, while did not cluster in final effluent samples. Our results suggest that wastewater treatment mitigates the environmental dissemination of urban resistome, through the removal of the hosts harbouring mobile resistance genes. |
| GROUP ALLELES; RISK; COHORT; CANCER | Background: Existing research suggests patients with blood group O are less likely to develop pancreatic ductal adenocarcinoma (PDAC) compared to those with non-O blood groups, and that survival from PDAC may be affected by ABO blood type. This study assessed survival outcomes in PDAC patients who underwent pancreatoduodenectomy (PD) in one health system. Methods: From 2010 to 2017, demographic, operative, chemotherapy and survival data for patients undergoing PD at Emory Healthcare were reviewed. Patients with blood type AB were excluded due to small sample size. The relationship between ABO blood group and survival was analyzed using Kaplan-Meier survival curves and multivariate cox proportional regression analysis. Results: Of 449 PDAC patients assessed, 204 (45.4%), 60 (13.4%) and 185 (41.2%) were blood groups A, B and O, respectively. Patients were well matched in clinicopathologic characteristics. Median survival did not differ by blood group (p = 0.82), and this relationship remained insignificant on cox regression analysis (p = 0.15). On multivariate analysis, lymph node positivity (p < 0.001) and increasing age (p = 0.001) were associated with reduced survival. Conclusion: In contrast to recent reports, this larger study found that blood group did not impact overall survival among patients undergoing PD for PDAC. |
| Mycobacterium avium; Dog; Non-tuberculous mycobacteria; Precision medicine; Cutaneous and disseminated mycobacteriosis | SUBSP HOMINISSUIS INFECTION; FREE-LIVING AMEBAS; CANINE LEPROID GRANULOMA; COMPLEX INFECTION; FORTUITUM INFECTION; BOVIS INFECTION; MOLECULAR CHARACTERIZATION; TUBERCULOSIS INFECTION; GENETIC DIVERSITY; PARATUBERCULOSIS | Purpose of Review Among the non-tuberculous mycobacteria (NTM),Mycobacterium aviumcomplex (MAC) is the leading cause of pulmonary disease in humans. Innate and acquired immunodeficiencies have been associated with an increased host susceptibility to NTM infections. The underlying mechanisms predisposing humans and dogs to MAC infections are being elucidated. Recent Findings Although MAC infection is infrequently diagnosed in dogs, a strong breed predisposition particularly for Miniature Schnauzer and Basset Hound dogs is evident. A recessively inherited defect of the adaptor protein CARD9 has recently been documented to be responsible for the increased susceptibility to MAC in the Miniature Schnauzer breed. Summary Given the zoonotic potential of a MAC-infected dog particularly to immunocompromised human patients, diseased dogs pose a public health risk. While not a reportable disease, treatment of systemic mycobacteriosis is generally not effective and discouraged in dogs. The collaborative efforts by microbiologists, veterinary clinicians, dog breeders, primary care physicians, and infectious disease specialists applying the One Health approach are therefore crucial for the best management and prevention of MAC infection. |
| Tick-borne encephalitis; Croatia; Goat milk; One health | VIRUS | In June 2019, the Croatian Institute of Public Health was informed of a cluster of patients with laboratory confirmed tick-borne encephalitis (TBE) from the Gorski Kotar region. Five of the six patients with TBE reported consuming raw (unpasteurized) goat milk in the two week period before symptom onset, and one reported a recent tick bite. To assess risk factors for infection, we selected six control individuals from among healthy family and community members, and conducted a case-control analysis. None of the cases or controls were vaccinated against TBE. Individuals with TBE (cases) had 25 (95 % CI 0.8-1410.2, p = 0.021) times higher odds of raw goat milk consumption compared to healthy controls. Milk samples from 12 goats from the implicated farm were tested for the TBE virus (TBEV) using RT PCR. TBEV RNA was not detected in the milk, but serological testing of goats and other farm animals yielded evidence of exposure to the virus: Six goats from the flock had TBEV neutralizing antibodies. Our findings suggest that the vehicle for the outbreak was raw goat milk from a single farm. Following public health advice to cease consumption of raw dairy products, no further cases have been reported. |
| Enterobacteriaceae; freshwater fish; pigs; livestock; One Health; aquaculture; antimicrobial resistance | ESCHERICHIA-COLI; ANTIMICROBIAL RESISTANCE; MULTIDRUG-RESISTANCE; RETAIL SEAFOOD; GENES; BACTERIA; DISSEMINATION; ANIMALS; FARMS; SPP. | This study identified and characterized extended-spectrum-beta-lactamase-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing Enterobacteriaceae (CPE) from farmed freshwater fish and pig offal procured from the wet markets across Hong Kong. During March 2018 to January 2019, 730 food animal samples, namely, 213 snakehead fish, 198 black carp, and 339 pig organs, were examined. ESBL-E and CPE were isolated from the homogenized samples plated on selective media and identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS). All ESBL-E and CPE strains were tested for antimicrobial susceptibilities. ESBL-E and CPE gene groups were detected by multiplex PCR and bla(CTX-M-1/-2/-9) group strains were Sanger sequenced for CTX-M types. All CPE isolates were whole-genome sequenced. Isolation of ESBL-E from pig small (52.4%) and large (50%) intestines and tongues (25.1%) was significantly (P < 0.05) more frequent than from snakehead (0.94%) and black carp (0.5%) fish. ESBL-E isolates (n = 171) revealed resistance rates of 16.3%, 29.8%, 35.6%, 53.2%, 55.0%, and 100% to piperacillin-tazobactam, amoxicillin-clavulanate, cefepime, gentamicin, ciprofloxacin, and ampicillin, respectively, whereas CPE (n = 28) were resistant to almost all the antibiotics tested except gentamicin, ciprofloxacin, and fosfomycin. The predominant ESBL gene groups in fishes and pig offals were bla(CTX), where bla(CTX-M-55) was the major subtype in the bla(CTX-M-1) group (64.4% of isolates in the group). bla(CTX-M-14/-17) was the major genotype in the bla(CTX-M-9) group (32.2%). All CPE strains possessed bla(NDM) genes. High rates of ESBL-E and CPE were identified in food animals from wet markets of Hong Kong, which may serve as a potential reservoir of antimicrobial-resistant genes and increase the challenges in tackling antimicrobial resistance beyond health care settings. IMPORTANCE Extended-spectrum-beta-lactamase-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing Enterobacteriaceae (CPE) are of global health importance, yet there is a paucity of surveillance studies on food animals in Hong Kong. Here, we report a high prevalence of ESBL-E (ranging from 0.5% to 52.4%) and CPE (0% to 9.9%) from various food animal samples procured from wet markets across Hong Kong. All CPE strains were characterized by whole-genome sequencing and possessed NDM-1 and -5 genes and other resistance determinants. Given the increased resistance profile of these strains, this study highlights the emerging threat of ESBL-E and CPE disseminated in farmed animals. Furthermore, our data enriched our understanding of antibiotic resistance reservoirs from a One Health perspective that can widely spread across various niches, beyond health care settings. |
| MOS sensor; nanowires; milk; Campylobacter spp.; GC-MS | FILM; US | Food poisoning is still the first cause of hospitalization worldwide and the most common microbial agent, Campylobacter jejuni, is the most commonly reported gastrointestinal disease in humans in the EU (European Union) as is reported by the European Union One Health 2018 Zoonoses Report styled by the EFSA (European Food Safety Authority) and ECDC (European Center for Disease Prevention and Control). One of the vehicles of transmission of this disease is milk. Nanostructured MOS (Metal Oxide Semiconductor) sensors have extensively demonstrated their ability to reveal the presence and follow the development of microbial species. The main objective of this work was to find a set up for the detection and development follow up of C. jejuni in milk samples. The work was structured in two different studies, the first one was a feasibility survey and the second one was to follow up the development of the bacteria inside milk samples. The obtained results of the first study demonstrate the ability of the sensor array to differentiate the contaminated samples from the control ones. Thanks to the second study, it has been possible to find the limit of microbial safety of the contaminated milk samples. |
| psychology of working theory; future decent work perceptions; career exploration; nursing students | CAREER DECISION-MAKING; PROACTIVE PERSONALITY; SOCIOPOLITICAL DEVELOPMENT; VOCATIONAL EXPECTATIONS; CRITICAL CONSCIOUSNESS; INITIAL VALIDATION; EXPLORATION; ADAPTABILITY; PSYCHOLOGY; CONCEPTUALIZATION | Drawing on the psychology of working theory (PWT), the present study was performed to evaluate the predictor session of the PWT and career exploration behavior with a sample of Chinese nursing college students from diverse backgrounds. The research employed a cross-sectional research design and 854 nursing students were recruited from one health vocational college situated in Northwest China. Structural equation modeling was utilized to conduct the analysis; confirmatory factor analysis and structural model testing were performed accordingly. Moreover, mediation analysis that used bias-corrected percentile bootstrapping method and moderation analysis were carried out in accordance. Overall, most of the proposed direct paths were significant, but the mediation results were mixed. Proactive personality simply moderated the impact of economic constraints on career adaptability. The results suggest that PWT is applicable to nursing college students and the model is generally supported in the Chinese context. It is the first empirical work that used this model among nursing college students and future decent work perceptions contributed another important antecedent of career exploration behavior. The practical implications based on these findings are provided as well. |
| Salmonellaserovars; antibiogram; resistant elements; virulence; biofilm | ANTIMICROBIAL RESISTANCE GENES; ESCHERICHIA-COLI; VIRULENCE FACTORS; RISK-FACTORS; PREVALENCE; ENTERICA; SWINE; SPP.; INFECTIONS; BACTERIA | The present study was carried out to characterizeSalmonellaserovars from commercial pig farms in Benin City, Nigeria. A total of 81 samples were collected from the Agricultural Development Program farms between January and June 2017. Standard culture-based and polymerase chain reaction procedures were adopted in the isolation and identification ofSalmonellaserovars. Antibiotic susceptibility profiles of the isolates were conducted using the Kirby-Bauer disc diffusion method with prominent resistance determinants screened for using specific primer sets. The 84 identifiedSalmonellaserovars include 15Salmonellaser. Enteritidis, 11Salmonellaser. Typhimurium, and 58 otherSalmonellaserovars. Phenotypic virulence factors include: hemolytic activity (51.7-100%), lipase activity (48.3-81.8%), protease activity (60.3-100%), gelatinase production (50-90.9%), DNA degrading activity (55.2-90.9%), and S-layer formation (63.8-100%). The biofilm formation profiles include nonbiofilm producers (0-12.1%), weak biofilm producers (0-20%), moderate biofilm producers (24.1-27.3%), and strong biofilm producers (48.3-72.7%).Salmonellaserovars in this study harbored resistant determinants, such astetA,tetC,ampC,sul1,sul2,sul3,floR,ermA, andermC. The occurrence of resistance phenotype and determinants in pathogenicSalmonellaserovars from pig farms is a significant public health concern, which could result in the dissemination of resistant elements within the environment. |
| Microbiome; 16S; Salutogenic; Biodiverse; One health; Urban design | SP NOV.; HUMAN HEALTH; BIODIVERSITY; FOREST; MICROBIOTA; SYSTEM; SENSITIZATION; ENVIRONMENT; SUCCESSION; BACTERIA | Exposure to biodiverse environments such as forests can benefit human well-being, and evidence suggests exposure to high microbial diversity may improve mental and immune health. However, the factors that drive microbial community assembly are poorly understood, as is the relationship between exposure to these communities and human health. We characterized airborne bacterial communities in two disparate types of urban greenspace (forest and grass) in late-spring 2017 at sites previously sampled in late-summer 2015 in Eugene-Springfield, Oregon, using high-throughput metabarcode sequencing. While all sites shared a core aerobiome in late-spring consisting of plant- and soil-associated genera, forests had significantly higher diversity than grass sites (F = 12, P = 0.004). Vegetation type explained 14% of the difference between forest and grass aerobiomes, yet individual site location explained 41% of the variation. These results were similar to but amplified over those from late summer, suggesting that both aerobiome diversity and vegetation-driven effects are higher when deciduous foliage is fresher and more active, temperatures cooler, and humidity higher. Continued exploration and hypothesis-driven research will enable development of mechanistic theory describing key drivers of urban aerobiome assembly and its relationship to human health, which, in turn, will help urban designers and planners create evidence-based salutogenic cities for future generations. |
| MERS-CoV; Dromedary camels; Seroprevalence; Saudi Arabia; Vaccine efficacy; Challenge model | RESPIRATORY SYNDROME CORONAVIRUS; DROMEDARY CAMELS; ANTIBODIES; REPLICATION | Background Middle East Respiratory Syndrome coronavirus (MERS-CoV) is an emerging virus that infects humans and camels with no approved antiviral therapy or vaccine. Some vaccines are in development for camels as a one-health intervention where vaccinating camels is proposed to reduce human viral exposure. This intervention will require an understanding of the prior exposure of camels to the virus and appropriate vaccine efficacy studies in camels. Methods We conducted a cross sectional seroprevalence study in young dromedary camels to determine the rate of MERS-CoV seropositivity in young camels. Next, we utilised naturally infected camels as a natural challenge model that can be used by co-housing these camels with healthy naive camels in a ratio of 1 to 2. This model is aimed to support studies on natural virus transmission as well as evaluating drug and vaccine efficacy. Results We found that 90% of the screened camels have pre-existing antibodies for MERS-CoV. In addition, the challenge model resulted in MERS-CoV transmission within 48 h with infections that continued for 14 days post challenge. Conclusions Our finding suggests that the majority of young dromedary camels in Saudi Arabia are seropositive and that naturally infected camels can serve as a challenge model to assess transmission, therapeutics, and vaccine efficacy. |
| COXIELLA-BURNETII DNA; DAIRY GOAT; SHEEP; OUTBREAK; HISTORY; SAMPLES | Between 2007 and 2010 a Q fever epidemic in Dutch dairy goat farms caused a large Q fever outbreak in human residents in the southern part of the Netherlands. Here we characterize the transmission of Coxiella burnetii, the aetiological agent of Q fever, between infected and susceptible dairy goat farms by estimating a spatial transmission kernel. In addition, we characterize the zoonotic transmission of C. burnetii by estimating the spatial kernel for transmission from infected farms to neighbouring residents. Whereas the range of between-farm transmission is comparable to the scale of the Netherlands, likely due to long-range between-farm contacts such as animal transport, the transmission risk from farms to humans is more localized, although still extending to 10 km and beyond. Within a range of about 10 km, the transmission risk from an infected goat farm to a single resident is of the same order of magnitude as the farm-to-farm transmission risk per animal in a receiving farm. We illustrate how, based on the estimated kernels, spatial patterns of transmission risks between farms and from farms to residents can be calculated and visualized by means of risk maps, offering further insight relevant to policy making in a one-health context. |
| one-health concept; anthrax; zoonotic diseases; veterinary diseases; stakeholders | CUTANEOUS ANTHRAX; VACCINE | The prevalence and outbreaks of anthrax are interlinked with the animal-environment-human context, which signifies the need for collaborative, trans-disciplinary and multi-sectoral approaches for the prevention and control of anthrax. In India, there are hardly any shreds of evidence on the role of various stakeholders’ on anthrax prevention and control. Therefore, this study addressed the experiences of various stakeholders on anthrax prevention and control strategies in Odisha, India. A qualitative explorative study was carried out using 42 in-depth-interviews among the stakeholders from health, veterinary and general administrative departments from the block, district, and state level. Two major themes emerged: (1) Epidemiological investigation of anthrax in Odisha, India, and (2) Biological and social prevention strategies for anthrax in Odisha, India. The study emphasizes setting up the surveillance system as per standard guideline, and strengthening the diagnostic facility at a regional medical college laboratory to avoid delay. Moreover, it emphasizes step-up inter-sectoral co-ordination, collaboration and sensitization among health, veterinary, forestry, education, nutrition and tribal welfare departments at all levels in order to reduce the prevalence and control the outbreaks of anthrax in Odisha state. It also recommends raising community literacy, in particular on safe carcass disposal, changing behavior on dead-livestock consumption, and compliance with livestock vaccinations. |
| bovine tuberculosis; awareness; Mpumalanga; surveillance; zoonosis | MYCOBACTERIUM-BOVIS; ZOONOTIC TUBERCULOSIS; LIVESTOCK; DISEASE | Tuberculosis (TB) is a global health concern of zoonotic importance, and Mycobacterium bovis and Mycobacterium tuberculosis are the most common causes of TB in animals and humans, respectively. Integral to TB control strategies are the communities affected by this epidemic. Tuberculosis awareness by the community is an effective TB control strategy as education empowers people to make informed choices with regard to mitigating TB risk factors in their daily lives. We conducted a knowledge, attitude and perceptions survey in Mnisi pastoral community in South Africa using a semi-structured questionnaire to evaluate the level of bovine TB (bTB) awareness, and provided informed feedback to the community on the outcome of the study. Although participants were aware of TB, the knowledge of the zoonotic potential of bTB and about susceptible hosts was limited. The study findings showed knowledge gaps regarding common risk factors, including coughing while herding cattle, unsupervised/uninspected communal slaughter and improper disposal of infected meat. In contrast, it was noted that the majority of participants discarded meat with visible lesions and consumed pasteurised milk; thus, the risk of TB transmission via the ingestion route is low. Tuberculosis knowledge gaps were evident in the community, and public health and veterinary authorities need to improve relationships with stakeholders and implement awareness programmes that use a one health approach. |
| KLEBSIELLA-PNEUMONIAE; ANTIMICROBIAL RESISTANCE; FOOD ANIMALS; MOLECULAR EPIDEMIOLOGY; INCREASING PREVALENCE; IRRIGATION WATER; COMMUNITY-ONSET; E.-COLI; ENTEROBACTERIACEAE; EMERGENCE | The increasing prevalence of oxyimino-cephalosporin-resistant Enterobacteriaceae has become a global concern because of their clinical impact on both human and veterinary medicine. The present study determined the prevalence, antimicrobial susceptibility, and molecular genetic features of extended-spectrum beta -lactamase (ESBL)-producing Escherichia coli (ESBL-EC) isolates from raw vegetables. A total of 1324 samples were collected from two agricultural wholesale markets in Incheon, South Korea in 2018. The ESBL-EC strains were isolated from 0.83% (11/1324) samples, and all of them were resistant to ampicillin, piperacillin, cefazoline, cefotaxime, and nalidixic acid and yielded CTX-M-type ESBL, including CTX-M-14, CTX-M-15, CTX-M-55, CTX-M-27, and CTX-M-65. The isolates belonged to phylogenetic subgroups D (n=5), A (n=4), and B1 (n=2). Multilocus sequence typing revealed nine known E. coli sequence types (STs), including ST10, ST38, ST69, ST101, ST224, ST349, ST354, ST2509, ST2847, and two new STs. Notably, ST69, ST10, ST38, and ST354 belong to the major human-associated extraintestinal pathogenic E. coli lineages. Our results demonstrate that ESBL-producing multidrug-resistant pathogens may be transmitted to humans through the vegetable intake, highlighting the importance of resistance monitoring and intervention in the One Health perspective. |
| bacteria; Asian dust storm; dust-generating sources region; Gobi Desert; field and laboratory experimental method | MICROBIAL COMMUNITY STRUCTURE; ASIAN DUST; SIZE DISTRIBUTION; PARTICLES; SOIL; MICROORGANISMS; DESERT; BIOAEROSOLS; EVENTS; HEALTH | The Gobi Desert is a major source of dust events, whose frequency of occurrence and damage caused have recently significantly increased. In the present study, we investigated the types of live bacteria present in the surface soil of the Gobi Desert in Mongolia, and determined their genetic identification as well as their geographical distribution. During the survey, four different topographies (dry lake bed, wadi, well, and desert steppe) were selected, and land characteristics were monitored for moisture and temperature. The surface soil was aerobically cultured to isolate bacterial colonies, and their 16s rDNA regions were sequenced. The sequence data were identified through NCBI-BLAST analysis and generated phylogenetic trees. The results revealed two phyla and seven families of isolates from the sample points. Each isolate was characterized by their corresponding sample site. The characteristics of land use and soil surface bacteria were compared. Most of the bacteria originated from the soil, however, animal-derived bacteria were also confirmed in areas used by animals. Our findings confirmed the existence of live bacteria in the dust-generating area, suggesting that their presence could affect animal and human health. Therefore, it is necessary to further investigate dust microbes based on the One Health concept. |
| Musculoskeletal system; Surgical procedures; Cemented arthroplasty; Uncemented arthroplasty; Outcomes; Metastatic disease | FEMORAL-NECK; SURGICAL-MANAGEMENT; METASTATIC-DISEASE; HEMIARTHROPLASTY; FRACTURE; FEMUR | Background and objectives: Cemented hip arthroplasty is considered the standard of care for treating both osteoporotic femoral neck fractures and pathologic disease of the proximal femur due to the ability to achieve strong fixation in poor quality bone. There is minimal literature evaluating uncemented arthroplasty for pathologic disease of the proximal femur. This objective of this study is to compare outcomes of patients under going cemented and uncemented arthroplasty of the proximal femur for an oncologic indication. Methods: Patients who underwent hip arthroplasty procedures in one health system for an oncologic indication were identified. Demographics, cancer history, operative history, and complications were collected retrospectively. Harris Hip Scores (HHS) and Musculoskeletal Tumor Society Scores (MSTS) were prospectively collected via telephone. Results: 41 patients met criteria for review. 18 underwent cemented and 23 underwent uncemented arthroplasty. There were no significant differences in age, demographics, complications, 30-day mortality, intraoperative blood loss, transfusion requirements, average HHS, or average MSTS. Conclusion: No significant differences were found for patients undergoing hip arthroplasty for an oncologic indication regardless of whether or not the femoral component was cemented. Our results suggest that cemented and uncemented techniques are both safe and effective methods to be used at the oncologic surgeon’s discretion. |
| bedridden; long-term care; multi-state modelling; elderly; Thailand | CARE; MODELS | The objective of this study is to predict the volume of the elderly in different health status categories in Thailand in the next ten years (2020-2030). Multistate modelling was performed. We defined four states of elderly patients (aged >= 60 years) according to four different levels of Activities of Daily Living (ADL): social group; home group; bedridden group; and dead group. The volume of newcomers was projected by trend extrapolation methods with exponential growth. The transition probabilities from one state to another was obtained by literature review and model optimization. The mortality rate was obtained by literature review. Sensitivity analysis was conducted. By 2030, the number of social, home, and bedridden groups was 15,593,054, 321,511, and 152,749, respectively. The model prediction error was 1.75%. Sensitivity analysis with the change of transition probabilities by 20% caused the number of bedridden patients to vary from between 150,249 and 155,596. In conclusion, the number of bedridden elders will reach 153,000 in the next decade (3 times larger than the status quo). Policy makers may consider using this finding as an input for future resource planning and allocation. Further studies should be conducted to identify the parameters that better reflect the transition of people from one health state to another. |
| Asthma; Chronic obstructive pulmonary; Inhalers; Education; Nursing | HEALTH LITERACY; ASTHMA; MANAGEMENT; ADULTS | Objectives: This study compared the effects of a tailored inhaler use education program with routine clinical practice in asthma and chronic obstructive pulmonary disease patients treated with inhalers. Methods: The participants included 59 patients from a >= 900-bed university hospital in J city. Participants were divided into two groups and received either the tailored inhaler use education program (n = 29) or routine clinical care (n = 30). Disease knowledge and correct inhaler use were assessed using a questionnaire and observational checklists at admission and discharge. Chi-square and Mann-Whitney U tests were used for data analysis. Results: Disease knowledge (asthmaz = -2.69, p = .007; chronic obstructive pulmonary disease z = -6.08, p < .001) and correct inhaler use (z = -5.51, p < .001) were significantly higher in the tailored inhaler use education program group compared to the control group. Conclusions: Nurses play a pivotal role in educating patients. Our results indicate that nurses are needed to identify diseases and inhaler types and to provide patients with individually tailored education that includes demonstration and feedback. Practice implications: One-on-one health literacy education tailored to inhaler type and patient age shows promise for chronic disease interventions provided by nurses, physicians, and pharmacists-all the parties involved in patient care. (C) 2020 Elsevier B.V. All rights reserved. |
| Avian influenza; Human infection; Avian influenza virus; A (H9N2); Poultry | A H7N9 VIRUSES; INTERNAL GENOMES; EVOLUTION; POULTRY; GENOTYPE; OUTBREAK; TRANSMISSION; ORIGIN; GENES | H9N2 viruses can cause great economic losses to the domestic poultry industry when co-infected with other influenza viruses or pathogens.. To better understand the molecular characteristics of H9N2 avian influenza viruses (ATVs) and analyze the genetic evolutionary relationship, we isolated three H9N2 subtypes ATVs from nasopharyngeal swab specimens from the three cases reported in Anhui province since 2015, and systematically reviewed the genome-wide data of 21 poultry-isolated H9N2 viruses during 1998-2017. The six internal genes of three human-isolated viruses and recent poultry-isolated viruses (since 2014) in Anhui province presented high gene homologies with HPAI H7N9, even including H10N8 and H5N6. The three human-isolated H9N2 AIVs and poultry-isolated viruses (since 2008) in Anhui province were highly similar, and classified into genotype S. Seven N-linked potential glycosylation sites in the HA protein were detected in the three human-isolated viruses, which also appeared in poultry-isolated H9N2 AIVs. None of the human-isolated H9N2 AIVs had the I368V mutation in PB1 protein, but all the poultry-isolated H9N2 viruses in 2017 carried this mutation. Multidisciplinary, cross-regional and cross-sectoral approaches are warranted to address complex public health challenges and achieve the goal of ‘one health’. |
| conservation; CoV; COVID-19; emerging infectious diseases; One Health | RESPIRATORY SYNDROME CORONAVIRUS; SARS-COV; BETACORONAVIRUS; PNEUMONIA; OUTBREAK | The novelSARS-CoV-2coronavirus has attracted attention due to the high number of human cases around the world. It has been proposed that this virus originated in bats, possibly transmitted to humans by an intermediate host, making bats a group of great interest during this outbreak. Almost 10% of the world’s bat species inhabit Mexico, and 14 previous novel CoVs have been recorded in Mexican bats. However, the phylogenetic relationships between these viruses and the novel coronavirus are unknown. The aim of this communication was therefore to describe the phylogenetic relationships between Mexican bat-CoVs andSARS-CoV-2. We showed that Mexican bat-CoVs sequences are grouped into two genera,AlphacoronavirusandBetacoronavirus, and the new coronavirus is an independent clade withinBetacoronavirus. Due to the diversity of CoVs in Mexican bats, the propensity of CoVs to shift hosts, the invasion mechanisms described for this new virus, and previous reports of animals infected bySARS-CoV-2, the risk of possible infection from humans to Mexican bats should not be discarded and warrants further analyses. To avoid future zoonotic infectious diseases and to limit persecution of bats, we urge researchers and the general population to take extreme precautions and avoid manipulation of bats during the current and future similar outbreaks. |
| staphylococci; zoonosis; MRSA; bacteriophage; MRSP | FUSIDIC ACID; AUREUS; PSEUDINTERMEDIUS | Transmission of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus pseudintermedius (MRSP) between people and pets, and their co-carriage, are well-described. Potential exchange of antimicrobial resistance (AMR) genes amongst these staphylococci was investigated in vitro through endogenous bacteriophage-mediated transduction. Bacteriophages were UV-induced from seven donor isolates of canine (MRSP) and human (MRSA) origin, containing tet(M), tet(K), fusB or fusC, and lysates filtered. Twenty-seven tetracycline- and fusidic acid- (FA-) susceptible recipients were used in 122 donor-recipient combinations (22 tetracycline, 100 FA) across 415 assays (115 tetracycline, 300 FA). Bacteriophage lysates were incubated with recipients and presumed transductants quantified on antimicrobial-supplemented agar plates. Tetracycline resistance transduction from MRSP and MRSA to methicillin-susceptible S. pseudintermedius (MSSP) was confirmed by PCR in 15/115 assays. No FA-resistance transfer occurred, confirmed by negative fusB/fusC PCR, but colonies resulting from FA assays had high MICs (>= 32 mg/L) and showed mutations in fusA, two at a novel position (F88L), nine at H457[Y/N/L]. Horizontal gene transfer of tetracycline-resistance confirms that resistance genes can be shared between coagulase-positive staphylococci from different hosts. Cross-species AMR transmission highlights the importance of good antimicrobial stewardship across humans and veterinary species to support One Health. |
| INFLUENZA-A VIRUS; ONE HEALTH; SEASONAL-VARIATION; EXPOSURE; CITY | The goal of this study was to compare the microbiota in different pig-present settings in China. Bioaerosol samples from pig farms and slaughterhouses and nasal samples from pig farmers and slaughterhouse workers were collected in Guangdong, southern China. The bacterial genomic DNA was isolated and subjected to 16S sequencing. The data were analyzed using QIIME2 with the DADA2 pipeline. A total of 14,923,551 clean reads and 2785 operational taxonomic units (OTUs) were obtained, which were mostly grouped into 4 phyla (Proteobacteria,Bacteroidetes,Firmicutes,andActinobacteria) and 220 families. The microbiota richness of nasal samples in pig-present workers was higher than that of bioaerosols collected in the vicinity of the pig enclosures. There were 31.7% (620/1954) shared OTUs between pig farm bioaerosols and pig farmers which was higher than that between pig slaughterhouses and slaughterhouse workers (23.4%, 364/1553) (p < 0.001).AcinetobacterandPseudomonaswere the most abundant in pig-present bioaerosols, andStaphylococcus,Pseudomonas,andCorynebacteriumwere dominant bacterial genus in pig farmers. The bacterial patterns are also specific to the location of sample collected. The results suggest that bioaerosol microbiota interact with human nasal microbes in the vicinity of the pig farm enclosures, providing the basis for further analysis of microbial transmission across hosts in pig-present settings. |
| antibiotics; bacterial resistance; one health; MALDI-TOF MS; biomarkers | SPECTRUM BETA-LACTAMASES; CTX-M; RESISTANCE; PROTEOMICS; TIME; DISCRIMINATION; MECHANISMS; VARIANTS; STRAINS; SPP. | The commensal bacteria Escherichia coli causes several intestinal and extra-intestinal diseases, since it has virulence factors that interfere in important cellular processes. These bacteria also have a great capacity to spread the resistance genes, sometimes to phylogenetically distant bacteria, which poses an additional threat to public health worldwide. Here, we aimed to use the analytical potential of MALDI-TOF mass spectrometry (MS) to characterize E. coli isolates and identify proteins associated closely with antibiotic resistance. Thirty strains of extended-spectrum beta-lactamase producing E. coli were sampled from various animals. The phenotypes of antibiotic resistance were determined according to Clinical and Laboratory Standards Institute (CLSI) methods, and they showed that all bacterial isolates were multi-resistant to trimethoprim-sulfamethoxazole, tetracycline, and ampicillin. To identify peptides characteristic of resistance to particular antibiotics, each strain was grown in the presence or absence of the different antibiotics, and then proteins were extracted from the cells. The protein fingerprints of the samples were determined by MALDI-TOF MS in linear mode over a mass range of 2 to 20 kDa. The spectra obtained were compared by using the ClinProTools bioinformatics software, using three machine learning classification algorithms. A putative species biomarker was also detected at a peak m/z of 4528.00. |
| Terpenes; antimicrobial; synergism; perillaldehyde; One Health | OREGANO ESSENTIAL OIL; ANTIBACTERIAL ACTIVITY; ANTIBIOTICS | Resistant bacterial infections represent one of the major threats in worldwide health services. In this scenario, plant essential oils are considered promising antimicrobial agents. Therefore, this study aimed to evaluate the antimicrobial potential of Pectis substriata essential oil alone and in combination with antibiotics, against clinical drug-resistant bacterial strains. The essential oil from the plant aerial parts was obtained by hydrodistillation. Antimicrobial activity was assessed against standard and clinical bacterial strains by broth microdilution method, and the synergistic effect was evaluated by checkerboard microtiter assay. The oil alone showed significant activity against clinical Staphylococcus warned (62.5 mu g.ml(-1)), and was moderately active on Staphylococcus aureus (standard strain) and clinical Staphylococcus intermedius (125 and 250 mu g.ml(-1),respectively). Synergism was achieved for the combinations of essential oil and ampicillin on S. warneri and of oil and kanamycin on S. intermedius. Additive effects were also observed. This is the first report of the chemical composition of P. substriata essential oil, and the results revealed the presence of compounds with proven antimicrobial activity. The oil proved active against resistant Gram-positive cocci, and showed synergism with antibiotics, revealing its potential use as adjuvant or in the development of new alternative treatments of drug-resistant antimicrobial infections. |
| cross-species transmission; zoonotic disease risk; machine learning; one health; big data; pathogen spillover | INFECTIOUS-DISEASES; HOST-SPECIFICITY; CENTRALITY; RISK; RANGE | Diseases that spread to humans from animals, zoonoses, pose major threats to human health. Identifying animal reservoirs of zoonoses and predicting future outbreaks are increasingly important to human health and well-being and economic stability, particularly where research and resources are limited. Here, we integrate complex networks and machine learning approaches to develop a new approach to identifying reservoirs. An exhaustive dataset of mammal-pathogen interactions was transformed into networks where hosts are linked via their shared pathogens. We present a methodology for identifying important and influential hosts in these networks. Ensemble models linking network characteristics with phylogeny and life-history traits are then employed to predict those key hosts and quantify the roles they undertake in pathogen transmission. Our models reveal drivers explaining host importance and demonstrate how these drivers vary by pathogen taxa. Host importance is further integrated into ensemble models to predict reservoirs of zoonoses of various pathogen taxa and quantify the extent of pathogen sharing between humans and mammals. We establish predictors of reservoirs of zoonoses, showcasing host influence to be a key factor in determining these reservoirs. Finally, we provide new insight into the determinants of zoonosis-sharing, and contrast these determinants across major pathogen taxa. |
| island; genotyping; one health; reservoir; Salmonella enterica; Salvator merianae | TUPINAMBIS-MERIANAE; REPTILES; PREVALENCE; SUSCEPTIBILITY; SEROVARS; SAMPLES; SPP. | Salmonella infection can pose serious health issues, especially to children, elders or immunosuppressed humans. Wild populations of reptiles can reach Salmonella prevalence of up to 100% and the direct or indirect transmission from reptiles to humans have been extensively reported. Fernando de Noronha (FN) is an inhabited oceanic archipelago in the northeast coast of Brazil, with an economy based on tourism. The tegu (Salvator merianae) is the largest lizard native to South America and was introduced to the archipelago in the early 20th century. This study determines the prevalence, serotypes, antimicrobial resistance, and molecular epidemiology of Salmonella enterica in the tegu population from FN archipelago. Results show that S. enterica is widely distributed in the FN tegu population, with 43.8% prevalence. The bacteria were isolated from 70.5% of the sampled sites and a total of 15 serotypes were detected in 98 S. enterica isolates. Strains were further classified into 31 genotypes. Recaptured animals presented distinct genotypes in each season, demonstrating a seasonal strain turnover. Most S. enterica isolates from FN tegus presented low antimicrobial resistance. This is possibly due to geographical isolation of the island population, hampering contact with strains from livestock from the continent, where antimicrobial resistance is common. |
| antibiotic resistance; genomics; E; coli; poultry; global health | URINARY-TRACT-INFECTIONS; GENETIC DIVERSITY; POULTRY; IMMUNOSUPPRESSION; STRAINS; PROFILE; TOOL | Poultry husbandry is important for the economic health of Pakistan, but the Pakistani poultry industry is negatively impacted by infections from Escherichia coli. We performed Illumina whole genome sequencing on 92 E. coli isolates obtained from the livers of deceased chickens originating in five Pakistani geographical regions. Our analysis indicates that the isolates are predominantly from the B1 and A clade and harbor a diverse number of antibiotic resistance and virulence genes, with no linkage between phylogeny and antibiotic resistance gene presence but some association between phylogeny and virulence gene and SNP presence for the B1 and E phylogroups. The colistin resistance gene mcr-1 and the quinolone resistance gene qnrS1 were both found in 13/92 isolates. Alarmingly, 82/92 of the E. coli strains characterized in this study are multidrug resistant with 100% (92/92) resistance to lincomycin, 81.5% (75/92) to streptomycin, 79.3% (73/92) to ampicillin and 66.3% (61/92) to ciprofloxacin. These results provide a high-resolution analysis of poultry-associated E. coli isolates in an area with a high endemic burden of antibiotic resistance. Surveillance of antibiotic resistance in poultry associated E. coli isolates is an important pillar of the One Health concept to integrate analysis of potential pathogens in human, animal, and environmental niches. |
| antimicrobial resistance; integrative conjugative element; integrons; oyster; Vibrio parahaemolyticus; virulence gene | CLASS 1 INTEGRONS; ANTIBIOTIC-RESISTANCE; QUINOLONE RESISTANCE; PREVALENCE; PLASMID; STRAINS; CONTAMINATION; SHELLFISH; PROFILES; IDENTIFICATION | A total of 594 Vibrio parahaemolyticus isolates from cultivated oysters (n = 361) and estuarine water (n = 233) were examined for antimicrobial resistance (AMR) phenotype and genotype and virulence genes. Four hundred forty isolates (74.1%) exhibited resistance to at least one antimicrobial agent and 13.5% of the isolates were multidrug-resistant strains. Most of the V. parahaemolyticus isolates were resistant to erythromycin (54.2%), followed by sulfamethoxazole (34.7%) and trimethoprim (27.9%). The most common resistance genes were qnr (77.8%), strB (27.4%) and tet(A) (22.1%), whereas bla(TEM) (0.8%) was rarely found. Four isolates (0.7%) from oysters (n = 2) and estuarine water (n = 2) were positive to tdh, whereas no trh-positive isolates were observed. Significantly positive associations among AMR genes were observed. The SXT elements and class 1, 2 and 3 integrons were absent in all isolates. The results indicated that V. parahaemolyticus isolates from oysters and estuarine water were potential reservoirs of resistance determinants in the environment. This increasing threat of resistant bacteria in the environment potentially affects human health. A ‘One Health’ approach involved in multidisciplinary collaborations must be implemented to effectively manage antimicrobial resistance. |
| companion animals; ESBL; goats; Klebsiella; sheep | CTX-M-15-PRODUCING KLEBSIELLA-PNEUMONIAE; LACTAMASE-PRODUCING ENTEROBACTERIACEAE; EXTENDED-SPECTRUM; ESCHERICHIA-COLI; BETA-LACTAMASE; ANTIMICROBIAL RESISTANCE; DOGS; INFECTION; HEALTHY; GENES | Antimicrobial resistance is a global emergency which needs one health approach to address. The present study was conducted to detect the prevalence of beta-lactamase and biofilm-producingKlebsiellastrains in rectal swabs (n = 624) collected from healthy dogs, cats, sheep and goats reared as companion or household animals in India. The dogs and cats were frequently exposed to third- or fourth-generation cephalosporins for therapy. The sheep and goats were occasionally exposed to antibiotics and had environmental exposure. Phenotypical ESBL (n = 93) and ACBL (n = 88)-producingKlebsiellawere isolated significantly more (P < 0 center dot 05) from companion animals than household animals. Majority of theKlebsiellapossessedbla(CTX-M-15). The sequencesbla(CTX-M-15.2),bla(CTX-M-197)andbla(CTX-M-225)are reported first time from the companion animals. All ACBL-producing isolates possessedbla(AmpC). The present study detected 65 center dot 8% ofKlebsiellastrains as biofilm producers possessing the studied biofilm associated genes. The isolates showed phenotypical resistance against chloramphenicol, tetracycline, doxycycline, co-trimoxazole, ampicillin, cefotaxime/clavulanic acid. The present study showed that companion and household animals (dogs, cats, sheep, goats) may act as a carrier of ESBL/biofilm-producing, multi-drug resistant, high-risk clonal lineage ofKlebsiella. |
| genomics; Aeromonas veronii; intensive pig farming; abattoir; antibiotics; mobile genetic elements; global phylogeny | INSERTION SEQUENCES; HYDROPHILA; SPP.; GENE; FOOD; IDENTIFICATION; PATHOGENICITY; DIVERSITY; SECRETION; CLUSTERS | The pathogenomics of carbapenem-resistant Aeromonas veronii (A. veronii) isolates recovered from pigs in KwaZulu-Natal, South Africa, was explored by whole genome sequencing on the Illumina MiSeq platform. Genomic functional annotation revealed a vast array of similar central networks (metabolic, cellular, and biochemical). The pan-genome analysis showed that the isolates formed a total of 4349 orthologous gene clusters, 4296 of which were shared; no unique clusters were observed. All the isolates had similar resistance phenotypes, which corroborated their chromosomally mediated resistome (bla(CPHA)(3) and bla(OXA-)(12)) and belonged to a novel sequence type, ST657 (a satellite clone). Isolates in the same sub-clades clustered according to their clonal lineages and host. Mobilome analysis revealed the presence of chromosome-borne insertion sequence families. The estimated pathogenicity score (P-score approximate to 0.60) indicated their potential pathogenicity in humans. Furthermore, these isolates carried several virulence factors (adherence factors, toxins, and immune evasion), in different permutations and combinations, indicating a differential ability to establish infection. Phylogenomic and metadata analyses revealed a predilection for water environments and aquatic animals, with more recent reports in humans and food animals across geographies, making A. veronii a potential One Health indicator bacterium. |
| antimicrobial resistance; Campylobacter jejuni; Campylobacter hyointestinalis; cattle; cgMLST; whole‐ genome sequencing | ANTIMICROBIAL RESISTANCE; JEJUNI; CATTLE; FLUOROQUINOLONE; SUSCEPTIBILITY; CONFIRMATION; ATTRIBUTION; PREVALENCE; PROFILES; OUTBREAK | Aims Cattle are the second most important cause of human campylobacteriosis, after poultry, but there are knowledge gaps regarding Campylobacter in cattle. This study examined the occurrence of Campylobacter, the species present, sequence types and antibiotic resistance in Swedish cattle. Methods and Results Faeces samples collected from 154 calves on seven Swedish farms, and 69 follow-up samples from a second collection occasion, were analysed. Campylobacter were isolated from 77% of calves at the first sampling, with Campylobacter jejuni as the most frequently isolated species. Animals kept on deep straw bedding were less likely to be colonized with Campylobacter. Whole-genome sequencing of 90 C. jejuni samples resulted in 11 sequence types, among which ST-19 and ST-21 were most frequent. Antimicrobial resistance analyses showed that 46% of 142 isolates analysed were resistant to quinolones, while all isolates belonging to ST-19, ST-22 and ST-441 were resistant to ciprofloxacin and nalidixic acid. Conclusions Campylobacter jejuni was the species most frequently isolated in calves and a strong association was found between sequence type and antimicrobial resistance pattern. Significance and Impact of the Study The high proportion of calves with quinolone-resistant Campylobacter jejuni should be considered in a One Health perspective. |
| Foodbome parasite; Climate change; Globalization; Food animal; Wild animal; Population growth | MEAT-PRODUCTS; CANIS-AUREUS; TRICHINELLA; FOOD; INFECTION; TRENDS; IMPACT; OPISTHORCHIASIS; URBANIZATION; EPIDEMIOLOGY | Foodbome parasites, most of which are zoonotic, represent an important human health hazard. These pathogens which include both protozoa (e.g., Cryptosporidium spp., Cyclospora cayetanensis, Toxoplasma gondii) and helminths (e.g., liver and intestinal flukes, Fasciola spp., Paragonimus spp., Echinococcus spp., Taenia spp., Angiostrongylus spp., Anisakis spp., Ascaris spp., Capillaria spp., Toxocara spp., Trichinella spp., Trichostrongylus spp.), have accompanied the human species since its origin and their spread has often increased due to their behavior. Since both domesticated and wild animals play an important role as reservoirs of these pathogens the increase/decrease of their biomasses, migration, and passive introduction by humans can change their epidemiological patterns. It follows that globalization and climate change will have a tremendous impact on these pathogens modifying their epidemiological patterns and ecosystems due to the changes of biotic and abiotic parameters. The consequences of these changes on foodborne parasites cannot be foreseen as a whole due to their complexity, but it is important that biologists, epidemiologists, physicians and veterinarians evaluate/address the problem within a one health approach. This opinion, based on the author’s experience of over 40 years in the parasitology field, takes into consideration the direct and indirect effects on the transmission of foodborne parasites to humans. |
| MYCOBACTERIUM-BOVIS; PUBLIC-HEALTH; KAFUE BASIN; INFECTION; ARUSHA; AREAS | Author summary Bovine tuberculosis (bTB) is a respiratory disease of cattle that is transmitted to other animals as well as humans (zoonotic TB) through direct contact with infected animals, and consumption of contaminated food (animal products) or water. The study explains the complexities of human-animal relations, reflects on how people understand and conceptualize risk of bovine tuberculosis (bTB) in an endemic area considering the economic value of livestock keeping as well as social and cultural practices of importance to the community. The results of this study identified socio-cultural practices that involved consumption of raw or undercooked animal products and handling of infected animal products during animal slaughter as major risky practices for bTB transmission to people. Introduction of animals into a herd without bTB testing for socio-cultural purposes and sharing of resources amongst the communal herd and with wildlife were identified as risky practices for bTB transmission to cattle. The findings of this study illustrate the need for a One Health strategy that develops appropriate public health policy and related education campaigns for the community as control of zoonotic TB in people depends on the successful control of bovine TB in cattle. Bovine tuberculosis (bTB) is a disease of cattle that is transmitted through direct contact with an infected animal or ingestion of contaminated food or water. This study seeks to explore the local knowledge on bTB, obtain information on social and cultural practices regarding risk of bTB transmission to cattle and humans (zoonotic TB) in a traditional livestock farming community with a history of bTB diagnosis in cattle and wildlife. Information was collected using a qualitative approach of Focus Group Discussions (FGDs) targeting household members of livestock farmers that owned bTB tested herds. We conducted fourteen FGDs (150 individuals) across four dip tanks that included the following categories of participants from cattle owning households: head of households, herdsmen, dip tank committee members and women. The qualitative data was managed using NVivo Version 12 Pro software. Social and cultural practices were identified as major risky practices for bTB transmission to people, such as the consumption of undercooked meat, consumption of soured /raw milk and lack of protective measures during slaughtering of cattle. The acceptance of animals into a herd without bTB pre-movement testing following traditional practices (e.g. lobola, ‘bride price’, the temporary introduction of a bull for ‘breeding’), the sharing of grazing and watering points amongst the herds and with wildlife were identified as risky practices for M. bovis infection transmission to cattle. Overall, knowledge of bTB in cattle and modes of transmission to people and livestock was found to be high. However, the community was still involved in risky practices that expose people and cattle to bovine TB. An inter-disciplinary ‘One Health’ approach that engages the community is recommended, to provide locally relevant interventions that allows the community to keep their traditional practices and socio-economic systems whilst avoiding disease transmission to cattle and people. |
| chikungunya; Republic of Congo; outbreak; Aedes spp; mosquito; arbovirus; ONE-HEALTH | VIRUS; ALIGNMENT; DENGUE; FEVER | The Republic of Congo (RoC) declared a chikungunya (CHIK) outbreak on 9 February 2019. We conducted a ONE-Human-Animal HEALTH epidemiological, virological and entomological investigation. Methods: We collected national surveillance and epidemiological data. CHIK diagnosis was based on RT-PCR and CHIKV-specific antibodies. Full CHIKV genome sequences were obtained by Sanger and MinION approaches and Bayesian tree phylogenetic analysis was performed. Mosquito larvae and 215 adult mosquitoes were collected in different villages of Kouilou and Pointe-Noire districts and estimates ofAedes (Ae.)mosquitos’ CHIKV-infectious bites obtained. We found two new CHIKV sequences of the East/Central/South African (ECSA) lineage, clustering with the recent enzootic sub-clade 2, showing the A226V mutation. The RoC 2019 CHIKV strain has two novel mutations, E2-T126M and E2-H351N. Phylogenetic suggests a common origin from 2016 Angola strain, from which it diverged around 1989 (95% HPD 1985-1994). The infectious bite pattern was similar for 2017, 2018 and early 2019. OneAe. albopictuspool was RT-PCR positive. The 2019 RoC CHIKV strain seems to be recently introduced or be endemic in sylvatic cycle. Distinct from the contemporary Indian CHIKV isolates and in contrast to the original Central-African strains (transmitted byAe. aegypti), it carries the A226V mutation, indicating an independent adaptive mutation in response to vector replacement (Ae. albopictusvsAe. aegypti). |
| DOLUTEGRAVIR | Background While the scale-up of HIV services has improved national health management information systems (HMIS), there remain challenges in using routine data to guide the introduction of optimized antiretroviral (ARV) drugs. Methods Building on the recent enhancements to the HMIS in Kenya and coinciding with the introduction of a new ARV regimen, tenofovir+lamivudine+dolutegravir (TLD), we developed and implemented an enhanced data system (EDS) to improve availability of safety and efficacy data among people living with HIV (PLHIV) in Kenya. Using data from one health facility, we showcase how the EDS can be used to monitor ARV transition and identify missed opportunities to transition eligible patients to optimized regimes. Results The EDS was designed to create a comprehensive PLHIV database by triangulating patient-level data from the EMR, the pharmacy ARV dispensing tool (ADT) and HIV viral load (VL) databases. On a monthly basis, the database is de-identified and uploaded into a national data warehouse, with interactive dashboards. Using the EDS, we determined that of the 5,500 PLHIV.15 years on first-line ART at one facility, 4,233 (77%) had transitioned to optimized ARVs. Of the 1,267 still on legacy regimens, 459 (36%) were determined to be eligible and prioritized to switch. Conclusions This project illustrates how enhancements to the national HMIS can facilitate the use of routine patient-level data to monitor the transition to new ARVs and inform the national HIV response. |
| paediatrics; quality in health care; qualitative research | HEALTH-SERVICE DELIVERY; CEREBRAL-PALSY; CHILDREN; PARENTS; GAIT | Objective To understand parent journeys while navigating diagnosis, assessment or treatment of their children with idiopathic toe walking (ITW). Design Mixed methods qualitative study: analyses of survey data from the measure of processes of care-20 (MPOC-20) and semistructured interviews were analysed with an interpretative phenomenological analysis approach. Trustworthiness of data was achieved through member checking, researcher triangulation, reflexivity and transferability and comparison with the MPOC-20 results. Setting USA and Australia. Participants Parents of children diagnosed with ITW who had seen more than one health professional during their care and lived in Australia or the USA. Results Ten parents of children aged between 3 and 13 years and diagnosed with ITW participated. Parents described complex themes relating to their journeys. The themes relating to their journeys were: (1) riding the rollercoaster of diagnosis; (2) navigating the treatment options and (3) supporting parents in the journey. Each theme was supported by parent quotes about their experiences. Challenges were not localised to one country, in spite of vastly different healthcare systems. Conclusions These findings create opportunities for an international approach to education, treatment recommendations and outcome measures to improve patient and parent experiences. Health professionals should consider the impact on parents in navigating between health professionals when provided with a diagnosis which can have variable outcomes and varied treatment options. |
| antimicrobial; hospital infections; bacterial resistance; one health | STAPHYLOCOCCUS-AUREUS; ANTIBIOTIC-RESISTANCE; ESCHERICHIA-COLI; EPIDEMIOLOGY; HANDS | The objective of this research was to determine the antimicrobial resistance of bacteria isolated from items related to hygiene and antisepsis, equipment, and instruments used in different hospital wards. Bacterial isolation and identification, phenotypic antimicrobial susceptibility assays, mecA gene detection, and multiple antimicrobial resistance index analysis were performed. In total, 105 bacteria were isolated from 138 items. Of these, 49.52% bacteria were collected from instruments, 43.80% from equipment, and 6.66% from items related to hygiene and antisepsis. All gram-positive bacteria (88 isolates) were identified as coagulase-negative Staphylococcus. Five species of gram-negative bacilli (17 isolates) were isolated, and the prevalence of Enterobacter agglomerans (29.41%), Escherichia coli (11.76%), and Serratia liquefaciens (11.76%) was high. Antimicrobial resistance was reported for 93.33% of the isolates. Gram-positive bacteria were resistant to sulfazotrim (88.64%) and penicillin (82.95%), while gram-negative bacteria showed resistance to sulfazotrim (70.59%) and ampicillin (64.71%). Analysis of multiple antibiotic resistance index showed that 73.33% of the isolates were a high risk to public health. The mecA gene was detected in 23 (71.88%) isolates. The evaluation of microorganisms isolated in the hospital environment revealed their high multidrug resistance index. Thus our study presses the need to pay more attention to the cleanliness of frequently used instruments, which may be potential sources of infections. |
| Heavy metals; Toxicity; Residual effects; Small ruminants; Histopathology | LEAD; RESIDUES | Considering one health concept, human health is thought to be affected by many factors. Heavy metal toxicity is now gaining its place as one of the major factors contributing to detrimental outcomes for human health. The study encompassed to target sites close to the industrial area of Lahore where heavy metal levels are believed to be higher, as industrial waste is drained into the two main drains. Sheep and goats (n = 5 from each species) reared in the locality were included in the study, and effects of heavy metal toxicity were evaluated in the selected organs (intestine, kidneys, liver, and muscles) via histopathological examination along with residual concentration of these heavy metals in the aforementioned organs. Heavy metals chromium, copper, zinc, lead, iron, magnesium, manganese, and nickel were detected in sample of selected organs by atomic absorption spectrometry (AAS) along with digestion method. The findings of the study indicated a statistically significant difference of residual concentrations of almost all the selected elements in almost all the tissue samples between the two sites where the values of site 1 (close to the drain) were higher compared with site 2 (away from the drain). Similar trend was depicted in histopathological examination where a higher degree of tissue degeneration, necrosis, and hence organ damage was observed in tissue samples collected from site 1 compared with site 2. |
| Blastocystis; phylogenetic analysis; South Korea; wild boar | GENETIC DIVERSITY; HUMANS; LIVESTOCK; PROVINCE; PIGS | Blastocystis is a genus of parasitic protozoans that live in humans, mammals, and birds and which has been widely studied due to its low host specificity. Limited data are available, however, regarding its presence in wildlife, particularly in South Korea. Contact between wild boars (Sus scrofa) and livestock or humans has steadily increased as wild boars venture down from the mountains to farms and residential areas. In this study, we examined the status and subtypes (STs) of Blastocystis in wild boars in South Korea and confirmed its zoonotic potential. From March 2016 to November 2018, we collected 433 fecal samples throughout the country from trapped or road-killed wild boars. The 18S rRNA gene was used for molecular identification and subtyping and the proportion of PCR-positive samples was 10.4%. We then assessed positive samples for associations with sex, region, and seasonal infection; however, no statistical significance was observed for any variable other than season. Phylogenetic analyses revealed that all sequences belonged to subtype 5 and had 99.5-99.9% identity with sequences obtained from Japanese cattle (Bos taurus) and 97.1% identity with sequences obtained from Chinese. Subtype 5 has been implicated in zoonoses, indicating that Korean wild boars could transmit Blastocystis to humans and other livestock. Our results, in accordance with the One Health concept, strongly support continued interest and efforts by public health and disease control organizations toward transmission prevention. |
| public health nurses work; rationed public health nurses care; public health nurses missed care; evolving public health nurse work; organisational change | CARE; CHALLENGES | Aim To explore public health nurse (PHN) perspectives of their evolving work and how public health nurse work is managed in a Canadian health region. Background Professional and public health organisations describe public health nurse practice roles as population-focused work. Health care management directs public health nurse work to achieve specific goals. Methods In this qualitative study, data were collected during focus groups with 42 public health nurse participants in one health region. Focus group data were analysed for meanings and themes. Results Public health nurses perceived increasing immunizations and limited resources for public health nurse work meant that population-focused care for the public was rationed or missing. Participants perceived the health care organisation directed, managed and assigned public health nurse specialist work; however, public health nurses managed their client-focused practice with knowledge, reasoning and support from colleagues. Conclusions Evolving visible public health nurse work was managed by health organisational management directives to increase immunizations and disease control. Public health nurses managed their evolving visible and invisible work supported by their knowledge, practice values and public health nurse colleagues. Implications for Nursing Management Nursing management must lead and communicate the vision supporting better health, better population-focused care and health outcomes to public health nurse and stakeholders, while reviewing resources needed to optimize public health nursing and improve population health. |
| co-circulation; West Nile encephalitis; horse; goshawk; epizootic; epidemiology; virus isolation | LINEAGE 2; INFECTION; TRANSMISSION; GREECE | The West Nile virus is endemic in multiple European countries and responsible for several epidemics throughout the European region. Its evolution into local or even widespread epidemics is driven by multiple factors from genetic diversification of the virus to environmental conditions. The year of 2018 was characterized by an extraordinary increase in human and animal cases in the Central-Eastern European region, including Hungary. In a collaborative effort, we summarized and analyzed the genetic and serologic data of WNV infections from multiple Hungarian public health institutions, universities, and private organizations. We compared human and veterinary serologic data, along with NS5 and NS3 gene sequence data through 2018. Wild birds were excellent indicator species for WNV circulation in each year. Our efforts resulted in documenting the presence of multiple phylogenetic subclades with Balkans and Western-European progenitor sequences of WNV circulating among human and animal populations in Hungary prior to and during the 2018 epidemic. Supported by our sequence and phylogenetic data, the epidemic of 2018 was not caused by recently introduced WNV strains. Unfortunately, Hungary has no country-wide integrated surveillance system which would enable the analysis of related conditions and provide a comprehensive epidemiological picture. The One Health approach, involving multiple institutions and experts, should be implemented in order to fully understand ecological background factors driving the evolution of future epidemics. |
| Biochemistry; conservation; environmental disturbances; hematology; microbiology; One Health; Perissodactyla; serology | INFECTIOUS-DISEASES; POPULATIONS; LESIONS; SHEEP | Over 2 yr, we assessed the health of 35 lowland tapirs (Tapirus terrestris) in the Brazilian Cerrado (CE) biome, an area that is highly affected by human activities. This involved physical examinations, hematology and blood biochemistry, urinalysis, fecal parasitologic evaluation, microbial profiling of anatomic cavities and lesions, and serologic surveys for evidence of infectious agents. Research methods closely resembled those used in previous tapir health assessments in the Atlantic Forest (AF) and Pantanal (PA) biomes, allowing for a comparison among the three populations. Although not reaching statistical significance (P>0.05), tapirs from the CE exhibited poorer body and skin condition as compared to animals from the AF and PA. Furthermore, there were higher prevalences of dental problems and traumatic lesions as compared to those from the AF and PA. Eight of the 12 hematologic parameters evaluated and 17 of the 30 biochemical parameters differed significantly (P<0.05) between the tapirs from CE and those from the AF and PA. We isolated 24 different microbiologic strains from swabs of anatomic cavities and dermal lesions, of which five taxa had not previously been found in the AF or PA. We detected serum antibodies to Leptospira interrogans, bluetongue virus, and porcine parvovirus. Overall, our results suggested that tapirs from the CE exhibited more health abnormalities than tapirs in the AF and PA, possibly due to a greater exposure to environmental disturbances in the area. |
| Poultry; Non-typhoidal Salmonella serovars; Nepal; Antimicrobial resistance; One health; Environment | | Background Antimicrobial resistance (AMR) among bacterial pathogens is a fast-growing public health concern. AMR in non-typhoidal Salmonella serovars (NTS) among food animals is of special concern as this may transmit resistant pathogens to humans during handling or consumption of animal products. In Nepal, the possibility of AMR Salmonella serovars among food animals is an important area of research, particularly in light of the rapidly growing poultry industry, lack of surveillance and proper biosecurity measures; and paucity of relevant data. This study was conducted with the aim to estimate the burden of NTS and associated antimicrobial resistance in the environments of commercial poultry farms and the poultry carcasses in slaughter house. This study also intends to find some basic knowledge of the poultry farmers and their practice relating to the use of antimicrobials, vaccination and biosecurity measures. Methods Taking one health approach, a cross-sectional study was carried out in Chitwan district of Nepal between May and October 2017. Various environmental samples viz. farm litter, feed, water, poultry faeces, vehicle swabs, farm swabs from 12 broiler poultry farms and various sections of poultry carcasses from 21 slaughter houses were aseptically collected. These were microbiologically assessed for the presence of NTS serovars and their phenotypic and genotypic indicators of antimicrobial resistance. The poultry farmers were also briefly interviewed regarding their basic biosecurity related knowledge and practices before collecting the environmental samples. Results Overall, of total environmental samples collected, 50% (31/62) tested positive for NTS serovars with environmental swabs (70%, 8/12) being the most culture positive sample types. Similarly, of 159 tissue samples collected from 24 carcasses, 79% (126/159) were culture positive for NTS serovars. Nearly 97% (153/157) of isolates showed antimicrobial resistance to tetracycline, while 11% (17/157) to ciprofloxacin and 5% (8/157) of isolates were resistant against azithromycin. All 157 isolates were sensitive to meropenem. In terms of AMR genes, tetA (83%, 131/157), QrnS (40%,64/157), mefA (8%, 13/157) and VIM-1 (0.6%, 1/157) were detected in the isolates that corresponded to the AMR to tetracycline, ciprofloxacin, azithromycin and meropenem respectively. In farmers interview, only 42% (5/12) of farmers mentioned of using basic biosecurity measures such as applying lime powder around the farm; 84% (10/12) of farmers reported vaccinating their birds with some vaccine and 75% (9/12) of farmers used various antimicrobials prophylactically such as neomycin (33%, 4/12), colistin (33%, 4/12), furaltadone (33%, 4/12), doxycycline (25%, 3/12), sulfatrimethoprim (25%, 3/12) and tylosin (16%, 2/12). Conclusions This study revealed gross contamination of farm environment and subsequent poultry meat samples with NTS serovars that were resistant to several clinically important antimicrobials. Further, inadequacy of even basic biosecurity measures and frequent prophylactic use of antimicrobials in the commercial poultry farms was observed. This reinforces an urgent need to raise awareness and implement proper biosecurity approaches from farms to slaughter houses in order to reduce the burden of NTS contamination of surrounding environment and poultry products. Further, high prevalence AMR among NTS isolates also underscores the need to strengthen the policies to prevent the rampant use of clinically used human antimicrobials in poultry sector. |
| Escherichia coli; Chicken; Cephalosporin; ESBL; AmpC | SPECTRUM BETA-LACTAMASE; QUINOLONE RESISTANCE; IMPORTED MEAT; SALMONELLA; POULTRY; GENES; ENTEROBACTERIACEAE; PREVALENCE; STRAINS; HUMANS | Contamination of retail meat with extended spectrum beta-lactamase (ESBL) and/or AmpC type beta-lactamase (AmpC) producing Escherichia coli may contribute to increased incidences of infections in humans. Regular monitoring of these bacteria is required in the view of one health approach. In this study, 100 chicken meat samples obtained from Kars, Turkey were analysed and 214 isolates recovered from 72/100 samples were identified as E. coli. Antibiotic susceptibility tests showed that 15.42% of isolates (33/214) were resistant to at least one cephalosporin antibiotic, 20 (9.34%) were beta-lactamase producer. Among beta-lactamase producing E. coli isolates 8 had blaTEM, 7 had blaCTX- M and 3 had blaSHV genes. Plasmid-mediated AmpC beta-lactamase (blaCMY) gene was present in 13 isolates. Plasmid mediated quinolone resistance genes were also screened by polymerase chain reaction and identified by sequencing of the isolates. As a result, 3 isolates were found to be positive for qnrB, whereas the qnrS gene was detected in 4 isolates. Regarding the virulence genes 19 isolates were positive for fimH and 2 isolates were carrying kpsMT II. Phylo-group D2, A0, A1, B1 and D1 were detected in 13, 2, 2, 2 and 1 isolates, respectively. Our findings indicate that poultry meat could be an important carrier of ESBL positive E. coli. |
| Dog; Antimicrobial resistance; Staphylococcus spp; Enterobacterales | POSITIVE STAPHYLOCOCCUS-AUREUS; ESCHERICHIA-COLI; COMPANION ANIMALS; ANTIBIOTIC-RESISTANCE; ONE HEALTH; PREVALENCE; CATS; PSEUDINTERMEDIUS; INTERMEDIUS; ENVIRONMENT | Transferring antimicrobial-resistant bacteria from companion animals to human hosts has become increasingly common. Data regarding antimicrobial susceptibility could help veterinarians to select the most appropriate antibiotic treatment. However, standardized and ongoing surveys regarding antimicrobial resistance remain limited. In this study, we investigated the antimicrobial-susceptibility patterns and trends of bacteria isolated from stray dogs, hospital-admitted dogs, and veterinary staff in South Korea from 2018 to 2019. The minimum inhibitory concentrations of different antimicrobials for Staphylococcus spp., Enterobacterales, and Enterococcus spp. were determined to establish representatives of different antibiotic classes relevant for treatment or surveillance. For coagulase-positive and-negative Staphylococci, resistance to gentamicin was <27 %, while that to ampicillin and penicillin was high (33-80 %). The mecA-detection rates among staphylococcal isolates were 28.5 %, 42.6 %, and 32 % from stray dogs, hospital-admitted dogs, and veterinary staffs, respectively. For Enterobacterales, resistance to carbapenems was low (0-6%). A total of 31.2 % and 18.9 % of Enterobacterales isolates from stray dogs and hospital-admitted dogs were confirmed to possess at least one of blaCTX-M, bla(SHV), or bla(TEM). Additionally, Enterococcus spp. isolates showed no resistance to vancomycin. These results demonstrate that dogs are commonly colonized with antimicrobial-resistant bacteria and highlight the need for further investigation. |
| calves; Clostridioides difficile; digestate; ribotype 033; ribotype 126; Thr82Ile; Holstein | LOCUS VARIABLE-NUMBER; CLOSTRIDIUM-DIFFICILE; PREVALENCE; CONTAMINATION; RESISTANCE; STRAINS; TOXIN | To investigate a possibleClostridioides difficilereservoir in the Czech Republic, we performed a study in 297 calves from 29 large-scale dairy farms. After enrichment, faecal samples were inoculated onto selective agar forC. difficile. From the 297 samples, 44C. difficileisolates were cultured (prevalence of 14.8%, 10 farms). The Holstein breed and use of digestate were associated withC. difficilecolonisation (p< 0.05).C. difficileisolates belonged to the ribotype/sequence type: RT033/ST11 (n= 37), RT126/ST11 (n= 6) and RT046/ST35 (n= 1). A multiple-locus variable-number tandem-repeat analysis revealed four clonal complexes of RT033 isolates and one clonal complex of RT126 isolates. All isolates were sensitive to amoxicillin, metronidazole and vancomycin. Forty isolates were resistant to ciprofloxacin, twenty-one to clindamycin, seven to erythromycin, seven to tetracycline and six to moxifloxacin. Moxifloxacin resistant isolates revealed an amino-acid substitution Thr82Ile in the GyrA. In conclusion, the calves of Holstein breed from farms using digestate as a product of bio-gas plants are more likely to be colonised by clonally-relatedC. difficileof ST 11 represented by ribotypes 033 and 126. The identified resistance to moxifloxacin with a Thr82Ile substitution in the GyrA highlights the need for further monitoring by the One health approach. |
| public perceptions; social media analytics; veterinarian; veterinary medicine | | The public perception of the veterinary medicine profession is of increasing concern given the mounting challenges facing the industry, ranging from student debt loads to mental health implications arising from compassion fatigue, euthanasia, and other challenging aspects of the profession. This analysis employs social media listening and analysis to discern top themes arising from social and online media posts referencing veterinarians. Social media sentiment analysis is also employed to aid in quantifying the search results, in terms of whether they are positivity/negativity associated. From September 2017-November 2019, over 1.4 million posts and 1.7 million mentions were analyzed; the top domain in the search results was Twitter (74%). The mean net sentiment associated with the search conducted over the time period studied was 52%. The top terms revealed in the searches conducted revolved mainly around care of or concern for pet animals. The recognition of challenges facing the veterinary medicine profession were notably absent, except for the mention of suicide risks. While undeniably influenced by the search terms selected, which were directed towards client-clinic related verbiage, a relative lack of knowledge regarding veterinarians’ roles in human health, food safety/security, and society generally outside of companion animal care was recognized. Future research aimed at determining the value of veterinarians’ contributions to society and, in particular, in the scope of One Health, may aid in forming future communication and education campaigns. |
| Dairy challenges; one health; Peri urban area; small scale dairy farming; zoonosis | MANAGEMENT | Background: Animal husbandry plays an important role in the Indian economy. Small scale milk producers contribute 62% of the total milk produced in the country. However, the lives and livelihoods of small dairy farmers are becoming vulnerable in India. Objectives: This article tried tried to explore the reasons of decrease in small scale dairy farms. Apart from that this article is also find out what were the challenges faced by small dairy farming families and its influence on animal health. Methods: A qualitative exploratory study was carried out in the peri-urban area of Hodal, Haryana. Purposive and snowball sampling were employed. Twenty-six in-depth interviews were conducted with current small scale dairy farmers, ex small scale dairy farmers, households, and other stakeholders. Results are presented in the form of core and sub-themes evolved during this process. Results: This study revealed that a small scale dairy farmer is present in peri-urban area, but there is a decrease in small scale dairy farming. The major reason is shrinking fringes, access to cattle provender, the tepid interest of future generation, increased cost of cattle, and cattle health. Conclusion: The study recommends that support (in the form of subsidy) should be provided to small scale dairy farmers for accessing land and provender. Awareness about the importance and scope of small scale dairy farming as a stable career opportunity should be spread among the young generation. |
| Cryptosporidium; Cyst; Drinking water; Ethiopia; Giardia; Oocyst | CHILDREN; CONTAMINATION; INFECTION; OOCYSTS | This study was part of a larger One Health project with the aim of investigating the epidemiology of Cryptosporidium and Giardia infections among humans and animals in rural areas of Tigray, Ethiopia. Here we report on the contamination of different drinking water sources in four locations of this region with these Cryptosporidium oocysts and Giardia cysts; 19 samples were from unprotected surface water sources and 18 from protected water sources. A modified version of the standard ISO 15553 technique was used for analysis, and Giardia cysts were detected in 6 of the samples (16%) and Cryptosporidium in two (5%), with one of these samples containing both parasites. The number of Giardia cysts in positive samples ranged from 3 to 22 cysts per 10 L sample, and the number of Cryptosporidium oocysts in positive samples ranged from 1 to 3 oocysts per 10 L sample. Low numbers of parasites and absence of nuclei, as indicated by the absence of DAPI staining, precluded further molecular analyses. We found no association with contamination and whether the water source was protected or not, but there was an association with location, with one location more likely to have a contaminated sample than the others. These preliminary data suggest that this location should be in focus for further parts of this study. (C) 2020 The Authors. Published by Elsevier Inc. on behalf of International Association of Food and Waterborne Parasitology. |
| PORCINE CYSTICERCOSIS; MBEYA REGION; PREVALENCE | A field trial was conducted in Tanzania to determine the effectiveness of TSOL18 vaccine used concurrently with oxfendazole (OFZ), and of OFZ alone, onT.soliumcysticercosis determined by organ and half carcase dissection of slaughter age pigs. This study followed a quasi-experimental group design. Suitable trial sites were randomly allocated to either treatment group T1 (OFZ treatment alone [30mg/kg, Paranthic 10%]) or T2 (TSOL18 [1ml, Cysvax] plus OFZ). Three 4-monthly treatments were administered to eligible pigs. A random selection of pigs were necropsied at baseline and at endline, 2-3.5 months after the final treatment. Additionally, untreated pigs from T1 and T2 areas were necropsied at endline to provide contemporaneous comparisons with T1 and T2 pigs. Baseline prevalence of viableT.soliumcysticerci for T1 was 25.5% (Exact 95% CI: 13.9, 40.3; n = 12/47), and for T2 was 12.0% (CI: 6.4, 20.0; n = 12/100). At endline, prevalence was 2.8% for T1 (CI: 0.1, 14.5, n = 1/36) and 0% for T2 (CI: 0, 4.7, n = 0/77). Among untreated pigs, three had viable cysticerci, one from T1 area (12.5%, CI: 0.3, 52.7; n = 1/8) and two from T2 area (5.7%, CI: 0.7, 19.2, n = 2/35). Fisher’s exact test showed significant changes in prevalence from baseline to endline in both groups (T1:p =0.005, T2:p =0.001). Firth’s penalized Maximum Likelihood method suggested the changes were not significant relative to their controls (T1:p =0.245, T2:p =0.076). These findings showed a significant reduction in the prevalence of viable cysticerci from baseline to endline after both interventions. However, the changes could not be definitively attributed to the interventions due, in part, to small numbers of control pigs. Concurrent administration of the TSOL18 and OFZ cleared infection among assessed pigs whereas infection remained after treatment with OFZ only. Further studies including larger sample sizes would be required for more definitive conclusions. A One Health approach is recommended for rapid and sustainable impact. Author summary The pork tapewormT.soliumaffects the health and income of poor people in endemic areas. A pig vaccine-TSOL18, and a drug-oxfendazole (OFZ) present options for its control. In this study we assessed the effectiveness of the two tools against the parasite in pigs. We provided one group of pigs (T1) with a concurrent administration of TSOL18 and OFZ, and another group (T2) with OFZ only, in three rounds at 4 months intervals. We compared infection prevalence before and after the interventions by detection of cysticerci through carcase dissections. In addition, untreated pigs from the T1 and T2 areas were also sacrificed to serve as controls. We found a significant reduction in prevalence within the groups after the interventions. However, the reductions were not significant when compared with the reductions in the control groups, hence could not be definitively attributed to the interventions. Further, concurrent administration of TSOL18 and OFZ cleared infection among assessed pigs whereas OFZ alone did not clear the infection. Further studies would be required to make more definitive conclusions. We advocate for a One Health approach for a more rapid and sustainable impact. |
| Europe; Germany; hepatitis E; meat; pork products; zoonosis | PORCINE LIVERS; PIGS; RNA; SEROPREVALENCE; TRANSMISSION; INFECTION; SEQUENCES; SAUSAGE; TISSUES; SPAIN | The hepatitis E virus (HEV) is one of the most common causes of hepatitis worldwide. HEV is also widespread in many developed countries, where the number of infections is steadily increasing. In those countries, the virus is transmitted mainly through consumption of undercooked or raw food or through contact with animals. Especially, pigs serve as a main reservoir of HEV. Here, we investigated the prevalence of HEV RNA in pork livers and pork meat products to assess the actual risk of HEV infection through food consumption in Germany. A total of 131 pork products were collected from grocery stores and butcher shops between October 2019 and February 2020 and screened for HEV RNA using nested PCR and subsequent sequencing. Overall, 10% of the samples were positive for HEV, including pork livers (5%), spreadable liver sausages (13%) and liver pate samples (15%). Sequence analyses indicated that the large majority of HEV strains belonged to subtype HEV-3c, representing the most frequent subtype in Germany. One sample belonged to subtype HEV-3f. Further sequence analysis revealed large sequence variation between the samples; however, most of the mutations identified were synonymous. Although infectivity of the virus was not tested, the results suggest a considerable risk of HEV infection through food consumption. Therefore, preventive measures should be taken according to a One Health approach. |
| ESBL; AmpC; CTX-M; Resistances; Carbapenemases | ESBL-PRODUCING ENTEROBACTERIACEAE; ESCHERICHIA-COLI; FECAL CARRIAGE; RESISTANCE; CHILDREN; AGENTS | Presence of extended-spectrum beta-lactamase (ESBL-E), AmpC-producing and carbapenemase-producing (CPE) Enterobacteriaceae has been observed not only in the clinical environment, but also in the out-of-hospital environment. The objective of this study was to isolate and characterize strains of ESBL, AmpC, and CPE present in feces of healthy carriers in Navarra (n = 125). Despite the fact that no CPE strains were isolated, 16% and 11.2% of the studied population were ESBL-E and AmpC carriers, respectively. No significant differences were found by gender or age; young people (5-18 years old) showed the highest ESBL-E prevalence (31.8%). The isolates corresponded to E. coli (57.1%), Enterobacter spp. (28.6%), and Citrobacter freundii (14.3%), and all strains showed multidrug-resistant profiles. High resistance against cephalosporins, penicillins, and monobactams, and sensitivity to carbapenems, quinolones, and aminoglycosides were observed. With respect to ESBL producers, 52.4% were CTX-M-type (19.0% CTX-M-14, 9.5% CTX-M-1, and 28.6% CTX-M-15) and 47.6% were TEM-type (38.1% TEM-171). These results confirm the extensive dissemination of these resistances among a healthy population and pose the need to implement control measures and strategies according to the One Health approach in order to prevent the increase of severe and untreatable infections in a not far future. |
| multidrug resistant; Salmonella; poultry; litter; feed; integron; one health; Bangladesh | ANTIMICROBIAL RESISTANCE; ANTIBIOTIC-RESISTANCE; ENTERICA; INTEGRONS; ANIMALS; POULTRY; GENES; SPP.; PREVALENCE; LIVESTOCK | Multidrug resistant (MDR) Salmonella are a leading cause of foodborne diseases and serious human health concerns worldwide. In this study we detected MDR Salmonella in broiler chicken along with the resistance genes and class 1 integron gene intl1. A total of 100 samples were collected from broiler farms comprising 50 cloacal swabs, 35 litter and 15 feed samples. Overall prevalence of Salmonella was 35% with the highest detected in cloacal swabs. Among the Salmonella, 30 isolates were confirmed as S. enterica serovar Typhimurium using molecular methods of PCR. Disk diffusion susceptibility test revealed that all the Salmonella were classified as MDR with the highest resistance to tetracycline (97.14%), chloramphenicol (94.28%), ampicillin (82.85%) and streptomycin (77.14%). The most prevalent resistance genotypes were tetA (97.14%), floR (94.28%), bla(TEM-1) (82.85%) and aadA1 (77.14%). In addition, among the MDR Salmonella, 20% were positive for class 1 integron gene (intl1). As far as we know, this is the first study describing the molecular basis of antibiotic resistance in MDR Salmonella from broiler farms in Bangladesh. In addition to tetA, floR, bla(TEM-1), aadA1 and intl1 were also detected in the isolated MDR Salmonella. The detection of MDR Salmonella in broiler chicken carrying intl1 is of serious public health concern because of their zoonotic nature and possibilities to enter into the food chain. |
| Hyalomma; Amblyomma; Rhipicephalus; Rickettsia spp; piroplasms; tick-borne diseases; vector-borne diseases | FEVER GROUP RICKETTSIAE; GENUS HYALOMMA KOCH; PARASITIC STAGES; BORNE RICKETTSIOSES; MOLECULAR-DETECTION; IXODID TICKS; ACARI; RHIPICEPHALUS; REDESCRIPTION; HUMANS | Ticks and tick-borne diseases (TBDs) have a major economic impact on animal production worldwide. In the present study, 2410 ticks were collected from January to August 2017 from livestock and other domestic animals in North Kordofan and Kassala, Sudan, for species identification and investigation of Rickettsia spp. and piroplasms, either individually or as pools containing up to 10 ticks by molecular methods. In total, 13 tick species were identified by morphology and 16S rDNA sequencing. The most frequent tick species were Hyalomma impeltatum (24.90%), Rhipicephalus evertsi evertsi (18.84%), Amblyomma lepidum (16.06%), and Rhipicephalus camicasi (12.49%). A pan-Rickettsia real-time PCR revealed an overall minimum infection rate (MIR) with Rickettsia spp. of 5.64% (136 positive tick pools/2410 total ticks). Rickettsia africae and Rickettsia aeschlimannii were the most frequently identified species by sequencing. Furthermore, the following highly pathogenic livestock parasites were detected: Theileria annulata, Theileria lestoquardi, Theileria equi, and Babesia caballi. The present study documented Rhipicephalus afranicus as well as Rickettsia conorii israelensis, Rickettsia massiliae, and Babesia pecorum for the first time in Sudan. These findings are significant for the animal production sector as well as in terms of One Health, as the detected Rickettsia spp. can cause serious illness in humans. |
| colistin resistance; faecal pollution; Hanoi; mcr‐ 1; urban water environments; Vietnam | CLASS 1 INTEGRON; WASTE-WATER; RIVER; PCR; QUANTIFICATION; PREVALENCE; CRASSPHAGE; ANIMALS; FARMS; PIG | Colistin is one of the antibiotics of last resort for human health. However, the dissemination of the plasmid-mediated colistin resistance gene mcr-1 is of great concern globally. In the One Health framework, the environment is an important component for managing antimicrobial resistance. However, little information is available concerning the prevalence of mcr-1 in water environments. We aimed to reveal the prevalence of mcr-1 in different water environments in Hanoi, Vietnam. Quantitative PCR was applied to detect mcr-1 in four urban drainages receiving untreated domestic wastewater, three rivers, five lakes and two groundwater samples. Urban drainages contained higher concentrations of mcr-1, suggesting that urban residents carry the gene. The class 1 integron-integrase gene was identified as a good surrogate of antibiotic resistance genes including mcr-1. A significant correlation was found between the levels of mcr-1 and the human-specific cross-assembly phage, which is an indicator of human faecal pollution. These results indicated that the primary source of mcr-1 in urban water environments is human faeces, which is consistent with the fact that most domestic wastewater is untreated in Hanoi. The control of untreated wastewater is critical for alleviating the spread of mcr-1 in water environments in Vietnam. |
| Campylobacter coli; resistance genes; one health; critically important antimicrobials | ANTIBIOTIC-RESISTANCE; FLUOROQUINOLONE; IDENTIFICATION; MUTATIONS; EMERGENCE; COLI; DOGS; MECHANISMS; SELECTION; GENES | Campylobacter (C.) spp. from poultry is the main source of foodborne human campylobacteriosis, but diseased pets and cattle shedding Campylobacter spp. may contribute sporadically as a source of human infection. As fluoroquinolones are one of the drugs of choice for the treatment of severe human campylobacteriosis, the resistance rates of C. jejuni and C. coli from poultry against antibiotics, including fluoroquinolones, are monitored within the European program on antimicrobial resistance (AMR) in livestock. However, much less is published on the AMR rates of C. jejuni and C. coli from pets and cattle. Therefore, C. jejuni and C. coli isolated from diseased animals were tested phenotypically for AMR, and associated AMR genes or mutations were identified by whole genome sequencing. High rates of resistance to (fluoro)quinolones (41%) and tetracyclines (61.1%) were found in C. jejuni (n = 29/66). (Fluoro)quinolone resistance was associated with the known point mutation in the quinolone resistance-determining region (QRDR) of gyrA, and tetracycline resistance was mostly caused by the tet(O) gene. These high rates of resistance, especially to critically important antibiotics in C. jejuni and C. coli, are worrisome not only in veterinary medicine. Efforts to preserve the efficacy of important antimicrobial treatment options in human and veterinary medicine have to be strengthened in the future. |
| hip fracture; COVID-19; coronavirus | | Objectives: To examine one health system’s response to the essential care of its hip fracture population during the COVID-19 pandemic and report on its effect on patient outcomes. Design: Prospective cohort study. Setting: Seven musculoskeletal care centers within New York City and Long Island. Patients/Participants: One hundred thirty-eight recent and 115 historical hip fracture patients. Intervention: Patients with hip fractures occurring between February 1, 2020, and April 15, 2020, or between February 1, 2019, and April 15, 2019, were prospectively enrolled in an orthopaedic trauma registry and chart reviewed for demographic and hospital quality measures. Patients with recent hip fractures were identified as COVID positive (C+), COVID suspected (Cs), or COVID negative (C-). Main Outcome Measurements: Hospital quality measures, inpatient complications, and mortality rates. Results: Seventeen (12.2%) patients were confirmed C+ by testing, and another 14 (10.1%) were suspected (Cs) of having had the virus but were never tested. The C+ cohort, when compared with Cs and C- cohorts, had an increased mortality rate (35.3% vs. 7.1% vs. 0.9%), increased length of hospital stay, a greater major complication rate, and a greater incidence of ventilator need postoperatively. Conclusions: COVID-19 had a devastating effect on the care of patients with hip fracture during the pandemic. Although practice patterns generally remained unchanged, treating physicians need to understand the increased morbidity and mortality in patients with hip fracture complicated by COVID-19. |
| Dirofilariasis; Humans; Eye; Skin; Helminths; Endemic diseases | AEDES-ALBOPICTUS; DIPTERA-CULICIDAE; EMERGENT ZOONOSIS; REPENS; MOSQUITOS; INFECTIONS; DIAGNOSIS; CLIMATE; VECTOR; ISTRIA | Introduction: Human dirofilariasis is a disease historically linked to the Mediterranean area. For the last few decades, however, Dirofilaria nematodes have been spreading, both in terms of prevalence and the geographical expansion in non-endemic areas. Currently, cases of human dirofilariasis are recorded in more than 40 countries worldwide. Croatia is considered an endemic area of the Adriatic basin. Methods: In a nationwide investigation, new and previously published cases of human dirofilariasis in Croatia were analyzed. Results: Since 1996, 30 cases of human dirofilariosis were reported in Croatia. A total of 14 (46,67%) cases were from the coastal and 16 (53,33%) from continental regions of the country. Based on anatomical location, 13 (43,33%) cases were subcutaneous, 12 (40%) were ocular and five (16,67%) occurred in the reproductive organs. In all 30 cases, Dirofilaria repens was identified as the causative agent. Conclusions: An increase in air temperature as climate change, changes in mosquito fauna, high prevalence of D. repens in dogs and limited use of chemoprophylaxis are possible risk factors for Dirofilaria infection in the Croatian population. Since reporting to epidemiological services is not mandatory in this country, the real number of human dirofilariasis cases is probably significantly higher than published. This emphasizes the need for mandatory reporting of human cases and surveillance of Dirofilaria infection in dogs and mosquitoes in Croatia, following the One Health concept. |
| Rabies; Vaccination; One health; Geo-epidemiology; Dog; Human health; Health economics | CANINE RABIES ELIMINATION; RURAL AFRICA; ECONOMICS; DYNAMICS; IMPACT; ISLAND | Objectives: Hoping to improve health-related effectiveness, a two-phase vaccination against rabies was designed and executed in northern Tanzania in 2018, which included geo-epidemiological and economic perspectives. Methods: Considering the local bio-geography and attempting to rapidly establish a protective ring around a city at risk, the first phase intervened on sites surrounding that city, where the population density was lower than in the city at risk. The second phase vaccinated a rural area. Results: No rabies-related case has been reported in the vaccinated areas for over a year post-immunisation; hence, the campaign is viewed as highly cost-effective. Other metrics included: rapid implementation (concluded in half the time spent on other campaigns) and the estimated cost per protected life, which was 3.28 times lower than in similar vaccinations. Conclusions: The adopted design emphasised local bio-geographical dynamics: it prevented the occurrence of an epidemic in a city with a higher demographic density than its surrounding area and it also achieved greater effectiveness than average interventions. These interdisciplinary, policy-oriented experiences have broad and immediate applications in settings of limited and/or time-sensitive (expertise, personnel, and time available to intervene) resources and conditions. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. |
| antimicrobial susceptibility; swine; respiratory pathogens | BORDETELLA-BRONCHISEPTICA; PIGS; RESISTANCE; DISEASE; AMOXICILLIN; SWINE | The monitoring of antimicrobial susceptibility of pig pathogens is critical to optimize antimicrobial treatments and prevent development of resistance with a one-health approach. The aim of this study was to investigate the antimicrobial susceptibility patterns of swine respiratory pathogens in Spain from 2017 to 2019. Bacterial isolation and identification were carried out following standardized methods from samples coming from sacrificed or recently deceased pigs with acute clinical signs compatible with respiratory tract infections. Minimum inhibitory concentration (MIC) values were determined using the broth microdilution method containing a total of 10 and 7-8 antimicrobials/concentrations respectively, in accordance with the recommendations presented by the Clinical and Laboratory Standards Institute (CLSI). The obtained antimicrobial susceptibility varies between pig respiratory pathogens.Actinobacillus pleuropneumoniae(APP) andPasteurella multocida(PM) were highly susceptible (>= 90%) to ceftiofur, florfenicol and macrolides (tilmicosin, tildipirosin and tulathromycin). However, the antimicrobial susceptibility was intermediate (>60% but <90%) for amoxicillin and enrofloxacin in the case of APP and sulfamethoxazole/trimethropim and tiamulin in the case of PM. Both bacteria showed low (<60%) antimicrobial susceptibility to doxycycline. Finally,Bordetella bronchisepticawas highly susceptible only to tildipirosin and tulathromycin (100%) and its susceptibility for florfenicol was close to 50% and <30% for the rest of the antimicrobial families tested. These results emphasize the need of determining antimicrobial susceptibility in pig respiratory cases in order to optimize the antimicrobial treatment in a case-by-case scenario. |
| mosquito; disease; vector; East Africa; arbovirus; Sylvatic; species diversity; distribution; emerging | WEST NILE VIRUS; CHIKUNGUNYA-VIRUS; DIPTERA-CULICIDAE; FAMILY BUNYAVIRIDAE; HEMORRHAGIC-FEVER; DENGUE VIRUS; TRANSMISSION; VECTOR; DISTRICT; MALARIA | As new and re-emerging vector-borne diseases are occurring across the world, East Africa represents an interesting location, being the origin of several arboviruses with a history of urbanization and global spread. Rapid expansion of urban populations and alteration of natural habitats creates the opportunity for arboviruses to host-switch from wild, sylvatic hosts or vectors into urban transmission affecting human populations. Although mosquito surveillance regularly takes place in urban areas of Kenya, for example identifying vectors of dengue virus or malaria viruses, little work has been carried out to determine the distribution and abundance of sylvatic vectors. Here, we describe the mosquito vector species and diversity collected at twelve forest habitats of rural Kenya. We conducted arbovirus screening of over 14,082 mosquitoes (47 species, 11 genera) as 1520 pools, and detected seven viruses (six bunyaviruses, and one flavivirus-bunyavirus co-infection) isolated from pools ofAedes dentatus,Anopheles funestus,Culex annulioris,andCx. vansomereni. Awareness of sylvatic vector species and their location is a critical part of understanding the ecological foci and enzootic cycling of pathogens that may be of concern to public, animal or wildlife health. As natural ecosystems come under anthropogenic pressures, such knowledge can inform us of the One Health potential for spillover or spillback leading to outbreaks, and assist in vector control strategies. |
| HUMAN-WILDLIFE INTERFACE; ANTIMICROBIAL RESISTANCE; BACTERIAL PATHOGENS; ENVIRONMENTAL SURVIVAL; SALMONELLA SPP.; RISK-FACTORS; PCR ASSAY; PREVALENCE; IDENTIFICATION; TRANSMISSION | Author summary Campylobacter infections are increasing worldwide but we still know little about the true burden of disease in the developing world, and even less about the role of wildlife and environmental reservoirs in human exposure and infection. Here we take a one-health approach evaluating Campylobacter infections in humans, banded mongooses (Mungos mungo), and the environment. We found evidence of widespread infection with Campylobacter spp. infecting nearly a quarter of sampled adults and children (23.0%, n = 122, 2011), dominantly with C. jejuni. Banded mongooses live in close association with humans in the area and over half of the animals sampled were found positive for Campylobacter spp. (56%, n = 201, 2017). Infection with C. jejuni was greater among mongooses utilizing human-made structures as den sites than those using natural dens. These data suggest that wildlife utilization of anthropogenic landscapes may increase C. jejuni exposure and infection. In turn, pathogen circulation and transmission in urbanizing wildlife reservoirs may increase human vulnerability to infection, particularly impoverished populations, where greater environmental exposures are expected. Background Campylobacter is a common, but neglected foodborne-zoonotic pathogen, identified as a growing cause of foodborne disease worldwide. Wildlife and domestic animals are considered important reservoirs, but little is known about pathogen infection dynamics in free-ranging mammalian wildlife particularly in sub-Saharan Africa. In countries like Botswana, there is significant overlap between humans and wildlife, with the human population having one of the highest HIV infection rates in the world, increasing vulnerability to infection. Methodology/Principal findings We investigated Campylobacter occurrence in archived human fecal samples (children and adults, n = 122, 2011), feces from free-ranging banded mongooses (Mungos mungo, n = 201), surface water (n = 70), and river sediment samples (n = 81) collected in 2017 from the Chobe District, northern Botswana. Campylobacter spp. was widespread in humans (23.0%, 95% CI 13.9-35.4%), with infections dominantly associated with C. jejuni (82.1%, n = 28, 95% CI 55.1-94.5%). A small number of patients presented with asymptomatic infections (n = 6). While Campylobacter spp. was rare or absent in environmental samples, over half of sampled mongooses tested positive (56%, 95% CI 45.6-65.4%). Across the urban-wilderness continuum, we found significant differences in Campylobacter spp. detection associated with the type of den used by study mongooses. Mongooses utilizing man-made structures as den sites had significantly higher levels of C. jejuni infection (p = 0.019) than mongooses using natural dens. Conversely, mongooses using natural dens had overall higher levels of detection of Campylobacter at the genus level (p = 0.001). Conclusions These results suggest that landscape features may have important influences on Campylobacter species exposure and transmission dynamics in wildlife. In particular, data suggest that human-modified landscapes may increase C. jejuni infection, a primarily human pathogen, in banded mongooses. Pathogen circulation and transmission in urbanizing wildlife reservoirs may increase human vulnerability to infection, findings that may have critical implications for both public and animal health in regions where people live in close proximity to wildlife. |
| E coil-; ESBL; River; Plasmid; Resistance | FOOD-PRODUCING ANIMALS; DISSEMINATION; CARRIAGE; SEQUENCE; INCFII | Antimicrobial resistance is a One Health issue that requires improved knowledge of the presence and abundance of resistant bacteria in the environment. Extended-spectrum cephalosporins (ESCs) are critically important antibiotics (CIAs), and resistance to these CIAs is often encoded by beta-lactamase genes borne on conjugative plasmids. We thus decided to characterise 21 plasmids of ESC-resistant Escherichia coil randomly selected from isolates previously obtained from river water collected in a rural area in western France. The plasmids encoding ESC resistance were sequenced to investigate the diversity of the genes encoding ESC resistance and their genetic context. Sequences revealed that eleven IncI1 pMLST3 plasmids carried the bla(CT)(X)(-M) and sul2 genes, and some of them also had the tet(A), aadA5 or dfrA17 genes. The bla(CTX-M-1) gene was also detected on an IncN plasmid. Five plasmids obtained from four rivers contained bla(CTX-M-14), either on Inch or on IncFII plasmids. Two strains from two rivers contained bla(CTX-M-15) on IncN pMLST7 plasmids, with qnrS1 and dfrA14 genes. One plasmid contained the bla(CTX-M-55), a bla(TEM)(-1B)-like, and fosA genes. One plasmid contained the bla(CMY-2) gene. The diversity of the genes and plasmids of the resistant bacteria isolated from French rivers is probably related to the various animal and human origins of the isolated bacteria. |
| Colonisation; humans; porcine; respiratory infection; zoonosis | RESISTANT STAPHYLOCOCCUS-AUREUS; INFLUENZA-C VIRUS; HEMAGGLUTINATING ENCEPHALOMYELITIS VIRUS; ANTIMICROBIAL RESISTANCE; ESCHERICHIA-COLI; MULTIPLEX PCR; IMPACT; ENTEROBACTERIACEAE; COLONIZATION; LIVESTOCK | Bacteria and viruses were analysed in the upper respiratory tract of symptomatic pig farmers and their domestic pigs. Eighty six human nasal and 495 (50 pools) porcine snout swabs were collected in Schleswig-Holstein, Germany.Staphylococcus (S.) aureus(62.8%, 54/86), human rhino- and coronaviruses (HRV, 29.1%, 25/86; HCoV, 16.3%, 14/86) were frequently detected in humans, whileHaemophilus parasuis(90.0%, 45/50),Mycoplasma hyorhinis(78.6%, 11/14),Enterovirus G(EV-G, 56.0%, 28/50) andS. aureus(36.0%, 18/50), respectively, were highly prevalent in pigs. The detection ofS. aureusin human follow-up samples indicates a carrier status. The methicillin-resistant phenotype (MRSA) was identified in 33.3% (18/54) of nasal swabs and in one of 18 (5.6%) pooled snout swabs that were tested positive forS. aureus. Strains were indicative of the livestock-associated clonal complex CC398, with t011 being the most common staphylococcal protein A type.Enterobacteralesand non-fermenters were frequently isolated from swabs. Their detection in follow-up samples suggests a carrier status. All were classified as being non-multiresistant. There was no example for cross-species transmission of viruses. In contrast, transmission ofS. aureusthrough occupational contact to pigs seems possible. The study contributes to the ‘One Health’ approach. |
| community-based; Mexico; participatory research; eosinophilia; Rocky Mountain spotted fever | SANGUINEUS-SENSU-LATO; GROUP RICKETTSIOSES; CARE PROVIDERS; UNITED-STATES; DOGS; ARIZONA; AMITRAZ; TICKS | Background: Rocky Mountain spotted fever (RMSF) is a significant public health problem in Sonora, Mexico, resulting in thousands of cases and hundreds of deaths. Outbreaks of RMSF are perpetuated by heavy brown dog tick infestations in and around homes. During 2009-2015, there were 61 RMSF cases and 23 deaths in a single community of Sonora (Community A). Methods: An integrated intervention was carried out from March-November 2016 aimed at reducing tick populations with long-acting acaricidal collars on dogs, environmental acaricides applied to peri-domestic areas and RMSF education. Tick levels were measured by inspection of community dogs to monitor efficacy of the intervention. A similar neighborhood (Community B) was selected for comparison and received standard care (acaricide treatment and education). Results: The prevalence of tick-infested dogs in Community A declined from 32.5% to 8.8% (p<0.01). No new cases of RMSF were identified in this area during the subsequent 18 mo. By comparison, the percentage of tick-infested dogs in Community B decreased from 19% to 13.4% (p=0.36) and two cases were reported, including one death. Conclusions: Community-based interventions using an integrated approach to control brown dog ticks can diminish the morbidity and mortality attributable to RMSF. |
| Animal feed; Feed mills; PCR; Salmonella enteritidis; Salmonella typhimurium; Virulence genes | VIRULENCE GENES; SEROVARS; SUSCEPTIBILITY; LACTOBACILLI; RESISTANCE; SAMPLES | Owing to the zoonotic nature of Salmonella, its transmission from feed-to-food is quite feasible and considered as one of the prime factors for the transmission and spread of virulent and drug-resistant strains in humans. Therefore, the present study was designed to investigate the prevalence of Salmonella in animal feed pellets from different feed mills in Jaipur and its nearby areas. For this, isolation of Salmonella was performed as per standard ISO methods and the presumable strains were further confirmed and characterized into different species by molecular methods. The confirmed strains were analyzed for virulence genes by PCR. Finally, the strains were analyzed for antimicrobial drug resistance by the standard disk diffusion method. The study revealed that the prevalence of Salmonella in feed pellets was moderate and Salmonella enteritidis and Salmonella typhimurium were the two dominated species. Strikingly, the majority of strains were found to possess the virulence genes and resistant to analyzed clinical antimicrobials. Results inferred that contaminated animal feeds may act as a potential source for the dissemination of virulent and drug-resistant Salmonella spp in animals as well as human beings. The present study implicated the need for more focused and extensive investigations from different parts of the country and the world for strict regulation of animal feed safety to assure one health concept. |
| Microbial contamination; Microbial source tracking; Environmental protection; One health | BACTERIAL PATHOGENS; ESCHERICHIA-COLI; PCR; QUANTIFICATION; ENUMERATION; DIARRHEA; GENES | Waterborne pathogens and their associated diseases are major threats to public health, and surveillance of pathogens and identification of the sources of pollution are imperative for preventing infections. However, simultaneously quantitative detection of multiple pathogens and pollution sources in water environments is the major challenge. In this study, we developed and validated a highly sensitive (mostly >80%) and highly specific (>99%) high-throughput quantitative PCR (HT-qPCR) approach, which could simultaneously quantify 68 marker genes of 33 human pathogens and 23 fecal markers of 10 hosts. The HT-qPCR approach was then successfully used to investigate pathogens and fecal pollution in marine recreational water samples of Xiamen, China. Totally, seven pathogenic marker genes were found in 13 beach bathing waters, which targeted Acanthamoeba spp., Clostridium pelfringens, enteropathogenic Escherichia coli, Klebsiellapneumoniae, Vibrio cholera/V. parahaemolyticus and Legionella spp.. Fecal markers from human and dog were the most frequently detected, indicating human and dog feces were the main contamination in the recreational waters. Nanopore sequencing of full-length 16S rRNA gene revealed that 28 potential human pathogens were detected and electrical conductivity, salinity, oxidation-reduction potential and dissolved oxygen were significantly correlated with the variation in bacterial community. Our results demonstrated that HT-qPCR approach had the potential rapid quantification of microbial contamination, providing useful data for assessment of microbial pathogen associated health risk and development of management practices to protect human health. |
| INSULIN-RESISTANCE; PSYCHOLOGICAL DISTRESS; AMERICAN ASSOCIATION; PRACTICE GUIDELINE; QUESTIONNAIRE; ALCOHOL; PATHOGENESIS; METAANALYSIS; POPULATION; MANAGEMENT | Psychological stress may have adverse metabolic effects and induce unhealthy behaviors, but the role of stress in the development of non-alcoholic fatty liver disease (NAFLD) is largely unexplored. We investigated the association between perceived stress and the prevalence of NAFLD in a large sample of apparently healthy men and women. We performed a cross-sectional study of 171,321 adults who underwent health screening examination between 2011 and 2013 in one health screening center. Perceived stress was assessed using the short version of the Perceived Stress Inventory (PSI). NAFLD was assessed using ultrasonography in the absence of excessive alcohol use or any other identifiable cause of liver disease. The prevalence of NAFLD was 27.8%. In fully-adjusted multivariable models, the odds ratio (95% confidence intervals) for NAFLD comparing participants in the 5th quintile of PSI score (>= 23) with those in the lowest quintile (<12) was 1.17 (1.11, 1.22), with a moderately increased prevalence of NALFD across quintiles of PSI score. The positive association between PSI score and NAFLD was observed in all subgroups analyzed, although the association was stronger in men compared to women (p interaction <0.001), and in obese compared to non-obese (p interaction 0.005). In this large study of apparently healthy men and women, higher perceived stress was independently associated with an increased prevalence of NAFLD, supporting a possible relationship between perceived stress and NAFLD. Prospective study is needed to elucidate mediating mechanisms to warrant stress management to reduce NAFLD. |
| rabies; dog bites; rabies vaccine; rabies immunoglobulin; rabies post-exposure prophylaxis; South Africa | ONE HEALTH; PREVENTION; EPIDEMIOLOGY; SURVEILLANCE; ELIMINATION; INJURIES; CHILDREN | Background: Rabies is an untreatable and highly fatal viral zoonosis. Despite the ability to control and prevent the disease, it is estimated that one person dies of rabies every 10 minutes in developing countries. However, the true burden of the disease remains undefined in most developing countries because of a lack of systematic surveillance. Dog bite data obtained from healthcare facilities where dog bite victims seek medical care may provide an additional source of information that can be used to inform the burden of disease and identify points for interventions for improved delivery of post-exposure prophylaxis (PEP) to prevent the disease. Methods: A descriptive epidemiological study was conducted using data obtained from dog bite registers and patient case files at a healthcare facility for a two year period (2015-2017). Results: The study reported frequency, demographics, source, geographic and temporal distribution of bite cases reported to a hospital serving a rabies-affected community. In addition, the post-exposure management of dog bite cases at this facility is described. Conclusion: Dog bites was not an infrequently reported at the healthcare facility, with up to 29 cases reported in a month during the study period. The affected population was defined and it is motivated that this information is useful for targeted health interventions. Findings related to the delivery of PEP may also be used to direct training and re-training of healthcare workers for improved delivery of PEP. |
| antimicrobial resistance; food safety; one health; zoonosis | ENTEROCOCCUS-FAECIUM; STAPHYLOCOCCUS-AUREUS; AVOPARCIN; COLISTIN; POULTRY; FARMS; LIVESTOCK; HUMANS; MEAT; TRANSMISSION | The surveillance of antimicrobial resistance among humans and food-producing animals is important to monitor the zoonotic transmission of multidrug-resistant bacteria (MDRB). We assessed the prevalence of four MDRB within the meat production chain, including extended-spectrum beta-lactamase (ESBL)-producing, carbapenemase-producing Enterobacterales (CPE) and colistin-resistant Enterobacterales (Col-E), as well as vancomycin-resistant enterococci (VRE). In total, 505 samples from four stages of meat production, i.e., slaughterhouses, meat-processing plants, fresh food products and the urban environment, were collected in northwestern Germany in 2018/2019 and screened for the presence of MDRB using both culture-based and PCR-based techniques. We detected genes encoding for carbapenemases in 9-56% (bla(OXA-48), bla(KPC), bla(NDM), bla(VIM)) and colistin resistance-encoding mcr genes in 9-26% of the samples from all stages. Culture-based analysis found CPE and VRE only in environmental samples (11% and 7%, respectively), but Col-E and ESBL-producers in 1-7% and 12-46% of samples from all stages, respectively. Overall, our results showed that ESBL-producers and mcr-carrying Col-E were common in food-producing animals at slaughterhouses, in meat-processing plants and in food items at retail, while CPE and VRE were only found in the environment. The discrepancy between detected carbapenemase genes and isolated CPE emphasizes the need for more sensitive detection methods for CPE monitoring. |
| TRANSMITTED HELMINTH INFECTIONS; LIFE-YEARS DALYS; HOOKWORM INFECTION; CEYLANICUM HOOKWORM; SYSTEMATIC ANALYSIS; NECATOR-AMERICANUS; GLOBAL BURDEN; DIARRHEA; IDENTIFICATION; COMMUNITY | Hookworm infections are classified as the most impactful of the human soil-transmitted helminth (STH) infections, causing a disease burden of similar to 4 million disability-adjusted life years, with a global prevalence of 406-480 million infections. Until a decade ago, epidemiological surveys largely assumed Necator americanus and Ancylostoma duodenale as the relevant human hookworm species implicated as contributing to iron-deficiency anemia. This assumption was based on the indistinguishable morphology of the Ancylostoma spp. eggs in stool and the absence of awareness of a third zoonotic hookworm species, Ancylostoma ceylanicum. The expanded use of molecular diagnostic assays for differentiating hookworm species infections during STH surveys has now implicated A. ceylanicum, a predominant hookworm of dogs in Asia, as the second most common hookworm species infecting humans in Southeast Asia and the Pacific. Despite this, with the exception of sporadic case reports, there is a paucity of data available on the impact of this emerging zoonosis on human health at a population level. This situation also challenges the current paradigm, necessitating a One Health approach to hookworm control in populations in which this zoonosis is endemic. Here, we have summarized the available research studies and case reports on human A. ceylanicum infections in Southeast Asia and the Pacific after 2013 using a systematic review approach. We summarized eight research articles and five clinical case studies, highlighting the importance of future in-depth investigation of zoonotic A. ceylanicum infections using sensitive and cost-effective diagnostic tools. |
| Staphylococcus; MRSA; microbiota; pig; Macrococcus; ESBL; Enterobacterales; Firmicutes; Proteobacteria; Actinobacteria | COAGULASE-NEGATIVE STAPHYLOCOCCI; MRSA; COLONIZATION; POPULATION; INFECTIONS; DIVERSITY; STRAINS; IMPACT; CC398; PIGS | Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) remains a serious public health threat. Porcine nasal cavities are predominant habitats of LA-MRSA. Hence, components of their microbiota might be of interest as putative antagonistically acting competitors. Here, an extensive culturomics approach has been applied including 27 healthy pigs from seven different farms; five were treated with antibiotics prior to sampling. Overall, 314 different species with standing in nomenclature and 51 isolates representing novel bacterial taxa were detected. Staphylococcus aureus was isolated from pigs on all seven farms sampled, comprising ten different spa types with t899 (n = 15, 29.4%) and t337 (n = 10, 19.6%) being most frequently isolated. Twenty-six MRSA (mostly t899) were detected on five out of the seven farms. Positive correlations between MRSA colonization and age and colonization with Streptococcus hyovaginalis, and a negative correlation between colonization with MRSA and Citrobacter spp. were found (p < 0.05). Of 209 non-S. aureus members of the Staphylococcaceae family, 25 isolates (12.0%) from three out of the seven farms exhibited methicillin resistance, including two Macrococcus goetzii isolates carrying the mecB gene. Among 125 Enterobacterales, none tested positive for extended-spectrum beta-lactamase (ESBL) and carbapenemase production. The high frequency of methicillin-resistant staphylococci supports the need for enhanced efforts within the One Health concept to manage the antibiotic resistance crisis in the human and veterinary medicine sector. |
| WEST-NILE; NEUTRALIZING ANTIBODIES; FLAVIVIRUSES; TRANSMISSION; EPIDEMIOLOGY; EVOLUTION; PIGS; ASIA | Mosquito-borne flaviviruses are emerging pathogens of an increasing global public health concern because of their rapid increase in geographical range and the impact of climate change. Japanese encephalitis virus (JEV) and West Nile virus (WNV) are of concern because of the risk of reemergence and introduction by migratory birds. In Singapore, human WNV infection has never been reported and human JEV infection is rare. Four sentinel vector surveillance sites were established in Singapore to understand the potential risk posed by these viruses. Surveillance was carried out from August 2011 to December 2012 at Pulau Ubin, from March 2011 to March 2013 at an Avian Sanctuary (AS), from December 2010 from October 2012 at Murai Farmway, and from December 2010 to December 2013 at a nature reserve. The present study revealed active JEV transmission in Singapore through the detection of JEV genotype II in Culex tritaeniorhynchus collected from an Avian Sanctuary. Culex flavivirus (CxFV), similar to the Quang Binh virus isolated from Cx. tritaeniorhynchus in Vietnam and CxFV-LSFlaviV-A20-09 virus isolated in China, was also detected in Culex spp. (vishnui subgroup). No WNV was detected. This study demonstrates the important role that surveillance plays in public health and strongly suggests the circulation of JEV among wildlife in Singapore, despite the absence of reported human cases. A One Health approach involving surveillance, the collaboration between public health and wildlife managers, and control of mosquito populations remains the key measures in risk mitigation of JEV transmission in the enzootic cycle between birds and mosquitoes. |
| dairy; workers; prevalence; tuberculosis; Texas | | Background: Mycobacterium bovis (bTB) is a potential health hazard to dairy workers. This study uses the One Health wholistic framework for examining bovine tuberculosis (TB) and its relationship to human health. This approach can help bridge surveillance data gaps and contribute to disease control and prevention programs for dairy farm workers, cattle, and the environment. The primary objective of this study was to compare the self-reported history of TB among dairy workers in Bailey County, Texas, with occupational categories of risk and exposure to TB. Methods: A cross-sectional study was conducted among dairy workers. Job positions were used as a proxy for exposure to cattle-high and medium/low. We employed bivariate analyses to examine differences between groups using both the chi-square test and the nonparametric Kruskal-Wallis test. Results: Of the 293 dairy workers invited, 77.0% (n = 225) participated. No statistically significant associations were found between job categories and reported history of TB exposure. Workers in the high group were younger, Guatemalan males with lower levels of formal education, more likely to be single with no children, and cohabitating with coworkers compared with the medium/low group. Conclusion/Application to Practice: Self-reported TB history among dairy workers is an imprecise measure of being previously diagnosed with TB. Dairy workers at risk for occupationally acquired TB could be tested for TB before employment and tested periodically thereafter, and more expeditiously treated if a positive test is obtained. Future studies should focus on the feasibility of offering on-farm health services, such as TB screening. |
| Presenteeism propensity; Unstable employment; Stable employment; Sickness absenteeism; Sickness presenteeism | PSYCHOSOCIAL WORK-ENVIRONMENT; SOCIOECONOMIC DIFFERENCES; ABSENCE; HEALTH; DETERMINANTS; PREVALENCE; RISK; ILL; FLEXIBILITY; ABSENTEEISM | Background: Sickness presenteeism (SP) indicates going to work while being ill. The importance of SP has only recently been investigated, and the association between SP and employment status has been inconsistent across studies. Therefore, we conducted this study to explore the association between SP and employment status by using presenteeism propensity (PP), which can reflect the individual decision-making process. Methods: The study population included employees participating in the 5th Korean Working Condition Survey. We analyzed data of only employees with at least one health event, which was calculated as the sum of SP and sickness absenteeism days. Employment status was grouped into 3 categories: stable employment, unstable employment (contract period >= 1 year), and unstable employment (contract period < 1 year). Survey-weighted logistic regression analysis was conducted to assess the association between employment status and PP (dichotomized as >= 0.5 and > 0.5). Results: Unstable employees (contract period >= 1 year) had higher odds of PP than stable employees (odds ratio [OR]: 1.23, 95% confidence interval [CI]: 1.03-1.47), whereas unstable employees (contract period < 1 year) had lower odds of PP than stable employees (OR: 0.82, 95% CI: 0.71-0.96). Conclusions: Employment status was associated with SP. Given the negative health impact of SP, social efforts, such as paid sick leave, are required to reduce SP and enhance the health status of unstable workers. |
| antimicrobial resistance; pigs; human; Thailand; Lao PDR | SPECTRUM BETA-LACTAMASE; MEDIATED QUINOLONE RESISTANCE; CLASS 1 INTEGRONS; ESCHERICHIA-COLI; CLASS-1 INTEGRONS; SALMONELLA; GENES; PREVALENCE; POULTRY; ENTEROBACTERIACEAE | This study aimed to investigate antimicrobial resistance (AMR) characteristics ofEscherichia coliisolates from pig origin (including pigs, pig carcass, and pork) and humans in Thailand and Lao People’s Democratic Republic (PDR) border provinces. The majority of theE. coliisolates from Thailand (69.7%) and Lao PDR (63.3%) exhibited multidrug resistance. Class 1 integrons with resistance gene cassettes were common (n = 43), of which the most predominant resistance gene cassette wasaadA1. The percentage of extended-spectrum beta-lactamase (ESBL) producers was 3.4 in Thailand and 3.2 in Lao PDR. The ESBL genes found werebla(CTX-M14),bla(CTX-M27), andbla(CTX-M55), of whichbla(CTX-M55)was the most common (58.6%). Ser-83-Leu and Asp-87-Asn were the predominant amino acid changes in GyrA of ciprofloxacin-resistant isolates. Twenty-two percent of all isolates were positive forqnrS. Class 1 integrons carryingaadA1from pigs (n = 1) and ESBL genes (bla(CTX-M55)andbla(CTX-M14)) from pigs (n = 2), pork (n = 1), and humans (n = 7) were located on conjugative plasmids. Most plasmids (29.3%) were typed in the IncFrepB group. In conclusion, AMRE. coliare common in pig origin and humans in these areas. The findings confirm AMR as One Health issue, and highlight the need for comprehensive and unified collaborations within and between sectors on research and policy. |
| Artificial intelligence; Big data; Crowdsourcing; Disaster response; Disease outbreak; Drones; Emergency response; Open-source data | | Disasters and disease outbreaks have long been a catalyst for innovative applications of emerging technologies. The urgent need to respond to an emergency leads to resourceful uses of the technologies at hand. However, the best and most cost-effective use of new technologies is to prevent disease and improve resilience. In this paper, the authors present a range of approaches through which both opportunities can be grasped. Global connectedness enables more data to be collected and processed in emergencies, especially with the rise of open-source data, including social media. In general, the poorest and most remote populations are most vulnerable to disaster. However, with smaller, faster, smarter, cheaper and more connected technology, reliable, efficient, and targeted response and recovery can be provided. Initially, crowdsourcing was used to find people, map affected areas, and determine resource allocation. This led to the generation of an overwhelming amount of data, and the need to extract valuable information from that data in a timely manner. As technology evolved, organisations started outsourcing many tasks, first to other people, then to machines. Since the volume of data generated outpaces human capacity, data analysis is being automated using artificial intelligence and machine learning, which furthers our abilities in predictive analytics. As we move towards prevention rather than remediation, information collection and processing must become faster and more efficient while maintaining accuracy. Moreover, these new strategies and technologies can help us to move forwards, by integrating layers of human, veterinary, public, and environmental health data for a One Health approach. |
| Enterobacteriaceae; ESBL; Colistin; Companion animal; Feline; One Health | | Objectives: Klebsiella pneumoniae has emerged as one of the major pathogens of humans and companion animals. Moreover, polymyxin resistance in K. pneumoniae is increasingly reported worldwide, mainly among extended-spectrum p-lactamase (ESBL)- and/or carbapenemase-producing isolates. The aim of this study was to report the draft genome sequence of a polymyxin-resistant, ESBL-producing K. pneumoniae isolate (14CSI) from a hospitalised domestic cat in Brazil. Methods: Whole-genome sequencing of strain 14CSI was performed on an Illumina NextSeq platform and the genome was de novo assembled using Velvet v.1.2.10. Data analysis was performed using bioinformatics tools available from the Center for Genomic Epidemiology and the Institut Pasteur database. Results: The genome size of strain 14CSI was calculated at 5 260 459 bp, with a GC content of 57.3% and comprising 5294 total genes, 28 tRNAs, 7 rRNAs, 8 ncRNAs and 237 pseudogenes. Klebsiella pneumoniae strain 14CSI belongs to sequence type 491 (ST491), presents a mutation (A14S) in the mgrB gene and coharbours bla(CTX-M-8) and qnrE1 genes. Genes conferring resistance to heavy metals were further identified. Conclusion: This draft genome could be used as a reference sequence for comparative analysis of polymyxin-resistant and/or CTX M 8 producing K. pneumoniae strains circulating at the human-animal interface. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. |
| ESBL; Escherichia coli; healthy volunteer; one health; CTX-M; whole genome sequencing | ESBL-PRODUCING ENTEROBACTERIACEAE; ESCHERICHIA-COLI; HEALTHY-INDIVIDUALS; FECAL CARRIAGE; RISK-FACTORS; COMMUNITY; COLONIZATION; PREVALENCE; SUBCLONE; HUMANS | We have attempted to define the prevalence and risk factors of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-Enterobacteriaceae) carriage, and to characterize antimicrobial susceptibility, beta-lactamase genes, and major types of isolated strains in volunteers, with a specific focus on humans in contact with animals. Samples were collected from 207 volunteers (veterinarians, pig farmers, dog owners, etc.) and cultured on selective agar. Clonal relationships of the isolated ESBL-Enterobacteriaceae were determined by whole genome sequencing and multi-locus sequence typing. Beta-lactamases were detected using a homology search. Subjects filled in questionnaires analyzed by univariate and multiple logistic regression. Colonization with ESBL-Enterobacteriaceae was found in fecal samples of 14 individuals (6.8%; 95%CI: 3.75-11.09%). In multiple regression analysis, working as a pig farmer was a significant risk factor for ESBL-Enterobacteriaceae carriage (OR 4.8; 95%CI 1.2-19.1). The only species isolated wasEscherichia colithat distributed into 11 sequence types. All ESBL-Enterobacteriaceae isolates were of CTX-M genotype, with theblaCTX-M-1 being the most prevalent and more common in pig farmers than in other groups. Despite the generally low prevalence of ESBL-Enterobacteriaceae in Estonia, the pig farmers may still pose a threat to transfer resistant microorganisms. The clinical relevance of predominantblaCTX-M-1 carryingE. coliis still unclear and needs further studies. |
| feline; horizontal gene transfer; One Health; plasmids; pan-resistome; staphylococci | BACTERIOCIN PRODUCTION; ANTIBIOTIC-RESISTANCE; CONJUGATIVE PLASMID; AUREUS; MOBILIZATION; GENES; STRAINS; ORIGIN | Staphylococcus nepalensis is a commensal bacterium from the oral microbiota of domestic cats, with a still obscure clinical importance. In this work, we analysed the ability of feline strains of S. nepalensis to transfer antimicrobial resistance genes to Staphylococcus aureus isolated from humans through plasmids. To this end, we first analysed all publicly available genomes from cat staphylococci using computational methods to build a pan-resistome. Genes that encode resistance to erythromycin, gentamicin, mupirocin and tetracycline, common to human and cat staphylococci and previously described to be located in mobile genetic elements, were chosen for the next analyses. We studied 15 strains of S. nepalensis, which were shown to be genetically different by GTG 5-PCR. As observed by disc diffusion, resistance to tetracycline was widespread (80%), followed by resistance to erythromycin (40 %), gentamicin (27 %) and mupirocin (7%). The strains were positive for several antimicrobial resistance genes and more than half of them harboured plasmids. The loss of plasmids and resistance genes in some strains were induced by stress with SDS. Through conjugation experiments, we observed that these plasmids can be transferred to S. aureus, thus increasing its potential to resist drug therapy. Our findings show that S. nepalensis, an underestimated inhabitant of the cat microbiota, can be a reservoir of antimicrobial resistance genes for S. aureus and, like many other staphylococci, be an overlooked and silent threat to their animal hosts and humans living with them. |
| energy; health promotion; healthy work conditions; occupational health; primary health care; salutogenic | PERCEIVED AUTONOMY; JOB-SATISFACTION; QUALITY ANALYSIS; RECOVERY; COHERENCE; SCALE; SENSE; ASSOCIATIONS; POPULATION; LEAVE | Objectives: The area of regenerative work is still close to unexplored. The aim was to explore the possibility for employees to gain energy at work. Methods: Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health, psychosocial work environment and experiences, recovery, social climate, and energy. Having an energy-building experience was defined by a positive response to two combined questions regarding energy at work. Analyses were performed with bivariate correlation and multiple logistic regression. Results: The response rate was 84%. Health and energy correlated positively (r = 0.54). In total, 44.5% of the employees reported having an energy-building experience. Predictors for having an energy-building experience were recovery [positive odds ratio (POR) = 2.78], autonomy (POR = 2.26), positive workplace characteristics (POR = 2.09), and internal work experiences (POR = 1.88). Conclusions: The results support the hypothesis that it is possible to gain energy at work, an area that is still close to unexplored. There is a high correlation between energy and health. Employees’ energy-building experiences relate to well-being at work and correlates to recovery, autonomy, positive workplace characteristics, and positive internal work experiences. This knowledge can help in improving future work environment development. |
| Toxoplasma gondii; seroprevalence; antigen; phylogeny; PCR; Korea | STRAY CATS; SEROLOGICAL SURVEY; PREGNANT-WOMEN; HOUSEHOLD CATS; FERAL CATS; INFECTION; PREVALENCE; ANTIBODIES; SEOUL; TRANSMISSION | The outbreak of human toxoplasmosis can be attributed to ingestion of food contaminated with Toxoplasma gondii. Toxoplasmosis recently increased in domestic and stray dogs and cats. It prompted studies on the zoonotic infectious diseases transmitted via these animals. Sero- and antigen prevalences of T gondii in dogs and cats were surveyed using ELISA and PCR, and B1 gene phylogeny was analyzed in this study. Toxoplasmosis antibodies were measured on sera of 403 stray cats, 947 stray dogs, 909 domestic cats, and 2,412 domestic dogs collected at nationwide regions, Korea from 2017 to 2019. In addition, whole blood, feces, and tissue samples were also collected from stray cats (1,392), stray dogs (686), domestic cats (3,040), and domestic dogs (1,974), and T gondii-specific B1 gene PCR was performed. Antibody prevalence of stray cats, stray dogs, domestic cats, and domestic dogs were 14.1%, 5.6%, 2.3%, and 0.04%, respectively. Antigen prevalence of these animals was 0.5%, 0.2%, 0.1%, and 0.4%, respectively. Stray cats revealed the highest infection rate of toxoplasmosis, followed by stray dogs, domestic cats, and domestic dogs. Bl gene positives were 5 of stray cats, and identified to high/moderate pathogenic Type I/III group. These findings enforce that preventive hygienic measure should be strengthened at One Health level in dogs and cats, domestic and stray, to minimize human toxoplasmosis infections. |
| CLIMATE-CHANGE | Objectives: We examine the public health response to an unprecedented multiple mortality event in bats following an extreme heat event. The main public health risk associated with the event and the environmental cleanup was potential human infection with Australian bat lyssavirus. We also consider the public health implications as we enter an age of climate change, vulnerability and unexpected events. Type of service: The Tropical Public Health Service of Far North Queensland worked collaboratively with the local council to coordinate a practical public health and health protection response to a mass mortality event in bats in late 2018. Methods: A coordinated response was instigated to remove thousands of decaying bat corpses from residential areas. This occurred alongside a health education campaign advising the public to avoid handling bats. Results: The combined efforts were successful; those requiring vaccination and post-exposure prophylaxis were treated appropriately and owing to a successful campaign, exposures were minimised. However, significant issues with misinformation and social media messaging were noted, alongside amateur bat carers handling sick and injured bats inappropriately, compounding the challenge for public health services. This mass mortality event has implications regarding the preparation for and management of other unexpected public health crises related to climate change. Lessons learnt: It is vital that areas populated with bats be prepared for extreme heat events (EHEs). Public health units need to be prepared for the unexpected events of climate change, advocate for a ‘one health’ approach to public health, and work with local and national governments to become ‘climate ready’. |
| Cerebrovascular accident; Disease management; Rehabilitation; Shoulder pain; Symptom assessment | RISK-FACTORS; NATURAL-HISTORY; STROKE; POPULATION; REHABILITATION; CLASSIFICATION; PARTICIPATION; ASSOCIATION; RELIABILITY; PREDICTORS | Background: Post-stroke Shoulder Pain (PSSP) is a common stroke-related syndrome that pro-longs hospitalization and diminishes quality of life. PSSP studies were unsuccessful in clarifying pathophysiological mechanisms. Therefore, cohort’s studies with greater variety of the sample and larger follow-up period could provide additional clinical data and may improve medical care. Objective: To classify people with PSSP and identify intergroup clinical differences, providing additional data useful for therapeutic care planning. Methods: One thousand individuals with stroke were selected from all levels of one health Area and followed up during one year. Demographic data, stroke clinical characteristics, stroke-related symptoms and rehabilitation parameters were collected. The shoulder muscle impairment was used to group participants into three clinical profiles: severe muscular impairment, moderate muscular impairment and low muscular impairment groups. Results: A total of 119 individuals were diagnosed with PSSP. The suggested classification criteria showed two groups that differed significantly in relation to the onset and duration of PSSP, presence of sensory and speech impairment, and spasticity. The outcomes did not firmly support the existence of a third suggested PSSP subtype. Conclusions: PSSP may vary in onset, clinical manifestations, severity and syndrome duration. These results highlight the course of different clinical profiles and require multidisciplinary management approaches. (C) 2019 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved. |
| Cattle; Coxiella burnetii; Caribbean islands; Q fever; Sheep; Seroepidemiologic studies; Veterinary school | LINKED-IMMUNOSORBENT-ASSAY; COMPLEMENT-FIXATION TEST; Q-FEVER ENDOCARDITIS; TICKS; PREVALENCE; WILDLIFE; IMMUNOFLUORESCENCE; SEROPREVALENCE; AUSTRALIA; INFECTION | Coxiella burnetii is a ubiquitous zoonotic bacterium reported worldwide that causes Q-fever. Infections result in profound economic losses to livestock producers by causing abortions and low birth weights. Current information about the disease in the Caribbean region is scarce. With multiple small islands and territories, it is often considered that the bacterium is absent or circulates at a low prevalence. Our study aimed to determine whether sheep and cattle housed at a veterinary campus in St Kitts had previous exposure to C. burnetii. Blood samples were taken from cattle (n = 63; 72% of the herd) and sheep (n = 133; 71% of the flock). Antibodies to C. burnetii were detected by a commercial indirect enzyme-linked immunosorbent assay (IDvet (R) ELISA) test. The seroprevalence was estimated at 26.3% (95% CI: 19.1-34.7%) in sheep and 0% (95% CI: 0-5.7%) in cattle. Sheep importation to St. Kitts is very rare, thus, these results suggest that C. burnetii is present on the island. The seronegativity of all the cattle highlights the absence of the bacterium on the veterinary campus. The high seroprevalence in sheep, however, has potentially important implications for animal health and public health as well as for wildlife conservation. Further investigation about animal seroprevalence and human exposure are warranted in St. Kitts and in the Caribbean region. |
| claims; food; beverage; label; nutrition; health | | Nutrition and health claims should be truthful and not misleading. We aimed to determine the use of nutrition and health claims in packaged foods sold in Mongolia and examine their credibility. A cross-sectional study examined the label information of 1723 products sold in marketplaces in Ulaanbaatar, Mongolia. The claim data were analysed descriptively. In the absence of national regulations, the credibility of the nutrition claims was examined by using the Codex Alimentarius guidelines, while the credibility of the health claims was assessed by using the European Union (EU) Regulations (EC) No 1924/2006. Nutritional quality of products bearing claims was determined by nutrient profiling. Approximately 10% (n = 175) of products carried at least one health claim and 9% (n = 149) carried nutrition claims. The credibility of nutrition and health claims was very low. One-third of nutrition claims (33.7%, n = 97) were deemed credible, by having complete and accurate information on the content of the claimed nutrient/s. Only a few claims would be permitted in the EU countries by complying with the EU regulations. Approximately half of the products with nutrition claims and 40% of products with health claims were classified as less healthy products. The majority of nutrition and health claims on food products sold in Mongolia were judged as non-credible, and many of these claims were on unhealthy products. Rigorous and clear regulations are needed to prevent negative impacts of claims on food choices and consumption, and nutrition transition in Mongolia. |
| ONE HEALTH; PROPHYLAXIS; RISK | Background: The risk of contracting rabies is low for travellers. However, the number of Dutch travellers potentially exposed abroad following an animal-associated injury and needing post-exposure prophylaxis (PEP) has increased, resulting in increased costs. Aim: Here, we evaluated the costs and the cost-effectiveness of different pre- and post-exposure interventions in the Netherlands, taking into account the 2018 World Health Organization ( WHO) recommendations for the prevention of rabies. Methods: A decision tree-based economic model was constructed. We calculated and compared the cost of different WHO pre- exposure prophylaxis (PrEP) recommendations, intramuscular vs intradermal vaccination and PEP subsequent to increased vaccination coverage in risk groups. We estimated cost-effectiveness, expressed as incremental costs per rabies immunoglobulin (RIG) administration averted, using a societal perspective. Statistical uncertainty regarding number of travellers and vaccination coverage was assessed. Results: Total costs at the national level were highest using previous WHO recommendations from 2012, estimated at EUR 15.4 million annually. Intradermal vaccinations in combination with the current recommendations led to the lowest costs, estimated at EUR 10.3 million. Higher vaccination uptake resulted in higher overall costs. The incremental costs per RIG administration averted varied from EUR 21,300-46,800. Conclusions: The change in rabies PrEP and PEP recommendations in 2018 reduced total costs. Strategies with increased pre-travel vaccination uptake led to fewer RIG administrations and fewer vaccinations after exposure but also to higher total costs. Although larger scale intradermal administration of rabies vaccine can reduce total costs of PrEP and can positively influence vaccination uptake, it remains a costly intervention. |
| Electronic health records; Scanned documents; Classification; Optical character recognition; Machine learning; Patient safety | | Objectives: Electronic Health Records (EHRs) contain scanned documents from a variety of sources such as identification cards, radiology reports, clinical correspondence, and many other document types. We describe the distribution of scanned documents at one health institution and describe the design and evaluation of a system to categorize documents into clinically relevant and non-clinically relevant categories as well as further subclassifications. Our objective is to demonstrate that text classification systems can accurately classify scanned documents. Methods: We extracted text using Optical Character Recognition (OCR). We then created and evaluated multiple text classification machine learning models, including both bag of words and deep learning approaches. We evaluated the system on three different levels of classification using both the entire document as input, as well as the individual pages of the document. Finally, we compared the effects of different text processing methods. Results: A deep learning model using ClinicalBERT performed best. This model distinguished between clinically relevant documents and not clinically-relevant documents with an accuracy of 0.973; between intermediate subclassifications with an accuracy of 0.949; and between individual classes with an accuracy of 0.913. Discussion: Within the EHR, some document categories such as external medical records may contain hundreds of scanned pages without clear document boundaries. Without further sub-classification, clinicians must view every page or risk missing clinically-relevant information. Machine learning can automatically classify these scanned documents to reduce clinician burden. Conclusion: Using machine learning applied to OCR-extracted text has the potential to accurately identify clinically-relevant scanned content within EHRs. |
| Participatory epidemiology; Participation; Translation; Interpreter; Public sphere; Consensus | LINEAGE-2 RINDERPEST VIRUS; DISEASE SURVEILLANCE; MOUTH-DISEASE; ONE HEALTH; EPIDEMIOLOGY; LIVELIHOODS; KNOWLEDGE; CATTLE; PASTORALISTS; EXPERIENCES | Participatory epidemiology (PE) is a method that gathers data from groups through focus group interviews and participatory visual and scoring exercises. The method is often used in poor communities in low-income countries where it is hard to obtain conventional epidemiological data. This paper draws on research on the public sphere and democratic deliberation, along with research on language and interpretation, to suggest how PE research could be better equipped to account for diversity in local knowledge, include minority views and acknowledge power dynamics. These aspects are discussed under the three themes of ‘plurality’, ‘power’ and ‘language’. A review of highly-cited PE literature suggests that PE research engages with plurality and power to a very limited extent, and only marginally more so with language and translation. Examples are taken from the authors’ own PE research on African swine fever in -Uganda, classical swine fever in Germany, peste des petits ruminants (PPR) in Eastern Europe, and Ugandan pastoralists’ understanding of cattle disease to provide more detail as to why conventional PE studies might fail to record issues of plurality, power and language, and also to suggest how this can be addressed. With reference to the literature on the public sphere and democratic deliberation, and on language and interpretation, this paper concludes with some suggestions as to how to take plurality, power and language into greater consideration in PE studies in future, thus improving the validity and reliability of PE data. |
| clinician; emergency department; nominal group technique; stress; wellness | PSYCHOLOGICAL SAFETY; HEALTH-CARE; STRESS; RESILIENCE; BURNOUT | Objective Busy, high-stress EDs prompt many work-based interventions to address staff wellness, with mixed success. The aim of the present study was to enable ED clinicians to systematically identify core components of a work-based strategy to improve their working environment and/or coping. Methods Purposively sampled ED doctors and nurses from one health service were invited to participate in modified nominal group technique. Participants identified, from a pre-defined list, a key ED stressor and then discussed and ratified proposed core components of a work-based strategy to address or ameliorate this stressor. Results Two nominal group technique sessions were held with a total of 10 participants (n= 7 nurses andn= 3 doctors). Participants proposed several strategies aimed at both individual and organisational levels to address occupational stress and coping, and support staff well-being in the workplace. These included mobile/web-based applications, group counselling sessions, yoga, social activities, team building activities and debriefing. Participants described three key components to promote staff wellness and hence enhance their ability to buffer negative aspects of occupational stress: (i) increased individual and team support; (ii) development of professional resilience; and (iii) maximising opportunities for social connection. Conclusions Ensuring appropriate systems, services and support for ED staff should be a priority at local departmental, wider organisational and governmental levels. ED clinicians are ideally placed to identify such systems, services and supports. Managers and policy makers can use these findings to inform the implementation of interventions in EDs. |
| Calendar; Survey; Health; Iran | INFORMATION-SYSTEMS; CARE | Background: Health survey is one of the important and valuable methods in producing health indicators and has become a part of health information system. Health surveys planned and performed properly can be used in assessing population health, policymaking, planning, health monitoring, evaluating, and observatories. Objectives: The present paper is the product of a project to establish a calendar for health observatory studies, which has to compatible with Iran’s Sustainable Development Plans. Methods: The main question of this qualitative study was: what are the reasons and solutions for having up-to-date, sufficient, quality information, and how could we ensure they are being carried out? Data collection methods included interviews, reviewing documents and records, and interviewing focus groups of Iranian experts and health policy-makers. Results: Thirty-one health observatory studies, concurrent with Iran’s five-year Socioeconomic Development Plans, passed the consensus of stakeholders. The span of time to conduct each study was determined based on five-year Development Plans and national and international organizations’ requests for certain information. Conclusions: If the policy-makers are constantly pleased with up-to-date, sufficient, and quality information, sustainability of sticking to this calendar can be secured. The effective factors in successful implementation of this calendar is timely financing, defining health observatory survey and study protocols, apportioning duties among valid research centers, training interviewers not affiliated with health system, maintaining of experienced Iranian and international legal observers, assessing performance method of each survey, and implementing the results and findings in the future. |
| One health; Rwanda; Human– wildlife interface; Mountain gorillas; HRSV; Respiratory disease | HUMAN METAPNEUMOVIRUS INFECTION; CHIMPANZEE PAN-TROGLODYTES; STREPTOCOCCUS-PNEUMONIAE; WILD CHIMPANZEES; NATIONAL-PARK; GROUP-A; MOLECULAR EPIDEMIOLOGY; CIRCULATION PATTERNS; POPULATION-DYNAMICS; BERINGEI-BERINGEI | Respiratory illness (RI) accounts for a large proportion of mortalities in mountain gorillas (Gorilla beringei beringei), and fatal outbreaks, including disease caused by human metapneumovirus (HMPV) infections, have heightened concern about the risk of human pathogen transmission to this endangered species, which is not only critically important to the biodiversity of its ecosystem but also to the economies of the surrounding human communities. Our goal was to conduct a molecular epidemiologic study to detect the presence of HRSV and HMPV in fecal samples from wild human-habituated free-ranging mountain gorillas in Rwanda and to evaluate the role of these viruses in RI outbreaks. Fecal samples were collected from gorillas with clinical signs of RI between June 2012 and February 2013 and tested by real-time and conventional polymerase chain reaction (PCR) assays; comparison fecal samples were obtained from gorillas without clinical signs of RI sampled during the 2010 Virunga gorilla population census. PCR assays detected HMPV and HRSV first in spiked samples; subsequently, HRSV-A, the worldwide-circulating ON1 genotype, was detected in 12 of 20 mountain gorilla fecal samples collected from gorillas with RI during outbreaks, but not in samples from animals without respiratory illness. Our findings confirmed that pathogenic human respiratory viruses are transmitted to gorillas and that they are repeatedly introduced into mountain gorilla populations from people, attesting to the need for stringent biosecurity measures for the protection of gorilla health. |
| Transition to adulthood; Disability; Food security; Health; Healthcare | INSECURITY; OUTCOMES; CHILDREN; INCOME; LIFE | Background: Due to a more stringent disability definition used for eligibility redetermination at age 18, individuals with disabilities may lose eligibility for the Supplement and Nutrition Assistance Program (SNAP). Objective: This study examines how the transition to adulthood may affect the association between food security and self-rated health and healthcare needs for individuals with disabilities. Methods: The study uses five years of data (2011-2015) from the National Health Interview Survey (NHIS). One health indicator, self-rated health status, and two indicators of unmet healthcare needs, delayed medical care and not receiving medical care due to cost, are analyzed as dependent variables. The effects of food security status on health and health-related outcomes are closely examined for the four groups: youth without disabilities, youth with disabilities, young adults without disabilities and young adults with disabilities. Results: Results indicate a statistically significant association between food security status and self-rated health and unmet healthcare needs in late childhood and young adulthood. Such association is stronger for young adults than for youth. The association between low food security and self-rated health and health-related outcomes does not significantly differ between the two youth groups or the two young adult groups by disability status. Conclusions: Suggestions for improving accessibility of public food and nutrition programs are discussed. The study also suggests the importance of creating a healthcare system that benefits every member of the society. (C) 2020 Elsevier Inc. All rights reserved. |
| Escherichia coli; MDR; bla(CMY); pig; feces; soil | MULTIPLEX PCR ASSAYS; ANTIMICROBIAL RESISTANCE; TYPING METHOD; PREVALENCE; PLASMIDS; SEQUENCE; TETRACYCLINE; MECHANISMS; CHILDREN; ANIMALS | Diarrheagenic Escherichia coli cause diarrheal diseases, which are a public health concern and affect mainly developing countries. Multidrug-resistant (MDR) pathogens have been spreading in different sources, including animals and the environment. E. coli strains were obtained from a small-scale pig farm and 33 antimicrobials were tested. All strains were classified as MDR and harbored several antimicrobial resistance genes (ARGs) [bla(CMY), bla(OXA-1-like), bla(SHV), tet(A), tet(B), aadA, aac(6′)-Ib, aph(3 ‘)-Ia, sul1, sul2, sul3, floR, and cmlA] and plasmids. Besides, mutations in quinolone resistance-determining region of GyrA (Ser83Leu and Asp87Asn) and ParC (Glu84Asp) were detected. Among the MDR E. coli, nine strains (52%) presented diarrheagenic virulence genes, including genes related to Shiga toxin-producing E. coli (STEC), enteroinvasive E. coli (EIEC), and enteroaggregative E. coli (EAEC). The pulsed-field gel electrophoresis results showed a high genetic diversity among the MDR E. coli strains. Multilocus sequence typing (MLST) analyses revealed different sequence types phylogenetically related to each other, including ST10 and ST56. Subtyping of MLST by fimH gene showed different fimH type. This study shows a high genetic diversity among MDR ARG-producing E. coli belonging to STEC, EIEC, and EAEC pathotypes obtained from a small-scale pig farm and contributes to the monitoring of antimicrobial-resistant pathogens worldwide, mainly in environmental samples, which are associated with One Health framework. |
| Coronavirus; Exercise; Covid-19; Exercise immunology | LYMPHOCYTE PROLIFERATIVE RESPONSE; PHYSICAL-ACTIVITY; SEDENTARY BEHAVIOR; MODERATE EXERCISE; OLDER-ADULTS; INFECTION; DISEASE; INTENSITY; RUNNERS; NEED | The aim of this review is to examine the mutual interaction of the regular moderate exercises that can be performed in an isolated environment and COVID-19 virus with the immune system and to emphasize the importance of physical activity and exercise practices which are known as complementary treatment method in struggling with diseases based on the data obtained. COVID-19 pandemic has become a great problem lately for the whole world population because of its fatal effect. Staying at home for months can cause sedentary behaviors and some changes in people’s immune responses by restricting their physical and social activities. The databases such as PubMed, Elsevier, Scopus and Science Direct and Google Scholar have been used for scientific surveys while working on this review. The sources cited in this review include reports on past or current public health by more than one health institution, online information, and a total of 59 scientific articles published in refereed journals. In this review, the interaction of physical activity and exercise practices with immune responses during COVID-19 pandemic has been presented and it has been indicated that according to the data obtained from the studies conducted in previous years, physical activity and moderate exercise practices have a positive effect on immune system responses, but high-intensity and long term exercises suppress the immune system. As a consequence, social isolation during COVID-19 pandemic may cause sedentary behaviors. Therefore, individualized proper exercise practices are strongly recommended. |
| ST1485 (CC648); ExPEC; MDR; ESBL; AmpC; dogs; E; coli; K; pneumoniae | SPECTRUM-BETA-LACTAMASE; ESCHERICHIA-COLI; ANTIMICROBIAL RESISTANCE; KLEBSIELLA-PNEUMONIAE; ENTEROBACTERIACEAE; VIRULENCE; CARRIAGE; RISK | The aim of this work was to assess the prevalence of extended spectrum-beta-lactamase (ESBL)- and carbapenemase-producingEnterobacteriaceaein fecal samples recovered from rural and urban healthy dogs in Northwest Spain (Galicia) to identify potential high-risk clones and to molecularly characterize positive isolates regarding the genes coding for ESBL/pAmpC resistance and virulence. Thirty-five (19.6%) out of 179 dogs were positive for cephalosporin-resistantEnterobacteriaceae, includingEscherichiacoliandKlebsiella pneumoniae(39 and three isolates, respectively). All the isolates were multidrug resistant, with high rates of resistance to different drugs, including ciprofloxacin (71.4%). A wide diversity of ESBL/pAmpC enzymes, as well asE. coliphylogroups (A, B1, C, D, E, F and clade I) were found. The eight isolates (20.5%) found to conform to the ExPEC status, belonged to clones O1:H45-clade I-ST770 (CH11-552), O18:H11-A-ST93-CC168 (CH11-neg), O23:H16-B1-ST453-CC86 (CH6-31), and O83:H42-F-ST1485-CC648 (CH231-58), with the latter also complying the uropathogenic (UPEC) status. The threeK. pneumoniaerecovered produced CTX-M-15 and belonged to the ST307, a clone previously reported in human clinical isolates. Our study highlights the potential role of both rural and urban dogs as a reservoir of high-riskEnterobacteriaceaeclones, such as the CC648 ofE. coliand antimicrobial resistance traits. Within a One-Health approach, their surveillance should be a priority in the fight against antimicrobial resistance. |
| AMR; Colistin; mcr-1; one health approach; food-producing animals | ANTIBIOTIC-RESISTANCE; BACTERIA; SPREAD; HEALTH; GENES | Objectives: This study aims at evaluating the phenotypic and genotypic antimicrobial resistance (AMR) patterns of 18 clinically relevant antibiotics in food animals in Qatar. Materials and Methods: Fecal samples from camels, cattle, and pigeons (300) were collected from different slaughterhouses and farms. Escherichia coli isolates were recovered on selective media, confirmed biochemically, and tested for antibiotic susceptibility using a disk diffusion assay. Any isolate that showed resistance to colistin was confirmed using the E-test and polymerase chain reaction for mcr genes. Results: Overall, a total of 88.7% (n = 266/300) recovery rate was achieved from all samples. Resistance to at least one antibiotic was recorded in 70.7% of pigeons, 37.2% of cattle, and only 20.8% of camel samples. Multidrug resistance (MDR) was highest in isolates from pigeons, 50% (n = 44). Moreover, trimethoprim/sulfamethoxazole (an antibiotic used to treat a variety of bacterial infections) resistance was present in 22.2% (n = 59) of all E. coli isolates. Only one E. coli isolate from a pigeon showed resistance to colistin (mcr-1 gene encoded), a drug of last resort in human medicine against gram-negative bacterial infection. Conclusions: We previously reported high multidrug resistance of E. coli in chickens, with significant resistance to colistin. We observed a lower AMR profile in ruminants. The high resistance profile observed in pigeons (70.7%), including high multidrug resistance (50%), is alarming as these animals could rapidly disseminate resistant bacteria to various locations. Continuous monitoring of AMR in livestock in Qatar is necessary toward introducing an antimicrobial stewardship program and control of antibiotic usage in the veterinary sector. |
| Lung cancer; cancer screening; guideline adherence; preventive health services; healthcare delivery | PREVENTIVE SERVICES; CT | Objectives Lung cancer remains the leading cause of cancer-related deaths in the United States. In 2013, the US Preventive Services Task Force recommended annual screening for lung cancer with low-dose computed tomography in adults meeting certain criteria. This study seeks to assess lung cancer screening uptake in three health systems. Setting This study was part of a randomized controlled trial to engage underserved populations in preventive care and includes 45 primary care practices in eight states. Methods Practice and clinician characteristics were manually collected. Lung cancer was measured from electronic health record data. A generalized linear mixed model was used to assess characteristics associated with screening. Results Patient records between 2012 and 2016 were examined. Lung cancer screening uptake overall increased only slightly after the guideline change (2.8-5.6%, p < 0.01). One health system did not show an increase in uptake (0.2-0.1%, p = 0.32), another had a clinically insignificant increase (1.5-2.9%, p < 0.01), and the third nearly doubled its higher baseline screening rate (10.4-19.1%, p < 0.01). Within the third health system, patients more likely to be screened were older, male, had more comorbid conditions, visited the office more frequently, were seen in practices closer to the screening clinic, or were uninsured or covered by Medicare or Medicaid. Conclusions Certain patients appeared more likely to be screened. The only health system with increased lung cancer screening explicitly promoted screening rather than relying on clinicians to implement the new guideline. Systems approaches may help increase the low uptake of lung cancer screening. |
| Child; health survey; health status; oral-dental health | QUALITY-OF-LIFE; EARLY-CHILDHOOD | Aim: This study aims to identify the frequency of the most commonly seen health complaints and their relations with the socio-demographic characteristics of households in Turkey. Materials and Methods: The Turkey Health Survey research was conducted as a cross-sectional study by The Turkish Statistical Institute. Within the scope of the research, the health status history of a total of 3.921 children aged 7-14 was examined to identify the following factors: Gender and age of the children, some sociodemographic characteristics of their households, health complaints in the previous 6 months and treatment status at health-care facilities for these children aged 7-14 years. Results: The findings showed that of the 3.921 children who participated in this research, 50.8% were male, 34.4% had at least one health complaint, and 88.0% of the children with health complaints were treated. The most commonly seen health complaints in the children in the previous 6 months were oral and dental-related health complaints (25.8%), eye-related health complaints (14.6%) and infectious diseases (9.8%). According to the results of a logistic regression, the higher the number of people living in the household, the presence of a person who defines their health status as poor and the presence of an individual with chronic disease in the household affect the presence of health complaints in children negatively. Conclusion: It was found that the health status of children can be affected in families with chronic disease or poor health, and it is suggested that research on child health should be investigated extensively in such families. |
| Subcritical zoonoses; Stuttering zoonoses; Epidemiological control; Emerging infectious diseases; Cross-species spillover transmission; Human-to-human transmission; Infectious disease dynamics | INFLUENZA-A H5N1; TRANSMISSION DYNAMICS; HUMAN MONKEYPOX; VIRUS; EBOLA; DISEASE; OUTBREAKS; MEASLES; CONGO; H7N9 | Background For many emerging or re-emerging pathogens, cases in humans arise from a mixture of introductions (via zoonotic spillover from animal reservoirs or geographic spillover from endemic regions) and secondary human-to-human transmission. Interventions aiming to reduce incidence of these infections can be focused on preventing spillover or reducing human-to-human transmission, or sometimes both at once, and typically are governed by resource constraints that require policymakers to make choices. Despite increasing emphasis on using mathematical models to inform disease control policies, little attention has been paid to guiding rational disease control at the animal-human interface. Methods We introduce a modeling framework to analyze the impacts of different disease control policies, focusing on pathogens exhibiting subcritical transmission among humans (i.e. pathogens that cannot establish sustained human-to-human transmission). We quantify the relative effectiveness of measures to reduce spillover (e.g. reducing contact with animal hosts), human-to-human transmission (e.g. case isolation), or both at once (e.g. vaccination), across a range of epidemiological contexts. Results We provide guidelines for choosing which mode of control to prioritize in different epidemiological scenarios and considering different levels of resource and relative costs. We contextualize our analysis with current zoonotic pathogens and other subcritical pathogens, such as post-elimination measles, and control policies that have been applied. Conclusions Our work provides a model-based, theoretical foundation to understand and guide policy for subcritical zoonoses, integrating across disciplinary and species boundaries in a manner consistent with One Health principles. |
| biting midges; Ixodes ricinus; moose; One Health; red deer; reindeer | IXODES-RICINUS TICKS; MOOSE ALCES-ALCES; MOLECULAR-DETECTION; SP-NOV.; DOMESTIC RUMINANTS; GENETIC DIVERSITY; LIPOPTENA-CERVI; VECTOR-BORNE; SPP.; DEER | Bartonellaspp. are fastidious, gram-negative, aerobic, facultative intracellular bacteria that infect humans, and domestic and wild animals. In Norway,Bartonellaspp. have been detected in cervids, mainly within the distribution area of the arthropod vector deer ked (Lipoptena cervi). We used PCR to survey the prevalence ofBartonellaspp. in blood samples from 141 cervids living outside the deer ked distribution area (moose [Alces alces,n = 65], red deer [Cervus elaphus,n = 41] and reindeer [Rangifer tarandus,n = 35]), in 44 pool samples of sheep tick (Ixodes ricinus, 27 pools collected from 74 red deer and 17 from 45 moose) and in biting midges of the genusCulicoides(Diptera: Ceratopogonidae, 120 pools of 6,710 specimens).BartonellaDNA was amplified in moose (75.4%, 49/65) and in red deer (4.9%, 2/41) blood samples. All reindeer were negative. There were significant differences inBartonellaprevalence among the cervid species. Additionally,Bartonellawas amplified in two of 17 tick pools collected from moose and in 3 of 120 biting midge pool samples. TheBartonellasequences amplified in moose, red deer and ticks were highly similar toB. bovis, previously identified in cervids. The sequence obtained from biting midges was only 81.7% similar to the closestBartonellaspp. We demonstrate thatBartonellais present in moose across Norway and present the first data on northern Norway specimens. The high prevalence ofBartonellainfection suggests that moose could be the reservoir for this bacterium. This is the first report of bacteria from theBartonellagenus in ticks from Fennoscandia and in Culicoides biting midges worldwide. |
| Bovine brucellosis; sero-surveillance; farming systems; zoonosis; food security; one health | CATTLE | Bovine brucellosis affects food safety, food security and human health in rural communities in the North West Province, South Africa. The World Organisation for Animal Health suggests routine sero-surveillance and vaccination of cattle for control and to prevent zoonotic transmission. Although sero-surveillance and subsidised vaccination have been in place for decades, data from Bojanala have not previously been analysed. The aim of this study was to retrospectively analyse historical data on routine sero-surveillance of bovine brucellosis and state subsidised vaccination, in communal, commercial and dairy cattle in the study area. This was a descriptive, cross-sectional retrospective analysis of records from all adult cows bled by the state veterinary services during routine sero-surveillance for bovine brucellosis, in the Bojanala Region, North West Province, between 2009 and 2013. Fewer communal (N = 11 815) and dairy (N = 6696), than commercial beef (N = 28 251) cows, were tested. Overall herd prevalence (33.33%), differed significantly from individual prevalence (3.18%) in all groups. Communal herds had both the highest herd prevalence (38.8%) and the highest individual prevalence (5.2%). Both herd and individual sero-prevalence were lowest in dairy cattle, possibly because registered dairy herds are routinely tested. Over the 5-year study period, only 24 086 (7.15%) of the 342 500 cows eligible for free vaccination, were vaccinated. The annual number of cattle tested was highly variable. Dairy cattle that were regularly tested had a significantly lower herd and individual prevalence. Herd prevalence would be useful for spatial mapping, whilst individual prevalence could better reflect the risk of zoonotic transmission. |
| Sporothrix brasiliensis; Sporotrichosis; Domestic cat (Felis catus); Veterinarian; Infant; Argentina | GUIDELINES; SCHENCKII; GLOBOSA; UPDATE | Sporotrichosis is considered a neglected disease of humans and animals in many regions of the world and is the most frequent implantation mycosis in Latin America. Objectives. – To illustrate the zoonotic importance of the disease, describing a case involving a veterinarian and an infant that acquired the disease from a domestic cat and to describe, genotype and characterize these new isolates. Methods. – Direct examination of tissue samples from the two patients and feline lesions revealed the presence of Sporothrix yeast-like organisms. Fungal cultures and molecular identification of the strains were performed. Since antifungal susceptibility data of animal-borne isolates are scarce, the in vitro susceptibility testing by a microdilution reference method was determined against azoles, amphotericin B and terbinafine. Results. – Fungal culture and sequence analysis of the ITS region of rDNA and calmodulin and b-tubulin genes confirmed the diagnosis and the causative agent as Sporothrix brasiliensis. In all cases, terbinafine was the most active drug, followed by posaconazole, itraconazole and voriconazole; the least active drugs were amphotericine B and fluconazole. Lack of clinical response in the veterinarian and in the infant to itraconazole and potassium iodide, respectively was observed. Conclusions. – This study contributed to the molecular epidemiology of Sporothrix species in Argentina and the characterization of the in vitro susceptibility pattern of S. brasiliensis isolates recovered from a cat and two humans involved in this case of zoonotic sporotrichosis. Bearing in mind the “One Health” concept, the experience described in the present study highlights the need for future strategies for sporotrichosis treatment, control and prevention. (C) 2019 Elsevier Masson SAS. All rights reserved. |
| Economic analysis; health services; self-care; complementary medicine; allied health | ALTERNATIVE MEDICINE USE; UNITED-STATES; COMPLEMENTARY; ADULTS; MANAGEMENT; ADHERENCE; CHILDREN; BURDEN | Objective: This study aims to describe the prevalence of health care utilization (including conventional medicine, self-care and complementary medicine treatments) for the management of asthma by women aged 45 years and over and their associated out-of-pocket expenditure. Methods: A self-reported mail survey of 375 Australian women, a cohort of the national 45 and Up Study, reporting a clinical diagnosis of asthma. The women were asked about their use of health care resources including conventional medicine, complementary medicine, and self-prescribed treatments for asthma and their associated out-of-pocket spending. Spearman’s correlation coefficient, student’s t-test and chi-square test were used as appropriate. Population level costs were created by extrapolating the costs reported by participants by available national prevalence data. Results: Survey respondents (N = 375; response rate, 46.9%) were, on average, 67.0 years old (min 53, max 91). The majority (69.1%; n = 259) consulted at least one health care practitioner in the previous 12 months for their asthma. Most of the participants (n = 247; 65.9%) reported using at least one prescription medication for asthma in the previous 12 months. The total out-of-pocket expenditure on asthma treatment for Australian women aged 50 years and over is estimated to be AU$159 million per annum. Conclusions: The breadth of conventional and complementary medicine health care services reported in this study, as well as the range of treatments that patients self-prescribe, highlights the challenges of coordinating care for individuals living with asthma. |
| Water reuse; Constructed wetland; Rhizosphere; Plant growth promoting bacteria; Emerging organic pollutants; Antibiotic resistance | ANTIBIOTIC-RESISTANCE GENES; FLOW CONSTRUCTED WETLANDS; FLOATING TREATMENT WETLANDS; MUNICIPAL WASTE-WATER; TEXTILE EFFLUENT; VETERINARY ANTIBIOTICS; ENHANCED DEGRADATION; PSEUDOMONAS-PUTIDA; URBAN WASTEWATERS; INTEGRATED-SYSTEM | Climate changes push for water reuse as a priority to counteract water scarcity and minimize water footprint especially in agriculture, one of the highest water consuming human activities. Phytodepuration is indicated as a promising technology for water reclamation, also in the light of its economic and ecological sustainability, and the use of specific bacterial inocula for microbial assisted phytodepuration has been proposed as a further advance for its implementation. Here we provided an overview on the selection and use of plant growth promoting bacteria in Constructed Wetland (CW) systems, showing their advantages in terms of plant growth support and pollutant degradation abilities. Moreover, CWs are also proposed for the removal of emerging organic pollutants like antibiotics from urban wastewaters. We focused on this issue, still debated in the literature, revealing the necessity to deepen the knowledge on the antibiotic resistance spread into the environment in relation to treated wastewater release and reuse. In addition, given the presence in the plant system of microhabitats (e.g. rhizosphere) that are hot spot for Horizontal Gene Transfer, we highlighted the importance of gene exchange to understand if these events can promote the diffusion of antibiotic resistance genes and antibiotic resistant bacteria, possibly entering in the food production chain when treated wastewater is used for irrigation. Ideally, this new knowledge will lead to improve the design of phytodepuration systems to maximize the quality and safety of the treated effluents in compliance with the ‘One Health’ concept. (C) 2019 The Authors. Published by Elsevier Ltd. |
| Enterobacter cloacaecomplex; mcr-9; VIM-1; IncHI2; WGS; Egypt; food | INCHI2 PLASMIDS; BETA-LACTAMASE; CARBAPENEMASE; RESISTANCE; IMPACT | We describe here the complete genome sequence of anEnterobacter hormaecheiST279 coharbouringbla(VIM-1)andmcr-9recovered from uncooked beef patty in June 2017, Egypt. The tested isolate was resistant to carbapenem but susceptible to colistin (minimum inhibitory concentration (MIC), 0.5 mu g/mL). The antimicrobial susceptibility profile and conjugation experiments were performed. The entire genome was sequenced by the Illumina MiniSeq and Oxford Nanopore methods. Thebla(VIM-1)andmcr-9genes are carried on the same IncHI2/pMLST1 plasmid, pMS37a (Size of 270.9 kb). Themcr-9gene was located within the physical boundaries demarcated by two insertion elements IS903(upstream) and IS1(downstream) but did not possess the downstream regulatory genes (qseC/qseB) which regulate the expression ofmcr-9. Therefore, themcr-9might be silently disseminated among carbapenem-resistant Enterobacterales. In addition tobla(VIM-1)andmcr-9, plasmid pMS37a harbored various antibiotic resistance genes includingaac(6′)-Il, Delta aadA22,aac(6′)-Ib-cr,sul1,dfrA1 and tetA.To the best of our knowledge, this is the first report of abla(VIM-1)andmcr-9-coharbouringE. hormaecheiisolate of food origin worldwide. The identification of a multidrug-resistant VIM-1 andmcr-9positiveEnterobacter hormaecheiisolate from food is worrisome as retail meat and meat products could serve as a vehicle for these MDR bacteria, which could be transferred between animals and humans through the food chain. It further highlights that Enterobacterales co-producing MCR and carbapenemases being found in the food chain indeed correspond to a One-Health issue, highlighting the need for serious steps to prevent their further dissemination. |
| DEMONSTRATION PROJECT; SURVEILLANCE; REGULATIONS; CAPACITY; LESSONS; SYSTEMS; WORLD; EBOLA; CARE | Background Global health security (GHS) and universal health coverage (UHC) are key global health agendas which aspire for a healthier and safer world. However, there are tensions between GHS and UHC strategy and implementation. The objective of this study was to assess the relationship between GHS and UHC using two recent quantitative indices. Methods We conducted a macro-analysis to determine the presence of relationship between GHS index (GHSI) and UHC index (UHCI). We calculated Pearson’s correlation coefficient and the coefficient of determination. Analyses were performed using IBM SPSS Statistics Version 25 with a 95% level of confidence. Findings There is a moderate and significant relationship between GHSI and UHCI (r = 0.662, p<0.001) and individual indices of UHCI (maternal and child health and infectious diseases: r = 0.623 (p<0.001) and 0.594 (p<0.001), respectively). However, there is no relationship between GHSI and the non-communicable diseases (NCDs) index (r = 0.063, p>0.05). The risk of GHS threats a significant and negative correlation with the capacity for GHS (r = -0.604, p<0.001) and the capacity for UHC (r = -0.792, p<0.001). Conclusion The aspiration for GHS will not be realized without UHC; hence, the tension between these two global health agendas should be transformed into a synergistic solution. We argue that strengthening the health systems, in tandem with the principles of primary health care, and implementing a One Health approach will progressively enable countries to achieve both UHC and GHS towards a healthier and safer world that everyone aspires to live in. |
| SADS; coronavirus; One Health; emerging infectious disease | PORCINE EPIDEMIC DIARRHEA; TRANSMISSIBLE GASTROENTERITIS VIRUS; MOUSE HEPATITIS-VIRUS; FUNCTIONAL RECEPTOR; KARYOTYPE VARIATION; REVERSE GENETICS; BAT CORONAVIRUS; SPIKE PROTEIN; EVOLUTION; ENTRY | Zoonotic coronaviruses represent an ongoing threat, yet the myriads of circulating animal viruses complicate the identification of higherrisk isolates that threaten human health. Swine acute diarrhea syndrome coronavirus (SADS-CoV) is a newly discovered, highly pathogenic virus that likely evolved from closely related HKU2 bat coronaviruses, circulating in Rhinolophus spp. bats in China and elsewhere. As coronaviruses cause severe economic losses in the pork industry and swine are key intermediate hosts of human disease outbreaks, we synthetically resurrected a recombinant virus (rSADS-CoV) as well as a derivative encoding tomato red fluorescent protein (tRFP) in place of ORF3. rSADS-CoV replicated efficiently in a variety of continuous animal and primate cell lines, including human liver and rectal carcinoma cell lines. Of concern, rSADS-CoV also replicated efficiently in several different primary human lung cell types, as well as primary human intestinal cells. rSADS-CoV did not use human coronavirus ACE-2, DPP4, or CD13 receptors for docking and entry. Contemporary human donor sera neutralized the group I human coronavirus NL63, but not rSADS-CoV, suggesting limited human group I coronavirus cross protective herd immunity. Importantly, remdesivir, a broad-spectrum nucleoside analog that is effective against other group 1 and 2 coronaviruses, efficiently blocked rSADS-CoV replication in vitro. rSADS-CoV demonstrated little, if any, replicative capacity in either immune-competent or immunodeficient mice, indicating a critical need for improved animal models. Efficient growth in primary human lung and intestinal cells implicate SADS-CoV as a potential higher-risk emerging coronavirus pathogen that could negatively impact the global economy and human health. |
| avian influenza; waterfowl; poultry; waterfowl-poultry interface; wetlands; One Health | OUTBREAKS; BIRDS; EPIDEMIOLOGY; ASIA | Highly pathogenic avian influenza (HPAI) virus, subtype H5N1, constitutes one of the world’s most important health and economic concerns given the catastrophic impact of epizootics on the poultry industry, the high mortality attending spillover in humans, and its potential as a source subtype for a future pandemic. Nevertheless, we still lack an adequate understanding of HPAI H5N1 epidemiology and infection ecology. The nature of the wild waterfowl-poultry interface, and the sharing of diverse wetland habitat among these birds, currently underscore important knowledge gaps. India has emerged as a global hotspot for HPAI H5N1, while also providing critical wintering habitat for many species of migratory waterfowl and year-round habitat for several resident waterfowl species. The current study sought to examine the extent to which the wild waterfowl-poultry interface, varied wetland habitat, and climate influence HPAI H5N1 epizootics in poultry in India. Using World Organisation for Animal Health reported outbreaks, this study showed that the wild waterfowl-poultry interface and lacustrine, riparian, and coastal marsh wetland systems were strongly associated with landscape suitability, and these relationships varied by scale. Although increasing poultry density was associated with increasing risk, this was only the case in the absence of wild waterfowl habitat, and only at a local scale. In landscapes increasingly shared between wild waterfowl and poultry, suitability was greater among lower density poultry, again at a local scale only. These findings provide further insight into the occurrence of HPAI H5N1 in India and suggest important landscape targets for blocking the waterfowl-poultry interface to interrupt virus transmission and prevent future outbreaks. |
| knee osteoarthritis; pain management; Japan; working-aged; HCRU | COSTS; CARE; COMORBIDITIES; RISK | Purpose: To assess comorbidity burden and pain-management patterns among working-aged patients with knee osteoarthritis only (KOA/O) and patients with knee osteoarthritis plus osteoarthritis at another site (KOA/+) in Japan. Patients and Methods: Retrospective claims data analysis was conducted using the Japan Medical Data Center database. Working-aged adults (aged 40 to 71 years) with 5 years of follow-up and diagnosed with knee osteoarthritis (KOA) between January 1, 2011, and December 31, 2012, were evaluated. The first claim with a KOA diagnosis defined the index date. Patients were divided into two mutually exclusive cohorts: KOA/O and KOA/+. Longitudinal pain-management patterns during each year of follow-up were analyzed. Results: A total of 2542 patients met study criteria: 1575 KOA/O and 967 KOA/+. Mean age and number of comorbidities were higher among the KOA/+ versus KOA/O cohort. Pharmaceutical treatment was received by 91.5% of patients in the KOA/+ compared with 85.1% of patients in the KOA/O cohort during the first year of follow-up. The most common pharmacological treatment received during the first year of follow-up was either topical or oral nonsteroidal anti-inflammatory drugs for both cohorts. During each year of follow-up, the KOA/+ cohort had greater proportion of patients with at least one health-care encounter (ie, hospital admissions, outpatient and pharmacy visits) and higher direct medical costs compared with the KOA/O cohort. Conclusion: This study demonstrates that a greater proportion of the working population with KOA/+ received pain-related treatment compared with patients with KOA/O. Further studies are necessary to evaluate appropriate pain management for both KOA only and KOA with other sites. |
| DENSITY-DEPENDENT FECUNDITY; POLYMORPHIC MICROSATELLITE MARKERS; MANSONI INFECTIONS; PRAZIQUANTEL TREATMENT; WORM BURDEN; EGG COUNTS; ONE HEALTH; HAEMATOBIUM; EPIDEMIOLOGY; MULTIHOST | Analyses of the population genetic structure of schistosomes under the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) contrasting treatment pressure scenarios in Tanzania, Niger, and Zanzibar were performed to provide supplementary critical information with which to evaluate the impact of these large-scale control activities and guide how activities could be adjusted. We predicted that population genetic analyses would reveal information on a range of important parameters including, but not exclusive to, recruitment and transmission of genotypes, occurrence of hybridization events, differences in reproductive mode, and degrees of inbreeding, and hence, the evolutionary potential, and responses of parasite populations under contrasting treatment pressures. Key findings revealed that naturally high levels of gene flow and mixing of the parasite populations between neighboring sites were likely to dilute any effects imposed by the SCORE treatment arms. Furthermore, significant inherent differences in parasite fecundity were observed, independent of current treatment arm, but potentially of major impact in terms of maintaining high levels of ongoing transmission in persistent biological hotspot sites. Within Niger, naturally occurring Schistosoma haematobium/Schistosoma bovis viable hybrids were found to be abundant, often occurring in significantly higher proportions than that of single-species S. haematobium infections. By examining parasite population genetic structures across hosts, treatment regimens, and the spatial landscape, our results to date illustrate key transmission processes over and above that which could be achieved through standard parasitological monitoring of prevalence and intensity alone, as well as adding to our understanding of Schistosoma spp. life history strategies in general. |
| BURULI ULCER; MYCOLACTONE; WEST | Background Mycobacterium ulcerans is an environmental mycobacterium responsible for an opportunistic, noncontagious tropical infection named Buruli ulcer that necrotizes the skin and the subcutaneous tissues. M. ulcerans is thought to penetrate through breached skin after contact with contaminated wetland environments, yet the exact biotopes where M. ulcerans occurs remain elusive, hence obscuring the epidemiological chain of transmission of this opportunistic pathogen. Methodology/Principal findings Polymerase chain reaction investigations detected M. ulcerans in 39/46 (84.7%) rhizosphere specimens collected in 13 Buruli ulcer-endemic areas in C (o) over cap te d’Ivoire and 3/20 (15%) specimens collected in a nonendemic area (P = 5.73.E-7); only 3/63 (4.7%) sediment specimens from sediment surrounding the rhizospheres were positive in endemic area (P = 6.51.E-12). High-throughput sequencing further detected three PCR-positive plants, Croton hirtus, Corton kongensis and Oriza sativa var. japonica (rice), in the rectal content of two M. ulcerans-positive wild Thryonomys swinderianus grasscutters that were hunted in Buruli ulcer-endemic areas, while no PCR-positive plants were detected in the rectal content of two negative control animals that were farmed in a nonendemic area. Conclusions/Significance Our data suggest an alimentary chain of transmission of M. ulcerans from plants to T. swinderianus grasscutters and people that utilize T. swinderianus as bush meat in Buruli ulcer-endemic areas in C (o) over cap te d’Ivoire. Guidance to adopt protective measures and avoid any direct contact with potentially contaminated rhizospheres and with grasscutter intestinal content when preparing the animals for cooking should be established for at-risk populations. |
| antibiotic resistance; antibiotic resistance genes; Escherichia coli; Arrone River; Tiber River | 1 INTEGRON-INTEGRASE; TREATMENT PLANTS; ANTHROPOGENIC PRESSURE; ONE HEALTH; IMPACT; PHARMACEUTICALS; ENVIRONMENT; BACTERIA | Background: Wastewater treatment plants (WWTPs) are microbial factories aimed to reduce the amount of nutrients and pathogenic microorganisms in the treated wastewater before its discharge into the environment. We studied the impact of urban WWTP effluents on the abundance of antibiotic resistance genes (ARGs) and antibiotic-resistant Escherichia coli (AR-E. coli) in the last stretch of two rivers (Arrone and Tiber) in Central Italy that differ in size and flow volume. Methods: Water samples were collected in three seasons upstream and downstream of the WWTP, at the WWTP outlet, and at sea sites near the river mouth, and analyzed for the abundance of ARGs by qPCR and AR-E. coli using cultivation followed by disk diffusion assays. Results: For all studied genes (16S rRNA, intI1, sul1, ermB, blaTEM, tetW and qnrS), absolute concentrations were significantly higher in the Tiber than in the Arrone at all sampling sites, despite their collection date, but the prevalence of target ARGs within bacterial communities in both rivers was similar. The absolute concentrations of most ARGs were also generally higher in the WWTP effluent with median levels between log 4 and log 6 copies per ml but did not show differences along the studied stretches of rivers. Statistically significant site effect was found for E. coli phenotypic resistance to tetracycline and ciprofloxacin in the Arrone but not in the Tiber. Conclusions: In both rivers, diffuse or point pollution sources other than the studied WWTP effluents may account for the observed resistance pattern, although the Arrone appears as more sensitive to the wastewater impact considering its lower flow volume. |
| COVID-19; coronavirus; nasopharyngeal; testing; swab; education; otolaryngology; simulation; PS; QI | | Objective To determine if rapid implementation of simulation training for the nasopharyngeal swab procedure can increase provider confidence regarding procedure competency. Methods A simulation training exercise was designed as a departmental initiative to improve competency performing nasopharyngeal swabs during the COVID-19 pandemic. Sixty-one health care workers attended teaching sessions led by the Department of Otorhinolaryngology on proper nasopharyngeal swab technique. After a brief lecture, participants practiced their swab technique using a high-fidelity airway simulation model. Pre- and postintervention self-evaluations were measured via standardized clinical competency questionnaires on a 5-point Likert scale ranging from No knowledge, unable to perform up to Highly knowledgeable and confident, independent. Results Forty-six participants in this study submitted pre- and postintervention self-assessments. Postintervention scores improved on average 1.41 points (95% CI, 1.10-1.73) out of 5 from a mean score of 3.13 to 4.54 (P < .0001). This reflects a large effect size with a Glass’s delta value of 1.3. Discussion Lecture coupled with simulation-based teaching can significantly improve health care workers’ confidence in performing nasopharyngeal swabs. Proper training for frontline workers performing swabs for COVID-19 is essential to improving testing accuracy and can be achieved in a simple and timely manner. Implications for Practice To meet the testing needs of the growing pandemic, many health care workers who are unfamiliar with nasopharyngeal swabs have been asked to perform this test. Simulation-based teaching sessions may improve health care workers’ confidence and help prevent false-negative results. This intervention is easily reproducible in any setting where frequent nasopharyngeal swab testing occurs. |
| Intestinal parasite; Risk factor; Children; Argentina | LA PLATA; POPULATION | Introduction: Intestinal parasitoses affect millions of people worldwide, especially children of developing countries. In Argentina, the prevalence of these infections varies among areas according to socio-economic and climatic variability. This study aimed to evaluate the prevalence of intestinal parasitoses and risk factors in child and youth populations from neighbourhoods of La Plata (Buenos Aires province, Argentina) affected by occasional floods, including a serious flood in 2013. Methods: Serial stool samples and anal swabs of 398 individuals were processed using techniques of sedimentation and flotation. Socio-economic variables were surveyed using a semi-structured questionnaire and the land use/cover was determined by classification of a satellite image. Results: Of all examined individuals, 70.9% were parasitized by at least one of the 12 parasites identified. The most prevalent species were Blastocystis sp. (42.7%), Enterobius vermicularis (34.7%) and Giardia lamblia (17.6%). Infection risk factors included houses built with makeshift materials and dirt floors; lack of piped water and public waste collection service, bed-sharing and living in the non-urban area. > 70.3% of the participants that lived within < 200 m from watercourses or permanent water bodies were parasitized. Conclusion: This research shows that parasitic infections are still a serious public health problem and that they are strongly associated with socio-economic conditions and land use/cover. In this context, studies focused on One Health strategy are need to ensure the diagnosis and surveillance of parasitosis and to tackle zoonotic diseases as well as to encourage the development of sanitary and educational programs sustainable over time. |
| One-health; Livestock; Veterinary science; Animals; Immunology; Ecology; Agriculture; Veterinary medicine; Zoology | MILK ANTIBODY ELISA; FECAL CALPROTECTIN; DAIRY HERDS; INFLAMMATION; POLYMERIZATION; METABOLISM; INFECTION; DISEASE | Background: Promoting and maintaining health is critical to ruminant welfare and productivity. Within human medicine, faecal lactoferrin is quantified for routine assessment of various gastrointestinal illnesses avoiding the need for blood sampling. This approach might also be adapted and applied for non-invasive health assessments in animals. Methods: In this proof-of-concept study, a bovine lactoferrin enzyme-linked immunosorbent assays (ELISA), designed for serum and milk, was applied to a faecal supernatant to assess its potential for quantifying lactoferrin in the faeces of cattle. Faecal lactoferrin concentrations were compared to background levels to assess the viability of the technique. A comparison was then made against serum lactoferrin levels to determine if they were or were not reflective of one another. Results: The optical densities of faecal samples were significantly greater than background readings, supporting the hypothesis that the assay was effective in quantifying faecal lactoferrin (T-13,T- 115 = 11.99, p < 0.0005). The mean faecal lactoferrin concentration was 0.269 mu g mL(-1) (S.E. 0.031) and the mean serum concentration 0.074 mu g mL(-1) (S.E. 0.005). Lactoferrin concentrations of faecal and serum samples, taken from the same animals on the same day, were significantly different (T-21 = 2.20, p = 0.039) and did not correlate (r = 0.2699, p = 0.238). Conclusion: Results support the hypothesis that lactoferrin can be quantified in cattle faeces by ELISA. Whilst further research is required to determine the physiological source of the lactoferrin, this highlights the potential of the method for non-invasive assessment of cattle immunology and pathology. |
| farmers' behavior; KAP questionnaire; parasite control; parasitic infection; one health | BENZIMIDAZOLE RESISTANCE; SHEEP; PREVALENCE; CATTLE | Iranian studies have shown a high prevalence of broad spectrum anthelmintic resistance (AR) in gastrointestinal helminths of ruminants. However, there is a lack of information about levels of knowledge, attitudes and practices among livestock farmers in Iran regarding the concept of parasite control and AR. This study aimed to evaluate the knowledge, attitudes and practices of livestock farmers of Hamedan, Iran, regarding parasitic diseases and AR by interviewing 150 farmers using a structured questionnaire. Most of farmers had some knowledge of the clinical signs associated with helminth parasitism, but more than half were unaware of the existence of zoonotic parasites. More than half of the participants had never heard about AR, but were interested to learn about it through their veterinarians. Those who were aware of the problem considered non-prescribed anthelmintic drugs to play a role in its emergence, while several of the participants believed that more expensive and foreign-branded drugs worked best. Almost all of the farmers reported that they frequently consulted with a veterinarian about anthelmintic treatments, but very few adhered to recognized principles of responsible and sustainable drug use. About half of the participating farmers treated their sheepdogs for helminth parasites, despite the common practice of regularly feeding likely infected livestock offal. Education had a significantly positive association with farmers’ knowledge, attitudes, and best practice scores, while knowledge was significantly associated with both attitudes and practices. Based on these results, we recommend that regular country-wide classes should be held to educate farmers on the evidence-based principles of sustainable helminth control and prevention of zoonotic helminth diseases. |
| dirofilariosis; dog; human; emerging; northern Europe; zoonosis | DIROFILARIA-REPENS; RUSSIAN-FEDERATION; INFECTIONS; POLAND; DOGS | The zoonotic parasiteDirofilaria repenshas spread toward north in Europe, and cases of autochthonous dirofilariosis caused byD. repenshave emerged in the Baltic countries Estonia, Latvia, and Lithuania. We conducted a review on the emergence of dirofilariosis in humans and domestic dogs in these three countries in northeastern Europe. Based on the available literature and reports, the first finding in the Baltic countries was made in Latvia in 2008, followed by the first in Lithuania in 2010, and the first in Estonia in 2012. In all three countries, further findings were reported soon after the first reports. By the end of 2019, autochthonous humanD. repensinfections had been described from Latvia and Lithuania, and autochthonous canineD. repensinfections had been described from all three Baltic countries. While no epidemiological studies estimating prevalence or incidence of the human infections have been published from the three countries, a substantial proportion of investigated dogs have tested positive for microfilariae in studies performed in Latvia and Lithuania. Dirofilariosis is an emerging zoonosis in northern Europe, and the summarized data confirm thatD. repenshas become established and endemic in the Baltic countries. The available data do not provide a good overview of the situation, and further epidemiological studies are needed. Awareness about the recently emerged zoonotic parasite should be increased among medical doctors, veterinarians, and the general public. Managing this zoonotic infection is a public health challenge that needs to be addressed using a One Health approach. Investigating the spread ofD. repensin the Baltic countries could be useful for better preparedness for the anticipated further spread to the Nordic countries. |
| Emergency department; Social determinants of health; Health services research; Veterans | INTIMATE PARTNER VIOLENCE; CARE UTILIZATION; SERVICES; VISITS; HOMELESSNESS; SUICIDE; WORK | Background: Social determinants of health (SDH) are strong predictors of morbidity and mortality but health care systems struggle to integrate documentation of SDH into health records in ways that can be used for health services research. Given the impact of social factors on health, it is important to examine the relationship with emergency department (ED) utilization. Objective: To examine the association between seven indicators of SDH and ED utilization using electronic health record (EHR) data from the Veterans Health Administration (VHA). Methods: This cross-sectional analysis included data from all patients who had at least one health care visit in the Veterans Integrated Service Network region 4 from October 1, 2015 through September 30, 2016 (n=293,872). Seven categories of adverse SDH included violence, housing instability, employment or financial problems, legal problems, social or family problems, lack of access to care or transportation, and non-specific psychosocial needs identified through structured coding in EHR. Negative binomial regression was used to examine the association of the count of adverse SDH (0-7) with the count of ED visits, adjusting for socio-demographic and health-related factors. Results: Approximately 18% of patients visited the ED during the observation period. After adjusting for covariates, adverse SDH were positively associated with VHA ED utilization. Each of the SDH indicators, other than legal issues, was positively associated with increased ED utilization. Conclusion: Even after accounting for several demographic and health-related factors, adverse SDH demonstrated strong positive associations with VHA ED utilization. Published by Elsevier Inc. |
| Ascaris spp; Cysticercosis; Nigeria; Pigs; Taenia solium; Zoonotic parasites | TAENIA-SOLIUM CYSTICERCOSIS; ASCARIS-SUUM; FOOD ANIMALS; NSUKKA AREA; PREVALENCE; LUMBRICOIDES; HUMANS | Pig production is an important component of animal agriculture in Nigeria but zoonotic parasites constrain the production and make pork unsafe for human consumption. This epidemiological study was therefore conducted, to ascertain the prevalence and determinants of Taenia solium cysticerci and Ascaris spp infections in pigs in Enugu State. Presence of cysticerci was determined by post-mortem examination of pig carcasses while pig faeces were coprologically examined for presence of Ascaris spp egg, according to standard parasitological protocol. Structured questionnaire was used to elicit information on pig farmers’ involvement in practices predisposing to parasitic infections and deworming progammes in 107 piggeries surveyed. Cysticerci were detected in 3.51% (12/342) of pig carcasses inspected. Overall prevalence of Ascaris spp. infections were 38.3% (41/107) and 14.3% (63/441) at farm and individual pig levels respectively. Major determinants of the infection and the percentage of farmers involved were: eating on duty (66.4%), open defecation (35.5%) and semi-extensive husbandry system (62.3%). Others are non-availability of deworming programme (54.4%), rearing pigs of different ages together (41.9%), non-disinfection of feeding or water troughs (41.2%) and early weaning (54.3%). Cognizant of the zoonotic potentials of Ascaris spp and Taenia solium cysticerci, the prevalence found for the parasites are significant from public health and food safety points of view. This underscores the need for cost-effect control measures against the parasites, using a coordinated One Health approach; in order to boost pig production, limit spread of the zoonoses and hence, the public health consequences thereof. |
| Cancer screening; Health plans; Program design; Implementation; Direct-mail FIT outreach; Qualitative | IMMUNOCHEMICAL TEST OUTREACH; COLON-CANCER; COLONOSCOPY OUTREACH; CLINICAL-TRIAL; UNITED-STATES; PROGRAM; CARE; DISPARITIES; ADAPTATION; FIDELITY | Screening rates for colorectal cancer (CRC) remain low, especially among certain populations. Mailed fecal immunochemical testing (FIT) outreach initiated by U.S. health plans could reach underserved individuals, while solving CRC screening data and implementation challenges faced by health clinics. We report the models and motivations of two health insurance plans implementing a mailed FIT program for age-eligible U.S. Medicaid and Medicare populations. One health plan operates in a single state with similar to 220,000 enrollees; the other operates in multiple states with similar to 2 million enrollees. We conducted in-depth qualitative interviews with key stakeholders and observed leadership and clinic staff planning during program development and implementation. Interviews were transcribed and coded using a content analysis approach; coded interview reports and meeting minutes were iteratively reviewed and summarized for themes. Between June and September 2016, nine participants were identified, and all agreed to the interview. Interviews revealed that organizational context was important to both organizations and helped shape program design. Both organizations were hoping this program would address barriers to their prior CRC screening improvement efforts and saw CRC screening as a priority. Despite similar motivations to participate in a mailed FIT intervention, contextual features of the health plans led them to develop distinct implementation models: a collaborative model using some health clinic staffing versus a centralized model operationalizing outreach primarily at the health plan. Data are not yet available on the models’ effectiveness. Our findings might help inform the design of programs to deliver mailed FIT outreach. |
| worksite; workplace; wellness; evidence-based; model; leadership; occupational health; health behavior; policy; health promotion | ENVIRONMENTAL INTERVENTIONS; PHYSICAL-ACTIVITY; ASSOCIATION; PREVENTION; PROGRAMS; POLICY; TIME | Background: Worksite wellness programs that target individual employees, rather than worksites, have demonstrated limited long-term success. The purpose of this overview was to describe the theoretical basis for implementing an effective worksite wellness initiative, WorkWell Kansas (WorkWell KS). WorkWell KS is not a traditional worksite wellness initiative, as its goal is to create healthy worksites, rather than target workers. Method: The WorkWell KS Strategic Framework is based on academic research that identified successful worksite wellness elements that produce sustainably healthy worksites. The curricula were built around the 3-4-80: three modifiable behaviors (tobacco use, poor access to nutritious foods and beverages, and physical inactivity) contribute to at least four chronic diseases (heart disease, type II diabetes, lung disease, and some cancers), which in turn contribute to approximately 80% of the premature deaths in the United States. Findings: To properly address these modifiable behaviors, the WorkWell KS Strategic Framework was developed to guide worksites to first build a solid worksite wellness foundation, which consists of five elements: the wellness committee, exercising leadership, communications, incentives, and data. Once built, worksites are then encouraged to employ a socio-ecological approach to developing a comprehensive, multi-strategy (information, program, benefit design, policy, and environment) intervention, focusing on one health behavior at a time. Conclusion/Application to Practice: The goal of WorkWell KS is to create healthy worksites, which create environments for employees to practice these healthy behaviors. Worksite wellness committees, occupational health professionals, and others interested in altering health behaviors at worksites have an opportunity to reframe their approach using this framework. |
| Cat; Antimicrobial resistance; Staphylococcus spp; Enterobacteriaceae; Enterococcus spp | COMPANION ANIMALS; ESCHERICHIA-COLI; STAPHYLOCOCCUS-PSEUDINTERMEDIUS; ANTIBIOTIC-RESISTANCE; PREVALENCE; DOGS; INTERMEDIUS; ENVIRONMENT; INFECTION; SAMPLES | Background Antimicrobial resistance is becoming increasingly important in both human and veterinary medicine. According to the One Health concept, an important step is to monitor the resistance patterns of pathogenic bacteria. In this study, the antimicrobial susceptibility patterns and trends of bacteria isolated from stray cats, hospital-admitted cats, and veterinary staff in South Korea between 2017 and 2018 were investigated. Results The minimum inhibitory concentrations of different antibiotics for Staphylococcus spp., Enterobacteriaceae, and Enterococcus spp. were determined to establish representatives of different antibiotic classes relevant for treatment or surveillance. For Coagulase-positive and Coagulase-negative Staphylococci, resistance to fluoroquinolones was below 13%, but resistance to ampicillin and penicillin was high (20-88%). A total of 9.5, 12.1, and 40.3% of staphylococcal isolates from stray cats, hospital-admitted cats, and veterinary staff, respectively, were confirmed to be mecA positive. For Enterobacteriaceae, resistance to carbapenems, fluoroquinolones, and 3rd generation cephalosporins was low (0-11.1%). The Enterococcus spp. isolates showed no resistance to vancomycin. The antimicrobial resistance rates of the Staphylococcus spp. and Enterobacteriaceae isolates from stray cats were usually lower than those of isolates from hospital-admitted cats and veterinary staff, but the Enterococcus spp. isolates revealed the opposite. Thus, the antimicrobial resistance varied across bacterial species according to the source from which they were isolated. Conclusions Resistance to critically important compounds were low. However, the presence of antimicrobial resistance in cat isolates is of both public health and animal health concern. |
| ANTIBIOTIC STEWARDSHIP; NURSING-HOMES; INFECTIONS; OUTCOMES; OPPORTUNITIES; PREVALENCE; STRATEGIES; COST | Background: In long-term care facilities (LTCFs) residents often receive inappropriate antibiotic treatment and infection prevention and control practices are frequently inadequate, thus favouring acquisition of MDR organisms. There is increasing evidence in the literature describing antimicrobial stewardship (AMS) activities in LTCFs, but practical guidance on how surveillance data should be linked with AMS activities in this setting is lacking. To bridge this gap, the JPIAMR ARCH and COMBACTE-MAGNET EPI-Net networks joined their efforts to provide practical guidance for linking surveillance data with AMS activities. Materials and methods: Considering the three main topics [AMS leadership and accountability, antimicrobial usage (AMU) and AMS, and antimicrobial resistance (AMR) and AMS], a literature review was performed and a list of target actions was developed. Consensus on target actions was reached through a RAND-modified Delphi process involving 40 experts from 18 countries and different professional backgrounds adopting a One Health approach. Results: From the 25 documents identified, 25 target actions were retrieved and proposed for expert evaluation. The consensus process produced a practical checklist including 23 target actions, differentiating between essential and desirable targets according to clinical relevance and feasibility. Flexible proposals for AMS team composition and leadership were provided, with a strong emphasis on the need for well-defined and adequately supported roles and responsibilities. Specific antimicrobial classes, AMU metrics, pathogens and resistance patterns to be monitored are addressed. Effective reporting strategies are described. Conclusions: The proposed checklist represents a practical tool to support local AMS teams across a wide range of care delivery organization and availability of resources. |
| inpatient; mental health care; qualitative research; sensory modulation; Theoretical Domain Framework | REDUCE SECLUSION; RESTRAINT; ROOM; CARE | Clinical guidelines and policies worldwide call for sensory modulation approaches to be incorporated into inpatient mental health care to assist in eliminating the use of restrictive practices. Although increasing evidence shows that these approaches reduce patient distress and the need for seclusion and restraint, sensory modulation approaches have been challenging to implement in many psychiatric units. Implementation strategies can effectively support inclusion of new approaches by addressing potential barriers to change and supporting likely enabling factors. This study aimed to gain a better understanding of the barriers and enablers influencing implementation of sensory modulation approaches in psychiatric inpatient units in one health region in Australia. A qualitative descriptive study design was used, with three focus groups and a total of 15 participants from nursing and allied health disciplines answering questions about the use of sensory modulation approaches. Framework analysis using the Theoretical Domains Framework and thematic analysis was used to analyse data. Overall, participants were positive about the use of sensory modulation approaches, particularly for reducing distress. Four domains (Social Influences; Belief about Consequences; Professional Role and Identify; and Environmental Context and Resources) were identified as the most salient. The key influencing factors were support from peers; beliefs about risks; belief it was part of their role; and availability of resources and materials. Numerous challenges and opportunities related to implementing sensory modulation approaches in mental health inpatient units, identified in this study, provide insights to support effective implementation of these approaches, underpinning more person-centred, trauma-informed, and recovery-orientated care. |
| companion dogs; One Health; proximity tagging; quality of life; heart rate variability; physical activity | PET OWNERSHIP; AUTONOMIC IMBALANCE; PHYSICAL-ACTIVITY; SLEEP; RISK | Heart rate variability (HRV) is a noninvasive tool used to evaluate autonomic nervous system function and is affected by age, stress, postural changes, and physical activity. Dog ownership has been associated with higher 24-hr HRV and increased physical activity compared to nonowners. The current pilot study was designed to evaluate the effects of proximity to a dog in real time (minute-by-minute) on older dog caregivers’ HRV measures and stress index during normal daily life over a 24-hr period. Eleven caregivers (56-83 years of age) wore ActiGraph GT9X Link accelerometers and camntech electrocardiogram monitors, and 11 dogs wore PetPace Collars and ActiGraph monitors to determine (a) proximity (absence or presence of Received Signal Strength Indicator, RSSI), (b) heart rate and HRV measures, (c) position (lying vs. sitting vs. standing), and (d) physical activity in the 11 dyads. Twenty-four hour HRV (SDNN index) and physical activity in the caregivers and dogs were related. Stress index was lower, and HRV parameters (SDNN, rMSDD, high frequency power (HF)) were higher when an RSSI signal was detected (presence of dog) compared to no RSSI signal (absence of dog) in the caregivers while inactive (lying + sitting + standing combined). HRV parameters (rMSDD and HF) were lower in the caregivers while standing and sitting compared to lying. The results from this pilot study support the hypothesis that spending time in the presence of a companion dog increases caregivers’ HRV throughout the day and suggest that proximity to a dog may contribute to overall improvements in 24-hr HRV and cardiac health in dog caregivers. |
| Leptospirosis; IgG; FIV positive; Free-roaming cats; One Health | CANINE LEPTOSPIROSIS; DOMESTIC CATS; ANTIBODIES | Leptospirosis is a zoonosis of global importance caused by Leptospira species. Rodents are the main reservoirs, known to shed the bacteria in urine, thus contaminating water and soil and infecting other animals and people. Leptospirosis has been re-emerging in both developing and developed countries including Europe. It has been hypothesized that cats could be asymptomatic carriers of Leptospira. This study aims to evaluate cats’ exposure to Leptospira in Lisbon, Portugal, by measuring IgG titres and correlating them with possible factors that may increase the risk of exposure in urban cats. Two hundred and forty-three samples were collected from the biobank. An ELISA test followed by a seroprevalence analysis using a finite mixture model was performed to detect and measure anti-Leptospira IgG antibodies titres. In parallel, a survey was conducted to identify possible risk factors for seropositivity. According to the ELISA test protocol, only twenty-three cats (9.5%; 95% CI =(6.1%;13.9%)) could be considered as seropositive to Leptospira antigens. However, when the same data were analysed by the best different mixture models, one hundred and forty-four cats (59.3%; 95%CI = (52.8%; 65.5%)) could be classified as intermediate and high antibody responders to Leptospira antigens. Seropositivity to Feline Immunodeficiency Virus infection (FIV) was found to be the only significant risk factor associated with anti-Leptospira IgG antibodies. In conclusion, the present studies raises the possibility of a higher exposure of cats to Leptospira than previously thought due to the identification of a subpopulation of cats with intermediate antibody levels. |
| Academic satisfaction; Career adaptability; Proactive personality; Core self-evaluation; Informational support | ACADEMIC SATISFACTION; PROACTIVE PERSONALITY; JOB SEARCH; EMOTIONAL INTELLIGENCE; LIFE SATISFACTION; SELF-EFFICACY; WORK VOLITION; MODEL; CONSTRUCTION; SUCCESS | Background: To better understand nursing students’ high attrition rates, especially for male student nurses, it is important to understand their academic satisfaction and compare it based on gender. Objectives: To examine the relationships between proactive personality, core self- evaluations, types of support (emotional/instrumental/informational support), career adaptability, and academic satisfaction in nursing college students using the career construction theory. Design: This study uses a cross-sectional design. Participants and methods: 1062 students recruited from one health vocational college in northwest China completed questionnaires measuring proactive personality, core self-evaluations, emotional/instrumental/informational support, career adaptability, and academic satisfaction. Data was analyzed by structural equation modeling, and mediation and moderation analyses were performed. Results: Proactive personality (Beta = 0.24, p < 0.001), core self-evaluations (Beta = 0.31, p < 0.001) and informational support (Beta = 0.21, p < 0.001) were positively correlated with career adaptability, and career adaptability was positively (Beta = 0.43, p < 0.001) associated with academic satisfaction. Career adaptability mediates the relationships between proactive personality, core self-evaluations, informational support and academic satisfaction. For male student nurses, emotional support (Beta = 0.31, p < 0.01) has a positive association with career adaptability. Conclusions: In nursing students, personal features (e.g., proactive personality, core self-evaluations) and supporting materials (e.g., informational support) have a positive association with career adaptability, and career adaptability has a mediating role in the relationships. Male student nurses need extra emotional support to promote their academic satisfaction. Targeted interventions may improve nursing college students’ academic satisfaction. |
| asthma; autoimmune diseases; decision aids; glucocorticoids; pregnancy | INFLAMMATORY-BOWEL-DISEASE; ASTHMA MEDICATION USE; BIRTH; SAFETY; WOMEN; RISK; PERSPECTIVES; ASSOCIATION; MANAGEMENT; EXPOSURE | Purpose There is unmet need for decision support regarding medication use during pregnancy. We aimed to inform the development of a decision aid on oral corticosteroid (OCS) use during pregnancy through focus groups. Methods We invited patients from one health system who had a recent live birth and a condition for which OCSs may be prescribed (ie, asthma or other autoimmune disease) to participate in focus groups. We conducted conventional qualitative content analysis of verbatim transcripts of the focus groups using inductive coding. Results There were 30 participants across five focus groups from May to June 2019. Women endorsed the need for patient-provider discussions about OCS use during pregnancy in which the provider shares risks and benefits and the patient makes her decision. Furthermore, women generally expressed support for patient-centered handouts about OCS use during pregnancy that the provider discusses with the patient. When considering whether to take OCSs in pregnancy, women had concerns about: the medication’s impact on their baby (eg, miscarriage, birth defects, long-term effects), themselves (eg, effects on mood, sleep, weight gain), pregnancy complications (eg, preterm birth, increased blood pressure), and lactation. Women wanted information on OCSs (eg, indications, length of treatment, and cost), alternative treatments, and risks of not taking OCSs. Conclusions We established patient need for a decision aid on OCS use during pregnancy that providers can discuss with patients. To address patient concerns, the aid should at a minimum describe the medication’s impact on baby, including long-term effects, maternal health, pregnancy complications, and lactation. |
| Urban; Sanitation; Bioaerosols; Exposure; Pathogens | SOLAR-RADIATION; RISK; INACTIVATION; DISPERSION | Evidence of exposure to enteric pathogens through the air and associated risk of infection is scarce in the literature outside of animal- or human-waste handling settings. Cities with poor sanitation are important locations to investigate this aerial exposure pathway as their rapid growth will pose unprecedented challenges in waste management. To address this issue, simple surveillance methods are needed. Therefore, the objectives of this study were to optimize a community exposure bioaerosol surveillance strategy for urban outdoor locations with poor sanitation, and to determine which bioaerosols could contribute to exposure. Passive and active bioaerosol sampling methods were used to characterize the fate and transport of sanitation-related bioaerosols during the rainy and dry seasons in La Paz, Bolivia. Median coliform bacteria fluxes were 71 CFU/(m(2) x h) during the rainy season and 64 CFU/(m(2) x h) during the dry season, with 38% of the dry season samples testing positive for E. coli. Wind speed, relative humidity and UVB irradiance were identified as significant covariates to consider in bioaerosol transport models in La Paz. Active sampling yielded one positive sample (10%) for human adenovirus (HadV) and one sample (10%) for influenza A virus during the rainy season. HadV was detected at the site with the highest bacterial flux. Four samples (8%) were positive for influenza A virus in the dry season. These findings suggest that aerosols can contribute to community exposure to potentially pathogenic microorganisms in cities with poor sanitation. The use of passive sampling, despite its limitations, can provide quantitative data on microorganisms’ viability within realistic timeframes of personal exposure. (C) 2020 Elsevier B.V. All rights reserved. |
| Mass gathering; Pilgrim health; Sabarimala; Environmental health; Travel medicine | HAJJ; RISKS; PREVENTION; PILGRIMS; DISEASES | Introduction: Mass gathering for religious and spiritual purposes are common in India. However, mass gathering health and travel medicine is still in its infancy in India. Objectives: The study explored bio-medical, environmental and psycho-social dimensions of mass gathering in Sabarimala pilgrimage, which is annually attended by 25 million pilgrims. Methods: In a cross sectional design, the investigators travelled the pilgrim trail and stayed in the shrine area to conduct the interviews (sample = 1259), to observe the practices as well as to assess the environmental conditions including sanitation. We did in-depth interviews of a subset of samples of the pilgrims, laboratory tests for water quality and secondary analysis of health services data. Result: 43.4% pilgrims reported at least one health problem. Leg pain, joint/muscle pain, breathlessness, were the common symptoms. Pilgrims expressed concern about drinking water and food safety and majority of them felt the crowd management as unsatisfactory. Untreated sewage and solid waste were found to pollute the water downstream. Average patient presentation rate for 2014-2017 was 4999.6 per 100,000 pilgrims and referral to Hospital Rate was 19 per 100,000 pilgrims. Mortality rate ranged from 18.5 to 21 per 100,000 pilgrims among those who attended the health centers for ailments. Death due to Coronary Artery Heart Disease (CAHD) has slightly decreased over the period of 3 years from 97.6% to 85.1%. Conclusion: Data with respect to safety, health and environment at the pilgrim sites need to be continuously assessed to understand changes and trends and to develop an effective mass gathering and safe pilgrimage policy (MGSPP). |
| Emerging pathogens; Zoonoses; Foodborne disease; Food systems; COVID-19; Agri-food policy; One health | DISEASE; SECURITY; RESISTANCE; NUTRITION; INFLUENZA; DRIVERS; IMPACTS; ADDRESS; TRENDS; EBOLA | Our food systems are progressively more industrialized and consolidated with many modern food value chains involving multiple countries and continents, and as such being associated with changes in risk profile and impacts of emerging and re-emerging diseases. Disease outbreaks that sweep through a single region can have massive impacts on food supply, while severe outbreaks of human pathogens can disrupt agricultural labor supply or demand for products perceived as ‘unsafe’. Market pressures have generally rewarded production of cash crops for fuel and energy dense, low nutrient processed foods over production of fruits and vegetables for local consumption. Climbing rates of food-related NCDs and pre-existing conditions leave the population increasingly susceptible to infectious diseases that are often driven by or arise from the food system. Therefore disease and diet from our food systems cause impacts on human health, and human health issues can impact on the functioning of the food system. The COVID-19 outbreak is the most recent example of food system driven disease emergence and of massive supply and demand shocks in the food system, experienced as a direct and indirect result of this disease. The effects of the food system on disease spread (and vice versa) must be addressed in future plans to prevent and mitigate large scale outbreaks. Health policies must acknowledge the food system as the base of our health system, as must agri-food policy recognize the pre-eminence of human health (directly and indirectly) in decision making. |
| Human African Trypanosomosis; Tsetse fly; Xenomonitoring; Kinshasa; Animal reservoir; One health | HUMAN AFRICAN TRYPANOSOMIASIS; SLEEPING SICKNESS FOCI; HOST PREFERENCE; TSETSE-FLIES; TRANSMISSION | Even if the number of Human African Trypanosomiasis (HAT) cases from Kinshasa province in DRC is going towards elimination for the last decade, cases still occur in the periphery of the city. The diagnosis of 21 cases in the south periphery of Kinshasa, between 2015 and 2017 gives evidence of the existence of an active focus in this area. Here, we present the results of a punctual entomological survey that was realized in july 2014 in the outskirts of the southeast of Kinshasa. Using pyramidal traps, we caught tsetse flies during 2 days, dissecting the fresh ones for further molecular analysis. The average Apparent Density of flies per Trap and per Day was three with a maximum of 5.6 flies in Nganda PIO. Polymerase chain reaction analysis of the midguts provided evidence of a high prevalence (57.2%) of infected flies. Ninety three percent of the trypanosomes that were identified belonged to the Nanomonas species, but Trypanozoon trypanosomes were also present in 24% of the infected flies, including mixed infections with Nanomonas, including 3 flies carrying Trypanosoma brucei gambiense, the human pathogen of trypanosomiasis. These results show that at the time of the field’s study there was an active reservoir of trypanosomes, closed to pigsties, knowing that pig is a potential animal reservoir. It also demonstrates that xenomonitoring using the entomological approach can be an efficient tool for monitoring sleeping sickness. Finally, results are discussed in the frame of WHO’s HAT elimination project. Regarding Kinshasa, it points out the need of regular epidemiologic surveys. |
| Listeria monocytogenses; pregnancy-associated; ST87; whole genome sequencing; comparative genomics analysis | OUTBREAK; PREVALENCE; CONSUMPTION; INVESTIGATE; PRODUCTS | Introduction: There are few investigations describing the pregnancy-associated listeriosis in China, and the molecular characteristics of Listeria monocytogenes causing such infections remain largely unknown. We aim to investigate the phenotypic and genomic profiles of pregnancy-associated L. monocytogenes isolates and their association with isolates recovered from human and non-human in China. Materials and Methods: In this study, we conducted a 3-year surveillance of listeriosis in a women’s hospital in Zhejiang province, using whole genome sequencing and bioinformatics tools. Results: From 2016 to 2018, we identified 13 clinical L. monocytogenes isolates. Among these pregnancy-associated isolates, we found seven sequence types (STs), with the prevalent STs of ST87 and ST7. Serotyping divided the strains into four serotypes, including serotype 1/2a, 1/2b, 3a, and 4b. Antimicrobial resistance testing showed that all the isolates were susceptible to 10 antibiotics. Comparative genomics analysis clearly classified our genome collection into four distinct evolutionary lineages with most isolates grouping into lineages I and II. Interestingly, we found three pairs of isolates with high identity, although no evident epidemiological association was observed. Conclusion: This study reports for the first time the surveillance of pregnancy-associated listeriosis in Zhejiang province, China, which indicates that the infection rate is low in this region. Our findings provide insight into the evolution and genetic diversity of pregnancy-associated L. monocytogenes from Zhejiang province. Additional investigations involving more human and non-human isolates with a one health strategy are needed for prediction of the listeriosis risk associated with a typical prevalent clone in Zhejiang province, such as ST87. |
| animal health; antibiotic-resistant; antimicrobial resistance; bacteria; veterinary | | Antimicrobial resistance (AMR) is a crucial multifactorial and complex global problem and Bangladesh poses a regional and global threat with a high degree of antibiotic resistance. Although the routine application of antimicrobials in the livestock industry has largely contributed to the health and productivity, it correspondingly plays a significant role in the evolution of different pathogenic bacterial strains having multidrug resistance (MDR) properties. Bangladesh is implementing the National Action Plan (NAP) for containing AMR in human, animal, and environment sectors through One Health approach where the Department of Livestock Services (DLS) is the mandated body to implement NAP strategies in the animal health sector of the country. This review presents a snapshot of the predisposing factors, and current situations of AMR along with the weakness and strength of DLS to contain the problem in animal farming practices in Bangladesh. In the present review, resistance monitoring data and risk assessment identified several direct and/or indirect predisposing factors to be potentially associated with AMR development in the animal health sector of Bangladesh. The predisposing factors are inadequate veterinary healthcare, monitoring and regulatory services, intervention of excessive informal animal health service providers, and farmers’ knowledge gap on drugs, and AMR which have resulted in the misuse and overuse of antibiotics, ultimate in the evolution of antibiotic-resistant bacteria and genes in all types of animal farming settings of Bangladesh MDR bacteria with extreme resistance against antibiotics recommended to use in both animals and humans have been reported and been being a potential public health hazard in Bangladesh. Execution of extensive AMR surveillance in veterinary practices and awareness-building programs for stakeholders along with the strengthening of the capacity of DLS are recommended for effective containment of AMR emergence and dissemination in the animal health sector of Bangladesh. |
| INFECTIONS | Background: Communities need to see antibiotic stewardship campaigns as relevant to enhance understanding of antibiotic use and influence health-seeking behaviour. Yet, campaigns have often not sought input from the public in their development. Objectives: To co-produce evidenced-based infographics (EBIs) about antibiotics for common childhood infections and to evaluate their effectiveness at increasing parents’ understanding of antibiotic use. Methods: A mixed-methods study with three phases. Phase 1 identified and summarized evidence of antibiotic use for three childhood infections (sore throat, acute cough and otitis media). In phase 2, we co-designed a series of prototype EBIs with parents and a graphic design team (focus groups). Thematic analysis was used to analyse data. Phase 3 assessed the effect of EBIs on parents’ understanding of antibiotic use for the three infections using a national online survey in the UK. Results: We iteratively co-produced 10 prototype EBIs. Parents found the evidence displayed in the EBIs novel and relevant to their families. Parents did not favour EBIs that were too medically focused. Parents preferred one health message per EBI. We included eight EBIs in a national survey of parents (n 998). EBIs improved knowledge by more than a third across the board (34%, IQR 20%-46%, P < 0.001). Respondents confirmed that EBIs were novel and potentially useful, corroborating our focus groups findings. Conclusions: Co-designed EBIs have the potential to succinctly change parents’ perceptions about antibiotics for acute respiratory tract infections in children. Further research should test EBIs in real-world settings to assess their reach as a potential public-facing intervention. |
| host adaptation; dynamic substitution; next-generation sequencing; H7N9 virus; PB2-627 | 5 EPIDEMIC WAVES; A VIRUS; AMINO-ACID; HUMAN INFECTIONS; PB2; POLYMERASE; ORIGIN; REPLICATION; VIRULENCE; HA | Avian-origin influenza viruses overcome the bottleneck of the interspecies barrier and infect humans through the evolution of variants toward more efficient replication in mammals. The dynamic adaptation of the genetic substitutions and the correlation with the virulence of avian-origin influenza virus in patients remain largely elusive. Here, based on the one-health approach, we retrieved the original virus-positive samples from patients with H7N9 and their surrounding poultry/environment. The specimens were directly deep sequenced, and the subsequent big data were integrated with the clinical manifestations. Unlike poultry/environment-derived samples with the consistent dominance of avian signature 627E of H7N9 polymerase basic protein 2 (PB2), patient specimens had diverse ratios of mammalian signature 627K, indicating the rapid dynamics of H7N9 adaptation in patients during the infection process. In contrast, both human- and poultry/environment-related viruses had constant dominance of avian signature PB2-701D. The intrahost dynamic adaptation was confirmed by the gradual replacement of 627E by 627K in H7N9 in the longitudinally collected specimens from one patient. These results suggest that host adaptation for better virus replication to new hosts, termed genetic tuning, actually occurred in H7N9-infected patients in vivo. Notably, our findings also demonstrate the correlation between rapid host adaptation of H7N9 PB2-E627K and the fatal outcome and disease severity in humans. The feature of H7N9 genetic tuning in vivo and its correlation with the disease severity emphasize the importance of testing for the evolution of this avian-origin virus during the course of infection. |
| Prostate cancer; Obesity; Waist circumference | OBESITY; METAANALYSIS; ADIPOSITY | Background We examined the association between obesity and prostate cancer based on both body mass index (BMI) and waist circumference (WC) using the National Health Insurance System (NHIS) database for the entire male population of Korea. Methods A total of 1,917,430 men who underwent at least one health examination in 2009 without a previous diagnosis of any other cancer were tracked through December 2015. The hazard ratio (HR) and 95% confidence interval (CI) value for the association between prostate cancer and obesity were analyzed using multiple Cox regression model. Since there was a statistically significant interaction between WC and BMI, a multiple HR for prostate cancer was estimated with stratifying both WC and BMI to control the interaction between WC and BMI. Results Without considering WC as an adjustment factor, very weak association between BMI and prostate cancer development risk was observed. When WC was considered as an adjustment factor, no significant change in the HRs for prostate cancer development beyond the reference BMI was observed in the group with WC < 85 cm in the multivariable-adjusted models. However, in the group with WC >= 85 cm, the HRs for prostate cancer increased as the BMI increased beyond the reference BMI. In addition, there was a discrepancy in the trend of prostate cancer development according to BMI among the groups with different categories for WC. Conclusion In groups with abdominal obesity, a significant linear relationship was observed between increasing BMI and prostate cancer risk. Higher the WC category, the stronger was the association with BMI, signifying that the association of BMI with risk of prostate cancer development depends on abdominal obesity. |
| Newcastle Disease virus; adenovirus vaccine; vaccine manufacturing; bioreactor production; HEK293; veterinary vaccination; vaccine production platform | GENETIC DIVERSITY; CELL-LINE; SCALE-UP; OPTIMIZATION; FORMULATION; PROTECTION; RESPONSES; CULTURE | Developing vaccine technology platforms to respond to pandemic threats or zoonotic diseases is a worldwide high priority. The risk of infectious diseases transmitted from wildlife and domestic animals to humans makes veterinary vaccination and animal health monitoring highly relevant for the deployment of public health global policies in the context of one world, one health principles. Sub-Saharan Africa is frequently impacted by outbreaks of poultry diseases such as avian influenza and Newcastle Disease (ND). Here, an adenovirus-vectored vaccine technology platform is proposed for rapid adaptation to ND or other avian viral threats in the region. Ethiopian isolates of the Newcastle Disease virus (NDV) were subjected to sequence and phylogenetic analyses, enabling the construction of antigenically matched vaccine candidates expressing the fusion (F) and hemagglutinin-neuraminidase (HN) proteins. A cost-effective vaccine production process was developed using HEK293 cells in suspension and serum-free medium. Productive infection in bioreactors (1-3 L) at 2 x 10(6) cells/mL resulted in consistent infectious adenoviral vector titers of approximately 5-6 x 10(8) TCID50/mL (approximately 10(11)VP/mL) in the harvest lysates. Groups of chickens were twice immunized with 1 x 10(10) TCID50 of the vectors, and full protection against a lethal NDV challenge was provided by the vector expressing the F antigen. These results consolidate the basis for a streamlined and scalable-vectored vaccine manufacturing process for deployment in low- and medium-income countries. |
| avian influenza; avian influenza viruses; birds; live bird market butchers; Pakistan; risk factors; seroprevalence; surveillance | A H7N9 VIRUS; HUMAN INFECTION; RISK-FACTORS; BIRD MARKETS; H5N1 VIRUS; PCR ASSAY; WORKERS; CHINA; TRANSMISSION; POPULATION | Background Live poultry retail stalls (LPRSs) are believed to be the source of human infection with avian influenza viruses (AIVs); however, little is known about epidemiology of these viruses in LPRSs of Pakistan. Objectives The current study was conducted to estimate the virological and serological prevalence of AIVs in humans and poultry and associated risk factors among seropositive butchers. Methods A field survey of LPRSs of Chakwal District was conducted between December 2015 and March 2016. In total, 322 samples (sera = 161 and throat swab = 161) from butchers and 130 pooled oropharyngeal swabs and 100 sera from birds were collected. Baseline sera (n = 100) from general population were also tested. Data were collected by structured questionnaires. Sera were tested by hemagglutination inhibition (HI) test further confirmed by micro-neutralization test (MN). Swabs were processed by real-time RT-PCR. Logistic regression analyses were conducted to identify risk factors. Results In butchers, 15.5% sera were positive for antibodies against H9 virus using a cutoff of >= 40 in HI titer; 6% sera from general population were positive for H9. Seroprevalence in poultry was 89%, and only 2.30% swabs were positive for H9. Presence of another LPRS nearby and the number of cages in the stall were risk factors (OR > 1) for H9 seroprevalence in butchers. Conclusions This study provides evidence of co-circulation of H9 virus in poultry and exposure of butchers in the LPRSs, which poses a continued threat to public health. We suggest regular surveillance of AIVs in occupationally exposed butchers and birds in LPRSs. |
| clinical pharmacology; drug information; medication safety; public health | ZOLPIDEM; IMPACT; RISKS; NEWS | Aims Drug regulators issue safety advisories to warn clinicians and the public about new evidence of harmful effects of medicines. It is unclear how often these messages are covered by the media. Our aim was to analyse the extent of media coverage of two medicines that were subject to safety advisories from 2007 to 2016 in Australia, Canada, the United Kingdom and the United States. Methods Two medicines widely used to treat mental health or physical conditions were selected: citalopram and denosumab. Media reports were identified by searching LexisNexis and Factiva. Reports were included if they stated at least one health benefit or harm. A content analysis of the reports was conducted. Results In total, 195 media reports on citalopram and 239 on denosumab were included. For citalopram, 43.1% (84/195) of the reports mentioned benefits, 85.6% (167/195) mentioned harms and 9.7% (19/195) mentioned the harm described in the advisories (cardiac arrhythmia). For denosumab, 94.1% (225/239) of the reports mentioned benefits and 39.7% (95/239) mentioned harms. The harms described in the advisories were rarely mentioned: 10.9% (26/239) of the reports mentioned osteonecrosis and <= 5% mentioned any of the other harms (atypical fractures, hypocalcaemia, serious infections and dermatologic reactions). Conclusions We found limited media coverage of the harms highlighted in safety advisories. Almost two-thirds of the media stories on denosumab did not include any information about harms, despite the many advisories during this time frame. Citalopram coverage covered harms more often but rarely mentioned cardiac arrhythmias. These findings raise questions about how to better ensure that regulatory risk communications reach the general public. |
| Greece; maternity care; migrant; refugee; refugee camp | HEALTH-CARE; PREGNANCY; CRISIS; EXPERIENCES; COMMUNITY; NEEDS; WOMEN | Background Over a two-year period between 2015 and 2016, unprecedented numbers of people arrived in Greece fleeing conflict, persecution, and poverty. With new arrivals every day, there is a significant unmet need for health care provision, posing a challenge to the Greek Healthcare System. For pregnant refugees, a known vulnerable group, this has resulted in a complex partnership of shared maternity care between humanitarian organizations, the Greek national health care system, and European multi-state initiatives. Our aim was to understand the challenges to providing maternity care services in Greek refugee camps as perceived by health care providers. Methods A qualitative study comprising observation and semi-structured interviews with health care providers working with pregnant refugees was conducted in five refugee camps in May 2017. Interviews were transcribed and analyzed with thematic coding. Results Twenty-one health care providers were interviewed and field notes taken from observational study of services in five refugee camps. Health care providers describe difficult cross-cultural communication to be their biggest challenge to caring for pregnant refugee women. The limited availability of female only safe spaces is also identified as a barrier. Lastly, the overburdened Greek public health system limits their ability to provide care. Conclusions Our research supports other literature describing difficult communication and the overburdened Greek health system as significant health care barriers for pregnant refugees in Greece. There is limited literature examining the role of safe space, and further research is needed. Stakeholders providing maternity care to refugees should look to tackle these key issues as they seek to provide care to this population. |
| Violence against women; Attitude of health personnel; Battered women; Women’s health; Delivery of health care | INTIMATE PARTNER VIOLENCE; SUBSTANCE USE; PROFESSIONALS; CONSEQUENCES | Objective: To determine the potential and limitations of Primary Health Care professionals to identify situations of violence against women. Location: A municipality of Rio Grande do Sul, Brazil. Design: Descriptive and exploratory study with a qualitative approach. Participants: Twenty-one health professionals of three Family Health Strategy units, as well as one Basic Health Unit. The inclusion criterion consisted of being a health worker in these services. The exclusion criterion was to be absent from work by any kind type license during the period of data production. Method: The technique used to produce data was individual, semi-structured, interviews in order to collect sociodemographic data and the monitoring by professionals related to the potentials and limitations to identify violence situations. The data collection was suspended based on the saturation criterion. The data were systematized and analyzed by the content analysis technique, according to the analytical categories of health care network and gender. Results: The potential to identify themes were: professional experience, receptive atmosphere, bonding, and listening to the reports of women, children and/or neighbors and observing their behavior; to identify the lesions; prenatal consultations; and home visits. As to the limitations: silence, denial/non-recognition of violence, lack of complaints by women; fear and guilt; flaws and unpreparedness of the health team; and fear due to the presence of aggressor. Conclusions: It is urgent to recognize the potential of Primary Care and to promote the qualification of professionals in order to identify the situation among visible and invisible complaints, leading to the confrontation of violence. (C) 2018 The Authors. Published by Elsevier Espana, S.L.U. |
| mcr-9; Salmonella; chicken meat; colistin | ANTIMICROBIAL RESISTANCE; PREVALENCE; SEROVARS; ANIMALS | Colistin is an important antibiotic currently used to manage infections caused by multidrug-resistant pathogens in both humans and livestock animals. A new mobile colistin-resistance (mcr-9) gene was recently discovered; this discovery highlighted the need for rigorous monitoring of bacterial resistance against colistin.Salmonellais one of the major pathogens responsible for foodborne illnesses; however, there is minimal information regarding the presence ofmcrgenes in foodborneSalmonellastrains. The aim of this study was to investigate the presence ofmcrgenes among 178Salmonellastrains isolated from chicken meat in Korea. Antimicrobial susceptibility was measured using the broth microdilution method. Bioinformatics characterization of colistin-resistant strains and genetic environment of themcr-9gene were analyzed using next-generation sequencing. Transferability of themcr-9carrying colistin-resistantSalmonellastrain was tested using broth-mating conjugation. Thirteen of the 178Salmonellaisolates showed colistin resistance, but only one strain,SalmonellaDessau ST14 (KUFSE-SAL043) from a traditional chicken market in Korea, carried anmcrfamily gene,mcr-9. This strain also carried other acquired antimicrobial resistance genes such asbla(TEM-1B),qnrS1, andaac(6 ‘)-Iaa. Only the IncX1 plasmid replicon type was detected in this strain. In the strain KUFSE-SAL043, themcr-9gene was located between two insertion sequences, IS903Band IS26, followed by the downstream regulatory genesqseB-like andqseC-like, which were located between IS1Rand Delta IS1R. Conjugation tests revealed that themcr-9gene was successfully transferred toEscherichia coliJ53 at a mean frequency of 2.03 x 10(-7). This is the first report of a transferablemcr-9gene inSalmonellaisolated from chicken meat in Korea, highlighting the possibility of transfer of colistin resistance. Therefore, the wide use of colistin should be reconsidered, and a One Health perspective should be adopted to monitor the antimicrobial resistance ofEnterobacteriaceaestrains in humans, livestock, and the environment. |
| campylobacteriosis; case cross-over; environment; meta-analysis; seasonality | CASE-CROSSOVER; SEASONALITY | Background Campylobacter bacteria infect both humans and animals. Sources of human exposure include contaminated food and water, contact with animals and/or their faeces, and contact with infected individuals. The objectives of this study were to: (a) identify environmental conditions associated with the occurrence of Campylobacter in humans in four regions of Ontario, and (b) identify pooled measures of effect across all four regions and potential sources of heterogeneity. Methods To address objective 1, human Campylobacter cases from four health regions of Ontario, Canada were analysed using negative binomial regression and case cross-over analysis to identify relationships between environmental factors (temperature, precipitation and hydrology of the local watershed) and the risk of human infection. To address objective 2, meta-analytic models were used to explore pooled measures of effect and when appropriate, meta-regression models were used to explore potential sources of heterogeneity. Results Human incidence exhibited strong seasonality with cases peaking in the late spring and summer. There was a decreasing yearly effect in three of the four health regions. A significant pooled effect was found for mean temperature after a 1-week lag (OR = 1.03, 95% CI 1.02, 1.04). No significant pooled effects were found for precipitation or water flow. However, increased precipitation was associated with lower odds of campylobacteriosis in Wellington and York regions at 2- and 3-week lags, respectively, from the case cross-over analysis. Conclusion These results demonstrate that a climatic factor (specifically, mean temperature in the week prior) was associated with human case occurrence after a biologically plausible time period, but hydrologic factors are not. |
| wildlife-livestock interface; peste des petits ruminants; small ruminant morbillivirus; global eradication; integrated management; wildlife conservation; one health | CAMELS; PPR | Growing evidence suggests that multiple wildlife species can be infected with peste des petits ruminants virus (PPRV), with important consequences for the potential maintenance of PPRV in communities of susceptible hosts, and the threat that PPRV may pose to the conservation of wildlife populations and resilience of ecosystems. Significant knowledge gaps in the epidemiology of PPRV across the ruminant community (wildlife and domestic), and the understanding of infection in wildlife and other atypical host species groups (e.g., camelidae, suidae, and bovinae) hinder our ability to apply necessary integrated disease control and management interventions at the wildlife-livestock interface. Similarly, knowledge gaps limit the inclusion of wildlife in the FAO/OIE Global Strategy for the Control and Eradication of PPR, and the framework of activities in the PPR Global Eradication Programme that lays the foundation for eradicating PPR through national and regional efforts. This article reports on the first international meeting on, Controlling PPR at the livestock-wildlife interface, held in Rome, Italy, March 27-29, 2019. A large group representing national and international institutions discussed recent advances in our understanding of PPRV in wildlife, identified knowledge gaps and research priorities, and formulated recommendations. The need for a better understanding of PPRV epidemiology at the wildlife-livestock interface to support the integration of wildlife into PPR eradication efforts was highlighted by meeting participants along with the reminder that PPR eradication and wildlife conservation need not be viewed as competing priorities, but instead constitute two requisites of healthy socio-ecological systems. |
| Antibiotic resistance; Live mycoplasma vaccination; Poultry Mycoplasma; Antimicrobial usage | SYNOVIAE; GALLISEPTICUM; RESISTANCE | Mycoplasma synoviae (n = 26) and M. gallisepticum (n = 11) isolates were gained from 164 clinical samples collected from China, India, Indonesia, Malaysia, Philippines, Republic of Korea and Thailand. Most isolates were from commercial chicken production systems. A method of filtering (0.45 mu m) samples immediately after collection was convenient allowing over a week for transit to the laboratory. Minimum inhibitory concentrations (MICs) were characterized by a broth microdilution method to enrofloxacin, difloxacin, oxytetracycline, chlortetracycline, doxycycline, tylosin, tilmicosin, tylvalosin, tiamulin, florfenicol, lincomycin, spectinomycin and lincomycin and spectinomycin combination (1:2). Increased MICs to various antimicrobials were seen in different isolates but appeared largely unrelated to the antimicrobial treatment histories. Overall, the results were similar to other MIC surveys around the world. Generally, low MICs to tetracyclines, tiamulin and tylvalosin were observed. Increased tilmicosin MICs were observed in both M. synoviae and M. gallisepticum isolates (>= 64 mu g/ml MIC90 values) and this was seen in all isolates with high tylosin MICs. Increases in lincomycin MICs were mostly associated with increases in tilmicosin MICs. The results also suggested that antimicrobial use after mycoplasma vaccination may interfere with vaccine strain persistence and efficacy (field strains were more commonly observed in flocks that had treatments after vaccination) and this area warrants more investigation. The study shows that isolation and MIC determination can be done from remote locations and suggests that this may provide information that will allow more effective use of antimicrobials or other methods of control of avian mycoplasma in chickens (e.g. live vaccines) and therefore more responsible use of antimicrobials from a one health perspective. |
| bushmeat; food; health risk; Laos; markets; one health; risk perception; wildlife; zoonoses | ZOONOTIC DISEASE RISK; WILDLIFE TRADE; BUSHMEAT; FOOD; CONSERVATION; DETERMINANTS; PATTERNS; ORIGINS; FEVER; NEXUS | Wet markets are a critical part of South-East Asian culture and economy. However, their role in circulation and transmission of both endemic and emerging disease is a source of concern in a region considered a hotspot of disease emergence. In the Lao People’s Democratic Republic (Lao PDR, Laos), live and dead wild animals are frequently found in wet markets, despite legislation against the bushmeat trade. This is generally considered to increase the risk of disease transmission and emergence, although whether or not wildlife vendors themselves have indeed increased incidence of zoonotic disease has rarely been assessed. In preparation for a future longitudinal study of market vendors investigating vendors’ exposure to zoonotic pathogens, we conducted a pilot survey of Lao market vendors of wildlife meat, livestock meat and vegetables, to identify demographic characteristics and potential control groups within markets. We also investigated baseline risk perception for infectious diseases among market vendors and assessed the association between risk perception and risk mitigation behaviours. The surveys conducted with 177 vendors revealed similar age, sex, ethnic background and geographical origin between vendor types, but differences in professional background and work history for livestock meat vendors. The perception of disease risk was very low across all vendors, as was the reported use of personal protective equipment, and the two appeared unrelated. Personal risk discounting and assumptions about transmission routes may explain this lack of association. This information will help inform the development of future research, risk communication and risk mitigation policy, especially in the light of the COVID-19 pandemic. |
| fungicides; herbicides; insecticides; risk; ethiopia | PERSISTENT ORGANIC POLLUTANTS; ORGANOCHLORINE PESTICIDES; VEGETABLE FARMERS; FISH; KNOWLEDGE; AFRICA; HEALTH; ENDOSULFAN; WORKERS; WATER | This paper studies the practice of synthetic chemical use among farmers and its possible occurrence as residue in fish foods in North-West Ethiopia. Cross-sectional study design was carried out from January to December 2018. A multi-stage sampling technique embedded with simple random sampling was employed for the selection of sampling units. The data were collected through in-depth interviews and observations of farmers. Data entered and analyzed by using SPSS version 20. The results showed that farmers applied chemicals indiscriminately and inappropriately on their farm, using unsafe storage facilities, ignoring risks and safety instructions. Consequently, farmers respond that insecticides and herbicides were used up to 100% and 96.4% of their farms, respectively. Most of the farmers (80.16%) of the study area have poor attitudes and practices of pesticide usage. Multivariable analysis showed, illiterate educational level; Adjusted Odds Ratio [AOR] = 3.39; 95% CI: 1.7, 6.77; Land holders situation (AOR = 1.8, 95% CI: 1.52, 2.9) has been formally not trained about pesticides usage (AOR = 2.97, 95% CI: 1.06, 8.37) and not read pesticide labels (AOR = 3.69, 95%CI: 1.62, 13.64) were significantly associated with possible poor attitude and practice of pesticide contamination. We conclude that there are high possibilities of chemical residues affects fish and occurring in food products (in milk, meat, fish, vegetable and fruit) that may have a public health risk in the study area. Therefore, one health intervention is required. |
| feature extraction; fuzzy C-means; knowledge discovery; multilabel classification; overlapping clustering | GENE-EXPRESSION DATA; FEATURE-SELECTION; VULNERABILITY; MAP | Medical diagnosis through classification is often critical as the medical datasets are multilabel in nature, that is, a patient may have more than one health condition: high blood pressure, obesity, and diabetes. The aim of this article is to improve the accuracy and performance of multilabel classification using multilabel feature selection and improved overlapping clustering method. The proposed system consists of Optimized Initial Cluster Centers and Enhanced Objective Function technique to reduce the number of iterations in the clustering process thereby improving the clustering performance and to improve the clustering accuracy which will result in improving the accuracy and performance of multilabel classification. Ratios of clustering distance to class distance and execution time are used as the evaluation metric for accuracy and total execution time is used as the evaluation metric for performance. Based on the different combination with the number of labels, attributes, instances, and number of clusters, different values of accuracy and performance are obtained. The results on all 10 datasets show that the proposed technique is superior to the current technique. Furthermore, on average, the proposed technique has improved the classification accuracy by 5%-7%. Furthermore, the performance of new technique is improved by decreasing the processing time by 0.5-1 s on average. The proposed system targets on improving the accuracy and performance of the multilabel classification for medical diagnosis, which consists of multilabel feature selection and enhanced overlapping clustering technique. This study provides an acceptable range of accuracy with improved processing time, which assists the doctors in medical diagnosis (high blood pressure, obesity, and diabetes) of patients. |
| Cynomys; deltamethrin; Peromyscus; rodent; Siphonaptera; Yersinia pestis | EARLY-PHASE TRANSMISSION; PRAIRIE DOGS CYNOMYS; YERSINIA-PESTIS; VECTOR COMPETENCE; GRASSHOPPER MICE; SIPHONAPTERA; MAINTENANCE; BURROWS; DELTAMETHRIN; EPIZOOTICS | Plague originated in Asia as a flea-borne zoonosis of mammalian hosts. Today, the disease is distributed nearly worldwide. In western United States of America, plague is maintained, transmitted, and amplified in diverse communities of rodents and fleas. We examined flea diversity on three species of prairie dogs (Cynomysspp., PDs) and six species of sympatric small rodents in Montana and Utah, United States of America. Among 2896 fleas, 19 species were identified; 13 were found on PDs and 9 were found on small rodents. In Montana, three flea species were found on PDs; the three species parasitize PDs and mice. In Utah, 12 flea species were found on PDs; the 12 species parasitize PDs, mice, voles, chipmunks, ground squirrels, rock squirrels, and marmots. Diverse flea communities and their willingness to parasitize many types of hosts, across multiple seasons and habitats, may favor plague maintenance and transmission. Flea parasitism onPeromyscusdeer mice varied directly with elevation. Fleas are prone to desiccation, and might prosper at higher, mesic elevations; in addition,Peromyscusnest characteristics may vary with elevation. Effective management of plague is critical. Plague management is probably most effective when encompassing communities of rodents and fleas. Treatment of PD burrows with 0.05% deltamethrin dust, which suppressed fleas on PDs for >365 days, suppressed fleas on small rodents for at least 58 days. At one site, deltamethrin suppressed fleas on small rodents for at least 383 days. By simultaneously suppressing fleas on PDs and small rodents, deltamethrin should promote ecosystem resilience and One Health objectives. |
| community; feasibility randomised controlled trial; fibromyalgia; self-management | SCALE; DIAGNOSIS; EFFICACY; CARE; INTERVENTIONS; PREVALENCE; FATIGUE; PEOPLE; SLEEP; COST | Background: Fibromyalgia (FM) is a complex long-term condition associated with chronic widespread pain, fatigue, sleep problems, memory and concentration difficulties and irritable bowel syndrome. Current guidelines for the treatment of FM recommend nonpharmacological interventions. The Fibromyalgia Self-Management Programme (FSMP) is a nonpharmacological, multidisciplinary exercise and education group intervention. It aims to provide education and teach core skills, enabling those affected by FM to self-manage. The FSMP is currently codelivered by a multidisciplinary team within a secondary care service. The aim of this feasibility randomised controlled trial (RCT) is to determine the practicality and acceptability of delivering the FSMP in a community setting, informing a future RCT of effectiveness. Methods: The feasibility RCT aims to recruit 70 people with FM. Participants will be randomised to either a community FSMP or control arm. All participants will be asked to complete six patient-reported outcome measures and one health economics questionnaire on three occasions; baseline, 6 weeks (end of the intervention) and 6 months. Between 12 and 16 participants and four therapists delivering the FSMP will be invited to take part in a semi-structured interview to explore their experiences of the FSMP. Patient participants will be purposively selected based upon key characteristics. Analysis: Quantitative data will be analysed descriptively to summarise recruitment and attendance, participant reported outcomes and health economic data. Semi-structured interviews will be transcribed, anonymised and inductively coded. The codes will be grouped into categories and theoretically thematically analysed, comparing the results to existing literature. |
| Albania; adverse childhood experience; health risk behavior; prevalence; cross-sectional | SEXUAL-ABUSE; NEGLECT | Adverse childhood experiences (ACEs) are associated with considerable harmful effects on various health outcomes of the affected individuals and non-negligible costs. ACEs are rather widespread and could increase the risk of a wide range of health risk behaviors. In this context our aim was to assess the association between ACE forms and number with various risk health behaviors in Albania. For this purpose, a cross-section survey was conducted in 2015 in a representative sample of 957 young adults studying in universities of four regions of Albania. The Family Health History questionnaire was used to retrieve information about 10 ACE forms, basic socio-demographic information and various health risk behaviors. Binary and Multinomial Logistic Regression was used to determine the associations between ACEs and health risk behaviors. The most prevalent ACE was emotional abuse (35%), followed by physical neglect (34%), witnessing mother’s violence (24%) and physical abuse (21%). Each ACE form was a significant predictor of at least one health risk behavior. Living in household with members that abuse with substances, emotional abuse, physical abuse, parental divorce and witnessing mother’s violence significantly increased the odds of suicide attempt by 8.8, 5.8, 4.6, 4.6 and 4.4 times, respectively whereas parental divorce was the strongest predictor of respondents problematic drug use, increasing the likelihood of the later by 24.3 times. The increasing number of ACEs was a significant predictor for most health risk behaviors. There is need for carefully planned strategies and interventions in order to address the burden of ACEs on Albanian population. |
| FOLLOW-UP; TESTS; DISCHARGE | Background: Mucosal biopsies are often obtained during inpatient endoscopies to aid diagnosis. Up to 75% of patients are reported to have pending test results at discharge. Incomplete result communication to patients can lead to patient anxiety and poor outcomes. This study aimed to evaluate the impact of a systemwide electronic medical record (EMR) update on result communication. Methods: The researchers retrospectively reviewed 100 inpatient endoscopies pending histopathology results at discharge to see if finalized results were communicated to the patients within 30 days. The same metric was studied after implementation of an EMR update that automatically routed results to the supervising endoscopist, by reviewing another 100 inpatient endoscopies during which biopsies were obtained. Follow-up rate pre- and post-EMR update was compared. Results: Prior to the update, 47/77 (61.0%) histopathology results were communicated to the patients. Of the 30 nonreported cases, 17 showed nonspecific/chronic inflammation, 8 had no abnormal findings, 3 showed hyperplastic colon polyps, and 2 had colonic tubular adenomas. Following the EMR update, 65/71 (91.5%) of pathology results were communicated, demonstrating an increase of 30.5 percentage points in the rate of follow-up (95% confidence interval [CI] = 17.7-43.0, p < 0.0001). Conclusion: This study observed that 39.0% of inpatient endoscopic mucosal biopsy results in one health care system were not communicated to the patients. Implementation of a systemwide EMR intervention reduced this to 8.5% by shifting the responsibility of result communication to the endoscopy team. Similar EMR enhancements can be applied to other pending test results in health care systems with similar issues. |
| catalase; dogs; interleukins; malondialdehyde; pyoderma; serum amyloid A | ACUTE-PHASE RESPONSE | Background and Aim: Staphylococcus pyoderma is a common problem in dogs that need a novel treatment rather than antibiotic therapy. The aim of this study was to investigate the therapeutic efficacy, anti-inflammatory, and antioxidative properties of Aloe vera (Aloe barbadensis) gel ointment on dogs’ Staphylococcus pyoderma compared to gentamicin ointment. Materials and Methods: The inhibition zone of A. vera extract 20% and 40% and gentamicin 1% against Staphylococcus aureus was determined on well diffusion agar. Twenty Baladi local breed dogs were used as control negative group before intradermal inoculation with 10(5) CFU S. aureus. The animals were classified into four equal groups, control positive group without treatment (n=5), treated groups by 20%A. vera gel ointment (n=5). 40%A. vera gel ointment (n=5), and gentamicin ointment 1% (n=5). Topical application of A. vera and gentamicin ointments was carried out twice daily for 2 weeks until complete healing of dogs’ pyoderma. Clinical evaluation was recorded. Inflammatory, oxidant, and antioxidant parameters were measured in serum. Results: The inhibition zone of A. vera extracts 20% and 40% was 19 mm and 23 mm, respectively, while gentamicin 1% was 18 mm. The half maximal inhibitory concentration (ofA. vera 20% and 40% were 13.70 with R-2 =0.98. Dogs’ pyoderma treated with A. vera gel ointment 20% and 40% were more likely to have low haptoglobin and tumor necrosis factor-a concentrations than gentamicin 1% ([odds ratio [OR]=4.6; 95% confidence interval [CI]=1.31-17.40; p<0.05]; [OR=5.2; 95% CI=1.04-22.30; p<0.05]), respectively. Conclusion: It seems evident that A. vera has therapeutic effect, antibacterial, and anti-inflammatory effects against dogs’ staphylococcal pyoderma than gentamicin that would support its further use rather than antibiotics in one health arena. |
| feline; cat; cancer; genomics; chromosome; comparative genomic hybridization (CGH) | MATRIX METALLOPROTEINASES; CANINE; ANEUPLOIDY; EXPRESSION; SEQUENCE | The utility of the domestic cat as a model system for biomedical studies was constrained for many years by the absence of a comprehensive feline reference genome sequence assembly. While such a resource now exists, the cat continues to lag behind the domestic dog in terms of integration into the ‘One Health’ era of molecular medicine. Stimulated by the advances being made within the evolving field of comparative cancer genomics, we developed a microarray platform that allows rapid and sensitive detection of DNA copy number aberrations in feline tumors using comparative genomic hybridization analysis. The microarray comprises 110,456 unique oligonucleotide probes anchored at mean intervals of 22.6 kb throughout the feline reference genome sequence assembly, providing similar to 350-fold higher resolution than was previously possible using this technique. We demonstrate the utility of this resource through genomic profiling of a feline injection-site sarcoma case, revealing a highly disrupted profile of DNA copy number imbalance involving several key cancer-associated genes including KIT, TP53, PTEN, FAS and RB1. These findings were supported by targeted fluorescence in-situ hybridization analysis, which identified major alterations in chromosome structure, including complex intrachromosomal reorganization events typical of those seen in aggressive soft-tissue sarcomas of other species. We then characterized a second mass that was identified at a nearby site in the same patient almost 12 months later. This mass demonstrated a remarkably conserved genomic profile consistent with a recurrence of the original tumor; however the detection of subtle differences reflected evolution of the tumor over time. These findings exemplify the diverse potential of this microarray platform to incorporate domestic cat cancers into comparative and translational research efforts in molecular oncology. |
| Mortality; Masticatory dysfunction; Teeth; Serum albumin; Older people | CORONARY-HEART-DISEASE; BODY-MASS INDEX; QUALITY-OF-LIFE; MASTICATORY DISABILITY; PERIODONTAL-DISEASE; 4-YEAR MORTALITY; HIGH-PROTEIN; PREDICTOR; HEALTH; COHORT | Background The association between dental status and mortality in community-dwelling older adults has been documented by several studies. The aim of this study was to analyze the contribution of self-assessed chewing ability, number of remaining teeth and serum albumin levels to mortality and the interactions between the three factors. Methods A 20-year follow-up study was conducted with 666 subjects aged 80 years (from 1996 to 2017) who resided in the 8 areas served by one health center in Iwate Prefecture. Health check-ups including physical fitness measurements were conducted at a meeting place or gymnasium. Medical interview and blood sampling were conducted by physician. Oral examination was examined by dentist. The number of remaining teeth, serum albumin levels, and self-assessed chewing ability were used as predictors of mortality. Results Among the 608 subjects (233 men and 375 women) included in this study, only 12 subjects (1.97%) survived after 20 years of follow-up. For men, dental status and serum levels of albumin were significantly associated with mortality. The hazard ratios of self-assessed chewing ability calculated by item response theory analysis and the inability to chew at least one food adjusted for serum albumin and tooth conditions were statistically significant in men. When adjusted by health status evaluated by blood tests, self-assessed chewing ability was statistically significant in men. According to path analysis, self-assessed chewing ability and serum albumin independently affected mortality in men. Conclusion Masticatory dysfunction may be an important risk factor for mortality in men, even though it was self-assessed. Retaining chewing ability might be a useful predictor of longevity in older male adults. |
| | IntroductionThe U.S. Army requires community health coalitions to develop targeted action plans in order to more effectively address top public health priorities. Reviews of community action plans indicate that they are often poorly developed and not fully implemented. To date, the U.S. Army has not implemented a standardized tool or process to evaluate action plans and provide recommendations for improvement to local installations. The Plan Quality Index (PQI) is an evidence-based, standardized tool that has been used successfully by technical experts to review and improve community action plans related to the prevention of obesity, injury and violence, and cancer.Materials and MethodsThe objective of this project was to determine the usability of the PQI and to provide recommendations for improving community health action plans focused on injury prevention for the U.S. Army. Five Health Promotion Project Officers and one Health Promotion Project Assistant at Army Public Health Center were trained on the PQI and reviewed injury prevention action plans for 17 installations. After using the PQI to assess injury prevention action plans, the individuals were given a System Usability Scale (SUS) survey to assess the usability of the PQI.ResultsResults of the SUS survey can range from 0 to 100, but do not represent percentages. A score of 65 indicates greater than average usability. Participant scores on the SUS demonstrated that the PQI has a high degree of usability. Mean usability was calculated at 83.3 (range 72.5-97.5, median 85, sd +/- 9.3).ConclusionThe PQI demonstrated a high level of usability by technical experts for providing feedback and recommendations regarding community health action plans for injury prevention in the U.S. Army. As a result, the PQI may be beneficial as a standard tool for community health improvement planning and consultation throughout the Army Public Health Center. |
| Enterocytozoon bieneusi; Genotype; Population genetics; China; Zoonotic infection | MOLECULAR CHARACTERIZATION; CRYPTOSPORIDIUM SPP.; GIARDIA-DUODENALIS; PUBLIC-HEALTH; LABORATORY MACAQUES; ENTERIC INFECTIONS; NORTHEAST CHINA; GENOTYPES; MICROSPORIDIOSIS; OUTBREAK | Enterocytozoon bieneusi is a zoonotic pathogen with worldwide distribution. Among the 11 established groups of E. bieneusi genotypes based on phylogenetic analysis of the ribosomal internal transcribed spacer (ITS), the human-infective potential and population genetics of the Group 1 genotypes from diverse hosts are well characterized. In contrast, Group 2 genotypes from ruminants have unclear population genetics, leading to poor understanding of their host range and zoonotic potential. In this study, we sequence-characterized 121 Group 2 isolates from dairy cattle, beef cattle, yaks, Tibetan sheep, golden takins, and deer from China at five genetic loci (ITS, MS1, MS3, MS4 and MS7), comparing with data from 113 Group 1 isolates from nonhuman primates. Except for MS7, most of the genetic loci produced efficient PCR amplification and high nucleotide identity between Groups 1 and 2 of E. bieneusi genotypes. In population genetic analyses of the sequence data, a strong linkage disequilibrium was observed among these genetic loci in the overall Group 2 population. The individual ITS genotypes (I, J and BEB4) within Group 2, however, had reduced linkage disequilibrium and increased genetic exchanges among isolates. There was only partial genetic differentiation between Group 1 and Group 2 genotypes, with some occurrence of genetic recombination between them. Genetic recombination was especially common between genotypes I and J within Group 2. The data presented indicate a high genetic identity between Group 1 and Group 2 genotypes of E. bieneusi, which could be responsible for the broad host range and high zoonotic potential of Group 2 genotypes in China. As there is no effective treatment against E. bieneusi, the One Health approach should be used in the control and prevention of zoonotic transmission of the pathogen. |
| antibiotic resistance; communication; livestock; Madagascar; opinions; participatory epidemiology | ANTIMICROBIAL USE; RESISTANCE; BIOSECURITY; KNOWLEDGE; HEALTH | Antimicrobial resistance is a One Health issue that must be tackled worldwide. In order to implement effective communication strategies in Madagascar, a better understanding must be gained of practices and perceptions related to antimicrobial use at the smallholder farm level. Our study used a semi-qualitative approach, called Q methodology, to identify patterns of opinion on antimicrobial use, or its alternatives, among pig and poultry smallholders and drug vendors in the commune of Imerintsiatosika, in Madagascar. Twenty-nine breeders and 23 drug vendors were asked to rank, respectively, 38 and 45 statements, produced from semi-structured interviews and secondary data, through a 7 grade scale from -3 (totally disagree) to +3 (totally agree) about antimicrobial use, related risks and alternatives. The interview ended with a discussion around extreme statements. TheQ-sortingswere analyzed by factor analysis and Principal Component Analysis. Regarding antimicrobial use, antimicrobial resistance and alternatives, the breeders and drug vendors were divided according to three discourses: A: confidence in antibiotics (respectively, 13 and 6 individuals), B: belief in alternatives (7 and 7 individuals), and C: moderate approach to antibiotic use (6 and 6 individuals), explaining, respectively, 57 and 60% of total variance. Group A was associated with the use of antibiotics as a preventive measure, poor knowledge of resistance and low trust in alternatives. Group B considered the preventive use of antibiotics to be a major problem for antimicrobial resistance and believed that alternatives, such as vaccines, were useful preventive methods. Group C seemed to have a hazy opinion. The presence of three main points of view offers the possibility to adapt awareness messages. Group B might also be used as a showcase to reduce the amounts of antibiotics used by the two other groups. This study revealed different practices and risk perceptions related to antimicrobial use that must be better characterized and accurately quantified. |
| animal welfare; animal hoarding; obsessive-compulsive disorder (OCD); behavioral and clinic signs; abused dogs | CHILDHOOD; DISORDER | Simple Summary Animal hording is a psychiatric disorder characterized by the accumulation of animals without providing them with adequate living conditions and the fulfillment of their minimum hygiene and ethological needs. It is now considered as a form of animal cruelty. Here, we present a case of an animal hoarding investigation from Italy that began in 2005 that remains unresolved. We describe the patient’s living and health conditions as well as the legal and animal welfare issues arising from the case. The difficulties that emerged from this case and the involvement of various bodies and agencies highlight the need for a multidisciplinary approach. In fact, this type of problem involves the human, animal, and environmental spheres. Moreover, a holistic approach should be taken and the creation of a National Observatory for Animal Hoarding Disorders could be useful to coordinate stakeholders’ interventions in order to adopt an efficient solution. Animal hoarding or compulsive hoarding of animals is a psychiatric disease, which has important social implications and a profound influence on animal welfare. To date, this phenomenon has been little investigated and largely unexplored. The present study aims to systematically describe a case of animal hoarding, which remains unresolved. The report refers to a case of a woman suffering from animal hoarding that emerged in 2005. From March 2014 to December 2019, 450 animals were seized over nine different occasions. This disease had significant implications on the welfare of the animals collected, which lived in poor housing and hygiene conditions that frequently led to their death. Since animal hoarding cases involve sanitary, legal, and veterinary aspects, we believe that a multidisciplinary approach is necessary in order to prevent a recurrence and a new accumulation of animals. A holistic approach should be taken according to the One Health principle that involves different stakeholders at every level in order to adopt an efficient solution. |
| dog bites; one health; rabies; zoonoses | UNITED-STATES; RABIES; CANINE; ATTACKS; OWNERSHIP; INCIDENTS | This study investigated self-reported dog bites in humans in rural and urban households in southern Ontario, Canada. Our objectives were to determine, and compare, the incidence of dog bites in rural and urban households, and to describe the profile of bite victims, biting dogs, and the proportion of biting dogs that respondents self-reported as being not up to date on rabies vaccination. We conducted a cross-sectional observational study using an online questionnaire. The 2,006 respondents, each representing one household, included 1,002 rural and 1,004 urban residences. The incidence risk of at least one person in the household being bitten over the previous year in rural households (6.09% per year) was less than in urban households (10.76% per year). In 53.20% of households from which at least one person had been bitten within the past year, only a single person had been bitten. Mostly, victims were 25 to 34 years old (21.67%), male (54.19%), and playing with or interacting with the biting dog at the time of the incident (59.11%). Most biting dogs were 3 to 5 years old (32.02%), males (53.69%), and unleashed (76.85%). Based on self-reporting by respondents, 83.33% of respondent-owned biting dogs were vaccinated against rabies at the time of the biting incident. Irrespective of dog ownership, the odds of an individual in a rural household being bitten by a dog were 0.53 (95% CI: 0.38-0.73) the odds for an individual in an urban household. Dog bites constitute a serious, yet preventable, public health concern that requires targeted, community-specific efforts. Public health organizations could consider findings in developing messaging, particularly as we highlight biting dogs reported by their owners as not up to date on rabies vaccination. |
| malaria surveillance; inpatient morbidity; children < 5 years old; Tanzania | | Background: Surveillance of the clinical morbidity of malaria remains key for disease monitoring for subsequent development of appropriate interventions. This case study presents the current status of malaria morbidities following a second round of mass distribution of long-lasting insecticidal nets (LLINs) on Ukerewe Island, northwestern Tanzania. Methods: A retrospective review of health-facility registers to determine causes of inpatient morbidities for every admitted child aged <5 years was conducted to ascertain the contribution of malaria before and after distribution of LLINs. This review was conducted from August 2016 to July 2018 in three selected health facilities. To determine the trend of malaria admissions in the selected facilities, additional retrospective collection of all malaria and other causes of admission was conducted for both <5- and >5-year-old patients from July 2014 to June 2018. For comparison purposes, monthly admissions of malaria and other causes from all health facilities in the district were also collected. Moreover, an LLIN-coverage study was conducted among randomly selected households (n=684). Results: Between August 2016 and July 2018, malaria was the leading cause of inpatient morbidity, accounting for 44.1% and 20.3% among patients <5 and >5 years old, respectively. Between October 2017 and January 2018, the mean number of admissions of patients aged <5 years increased 2.7-fold at one health center and 1.02-fold for all admissions in the district. Additionally, approximately half the households in the study area had poor of LLIN coverage 1 year after mass distribution. Conclusion: This trend analysis of inpatient morbidities among children aged <5 years revealed an upsurge in malaria admissions in some health facilities in the district, despite LLIN intervention. This suggests the occurrence of an unnoticed outbreak of malaria admissions in all health facilities. |
| diseased birds; virulence factors; phylogenetic analysis; antimicrobial resistance | VIBRIO-CHOLERAE O1; MULTIPLEX PCR ASSAY; BACTERIOPHAGE K139; VIRULENCE FACTORS; SECRETION SYSTEM; SEQUENCE; ISLAND; GENES; IDENTIFICATION; STRAINS | Vibrio choleraenon-O1, non-O139 bacteria are natural inhabitants of aquatic ecosystems and have been sporadically associated with human infections. They mostly lack the two major virulence factors of toxigenicV. choleraeserogroups O1 and O139 strains, which are the causative agent of cholera. Non-O1, non-O139 strains are found in water bodies, sediments, and in association with other aquatic organisms. Occurrence of these bacteria in fecal specimens of waterfowl were reported, and migratory birds likely contribute to the long-distance transfer of strains. We investigated fourV. choleraenon-O1, non-O139 isolates for phenotypic traits and by whole genome sequencing (WGS). The isolates were recovered from organs of domestic ducks with serious disease symptoms. WGS data revealed only a distant genetic relationship between all isolates. The isolates harbored a number of virulence factors found in mostV. choleraestrains. Specific virulence factors of non-O1, non-O139 strains, such as the type III secretion system (TTSS) or cholix toxin, were observed. An interesting observation is that all isolates possess multifunctional autoprocessing repeats-in-toxin toxins (MARTX) closely related to the MARTX of toxigenic El Tor O1 strains. Different primary sequences of the abundant OmpU proteins could indicate a significant role of this virulence factor. Phenotypic characteristics such as hemolysis and antimicrobial resistance (AMR) were studied. Three isolates showed susceptibility to a number of tested antimicrobials, and one strain possessed AMR genes located in an integron. Knowledge of the environmental occurrence ofV. choleraenon-O1, non-O139 in Germany is limited. The source of the infection of the ducks is currently unknown. In the context of the ‘One Health’ concept, it is desirable to study the ecology ofV. choleraenon-O1, non-O139, as it cannot be excluded that the isolates possess zoonotic potential and could cause infections in humans. |
| Cryptosporidium hominis; foxes; genotyping; Giardia; prevalence; Spain; sylvatic cycle | DEER CAPREOLUS-CAPREOLUS; GIARDIA-DUODENALIS; GALICIA NW; MOLECULAR EPIDEMIOLOGY; ONE HEALTH; 1ST REPORT; SPP.; WILD; PREVALENCE; PARVUM | Giardia duodenalis and Cryptosporidium spp. are ubiquitous intestinal protozoa that parasitize domestic and wild animals, as well as human beings. Due to their zoonotic potential, the objective of the present study was to determine the presence of these pathogens in the fox population (Vulpes vulpes) located in Northwest Spain. A total of 197 faecal samples from legally hunted foxes were collected in the autonomous region of Galicia. The presence of G. duodenalis and Cryptosporidium spp. was investigated by PCR-based methods amplifying the small subunit ribosomal RNA (ssu rRNA) gene of the parasites. Attempts to genotype obtained positive samples were subsequently conducted at the glutamate dehydrogenase (gdh) and beta-giardin (bg) genes of G. duodenalis, and the 60 kDa glycoprotein (gp60) gene of Cryptosporidium. Giardia duodenalis and Cryptosporidium spp. were identified in 19 (9.6%) and 12 (6.1%) of the investigated samples, respectively. However, five Cryptosporidium species were detected at the ssu rRNA locus: C. hominis (33.4%, 4/12), C. canis (25.0%, 3/12), C. parvum (16.7%, 2/12), C. ubiquitum (8.3%, 1/12) and C. suis (8.3%, 1/12). An additional Cryptosporidium-positive sample was identified at the genus level only. Typing and subtyping of Giardia- and Cryptosporidium-positive samples were unsuccessful. The detection of C. hominis in wild foxes indicates the probable overlapping of sylvatic and domestic cycles of this parasite in rural settings. Besides, this finding raises the question of whether red foxes may act as natural reservoirs of C. hominis. The detection of C. parvum and C. suis is suggestive of active transmission events between farm and wild animals, opening up the possibility of transmission to human beings. |
| Antibiotic use; antimicrobial resistance; awareness campaigns | RECOMMENDATIONS; PRESCRIPTIONS; EUROPE | Objective: To present an overview of almost two decades of multi-faceted campaigning by the Belgian Antibiotic Policy Coordination Committee (BAPCOC) and partners, and its impact on public and prescribers’ awareness, outpatient antibiotic use, its cost and antimicrobial resistance in Belgium.Methods: Awareness of both public and prescribers was assessed through pre- and post-campaign interviews and surveys. Outpatient antibiotic use was evaluated using national reimbursement data expressed in number of defined daily doses and packages (a good proxy for treatments) per 1000 inhabitants per day (DID and PID, respectively) from July 1997 to June 2018. Its cost was studied using the same data expressed in number of euros per 1000 inhabitants per day. Antimicrobial resistance was evaluated between 1986 and 2017 using national data on the proportion of Streptococcus pneumoniae isolates not susceptible to penicillins, macrolides and tetracyclines.Results: Antibiotic awareness improved significantly, with general practitioners preferred by 87.5% of respondents as source of information. The Belgian outpatient antibiotic use has decreased by 12.8% in DID and by 42.8% in PID in the 2017-2018 winter compared to the winter before the start of its public awareness campaigns (1999-2000). This evolution coincided with decreasing costs for antibiotics and decreasing antimicrobial resistance. Despite multi-faceted campaigning, outpatient antibiotic use and use of broad-spectrum antibiotics, especially fluoroquinolones and amoxicillin with clavulanic acid, are still high in Belgium.Conclusion: Almost two decades of multi-faceted campaigning coincide with improvements in antibiotic awareness among the public and prescribers, outpatient antibiotic use and resistance. Nevertheless, additional efforts are needed to reach the targets set in BAPCOC’s national action plan 2014-2019. Therefore, a new national action plan was developed for 2020-2024 using a One Health approach. |
| cystic fibrosis; exercise testing; exercise training; healthcare survey | PHYSIOTHERAPY; ADULTS | Background: Within Australian and New Zealand cystic fibrosis (CF) centres, exercise testing and exercise training are common components of clinical care, but current practices regarding these components have not been reported. Aim: To determine the extent, scope and importance placed on exercise testing and exercise training within CF centres across Australia and New Zealand. Methods: Information pertaining to exercise testing and training practices was sought by administering a survey to health professionals working in CF centres across Australia and New Zealand. The survey comprised five sections (46 questions) and was sent via an online link (Qualtrics). Response rate was optimised using the Dillman approach. Approval for this study was granted from the Human Research Ethics Committee at Curtin University (HRE2018-074). Completion of the survey was taken as informed consent. Results: A response rate of 80% (n = 32/40) was achieved. Each state/territory in Australia, except the Northern Territory was represented in the survey responses. Eight of the 12 major regions in New Zealand were also represented. Regarding tests of exercise capacity, field-based tests were performed more commonly than laboratory-based tests (n = 28/32; 88% vs n = 11/32 centres; 34%; difference: 54%; 95% confidence interval 31-70%). Most (89%) respondents perceived field tests to be at least ‘somewhat’ important, whereas 91% of respondents perceived laboratory tests to be ‘a little’ to ‘somewhat’ important. Physical activity and/or exercise were discussed by at least one health professional in the CF team at every clinic appointment and/or annual review. Most centred offered outpatient exercise training each year to their patients (n = 24/32; 75%). Conclusion: This survey captures the current practices of exercise testing and training in CF centres across Australia and New Zealand. |
| antibiogram; antibiotics; antimicrobial resistance; aquaculture; detection | MEDIATED QUINOLONE RESISTANCE; ANTIBIOTIC-RESISTANCE; TETRACYCLINE RESISTANCE; ESCHERICHIA-COLI; MULTIPLEX PCR; METAGENOMIC ANALYSIS; STREPTOMYCIN RESISTANCE; CLASS-1 INTEGRONS; GENE CASSETTES; BACTERIA | One of the major problems to be addressed in aquaculture is the prominence of antimicrobial resistance (AMR). The occurrence of bacterial infections in cultured fishes promotes the continuous use of antibiotics in aquaculture, which results in the selection of proliferated antibiotic-resistant bacteria and increases the possibility of transfer to the whole environment through horizontal gene transfer. Hence, the accurate cultivation-dependent and cultivation-independent detection methods are very much crucial for the immediate and proper management of this menace. Antimicrobial resistance determinants carrying mobile genetic transfer elements such as transposons, plasmids, integrons and gene cassettes need to be specifically analysed through molecular detection techniques. The susceptibility of microbes to antibiotics should be tested at regular intervals along with various biochemical assays and conjugation studies so as to determine the extent of spread of AMR. Advanced omic-based and bioinformatic tools can also be incorporated for understanding of genetic diversity. The present review focuses on different detection methods to unearth the complexity of AMR in aquaculture. This monitoring helps the authorities to curb the use of antibiotics, commencement of appropriate management measures and adequate substitute strategies in aquaculture. The long battle of AMR could be overcome by the sincere implementation of One Health approach. Significance and Impact of the Study The use of antibiotics and increased antimicrobial resistance (AMR) are of major concerns in aquaculture industry. This could result in global health risks through direct consumption of cultured fishes and dissemination of AMR to natural environment through horizontal gene transfer. Hence, timely detection of the antimicrobial-resistant pathogens and continuous monitoring programmes are inevitable. Advanced microbiological, molecular biological and omic-based tools can unravel the menace to a great extent. This will help the authorities to curb the use of antibiotics and implement appropriate management measures to overcome the threat. |
| Antibiotics; Pharma-pollution; Plasmids; Resistance genes; Scavengers; Wildlife | SPECTRUM BETA-LACTAMASE; MEDIATED QUINOLONE RESISTANCE; ESCHERICHIA-COLI STRAINS; FOOD-ANIMAL PRODUCTION; ANTIBIOTIC-RESISTANCE; LIVESTOCK; CONSERVATION; HUMANS; GENES; BIRDS | The role of wild birds in the carriage and transmission of human and food animal bacteria with resistant genotypes has repeatedly been highlighted. However, few studies have focussed on the specific exposure sources and places of acquisition and selection for antimicrobial-resistant bacteria in vultures relying on livestock carcasses across large areas and different continents. The occurrence of bacterial resistance to antimicrobial agents was assessed in the faecal microbiota of sedentary Griffon vultures (Gyps fulvus) and trans-Saharan migratory Egyptian vultures (Neophron percnopterus) in central Spain. High rates (generally >50%) of resistant Escherichia coli and other enterobacteria to amoxicillin, cotrimoxazole and tetracycline were found. About 25-30% of samples were colonised by extended-spectrum beta-lactamases (ESBL) producing bacteria, while 5-17% were positive for plasmid mediated quinolone resistance (PMQR) phenotypes, depending on vulture species and age. In total, nine ESBL types were recorded (7 in griffon vultures and 5 in Egyptian vultures), with CTX-M-1 the most prevalent in both species. The most prevalent PMQR was mediated by qnrS genes. We found no clear differences in the occurrence of antimicrobial resistance in adult vultures of each species, or between nestling and adult Egyptian vultures. This supports the hypothesis that antimicrobial resistance is acquired in the European breeding areas of both species. Bacterial resistance can directly be driven by the regular ingestion of multiple active antimicrobials found in medicated livestock carcasses from factory farms, which should be not neglected as a contributor to the emergence of novel resistance clones. The One Health framework should consider the potential transbounday caniage and spread of epidemic resistance from high-income European to low-income African countries via migratory birds. (C) 2020 Elsevier B.V. All rights reserved. |
| Clostridium perfringens; lipoteichoic acid (LTA); food safety; one health; NMR spectroscopy; cell surface; Gram-positive bacteria; necrotic enteritis; glycoconjugate vaccines; foodborne illness; glycoconjugate; glycobiology; glycolipid structure; cell wall; carbohydrate biosynthesis; carbohydrate structure; microbiology; microbial pathogenesis | CLOSTRIDIUM-PERFRINGENS; NECROTIC ENTERITIS; CAPSULAR POLYSACCHARIDE; PHOSPHOETHANOLAMINE TRANSFERASE; ESCHERICHIA-COLI; BROILER-CHICKENS; BIOSYNTHESIS; PERFORMANCE; VACCINE; IMMUNIZATION | Clostridium perfringensis a leading cause of food-poisoning and causes avian necrotic enteritis, posing a significant problem to both the poultry industry and human health. No effective vaccine againstC. perfringensis currently available. Using an antiserum screen of mutants generated from aC. perfringenstransposon-mutant library, here we identified an immunoreactive antigen that was lost in a putative glycosyltransferase mutant, suggesting that this antigen is likely a glycoconjugate. Following injection of formalin-fixed whole cells ofC. perfringensHN13 (a laboratory strain) and JGS4143 (chicken isolate) intramuscularly into chickens, the HN13-derived antiserum was cross-reactive in immunoblots with all tested 32 field isolates, whereas only 5 of 32 isolates were recognized by JGS4143-derived antiserum. The immunoreactive antigens from both HN13 and JGS4143 were isolated, and structural analysis by MALDI-TOF-MS, GC-MS, and 2D NMR revealed that both were atypical lipoteichoic acids (LTAs) with poly-(?1?4)-ManNAc backbones substituted with phosphoethanolamine. However, although the ManNAc residues in JGS4143 LTA were phosphoethanolamine-modified, a few of these residues were instead modified with phosphoglycerol in the HN13 LTA. The JGS4143 LTA also had a terminal ribose and ManNAc instead of ManN in the core region, suggesting that these differences may contribute to the broadly cross-reactive response elicited by HN13. In a passive-protection chicken experiment, oral challenge withC. perfringensJGS4143 lead to 22% survival, whereas co-gavage with JGS4143 and ?-HN13 antiserum resulted in 89% survival. This serum also induced bacterial killing in opsonophagocytosis assays, suggesting that HN13 LTA is an attractive target for future vaccine-development studies. |
| Barriers; health education; health-care system | | BACKGROUND: According to the importance of health education (HE) in disease control and prevention and inadequacy of HE in the Iran’s health-care system, clarifying the HE barriers is necessary. OBJECTIVES: This study aimed to clarifying the comprehensive model of HE barriers of health-care system in Iran. METHODS: This qualitative study was conducted in 2019. Twenty-one health experts and physicians at different levels of the health system, a former health deputy of the Ministry of Health, and 26 community health workers (CHWs) were selected through purposive sampling. Data were collected through semi-structured individual interviews and group discussions and analyzed simultaneously by conventional content analysis. RESULTS: Five themes were extracted including individual barriers (most important categories: inadequate ability of CHWs in HE, poor motivational factors at individual level, and educator’s wrong beliefs), interpersonal (most important categories: weakness of other health-care providers in the education of CHWs, lack of proper understanding by health authorities of scientific and correct HE, inappropriate communication, unrealistic expectations from CHWs, problems with monitoring and supervision, poor work commitment, and client-related problems), organizational (most important categories: high workload of CHWs, problems related to educational resources, inappropriate attitude of managers and officials, and inappropriate evaluation and monitoring), community (most important categories: not believing CHWs by people, people’s disinterest and lack of motivation in education, cultural problems, problems with the Internet and virtual social networks, and weak cross-sectoral cooperation), and contextual barriers (most important categories: barriers related to universities, broadcasting, the nature of HE science, as well as gap between practical education and theory). CONCLUSION: Considering the multidimensional barriers such as individual, interpersonal, organizational, community, and contextual barriers, compiling and executing a comprehensive document with the participation of authorities, specialists, and service providers is recommended to remove barriers. This is in line with the Ottawa Charters’ reorienting health services. |
| Hospice; quality measurement; quality improvement; health care systems; care transitions | PALLIATIVE CARE; DEMONSTRATION PROJECT; FAMILY PERSPECTIVES; STAFF TURNOVER; MEDICARE; END; IMPLEMENTATION; ASSOCIATION; CATALONIA; SERVICES | The quality of hospice care remains highly variable in the U.S. Patients, providers, and health care systems lack a comprehensive method of measuring the quality of care provided by an individual hospice. Partners HealthCare sought to assess hospice quality based on objective and quantitative criteria obtained directly from hospices and through public reporting. Here, we describe the process of creating and administering this assessment and the initial creation of a collaborative network with high-quality hospices. A multidisciplinary advisory council developed criteria and a scoring system, focusing on organizational information (e.g., nursing turnover), clinical care quality indicators (e.g., visit hours before death), and training (e.g., medical director certification) and satisfaction (e.g., patient and family surveys). All Medicare-certified hospices in good standing in Massachusetts were eligible to participate in a request for information (RFI) process. We blinded data before scoring and invited hospices scoring above the 15th percentile to join the initial collaborative. Of 72 eligible hospices, most (53%) responded to the RFI, and 32% (n = 23) submitted completed surveys. Hospices could receive up to 23.75 points, and scores ranged from 2.25 to 19.5. The median score was 13.62 (interquartile range 10.5- 16.75). For hospices scoring above the 15th percentile (n = 19), scores ranged from 10.0 to 19.5 (median 14). The hospice RFI process is one health care system’s attempt to evaluate hospice quality. Further research will determine whether the scoring system proves to be a sensitive, specific, and reproducible measure of hospice quality, and whether the collaborative can foster quality improvement over time.(C) 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved. |
| WWTPs; collectors; rivers; antibiotic resistance bacteria; antibiotic resistance gene; ESBL | SPECTRUM BETA-LACTAMASES; PLASMID-MEDIATED AMPC; STAPHYLOCOCCUS-AUREUS; WASTE-WATER; ANTIBIOTIC-RESISTANCE; ESCHERICHIA-COLI; MULTIPLEX PCR; ENTEROBACTERIACEAE; GENES; PREVALENCE | Due to the global progress of antimicrobial resistance, the World Health Organization (WHO) published the list of the antibiotic-resistant priority pathogens in order to promote research and development of new antibiotics to the families of bacteria that cause severe and often deadly infections. In the framework of the One Health approach, the surveillance of these pathogens in different environments should be implemented in order to analyze their spread and the potential risk of transmission of antibiotic resistances by food and water. Therefore, the objective of this work was to determine the presence of high and critical priority pathogens included in the aforementioned list in different aquatic environments in the POCTEFA area (North Spain-South France). In addition to these pathogens, detection of colistin-resistant Enterobacteriaceae was included due its relevance as being the antibiotic of choice to treat infections caused by multidrug resistant bacteria (MDR). From the total of 80 analyzed samples, 100% of the wastewater treatment plants (WWTPs) and collectors (from hospitals and slaughterhouses) and 96.4% of the rivers, carried antibiotic resistant bacteria (ARB) against the tested antibiotics. Fifty-five (17.7%) of the isolates were identified as target microorganisms (high and critical priority pathogens of WHO list) and 58.2% (n= 32) of them came from WWTPs and collectors. Phenotypic and genotypic characterization showed that 96.4% were MDR and resistance to penicillins/cephalosporins was the most widespread. The presence ofblagenes, KPC-type carbapenemases,mcr-1andvanBgenes has been confirmed. In summary, the presence of clinically relevant MDR bacteria in the studied aquatic environments demonstrates the need to improve surveillance and treatments of wastewaters from slaughterhouses, hospitals and WWTPs, in order to minimize the dispersion of resistance through the effluents of these areas. |
| | Objectives: To the best of our knowledge, we describe the first evidence in Europe of an MDR, bla(NDM-4)-positive Escherichia coli isolated from a food-producing animal, harboured by a novel IncFII plasmid of which we report the complete sequence. Methods: One bla(NDM-4)-positive E. coli isolated in 2019 from the caecal contents of a fattening pig in Italy was in-depth characterized by combined bioinformatic analysis of Oxford Nanopore long reads and Illumina short reads, for in silico typing, determination of the bla(NDM-4) genetic context and full reconstruction of the bla(NDM-4)-carrying plasmid. Results: The isolate belonged to ST641 and to the genoserotype O108:H23 and tested positive for different virulence genes and plasmid replicons. The MDR phenotype of resistance to all beta-Lactams, carbapenems, sulfamethoxazole and trimethoprim was mediated by bla(TEM-1B), bla(NDM-4), sul1/sul3 and dfrAl2, respectively. The bla(NDM-4) gene was harboured by a novel 53 043 bp IncFII plasmid (pMOL412_FII) composed of four main genetic regions, including an MDR region (MRR-NDM-4) of 16 kb carrying bla(NDM-4) and several antimicrobial resistance genes located in a class 1 integron. pMOL412_FII was closely related to another similar to 90.3 kb plasmid (pM109_FII) harbouring bla(NDM-4) in an E. coli isolated from a human patient in Myanmar. Conclusions: To the best of our knowledge, we have identified for the first time in Europe an NDM-producing Enterobacterales in livestock and resolved the complete sequence of the novel pMOL412_FII plasmid harbouring bla(NDM-4) in an MRR. A global One Health approach, comparing genomic data from different sources and geographical areas, may help to trace back and control possible plasmid-borne carbapenemase gene transmission between animals and humans and along the food chain at international level. |
| Experimental auctions; Willingness-to-pay; India; Iron-biofortification; Finger millet; Health benefits; Modern breeding techniques | GENETICALLY-MODIFIED FOOD; TO-PAY; PEARL-MILLET; INDIVIDUAL-DIFFERENCES; PUBLIC ACCEPTANCE; INFORMATION; QUALITY; COUNTRIES; BENEFITS; CROPS | Purpose Biofortification of staple crops is a promising strategy to alleviate micronutrient deficiencies in rural populations of the developing world. The possibility to sell biofortified crops at a good market price plays a vital role for the acceptance by smallholder farmers. This study is therefore focused on non-farming consumers’ willingness to pay (WTP) for biofortified crops. Design/methodology/approach Specifically, we elicited non-farming consumers’ WTP a premium for the improved iron content (+30% iron) in a 1kg finger millet bag using a 2nd price Vickrey auction with six auction rounds and one health- and one process-related information treatment. Due to multiple bids per subject, premiums were analyzed using a linear mixed-effects model, controlling for market feedback and auction round. Findings Despite more than half of the respondents being skeptical toward new crop varieties, the acceptance rate was very high (98% with a WTP above zero). The average premium amounted to 27% and could be significantly increased with the provision of health-related information. In contrast, information about the breeding method was ineffective. The WTP was significantly higher for higher income and lower for higher age, education and skepticism toward new crop varieties and increased with increasing rounds. Research limitations/implications Our results suggest that non-farming consumers are willing to pay a good market price for iron-biofortified finger millet. Our analysis also confirms the importance of health-related information for raising consumers’ WTP. This information supports the further development and introduction of biofortified crops to alleviate micronutrient malnutrition. Originality/value This study adds to the still limited literature on consumers’ WTP for iron-biofortified crops in India, focusing on non-farming consumers to assess the price such crops can achieve on the market. |
| GOHAI; Oral health-related quality of life; Gerodontology | QUALITY-OF-LIFE; PSYCHOMETRIC PROPERTIES; CHINESE VERSION; DENTAL STATUS; OLDER-ADULTS; RELIABILITY; ASSOCIATION; DISEASE; CARE | Background The Geriatric Oral Health Assessment Index (GOHAI) was developed and validated in 1990 and translated into Spanish in 1999. Since then, the original version has been used in numerous studies, but it has not been re-evaluated in terms of language in the new generations of older adults. The purpose of this study is to confirm the validity of the Spanish version of the Geriatric Oral Health Assessment Index (GOHAI-SP) after three decades to be used as part of an ongoing field trial. Methods The GOHAI-SP was pilot tested in a focus group to confirm linguistic comprehension. A version with minor language changes was administered to individuals with metabolic syndrome aged 55-75 years from one health care district in southern Spain as part of an ongoing field trial (PREDIMED-Plus). Clinical evaluation included assessment of dental and periodontal status. The psychometric properties of the GOHAI-SP were evaluated through stability and internal consistency measures, and concurrent and discriminant validity were assessed. Results The new version of the GOHAI-SP was administered to 100 individuals. The application time was reduced by 7 min. The alpha value for reliability was 0.87. The item-scale correlation coefficients ranged from 0.54 to 0.75, and the test-re-test correlation for the total score was 0.75. There were inverse correlations between GOHAI-SP scores and the number of lost teeth and the decayed-missing-filled teeth index (p < 0.001). Conclusions The GOHAI-SP questionnaire remains a valid and useful tool to assess oral health-related quality of life in primary health care settings. A linguistic update of the questionnaire brought improvements to the instrument application. |
| E; coli; ESBL; CTX-M; AmpC; CMY-2; quinolones; dogs; antibiotics | AMPC BETA-LACTAMASE; ESCHERICHIA-COLI; EXTENDED-SPECTRUM; ANTIMICROBIAL RESISTANCE; HIGH PREVALENCE; RISK-FACTORS; ENTEROBACTERIACEAE; COMPANION; EMERGENCE; PLASMIDS | Objective:This study aimed to determine the prevalence of fecal carriage of antibiotic-resistantEscherichia coliof healthy household dogs with an emphasis on extended-spectrum beta-lactamases (ESBL), AmpC-type beta-lactamases and resistance to quinolones. Materials and Methods:Rectal swabs were collected from 74 dogs without any clinical evidence of gastrointestinal disease. Samples were cultured on MacConkey agar plates and MacConkey supplemented with 2 mu g/mL cefotaxime or 5 mu g/mL ciprofloxacin. Isolates were identified with Vitek 2 Compact and susceptibility testing performed by Kirby Bauer disk diffusion method. Minimal inhibitory concentration (MIC) was done on isolates resistant to cefotaxime, ciprofloxacin, and nalidixic acid. PCR amplification was performed to detect CTX-M and CMY-2. Isolates positive for CTX-M and/or CMY-2 were selected for whole-genome sequencing. Results:Multiresistance was detected in 56% of the isolates. A high percentage of resistance was detected for cefazolin (63%), ampicillin (54%), streptomycin (49%), nalidixic acid (42%) and tetracycline (38%). The MIC(50)and MIC(90)for isolates resistant to cefotaxime (24%) was determined as 16 and >250 mu g/mL, respectively; for ciprofloxacin (18%), 125 and 250 mu g/mL, respectively. ESBL (CTX-M type) and AmpC (CMY-2 type) were detected in 6 (7.1%) and 14 (19%) of the isolates, respectively. Whole-genome sequence analysis showed high genetic diversity in most of the isolates and a large variety of resistance mechanisms, including mobile genetic elements. Conclusion:The frequency of multidrug-resistantE. coliis worrying, mainly because of the presence of many isolates producing ESBL and AmpC beta-lactamases. Based on the One Health concept, considering the relationships between animals, humans, and the environment, these data support the notion that companion animals are important reservoirs of multidrug-resistant bacteria. |
| health services administration & management; organisation of health services; qualitative research | RISK-FACTORS; READINESS; COMMUNICATION | ObjectivesTo understand from a patient and carer perspective: (1) what features of the discharge process could be improved to avoid early unplanned hospital readmission (within 72hours of acute care discharge) and (2) what elements of discharge planning could have enhanced the discharge experience.DesignA qualitative descriptive design was used. Study data were collected using semi-structured interviews that were transcribed verbatim and analysed using inductive thematic analysis. Data related to participant characteristic were collected by medical record audit and summarised using descriptive statistics.SettingThree acute care hospitals from one health service in Australia.ParticipantsPatients who had an early unplanned hospital readmission and/or their carers, if present during the interviews and willing to participate, with patient permission.FindingsThirty interviews were conducted (23 patients only; 6 patient and carer dyads; 1 carer only). Five themes were constructed: ‘experiences of care’, ‘hearing and being heard’, ‘what’s wrong with me’, ‘not just about me’ and ‘all about going home’. There was considerable variability in patients’ and carers’ experiences of hospital care, discharge processes and early unplanned hospital readmission. Features of the discharge process that could be improved to potentially avoid early unplanned hospital readmission were better communication, optimal clinical care including ensuring readiness for discharge and shared decision-making regarding discharge timing and goals on returning home. The discharge experience could have been enhanced by improved communication between patients (and carers) and the healthcare team, not rushing the discharge process and a more coordinated approach to patient transport home from hospital.ConclusionsThe study findings highlight the complexities of the discharge process and the importance of effective communication, shared decision-making and carer engagement in optimising hospital discharge and reducing early unplanned hospital readmissions. |
| Academic medicine; academic success; community medicine; practice management; primary care; public health | GENERAL-PRACTICE RESEARCH; FAMILY PHYSICIANS; RESEARCH CAPACITY; INVOLVEMENT; PARTICIPATION; EDUCATION; FACULTY; STATE | Background: Clinical research in family medicine can improve health outcomes and increase physicians’ professionalism, yet is modest compared to other disciplines and receives little funding. Objectives: To identify factors that promote and impede engagement of family physicians in research and to compare characteristics of family physicians who do and do not engage in research. Methods: During September to October 2018, e-mail questionnaires were sent to 1424 primary care physicians of one health maintenance organization. Respondents were classified as researchers and non-researchers based on their research experience. Responses were analysed using univariate analysis, principal component analysis and multivariate logistic regression. Results: Of 235 respondents, 48 (20.4%) were categorized as researchers. The respondents generally agreed that research in primary care improves medical services and provides professional prestige; and that workload, bureaucracy and lack of dedicated time hinder engagement in research. Logistic regression analysis identified several factors associated with being a researcher, including advanced research training (P = 0.001, AOR = 8.49, 95% CI [2.49-29.14]), reading more research articles (P = 0.013, AOR = 14.16, 95% CI [1.76-113.5] and self-employment (P = 0.005, AOR = 5.92, 95% CI [1.71-20.44]). In a factor analysis, only ‘importance of research’ was associated with being a researcher (P = 0.039, AOR = 1.89, 95% CI [1.03-3.48]). Compared to non-researchers, researchers were older (83.3% versus 51.3% aged >40 years, P < 0.001), more often men (60.4% versus 37.4%, P = 0.02) and worked more (41.7% versus 16.7% worked >41 hours weekly, P = 0.02). Conclusions: Providing time dedicated to research, administrative support, research training and education about the importance of research could increase participation in research by primary care physicians. |
| Metagenomic analysis; Environmental reservoirs; Bacterial diversity; Functional profiles; Human diseases; Hospital setting | COMMUNITIES; TECHNOLOGIES; INFECTION | With the introduction of the One Health approach to global health advocated by the World Health Organization, the role of the environment as a reservoir and transmission route for diverse microorganisms is increasingly being recognised globally. This study investigated the diversity and functional profiles of bacterial communities using high-throughput metagenomics of the 16S rRNA gene in samples collected from environmental surfaces in different levels of healthcare in South Africa. A total of 150 samples were collected in three public hospitals [District (A), Regional (C) and Central (B)] from intensive care and paediatric wards. Military hospitals were excluded. Swabs were taken from mattresses, drip stands, ward telephones, patient files and sinks. A total of 7,996,346 reads were found, of which 7,319,569 were quality-filtered reads. Unique (and shared) microbial community structures were identified within the different hospital levels, locations and sample source. A total of 11 phyla, 29 classes, 50 orders, 105 families, 190 genera and 288 known species were identified. The primary phyla identified were Proteobacteria, Firmicutes and Actinobacteria. The dominant dass identified was Gammaproteobacteria, followed by Bacilli and Actinobacteria. Acinetobacter (16.08%), Citrobacter (13.64%), Staphylococcus (9.65%) and Cotynebacterium (6.15%) were predominant genera. Although the functional profile analysis identified citrate cyde (TCA), signal transduction mechanisms, bisphenol degradation, tyrosine metabolism and transcription-factors as the dominant pathways, human disease functional classes, including involvement in antibiotic resistance, were significantly identified. The drip stands, patient files and ward telephones in all the wards of Hospitals A and C contained a higher number of human diseases functional classes. These findings highlight the potential of different hospital environments to serve as reservoirs and possible sources of bacterial pathogens; thus, the need for better monitoring and hygienic practices within the hospital environment. (C) 2020 Published by Elsevier B.V. |
| IMPLEMENTATION; PREVENTION | Introduction The U.S. Army requires community health coalitions to develop targeted action plans in order to more effectively address top public health priorities. Reviews of community action plans indicate that they are often poorly developed and not fully implemented. To date, the U.S. Army has not implemented a standardized tool or process to evaluate action plans and provide recommendations for improvement to local installations. The Plan Quality Index (PQI) is an evidence-based, standardized tool that has been used successfully by technical experts to review and improve community action plans related to the prevention of obesity, injury and violence, and cancer. Materials and Methods The objective of this project was to determine the usability of the PQI and to provide recommendations for improving community health action plans focused on injury prevention for the U.S. Army. Five Health Promotion Project Officers and one Health Promotion Project Assistant at Army Public Health Center were trained on the PQI and reviewed injury prevention action plans for 17 installations. After using the PQI to assess injury prevention action plans, the individuals were given a System Usability Scale (SUS) survey to assess the usability of the PQI. Results Results of the SUS survey can range from 0 to 100, but do not represent percentages. A score of 65 indicates greater than average usability. Participant scores on the SUS demonstrated that the PQI has a high degree of usability. Mean usability was calculated at 83.3 (range 72.5-97.5, median 85, sd +/- 9.3). Conclusion The PQI demonstrated a high level of usability by technical experts for providing feedback and recommendations regarding community health action plans for injury prevention in the U.S. Army. As a result, the PQI may be beneficial as a standard tool for community health improvement planning and consultation throughout the Army Public Health Center. |
| Bartonella henselae; B. cooperplainsensis; invasive species; rodents; rats; zoonoses | GENETIC-HETEROGENEITY; B-HENSELAE; ONE HEALTH; PREVALENCE; INFECTION; CATS | Simple Summary: Invasive rats and field mice were captured under the project RESTO CON LIFE Island conservation in Tuscany, restoring habitat not only for birds, aiming to improve habitats preservation on the Italian islands of Pianosa, Elba, Montecristo, and Giannutri. Bartonella henselae DNA was detected in one captured animal. This is the first report of the presence of B. henselae DNA in rodents in Italy. B. henselae is the causative agent of cat scratch disease, and the detection of this bacterium in rodents might have public health implications. Wild rodents are reservoirs of several Bartonella species that cause human bartonellosis. The aim of this study was to assess the presence of Bartonella spp. DNA in wild rodents in Pianosa island, Italy. Rats (Rattus spp.; n = 15) and field mice (Apodemus spp.; n = 16) were captured and spleen DNA tested for the presence of Bartonella spp. by means of an initial screening using a qPCR amplifying a short segment of the 16S-23S rRNA gene intergenic transcribed spacer region (ITS, similar to 200 bp) followed by conventional PCR amplification of a longer ITS fragment (similar to 600 bp) and of a citrate synthase (gltA, similar to 340 bp) gene segment. A total of 25 spleen DNA samples obtained from 31 rodent carcasses (81%) yielded positive qPCR results. Bartonella genus was confirmed by amplicon sequencing. By conventional PCR, eight out of 25 samples (32%) yielded bands on gels consistent with ITS segment, and 6/25 (24%) yielded bands consistent with the gltA locus. Amplicon sequencing identified B. henselae and B. coopersplainsensis in 1/25 (4%), and 4/25 (16%) samples, respectively. Moreover, 5/25 (20%) of Bartonella spp. positive samples showed gltA sequences with about 97% identity to B. grahamii. These results provide support to recently published observations suggesting that B. henselae circulates in wild rodent populations. |
| CHELONIA-MYDAS; CARETTA-CARETTA; CLIMATE-CHANGE; GREEN TURTLES; INFECTIOUS-DISEASES; ANTIBIOTIC-RESISTANCE; ENVIRONMENTAL DNA; LOGGERHEAD TURTLE; LONG-TERM; FIBROPAPILLOMATOSIS | The impact of a range of different threats has resulted in the listing of six out of seven sea turtle species on the IUCN Red List of endangered species. Disease risk analysis (DRA) tools are designed to provide objective, repeatable and documented assessment of the disease risks for a population and measures to reduce these risks through management options. To the best of our knowledge, DRAs have not previously been published for sea turtles, although disease is reported to contribute to sea turtle population decline. Here, a comprehensive list of health hazards is provided for all seven species of sea turtles. The possible risk these hazards pose to the health of sea turtles were assessed and One Health aspects of interacting with sea turtles were also investigated. The risk assessment was undertaken in collaboration with more than 30 experts in the field including veterinarians, microbiologists, social scientists, epidemiologists and stakeholders, in the form of two international workshops and one local workshop. The general finding of the DRA was the distinct lack of knowledge regarding a link between the presence of pathogens and diseases manifestation in sea turtles. A higher rate of disease in immunocompromised individuals was repeatedly reported and a possible link between immunosuppression and environmental contaminants as a result of anthropogenic influences was suggested. Society based conservation initiatives and as a result the cultural and social aspect of interacting with sea turtles appeared to need more attention and research. A risk management workshop was carried out to acquire the insights of local policy makers about management options for the risks relevant to Queensland and the options were evaluated considering their feasibility and effectiveness. The sea turtle DRA presented here, is a structured guide for future risk assessments to be used in specific scenarios such as translocation and head-starting programs. |
| Integrated control; Cost; Neglected zoonoses; Rabies; Visceral leishmaniasis; Cystic echinococcosis; One health; Morocco | COLLARS; INFECTION | The present study is a component of a major European research project, ICONZ (Integrated Control of Neglected Zoonoses). The objective of this component was to implement, and then evaluate an Integrated Control Intervention (ICI) against three dog transmitted zoonoses, namely rabies, visceral leishmaniasis, and cystic echinococcosis. This was undertaken in Sidi Kacem Province (northwestern Morocco) where 22 control and 22 treated douars (villages) were randomly allocated to two control and one evaluation interventions over a period of 13 months. Across the 44 douars, an overall total of 6922 dogs were registered, 4519 were vaccinated against rabies, and 2885 persons attended the complementary health education campaigns; whereas, within the 22 treated douars, 466 dogs received anti-sandfly collars (deltamethrin-impregnated) and 2487 were dewormed (praziquantel). Evaluation of the ICI, revealed that (i) a canine rabies vaccination coverage of 65.0% was achieved, (ii) the use of deltamethrin-impregnated collars for dogs provided highly significant protection (p = 0.01) against leishmaniasis infection of more than 44%, and up to 100% for dogs that had kept the collar until the end of the intervention, (iii) despite a non-significant difference (p>0.05), dog-deworming with praziquantel yielded a reduction in the rate of Echinococcus granulosus infection, and (iv) health education was successful in improving respondents’ knowledge; However, the target communities remained unconvinced of the necessity of changing some of their risky behaviours. Lastly, the estimated total cost of the global intervention, including its research components, was US$ 143,050, of which 67% was for disease control work with clear evidence of significant economies of scale due to targeting three diseases together. It appears from this study that the integrated control approach against the three zoonoses was effective on both economic and logistical levels. |
| disease ecology; disease eradication; domestic dogs; Guinea worm; Neglected Tropical Diseases; One Health | ISOTOPE; MODELS | The global programme for the eradication of Guinea worm disease, caused by the parasitic nematodeDracunculus medinensis, has been successful in driving down human cases, but infections in non-human animals, particularly domestic dogs (Canis familiaris), now present a major obstacle to further progress. Dog infections have mainly been found in Chad and, to a lesser extent, in Mali and Ethiopia. While humans classically acquire infection by drinking water containing infected copepods, it has been hypothesized that dogs might additionally or alternatively acquire infection via a novel pathway, such as consumption of fish or frogs as possible transport or paratenic hosts. We characterized the ecology of free-ranging dogs living in three villages in Gog woreda, Gambella region, Ethiopia, in April-May 2018. We analysed their exposure to potential sources of Guinea worm infection and investigated risk factors associated with infection histories. The home ranges of 125 dogs and their activity around water sources were described using GPS tracking, and the diets of 119 dogs were described using stable isotope analysis. Unlike in Chad, where Guinea worm infection is most frequent, we found no ecological or behavioural correlates of infection history in dogs in Ethiopia. Unlike in Chad, there was no effect of variation among dogs in their consumption of aquatic vertebrates (fish or frogs) on their infection history, and we found no evidence to support hypotheses for this novel transmission pathway in Ethiopia. Dog owners had apparently increased the frequency of clean water provision to dogs in response to previous infections. Variations in dog ranging behaviour, owner behaviour and the characteristics of natural water bodies all influenced the exposure of dogs to potential sources of infection. This initial study suggests that the classical transmission pathway should be a focus of attention for Guinea worm control in non-human animals in Ethiopia. |
| giardiasis; prevalence; protozoological diagnosis; risk factors | PUBLIC-HEALTH; PREVALENCE; DIAGNOSIS; CATS; CRYPTOSPORIDIUM; PERCEPTION; UPDATE; STATE | Giardia duodenalis is a zoonotic pathogen associated with gastrointestinal disease that has a direct life cycle, with cysts eliminated in the faeces of an infected host being ingested by a susceptible host. In Brazil, studies of chronically infected adult dogs estimated a prevalence of 10%-20%. Diagnosis of giardiasis, as a cause of diarrhoea is important for the global One-Health guidelines when controlling cyst dissemination in the environment. We investigated the prevalence of G. duodenalis in the pet dog population of the metropolitan area of Sao Paulo, compared the efficacy of direct tests available to the veterinary clinical practice and attempted to identify possible risk factors associated with the parasite. Ten veterinary practices distributed throughout the municipality randomly performed the rapid SNAP ELISA test on canine faecal samples, and dog owners provided information specific to the animal via a questionnaire. The samples were also analysed using sucrose and zinc sulphate flotation techniques. Sensitivity and specificity of the tests were used to calculate required number of samples and true prevalence. Significance, agreement among tests, and odds ratio (OR) were assessed with a confidence interval (CI) of 95%. The prevalence of G. duodenalis in dogs (n = 265) was 6.9% (CI 3.47-11.21). Positive tests were significantly more frequent in animals younger than 1 year, with an OR for G. duodenalis occurrence nearly 7-fold that of older dogs. Direct diagnosis tests showed high agreement (96.1%, kappa = 0.729; p < .0001) showing that the combined techniques provide a highly accurate diagnosis. Results indicated that the control of the pathogen has been improving in the pet dog population in metropolitan Sao Paulo, but management tools including diagnosis, immunization, and treatment, especially in puppies, must be continued in order to advance towards continuous decrease of the disease. |
| Antimicrobial; One health; Animal; Livestock; Storage; Antibiotic stewardship | ANTIMICROBIAL RESISTANCE; PUBLIC-HEALTH; PRODUCERS; USAGE | China is among the world’s largest consumers of antibiotics for livestock, and the demand for meat protein continues to rise. Pig production takes place at a range of facilities, including backyard pig farms. The aim of this study was to describe the knowledge, attitudes and practices of backyard pig farmers concerning antibiotic use and resistance, and to observe household storage of antibiotics for use in pigs. We conducted a cross-sectional questionnaire survey among 271 rural residents with backyard pig farms in 12 villages in one town in Shandong province. The median number of pigs per backyard farm was 14, and 82 % (222/271) of participants reported not having had any training about raising pigs. Eighteen percent of participants (48/271) reported always or often adding antibiotics to feed to keep pigs healthy and prevent diseases, and a third (88/271) of participants believed that pigs should be given antibiotics when they stop eating. Thirty percent (82/271) reported having bought antibiotics in the previous year without having first spoken with a veterinarian. Antibiotics accounted for over half of all medicines stored (55 %, 197/358), and were observed in 31 % of all households (83/271). Less than half of participants (45 %, 37/83) from households in which antibiotics for pig use were found knew that they were storing antibiotics. The most common class of antibiotics stored for use in pigs was (Q)J01C betalactam antibiotics, penicillins (19 %, 37/197), followed by (Q)J01F macrolides, lincosamides and streptogramins (14 %, 28/197), and (Q)J01M quinolones (12 %, 25/197). These results provide important insights into how backyard pig farmers are using antibiotics in rural China and suggest potential targets for interventions to reduce unnecessary and inappropriate use. |
| Salmonellaspp; epidemiology; one health approach; arctic foxes; Poland | SALMONELLA SPP.; INFECTIONS; CARCASSES; OUTBREAK; VULPES | Simple Summary Salmonella entericasubsp.entericaderived from poultry meat is the primary cause ofSalmonellainfection in humans and the second most ubiquitous zoonosis in the European Union after campylobacteriosis. Wildlife animals and livestock can be a reservoir ofSalmonellaspp., and they can contribute to the persistence of bacteria in the environment.Salmonellaspp. pathogens can also be a source of widespread infections in fur-bearing animals, such as foxes(Vulpes vulpes)and mink (Neovison vision). This study analysed the prevalence ofSalmonellaspp. in two Arctic fox (Alopex lagopus) farms and the correlations between animals that tested positive forSalmonellaspp and breeding results.SalmonellaHeidelberg,S.Saintpaul, andS.Reading were isolated. All three serotypes are typically isolated from commercial poultry flocks. In this study,Salmonellaspp. increased the risk of female infertility, but further research is needed to confirm the results. This is the first report on the prevalence ofS. Heidelberg,S.Saintpaul, andS.Reading in an Arctic fox (Alopex lagopus) population. The objective of the study was to determine the occurrence ofSalmonellaspp. infections in two Arctic fox (Alopex lagopus) farms in Poland, and to analyse the correlations between animals that tested positive forSalmonellaspp and breeding results. Faecal samples were taken from 1094 clinically healthy blue foxes from the basic stock of farms A and B.Salmonellaspp. were detected in 18.06% (56/310) of the samples collected in farm A and in 15.94% (125/784) of the samples collected in farm B. All isolated strains belonged toS.entericasubsp.entericaserotypesSalmonellaSaintpaul (S.Saintpaul),SalmonellaReading (S.Reading), andSalmonellaHeidelberg (S. Heidelberg). All three serotypes are typically isolated from commercial poultry flocks.Salmonellaspp. infections significantly increased the risk of female infertility, but further research is needed to confirm the results. This is the first report on the prevalence ofS.Heidelberg,S.Saintpaul, andS. Reading in faecal samples collected from Arctic fox (Alopex lagopus) farms in Poland. |
| Campylobacter; Case study; Early warning system; Enteric disease surveillance; Enteric pathogen; Enteric zoonotic pathogen; Escherichia coli; Non-typhoidal Salmonella; Outbreak; Surveillance; United States of America | ACTIVE SURVEILLANCE NETWORK; 10 US SITES; FOOD; INFECTIONS; TRENDS; PULSENET | Enteric pathogens, such as non-typhoidal Salmonella, Campylobacter and Escherichia coli, can reside in the intestinal tract of many animals, including livestock, companion animals, small mammals and reptiles. Often, these animals can appear healthy; nonetheless, humans can become infected after direct or indirect contact, resulting in a substantial illness burden. An estimated 14% of the 3.2 million illnesses that occur in the United States of America (USA) each year from such enteric pathogens are attributable to animal contact. Surveillance for enteric pathogens in the USA includes the compilation and interpretation of both laboratory and epidemiologic data. However, the authors feel that a collaborative, multisectoral and transdisciplinary – or One Health – approach is needed for data collection and analysis, at every level. In addition, they suggest that the future of enteric illness surveillance lies in the development of improved technologies for pathogen detection and characterisation, such as genomic sequencing and metagenomics. In particular, using whole-genome sequencing to compare genetic sequences of enteric pathogens from humans, food, animals and the environment, can help to predict antimicrobial resistance among these pathogens, determine their genetic relatedness and identify outbreaks linked to a common source. In this paper, the authors describe three recent, multi-state human enteric illness outbreaks linked to animal contact in the USA and discuss how integrated disease surveillance was essential to outbreak detection and response. Additional data-sharing between public health and animal health laboratories and epidemiologists at the local, national, regional and international level may help to improve surveillance for emerging animal and human health threats and lead to new opportunities for prevention. |
| Milk; Microbial load; Season; Garmsar; Iran | | Milk has a high nutritional value and can affect human health. Therefore, it is important to know the factors affecting its quality. The purpose of this study was to evaluate the raw milk microbial quality and factors affecting it. A total of 4260 raw cow milk samples, which were collected from villages around Garmsar city, Iran, and their microbial load were registered at Garmsar Dairy Cow Association between 2013 and 2014, was used in the present study. The total average +/- SD of microbial load concentration was 3.02 x 10(5) +/- 2.75 x 10(5) (CFU/ml). The average concentration of total bacteria in 2013 was 2.73 x 10(5) +/- 1.58 x 10(5) (CFU/ml) and in 2014 it was 3.32 x 10(5) +/- 3.93 x 10(5)(CFU/ml). Seasonally, it was 2.94 x 10(5) +/- 1.72 x 10(5) (CFU/ml), 3.69 x 10(5) +/- 4.55 x 10(5) (CFU/ml), 2.91 x 10(5) +/- 1.62 x 10(5) (CFU/ml), and 2.63 x 10(5) +/- 1.67 x 10(5) (CFU/ml) for spring, summer, autumn, and winter, respectively. There was a significant difference in seasonal average microbial concentration of milk samples (p < 0.05). The present study concludes that microbial load of milk can be affected by environmental and hygienic conditions. Ranchers need to pay more attention to hygiene especially in warm seasons. Because in case of high microbial load in raw milk, even after milk pasteurization, it is not possible to have a high-quality and desirable product. Milk producers and distributors need also awareness in order to reduce the incidence of secondary contamination. But, the main correction is to establish direct supervision of the Ministry of Health onto the health of dairy cow farmers by structural integrity of Veterinary Medical Organization as the global one health. |
| isotope dilution analysis; external calibration; standard addition; inductively coupled plasma mass spectrometry (ICP-MS); uncertainty of measurement | UNCERTAINTY | The National Metrology Institute of South Africa (NMISA) is expanding its capabilities in the field of the analysis of trace and ultra-trace levels of toxic and minor elements in environmental samples, with a special focus on soils to support projects of the University of Pretoria (UP) in the field of veterinary geology for the One Health Platform. The most accurate calibration strategy developed by the laboratory involves double isotope dilution analysis, where a stable isotope standard of the element of interest is used as the ideal internal standard. External calibration is the most commonly used calibration strategy for elemental analysis. To reduce the impact of instrumental drift on the accuracy of the measurement results, nominally the same amount of an internal standard is added to the samples and the standards. Standard addition is a calibration strategy that could eliminate the issue of matrix effects for trace and ultra-trace elemental analysis, because the calibration standards are added as spikes to aliquots of the sample to prepare the calibration curve. The purpose of the study was to compare the results obtained for the analysis of trace elements in soil samples using the calibration strategies of isotope dilution analysis; gravimetric external calibration with gravimetric internal standardisation; as well as gravimetric standard addition with gravimetric internal standardisation. The aim was to show that the application of gravimetric preparation to the more routine calibration approaches of external calibration and standard addition could achieve very comparable results and associated measurement uncertainties to isotope dilution analysis. The application of gravimetric sample preparation could assist routine laboratories, that have significant resource constraints, to improve the accuracy of their measurement results. These approaches could also be used in the experimental homogeneity and stability studies required for the production of reference materials, where high precision methods are required. |
| Visceral leishmaniasis (VL); Kala-azar; VL case management; Marsabit County; Kenya | SODIUM STIBOGLUCONATE; CUTANEOUS LEISHMANIASIS; KALA-AZAR; DIAGNOSIS; SUDAN; TROPICA | BackgroundVisceral leishmaniasis (VL) is caused by protozoa of the Leishmania donovani complex. Annually, an estimated 500,000 cases of VL are reported globally posing a public health challenge. The objectives of our study were to confirm and determine the magnitude of VL outbreak, characterize the outbreak clinically and epidemiologically and evaluate the county preparedness and response in Marsabit County, Kenya.MethodsA retrospective review of laboratory registers and patients’ clinical notes was done at Marsabit County Hospital. Cases were persons with confirmed VL diagnosis either by microscopy, serology or molecular technique coming from Marsabit County from May to October 2014. Cases were interviewed using structured questionnaire to collect clinical and epidemiologic information. Blood samples were collected from cases for laboratory confirmation.ResultsA total of 136 cases were confirmed of which 77% (105) were male with a median age of 17 (IQR: 22) years and 9.6% (13) case fatality rate. All cases were admitted at Marsabit County Referral Hospital, Kenya. Medical records of 133 cases were retrieved. Of the 133 cases, 102 (77%) presented with fever, 43 (32%) with splenomegaly, 26 (20%) with hepatomegaly and 96 (72%) were managed with Sodium stibogluconate (SSG) monotherapy. Thirty-four cases (26%) received Full haemogram (FHG) test and none had more than one Liver Function Tests (LFTs) in a span of 6 months. Presenting with headache (OR: 4.21, 95% CI: 1.10-16.09) and hepatomegaly (OR: 4.2, 95% CI: 1.30-14.11) were associated with VL death. No VL case management training had been conducted nor VL treatment guidelines distributed among health care workers (HCWs) in the last 1 year.ConclusionsVL cases were confirmed. Inadequate case monitoring and management was evident. VL case management sensitization training was conducted. The County health department should put in place one health VL surveillance and facilitate periodic case management trainings. |
| cardiovascular diseases; framingham risk score; life style modification; randomized controlled trial | | Background Cardiovascular disease (CVD) remains the major cause of global mortality. Applying a comprehensive interventional program may reduce the incidence of cardiovascular disease and its complications. Objective This study compared the effects of a three-month intervention involving lifestyle modification and physical activity with standard care in women >= 30 years having a moderate to high risk of CVD, with respect to improving physical activity and cardiovascular disease risk factors at the National Guard Residential City in Jeddah, Saudi Arabia, in 2015. Methods The effects of this community-based lifestyle program were assessed through a randomized controlled trial from January 1st to September 6th, 2015. Women in the intervention group (n = 31) received health education, exercise training, and diet counselling as individuals and in groups according to the participant’s risk. Women in the control group (n = 28) received one health education session at the screening site. The primary outcome was the proportion of women with moderate Framingham risk scores (FRS) reducing their risk by 10% and the proportion of women with high FRS reducing their risk by 25%. The secondary outcome was the proportion of women reducing their risk by >= 1 risk category. Results The mean participant age was 42 +/- 8 years. At three-month’s follow-up, reductions were greater in the intervention group and the difference between groups was statistically significant (p < 0.05). Lifestyle intervention program significantly reduced systolic blood pressure (-9.2 mmHg), blood glucose (-45 mg/dL) and Framingham risk score (-13.6). Linear regression analysis revealed a significant improvement in the Framingham risk score (p < 0.01). Conclusion In a population of women with moderate-to-high risk of CVD, a personalized lifestyle modification program showed positive association in improving the 10-year cardiovascular Framingham risk score after three months. |
| HOSPITAL READMISSIONS; AMERICAN-COLLEGE; ADMISSION; IMPACT; INTERVENTIONS; DURATION; RISK; RACE | Background: This study used coarsened exact matching to investigate the effectiveness of the LACE+ index (i.e., length of stay, acuity of admission, Charlson Comorbidity Index, and emergency department visits in the past 6 months) predictive tool in patients undergoing plastic surgery. Methods: Coarsened exact matching was used to assess the predictive ability of the LACE+ index among plastic surgery patients over a 2-year period (2016 to 2018) at one health system (n= 5744). Subjects were matched on factors not included in the LACE+ index such as duration of surgery, body mass index, and race, among others. Outcomes studied included emergency room visits, hospital readmission, and unplanned return to the operating room. Results: Three hundred sixty-six patients were matched and compared for quarter 1 to quarter 4 (n= 732, a 28.2 percent match rate); 504 patients were matched for quarter 2 to quarter 4 (n= 1008, a 36.7 percent match rate); 615 patients were matched for quarter 3 to quarter 4 (n= 1230, a 44.8 percent match rate). Increased LACE+ score significantly predicted readmission within 30 days for quarter 1 versus quarter 4 (1.09 percent versus 4.37 percent;p= 0.019), quarter 2 versus quarter 4 (3.57 percent versus 7.34 percent;p= 0.008), and quarter 3 versus quarter 4 (5.04 percent versus 8.13 percent;p= 0.028). Higher LACE+ score also significantly predicted 30-day reoperation for quarter 3 versus quarter 4 (1.30 percent versus 3.90 percent;p= 0.003) and emergency room visits within 30 days for quarter 2 versus quarter 4 (3.17 percent versus 6.75 percent;p= 0.008). Conclusion: The results of this study demonstrate that the LACE+ index may be suitable as a prediction model for patient outcomes in a plastic surgery population. |
| Health; Sustainability; Skill set; Competencies | | Students in environmental studies, sciences, and sustainability need some degree of health literacy to pursue their own interests because health issues have played a disproportionate role in shaping environmental history, regulation, and interventions. Those entering careers in practice, advocacy, and deep study of environmental issues need further depth to have the capacity to evaluate the plausibility and context of health claims, to advocate responsibly, and to address health disparities. How much education is required for a minimum foundation and in which areas of content? A workshop held at the 2018 Annual Meeting of the Association of Environmental Studies and Sciences focused on minimum health content required for undergraduate and master’s-level graduate students to deal with issues involving health. The goal was a set of recommendations or guidelines for cognitive frameworks and fund of knowledge related to human health that may be considered fundamental in education of these students. Four sets of findings were formulated, addressing four key dimensions: (1) Participants agreed that the health content of current curricula in environmental studies, sciences, and sustainability is sparse. (2) The purpose of introducing health into education in these fields is to reflect the influence or significance of health problems on or arising from environmental justice, regulation and ecosystem management, or sustainability practice, respectively, and to provide the student with a context for understanding health issues. (3) A high-level working knowledge of the essentials of toxicology, epidemiology, risk science, planetary health, and related fields was prioritized, but mastery was deemed unnecessary for education at this level. (4) Teaching human and animal health is facilitated by analogy or reference to instruction already incorporated in the curriculum. For example, toxicology can be taught by analogy to ecotoxicology, because the same principles apply, and basic concepts of epidemiology build on population studies. Integrative case studies were suggested as a teaching tool, and the One Health (human and veterinary health) paradigm was recommended as a natural bridge. |
| antibiotic-resistance; bioindicators; ecopathology; wild micromammals | MOUSE APODEMUS-SYLVATICUS; HOME-RANGE SIZE; ANTIMICROBIAL RESISTANCE; ESCHERICHIA-COLI; MAMMALS | Simple Summary In recent years, animal and human health have been linked in a One Health approach. Wildlife could act as a reservoir for different antibiotic-resistant pathogens, representing an issue for human and domestic animal health. The aim of this study was to evaluate the presence and circulation of antimicrobial-resistant bacterial species in wild micromammals in the province of Parma, Northern Italy. Multi-drug-resistant strains and a high prevalence of resistance to critically important antibiotics were detected. Furthermore, resistance to commonly used antibiotics was detected in a large percentage of isolates. Considering that micromammals are good bioindicators, obtained results highlighted a high prevalence of strains resistant to antimicrobials of critical importance for human and animals in the investigated areas, thus representing a public health hazard. Antimicrobial resistance (AMR) is an increasing threat to human health and an important issue also in the natural environment. For this study, an ecopathological approach was applied to the monitoring of the antimicrobial resistance in the province of Parma, Northern Italy. Fourteen monitoring sites and seventy-four faecal samples from four species of wild micromammals (Apodemus sylvaticus, Microtus savii, Mus domesticusandSuncus etruscus) were collected. Samples were subjected to bacteriological examination and antimicrobial susceptibility testing. Antibiotics belonging to 13 different antibiotic classes were tested. Collected data showed a prevalence of multi-drug resistant (MDR) strains of 55.13% and significant differences in the prevalence of MDR strains among the different micromammal species, while sex, age and anthropization level did not significantly affected MDR strains prevalence. Moreover, a high prevalence of bacterial strains resistant to colistin (95%), gentamicin (87%) and amikacin (83%) was observed. To our knowledge, this is the first report on antibiotic resistance in wild micromammals in the province of Parma. |
| Antimicrobial resistance; Pakistan; financial interests; power | BEHAVIOR | Despite political commitment to address antimicrobial resistance (AMR), countries are facing challenges to implementing policies to reduce inappropriate use of antibiotics. Critical factors to the success of policy implementation in low-and middle-income countries (LMIC), such as capacity for enforcement, contestation by influential stakeholders and financial interests, have been insufficiently considered. Using Pakistan as a case study representing a populous country with extremely high antibiotic usage, we identified 195 actors who affect policies on antibiotic use in humans and animals through a snowballing process and interviewed 48 of these who were nominated as most influential. We used a novel card game-based methodology to investigate policy actors’ support for implementation of different regulatory approaches addressing actions of frontline healthcare providers and antibiotic producers across the One Health spectrum. We found that there was only widespread support for implementing hard regulations (prohibiting certain actions) against antibiotic suppliers with little power-such as unqualified/informal healthcare providers and animal feed producers-but not to target more powerful groups such as doctors, farmers and pharmaceutical companies. Policy actors had limited knowledge to develop implementation plans to address inappropriate use of antibiotics in animals, even though this was recognized as a critical driver of AMR. Our results indicate that local political and economic dynamics may be more salient to policy actors influencing implementation of AMR national action plans than solutions presented in global guidelines that rely on implementation of hard regulations. This highlights a disconnect between AMR action plans and the local contexts where implementation takes place. Thus if the global strategies to tackle AMR are to become implementable policies in LMIC, they will need greater appreciation of the power dynamics and systemic constraints that relate to many of the strategies proposed. |
| Horse welfare; management; breeding; stallion; broodmare | RISK-FACTORS; HORSES; PREVALENCE; WORKING; MANAGEMENT; BEHAVIOR; ANIMALS; HUMANS; SCORE; FEAR | The study aimed to assess the effect of two management housing system on breeding horse welfare. An adapted version of the assessment protocol for horses was used for that purposed to this study, with the focus on the animal-based measures section. This includes individual animal scoring of good feeding, good health and appropriate behaviour. The study was conducted in a professional Equine Breeding Centre with a representative set of housing and management systems and practices used for breeding purposes in Spain. A total of 49 stallions stabled individually and 43 broodmares living loose housing in groups were subject for individual scoring. A descriptive statistic for each welfare indicator was calculated. Pearson’s Chi-square test or Fisher’s test were calculated between the different welfare measures and the housing system. Odds ratios were computed to quantify the association of prevalence of welfare issues with husbandry and management practices according to the type of housing. The stallions were almost two and a half times more at risk than mares to exhibit acceptation to the chin contact behavioural test. Broodmares were prone to present significant lower body condition scores (BCS). The prevalence of rubbed and broken hairs in mane and tail (OR = 4.413), gait abnormalities (OR = 5.429), skin lesions in upper and lower legs regions (OR = 2.691) was higher in stabled animals. In contrast, broodmares presented more often with general skin lesions, specifically in withers-back-barrel-girth (OR = 0.349), hindquarters (OR = 0.016) and skin irritation in lower legs (OR = 0.287). The risk factor analysis applying a multivariable logistic regression model disclosed the way that the group housing freedom system management predicted significantly the prevalence of three animal based indicators deviations: one behavioural indicator (fear to the novel object test), one feeding indicator (lower BCS) and one health indicator (harm in lower legs). |
| Developing countries; Environmental health; Food safety; Nutrition security; Food security; Non-communicable diseases; One health; Risk analysis | EXCESSIVE IODINE INTAKE; ADVERSE BIRTH OUTCOMES; DISRUPTING CHEMICALS; CONGENITAL-ANOMALIES; DEVELOPING-COUNTRIES; PRIMARY PREVENTION; TRACE-ELEMENTS; STREET FOODS; BISPHENOL-A; HEALTH | Toxicant exposures may worsen the micronutrient status, especially during the womb-to-childhood development, impairing organism programming and increasing the risk for health disorders in adulthood. Growing evidence calls for an integrated risk analysis of the interplay of environment, behavior and lifestyle, where a) imbalanced diet and micronutrient deficiencies may increase the vulnerability to toxicants and alter body defence systems and b) intake of antinutrients and contaminants may increase nutritional requirements. Such scenarios are especially evident in communities undergoing a fast nutrition transition, such as in many countries of sub-Saharan Africa. Specific challenges of toxicological risk analysis in sub-Saharan Africa still need a thorough assessment, including: rapid changes of lifestyle and consumers’ preferences; dumping of foods and consumer’ products; risk management under weak or non-existent awareness, legislation enforcement and infrastructures. The significant and growing literature from Africa-led scientific research should be used to build quality-controlled data repositories supporting regulatory top-down actions. Meanwhile, bottom-up actions (eg consumer’s empowerment) could exploit social and economic drivers toward a qualified African presence in the global and local markets. A science-based combination of top-down and bottom-up actions on preventable toxicological risk factors will contribute fighting the new forms of malnutrition and prevent multi-factorial diseases. Exposures to toxicants should be included in the integrated approach proposed by WHO to address the urgent health challenge of simultaneously reduce the risk or burden of both malnutrition (ie deficiency of one or more essential nutrients) and overweight, obesity, and diet-related NCDs. |
| Hemangiosarcoma; Cancer registry; Dog; Case-control study; One health | CANINE HEMANGIOSARCOMA; CANCER; FEATURES; EXPOSURE; TUMORS | The genetic and breed susceptibility of visceral hemangiosarcoma in dogs has been studied, but there is no evidence of environmental risk factors as reported in human medicine. We conducted a case-control study in which the sampling population was the list of canine oncology cases of the Animal Tumour Registry of Lazio region, Italy (2009-2017). We defined cases as dogs with visceral hemangiosarcoma and controls as dogs affected by another neoplasm. The ratio between controls and cases was 3:1. Analysed variables were: age, weight, sex, reproductive status, size, breed, nutrition habit, living environment and location of the house. We performed a preliminary univariate analysis to select potential risk factors (p-value 0.2) then entered in a forward stepwise logistic regression model. Ninety-three cases enrolled in the study were compared with 279 controls. The multivariable logistic regression identified age, reproductive status and breed as significant risk factors. Results showed an increasing risk with increasing age for age classes 6-10 and 10 years old (OR = 9.69, 95 % CI: 1.21-77.62; OR = 14.01, 95 % CI: 1.65-119.03). Neutered animals (male and female) were at greater risk compared to intact ones. The breeds at greatest risk were German shepherd (OR = 4.17, 95 % CI: 1.25-13.86) and mixed breed (OR = 3.50, 95 % CI: 1.44-8.51). The last finding could be explained by the genetic origin of the animals, which may include German shepherd or another possible breed at risk. No other individual or environmental variables were identified as risk factors. The findings of this work indicate that genetic predisposition is the key element in visceral hemangiosarcoma development. |
| serology; zoonosis; vector borne; Western blotting; antigen; Bartonella henselae | ONE HEALTH; EXPERIMENTAL-INFECTION; ANTIGENS; ENDOCARDITIS; BERKHOFFII; BLOOD; SPP. | Bartonella spp. are etiological agents of life-threatening zoonotic diseases in dogs worldwide. Due to the poor sensitivity of immunofluorescent-antibody assays (IFAs), a reliable serodiagnostic test for canine bartonelloses is of clinical importance. The utility of Western blotting (WB) for the serodiagnosis of canine bartonelloses has not been critically investigated. The objective of this study was to characterize WB immunodominant proteins that could be used to confirm a serodiagnosis of bartonelloses. Using agar-grown Bartonella henselae San Antonio type 2 (SA2) wholecell proteins, sera derived from four dog groups were tested by WB to assess immunodominant protein recognition patterns: group I consisted of 92 serum samples (10 preexposure and 82 postexposure serum samples) from 10 adult beagles experimentally inoculated with Bartonella spp., group II consisted of 36 serum samples from Bartonella PCR-positive naturally infected dogs, group III consisted of 26 serum samples from Bartonella PCR-negative and IFA-negative dogs, and group IV consisted of serum samples from 8 Brucella canis IFA-positive and 10 Rickettsia rickettsii IFA-positive dogs. Following experimental inoculation, 9 (90%) group I dogs were variably seroreactive to one or more of six specific immunodominant proteins (13, 17, 29, 50, 56, and 150 kDa). There was a strong but variable recognition of these proteins among 81% of group II dogs. In contrast, 24/26 group III dogs were not reactive to any immunodominant protein. In this study, the sensitivity and diagnostic accuracy of B. henselae SA2 WB were higher than those of B. henselae SA2 IFA testing. Some B. henselae SA2 immunodominant proteins were recognized by dogs experimentally and naturally infected with Bartonella spp. other than B. henselae. Additional research is necessary to more fully define the utility of WB for the serodiagnosis of canine bartonelloses. |
| UROGENITAL SCHISTOSOMIASIS; TRANSMISSION; HAEMATOBIUM; MANSONI; HYBRIDS; AFRICA | Background Schistosomiasis is a neglected tropical disease of global medical and veterinary importance. As efforts to eliminate schistosomiasis as a public health problem and interrupt transmission gather momentum, the potential zoonotic risk posed by livestock Schistosoma species via viable hybridisation in sub-Saharan Africa have been largely overlooked. We aimed to investigate the prevalence, distribution, and multi-host, multiparasite transmission cycle of Haematobium group schistosomiasis in Senegal, West Africa. Methods In this epidemiological study, we carried out systematic surveys in definitive hosts (humans, cattle, sheep, and goats) and snail intermediate hosts, in 2016-18, in two areas of Northern Senegal: Richard Toll and Lac de Guiers, where transmission is perennial; and Barkedji and Linguere, where transmission is seasonal. The occurrence and distribution of Schistosoma species and hybrids were assessed by molecular analyses of parasitological specimens obtained from the different hosts. Children in the study villages aged 5-17 years and enrolled in school were selected from school registers. Adults (aged 18-78 years) were self-selecting volunteers. Livestock from the study villages in both areas were also randomly sampled, as were post-mortem samples from local abattoirs. Additionally, five malacological surveys of snail intermediate hosts were carried out at each site in open water sources used by the communities and their animals. Findings In May to August, 2016, we surveyed 375 children and 20 adults from Richard Toll and Lac de Guiers, and 201 children and 107 adults from Barkedji and Linguere; in October, 2017, to January, 2018, we surveyed 386 children and 88 adults from Richard Toll and Lac de Guiers, and 323 children and 85 adults from Barkedji and Linguere. In Richard Toll and Lac de Guiers the prevalence of urogenital schistosomiasis in children was estimated to be 87% (95% CI 80-95) in 2016 and 88% (82-95) in 2017-18. An estimated 63% (in 2016) and 72% (in 2017-18) of infected children were shedding Schistosoma haematobium-Schistosoma bovis hybrids. In adults in Richard Toll and Lac de Guiers, the prevalence of urogenital schistosomiasis was estimated to be 79% (52-97) in 2016 and 41% (30-54) in 2017-18, with 88% of infected samples containing S haematobium-S bovis hybrids. In Barkedji and Linguere the prevalence of urogenital schistosomiasis in children was estimated to be 30% (23-38) in 2016 and 42% (35-49) in 2017-18, with the proportion of infected children found to be shedding S haematobium-S bovis hybrid miracidia much lower than in Richard Toll and Lac de Guiers (11% in 2016 and 9% in 2017-18). In adults in Barkedji and Linguere, the prevalence of urogenital schistosomiasis was estimated to be 26% (17-36) in 2016 and 47% (34-60) in 2017-18, with 10% of infected samples containing S haematobium-S bovis hybrids. The prevalence of S bovis in the sympatric cattle population of Richard Toll and the Lac de Guiers was 92% (80-99), with S bovis also found in sheep (estimated prevalence 14% [5-31]) and goats (15% [5-33]). In Barkedji and Linguere the main schistosome species in livestock was Schistosoma curassoni, with an estimated prevalence of 73% (48-93) in sheep, 84% (61-98) in goats and 8% (2-24) in cattle. S haematobium-S bovis hybrids were not found in livestock. In Richard Toll and Lac de Guiers 35% of infected Bulinus spp snail intermediate hosts were found to be shedding S haematobium-S bovis hybrids (68% shedding S haematobium; 17% shedding S bovis); however, no snails were found to be shedding S haematobium hybrids in Barkedji and Linguere (29% shedding S haematobium; 71% shedding S curassoni). Interpretation Our findings suggest that hybrids originate in humans via zoonotic spillover from livestock populations, where schistosomiasis is co-endemic. Introgressive hybridisation, evolving host ranges, and wider ecosystem contexts could affect the transmission dynamics of schistosomiasis and other pathogens, demonstrating the need to consider control measures within a One Health framework. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd. |
| HPV; Vaccination; Consent; Qualitative research; Adolescent health | PROGRAM | Background: Human Papillomavirus (HPV) vaccination programmes have the potential to reduce the incidence of cervical cancer. The preferred age for HPV vaccination is 12-13 years for optimal benefit. The legal framework in England allows adolescents to be vaccinated without parental consent if they are assessed as competent. A ‘South West Template Pathway on Self Consent for School Aged Immunisations’ was developed to improve uptake of immunisations in south-west England. Study aim: To examine how acceptable the new procedures are to the young women, parents and carers, school staff and immunisation nurses involved. Methods: The research was undertaken in two local authorities in south-west England during the 2017/18 and 2018/19 programme years. Semi-structured digitally recorded interviews were undertaken with 53 participants: one health service manager, three immunisation nurses, five staff at alternative education providers, three staff at mainstream schools, 19 young women and 22 parents. All recordings were transcribed verbatim and thematic analysis was undertaken, assisted by NVivo software. Results: Most participants were not fully aware of the legal framework that enables a young person to self-consent to vaccination. There was a strong presumption that parents should make decisions affecting the health of their children. The preferred age at which the HPV vaccination is administered (12-13 years) contributed to reluctance in endorsing self-consent which was thought to have the potential to break down trust between parents and school staff, and within families. In practice, formal self-consent was rare. Conclusion: Unresolved issues in relation to adolescent self-consent include public and professional perceptions of young people’s rights and abilities to take responsibility for decisions affecting their health, and concerns about the impact of self-consent on relationships both within families and between professionals and the families they serve. (C) 2020 The Authors. Published by Elsevier Ltd. |
| Salmonella Infantis; antimicrobial susceptibility; ESBL; genetic profile; PFGE | ENTERICA SEROVAR INFANTIS; MOLECULAR CHARACTERIZATION; ANTIBIOTIC-RESISTANCE; ESCHERICHIA-COLI; MEDICINE; HUMANS | This work aimed to evaluate the antimicrobial susceptibility of 87 Salmonella Infantis strains isolated in Italy from 2016 to 2019 along the food chain of broiler meat production and in humans and to determine the genetic profiles of the strains in order to establish a possible correlation with the antimicrobial pattern. All isolates were tested by the disk diffusion method to evaluate antimicrobial susceptibility toward sixteen antimicrobials, and the broth microdilution method was used to confirm extended spectrum beta-lactamase (ESBL) production. PCR and pulsed field gel electrophoresis (PFGE) were applied to characterize ESBL-encoding and AmpC beta-lactamase genes and to analyze the S. Infantis strains genetic profiles respectively. S. Infantis isolates showed high prevalence of resistance, in particular toward nalidixic acid (97.7%), tetracycline (96.5%), sulphamethoxazole/trimethoprim (91%) and cefepime (72.4%). The 80.5% of isolates were ESBL, cefotaxime-resistant, carrying the bla(CTX-M1) gene. The most prevalent PFGE profile was XbaI.0126 (35.6%). The remaining strains had a genetic homology from 81% to 97% with the XbaI.0126 profile. The strains belonging to these profiles were isolated from different matrices collected along the broiler food chain independently on the year and from the region and there was no correlation between the PFGE profiles and resistance patterns. We found two ESBL-producing S. Infantis strains with the same XbaI.2621 profile isolated from humans and from poultry feces, not yet reported in Italy. Our findings confirmed the diffusion of ESBL-multi drug resistant (MDR) S. Infantis along the broiler food chain and in humans and underlined the importance of continuous monitoring to control and to reduce the prevalence of this bacterium, applying a global One Health approach. |
| hip hemiarthroplasty; femoral neck fracture; surgeon sub-specialty; arthroplasty | HIP FRACTURE; UNCEMENTED HEMIARTHROPLASTY; POSTOPERATIVE INFECTION; SURGICAL APPROACH; RISK-FACTORS; MORTALITY; OLDER | Objectives: To determine if surgeon subspecialty training affects perioperative outcomes for displaced femoral neck fractures treated with hemiarthroplasty. Design: Retrospective comparative study. Setting: One health system with 2 hospitals (Level I and Level III trauma centers). Patient and Participants: Patients who were treated with hemiarthroplasty for displaced femoral neck fractures between October 2012 and September 2017. Outcome Measures: Leg length discrepancy, femoral offset, estimated blood loss (EBL), incidence of blood transfusion, time to surgery, operative time, and length of stay. Data were analyzed based on the treating surgeon’s subspecialty training [arthroplasty (A), trauma (T), other (O)]. Hierarchical regression was used to compare the groups and control for confounding variables. Results: A total of 292 patients who received hemiarthroplasty for displaced femoral neck fractures were included (A = 158; T = 73; O = 61). Surgeon subspecialty had a statistically significant effect on operative time, with arthroplasty surgeons completing the procedure 9.6 minutes faster than trauma surgeons and 17.7 minutes faster than other surgeons (P < 0.01; Delta R-2 = 0.03). Surgeon subspecialty did not significantly affect other outcomes, including leg length discrepancy (P = 0.26), femoral offset (P = 0.37), EBL (P = 0.10), incidence of transfusion (P = 0.67), time to surgery (P = 0.10), or length of stay (P = 0.67). Conclusions: This study demonstrates that arthroplasty-trained surgeons perform hemiarthroplasty slightly faster than other subspecialists, but subspecialty training does not affect other perioperative outcomes, including leg length discrepancy, femoral offset, EBL, transfusion rate, time to surgery, or length of stay. This suggests that hemiarthroplasty can be adequately performed by various subspecialists, and deferring treatment to an arthroplasty surgeon might not have a clinically significant benefit in the perioperative period. |
| Toxoplasma gondii; immunocompromised patients; West Africa; Meta-analysis | ATTENDING ANTENATAL CARE; INFECTED PATIENTS; CONGENITAL TOXOPLASMOSIS; BOBO-DIOULASSO; SEROPREVALENCE; PREVALENCE; CYTOMEGALOVIRUS; TRANSMISSION; ENCEPHALITIS; MANAGEMENT | Toxoplasmosis in immunocompromised individuals can be life threatening. The information needed for proper control and management strategies in endemic West African countries is lacking, hence a systematic review and meta-analysis were performed. This study aimed to determine the seroprevalence of anti-Toxoplasma gondii among pregnant women, HIV/AIDS and children in West Africa, Cameroon and Gabon. The epidemiology of the disease published between 1984 and 2019 using PubMed, Web of Science, Ovid MEDLINE, AJOL and Google Scholar databases were identified. Studies that met the inclusion criteria of Toxoplasma gondii infections under the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist were analysed. A total of 58 eligible studies were selected for meta-analysis. These studies considered 18,674 hosts and an overall pooled seroprevalence of anti-T. gondii antibodies were 45.4, 39.0 and 29.5% for pregnant women, HIV/AIDS patients and children, respectively. Pooled seroprevalence was highest in Gabon and lowest in Mali for pregnant women while highest levels of seropositivity for anti-T. gondii antibodies for HIV/AIDS individuals and children were both observed in Ghana. The major risk factors associated with anti-T. gondii seropositivity were gravida status, contact with cats, consumption of raw vegetables and /fruits, age and CD4 counts. More studies are needed to determine seroconversion rate. Improved sensitization among immunocompromised patients on T. gondii and its risk factors will be an efficient method to reducing the prevalence of the disease. One Health interventions involving transdisciplinary, integrative research and capacity building are necessary to address the problem of toxoplasmosis in West Africa. |
| Leishmania; Reservoir; Sand fly; Vector | DELAYED-TYPE HYPERSENSITIVITY; IMPREGNATED DOG COLLARS; VISCERAL LEISHMANIASIS; CUTANEOUS LEISHMANIASIS; CANINE LEISHMANIASIS; CLINICAL-FEATURES; TROPICA; INFANTUM; FOCUS; INFECTION | Leishmania has biologically adapted to specific phlebotomine sand flies through long co-evolution. The ability of Leishmania spp. to bind to sand fly midgut allows each Leishmania species to propagate and differentiate into infectious promastigotes and be transmitted. Sand fly feeding upon a mammalian host is the first step towards being infected and a host of Leishmania. Once deposited into the skin, host susceptibility to infection vs. ability to mount a sterilizing immune response predicts which hosts could be reservoirs of different Leishmania spp. Materials, in addition to parasites, are expelled during sand fly during feeding, including salivary antigens and other factors that promote local inflammatory responses. These factors aid visceralization of infection increasing the likelihood that systemic infection is established. Any environmental factor that increases sand fly biting of a particular host increases that host’s role in Leishmania transmission. First descriptions of reservoir species were based on association with local human disease and ability to observe infected leukocytes on cytology. This approach was one pathogen for one reservoir host. Advances in sensitive molecular tools greatly increased the breadth of mammals found to host Leishmania infection. Visceralizing species of Leishmania, particularly L. infantum, are now known to have multiple mammalian hosts. L. donovani, long been described as an anthroponotic parasite, was recently identified through molecular and serologic surveys to have additional mammalian hosts. The epidemiological role of these animals as a source of parasites to additional hosts via vector transmission is not known. Current evidence suggests that dogs and other domestic animals either control infection or do not have sufficient skin parasitemia to be a source of L. donovani to P. argentipes. Further xenodiagnosis and characterization of skin parasitemia in these different hosts is required to more broadly understand which Leishmania spp. hosts can be a source of parasites to sand flies and which ones are dead-end hosts. |
| antimicrobial resistance; multidrug resistance; plasmids; epidemiology; risk factor analysis; pig farms; Escherichia coli; Great Britain | POPULATION-STRUCTURE; FOOD ANIMALS; SALMONELLA; GENES; VIRULENCE; IMPACT; SUSCEPTIBILITY; EVOLUTION; ENGLAND; TOOL | Combatting antimicrobial resistant (AMR) using a One-Health approach is essential as various bacteria, including Escherichia coli, a common bacteria, are becoming increasingly resistant and livestock may be a reservoir. The AMR gene content of 492 E. coli, isolated from 56 pig farms across Great Britain in 2014-2015, and purified on antibiotic selective and non-selective plates, was determined using whole genome sequencing (WGS). The E. coli were phylogenetically diverse harboring a variety of AMR profiles with widespread resistance to old antibiotics; isolates harbored up to seven plasmid Inc-types. None showed concurrent resistance to third-generation cephalosporins, fluoroquinolones and clinically relevant aminoglycosides, although similar to 3% harbored AMR genes to both the former two. Transferable resistance to carbapenem and colistin were absent, and six of 117 E. coli STs belonged to major types associated with human disease. Prevalence of genotypically MDR E. coli, gathered from non-selective media was 46.9% and that of extended-spectrum-beta-lactamase E. coli was low (similar to 4% from non-selective). Approximately 72.6% of E. coli from ciprofloxacin plates and only 8.5% from the other plates harbored fluoroquinolone resistance due to topoisomerase mutations; the majority were MDR. In fact, multivariable analysis confirmed E. coli purified from CIP enrichment plates were more likely to be MDR, and suggested MDR isolates were also more probable from farms with high antibiotic usage, specialist finisher farms, and farms emptying their manure pits only after each batch. Additionally, farms from the South East were more likely to have MDR E. coli, whereas farms in Yorkshire and the Humber were less likely. Future investigations will determine whether suggested improvements such as better biosecurity or lower antimicrobial use decreases MDR E. coli on pig farms. Although this study focuses on pig farms, we believe the methodology and findings can be applied more widely to help livestock farmers in the United Kingdom and elsewhere to tackle AMR. |
| Poultry; Childhood stunting; Environmental hygiene; Campylobacter; One health; Ethiopia | NUTRITIONAL-STATUS; ANIMAL HUSBANDRY; VILLAGE POULTRY; CHILDREN; SETTINGS; EXPOSURE; HEALTH; INTERVENTION; PREFERENCES; INFECTIONS | Background Childhood stunting and malnutrition condemn millions of people globally to a life of disadvantage and cognitive and physical impairment. Though increasing egg consumption is often seen as an important solution for low and middle income countries (including Ethiopia), emerging evidence suggests that greater exposure to poultry feces may also inhibit child growth due to the effects of enteric bacteria, especially Campylobacter, on gut health. Methods In this rapid ethnographic study, we explored village poultry production, child dietary practices, and environmental hygiene conditions as they relate to Campylobacter risk and intervention in 16 villages in Haramaya Woreda, Eastern Ethiopia. Results In the study area, we found that women assumed primary responsibility to care for both chickens and children: in feeding, housing, and healthcare. Most chickens were free-range local indigenous breeds, and flock sizes were small and unstable due to epidemics, seasonal trends, reproductive patterns, and lack of food. Generally, eggs were seen as too luxurious to be eaten, and were predominantly sold at local markets for scarce cash, despite high malnutrition rates. Local narratives of extreme poverty, social dietary norms, parental fatalism, and lack of dietary consciousness (as it was called) were invoked to explain this. We found that homesteads were highly contaminated with human and animal feces. Although community members viewed chicken feces and poultry gastrointestinal contents as particularly noxious in comparison to other animals because of their feeding behaviour, they did not relate them to any particular disease. Shared human-animal housing and childcare practices place children at high risk of exposure to enteric bacteria from animal manure, despite daily routines designed to manage the domestic landscape. Conclusions Addressing childhood stunting and malnutrition through egg production in rural landscapes like Haramaya must navigate three distinct health and care regimes: for children, chickens, and home environments. Interventions should be based on a holistic approach to social and economic empowerment, one that considers both women and men and integrates nutrition, health, and community change as its overarching goal. |
| Normative data; EORTC QLQ-C30; Quality of life; Oncology; Patient-reported outcome measures; Austria; General population | QUALITY-OF-LIFE; PATIENT-REPORTED OUTCOMES; RANDOMIZED CONTROLLED-TRIALS; THYROID-CANCER SURVIVORS; EUROPEAN-ORGANIZATION; REFERENCE VALUES; CLINICAL-TRIALS; POOLED ANALYSIS; QUESTIONNAIRE; GENDER | Background The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a widely used cancer-specific questionnaire assessing 15 domains of health-related quality of life (HRQoL). Our aim was to facilitate the interpretation of scores on this questionnaire by providing Austrian normative data based on a general population sample. Methods The calculation of normative data was based on the EORTC QLQ-C30 data collected from an Austrian general population sample that was part of an international online panel study on the development of European normative data. Data reported herein were stratified and weighted by age and sex. Normative data were calculated for all 15 HRQoL domains of the EORTC QLQ-C30. For precise predictions of EORTC QLQ-C30 scores, a regression model based on sex, age and the presence of health conditions was built. Results The Austrian sample comprised 1002 Austrian participants (50.1% female, 51.4% when weighted by age and sex based on United Nation statistics). The mean age was 53.7 years (weighted: 47.7 years) and 53.6% (weighted: 47.4%) reported at least one health condition. Men reported better physical (Cohen’sd = 0.17) and emotional (Cohen’sd = 0.17) functioning as well as less fatigue (Cohen’sd = 0.18) and insomnia (Cohen’sd = 0.25) compared with women. Younger individuals (< 40 years) reported less dyspnea (Cohen’sd = 0.61) and pain (Cohen’sd = 0.51), whereas older individuals (>= 60 years) reported better emotional functioning (Cohen’sd = 0.55). Conclusions We present Austrian normative data for the EORTC QLQ-C30. Differences by age and sex are mostly in line with the findings of other European normative studies. The Austrian population sample shows higher HRQoL and lower morbidity compared with other European countries. The normative data in this study will facilitate the interpretation of EORTC QLQ-C30 scores in oncological practice and research at a national and international level (including cross-cultural comparisons). |
| Nursing; pharmacy; wipe sample | OCCUPATIONAL-EXPOSURE; SURFACE CONTAMINATION; ENVIRONMENTAL CONTAMINATION; GUIDANCE VALUES; HAZARDOUS DRUGS; CHEMOTHERAPY; HOSPITALS; WORKING; NURSES; AGENTS | Contamination of multiple antineoplastic drugs (ADs) on work surfaces presents an exposure concern for health care workers. Surface wipe sampling is a recognized method to evaluate the degree of contamination present. Our research team has previously reported on wipe sampling and analytical methods to simultaneously detect 10 commonly used ADs from a single wipe. Our objectives here were: to field test a protocol consisting of the wipe sampling method and an accompanying wipe sample collection tool kit and confirm this protocol can be effectively used by health care workers to assess drug contamination levels in their facilities; and, to confirm the potential for simultaneous exposure to multiple antineoplastic drugs. Three facilities within one health authority in British Columbia, Canada participated in this field study. In collaboration with the site health and safety advisors, up to 25 surfaces within each facility were considered for sampling. Collected wipe samples were analyzed using HPLC-MS/MS to quantify the 10 analyte, resulting in 750 potential analyses. Following the sampling, each of the three facilities’ safety advisors provided feedback regarding the usability of the protocols. Among the 72 wipe samples actually collected (or 720 analyses conducted), detectable levels and simultaneous contamination of work surfaces of five of the 10 analytes were found at all three participating sites: 5-fluorouracil, cyclophosphamide, vincristine, paclitaxel, and methotrexate; (range < LoD to 33.0 ng/cm(2)) with 5-fluorouracil having the highest concentration in every instance. Drug contamination was found on a variety of different work surfaces in pharmacies and patient care areas among all three sites. Users of the sampling protocols were generally satisfied with the wipe sample collection toolkit with some minor suggestions for improvement. Our findings support the hypothesis that health care workers may be simultaneously at risk of exposure to several ADs. Our toolkit was found to be user-friendly and manageable by those who were not experienced in collecting wipe samples to monitor contamination of ADs on the work surfaces in their facilities. |
| condom utilization; HIV/AIDS; Hawassa City | SEXUAL-BEHAVIOR; ANTIRETROVIRAL THERAPY; RISK BEHAVIOR; TRANSMISSION; PREVENTION; PEOPLE; HIV-1 | Background: Antiretroviral therapy (ART) introduction has sharply decreased mortality and morbidity rates among HIV-infected patients and resulted in longer and healthier lives among people living with HIV. Hence, the aim of this study is to determine the level of consistent condom use and associated factors among ART users in Hawassa City. Methods: Cross-sectional study design triangulated with qualitative phenomenology was used. One hospital and one health center were selected by simple random sampling and proportional to size allocation was used to assign participants to each health facility. Accordingly, 358 study subjects were selected. Adjusted odds ratio (AOR) with 95% confidence interval was used to implicate significant factors. Thematic content analysis was used and narrative report writing with a quote was used to present qualitative data. Results: The prevalence of consistent condom utilization in this study was 51.4%. Sex (AOR= 4.20, 95% CI: 2.386, 7.41), residence (AOR=3.55, 95% CI: 1.81, 6.99) educational status (AOR=0.4, 95% CI: 0.196, 0.946), perception on ART’s does not reduction of HIV transmission (AOR=1.96, 95% CI: 1.12, 3.43), rate of counseling (AOR=0.37, 95% CI: 0.17, 0.84) and use condom to prevent pregnancy (AOR=4.53, 95% CI: 2.11, 9.73) were found to be independent predictors of consistent condom utilization among ART users. Refusal by husbands, decrement in satisfaction, gender difference with more women than men willing to use consistently and religious reasons were factors associated with inconsistent condom utilization in the qualitative study. Conclusion and Recommendation: Consistent condom utilization among ART users was low. Sex, residence, educational status, perception towards ART were significantly associated with consistent condom utilization. Moreover, husband refusal, religious reason, decrement in satisfaction on the qualitative study were associated with non-consistent use of a condom. The importance of consistent condom use should be well addressed in HIV/AIDS patients, to prevent transmission and multiple infections of HIV. |
| Foodborne diseases; One health; Zoonoses; Livestock; Infectious disease reservoirs; Viral hepatitis | NATURALLY INFECTED SWINE; SLAUGHTER-AGE PIGS; PHYLOGENETIC ANALYSIS; PREVALENCE; ANTIBODIES; STRAINS; ASSAY; FORM; TIME; HEV | Background Hepatitis E virus (HEV) is a major cause of human hepatitis worldwide. Zoonotic genotypes of the virus have been found in diverse animal species with pigs playing a major role. Putative risk of zoonotic infection from livestock particularly swine in Sub-Saharan Africa including Ghana is poorly understood due to scarcity of available data, especially HEV sequence information. Methods Serum samples were collected from cattle, sheep, goats and pigs from Kumasi in the Ashanti region of Ghana. Samples were subjected to nested RT-PCR screening and quantification of HEV RNA-positive samples using real-time RT-PCR and the World Health Organization International Standard for HEV. Testing of all pig samples for antibodies was done by ELISA. Sanger sequencing and genotyping was performed and one representative complete genome was generated to facilitate genome-wide comparison to other available African HEV sequences by phylogenetic analysis. Results A total of 420 samples were available from cattle (n = 105), goats (n = 124), pigs (n = 89) and sheep (n = 102). HEV Viral RNA was detected only in pig samples (10.1%). The antibody detection rate in pigs was 77.5%, with positive samples from all sampling sites. Average viral load was 1 x 10(5) (range 1.02 x 10(3) to 3.17 x 10(5)) International Units per mL of serum with no statistically significant differences between age groups (<= 6 month, > 6 months) by a T-test comparison of means (t = 1.4272, df = 7, p = 0.1966). Sequences obtained in this study form a monophyletic group within HEV genotype 3. Sequences from Cameroon, Ghana, Burkina Faso and Madagascar were found to share a most recent common ancestor; however this was not the case for other African HEV sequences. Conclusion HEV genotype 3 is highly endemic in pigs in Ghana and likely poses a zoonotic risk to people exposed to pigs. HEV genotype 3 in Ghana shares a common origin with other virus strains from Sub-Saharan Africa. |
| nanopore sequencing; harmful algal bloom; dinoflagellate; MinION; sequencing; alexandrium; eDNA | PARALYTIC SHELLFISH TOXINS; ALEXANDRIUM-TAMARENSE; ENVIRONMENTAL DNA; POISONING TOXINS; BLOOMS; REFINEMENT; CATENELLA; PATHOGENS; PROFILES; STRAINS | Harmful algal blooms (HABs) are a naturally occurring global phenomena that have the potential to impact fisheries, leisure and ecosystems, as well as posing a significant hazard to animal and human health. There is significant interest in the development and application of methodologies to study all aspects of the causative organisms and toxins associated with these events. This paper reports the first application of nanopore sequencing technology for the detection of eukaryotic harmful algal bloom organisms. The MinION sequencing platform from Oxford Nanopore technologies provides long read sequencing capabilities in a compact, low cost, and portable format. In this study we used the MinION to sequence long-range PCR amplicons from multiple dinoflagellate species with a focus on the genus Alexandrium. Primers applicable to a wide range of dinoflagellates were selected, meaning that although the study was primarily focused on Alexandrium the applicability to three additional genera of toxic algae, namely; Gonyaulax, Prorocentrum, and Lingulodinium was also demonstrated. The amplicon generated here spanned approximately 3 kb of the rDNA cassette, including most of the 18S, the complete ITS1, 5.8S, ITS2 and regions D1 and D2 of the 28S. The inclusion of barcode genes as well as highly conserved regions resulted in identification of organisms to the species level. The analysis of reference cultures resulted in over 99% of all sequences being attributed to the correct species with an average identity above 95% from a reference list of over 200 species (see Supplementary Material 1). The use of mock community analysis within environmental samples highlighted that complex matrices did not prevent the ability to distinguish between phylogenetically similar species. Successful identification of causative organisms in environmental samples during natural toxic events further highlighted the potential of the assay. This study proves the suitability of nanopore sequencing technology for taxonomic identification of harmful algal bloom organisms and acquisition of data relevant to the World Health Organisations one health approach to marine monitoring. |
| TIMES | Background Hospital-affiliated freestanding emergency departments (FREDs) are rapidly proliferating in some states and have been the subject of recent policy debate. As FREDs’ role in acute care delivery is expanding in certain regions, little is known about the quality of care that they provide for their sickest patients. Our aim was to compare timeliness of emergent care at FREDs and hospital-based EDs (HEDs) for patient visits with selected high-acuity and time-sensitive conditions. Methods We performed a retrospective observational analysis of adult patient visit data from 19 FREDs and five HEDs from one health system over a 1-year period. Median times to events and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated via Cox regression. Results The median time to electrocardiogram for visits with chest pain was 10 minutes at FREDs and 9 minutes at HEDs (HR = 0.91 [CI = 0.87 to 0.96]). Time to cardiac catheterization lab for visits with ST-segment elevation myocardial infarction (STEMI) was 78 minutes at FREDs, inclusive of transfer time, and 31 minutes at HEDs (HR = 0.41 [CI = 0.24 to 0.71]). Time to computed tomography for visits with stroke was 37 minutes at FREDs and 29 minutes at HEDs (HR = 0.42 [CI = 0.31 to 0.58]). Among visits with sepsis, FREDs had longer times to lactate collection (HR = 0.41 [CI = 0.30 to 0.56]), blood culture collection (HR = 0.24 [CI = 0.11 to 0.51]), and antibiotic administration (HR = 0.61 [CI = 0.26 to 1.42]). Beta agonists were administered for visits with asthma exacerbations in 24 minutes at FREDs and 44 minutes at HEDs (HR = 2.50 [CI = 2.34 to 2.68]), with similar times for anticholinergic and corticosteroid administration. Conclusions Freestanding EDs provided more timely care than HEDs for visits with asthma exacerbation and less timely care for acute chest pain, stroke, and sepsis, although absolute differences were small. Even though STEMI patients at FREDs required transfer for catheterization, they tended to receive care in line with national guidelines. |
| Rabies; Lyssavirus; Molecular-epidemiology; KAP; Phylogeography | SEQUENCE ALIGNMENT | BackgroundRabies is a deadly preventable viral disease that affects all warm-blooded animals and widespread in many regions including Africa. The disease remains of major public health importance in Uganda.The purpose of this study was to establish Knowledge, Attitude, Practice (KAP) of Rabies in Moyo and Ntoroko districts and to characterize Rabies virus (RABV) strains from seven districts of Uganda with consistent prevalence of rabies.MethodsKAP survey data were collected based on animal biting history by interviewing the head of the veterinary departments, the medical centers and selected households from the study sites. Data were obtained from 84 households in Ntoroko and Moyo districts. Thirty-five (35) brain samples were collected from bovine, dogs, goats, foxes, jackals ad sheep between 2011 and 2013. Samples were tested using fluorescent antibody test (FAT), One step RT-PCR (following RNA extraction) and partial RABV N gene was sequenced by Sanger method before phylogenetic and phylogeographic analyses of sequences.ResultsScarcity of post-exposure prophylaxis services in the health centers was noted. Poor attitude of wound washing and deficiency of knowledge on how to handle wounds related to dog bites and the significance among household participants lacked. There is a high risk of rabies infection due to a limited dog’s vaccination. Dog biting episodes in humans were of 75.00 and 62.50% in Moyo and Ntoroko districts respectively. Twenty-seven (27) samples tested positive for rabies by FAT and PCR. Ugandan sequences were closely related (97% nucleotide id) to the rabies virus sequences from Tanzania, Rwanda, Burundi, Nigeria, Central African Republic and Sudan with both the Africa 1A and Africa 1B RABV clades represented. A putative new clade 1D was also detected.ConclusionsRabies remains a public health hazard in Uganda. There is urgent need to establish advocacy programs in both schools and communities to curtail the spread of rabies. Increasing the knowledge regarding wound washing, post-exposure prophylaxis and dogs vaccination would enhance prevention of rabies. A strong collaboration between medical and veterinary sectors under a one health platform is required to ensure sufficient preventative services to the communities. |
| Fingolimod; interferon-β 1a; pediatric-onset multiple sclerosis; cost-effectiveness; Canada | HEALTH UTILITIES; CHILDHOOD; PEDSQL(TM); POPULATION; MANAGEMENT; CHILDREN; BETA-1A; SCORES; RATES | Aims To evaluate the cost-effectiveness of fingolimod versus interferon (IFN)-beta 1a at a dose of 30 mu g per week for the treatment of relapsing pediatric-onset multiple sclerosis (POMS) in Canada. Material and methods A discrete-time Markov model was developed to compare fingolimod with IFN beta-1a over a time horizon of two years representing patients followed up to mean age of 18 years from a Canadian health care system perspective. Twenty-one health states based on the Expanded Disability Status Scale (EDSS) were considered: EDSS 0-9 for relapsing multiple sclerosis (MS), EDSS 0-9 for secondary progressive MS, and Death. Relative treatment efficacy for fingolimod versus IFN-beta 1a was estimated from the PARADIGMS study. Costs and resource use were obtained from published literature and Canadian sources. Utilities were estimated by mapping the Pediatric Quality of Life inventory data onto the Child Health Utility Index-9 Dimension using a published mapping algorithm. Future costs and benefits were discounted at 1.5% per annum. Results Compared with IFN beta-1a, fingolimod led to an increase in quality-adjusted life-years (QALYs) (0.125) with incremental costs (Canadian dollars [CAD] 2,977) and to an incremental cost-effectiveness ratio (ICER) of CAD 23,886/QALY over a time horizon of two years representing patients followed up to mean age of 18 years. The monetary benefits of fingolimod treatment versus IFN beta-1a at a willingness-to-pay (WTP) threshold of CAD 50,000 per QALY gained were higher than the costs. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) both confirmed the robustness of the results. Limitations The main limitations of this analysis primarily stem from the limited data availability in POMS. Conclusions Fingolimod is cost effective compared with IFN beta-1a for the treatment of POMS over a time horizon of two years representing patients followed up to a mean age of 18 years in Canada. |
| digenetic trematodes; gill fluke; invasive species; molecular diagnosis; species-specific primer pair; zoonosis | ZOONOTIC TREMATODE METACERCARIAE; FRESH-WATER FISH; ORNAMENTAL FISH; DIGENEA HETEROPHYIDAE; CHAMPASAK PROVINCE; CYPRINUS-CARPIO; CHIANG-MAI; PREVALENCE; NISHIGORI; MEXICO | Simple SummaryCentrocestus formosanus is an invasive parasite which originated from outside the European countries. Infections by this parasite seem to be related to the movements of its hosts. However, in Europe, the presence of C. formosanus has been sporadically reported and its zoonotic potential is still underestimated. Therefore, the present study proposes a fast and inexpensive diagnostic method through molecular analyses targeting the ribosomal internal transcribed sequence 2 (ITS2) using a newly designed species-specific primer pair. Given the potential negative consequences of C. formosanus global expansion, those responsible should adopt a one health approach to control the spread of this organism. AbstractCentrocestus formosanus is a digenetic trematode with a complex life cycle, involving invertebrate and vertebrate hosts, humans included. In particular, it causes gill lesions and mortality in freshwater fish species, and gastrointestinal symptoms in infected humans. Here, we describe the occurrence of C. formosanus infection in zebrafish imported in Italy and propose a newly designed species-specific primer pair to ameliorate the diagnostic investigations for C. formosanus. Gill arches of 30 zebrafish were examined for the presence of encysted metacercariae under a stereomicroscope and processed through molecular analyses targeting the ribosomal internal transcribed sequence 2 (ITS2). Although C. formosanus distribution was originally restricted to Asia, it has been subsequently reported in new countries, revealing itself as an invasive species and raising important concerns for biodiversity, economy, scientific research, as well as animal and public health. Given the crucial role played by the ornamental fish industry in spreading this parasite, there is an urgent need for control measures to prevent the introduction and establishment of C. formosanus in non-endemic areas, including Europe. We also suggest developing new strategies in microbiology and epidemiology to better explore this new globalization-derived invasive species. |
| Health services research; Health systems; Patient safety; Quality of health care | RESPECT; PERSPECTIVE; HARASSMENT; AGGRESSION; INCIVILITY; CULTURE | Objective To identify individual and organisational factors associated with the prevalence, type and impact of unprofessional behaviours among hospital employees. Design, setting, participants Staff in seven metropolitan tertiary hospitals operated by one health care provider in three states were surveyed (Dec 2017 – Nov 2018) about their experience of unprofessional behaviours – 21 classified as incivility or bullying and five as extreme unprofessional behaviour (eg, sexual or physical assault) – and their perceived impact on personal wellbeing, teamwork and care quality, as well as about their speaking-up skills. Main outcome measures Frequency of experiencing 26 unprofessional behaviours during the preceding 12 months; factors associated with experiencing unprofessional behaviour and its impact, including self-reported speaking-up skills. Results Valid surveys (more than 60% of questions answered) were submitted by 5178 of an estimated 15 213 staff members (response rate, 34.0%). 4846 respondents (93.6%; 95% CI, 92.9-94.2%) reported experiencing at least one unprofessional behaviour during the preceding year, including 2009 (38.8%; 95% CI, 37.5-40.1%) who reported weekly or more frequent incivility or bullying; 753 (14.5%; 95% CI, 13.6-15.5%) reported extreme unprofessional behaviour. Nurses and non-clinical staff members aged 25-34 years reported incivility/bullying and extreme behaviour more often than other staff and age groups respectively. Staff with self-reported speaking-up skills experienced less incivility/bullying (odds ratio [OR], 0.53; 95% CI, 0.46-0.61) and extreme behaviour (OR, 0.80; 95% CI, 0.67-0.97), and also less frequently an impact on their personal wellbeing (OR, 0.44; 95% CI, 0.38-0.51). Conclusions Unprofessional behaviour is common among hospital workers. Tolerance for low level poor behaviour may be an enabler for more serious misbehaviour that endangers staff wellbeing and patient safety. Training staff about speaking up is required, together with organisational processes for effectively eliminating unprofessional behaviour. |
| reverse vaccinology; bioinformatics; multi-epitope vaccine; chimeric protein; T cells; adaptive immunity; innate immunity; long-term protection; visceral leishmaniasis | HEMATOPOIETIC STEM-CELLS; N-TERMINAL DOMAIN; VISCERAL LEISHMANIASIS; DENDRITIC CELLS; CONFERS PROTECTION; PEPTIDE VACCINE; LEISH-F1+MPL-SE VACCINE; POLYPROTEIN VACCINE; PROTEOMIC ANALYSIS; HUMORAL RESPONSE | Leishmaniases are complex vector-borne diseases caused by intracellular parasites of the genusLeishmania. The visceral form of the disease affects both humans and canids in tropical, subtropical, and Mediterranean regions. One health approach has suggested that controlling zoonotic visceral leishmaniasis (ZVL) could have an impact on the reduction of the human incidence of visceral leishmaniasis (VL). Despite the fact that a preventive vaccination could help with leishmaniasis elimination, effective vaccines that are able to elicit protective immune responses are currently lacking. In the present study, we designed a chimeric multi-epitope protein composed of multiple CD8(+)and CD4(+)T cell epitopes which were obtained from six highly immunogenic proteins previously identified by an immunoproteomics approach, and the N-termini of the heparin-binding hemagglutinin (HBHA) ofMycobacterium tuberculosisserved as an adjuvant. A preclinical evaluation of the candidate vaccine in BALB/c mice showed that when it was given along with the adjuvant Addavax it was able to induce strong immune responses. Cellular responses were dominated by the presence of central and effector multifunctional CD4(+)and CD8(+)T memory cells. Importantly, the vaccination reduced the parasite burden in both short-term and long-term vaccinated mice challenged withLeishmania infantum. Protection was characterized by the continuing presence of IFN-gamma+TNF alpha(+)-producing CD8(+)and CD4(+)T cells and increased NO levels. The depletion of CD8(+)T cells in short-term vaccinated mice conferred a significant loss of protection in both target organs of the parasite, indicating a significant involvement of this population in the protection againstL. infantumchallenge. Thus, the overall data could be considered to be a proof-of-concept that the design of efficacious T cell vaccines with the help of reverse vaccinology approaches is possible. |
| beliefs; education; family nursing interventions; family-centred care; nurse roles; nursing models; parenting; programme evaluation; qualitative approaches | REFLECTIVE PRACTICE; HEALTH-CARE; TRANSITION; FAMILIES; CHILDREN; MODEL | Aims and objectives The study aimed to assess the impacts of the Father-Friendly Initiative within Families (FFIF) programme, an interdisciplinary programme supporting father involvement, on health professionals’ practices with fathers. Background It is increasingly recognised that father involvement benefits children’s cognitive and social development and contributes to both parents’ well-being. Recent research has shown health professionals’ support to be a protective factor in father involvement. Research results were translated into practice through the implementation of a programme, the FFIF, aimed at empowering health professionals to support father involvement. Design The study employed a qualitative impact assessment approach based on semi-structured interviews with 36 health professionals to assess the impacts of the FFIF on professionals’ practices with fathers. Methods A total of 36 health professionals were interviewed (13 nurses, 10 social workers, six community workers, three educators, two psychoeducators, one health manager, and one special education teacher). Interviews were transcribed, and a qualitative thematic analysis was carried out. This study is presented in line with COREQ’s checklist. Results Impacts of the FFIF on health professionals were seen in changes on three fronts: (a1) their beliefs; (b) their conception of their role; and (c) their interventions. These changes related to three themes: (a) difficulties experienced by fathers; (b) importance of father involvement; and (c) differences between fathers and mothers. The professionals, having realised the importance of their own role in improving the services offered to fathers, made concrete changes in their interventions, such as reaching out to fathers more effectively, encouraging their participation and treating them fairly and equitably. Conclusions After attending this interdisciplinary programme supporting father involvement, participating professionals adopted father-friendly beliefs, redefined their conception of their role and modified their interventions. Relevance to clinical practice To provide family-centred care, nurses and other health professionals need to adopt father-inclusive practices. |
| bivalirudin; hemorrhage; percutaneous coronary intervention; radial artery; vascular closure device | CARDIOVASCULAR DATA REGISTRY; RADIAL ACCESS; MYOCARDIAL-INFARCTION; FEMORAL ACCESS; BIVALIRUDIN; OUTCOMES; HEPARIN; METAANALYSIS; ASSOCIATION; INSIGHTS | Background: Procedural anticoagulation with bivalirudin (BIV), trans-radial intervention (TRI), and use of a vascular closure device (VCD) are thought to mitigate percutaneous coronary intervention (PCI)-related bleeding. We compared the impact of these bleeding avoidance strategies (BAS) for PCIs stratified by bleeding risk. Methods: We performed a retrospective cohort analysis of PCIs from 18 facilities within one health care system from 2009Q3 to 2017Q4. Bleeding risk was assessed per the National Cardiovascular Data Registry CathPCI bleeding model, with procedures stratified into 6 categories (first, second, third quartiles, 75th-90th, 90th-97.5th, and top 2.5th percentiles). Regression models were used to assess the impact of BAS on bleeding outcome. Results: Of 74 953 PCIs, 9.4% used no BAS, 12.0% used BIV alone, 20.8% used TRI alone, 26.8% used VCD alone, 5.4% used TRI+BIV, and 25.6% used VCD+BIV. The crude bleeding rate was 4.4% overall. Only 2 comparisons showed significant trends across all risk strata: VCD+BIV versus no BAS, odds ratio (95% CI) range: first quartile, 0.36 (0.18-0.72) to top 2.5th percentile, 0.50 (0.32-0.78); TRI versus no BAS, odds ratio (95% CI) range: first quartile, 0.15 (0.06-0.38) to top 2.5th percentile, 0.49 (0.28-0.86). TRI had lower odds of bleeding compared with BIV for all risk strata except the top 2.5th percentile. Addition of BIV to TRI did not change the odds of bleeding for any risk strata. Factors potentially limiting use of TRI (renal failure, shock, cardiac arrest, and mechanical circulatory support) were present in <= 10% of procedures below the 90th percentile. Conclusions: Among individual BAS, only TRI had consistently lower odds of bleeding across all risk strata. Factors potentially limiting TRI were found infrequently in procedures below the 90th percentile of bleeding risk. For transfemoral PCI, VCD+BIV had lower odds of bleeding compared with no BAS across all risk strata. |
| ESCCAP; Risk assessment; Intestinal parasites; Zoonosis; Parasite control; Dogs; Cats; Spain | INTESTINAL PARASITES; ASCARID INFECTIONS; CATS; DOGS; PREVALENCE; HEALTH; ECHINOCOCCOSIS; EPIDEMIOLOGY; ZOONOSES; VETERINARY | Background Pets may be carriers of infectious agents including parasites. As part of a larger-scale study covering the whole of Europe, this study examines deworming measures reported by Spanish pet owners and identifies risk factors. Methods An online questionnaire was administered to cat and dog owners in Spain. The replies provided were used to obtain information about the pets’ living conditions and to accordingly classify each pet into one of the four ESCCAP infection risk categories (A, B, C or D) for which different deworming frequencies are recommended. Questions were also asked about pet care and owners’ attitude toward their pets. The Kruskal-Wallis test was used to correlate risk groups with deworming frequencies. Results Completed questionnaires were returned by 500 cat owners and 501 dog owners. According to responses, 96.21% of dogs were assigned to risk category D (maximum risk), and only 1.2%, 2.2% and 0.4% to A, B and C, respectively. Almost all cats were assigned to the minimum risk category A (indoor cats, 62%) or maximum risk category D (outdoor cats, 32.8%); only 3.4% and 1.8% of cats were classified as risk B and C respectively. More dogs were allocated to the higher risk group compared to cats, which were more frequently kept indoors. Cats were reportedly dewormed less frequently than dogs (2.56 and 3.13 times per year respectively), consistent with their different infestation risk. Thus, pets in the lower risk group A were either adequately dewormed or treated more often than necessary. Only a small proportion of cats were not dewormed at all (n = 14). Alarmingly, almost all pets in risk groups B, C or D (representing 95% of dogs and 39% of cats) were dewormed less often than recommended. Conclusions More effective health education is required for the management of zoonotic endoparasite diseases under the umbrella of One Health targeted at owners, veterinarians, general practitioners, and health authorities. To align deworming frequency with infection risk, pet owners should be provided with clear, compelling instructions. |
| hospitalization; length of stay; methicillin-resistantStaphylococcus aureus; mortality; one health | RESISTANT STAPHYLOCOCCUS-AUREUS; CLONAL COMPLEX 398; QUALITY | Livestock-associated methicillin-resistantStaphylococcus aureus(LA-MRSA) CC398 has emerged in humans throughout Europe and the USA during the last decade and is associated with the spread of LA-MRSA CC398 in production animals. In this study, we investigated the risk of subsequent hospitalization with anS. aureus-related diagnosis and death within the first 2 years after MRSA diagnosis. The study included 7,521 carriers of MRSA, an age-matched reference population of 376,041 individuals and 7,607 patients infected with MRSA. Hazard ratios (HR) for hospitalization with anS. aureus-related diagnosis were 4.09 (95% CI: 2.78-6.00) and for death 1.21 (95% CI: 0.80-1.83) in LA-MRSA CC398 carriers compared with the reference population. Comparing carriers of LA-MRSA CC398 and non-CC398 MRSA, HR for hospitalization was 0.61 (95% CI: 0.37-0.99) and death 0.25 (95% CI: 0.16-0.40), respectively. Patients initially diagnosed with LA-MRSA CC398 or non-CC398 MRSA infection differed from MRSA carriers in terms of older age, higher Charlson comorbidity index score and longer hospital stays. HR for subsequent hospitalization and death was similar regardless having infection with LA-MRSA CC398 or non-CC398 MRSA at the time of MRSA diagnosis. We established that MRSA CC398 carriers have a lower risk of hospitalization and death up to 2 years after MRSA diagnosis than non-CC398 MRSA carriers do. In contrast, MRSA carriage, regardless the MRSA strain is a burden in terms of hospitalization and death when compared to the background reference population. Further, we established that there are no differences in risk of subsequent hospitalization and death in patients initially diagnosed with MRSA CC398 or non-CC398 MRSA infection. We suggest that public health surveillance of MRSA clearly needs to distinguish between carriage and infection as well as strain type before any inference from number of cases to disease burden is made. |
| coronavirus; global public health; globalization; pandemics; Sir William Osler; World Health Organization | EMERGENCIES; FRAMEWORK | For a large number of health care providers world-wide, the coronavirus disease 2019 (COVID-19) pandemic is their first experience in population-based care. In past decades, lower population densities, infectious disease outbreaks, epidemics, and pandemics were rare and driven almost exclusively by natural disasters, predatory animals, and war. In the early 1900s, Sir William Osler first advanced the knowledge of zoonotic diseases that are spread from reservoir animals to human animals. Once rare, they now make up 71% or more of new diseases. Globally, zoonotic spread occurs for many reasons. Because the human population has grown in numbers and density, the spread of these diseases accelerated though rapid unsustainable urbanization, biodiversity loss, and climate change. Furthermore, they are exacerbated by an increasing number of vulnerable populations suffering from chronic deficiencies in food, water, and energy. The World Health Organization (WHO) and its International Health Regulation (IHR) Treaty, organized to manage population-based diseases such as Influenza, severe acute respiratory syndrome (SARS), H1N1, Middle East respiratory syndrome (MERS), HIV, and Ebola, have failed to meet population-based expectations. In part, this is due to influence from powerful political donors, which has become most evident in the current COVID-19 pandemic. The global community can no longer tolerate an ineffectual and passive international response system, nor tolerate the self-serving political interference that authoritarian regimes and others have exercised over the WHO. In a highly integrated globalized world, both the WHO with its IHR Treaty have the potential to become one of the most effective mechanisms for crisis response and risk reduction world-wide. Practitioners and health decision-makers must break their silence and advocate for a stronger treaty, a return of the WHO’s singular global authority, and support highly coordinated population-based management. As Osler recognized, his concept of one medicine, one health defines what global public health is today. |
| service accessibility; network analysis; MCDA; quality of life; spatial suitability; AHP; KSA vision 2030 | SUITABILITY; DEPRIVATION; ENVIRONMENT; INDICATORS; GEOGRAPHY | The present study was aimed at evaluating the quality of life in the districts of Buraidah city in the Kingdom of Saudi Arabia as part of the Kingdom’s Vision 2030, based on provided services in terms of distance and time parameters. This was achieved by integrating Geographic Information System (GIS)-based network analysis and multicriteria decision analysis (MCDA) techniques. The service area analysis technique of the GIS Network Analysis tools was applied to the available services in the districts of Buraidah city. Twelve services were investigated with regard to their coverage within 5, 10, and 15 minutes of travel time: universities, high schools, middle schools, elementary schools, hospitals, health centers, ambulance facilities, government services, religious services, security services, sports services, and recreational services. GIS-based multicriteria decision analysis (GIS-MCDA) was implemented in the study to obtain a spatial suitability map of the standard of living quality in the various districts in Buraidah city. The analytic hierarchy process (AHP) technique was used to determine the criteria weights. The location-allocation model was used in the study as well for suggestions of new service locations to improve the spatial distribution of services and enhance the quality of life in the districts. The results of the final suitability map to determine districts with the best standard of living according to the provided services show that the living standards in the city are very good, with very high and high levels in around 51 districts, representing 72.9% (449,235 people), and about 19 districts with moderate, low, and very low levels, representing 27.1% (56,765 people). Narrowing the quality of life gap and improving spatial planning requires correcting the current deficiency in services, which is estimated in this study to be 16 services: one high school, one elementary school, one middle school, two universities, one sports service, two security services, two courts, two hospitals, one health center, one park, and two ambulance facilities. |
| LONGIAREOLATA MACQUART; ULTRAVIOLET-RADIATION; SKIN-CANCER; VIRUS; DIPTERA; HEALTH; CIRCULATION; CULICIDAE; MOSQUITO; SRES-A1B | Motivated by the One Health paradigm, we found the expected changes in temperature and UV radiation (UVR) to be a common trigger for enhancing the risk that viruses, vectors, and diseases pose to human and animal health. We compared data from the mosquito field collections and medical studies with regional climate model projections to examine the impact of climate change on the spreading of one malaria vector, the circulation of West Nile virus (WNV), and the incidence of melanoma. We analysed data obtained from ten selected years of standardised mosquito vector sampling with 219 unique location-year combinations, and 10 years of melanoma incidence. Trends in the observed data were compared to the climatic variables obtained by the coupled regional Eta Belgrade University and Princeton Ocean Model for the period 1961-2015 using the A1B scenario, and the expected changes up to 2030 were presented. Spreading and relative abundance of Anopheles hyrcanus was positively correlated with the trend of the mean annual temperature. We anticipated a nearly twofold increase in the number of invaded sites up to 2030. The frequency of WNV detections in Culex pipiens was significantly correlated to overwintering temperature averages and seasonal relative humidity at the sampling sites. Regression model projects a twofold increase in the incidence of WNV positive Cx. pipiens for a rise of 0.5 degrees C in overwintering TOctober-April temperatures. The projected increase of 56% in the number of days with T-max >= 30 degrees C (Hot Days-HD) and UVR doses (up to 1.2%) corresponds to an increasing trend in melanoma incidence. Simulations of the Pannonian countries climate anticipate warmer and drier conditions with possible dominance of temperature and number of HD over other ecological factors. These signal the importance of monitoring the changes to the preparedness of mitigating the risk of vector-borne diseases and melanoma. |
| endoscopy; bacteremia; incidence risk; risk ratio; dogs; veterinary teaching hospital | ANTIBIOTIC-PROPHYLAXIS; BLOOD CULTURES; CONTAMINATION; CANINE; UNITS; CATS | Simple Summary Antimicrobial resistance is a threat that poses a great risk to public health. It has been predicted that, by 2050, there will have been 10 million deaths worldwide due to drug-resistant infections. There is a crucial need in Veterinary Medicine to reduce the use of antimicrobials to slow down the process and incidence of antimicrobial resistance as a One Health concern. The aim of this study was to evaluate the appearance of bacteremia following endoscopic procedures in dogs brought to the Veterinary Teaching Hospital (VTH) of the Department of Veterinary Medical Science of the University of Bologna. The results obtained from hemocultures before and after the endoscopic procedures demonstrated a low incidence of bacteremia after endoscopy. This could be seen as an attempt to reduce the use of antimicrobials to avoid the spread of antimicrobial resistance. Endoscopic procedures are widely used in veterinary medicine, and their role in producing transient bacteremia is debatable. The growing issue of antibiotic resistance requires the correct use of antibiotics, avoiding their administration when not strictly necessary. Studies highlighting post-endoscopy bacteremia in veterinary medicine are extremely rare and often involve very few animals. This study describes the results from 74 owned dogs, brought to the Veterinary Teaching Hospital of the Department of Veterinary Medical Science of the University of Bologna, for the purpose of undergoing an endoscopic procedure. Two blood samples were taken from each dog, one before and one after the procedure, in order to assess the incidence of bacteremia linked to endoscopic procedures. Eight dogs were tested positive at the second blood culture with an Incidence Risk (IR) of 10.8%. No statistical differences were found by comparing positive and negative blood cultures with respect to sex, age, weight and anesthesia duration. In addition, no difference was found between airway and digestive tract procedures. The present findings showed that the probability of developing bacteremia after an endoscopic procedure was quite low, and additional studies confirming this are certainly recommended as well as the evaluation of categories of patients potentially considered at risk. |
| Type 2 diabetes; Hypoglycemia; Models; Decision support | EVENTS; MORTALITY; ADULTS | Background/Aim: Episodes of non-severe hypoglycemia can be captured through diagnoses documented in the electronic medical record. We aimed to create a clinically useful prediction model for a severe hypoglycemia event, requiring an emergency department visit or hospitalization, in patients with Type 2 diabetes with a history of non-severe hypoglycemia. Methods: Using electronic medical record data from 50,439 patients with Type 2 diabetes in one health system, number of severe hypoglycemia events and associated patient characteristics from 2006 to 2015 were previously defined. Using the landmarking method, a dynamic prediction model was built using the subset of 1876 patients who had a documented non-severe hypoglycemia diagnosis code, using logistic regression to obtain landmark-specific odds of severe hypoglycemia in this group. For model performance, the bootstrap procedure was employed for internal validation and area under the curve (AUC) and index of prediction accuracy (IPA) were calculated. Results: Glycosylated hemoglobin (HbA1c) less than 7% (53 mmol/mol) was associated with increased odds ratio (OR) of severe hypoglycemia at 3 months (OR 1.92 95% Confidence Interval (CI) 1.19-3.10 at HbA1c 5% (31 mmol/mol) and OR 1.21, CI 1.03-1.41 at HbA1c 6%(42 mmol/mol).) History of non-severe hypoglycemia within the past 3 months increased odds for severe hypoglycemia (OR 2.58 95% CI 1.80-3.70) as did Black race, insulin use with the past 3 months, and comorbidities. Metformin and sulfonlylurea use in the past 3 months, increasing age and body mass index had lower odds of a future severe hypoglycemia event. For the prediction model for 3 month risk of severe hypoglycemia, the AUC was 0.890 (CI 0.843-0.907) and the IPA was 10.8% (CI 4.4% – 12.4%). Conclusion: In patients with a documented diagnosis of non-severe hypoglycemia, a dynamic prediction model identifies patients with Type 2 diabetes with 3-month increased risk of severe hypoglycemia, allowing for preventive efforts, such as medication changes, at the point of care. (C) 2019 Elsevier Inc. All rights reserved. |
| Antibiotic resistance; Chicken farm; Patterns of antibiotic use; Factors of misuse; One health | PERFORMANCE LIQUID-CHROMATOGRAPHY; ESCHERICHIA-COLI; RESISTANCE; POULTRY; FEED | Background Misuse of antibiotics in food animals contributes to an increase of antibiotic resistant bacteria transmitting to humans. China is the largest producer and user of antibiotics in the world, of which animals share more than half of the total consumption. This study aimed to explore Chinese farmer’s practice of antibiotic use and the factors associated with their use. Methods In this cross-sectional survey, we interviewed farmers from 88 chicken farms in northwestern China. We defined two kinds of misuse: 1) using antibiotics in the Chinese prohibited list, and 2) using antibiotics within the recommended withdrawal period. Factor analysis was used to select farmers’ knowledge variables and multinomial logistic regression was used to determine factors associated with antibiotic misuse. Results All the participating farmers used antibiotics on their farms. Amoxicillin was the most common antibiotic used (76.5%), followed by norfloxacin, ofloxacin, ceftriaxone and oxytetracycline. 75% of farmers used antibiotics in the prohibited list while 14.8% continued to use antibiotics during the withdrawal period. Hierarchical cluster analysis revealed three patterns of antibiotic use: 1) excessive use of non-prohibited and prohibited antibiotics or an excessive user, 2) low use of a few types of non-prohibited and moderate use of prohibited antibiotics or a low user, 3) multiple use of a variety (>= 7 types) of non-prohibited and prohibited antibiotics or a moderate user. Farmers from medium size, family-based farms, those with a low education level and low income were more likely to misuse antibiotics. Prior formal agricultural training was associated with reducing multiple types of antibiotic use. There was a huge gap between policy and reinforcement causing antibiotic misuse in the study community. Conclusion Antibiotics are commonly used on chicken farms; misuse of antibiotics is high; improvement in farm sanitation, education on antibiotic use for farmers and veterinarians/pharmacists and enforcement of the regulations may reduce antibiotic use on chicken farms in China. |
| antimicrobial resistance genes; whole metagenome sequencing; milk; host DNA depletion; sequencing depth | RAW | Over the past decades, antimicrobial resistance (AMR) has been recognized as one of the most serious threats to public health. Although originally considered a problem to human health, the emerging crisis of AMR requires a One Health approach, considering human, animal, and environmental reservoirs. In this regard, the extensive use of antibiotics in the livestock production systems to treat mastitis and other bacterial diseases can lead to the presence of AMR genes in bacteria that contaminate or naturally occur in milk and dairy products, thereby introducing them into the food chain. The recent development of high-throughput next-generation sequencing (NGS) technologies is improving the fast characterization of microbial communities and their functional capabilities. In this context, whole metagenome sequencing (WMS), also called shotgun metagenomic sequencing, allows the generation of a vast amount of data which can be interrogated to generate the desired evidence, including the resistome. However, the amount of host DNA poses a major challenge to metagenome analysis. Given the current absence of literature concerning the application of WMS on milk to detect the presence of AMR genes, in the present study, we evaluated the effect of different sequencing depths, host DNA depletion methods and matrices to characterize the resistome of a milk production environment. WMS was conducted on three aliquots of bulk tank milk and three aliquots of the in-line milk filter collected from a single dairy farm; a fourth aliquot of milk and milk filter was bioinformatically subsampled. Two commercially available host DNA depletion methods were applied, and metagenomic DNA was sequenced to two different sequencing depth. Milk filters proved to be the most suitable matrices to evaluate the presence of AMR genes; besides, the pre-extraction host DNA depletion method was the most efficient approach to remove host reads. To our knowledge, this is the first study to evaluate the limitations posed by the host DNA in investigating the milk resistome with a WMS approach, confirming the circulation of AMR genes in the milk production environment. |
| anthropology; avian influenza; epidemiology; Newcastle disease; One Health; public health | NEWCASTLE-DISEASE; VACCINATION; CHICKENS; CHALLENGES; VACCINES; IMPACT | Significant global efforts have been directed towards understanding the epidemiology of highly pathogenic avian influenza (HPAI) across poultry production systems and in wild-bird reservoirs, yet understanding of disease dynamics in the village poultry setting remains limited. This article provides a detailed account of the first laboratory-confirmed outbreak of HPAI in the south-eastern provinces of Lao PDR, which occurred in a village in Sekong Province in October 2018. Perspectives from an anthropologist conducting fieldwork at the time of the outbreak, clinical and epidemiological observations by an Australian veterinarian are combined with laboratory characterization and sequencing of the virus to provide insights about disease dynamics, biosecurity, outbreak response and impediments to disease surveillance. Market-purchased chickens were considered the likely source of the outbreak. Observations highlighted the significance of a-lack-of pathognomonic clinical signs and commonness of high-mortality poultry disease with consequent importance of laboratory diagnosis. Sample submission and testing was found to be efficient, despite the village being far from the national veterinary diagnostic laboratory. Extensively raised poultry play key roles in ritual, livelihoods and nutrition of rural Lao PDR people. Unfortunately, mass mortality of chickens due to diseases such as HPAI and Newcastle disease (ND) imposes a significant burden on smallholders in Lao PDR, as in most other SE Asian countries. We observed that high mortality of chickens is perceived by locals as a new ‘normal’ in raising poultry; this sense of it being ‘normal’ is a disincentive to reporting of mortality events. Establishing effective people-centred disease-surveillance approaches with local benefit, improving market-biosecurity and veterinary-service support to control vaccine-preventable poultry diseases could all reduce mass-mortality event frequency, improve veterinary-producer relationships and increase the likelihood that mortality events are reported. Priority in each of these aspects should be on working with smallholders and local traders, appreciating and respecting their perspectives and local knowledge. |
| Bartonella; Phylogenetic; Wildlife; Small mammals | NECROMYS-LASIURUS RODENTIA; VINSONII SUBSP BERKHOFFII; ARTHROPOD-BORNE PATHOGENS; ESPIRITO-SANTO STATE; CRAB-EATING-FOX; MOLECULAR CHARACTERIZATION; WILD CARNIVORES; GUT SYMBIONT; MATO-GROSSO; ONE HEALTH | The Bartonella species are zoonotic agents that infect mammals and are transmitted by arthropod vectors. Approximately 18 distinct genotypes cause diseases in humans, and may be spread by both domestic and wild animals. In Brazil, Bartonella genotypes have been identified in several species of wild mammals, and in the present study, we analyzed samples from non-human primates (marmosets), marsupials, rodents, and bats, and compared them with the genotypes described in mammals from Brazil, to examine the distribution of Bartonella genotypes in two impacted areas of Rio de Janeiro state, in southeastern Brazil. We used polymerase chain reaction (PCR) methods to detect the Bartonella DNA using partial sequences of the gltA, ftsZ, and groEL genes. We generated Bayesian inference and maximum likelihood trees to characterize the positive PCR samples and infer the phylogenetic relationships of the genotypes. A total of 276 animals were captured, including 110 bats, 91 rodents, 38 marsupials, and 37 marmosets. The DNA of Bartonella was amplified from tissue samples collected from 12 (4.34%) of the animals, including eight rodents -Akodon cursor (5/44) and Nectomys squamipes (3/27) – and four bats, Artibeus lituratus (3/58) and Carollia perspicillata (1/15). We identified Bartonella genotypes closely related to those described in previous studies, as well as new genotypes in both the rodent and the bat samples. Considering the high diversity of the Bartonella genotypes and hosts identified in the present study, further research is needed to better understand the relationships between the different Bartonella genotypes and their vectors and host species. The presence of Bartonella in the wild rodents and bats from the study area indicates that the local human populations may be at risk of infection by Bartonella due to the spillover of these strains from the wild environment to domestic and peri-domestic environments. |
| Air; Metagenomics; Resistome; Microbiome; Farm; One health | ANTIBIOTIC-RESISTANCE GENES; SOIL; EXPOSURE | Background: Livestock farms are a reservoir of antimicrobial resistant bacteria from feces. Airborne dust-bound bacteria can spread across the barn and to the outdoor environment. Therefore, exposure to farm dust may be of concern for animals, farmers and neighboring residents. Although dust is a potential route of transmission, little is known about the resistome and bacterial microbiome of farm dust. Objectives: We describe the resistome and bacterial microbiome of pig and poultry farm dust and their relation with animal feces resistomes and bacterial microbiomes, and on-farm antimicrobial usage (AMU). In addition, the relation between dust and farmers’ stool resistomes was explored. Methods: In the EFFORT-study, resistomes and bacterial microbiomes of indoor farm dust collected on Electrostatic Dust fall Collectors (EDCs), and animal feces of 35 conventional broiler and 44 farrow-to-finish pig farms from nine European countries were determined by shotgun metagenomic analysis. The analysis also included 79 stool samples from farmers working or living at 12 broiler and 19 pig farms and 46 human controls. Relative abundance of and variation in resistome and bacterial composition of farm dust was described and compared to animal feces and farmers’ stool. Results: The farm dust resistome contained a large variety of antimicrobial resistance genes (ARGs); more than the animal fecal resistome. For both poultry and pigs, composition of dust resistomes finds (partly) its origin in animal feces as dust resistomes correlated significantly with fecal resistomes. The dust bacterial microbiome also correlated significantly with the dust resistome composition. A positive association between AMU in animals on the farm and the total abundance of the dust resistome was found. Occupational exposure to pig farm dust or animal feces may contribute to farmers’ resistomes, however no major shifts in farmers resistome towards feces or dust resistomes were found in this study. Conclusion: Poultry and pig farm dust resistomes are rich and abundant and associated with the fecal resistome of the animals and the dust bacterial microbiome. |
| CORONAVIRUS SPIKE PROTEIN; SARS-CORONAVIRUS; VERVET MONKEYS; COVID-19; REHABILITATION; CONSERVATION; ACTIVATION; HUMANS; GENOME; GREEN | The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, has devastated health infrastructure around the world. Both ACE2 (an entry receptor) and TMPRSS2 (used by the virus for spike protein priming) are key proteins to SARS-CoV-2 cell entry, enabling progression to COVID-19 in humans. Comparative genomic research into critical ACE2 binding sites, associated with the spike receptor binding domain, has suggested that African and Asian primates may also be susceptible to disease from SARS-CoV-2 infection. Savanna monkeys (Chlorocebusspp.) are a widespread non-human primate with well-established potential as a bi-directional zoonotic/anthroponotic agent due to high levels of human interaction throughout their range in sub-Saharan Africa and the Caribbean. To characterize potential functional variation in savanna monkeyACE2andTMPRSS2, we inspected recently published genomic data from 245 savanna monkeys, including 163 wild monkeys from Africa and the Caribbean and 82 captive monkeys from the Vervet Research Colony (VRC). We found several missense variants. One missense variant inACE2(X:14,077,550; Asp30Gly), common inCh.sabaeus, causes a change in amino acid residue that has been inferred to reduce binding efficiency of SARS-CoV-2, suggesting potentially reduced susceptibility. The remaining populations appear as susceptible as humans, based on these criteria for receptor usage. All missense variants observed in wildCh.sabaeuspopulations are also present in the VRC, along with two splice acceptor variants (at X:14,065,076) not observed in the wild sample that are potentially disruptive to ACE2 function. The presence of these variants in the VRC suggests a promising model for SARS-CoV-2 infection and vaccine and therapy development. In keeping with a One Health approach, characterizing actual susceptibility and potential for bi-directional zoonotic/anthroponotic transfer in savanna monkey populations may be an important consideration for controlling COVID-19 epidemics in communities with frequent human/non-human primate interactions that, in many cases, may have limited health infrastructure. |
| Veterinary Teaching Hospital; Endoparasites; Fecal examination; Epidemiology; Risk factors; Pets; Canada | INTESTINAL PARASITES; ECHINOCOCCUS-MULTILOCULARIS; GASTROINTESTINAL PARASITES; ZOONOTIC PARASITES; PET DOGS; PREVALENCE; INFECTIONS; EPIDEMIOLOGY; ZOONOSES; GIARDIA | Although many studies on the frequency of endoparasites in dogs and cats in Canada have been reported, seasonal and/or annual patterns are often not evaluated. The frequency and risk factors of endoparasite infections from fecal samples of cats and dogs submitted to the Veterinary Teaching Hospital of the Atlantic Veterinary College, University of Prince Edward Island-Canada were determined, using univariable and multivariable logistic regression analyses. Investigated predictors of endoparasitism available in the 2000-2017 database included sex, age, geographic origin and seasonality. A total of 15,016 dogs and 2,391 cats were evaluated for endoparasite status using specific diagnostic tests: direct smear, Baermann, and/or 33 % zinc sulfate solution in a standardized centrifugal flotation method. Overall, twelve and eight parasite genera were detected in dogs and cats, respectively. The overall proportional infection was 14.6 %, and the cat population showed a higher frequency of positivity to parasites compared to the dog population (P < 0.001). The most frequent genera recovered in the whole population (dogs and cats), were Giardia duodenalis (5.2 %), Cystoisospora spp. (3.3 %) and Toxocara spp. (3.2 %). Endoparasitism levels were diagnosed more in feces submitted from young, female intact dogs from PEI compared to the baselines of mature, sterilized male dogs from other provinces, respectively, and diagnoses occurred more often in autumn months than in winter months. There was no significant diagnostic trend across the years for the individual parasites models. The frequency of detected potentially zoonotic parasites in this study highlights the veterinary public health and One Health context of parasitic infections in pets. Although the presented results are not from a random sample and therefore frequency results should be interpreted with caution, the model relationship results may still be relevant. In addition, results are of value to estimate parasite impact and to assist researchers, veterinarians and pet-owners with suitable information to control parasites. |
| Ctenocephalides felis; Democratic Republic of Sao Tome and Principe; Rickettsia felis; Tunga penetrans | FLEAS SIPHONAPTERA PULICIDAE; ACUTE FEBRILE ILLNESS; COLONIZED CAT FLEAS; MOLECULAR-IDENTIFICATION; BARTONELLA-QUINTANA; BORNE RICKETTSIOSES; MURINE TYPHUS; TICK-BORNE; MALARIA; TRANSMISSION | Rickettsia felis is an obligate intracellular Gram-negative bacterium which causes flea-borne spotted fever in humans. In the past decades, R. felis has been detected worldwide in Ctenocephalides felis fleas and various other arthropods. However, due to its shared symptoms with other common vector-borne diseases, human infection is prone to be underestimated or misdiagnosed, especially in the malaria-endemic areas including sub-Saharan Africa, where confirmatory laboratory diagnoses are not usually available. In this study, a ‘One Health’ approach was adopted to explore potential vector-borne and zoonotic pathogens in the Democratic Republic of Sao Tome and Principe (DRSTP), an island nation in the Gulf of Guinea. By collaborating with local veterinarians, 1,187 fleas were collected from 95 domestic dogs across the country and later identified as Ct. felis using taxonomic keys. A cytochrome oxidase gene-based phylogenetic analysis revealed that all collected fleas belonged to a single haplotype and were identical to isolates from Ivory Coast and Brazil that clustered into a clade of tropical distribution. Additional samples of 14 chigoe fleas (Tunga penetrans) were collected from the surrounding environment of the dogs’ resting spots. Rickettsia felis infection in fleas was examined by molecular methods targeting the citrate synthase (gltA)- and outer membrane protein A (ompA)-coding genes as well as the R. felis-specific pRF plasmid. The bacterial DNA was detected in 21.01% (146/695) of cat fleas but none of the chigoe fleas. Microimmunofluorescence assay was then performed to assess pathogen exposure of the residents. Of 240 dried blood spots from participants with dog contacts, 8 (3.33%) exhibited R. felis antibodies. Our findings demonstrated the presence of R. felis in DRSTP. Further extensive epidemiological studies regarding its prevalence and its role in causing febrile illness while the nation is entering pre-elimination stage of malaria will be carried out. |
| Staphylococcus pseudintermedius; canine skin disorder; essential oils; MIC; MBC | LEPTOSPERMUM-SCOPARIUM; ANTIBACTERIAL; MANUKA; ANTIOXIDANT; CINNAMON; EFFICACY; EXTRACT; EUROPE | Simple Summary Pyoderma is one of the most common diseases in dogs, and Staphylococcus pseudintermedius, a Gram-positive coagulase-positive bacterium, represents the most common infectious agent causing canine pyoderma. Since multidrug-resistant S. pseudintermedius strains have become a relevant threat in veterinary medicine, this study aimed to test the antimicrobial properties of some essential oils (EOs) against S. pseudintermedius strains isolated from dogs suffering from pyoderma. The obtained findings demonstrated a clear in vitro efficacy of some tested EOs against clinical methicillin-resistant and methicillin-sensible S. pseudintermedius strains. The applicability and efficacy of EOs in cases of canine pyoderma supported by S. pseudintermedius could be beneficial for both dogs and pet owners, who are inevitably exposed to this zoonotic bacterium. This study aimed to test in vitro the antimicrobial activity of 11 essential oils (EOs) against four methicillin-resistant Staphylococcus pseudintermedius (MRSP) and four methicillin-susceptible S. pseudintermedius (MSSP) clinical isolates. The obtained findings demonstrated a clear in vitro efficacy of some tested EOs against both MRSP and MSSP strains. Particularly, modal minimum inhibitory concentration (MIC) values ranging from 1:2048 v/v for Melissa officinalis against an MSSP strain to 1:256 v/v for Cymbopogon citratus against all MRSP strains were observed. The best results, highlighting a modal MIC value of 1:1024 v/v for all tested isolates, was provided by Cinnamomum zeylanicum. Intriguingly, Cinnamomum zeylanicum showed, in many cases, a correspondence between minimum bactericidal concentration (MBC) and MIC values, indicating that the inhibiting dose is also often bactericidal. Moreover, a mild antibacterial and bactericidal activity against both MRSP and MSSP isolates was detected for the other tested EOs. Considering the zoonotic potential of S. pseudintermedius and the increased dissemination of multidrug-resistant strains, the employment of EOs could be useful for the treatment of canine pyoderma. Since antibiotic resistance has become the most urgent issue, from the perspective of the One Health initiative, alternative therapeutic approaches are desirable to limit the use of antibiotics or to improve the efficacy of conventional therapies. |
| Health-related quality of life; EQ-5D-3L; Perceived needs | DISEASE; BURDEN; FATIGUE; ASSOCIATION; DEPRESSION; DISABILITY; SYMPTOMS; INSIGHTS; IMPACT; COSTS | Background: People with MS are a heterogeneous population with varying difficulties and needs that are influenced by the individual experience of the disease, symptoms and disease course. The aim of the present study was to identify factors that influence health-related quality of life in a sample of subjects with MS, specifically health and social care-related needs and demographic and disease characteristics. Methods: Individuals with a definite diagnosis of MS were identified through MS out-patient clinics and local branches of the Italian MS Society. The EQ-5D-3L utility index was used to describe health profiles and as an overall measure of perceived HRQoL. The number of unmet health and social care-related needs was used to describe the impact of unmet needs on HRQoL. Multiple regression analyses were performed using a hierarchical approach. Results: Data was analyzed from 1013 subjects. Overall, 83% of subjects reported at least one health or social care-related need as being unmet and subjects with a higher number of unmet needs had lower HRQoL (p < 0.001). The number of unmet needs was entered at the first step with a statistically significant effect (Cox-Snell R-2 0.15, BIC 870.9, AIC 851.2). Clinical variables, included in the second step, contributed significantly to explaining the variability between models (Cox-Snell R-2 0.43, BIC 481.0, AIC 446.6), and the addition of sociodemographic factors further accounted for variability (Cox-Snell R-2, 0.46, BIC 461.0, AIC 402.0). Conclusions: The study demonstrated that a higher number of both health and social care-related unmet needs predicted lower HRQoL. The health profile of the sample identified all domains of the EQ-5D-3L as being important in determining HRQoL. Data confirms that unmet needs alone are significantly related to reduced HRQoL, although the multifactorial and complex nature of MS makes it a challenge to identify the combination of aspects that fully predict variability in quality of life. |
| COVID-19; global change; ocean literacy; protection; social norms; sustainability | CORAL-REEF FISH; SEA-LEVEL RISE; CLIMATE-CHANGE; MARINE RESERVES; MASS EXTINCTION; ANTHROPOGENIC NITROGEN; CONSERVATION OUTCOMES; AREAS; COASTAL; BIODIVERSITY | 1. The ocean is the linchpin supporting life on Earth, but it is in declining health due to an increasing footprint of human use and climate change. Despite notable successes in helping to protect the ocean, the scale of actions is simply not now meeting the overriding scale and nature of the ocean’s problems that confront us. 2. Moving into a post-COVID-19 world, new policy decisions will need to be made. Some, especially those developed prior to the pandemic, will require changes to their trajectories; others will emerge as a response to this global event. Reconnecting with nature, and specifically with the ocean, will take more than good intent and wishful thinking. Words, and how we express our connection to the ocean, clearly matter now more than ever before. 3. The evolution of the ocean narrative, aimed at preserving and expanding options and opportunities for future generations and a healthier planet, is articulated around six themes: (1) all life is dependent on the ocean; (2) by harming the ocean, we harm ourselves; (3) by protecting the ocean, we protect ourselves; (4) humans, the ocean, biodiversity, and climate are inextricably linked; (5) ocean and climate action must be undertaken together; and (6) reversing ocean change needs action now. 4. This narrative adopts a ‘One Health’ approach to protecting the ocean, addressing the whole Earth ocean system for better and more equitable social, cultural, economic, and environmental outcomes at its core. Speaking with one voice through a narrative that captures the latest science, concerns, and linkages to humanity is a precondition to action, by elevating humankind’s understanding of our relationship with ‘planet Ocean’ and why it needs to become a central theme to everyone’s lives. We have only one ocean, we must protect it, now. There is no ‘Ocean B’. |
| animal-encounter fatalities; animal-encounter deaths; bites and stings; underlying cause of death; multiple cause of death; death certification; misreporting; miscoding; One Health | PASTEURELLA-MULTOCIDA; NONVENOMOUS ANIMALS; INJURIES; COMPLETION; ACCURACY; BITE | Objectives Errors and misreporting on death certificates are common, along with potential inaccuracies in cause-of-death coding. We characterized and compared fatalities by animal-encounter mentions reported as underlying cause of death (UCD) with animal-encounter mentions reported as multiple cause of death (MCD) to determine factors associated with misreporting UCD. Methods We analyzed fatality data from 1999-2016 from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research by UCD and MCD animal-encounter mentions (International Classification of Diseases, 10th Revisioncodes W53-59, X20-27 and X29, T63.0-63.6, T63.8-63.9, and T78.2-78.4). We examined differences in reporting by age, sex, race, autopsy (yes, no, unknown), allergic reactions, and toxicities. Results The number of animal-encounter mentions by UCD was 3638 (202 average per year) and by MCD was 4280 (238 average per year), a difference of 18% (n = 642; 36 average per year) by MCD analysis. The number of nonvenomous animal-encounter mentions increased 20% (from 2138 UCD to 2567 MCD), and the number of venomous animal-encounter mentions increased 14% (from 1500 UCD to 1713 MCD). Decedents aged >= 65 had the highest additional number of animal-encounter mentions among all age groups, primarily encounters with other reptiles (n = 113), other mammals (n = 71), and dogs (n = 42). Of 642 MCD additional animal-encounter mentions, heart disease (n = 211, 33%) and infections (n = 146, 23%) represented more than half of the UCD. Of 553 dog-encounter fatalities, 165 (30%) were among children aged <= 4. Conclusions Animal-encounter fatalities, analyzed by UCD alone, may be underreported. An initiating animal injury, complicated by comorbidities and fatality, may obscure the causal chain, resulting in misreporting UCD. Ongoing training for medical certifiers is recommended, highlighting accurate identification of UCD and contributing causes in the causal chain of death. |
| RESISTANT KLEBSIELLA-PNEUMONIAE; ESCHERICHIA-COLI; BETA-LACTAMASE; ANIMALS; HUMANS; MCR-1; TRANSMISSION; POLYMYXINS; PLASMIDS | Objectives: Intestinal colonization with extended-spectrum cephalosporin-resistant (ESC-R) and colistin-resistant (CST-R) Enterobacterales (Ent) can be driven by contact with colonized animals and/or contamination of the food chain. We studied the ESC-R-Ent and COL-R-Ent colonizing poultry as well as contaminating chicken meat in Zanzibar (Tanzania). Results were compared with recently published data obtained from rectal swabs of people in the community. Methods: During June and July 2018, we collected poultry faecal material (n = 62) and retail chicken meat (n = 37) samples. ESC-R and CST-R strains were isolated implementing selective approaches and characterized with different molecular methods, including WGS coupled with core-genome analyses. Results: The prevalence of ESC-R-Ent and CST-R-Ent, respectively, were: 88.7% and 48.4% in poultry; and 43.2% and 18.9% in chicken meat. Overall, the following strains and main resistance mechanisms were found in the two settings: 69 ESC-R Escherichia coli (CTX-M-15 subgroup, 75%), 34 ESC-R Klebsiella pneumoniae (CTX-M-9 group, 54.5%), 24 non-ESC-R but CST-R E. coli (mcr-1, 95.8%) and 17 non-ESC-R but CST-R K. pneumoniae (D150G substitution in PhoQ). Several clones (differing by only 0-13 single nucleotide variants) were concomitantly and frequently found in human and non-human settings: mcr-1-carrying E. coli ST46; CTX-M-15-producing E. coli ST361; CTX-M-14-producing K. pneumoniae ST17; and CTX-M-15-producing K. pneumoniae ST1741. Conclusions: This is one of the few studies that have assessed the occurrence of identical MDR Enterobacterales in human and non-human settings. The frequent human gut colonization observed in the community might be favoured by the spread of ESC-R-Ent and CST-R-Ent in poultry and chicken meat. Further studies with a One Health approach should be carried out to better investigate this phenomenon. |
| Lookback period; Pre-observation; Wash-out period; Claims data; Selectivity; Incidence; Socioeconomic status; Age structure; Social gradient | ACUTE MYOCARDIAL-INFARCTION; ADMINISTRATIVE DATA; SURVIVAL; EVENTS; STROKE; TRENDS | Background Defining incident cases has always been a challenging issue for researchers working with routine data. Lookback periods should enable researchers to identify and exclude recurrent cases and increase the accuracy of the incidence estimation. There are different recommendations for lookback periods depending on a disease entity of up to 10 years. Well-known drawbacks of the application of lookback periods are shorter remaining observation period in the dataset or smaller number of cases. The problem of selectivity of the remaining population after introducing lookback periods has not been considered in the literature until now. Methods The analyses were performed with pseudonymized claims data of a German statutory health insurance fund with annual case numbers of about 2,1 million insured persons. Proportions of study population excluded due to the application of lookback periods are shown according to age, occupational qualification and income. Myocardial infarction and stroke were used to demonstrate changes in incidence rates after applying lookback periods of up to 5 years. Results Younger individuals show substantial dropouts after the application of lookback periods. Furthermore, there are selectivities regarding occupational qualification and income, which cannot be handled by age standardization. Due to selective dropouts of younger individuals, crude incidence rates of myocardial infarction and stroke increase after applying lookback periods. Depending on the income group, age-standardized incidence rates changed differentially, leading to a decrease and possible underestimation of the social gradient after applying lookback periods. Conclusions Selectivity analyses regarding age and sociodemographic structure should be performed for the study population after applying lookback periods since the selectivity can affect the outcome especially in health care research. The selectivity effects might occur not only in claims data of one health insurance fund, but also in other longitudinal data with left- or right-censoring not covering the whole population. The effects may also apply to health care systems with a mix of public and private health insurance. A trade-off has to be considered between selectivity effects and eliminating recurrent events for more accuracy in the definition of incidence. |
| Pregnancy; Domestic violence; Intervention; Screening | INTIMATE PARTNER VIOLENCE; OUTCOMES; PROGRAM; WOMEN | To assess the impact of a brief training for obstetricians and midwives about screening for domestic violence during pregnancy follow-up and to identify barriers to a routine enquiry. A monocentric quasi-experimental study was performed in an obstetrics department in Paris, France. We asked patients during their pregnancy follow-up to complete a survey describing their demographic characteristics. They were also asked if a health professional had screened them for domestic violence during the current pregnancy. Exclusion criteria were refusal and inability to complete the survey alone. Health professionals attended a brief training about domestic violence. The intervention provided general information about domestic violence to alert health professionals (prevalence, risk factors, consequences on women’s health, pregnancy, and children) and guidelines on screening and how to deal with women disclosing domestic violence. They also had to complete a survey about their knowledge and practice concerning domestic violence. Two months later, patients consulting for their pregnancy follow-up completed the same survey. Health professionals were not aware of the study’s aim throughout its course. The primary outcome was the rate of patients screened for domestic violence during pregnancy follow-up. The secondary outcome was the identification of barriers to a routine enquiry. Four hundred ninety-five patients completed the first survey (control group): 21 patients (4.8%) had been screened for domestic violence. Twenty-one health professionals attended the intervention. Eight (38.1%) stated that they never screened for domestic violence, and 3 (14.3%) stated that they always did. Three hundred ninety-five patients completed the second survey (experimental group): 17 patients (4.3% vs 4.8%,p = 0.53) stated that they had been screened for domestic violence. The main barriers to screening mentioned by health professionals were the presence of the partner, the lack of awareness of the need to screen, uncomfortable feelings, and the difficulty to identify victims. There was no increased screening for domestic violence during pregnancy follow-up after a brief training of obstetricians and midwives. An early training during medical studies or more extensive training for professionals could be more efficient. |
| Mental health care; Inpatient care; Pre-post study; Patient autonomy; User participation; Severe mental disorders; Admission procedures | CONTROLLED HOSPITAL ADMISSION; HEALTH | Background Mental health professionals usually decide patients’ access to inpatient care to ensure the rational and fair distribution of care based on need and prognosis. The purpose of the current study is to investigate the effects of increasing patients’ influence on admission by enabling patients to initiate brief inpatient stays of up to five days at a community mental health center. Patients can initiate admission according to their own discretion, outside the existing referral and gatekeeping system. Methods Patient-controlled admission (PCA) contracts were offered to eligible patients for inpatient stays in four community mental health centers in one health trust in Norway. Data on included patients’ inpatient stays at any of the hospitals’ mental health or addiction wards were collected by hospital electronic journal data extraction specialists for the two years before PCA contracts were introduced and the first two years after PCA contracts were introduced for the included patients. Results The included patients (n = 57) had 406 PCAs in the two years following signing PCA contracts. When comparing the periods before and after the introduction of the contracts, the total number of admissions increased from 203 to 498 (p < .001), while the number of inpatient days decreased from 7172 to 3178 (p < .001). No significant change in involuntary care was observed. A comparison of box plots of inpatient day use in the eight half-year periods of the study indicates a gradual increase in median inpatient days up to the signing of a PCA contract for the sample, and an abrupt reduction to a stable median level of inpatient days after signing a contract. Conclusions The included patients’ use of inpatient days changed profoundly after signing PCA contracts, similar to what previous studies of PCAs have indicated. In spite of the marked reductions in inpatient days, the pre-post design makes it impossible to rule out that the reductions were caused by regression toward the mean. No study of PCAs has reported negative effects, indicating that giving patients control over very short admissions is a feasible and potentially positive scheme in mental health care wards. |
| Brucella canis; canine brucellosis; canine infertility; qPCR; whole-genomic sequencing; zoonosis; stray dogs; genomic characterization | INFECTION; SEROPREVALENCE; PROTEINS; EXPOSURES; DIAGNOSIS; OUTBREAK; ABORTUS; VACCINE; CITY; PCR | Simple Summary Canine brucellosis caused by Brucella canis is a zoonotic disease that is considered the main infectious cause of infertility and reproductive failure in dogs worldwide, particularly in Latin America. Reports of B. canis infection in people have increased, especially in people who work with dogs and their owners, where the adoption of stray dogs poses a public health risk. Thus, this study determined the prevalence of infection in kennels, household, and stray dogs in the Metropolitan region, Chile, recording the genomic characteristics of the isolated circulating strains. Our results demonstrate that the infection is widespread in the three canine populations analyzed, with no differences in age or sex, and most of the infected animals do not show clinical signs or bacteremia. Furthermore, the high genetic similarity of the isolated strains suggests a common transmission route throughout the country. This study corroborates the need to implement official strategies for the control and prevention of B. canis infection, including sanitary, diagnostic, and educational measures under the One Health vision. Canine brucellosis caused by Brucella canis is a zoonotic disease that causes reproductive alterations in dogs, such as infertility, abortion, and epididymitis. This pathogen is especially prevalent in South America, and due to the lack of official control programs and the growing trend of adopting dogs it constitutes a public health risk that must be addressed. The aim of this study was to determine the prevalence of B. canis infection in kennel, shelter, and household dogs and to characterize the genomic properties of circulating strains, including ure and virB operons and omp25/31 genes. Samples from 771 dogs were obtained, and the infection was detected by blood culture and/or serology in 7.0% of the animals. The complete ure and virB operons and the omp25/31 genes were detected. Interestingly, we found different single-nucleotide polymorphisms (SNPs) in some of the analyzed genes, which could mean a change in the fitness or virulence of these strains. This study provides further evidence about dogs as a source of B. canis strains that can infect people. This also highlights the need to implement official control programs, including the mandatory testing of dogs, especially stray dogs, before adoption. |
| communicable disease control; Coxiella burnetii infection; international health regulations; one health; outbreaks; Q fever | COXIELLA-BURNETII INFECTION | Background Following outbreaks in other parts of the Netherlands, the Dutch border region of South Limburg experienced a large-scale outbreak of human Q fever related to a single dairy goat farm in 2009, with surprisingly few cases reported from neighbouring German counties. Late chronic Q fever, with recent spikes of newly detected cases, is an ongoing public health concern in the Netherlands. We aimed to assess the scope and scale of any undetected cross-border transmission to neighbouring German counties, where individuals unknowingly exposed may carry extra risk of overlooked diagnosis. Methods (A) Seroprevalence rates in the Dutch area were estimated fitting an exponential gradient to the geographical distribution of notified acute human Q fever cases, using seroprevalence in a sample of farm township inhabitants as baseline. (B) Seroprevalence rates in 122 neighbouring German postcode areas were estimated from a sample of blood donors living in these areas and attending the regional blood donation centre in January/February 2010 (n = 3,460). (C) Using multivariate linear regression, including goat and sheep densities, veterinary Q fever notifications and blood donor sampling densities as covariates, we assessed whether seroprevalence rates across the entire border region were associated with distance from the farm. Results (A) Seroprevalence in the outbreak farm’s township was 16.1%. Overall seroprevalence in the Dutch area was 3.6%. (B) Overall seroprevalence in the German area was 0.9%. Estimated mean seroprevalence rates (per 100,000 population) declined with increasing distance from the outbreak farm (0-19 km = 2,302, 20-39 km = 1,122, 40-59 km = 432 and >= 60 km = 0). Decline was linear in multivariate regression using log-transformed seroprevalence rates (0-19 km = 2.9 [95% confidence interval (CI) = 2.6 to 3.2], 20 to 39 km = 1.9 [95% CI = 1.0 to 2.8], 40-59 km = 0.6 [95% CI = -0.2 to 1.3] and >= 60 km = 0.0 [95% CI = -0.3 to 0.3]). Conclusions Our findings were suggestive of widespread cross-border transmission, with thousands of undetected infections, arguing for intensified cross-border collaboration and surveillance and screening of individuals susceptible to chronic Q fever in the affected area. |
| envenomation; One Health; snakebite; surveillance; venomous snake | EMERGENCY-DEPARTMENTS; VENOMOUS SNAKEBITES; RATTLESNAKE BITES; ENVENOMATION; EPIDEMIOLOGY; MANAGEMENT | Objectives: Venomous and nonvenomous snakes are found throughout the United States. Two families of venomous snakes are indigenous to this country: the Viperidae, or pit vipers (rattlesnakes, cottonmouths, and copperheads), and the Elapidae (three species of coral snakes and a sea snake). Bites from captive nonindigenous venomous snakes such as cobras also may present at medical facilities, given the interest in exotic pet ownership in the United States. Even dry, nonenvenomating snakebites and those from nonvenomous snakes can result in puncture wounds that require medical evaluation. This article presents updated national estimates of snakebite injuries treated in US emergency departments (EDs). Methods: Data on nonfatal snakebite injuries were abstracted from the National Electronic Injury Surveillance System-All Injury Program (2001-2015). Variables included age, sex, body part affected, cause, disposition, and treatment month. The snake species were coded based on narrative comments. Estimates were weighted and analyzed with SAS 9.4. Data on fatal snakebites were obtained from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiological Research (1999-2017). Results: From 2001-2015, an estimated 137,800 snakebite injuries were treated in US EDs (crude rate: 3.0 individuals per 100,000 population). The majority of patients were male (70.7%; crude rate 4.4/100,000 population). Arms/hands (46.8%) and legs/feet (46.1%) were the primary body parts injured. The majority of patients were treated and released (67.1%); however, nearly 30% were hospitalized or transferred to another hospital. Two-thirds of the cases involved a nonvenomous or unknown snake (67.7%). Among venomous encounters, 70.3% involved a rattlesnake. For fatal snakebites, an average of 6 deaths per year was reported (range 2-12). Conclusions: Although rare, nonfatal snakebites in this study resulted in an estimated average of 9192 annual visits to EDs (roughly 1 visit per hour) and an average of 6 fatal snakebites per year. Epidemiologic data on snakebite injuries provide healthcare providers, public health officials, and veterinarians with information on populations at risk for snakebites, species of snakes likely to be encountered, and guidance for prevention efforts. |
| West Nile virus; Culex pipiens; surveillance; infection rate; temperature; one-health | CULEX-TARSALIS DIPTERA; AEDES-ALBOPICTUS; VECTOR COMPETENCE; MOSQUITO VECTOR; PCR ASSAY; RT-PCR; TRANSMISSION; TEMPERATURE; EPIDEMIC; LINEAGES | With several human cases reported annually since 2008 and the unapparent risk of infection of blood donors, the West Nile virus (WNV) is emerging as an important health issue in Europe. Italy, as well as other European countries, experienced a recrudescence of the virus circulation in 2018, which led to an increased number of human cases. An integrated surveillance plan was activated in the Emilia-Romagna and Lombardy regions (Northern Italy) since 2008 in order to monitor the intensity and timing of WNV circulation. A fundamental part of this plan consists in entomological surveillance. In 2018, the surveillance plan made it possible to collect 385,293 mosquitoes in 163 stations in the two Regions. In total 269,147 Culex mosquitoes were grouped into 2,337 pools and tested for WNV, which was detected in 232 pools. Circulation started in the central part of the Emilia-Romagna region in the middle of June, about one month before the previous seasons. Circulation suddenly expanded to the rest of the region and reached the Lombardy region in the middle of July. WNV circulated more intensively in the eastern part of the surveyed area, as confirmed by the highest number of human cases. A relationship between the number of mosquitoes collected and the virus incidence emerged, but the data obtained highlighted that the probability of detecting the virus in a given site was less than expected with a higher number of collected mosquitoes. A significant relationship was observed between the temperature recorded one week before the sampling and the number of collected mosquitoes, as well as between the estimated number of WNV-positive mosquitoes and the temperature recorded two weeks before the sampling. The two weeks delay in the influence of temperature on the positive mosquitoes is in line with the time of the virus extrinsic incubation in the mosquito. This finding confirms that temperature is one of the principal drivers in WNV mosquito infection. The surveillance system demonstrated the ability to detect the virus circulation early, particularly in areas where circulation was more intense. This allowed evaluating the effect of mosquito abundance and weather factors on virus circulation. |
| Dementia; Quality of life; Outcome measurement; Preference-based measures; Proxy | OF-LIFE MEASURE; OLDER-PEOPLE; INSTRUMENTAL ACTIVITIES; CLASSIFICATION-SYSTEM; ALZHEIMERS-DISEASE; COST-EFFECTIVENESS; HEALTH-STATUS; PATIENT; PROXY; EQ-5D | Background Assessing the cost-effectiveness of interventions for people with dementia, based on cost per quality-adjusted life years (QALYs) gained, requires that the measures used to derive QALYs are preference-based whilst also being valid, feasible to use, comprehensible and acceptable for people with dementia. The aim of this study was to assess the content and face validity of six preference-based measures (PBMs) within the context of dementia. Methods Qualitative focus groups and interviews were conducted with community-dwelling individuals with mild dementia and carers of people with dementia. After exploring participants’ understanding of ‘quality of life’ (QoL), six PBMs were assessed for content and face validity: two measures assessing health-related QoL (EQ-5D-5L and AQoL-8D); two covering broader aspects of capability wellbeing and social care-related QoL (ICECAP-O and ASCOT); and two dementia-specific QoL measures (DEMQOL-U and AD-5D). A random mix of one health-related QoL measure, one wellbeing measure, and one dementia-specific measure was explored in each session. All sessions were audiotaped and transcribed verbatim. Data were analysed thematically. Results Nine individuals with mild dementia and 17 carers of people with dementia participated across 4 focus groups and 10 interviews. Participants perceived 9 broad QoL domains as relevant to them: Activity, Autonomy, Cognition, Communication, Coping, Emotions, End-of-Life, Physical Functioning, and Relationships. These domains had limited overlap with the content of the six PBMs. Assessment of face validity was summarized into eight themes: (1) ambiguous questions, (2) double -barrelled questions, (3) difficult/abstract questions, (4) judgemental/confronting questions, (5) lack of relevance and comprehensiveness, (6) response options, (7) layout/format and (8) proxy-response. There was no clear preference for one of the six measures explored; participants identified advantages and disadvantages across all measures. Although particularly designed for individuals with dementia, dementia-specific QoL measures were not always favoured over non-specific measures. Conclusion Given the shortcomings of PBMs identified in this study, further empirical comparative analyses are necessary to guide the selection of PBMs for future dementia research. |
| paralytic shellfish toxins; benthic organisms; starfish; saxitoxins; sunstar; sea chervil | CRAB CANCER-PAGURUS; ALEXANDRIUM-FUNDYENSE CYST; HARMFUL ALGAL BLOOMS; POISONING TOXINS; RESTING CYSTS; GYMNODINIUM-CATENATUM; LIQUID-CHROMATOGRAPHY; HIROSHIMA PREFECTURE; TRANSFORMING ENZYME; FORAGING BEHAVIOR | In early 2018, a large easterly storm hit the East Anglian coast of the UK, colloquially known as the ‘Beast from the East’, which also resulted in mass strandings of benthic organisms. There were subsequent instances of dogs consuming such organisms, leading to illness and, in some cases, fatalities. Epidemiological investigations identified paralytic shellfish toxins (PSTs) as the cause, with toxins present in a range of species and concentrations exceeding 14,000 mu g STX eq./kg in the sunstarCrossaster papposus. This study sought to better elucidate the geographic spread of any toxicity and identify any key organisms of concern. During the summers of 2018 and 2019, various species of benthic invertebrates were collected from demersal trawl surveys conducted across a variety of locations in the North Sea. An analysis of the benthic epifauna using two independent PST testing methods identified a ‘hot spot’ of toxic organisms in the Southern Bight, with a mean toxicity of 449 mu g STX eq./kg. PSTs were quantified in sea chervil (Alcyonidium diaphanum), the first known detection in the phylum bryozoan, as well as eleven other new vectors (>50 mu g STX eq./kg), namely the opisthobranchScaphander lignarius, the starfishAnseropoda placenta, Asterias rubens, Luidia ciliaris,Astropecten irregularisandStichastrella rosea, the brittlestarOphiura ophiura, the crustaceansAtelecyclus rotundatusandMunida rugosa, the sea mouseAphrodita aculeata, and the sea urchinPsammechinus miliaris. The two species that showed consistently high PST concentrations wereC. papposusandA. diaphanum. Two toxic profiles were identified, with one dominated by dcSTX (decarbamoylsaxitoxin) associated with the majority of samples across the whole sampling region. The second profile occurred only in North-Eastern England and consisted of mostly STX (Saxitoxin) and GTX2 (gonyautoxin 2). Consequently, this study highlights widespread and variable levels of PSTs in the marine benthos, together with the first evidence for toxicity in a large number of new species. These findings highlight impacts to ‘One Health’, with the unexpected sources of toxins potentially creating risks to animal, human and environmental health, with further work required to assess the severity and geographical/temporal extent of these impacts. |
| Health inequalities; Physical growth trend; Economic reform; Guangzhou city | NUTRITION TRANSITION; HEALTH; ADOLESCENTS; HEIGHT; URBAN; SHANDONG; STATURE; WEIGHT; CITIES | BackgroundGreat growth inequalities between urban and rural areas have been reported in China over the past years. By examining urban/rural inequalities in physical growth among children <7years old over the past three decades from 1985 to 2015 in Guangzhou, we analyzed altering trends of anthropometric data in children and their association with economic development during the period of rapid urbanization in Guangzhou.MethodsThe height, body weight and nutrition status of children under 7years old were obtained from two successive cross-sectional surveys and one health surveillance system. Student’s t-test, Spearman’s rank-order correlation and polynomial regression were used to assess the difference in physical growth between children in urban and rural areas and the association between socioeconomic index and secular growth changes.ResultsA height and weight difference was found between urban and rural children aged 0-6years during the first two decades of our research (1985-2005), which gradually narrowed in both sex groups over time. By the end of 2015, elder boys (age group <greater than or equal to>5year) and girls (age group >= 4year) in rural areas were taller than their counterparts in urban areas (p<0.05).The same trend could be witnessed in the weight of children aged 6years, with a-1.30kg difference (P=0.03) for boys, and a-0.05 difference (P=0.82) for girls. When GDP increased, the gap in boys’ weight-for-age z-score (WAZ from 0.25 to 0.01) and height-for-age z-score (HAZ from 0.55 to 0.03) between urban and rural areas diminished, and disappeared when the GDP per capita (USD) approached 25,000. In either urban or rural areas, the urbanization rate and GDP were positively associated with the prevalence of obesity (all R>0.90 with P<0.05) and negatively correlated with the prevalence of stunted growth (all R<-0.87 with P<0.05).ConclusionGrowth inequalities gradually decreased with economic development and urbanization, while new challenges such as obesity emerged. To eliminate health problems due to catch-up growth among rural children, comprehensive intervention programs for early child growth should be promoted in rural areas. |
| Avian influenza; One health; Poultry; Knowledge; Attitudes; And practices; Farmers; Commercial farm; Biosecurity; Nepal | WORKERS; ANTIBODIES | Avian influenza (AI) is a global health obstacle of critical concern as novel viruses are capable of initiating a pandemic. Recent spillover events of AI into human populations have occurred at human-poultry food system interfaces. As Nepal’s poultry sector transitions to more intensified commercial production systems, it is important to examine the epidemiology of AI and the knowledge, attitudes and practices (KAP) of poultry sector workers. We conducted a cross-sectional KAP study utilizing a structured survey to interview 150 commercial poultry farmers in Chitwan District, Nepal. All commercial poultry farmers had knowledge of AI previous to the study and the majority farmers were able to identify farm-farm and poultry-human transmission mechanisms of AI. Farmers had more knowledge surrounding poultry AI symptoms as compared to human AI symptoms. Most farmers believe that AI is serious, contagious and a threat to everyone, yet only half believe it can be prevented. Individual-level personal protective equipment (PPE) uptake, such as facemask, glove and boot usage, on the enrolled farms was low and farm-level biosecurity practices varied greatly. Nine commercial poultry farms (6%) self-reported having an HPAI outbreak and 60 farms (40%) self-reported having an LPAI outbreak in the past 5 years. Layer farms had higher odds (OR: 5.4, 95% CI: 2.3-12.8) of self-reported LPAI as compared broiler farms. Poultry sector farmers face multiple obstacles when attempting to report AI to government authorities such as the fear of flock culling and the perceived lack of monetary compensation for culling. Our study provides updated KAP surrounding AI of farmers and self-reported AI farm-level epidemiology in Nepal’s highest density commercial poultry production district. Commercial poultry farmers are fairly knowledgeable on AI, but do not take further protective practice efforts to implement their knowledge and prevent AI. Due to the potential role that human-poultry interfaces may play in AI emergence, it is critical to collaborate with the commercial poultry industry when planning and conducting AI pandemic preparedness mechanisms. |
| ESCHERICHIA-COLI; ANTIBIOTIC USE; ONE HEALTH; USAGE; FOOD; PROVINCE; ANIMALS; TRENDS | The nutritional and economic potentials of livestock systems are compromised by the emergence and spread of antimicrobial resistance. A major driver of resistance is the misuse and abuse of antimicrobial drugs. The likelihood of misuse may be elevated in low- and middle-income countries where limited professional veterinary services and inadequately controlled access to drugs are assumed to promote non-prudent practices (e.g., self-administration of drugs). The extent of these practices, as well as the knowledge and attitudes motivating them, are largely unknown within most agricultural communities in low- and middle-income countries. The main objective of this study was to document dimensions of knowledge, attitudes and practices related to antimicrobial use and antimicrobial resistance in livestock systems and identify the livelihood factors associated with these dimensions. A mixed-methods ethnographic approach was used to survey households keeping layers in Ghana (N = 110) and Kenya (N = 76), pastoralists keeping cattle, sheep, and goats in Tanzania (N = 195), and broiler farmers in Zambia (N = 198), and Zimbabwe (N = 298). Across countries, we find that it is individuals who live or work at the farm who draw upon their knowledge and experiences to make decisions regarding antimicrobial use and related practices. Input from animal health professionals is rare and antimicrobials are sourced at local, privately owned agrovet drug shops. We also find that knowledge, attitudes, and particularly practices significantly varied across countries, with poultry farmers holding more knowledge, desirable attitudes, and prudent practices compared to pastoralist households. Multivariate models showed that variation in knowledge, attitudes and practices is related to several factors, including gender, disease dynamics on the farm, and source of animal health information. Study results emphasize that interventions to limit antimicrobial resistance should be founded upon a bottom-up understanding of antimicrobial use at the farm-level given limited input from animal health professionals and under-resourced regulatory capacities within most low- and middle-income countries. Establishing this bottom-up understanding across cultures and production systems will inform the development and implementation of the behavioral change interventions to combat antimicrobial resistance globally. |
| Health economics; Infectious disease; Rabies; Vaccination; Zoonotic diseases; One health; Global health | CANINE RABIES; ELIMINATION; AFRICA; HAITI; CAMPAIGN; EPIDEMIC; TANZANIA; NDJAMENA; AMERICA; UPDATE | Dog-rabies elimination programs have typically relied upon parenteral vaccination at central-point loca-tions; however, dog-ownership practices, accessibility to hard-to-reach sub-populations, resource limita-tions, and logistics may impact a country’s ability to reach the 70% coverage goal recommended by the World Organization for Animal Health (OIE) and World Health Organization (WHO). Here we report the cost-effectiveness of different dog-vaccination strategies during a dog-rabies outbreak in urban and peri- urban sections of Croix-des-Bouquets commune of the West Department, Haiti, in 2016. Three strategies, mobile static point (MSP), mobile static point with capture-vaccinate-release (MSP + CVR), and door-to-door vaccination with oral vaccination (DDV + ORV), were applied at five randomly assigned sites and assessed for free-roaming dog vaccination coverage and total population coverage. A total of 7065 dogs were vaccinated against rabies during the vaccination campaign. Overall, free-roaming dog vaccination coverage was estimated at 52% (47%-56%) for MSP, 53% (47%-60%) for DDV + ORV, and 65% (61%-69%) for MSP + CVR (differences with MSP and DDV + ORV significant at p < 0.01). Total dog vaccination cover-age was 33% (95% CI: 26%-43%) for MSP, 49% (95% CI: 40%-61%) for MSP + CVR and 78% (77%-80%) for DDV + ORV (differences significant at p < 0.001). Overall, the least expensive campaign was MSP, with an esti-mated cost of about $2039 per day ($4078 total), and the most expensive was DDV + ORV with a cost of $3246 per day ($6492 total). Despite the relative high cost of an ORV bait, combining DDV and ORV was the most cost-effective strategy in our study ($1.97 per vaccinated dog), largely due to increased efficiency of the vaccinators to target less accessible dogs. Costs per vaccinated dog were $2.20 for MSP and $2.28 for MSP + CVR. We hope the results from this study will support the design and implementation of effective dog vaccination campaigns to achieve the goal of eliminating dog-mediated human rabies deaths by 2030. (c) 2020 The Author(s). Published by Elsevier Ltd. |
| REDUCED DISLOCATION; THA; HEADS; RISK; CUP; EPIDEMIOLOGY; INSTABILITY; COMPONENT; OUTCOMES; MODELS | Aims The rate of dislocation when traditional single bearing implants are used in revision total hip arthroplasty (THA) has been reported to be between 8% and 10%. The use of dual mobility bearings can reduce this risk to between 0.5% and 2%. Dual mobility bearings are more expensive, and it is not clear if the additional clinical benefits constitute value for money for the payers. We aimed to estimate the cost-effectiveness of dual mobility compared with single bearings for patients undergoing revision THA. Methods We developed a Markov model to estimate the expected cost and benefits of dual mobility compared with single bearing implants in patients undergoing revision THA. The rates of revision and further revision were calculated from the National Joint Registry of England and Wales, while rates of transition from one health state to another were estimated from the literature, and the data were stratified by sex and age. Implant and healthcare costs were estimated from local procurement prices and national tariffs. Quality-adjusted life-years (QALYs) were calculated using published utility estimates for patients undergoing THA. Results At a minimum five-year follow-up, the use of dual mobility was cost-effective with an estimated incremental cost-effectiveness ratio (ICER) of between 3,006 pound and 18,745 pound/QALY for patients aged < 55 years and between 64 and 75 years, respectively. For those aged > 75 years dual mobility was only cost-effective if the timeline was beyond seven years. The use of dual mobility bearings was cost-saving for patients aged < 75 years and cost-effective for those aged > 75 years if the time horizon was beyond ten years. Conclusion The use of dual mobility bearings is cost-effective compared with single bearings in patients undergoing revision THA. The younger the patient is, the more likely it is that a dual mobility bearing can be more cost-effective and even cost-saving. The results are affected by the time horizon and cost of bearings for those aged > 75 years. For patients aged > 75 years, the surgeon must decide whether the use of a dual mobility bearing is a viable economic and clinical option. |
| PMTCT; PMTCT cascade; prevention cascade; data integration; data triangulation; data layering; HIV | CARE CASCADE | Introduction Despite improvements in prevention of mother-to-child transmission (PMTCT) of HIV outcomes, there remain unacceptably high numbers of mother-to-child transmissions (MTCT) of HIV. Programmes and research collect multiple sources of PMTCT data, yet this data is rarely integrated in a systematic way. We conducted a data integration exercise to evaluate the Zimbabwe national PMTCT programme and derive lessons for strengthening implementation and documentation. Methods We used data from four sources: research, Ministry of Health and Child Care (MOHCC) programme, Implementer – Organization for Public Health Interventions and Development, and modelling. Research data came from serial population representative cross-sectional surveys that evaluated the national PMTCT programme in 2012, 2014 and 2017/2018. MOHCC and Organization for Public Health Interventions and Development collected data with similar indicators for the period 2018 to 2019. Modelling data from 2017/18 UNAIDS Spectrum was used. We systematically integrated data from the different sources to explore PMTCT programme performance at each step of the cascade. We also conducted spatial analysis to identify hotspots of MTCT. Results We developed cascades for HIV-positive and negative-mothers, and HIV exposed and infected infants to 24 months post-partum. Most data were available on HIV positive mothers. Few data were available 6-8 weeks post-delivery for HIV exposed/infected infants and none were available post-delivery for HIV-negative mothers. The different data sources largely concurred. Antenatal care (ANC) registration was high, although women often presented late. There was variable implementation of PMTCT services, MTCT hotspots were identified. Factors positively associated with MTCT included delayed ANC registration and mobility (use of more than one health facility) during pregnancy/breastfeeding. There was reduced MTCT among women whose partners accompanied them to ANC, and infants receiving antiretroviral prophylaxis. Notably, the largest contribution to MTCT was from postnatal women who had previously tested negative (12/25 in survey data, 17.6% estimated by Spectrum modelling). Data integration enabled formulation of interventions to improve programmes. Conclusions Data integration was feasible and identified gaps in programme implementation/documentation leading to corrective interventions. Incident infections among mothers are the largest contributors to MTCT: there is need to strengthen the prevention cascade among HIV-negative women. |
| male dairy calf; calf health; auction market; price | BODY-WEIGHT; PRICE; SOLD; MORTALITY; DISEASE; HEALTH; FARM | Male dairy calves in North America are frequently marketed through live auctions. Calves have been observed in suboptimal condition both at auctions and upon arrival at calf-rearing facilities that supply the veal or dairy-beef industries. The objectives of this study were to describe the health of male dairy calves at a commercial auction in British Columbia, Canada, examine the relationships between calf price and condition, and use price data from other auctions to reflect more broadly on the variability in calf condition at auction markets. Price and breed were recorded for 1,624 male calves, and a sample of 355 calves was assessed using a standardized health exam and body weight estimation. Linear regression was used to assess which calf characteristics were associated with price. Prices for young dairy calves at auctions in 2 other provinces (Nova Scotia and Quebec) were compiled for comparison. Twenty percent of calves had at least one health abnormality; the most common was navel disease (12%), followed by ocular or nasal discharge (4%), a depressed (dull, unable, or unwilling to rise) attitude (2%), coughing (2%), and joint inflammation (1%). The mean (+/- SD) estimated body weight was 47 +/- 8 kg with a range of 27 to 82 kg. Calves were sold for up to Can$370 (median Can$140), but 10.5% sold for Can$10 or less, and 2.8% were not sold at all. [The mean exchange rate over the course of this study (Oct. 2017 to Mar. 2018) was Can$1 = US$0.79.] Calves with a depressed attitude sold for lower prices than bright, alert calves. In addition, those with Brown Swiss or Jersey genetics sold for lower prices than those with Holstein genetics, and cross-bred calves with beef genetics sold for higher prices. During 2018, 62% of young dairy calves sold at the Nova Scotia auction and 18% of young Holstein calves sold in Quebec were classed as lower quality and sold for 23% and 40%, respectively, of the value of higher-quality calves. The results under-line the need to develop solutions to reduce the risk of marketing calves in poor condition at auction markets. |
| ESBLs; Enterobacteriaceae; mcr-9.1; South Africa; critical pathogens; colistin resistance | COLISTIN RESISTANCE GENE; ESCHERICHIA-COLI; CARBAPENEM-RESISTANT; PLASMID; COEXISTENCE; MECHANISMS; POLYMYXINS; BACTERIA | Extended-spectrum-beta-lactamase (ESBL)-producing Enterobacteriaceae are critical-priority pathogens that cause substantial fatalities. With the emergence of mobile mcr genes mediating resistance to colistin in Enterobacteriaceae, clinicians are now left with few therapeutic options. Eleven clinical Enterobacteriaceae strains with resistance to cephems and/or colistin were genomically analyzed to determine their resistomes, mobilomes, and evolutionary relationships to global strains. The global phylogenomics of mcr genes and mcr-9.1-bearing genomes were further analyzed. Ten isolates were BBL positive. The isolates were multidrug resistant and phylogenetically related to global clones but distant from local strains. Multiple resistance genes, including bla(CTX-M-15) bla(TE)(M-1), and mcr-9.1, were found in single isolates; ISEc9, IS19, and Tn3 transposons bracketed bla(CTX-M-15) and bla(TEM-1). Common plasmid types included IncF, IncH, and CoIRNAI. mcr-9 was of close sequence identity to mcr-3, mcr-5, mcr-7, mcr-8, and mcr-10. Genomes bearing mcr-9.1 clustered into six main phyletic groups (A to F), with those of this study belonging to Glade B. Enterobacter species and Salmonella species are the main hosts of mcr-9.1 globally, although diverse promiscuous plasmids disseminate mcr-9.1 across different bacterial species. Emergence of mcr-9.1 in ESBL-producing Enterobacteriaceae in South Africa is worrying, due to the restricted therapeutic options. Intensive One Health molecular surveillance might discover other mcr alleles and inform infection management and antibiotic choices. IMPORTANCE Colistin is currently the last-resort antibiotic for difficult-to-treat bacterial infections. However, colistin resistance genes that can move from bacteria to bacteria have emerged, threatening the safe treatment of many bacterial infections. One of these genes, mcr-9.1, has emerged in South Africa in bacteria that are multi-drug resistant, further limiting treatment options for clinicians. In this work, we show that this new gene is disseminating worldwide through Enterobacter and Salmonella species through multiple plasmids. This worrying observation requires urgent action to prevent further escalation of this gene in South Africa and Africa. |
| Bovine tuberculosis; Cattle; Human; Risk factors | MYCOBACTERIUM-BOVIS; ZOONOTIC TUBERCULOSIS; TRANSMISSION; INFECTION; TOBACCO; FARMS; INDIA | Tuberculosis (TB) in humans is primarily caused by Mycobacterium tuberculosis (M. tuberculosis), with millions of infections and hundreds of thousands of deaths worldwide. It creates a substantial economic burden on the community. Unlike M. tuberculosis, Mycobacterium bovis infects cattle and causes bovine TB, also known as zoonotic TB. People can contract zoonotic TB after consumption of unpasteurized dairy products, handling the sick animals, and via occupational exposures. The association between the zoonotic TB in humans and cattle is not well known in Nepal. The study examined the associated risk factors, including exposure to infected cattle, that contribute to TB’s development in human beings in Nepal. The study consists of human and animal subjects. Firstly, a retrospective matched case-control study was conducted at the National Tuberculosis Center (NTC), Bhaktapur, Nepal. A total of 290 people (equal numbers of TB cases and control subjects) were interviewed to obtain information on socio-demographic, behavioral, and occupational risks, including the history of cattle related exposures. Secondly, a cross-sectional study was performed among the cattle owned by the TB-confirmed patients. Comparative tuberculin skin test, rapid antibody test, and ELISA were used in parallel to detect M. bovis infection in cattle. The risk factors for the development of TB in humans were smokers (OR = 4.6, 95% CI: 2.1-10.0, p < 0.001), previous history of TB (OR = 7.9, 95% CI: 3.0-20.6, p < 0.001) and history of cattle exposures (OR = 3.9, 95% CI: 2.1-7.4, p = 0.001). Out of 123 cattle sampled, 12 cattle (9.76%, 95% CI: 5.37-16.76, p < 0.0001) were positive by the tuberculin test, 46 (37.4%, 95% CI: 28.97-46.62, p = 0.007) were tested positive by the rapid test, and 7 (5.7%, 95% CI: 2.52-11.80, p < 0.0001) by ELISA test. The inter-test agreement between the tuberculin and ELISA was very strong (kappa = 0.72, 95% CI: 0.48-0.95, p < 0.01). This study indicates that exposure to infected cattle and socio-demographic risk factors can contribute to the development of TB in human beings. |
| Taenia solium; Cysticercosis; Pigs; Mbeya; Mbozi; Tanzania | TAENIA-SOLIUM; PORCINE CYSTICERCOSIS; PREVALENCE; DIAGNOSIS; EFFICACY; SYSTEMS; RISK | Background Taenia soliumtaeniasis/cysticercosis is a disease of substantial economic and public health importance particularly in low-income countries. The disease was reported to be endemic in Mbeya Rural and Mbozi districts, in the southern highlands of Tanzania, the major pig production area in the country. In 2008, using B158/B60 antigen detection enzyme-linked immunosorbent assay (Ag-ELISA), porcine cysticercosis prevalence of up to 32% was reported in the districts. A number of interventions have been implemented in selected villages including an integrated approach consisting of improving pig confinement and selective treatment of pigs with oxfendazole. Mass drug administration with praziquantel targeting schistosomiasis, with an expected effect onT. solium, was also provided to school-age children in the area. This study aimed at providing an update on prevalence and intensities of porcine cysticercosis; and assessing farmers’ knowledge, attitudes and practices which could be associated to disease transmission in the area. The study involved a questionnaire survey conducted using face-to-face household interviews with 890 consenting farmers; and carcass dissections performed on 282 pigs randomly selected from the surveyed households. Results Twenty-six pigs (9.2%) were infected withT. solium; of which two-thirds (65.4%) had light to moderate infection intensities (1-1000 cysticerci), and one-third (34.6%) had heavy intensities (> 1000 cysticerci). Questionnaire results showed that only 5.7% of the respondents perceivedT. soliumcysticercosis to be an important disease in pigs. About 18.5% of the respondents were aware ofT. soliumtaeniasis, but 32% of them were unaware of how the infection is acquired. Half of the respondents had seen cysticerci in pork, of whom 61% were not aware that consumption of infected pork could cause taeniasis. Latrines were observed to often (90%) lack doors with 45% considered accessible to pigs. Conclusions This study provided an evidence that the disease was still endemic in the area. Poor knowledge of farmers, attitudes, and risky practices responsible for disease perpetuation were also revealed. A One Health approach targeting the whole area incorporating improvement of farmer knowledge regarding disease transmission needs to be trialed as a feasible approach to control. |
| antibiotic usage; antibiotic resistance; poultry; KAP; Kwara; Nigeria | ANTIMICROBIAL DRUG RESIDUES; ONE HEALTH | Overwhelming empirical evidence has highlighted the contribution of indiscriminate antibiotic usage (ABU) in food animals to the overall burden of antibiotic resistance (ABR) in humans, thus making antibiotic use the main selective pressure driving antibiotic resistance. The social and behavioral perspective on antibiotic use and resistance in poultry is limited. Our study therefore aimed at obtaining information on antibiotic usage, awareness of ABR, and the attitude and perceptions towards prudent antibiotic usage and ABR. A cross-sectional survey using a structured questionnaire was conducted in 125 poultry farms in Kwara state in December 2019. Most farmers (69.6%,n= 87/125) were aware of ABR and had satisfactory knowledge about ABR with a mean knowledge score of 3.2 +/- 1.5. Age (older farmers; OR: 1.1, 95% CI: 1.0, 1.2) and gender (male respondents, OR: 8.5, 95% CI: 3.0, 23.9;p< 0.01) were more likely to have satisfactory knowledge of ABR. Tertiary education was significantly associated with ABR awareness (OR: 4.7; 95% CI: 0.1, 0.7;p= 0.007) and the ABR knowledge level (OR: 7.8; 95% CI: 3.3, 18.7;p< 0.01). Higher flock size was significantly associated with a satisfactory knowledge of ABR (OR: 9.5; 95% CI: 3.8, 23.6;p< 0.01). Most of the poultry farmers (68%) had positive attitudes towards prudent antibiotic use with a mean score of 2.7 +/- 0.9. On the contrary, only 32.8% of poultry farmers had a desirable perception of ABR with a mean perception score of 4.9 +/- 1.1. The ABR knowledge level was significantly associated with the perceptions of farmers (p< 0.05) but not their attitudes toward ABU and ABR (p= 0.083). There was evidence of unprescribed use of antibiotics in poultry and a failure to observe antibiotic withdrawal periods. These constitute a risk of exposure to unacceptable levels of drug residues from poultry products and an increased risk of ABR. Improving education and communication on antibiotic stewardship programs are crucial to prevent the looming antibiotic threat. |
| Treponema pallidum subsp; pertenue; Yaws; Tropics; Africa; Nonhuman primates; Serology; Syphilis; Treponematoses | YAWS | Background The first yaws eradication campaign reduced the prevalence of yaws by 95%. In recent years, however, yaws has reemerged and is currently subject to a second, ongoing eradication campaign. Yet, the epidemiological status of Tanzania and 75 other countries with a known history of human yaws is currently unknown. Contrary to the situation in humans in Tanzania, recent infection of nonhuman primates (NHPs) with the yaws bacterium Treponema pallidum subsp. pertenue (TPE) have been reported. In this study, we consider a One Health approach to investigate yaws and describe skin ulcers and corresponding T. pallidum serology results among children living in the Tarangire-Manyara ecosystem, an area with increasing wildlife-human interaction in northern Tanzania. Methods To investigate human yaws in Tanzania, we conducted a cross-sectional study to screen and interview skin-ulcerated children aged 6 to 15 years, who live in close proximity to two national parks with high numbers of naturally TPE-infected monkeys. Serum samples from children with skin ulcers were tested for antibodies against the bacterium using a treponemal (Treponema pallidum Particle Agglutination assay) and a non-treponemal (Rapid Plasma Reagin) test. Results A total of 186 children aged between 6 and 15 years (boys: 10.7 +/- 2.1 (mean +/- SD), N = 132; girls: 10.9 +/- 2.0 (mean +/- SD), N = 54) were enrolled. Seven children were sampled at health care facilities and 179 at primary schools. 38 children (20.4%) reported active participation in bushmeat hunting and consumption and 26 (13.9%) reported at least one physical contact with a NHP. None of the lesions seen were pathognomonic for yaws. Two children tested positive for treponemal antibodies (1.2%) in the treponemal test, but remained negative in the non-treponemal test. Conclusions We found no serological evidence of yaws among children in the Tarangire-Manyara ecosystem. Nevertheless, the close genetic relationship of human and NHPs infecting TPE strains should lead to contact prevention with infected NHPs. Further research investigations are warranted to study the causes and possible prevention measures of spontaneous chronic ulcers among children in rural Tanzania and to certify that the country is free from human yaws. |
| behaviour; genetics; health sciences; meat science; nutrition; reproduction | DAIRY-COWS; HAEMONCHUS-CONTORTUS; GROWTH-HORMONE; AGRICULTURAL-RESEARCH; ENERGY-REQUIREMENTS; METHANE EMISSIONS; MILK-PRODUCTION; MERINO SHEEP; LONG-TERM; CATTLE | This account of the development and achievements of the animal sciences in Australia is prefaced by a brief history of the livestock industries from 1788 to the present. During the 19th century, progress in industry development was due more to the experience and ingenuity of producers than to the application of scientific principles; the end of the century also saw the establishment of departments of agriculture and agricultural colleges in all Australian colonies (later states). Between the two world wars, the Council for Scientific and Industrial Research was established, including well supported Divisions of Animal Nutrition and Animal Health, and there was significant growth in research and extension capability in the state departments. However, the research capacity of the recently established university Faculties of Agriculture and Veterinary Science was limited by lack of funding and opportunity to offer postgraduate research training. The three decades after 1945 were marked by strong political support for agricultural research, development and extension, visionary scientific leadership, and major growth in research institutions and achievements, partly driven by increased university funding and enrolment of postgraduate students. State-supported extension services for livestock producers peaked during the 1970s. The final decades of the 20th century featured uncertain commodity markets and changing public attitudes to livestock production. There were also important Federal Government initiatives to stabilise industry and government funding of agricultural research, development and extension via the Research and Development Corporations, and to promote efficient use of these resources through creation of the Cooperative Research Centres program. These initiatives led to some outstanding research outcomes for most of the livestock sectors, which continued during the early decades of the 21st century, including the advent of genomic selection for genetic improvement of production and health traits, and greatly increased attention to public interest issues, particularly animal welfare and environmental protection. The new century has also seen development and application of the ‘One Health’ concept to protect livestock, humans and the environment from exotic infectious diseases, and an accelerating trend towards privatisation of extension services. Finally, industry challenges and opportunities are briefly discussed, emphasising those amenable to research, development and extension solutions. |
| ANTIFUNGALS; FUNGICIDES | Background: Acquired azole resistance (AR) in Aspergillus fumigatus emphasizes the importance of the One Health multisectorial approach. The prevalence of azole-resistant A. fumigatus in the environment of Greece is unknown. Methods: Between October 2016 and September 2017, a total of 716 soil samples were collected from 23 provinces and screened for AR using azole-containing agar plates. Recovered isolates were macro-/microscopically identified and colonies were counted. Azole susceptibility testing of A. fumigatus species complex (SC) isolates was performed (EUCAST E.DEF9.3.1). Azole-resistant A. fumigatus isolates were subjected to confirmatory molecular identification and sequencing of the cyp51A gene. Results: No yeasts were recovered, while multiple moulds grew on 695 (97%) samples. Overall, zygomycetes (most non-Mucor genera) grew on 432 (60%) samples, while Aspergillus spp. grew on 500 (70%) [410 (57%) Aspergillus niger SC; 120 (17%) Aspergillus terreus SC; 101 (14%) A. fumigatus SC; 34 (5%) Aspergillus flavus SC]. The mean +/- SD soil Load of Aspergillus spp. was 2.23 +/- 0.41 log(10) cfu/g (no differences among species). No azole-resistant nonA. fumigatus spp. isolate was detected. Itraconazole, voriconazole, isavuconazole and posaconazole MIC50/MIC90 (MIC range) of A. fumigatus SC strains were 0.25/0.5 (0.25 to >8), 0.5/1 (0.25 to >8), 1/1 (0.125 to >8) and 0.06/0.125 (0.06-1) mg/L, respectively. Overall, 1/500 (0.2%) of Aspergillus isolates, and 1/101 (1%) of A. fumigatus SC isolates, was pan-azole-resistant (itraconazole, voriconazole, isavuconazole and posaconazole MIC >8, >8, >8 and 1 mg/L, respectively). The resistant isolate was recovered from organically grown raisin grapes treated with homemade compost and it was an A. fumigatus sensu stricto isolate harbouring the TR46/Y121F/T289A mutation. The soil’s Load was higher compared with azole-susceptible strains (3.74 versus 2.09 log(10) cfu/g). Conclusions: This is the first known report of environmental pan-azole-resistant A. fumigatus in Greece. Since data on Greek clinical isolates are Lacking, this finding must alarm the systematic Local surveillance of AR in medical settings. |
| PHYLOGENETIC ANALYSIS; COMPLEX; ORYGIS; TOOL; IDENTIFICATION; PREVALENCE; MUTATIONS; INDIA | Background Zoonotic tuberculosis is defined as human infection with Mycobacterium bovis. Although globally, India has the largest number of human tuberculosis cases and the largest cattle population, in which bovine tuberculosis is endemic, the burden of zoonotic tuberculosis is unknown. The aim of this study was to obtain estimates of the human prevalence of animal-associated members of the Mycobacterium tuberculosis complex (MTBC) at a large referral hospital in India. Methods We did a molecular epidemiological surveillance study of 940 positive mycobacteria growth indicator tube (MGIT) cultures, collected from patients visiting the outpatient department at Christian Medical College (Vellore, India) with suspected tuberculosis between Oct 1, 2018, and March 31, 2019. A PCR-based approach was applied to subspeciate cultures. Isolates identified as MTBC other than M tuberculosis or as inconclusive on PCR were subject to whole-genome sequencing (WGS), and phylogenetically compared with publicly available MTBC sequences from south Asia. Sequences from WGS were deposited in the National Center for Biotechnology Information Sequence Read Archive, accession number SRP226525 (BioProject database number PRJNA575883). Findings The 940 MGIT cultures were from 548 pulmonary and 392 extrapulmonary samples. A conclusive identification was obtained for all 940 isolates; wild-type M bovis was not identified. The isolates consisted of M tuberculosis (913 [97.1%] isolates), Mycobacterium orygis (seven [0.7%]), M bovis BCG (five [0.5%]), and non-tuberculous mycobacteria (15 [1.6%]). Subspecies were assigned for 25 isolates by WGS, which were analysed against 715 MTBC sequences from south Asia. Among the 715 genomes, no M bovis was identified. Four isolates of cattle origin were dispersed among human sequences within M tuberculosis lineage 1, and the seven M orygis isolates from human MGIT cultures were dispersed among sequences from cattle. Interpretation M bovis prevalence in humans is an inadequate proxy of zoonotic tuberculosis. The recovery of M orygis from humans highlights the need to use a broadened definition, including MTBC subspecies such as M orygis, to investigate zoonotic tuberculosis. The identification of M tuberculosis in cattle also reinforces the need for One Health investigations in countries with endemic bovine tuberculosis. Copyright (c) 2020 The Author(s). Published by Elsevier Ltd. |
| Tuberculosis; Health system; Infrastructure; GeneXpert; Infectious disease; Diagnosis | CARE | Background Many high burden countries are scaling-up GeneXpert (R) MTB/RIF (Xpert) testing for tuberculosis (TB) using a hub-and-spoke model. However, the effect of scale up on reducing TB has been limited. We sought to characterize variation in implementation of referral-based Xpert TB testing across Uganda, and to identify health system factors that may enhance or prevent high-quality implementation of Xpert testing services. Methods We conducted a cross-sectional study triangulating quantitative and qualitative data sources at 23 community health centers linked to one of 15 Xpert testing sites between November 2016 and May 2017 to assess health systems infrastructure for hub-and-spoke Xpert testing. Data sources included a standardized site assessment survey, routine TB notification data, and field notes from site visits. Results Challenges with Xpert implementation occurred at every step of the diagnostic evaluation process, leading to low overall uptake of testing. Of 2192 patients eligible for TB testing, only 574 (26%) who initiated testing were referred for Xpert testing. Of those, 54 (9.4%) were Xpert confirmed positive just under half initiated treatment within 14 days (n = 25, 46%). Gaps in required infrastructure at 23 community health centers to support the hub-and-spoke system included lack of refrigeration (n = 14, 61%) for sputum testing and lack of telephone/mobile communication (n = 21, 91%). Motorcycle riders responsible for transporting sputum to Xpert sites operated variable with trips once, twice, or three times a week at 10 (43%), nine (39%) and four (17%) health centers, respectively. Staff recorded Xpert results in the TB laboratory register at only one health center and called patients with positive results at only two health centers. Of the 15 Xpert testing sites, five (33%) had at least one non-functioning module. The median number of tests per day was 3.57 (IQR 2.06-4.54), and 10 (67%) sites had error/invalid rates > 5%. Conclusions Although Xpert devices are now widely distributed throughout Uganda, health system factors across the continuum from test referral to results reporting and treatment initiation preclude effective implementation of Xpert testing for patients presenting to peripheral health centers. Support for scale up of innovative technologies should include support for communication, coordination and health systems integration. |
| plant medicines; SRS; fish pathology; antibiotic usage; salmonids; Chile | SAPONIN INTERACTIONS; ANTIMICROBIAL USE; AQUEOUS EXTRACTS; RAINBOW-TROUT; ONE HEALTH; AQUACULTURE; MEMBRANE; FISH; ANTIBIOTICS; CHILE | Simple Summary Bacterial diseases causes massive mortalities in aquaculture and antibiotic use remains the main measure to keep these under control. Pisciricketssia salmonis, an intracellular bacterium only present in Chile, produces high mortalities in farmed salmon and is currently the main reason for using antimicrobials compared to other salmon-producing countries such as Norway. Environmental and antimicrobial resistance concerns have been raised by the local and global public and society, although no scientific evidence has demonstrated such an impact. Thus, there is a constant search for new alternatives that can complement or reduce the use of antimicrobial in intensive salmon farming. Phytochemicals such as saponins from Quillaja saponaria extracts have been proven to prevent and control diseases in other animal production systems. This study explored the safety and efficacy of quillaja extract in in vitro infections with P. salmonis. The results of this study showed a good in vitro safety and efficacy to infections. The efficacy proved to be dependent on the quantity of saponins and toxicity dependent on purification. The results showed that quillaja extracts could be potentially used as a new sustainable and eco-friendly alternative to control P. salmonis infection, contributing to decreased fish mortality, antibiotic use and antimicrobial resistance in intensive aquaculture worldwide. P. salmonis infections are the cause of major bacterial disease in salmonids in Chile, and the reason for using more antibiotics compared to other salmon-producing countries. Vaccination and antibiotics have not been efficient and new approaches are needed. The safety of Quillaja saponaria extracts was measured by cytotoxicity using flow cytometry of cytopathic and death of fish cell cultures and efficacy was assessed using in vitro infection models with pathogenic P. salmonis. Cytotoxicity was low and control of in vitro infections was achieved with all products, with protection of over 90%. Minimum inhibitory concentrations were much higher than those in the infection using cell cultures. These results suggest a dual mechanism of action where less purified extracts with a combination of saponin and non-saponin components simultaneously decrease P. salmonis infection while protecting cell lines, rather than exerting a direct antimicrobial effect. Quillaja saponins controlled in vitro infections with P. salmonis and could be considered good candidates for a new, safe and sustainable method of controlling fish bacterial infectious diseases. |
| prevention; Africa; capacity development; environmental health; food safety; food security; toxicology | SUSTAINABLE DEVELOPMENT; NUTRITION EDUCATION; BEVERAGE PURCHASES; ELECTRONIC WASTE; TRACE-ELEMENTS; STREET FOODS; BISPHENOL-A; HEALTH; MANAGEMENT; PERSPECTIVE | Background and objectives: With globalization of culture and products, choices and behaviors associated with the unawareness of toxicological risk factors result in human and environmental toxic exposures along with health disparities. Toxic exposures are risk factors for malnutrition and diseases, impairing the chances of being healthy and having a healthy adulthood for current and next generation(s). Increasing research funds, infrastructures, analytical data and risk assessment is a reality well worth attention in sub-Saharan Africa. These countries are still unprotected nowadays and are particularly exposed and data-poor in respect to risk factors (e.g., neurotoxicants, immunotoxicants and endocrine disruptors). This paper presents how-based on scientific literature-low-resource countries may achieve more with less. As one of the world’s most important emerging markets, Africa can, and should, assess the benefits and risks of modernity versus tradition and ask for safe and quality products at affordable prices while producing safe and nutritious foods. Materials and Methods: Exempla and experiences of risk analysis based on participant observation in field anthropological research, consumer safaris and reportages in the field of food safety, environmental health and consumer products are discussed in terms of narrative prevention and its power to highlight previously unrecognized/overlooked real-life risk scenarios. Knowledge return initiatives are discussed in light of their power to feed awareness raising, informed choice and empowerment of communities. Results: In some cases, data exist but remain too sparse, unknown or underused; in other cases, the information is totally neglected. When there is international scientific evidence, a diagnostic risk assessment is feasible. Despite significant resource constraints, properly science-driven targeted reportages in data-poor countries can bridge the gaps between international scientific knowledge and the implementation of relevant findings in an awareness-empowerment vortex. When a clear message promoting healthy choices and behaviors is given, African communities are ready to respond. Conclusions: Poor skills are an avoidable consequence of low national income. Narrative prevention does not replace scientific research but stimulates scientific research and toxicological risk analysis during the ongoing risk transition in Africa. While African populations increasingly aspire to improve life expectancy in health, increasing exposure to such new health risk factors in sub-Saharan Africa needs top-down choices for diseases prevention, One Health, as well as public awareness and empowerment towards everyday habits and health protective choices. |
| health information manager; health information management; health workforce; health information management workforce; health information management profession; health informatics; education; professional; health education; professional competence; workplace; health manpower | JOB PROFILES; MEDICAL INFORMATICS | Background: Employability, employment destinations and utilisation of knowledge-skill domains of new graduate health information managers (HIMs) have not been explored. Objectives: To capture the timing from course completion to employment and employment locations of a 5-year cohort of health information management graduates of La Trobe University, Australia, in 2017-2018; identify professional knowledge and skills used by the graduates in executing their roles; and map these to four domains of the health information management curriculum. Method: A mixed-methods descriptive study utilising a survey investigated early career pathways of new graduates of health information management courses from 2012 to 2016. Demographic data included age, year of graduation, lead time from course completion to employment, position title, number of positions held post-graduation and knowledge-skills used in the workplace. Results: Eighty percent (n= 167) of graduates working in Australia with known contact details responded to the survey. Of these, 96.4% (n= 161) worked in at least one health information management-related position since graduation. Forty-five percent (n= 72) of graduates obtained a position before course completion, and over 94% (n= 150) were employed in the profession within 6 months of completion. Sixty percent (n= 97) of graduates had worked in two or more positions from 2012 to 2016. The large majority of new graduate HIMs (82.4%) were employed in the public healthcare sector in health information management (44%), or health classification (28.1%) roles. Most graduates (61%) had utilised at least three or four domains of professional knowledge-skills in the workplace. Whereas 16% (n= 26) of graduates used, solely, their health classification knowledge-skill set, almost 74% (n= 117) undertook some health classification-related activities. Only 16% (n= 26) of graduates were over 40 years of age, and there were no statistically significant differences between Bachelor and Master (Combined Degree Programs) graduates and Graduate-entry Master degree graduates in terms of lead time to employment, number of positions held, type of employing agency and professional knowledge-skills utilised in the workplace. Conclusion: Graduate HIMs have very high employability, demonstrate job mobility consistent with the national trends, are largely represented in the public sector but have presence throughout the healthcare system and utilise most or all of the specialised domains of professional knowledge and skills studied at university. |
| Escherichia coli; genomic diversity; accessory genes; soils; household settings | ANTIMICROBIAL RESISTANCE; FECAL CONTAMINATION; DRINKING-WATER; SOIL; SPECTRUM; HANDS; PREVALENCE; PATHOTYPES; TEMPERATE; CHILDREN | Escherichia coli is present in multiple hosts and environmental compartments as a normal inhabitant, temporary or persistent colonizer, and as a pathogen. Transmission of E. coli between hosts and with the environment is considered to occur more often in areas with poor sanitation. We performed whole-genome comparative analyses on 60 E. coli isolates from soils and fecal sources (cattle, chickens, and humans) in households in rural Bangladesh. Isolates from household soils were in multiple branches of the reconstructed phylogeny, intermixed with isolates from fecal sources. Pairwise differences between all strain pairs were large (minimum, 189 single nucleotide polymorphisms [SNPs]), suggesting high diversity and heterogeneous origins of the isolates. The presence of multiple virulence and antibiotic resistance genes is indicative of the risk that E. coli from soil and feces represent for the transmission of variants that pose potential harm to people. Analysis of the accessory genomes of the Bangladeshi E. coli relative to E. coli genomes available in NCBI identified a common pool of accessory genes shared among E. coli isolates in this geographic area. Together, these findings indicate that in rural Bangladesh, a high level of E. coli in soil is likely driven by contributions from multiple and diverse E. coli sources (human and animal) that share an accessory gene pool relatively unique to previously published E. coli genomes. Thus, interventions to reduce environmental pathogen or antimicrobial resistance transmission should adopt integrated One Health approaches that consider heterogeneous origins and high diversity to improve effectiveness and reduce prevalence and transmission. IMPORTANCE Escherichia coli is reported in high levels in household soil in low-income settings. When E. coli reaches a soil environment, different mechanisms, including survival, clonal expansion, and genetic exchange, have the potential to either maintain or generate E. coli variants with capabilities of causing harm to people. In this study, we used whole-genome sequencing to identify that E. coli isolates collected from rural Bangladeshi household soils, including pathogenic and antibiotic-resistant variants, are diverse and likely originated from multiple diverse sources. In addition, we observed specialization of the accessory genome of this Bangladeshi E. coli compared to E. coli genomes available in current sequence databases. Thus, to address the high level of pathogenic and antibiotic-resistant E. coli transmission in low-income settings, interventions should focus on addressing the heterogeneous origins and high diversity. |
| FRAMEWORK; EDUCATION; IDENTITY; COLLABORATION; PROFESSIONS; ATTITUDES | Purpose With the emergence of zoonoses such as Ebola, many medical educators, have recommended the need for providing Interprofessional Education (IPE) as a pedagogical tool for familiarizing medical (MD) students with the framework of One Health (OH). This is important as students need to understand, the wider impacts of animal and environmental health factors on human health. IPE initiatives which typically incorporate the principles of OH, can provide MD and veterinary (DVM) students with a greater awareness of the role that animal diseases and climate change have on global health. However, negative attitudes to IPE have been reported as a key limitation to IPE implementation. The purpose of this paper is to examine the differences in readiness for interprofessional learning of medical and other allied human health professional students, including veterinarians and students undertaking dual degrees in combination with a Master of Public Health (MPH). Reflecting on Role Theory (RT) and Social Identity Theory (SIT), the paper aims to contribute to the understanding of differences in perceptions that exist between different types of health professionals. Methods Students at a medical University enrolled in MD, DVM, DVM MPH and MD MPH programs, were invited to complete the standardized Readiness for Interprofessional Learning Scale (RIPLS), which consists of 19 Likert scale items measuring concepts relating to teamwork, professional identity and roles and responsibilities. A total of 364 students across the four programs took part. Descriptive and inferential statistical analyses were performed to assess differences between the programmes. Results Results indicate that MD students score lower on the different RIPLS items compared to DVM, MD MPH and DVM MPH students. DVM and DVM MPH students are generally more positive about the need for teamwork, while MD MPH and DVM MPH students have a stronger positive identity about the need for IPE. Conclusions The findings drawn from this study suggests that the MD students keep on seeing themselves as a separate group of health professionals in their own right. In order to guarantee an increased level of understanding on issues relating to the human-animal-environmental spectrum, medical curricula might benefit from the incorporation of shared learning and teamwork, as occurs within the MPH, enabling students to appreciate the value of interprofessional collaboration to their future practice. This is especially important during a time at which human-animal-environmental issues are affecting social and economic life worldwide. |
| Staphylococcus aureus; human; methicillin; antimicrobial resistance; sequencing; DNA sequencing | HEALTH-CARE; MRSA; LIVESTOCK; COLONIZATION; ANIMALS; PHYLOGENIES; INFECTIONS; PREVALENCE; EMERGENCE; ALGORITHM | Methicillin-resistant Staphylococcus aureus (MRSA) has emerged over the last few decades as a One Health problem with an increasing prevalence in various animal species. The most notable animals are pigs, as asymptomatic carriers, and horses, where there is often an association with infections. The current study looked at the course of MRSA prevalence in Swiss livestock since 2009, with a special focus on pigs, followed by screening of veterinarians and farmers. Livestock isolates were obtained from the Swiss monitoring program and then characterized by spa typing. Concentrating on the year 2017, we analyzed the prevalence of MRSA in Swiss veterinarians and farmers, followed by whole-genome sequencing of selected human and animal strains. The phylogeny was assessed by applying core-genome multilocus sequence typing (MLST) and single-nucleotide polymorphism (SNP) analyses, followed by screening for resistance genes and virulence factors. The prevalence of MRSA in Swiss pigs showed a dramatic increase from 2% in 2009 to 44% in 2017. Isolates typically belonged to clonal complex 398 (CC398), split between spa t011 and t034. The higher prevalence was mainly due to an increase in t011. spa t034 strains from farmers were found to be closely associated with porcine t034 strains. The same could be shown for spa t011 strains from horses and veterinarians. spa t034 strains had a high number of additional resistance genes, and two strains had acquired the immune evasion cluster. However, all but one of the pig spa t011 strains clustered in a separate group. Thus, the increase in pig spa t011 strains does not directly translate to humans. IMPORTANCE MRSA is an important human pathogen; thus, its increasing prevalence in livestock over the last decade has a potentially large impact on public health. Farmers and veterinarians are especially at risk due to their close contact with animals. Our work demonstrates a dramatic increase in MRSA prevalence in Swiss pigs, from 2% in 2009 to 44% in 2017. Whole-genome sequencing allowed us to show a close association between farmer and pig strains as well as veterinarian and horse strains, indicating that the respective animals are a likely source of human colonization. Furthermore, we could demonstrate that pig spa t011 strains cluster separately and are probably less likely to colonize humans than are pig spa t034 strains. This research may provide a basis for a more substantiated risk assessment and preventive measures. |
| CARDIORESPIRATORY FITNESS; LIFE-STYLE; DECLINE; RISK | Background Studies have suggested associations between self-reported engagement in health behaviors and reduced risk of cognitive decline. Most studies explore these relationships using one health behavior, often cross-sectionally or with dementia as the outcome. In this study, we explored whether several individual self-reported health behaviors were associated with cognitive decline when considered simultaneously, using data from the Wisconsin Registry for Alzheimer’s Prevention (WRAP), an Alzheimer’s disease risk-enriched cohort who were non-demented and in late midlife at baseline. Method We analyzed longitudinal cognitive data from 828 participants in WRAP, with a mean age at baseline cognitive assessment of 57 (range = 36-78, sd = 6.8) and an average of 6.3 years (standard deviation = 1.9, range = 2-10) of follow-up. The primary outcome was a multidomain cognitive composite, and secondary outcomes were immediate/delayed memory and executive function composites. Predictors of interest were self-reported measures of physical activity, cognitive activity, adherence to a Mediterranean-style diet (MIND), and interactions with each other and age. We conducted linear mixed effects analyses within an Information-theoretic (IT) model averaging (MA) approach on a set of models including covariates and combinations of these 2- and 3-way interactions. The IT approach was selected due to the large number of interactions of interest and to avoid pitfalls of traditional model selection approaches. Results Model-averaged results identified no significant self-reported health behavior* age interactions in relationship to the primary composite outcome. In secondary outcomes, higher MIND diet scores associated with slower decline in executive function. Men showed faster decline than women on delayed memory, independent of health behaviors. There were no other significant interactions among any other health behaviors and cognitive trajectories. Conclusions When multiple covariates and health behaviors were considered simultaneously, there were limited weak associations with cognitive decline in this age range. These results may be explained alone or in combination by three alternative explanations: 1) the range of cognitive decline is in middle age is too small to observe relationships with health behaviors, 2) the putative associations of these health behaviors on cognition may not be robust in this age range, or 3) the self-reported measures of the health behaviors may not be optimal for predicting cognitive decline. More study may be needed that incorporates sensitive measures of health behaviors, AD biomarker profiles, and/or other disease comorbidities. |
| Beef; antibiotic; antimicrobial; Defined Daily Dose (DDD); Piedmont | PREFERENCES; CHOICE; IMPACT | Beef production in Italy represents an important economic sector. Antimicrobials are administered to cattle to treat various pathological disorders such as respiratory diseases. The One Health approach promotes the rational use of antimicrobial drugs to contrast the antimicrobial resistance (AMR). The present study constitutes the first attempt to analyse antibiotic consumption of the beef cattle sector in the region of Piedmont (North-West of Italy). The goal of our study was to assess the antibiotic use, in both quantitative and qualitative terms, of a sample of beef farms with a software that would then enable us to set benchmark levels for the considered sample. To this aim, the antibiotic usage of ten intensive beef farms in the two-year period was recorded and analysed. For each farm that is part of the panel analysed, data about its annual antibiotic usage in 2017 and 2018, subdivided between the various antibiotic commercial products utilised, was recorded directly by the veterinarians that manage the selected farm. These data was then used as an input for the specific software, developed by the Italian Society of Veterinarians operating in the Livestock Sector (Sivar), to measure the antibiotic consumption of each selected beef farm and calculate the DDD/y (Defined Daily Dose per year), in mg/kg/day, of a singular farm. The results of data elaboration were discussed considering a DDD/y benchmark system, specifically designed for the considered farm’s panel, based as close as possible to the one already use by the Netherlands Veterinary Medicines Institute (SDa). The DDD/y benchmark levels, at the basis of the considered one, were developed to fit the specific farming conditions of the intensive Pied-montese beef cattle sector, in accordance with the veterinarians that manage the selected farms. The main results showed an average DDD/y value of the considered panel of farms equal to 2.876 considering the two-years period. The DDD/y ranged from 0.150 to 7.409 for the singular farm in one year. Differences about the relative use of different classes of antibiotics were detected between farms. Furthermore, three farms out of ten fell out of the highest set benchmark level in at least one year of the biennium analysed. Further studies will be needed to assess whether the benchmark levels set in the current pilot study can be extended to all the Piedmontese beef farming sector. |
| Dog; Moxidectin; Oral; Pyrantel; Isoxazoline; Ixodes scapularis; Sarolaner; Simparica Trio (TM); Speed of kill; Tick | HUMAN GRANULOCYTIC EHRLICHIOSIS; TICK-BORNE DISEASES; HUMAN BABESIOSIS; ONE HEALTH; TRANSMISSION; PREVENTION; ATTACHMENT; DURATION; MICROTI; AGENT | BackgroundThe black-legged (or deer) tick, Ixodes scapularis, commonly infests dogs in the USA and is the vector of important zoonotic pathogens, including Borrelia burgdorferi, the causative agent of Lyme disease. Rapid onset of activity is important in reducing the feeding activity of ticks, thereby reducing the possibility of transmission of infections. The speed of kill of a novel oral combination product, Simparica Trio (TM) containing sarolaner, moxidectin and pyrantel was evaluated in a well-controlled laboratory study against an existing infestation and subsequent weekly induced infestations of I. scapularis ticks on dogs.MethodsDogs were allocated randomly based on host suitability tick counts to treatment with a single dose of either placebo or Simparica Trio (TM) at the minimum label dose of 1.2 mg/kg sarolaner, 24 mu g/kg moxidectin and 5 mg/kg pyrantel (as pamoate salt). All dogs were infested with approximately 50 unfed adult I. scapularis ticks at a 1:1 sex ratio on Days -2, 7, 14, 21, 28 and 35. Tick counts were conducted at 8, 12 and 24 h after treatment on Day 0 and after each subsequent infestation.ResultsNo treatment-related adverse events occurred during the study. Dogs in the placebo-treated group maintained adequate tick infestations for the duration of the study. Day 0 tick counts at 8 h after treatment with Simparica Trio (TM) were reduced relative to placebo against an existing infestation with efficacy of 67.5%, demonstrating that Simparica Trio (TM) started killing ticks soon after treatment. Efficacy was 98.4 % at 12 h and 99.4% at 24 h. Rapid speed of kill was maintained throughout the month, with efficacy of >= 94.2% at 24 h after re-infestation through Day 28.ConclusionsA single dose of Simparica Trio (TM) administered orally to dogs at the minimum label dose of 1.2 mg/kg sarolaner, 24 mu g/kg moxidectin and 5 mg/kg pyrantel (as pamoate salt) was safe and began to kill existing I. scapularis ticks within 8 h after treatment and resulted in >= 94.2% efficacy within 24 h against re-infestations for a month. |
| | Background objectives: Bats are considered to be the natural reservoir for many viruses, of which some are potential human pathogens. In India, an association of Pteropus medius bats with the Nipah virus was reported in the past. It is suspected that the recently emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) also has its association with bats. To assess the presence of CoVs in bats, we performed identification and characterization of bat CoV (BtCoV) in P. medius and Rousettus species from representative States in India, collected during 2018 and 2019. Methods: Representative rectal swab (RS) and throat swab specimens of Pteropus and Rousettus spp. bats were screened for CoVs using a pan-CoV reverse transcription-polymerase chain reaction (RT-PCR) targeting the RNA-dependent RNA polymerase (RdRp) gene. A single-step RT-PCR was performed on the RNA extracted from the bat specimens. Next-generation sequencing (NGS) was performed on a few representative bat specimens that were tested positive. Phylogenetic analysis was carried out on the partial sequences of RdRp gene sequences retrieved from both the bat species and complete viral genomes recovered from Rousettus spp. Results: Bat samples from the seven States were screened, and the RS specimens of eight Rousettus spp. and 21 Pteropus spp. were found positive for CoV RdRp gene. Among these, by Sanger sequencing, partial RdRp sequences could be retrieved from three Rousettus and eight Pteropus bat specimens. Phylogenetic analysis of the partial RdRp region demonstrated distinct subclustering of the BtCoV sequences retrieved from these Rousettus and Pteropus spp. bats. NGS led to the recovery of four sequences covering approximately 94.3 per cent of the whole genome of the BtCoVs from Rousettus bats. Three BtCoV sequences had 93.69 per cent identity to CoV BtRt-BetaCoV/GX2018. The fourth BtCoV sequence was 96.8 per cent identical to BtCoV HKU9-1. Interpretation conclusions: This study was a step towards understanding the CoV circulation in Indian bats. Detection of potentially pathogenic CoVs in Indian bats stresses the need for enhanced screening for novel viruses in them. One Health approach with collaborative activities by the animal health and human health sectors in these surveillance activities shall be of use to public health. This would help in the development of diagnostic assays for novel viruses with outbreak potential and be useful in disease interventions. Proactive surveillance remains crucial for identifying the emerging novel viruses with epidemic potential and measures for risk mitigation. |
| Campylobacter; Poultry farm; Live bird market; Multi-drug resistance; Residual antimicrobial; Risk factors | MULTIPLEX PCR ASSAY; DISTENDING TOXIN CDT; ANTIBIOTIC-RESIDUES; GENETIC DIVERSITY; UNITED-STATES; BETA-LACTAM; BROILER; IDENTIFICATION; CONTAMINATION; JEJUNI | Background Understanding potential risks of multi-drug resistant (MDR) pathogens from the booming poultry sector is a crucial public health concern. Campylobacter spp. are among the most important zoonotic pathogens associated with MDR infections in poultry and human. This study systematically examined potential risks and associated socio-environmental factors of MDR Campylobacter spp. in poultry farms and live bird markets (LBMs) of Bangladesh. Methods Microbial culture and PCR-based methods were applied to examine the occurrence and MDR patterns of Campylobacter spp. in potential sources (n = 224) at 7 hatcheries, 9 broiler farms and 4 LBMs in three sub-districts. Antimicrobial residues in broiler meat and liver samples (n = 50) were detected by advanced chromatographic techniques. A questionnaire based cross-sectional survey was conducted on socio-environmental factors. Results Overall, 32% (71/ 224) samples were found contaminated with Campylobacter spp. In poultry farms, Campylobacter spp. was primarily found in cloacal swab (21/49, 43%), followed by drinking water (8/24, 33%), and meat (8/28, 29%) samples of broilers. Remarkably, at LBMs, Campylobacter spp. was detected in higher prevalence (p < 0.05) in broiler meat (14/26, 54%), which could be related (p < 0.01) to bacterial contamination of drinking water (11/21, 52%) and floor (9/21, 43%). Campylobacter isolates, one from each of 71 positive samples, were differentiated into Campylobacter jejuni (66%) and Campylobacter coli (34%). Alarmingly, 49 and 42% strains of C. jejuni and C. coli, respectively, were observed as MDR, i.e., resistant to three or more antimicrobials, including, tetracycline, amoxicillin, streptomycin, fluoroquinolones, and macrolides. Residual antimicrobials (oxytetracycline, ciprofloxacin and enrofloxacin) were detected in majority of broiler liver (79%) and meat (62%) samples, among which 33 and 19%, respectively, had concentration above acceptable limit. Inadequate personal and environmental hygiene, unscrupulously use of antimicrobials, improper waste disposal, and lack of health surveillance were distinguishable risk factors, with local diversity and compound influences on MDR pathogens. Conclusion Potential contamination sources and anthropogenic factors associated with the alarming occurrence of MDR Campylobacter, noted in this study, would aid in developing interventions to minimize the increasing risks of poultry-associated MDR pathogens under ‘One Health’ banner that includes poultry, human and environment perspectives. |
| lambs; tail docking; pain response; wound infection; cortisol; serum amyloid A | ACUTE-PHASE PROTEINS; CASTRATION; SHEEP; DIAGNOSIS; RESPONSES; CORTISOL; WELFARE; STRESS | Simple Summary Tail docking is routinely conducted in sheep husbandry around the world, often without anaesthesia or analgesia despite recognition that it is a painful process. Several methods are used, although the Council of Europe states that surgical methods with anaesthesia should be used to dock the tail, with these recommendations copied into national legislation by most European countries. However, no studies have been documented comparing the use of general anaesthesia and stitching. This study compared different surgical approaches with and without general anaesthesia, and with and without surgical stitching, plus examined the efficacy of applying a commercially available wound gel spray containing topical anaesthetics and an antiseptic, immediately on tail amputation. Results demonstrated that lambs display more pain when the surgery included stitching and these wounds became more readily infected, potentially requiring antibiotic therapy. As the generation of potential antimicrobial resistance and drug residues issues in food-producing animals from over-use of antibiotics is an emerging one health consideration, the availability of a topical anaesthetic formulation that provides pain relief and contains an antiseptic that reduces secondary infections and hasten wound healing, is of potential importance for improving husbandry procedures such as tail docking. We examined several procedures for surgical tail docking; with and without general anaesthesia (GA), including the use of a topical wound gel formulation to provide pain relief (PR) and improve healing after surgery, containing local anaesthetics lignocaine and bupivacaine, with cetrimide and adrenalin. Forty-four lambs were recruited into four equal cohorts: Groups A and C, the tail was excised with a scalpel without anaesthesia or stitches; Groups B and D, the tail was surgically excised and stitched under GA; Groups C and D wounds were immediately sprayed with PR. Behavioural observations identified that Groups A and C displayed significantly less pain-related behaviours than Groups B and D shortly after the procedure, especially if treated with PR. Similarly, the mean of days when animals showed no signs of wound infection was longer in the groups not undergoing stitching. Finally, treatment with PR appeared to reduce the cortisol response and avoided the elevation of serum amyloid A in lambs where the tail was excised without general anaesthesia. In conclusion, surgical tail-docking without GA but where wounds are immediately sprayed with PR, appears as an affordable and more welfare-appropriate method for conducting tail docking in lambs. |
| breast mass; thyroid nodule; ultrasound; screening; BI-RADS; TI-RADS | BODY-MASS INDEX; BENIGN BREAST; RISK-FACTORS; CANCER; NODULES; SIZE; DISEASE; PREVALENCE; RECEPTOR; HORMONES | Introduction: Prior research has shown an association between breast and thyroid cancers, although their relationship is unclear. In China, asymptomatic women undergoing regular health checkups usually undergo breast and thyroid ultrasonography screening. The present cross-sectional ultrasound-based study estimated the prevalence of breast masses (BM) and thyroid nodules (TN) and their relationship among a population-based cohort of Chinese women. Methods: This study included 34,184 consecutive asymptomatic Chinese women who underwent both breast and thyroid ultrasound evaluation during one health care examination. Detected lesions were assigned into categories of different malignant risks according to the Breast and Thyroid Imaging Reporting and Data System (BI-/TI-RADS). Binomial logistic regression was used to determine the association between occurrence of BM and TN, and multinomial logistic regression was used to analyze the correlation of BM and TN in different BI-/TI-RADS categories. Associations between BM and TN, as well as anthropometric and biochemical markers, were also explored. Results: Of those enrolled, 6371 (18.6%) had BM, 12,153 (35.6%) had TN, and 2279 (6.7%) had both. After adjusting for age, body mass index (BMI), and height, females with TN had a higher risk of BM (odds ratio [OR] = 1.151, 95% confidence interval [CI 1.081-1.225], p < 0.0001) than those with normal thyroids, and females with BM had a higher risk of TN (OR = 1.165 [CI 1.096-1.238], p < 0.0001) than those without BM. Women with a TN >10 mm (OR = 1.249 [CI 1.104-1.413], p = 0.0004) and those with a TN <= 10 mm (OR = 1.134 [CI 1.062-1.211], p = 0.0002) were at higher risk of BM compared with those with normal thyroids. As RADS categories increased, so did the correlation between BM and TN. The increased risk of TN was associated with a higher BMI, height, systolic blood pressure, and a lower plasma albumin level. The increased risk of BM was associated with a lower BMI, plasma albumin levels, and higher height. Conclusions: A high prevalence of BM and TN was detected by ultrasonography screening in this cohort of Chinese women. These lesions occurred frequently and simultaneously, particularly in women with lesions in higher RADS categories. |
| Sparus aurata; aquaculture; antibiotic resistance; qnrB19; One Health | MEDIATED QUINOLONE RESISTANCE; ESCHERICHIA-COLI; EXTENDED-SPECTRUM; BETA-LACTAMASES; ENTEROBACTER-CLOACAE; MOLECULAR CHARACTERIZATION; ANTIMICROBIAL RESISTANCE; KLEBSIELLA-PNEUMONIAE; FARMED FISH; PREVALENCE | In a world where the population continues to increase and the volume of fishing catches stagnates or even falls, the aquaculture sector has great growth potential. This study aimed to contribute to the depth of knowledge of the diversity of bacterial species found in Sparus aurata collected from a fish farm and to understand which profiles of diminished susceptibility to antibiotics would be found in these bacteria that might be disseminated in the environment. One hundred thirty-six bacterial strains were recovered from the S. aurata samples. These strains belonged to Bacillaceae, Bacillales Family XII. Incertae Sedis, Comamonadaceae, Enterobacteriaceae, Enterococcaceae, Erwiniaceae, Micrococcaceae, Pseudomonadaceae and Staphylococcaceae families. Enterobacter sp. was more frequently found in gills, intestine and skin groups than in muscle groups (p <= 0.01). Antibiotic susceptibility tests found that non-susceptibility to phenicols was significantly higher in gills, intestine and skin samples (45%) than in muscle samples (24%) (p <= 0.01) and was the most frequently found non-susceptibility in both groups of samples. The group of Enterobacteriaceae from muscles presented less decreased susceptibility to florfenicol (44%) than in the group of gills, intestine and skin samples (76%). We found decreased susceptibilities to beta-lactams and glycopeptides in the Bacillaceae family, to quinolones and mupirocin in the Staphylococcaceae family, and mostly to beta-lactams, phenicols and quinolones in the Enterobacteriaceae and Pseudomonadaceae families. Seven Enterobacter spp. and five Pseudomonas spp. strains showed non-susceptibility to ertapenem and meropenem, respectively, which is of concern because they are antibiotics used as a last resort in serious clinical infections. To our knowledge, this is the first description of species Exiguobacterium acetylicum, Klebsiella michiganensis, Lelliottia sp. and Pantoea vagans associated with S. aurata (excluding cases where these bacteria are used as probiotics) and of plasmid-mediated quinolone resistance qnrB19-producing Leclercia adecarboxylata strain. The non-synonymous G385T and C402A mutations at parC gene (within quinolone resistance-determining regions) were also identified in a Klebsiella pneumoniae, revealing decreased susceptibility to ciprofloxacin. In this study, we found not only bacteria from the natural microbiota of fish but also pathogenic bacteria associated with fish and humans. Several antibiotics for which decreased susceptibility was found here are integrated into the World Health Organization list of critically important antimicrobials and highly important antimicrobials for human medicine. |
| SERVICES; MULTICENTER; IMPROVE | Objective The aim of this study was to describe timelines and challenges encountered in obtaining ethics and governance approvals for an Australian multicentre audit study involving 100 public (n = 22) and private (n = 78) sites from three health sectors and all eight Australian states and territories. Methods We determined and compared the processes, documentation and number of business days required to prepare applications and obtain research ethics and governance approvals. Results In total, the full ethics and governance process (calculated from the date the first application was started to the date the final approval was granted) took 203 business days (79% of the study timeline). Standard risk ethics applications (n = 4) took a median of 17 business days (range 3-35 days) to prepare and 32 business days (range 17-67 days) to be approved; expedited ethics applications (n = 4) took a median of 5 business days (range 1-20 days) to prepare and 10 business days (range 1-44 days) to be approved. Governance approvals (n = 23) took a median of 27 business days (range 4-63 days) to prepare and 20 business days (range 4-61 days) to be approved. Challenges included the lack of a nationwide single-site ethical review process, the extensive time required to duplicate content across applications, variability in application requirements and submission systems, and contract negotiations. Conclusion Further improvements are needed to reduce duplication and increase the efficiency of Australian ethics and governance review processes. What is known about the topic? The process for obtaining ethics approval for multicentre research has been streamlined through the introduction of single-site ethics review. However, the process of gaining ethics and governance approvals for national multicentre research continues to be time-consuming, resource-intensive and duplicative. What does this paper add? This is the first study to examine the challenges of obtaining ethics and governance approvals for a non-interventional multicentre study involving three health sectors (hospital, aged care, general practice), both private and public services and all eight Australian jurisdictions. Previous examinations of Australian multicentre studies have considered only one health sector, focused on the public system and/or were not national in scope. What are the implications for practitioners? Researchers and funders need to be aware of the considerable time, resources and costs involved in gaining research ethics and governance approvals for multicentre studies and include this in budgets and study timelines. Policy makers and administrators of ethics and governance review processes must address barriers to conducting multicentre research in Australia. |
| Flies; Colonization; Multidrug resistance; Transmission; One health; Africa; Antimicrobial resistance | MUSCA-DOMESTICA; GENE; RESISTANCE | BackgroundLocal data from the Asella Teaching and Referral Hospital in the town of Asella, Ethiopia reveal a high prevalence of extended-spectrum beta -lactamase- (ESBL) producing Gram-negative bacteria (GNB) in clinical isolates. To investigate a possible route of transmission, we determined the proportions ESBL-producing GNB in isolates from flies caught in the hospital and in the town of Asella. MethodsFlies were collected in August 2019 from the neonatal intensive care unit (NICU), the orthopedic ward, the hospital’s waste disposal area, and from a butchery situated 1.5 km from the hospital. After trapping, the flies were macerated and suspended in sterile normal saline. The suspensions were inoculated on MacConkey agar and incubated overnight. Species identification and antimicrobial susceptibility testing were performed using Vitek (R) -MS and VITEK (R) 2. ResultsIn total, 103 bacterial isolates were obtained from 85 flies (NICU: 11 isolates from 20 flies, orthopedic ward: 10 isolates from 12 flies, waste disposal area: 37 isolates from 26 flies, butchery: 45 isolates from 27 flies). The proportions of ESBL-producing bacteria among isolates obtained from flies collected in the hospital compound were significantly higher (82%, 90%, and 57% in NICU, orthopedic ward and waste disposal area, respectively) compared to flies collected outside of the hospital compound (2% (@1/45) in the butchery) (p <= 0.001). The proportion of ESBL was 67% (6/9) among Raoultella spp. 67% (4/6) among Kluyvera spp., 56% (5/9) among Enterobacter spp., 50% (5/10) among E. coli, and 44% (8/18) among Klebsiella spp.. Of the 40 ESBL-genes detected, 85% were CTX-M-like, 83% TEM-like, 23% SHV-like, and 2% CTX-M-2-like. ESBL-producing bacteria showed higher rates of resistance against ciprofloxacin (66% vs. 5%), gentamicin (68% vs. 3%), piperacillin-tazobactam (78% vs. 5%), and trimethoprim-sulfamethoxazole (88% vs. 16%), compared to non-ESBL-producing bacteria.ConclusionA high proportion of ESBL was identified in isolates from flies caught in the hospital compound compared with isolates of flies collected at a distance of 1.5 km from the hospital. Flies can be potential vectors for transmission of multidrug-resistant (MDR) bacteria within hospitals. Further studies are needed to determine the source of MDR colonization in flies and possible impact of MDR for nosocomial infections. |
| well-being; mental health; behavior change; acceptance and commitment therapy; web-delivered intervention; gamification; adherence and engagement; internet-based intervention | | Background: Poor mental health and emotional well-being can negatively impact ability to engage in healthy lifestyle behavior change. Health care staff have higher rates of sickness and absence than other public sector staff, which has implications at both individual and societal levels. Individual efforts to self-manage health and well-being which add to the UK mental health prevention agenda need to be supported. Objective: The objective of this study was to establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based acceptance and commitment therapy intervention in an existing health promotion program, to improve subjective well-being and encourage engagement with lifestyle behavior change. Methods: For this 12-week, 4-armed, randomized controlled cluster feasibility study, we recruited participants offline and randomly allocated them to 1 of 3 intervention arms or control (no well-being intervention) using an automated web-based allocation procedure. Eligibility criteria were current health care staff in 1 Welsh health board, age >= 18 years, ability to read English, and ability to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes were randomization procedure, acceptance of intervention, and adherence to and engagement with the wider program. We evaluated health and well-being data via self-assessment at 2 time points, registration and postintervention, using the 14-item Warwick-Edinburgh Mental Well-Being Scale, the 4-item Patient Health Questionnaire, and the 7-item Acceptance and Action Questionnaire-Revised. Results: Of 124 participants who provided consent and were randomly allocated, 103 completed full registration and engaged with the program. Most participants (76/103) enrolled in at least one health behavior change module, and 43% (41/96) of those randomly allocated to an intervention arm enrolled in the well-being module. Adherence and engagement was low (7/103, 6.8%), but qualitative feedback was positive. Conclusions: The procedure and randomization process proved feasible, and the addition of the well-being module proved acceptable to health care staff. However, participant engagement was limited, and no one completed the full 12-week program. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale randomized controlled trial, which would be feasible with additional recruitment. |
| animal-based outcomes; biosecurity; farm sustainability; IZSLER; CReNBA; management-based indicators; resource-based indicators | ROAD TRANSPORT; ONE HEALTH; ONE WORLD | Context European beef production is facing fresh challenges on various fronts: increasing public concern on animal welfare; declining EU meat consumption; and, conversely, expected growth in global demand for meat. The Italian National Reference Centre for Animal Welfare (CReNBA) has developed an assessment protocol for collecting information about beef cattle welfare and biosecurity conditions, with the intention of better understanding animal needs and disseminating best practices. Aims The protocol was applied on Italian and Irish farms, and the results were used as a starting point for a specific statistical analysis for comparing animal welfare and biosecurity levels in the two countries. Methods The protocol consists of animal-based measures and non-animal-based measures (management-based and resource-based indicators) and has been designed to determine the major hazards and benefits that can influence cattle health and welfare, including the presence of biosecurity issues. The outcomes of welfare and biosecurity assessments conducted during November 2016-July 2017 of 40 Irish beef herds reared indoors were compared with those of 85 Italian beef units assessed over the same period. Differences obtained within each beef-unit distribution were calculated by the VARNC index (diversity index), and a distance estimate of the beef-unit distribution from a hypothetical ideal condition was calculated by using the distance from ideal (dfi) index. Key results Thedfiindex revealed that Irish farms were closer to the ideal condition for the measures ‘experience and training of stockpersons’, ‘water provision’, ‘handling facilities’, ‘restraint facilities’, and ‘temperature, humidity and ventilations conditions’. Italian farms were closer to the ideal condition for ‘diet calculation and feed quality’, ‘feeding management’, ‘feeding place dimension’, ‘cleanliness of water points’, ‘cleanliness of floors’, ‘type of floors’, ‘cleanliness of animals’, and ‘integument alterations’. In contrast to the Italian farms, there was particular awareness of the importance of biosecurity on Irish farms. Conclusions The results revealed intrinsic management and housing differences between the two rearing systems, although only few dissimilarities were found in the animal outcomes: in fact, the assessment of the animal-based measures gave very similar results for the two countries, except for ‘cleanliness of the animals’ and ‘integument alterations’. Implications In the face of global challenges affecting the pursuit of farming sustainability, farmers should be encouraged to improve safeguards for animal welfare and reduce the spread of animal diseases. This can be achieved by facilitating knowledge exchange internationally. |
| Enterobacteriaceae; anthropogenic landscapes; antimicrobial resistance; metagenomics; raptors; spatial epidemiology; wildlife | ANTIBIOTIC-RESISTANCE; ESCHERICHIA-COLI; REHABILITATION CENTERS; PREVALENCE; BIRDS; ENTEROCOCCI; CALIFORNIA; INTEGRONS; EMERGENCE; ABUNDANCE | Antimicrobial resistance (AMR) is a well-documented phenomenon in bacteria from many natural ecosystems, including wild animals. However, the specific determinants and spatial distribution of resistant bacteria and antimicrobial resistance genes (ARGs) in the environment remain incompletely understood. In particular, information regarding the importance of anthropogenic sources of AMR relative to that of other biological and ecological influences is lacking. We conducted a cross- sectional study of AMR in great horned owls (Bubo virginianus) and barred owls (Strix varia) admitted to a rehabilitation center in the midwestern United States. A combination of selective culture enrichment and shotgun metagenomic sequencing was used to identify ARGs from Enterobacteriaceae. Overall, the prevalence of AMR was comparable to that in past studies of resistant Enterobacteriaceae in raptors, with acquired ARGs being identified in 23% of samples. Multimodel regression analyses identified seasonality and owl age to be important predictors of the likelihood of the presence of ARGs, with birds sampled during warmer months being more likely to harbor ARGs than those sampled during cooler months and with birds in their hatch year being more likely to harbor beta-lactam ARGs than adults. Beyond host-specific determinants, ARG-positive owls were also more likely to be recovered from areas of high agricultural land cover. Spatial clustering analyses identified a significant high-risk cluster of tetracycline resistance gene-positive owls in the southern sampling range, but this could not be explained by any predictor variables. Taken together, these results highlight the complex distribution of AMR in natural environments and suggest that both biological and anthropogenic factors play important roles in determining the emergence and persistence of AMR in wildlife. IMPORTANCE Antimicrobial resistance (AMR) is a multifaceted problem that poses a worldwide threat to human and animal health. Recent reports suggest that wildlife may play an important role in the emergence, dissemination, and persistence of AMR. As such, there have been calls for better integration of wildlife into current research on AMR, including the use of wild animals as biosentinels of AMR contamination in the environment. A One Health approach can be used to gain a better understanding of all AMR sources and pathways, particularly those at the humananimal-environment interface. Our study focuses on this interface in order to assess the effect of human-impacted landscapes on AMR in a wild animal. This work highlights the value of wildlife rehabilitation centers for environmental AMR surveillance and demonstrates how metagenomic sequencing within a spatial epidemiology framework can be used to address questions surrounding AMR complexity in natural ecosystems. |
| | Introduction Gastrointestinal anthrax is a rare but serious disease. In August 2017, Isingiro District, Uganda reported a cluster of >40 persons with acute-onset gastroenteritis. Symptoms included bloody diarrhoea. We investigated to identify the etiology and exposures, and to inform control measures. Methods We defined a suspected case as acute-onset of diarrhoea or vomiting during 15-31 August 2017 in a resident (aged >= 2 years) of Kabingo sub-county, Isingiro District; a confirmed case was a suspected case with a clinical sample positive for Bacillus anthracis by culture or PCR. We conducted descriptive epidemiology to generate hypotheses. In a case-control study, we compared exposures between case-patients and neighbourhood-matched controls. We used conditional logistic regression to compute matched odds ratios (MOR) for associations of illness with exposures. Results We identified 61 cases (58 suspected and 3 confirmed; no deaths). In the case-control study, 82% of 50 case-patients and 12% of 100 controls ate beef purchased exclusively from butchery X during the week before illness onset (MOR = 46, 95%CI = 4.7-446); 8.0% of case-patients and 3.0% of controls ate beef purchased from butchery X and elsewhere (MOR = 19, 95%CI = 1.0-328), compared with 6.0% of case-patients and 30% of controls who did not eat beef. B. anthracis was identified in two vomitus and one stool sample. Butchery X slaughtered a sick cow and sold the beef during case-patients’ incubation period. Conclusion This gastrointestinal anthrax outbreak occurred due to eating beef from butchery X. We recommended health education, safe disposal of the carcasses of livestock or game animals, and anthrax vaccination for livestock. Author summary Gastrointestinal anthrax is one of the forms of anthrax caused by Bacillus anthracis. It is a serious but rarely diagnosed form owing to its presentation being similar to gastroenteritis illness due to other organisms. In this investigation, we ascertained that this was a gastrointestinal anthrax outbreak that was caused by consumption of beef of suspicious origin. Trace back identified the source of this beef as being from one specific butcher. All the case-patients were treated and recovered. The outbreak was controlled at the source through treatment and we provided public education of the masses about the dangers of eating meat of animals that have died of unknown causes. We additionally recommended inspection of meat before sale at butcheries to ensure that it is suitable for human consumption as well as vaccination of the animals in the region. In the long term, anthrax control requires a One-Health approach that is multisectoral, involving ministries of agriculture, animal industries and ministries of health. |
| antimicrobial resistance; extended-spectrum beta-lactamases; Escherichia coli; camels | ANTIMICROBIAL RESISTANCE; COMPANION ANIMALS; ANTIBIOTIC-RESISTANCE; WILD BIRDS; GENES; INFECTIONS; LINEAGES; PLASMID; CLONE; CATS | Simple Summary: Extended-spectrum beta-lactamase (ESBL) producing Escherichia coli is an important problem in hospital settings. Camels are known to harbor multidrug-resistant Gram-negative bacteria and to be involved in the transmission of various microorganisms to humans. Fecal samples of 58 camels were recovered in the Canary Islands for detection and characterization of cefotaxime-resistant (CTX(R)) and ESBL-producing E. coli isolates. Five samples carried CTX(R)E. coli isolates and two of them contained ESBL-positive E. coli(3.4%) with the following characteristics: (ESBL/phylogroup/sequence type): CTX-M-15/A/ST3018 and CTX-M-15/B1/ST69. The three remaining isolates recovered from CTX-supplemented plates were ascribed to phylogroup-B-1. Due to the participation of these animals in touristic activities in the region, the potential transference of ESBL-positive bacteria between humans and animals could happen and should be further monitored. Objective: This work aimed to determine the carriage rate of ESBL-producing Escherichia coli as well as their genetic characteristics in camels from the Canary Islands, Spain. Methods: Fecal samples were recovered from 58 healthy camels from Gran Canaria (n = 32) and Fuerteventura Islands (n=26) during July 2019. They were seeded on MacConkey (MC) agar no supplemented and supplemented (MC + CTX) with cefotaxime (2 mu g/mL). Antimicrobial susceptibility was determined by disk diffusion test (CLSI, 2018). The presence of bla(CTX-M), bla(SHV), bla(TEM,) bla(CMY-2) and bla(OXA-1/48) genes was tested by PCR/sequencing. Furthermore, the mcr-1 (colistin resistance), tetA/tetB (tetracycline resistance), int1 (integrase of class 1 integrons) and stx(1,2) genes were analyzed. Phylogenetic groups and sequence types were determined by specific-PCR/sequencing for selected isolates. Results:E. coli was obtained from all the 58 camels in MC media (100%) and in five of them in MC + CTX media (8.6%). Furthermore, 63.8% of E. coli isolates recovered from MC agar were susceptible to all the antibiotics tested. The five E. coliisolates recovered from MC + CTX media were characterized and two of them were ESBL-producers (3.4%). Both ESBL-producer isolates carried the bla(CTX-M-15) gene and belonged to the lineages ST3018 (phylogroup A) and ST69 (phylogroup B1). The 3 ESBL-negative isolates recovered from MC-CTX plates were ascribed to phylogroup-B-1. Conclusions: Camels can be a source of ESBL-producer bacteria, containing the wide spread bla(CTX-M-15) gene associated with the lineages ST3018 and ST69. |
| Rabies; One health; Dog vaccination; Dog sterilisation; Economic analysis | CANINE VACCINATION; DISEASE; BURDEN; STERILIZATION; DURATION; BENEFITS; IMMUNITY; PROGRAM | A global strategic plan for the elimination of dog-mediated human rabies deaths by 2030 was announced in 2018. The cost-effectiveness of annual mass dog vaccination programmes, as a control and elimination method, has been advocated on many occasions. Complementary methods, such as animal birth control (ABC) activities, have received less attention. This paper provides a case-study of a programme operated by Help in Suffering (HIS) in Jaipur, India from 1994/95 until 2016/17 comprising both ABC and additional vaccination-only activities. The availability of cost data alongside information on dog numbers, dog bites and human rabies cases provided an exceptionally detailed and unique retrospective dataset recording actual events and expenditures. Updated to 2016/17 prices, the total cost of the programme was 658,744 USD. Since 2007/2008, activity costs have been separated and returned costs of 10.78 USD per dog, both sterilised and vaccinated, and 1.86 USD per dog, vaccinated only. Over the course of the programme, the number of disability-adjusted life years (DALYs) due to premature death and the distress associated with dog bites was estimated to be 36,246 fewer than would have been expected if HIS had not been operating, based on a counterfactual scenario using pre-intervention values. Linking the DALY figure to the cost of the activities undertaken by HIS yields a cost of 26 USD per DALY averted. Discounted at 3%, the DALYs averted equate to 16,587 at a cost of 40 USD per DALY averted. Both cases make it a very cost-effective intervention, in relation to the threshold of investing one year’s gross domestic product (GDP) per DALY averted (1981 USD in 2016/17). The monetary benefit from fewer dog bites and clinical human rabies cases requiring treatment amounted to 5.62 million USD after discounting, which, if attributed to Help in Suffering, yields a monetary benefit-cost ratio of 8.5. Thus, the potential monetary benefits greatly outweigh the programme costs, even without considering the DALYs averted. If a modest notional monetary value of one year’s GDP is assigned to represent the human capital or production value of DALYs averted, the discounted societal economic benefit reaches 38.48 million USD and implies a benefit-cost ratio of 58.4. These economic analyses demonstrate that ABC activities in combination with additional vaccination efforts can be a cost-effective control measure for dog-mediated human rabies. |
| Brucellosis; Farmers; Perceived impact; Baringo County; Kenya | CATTLE; COSTS; AREAS; RISK | Background Brucellosis in Africa is caused by Brucella species transmitted through contaminated or contacts with infected animals or their carcasses. The disease reduces livestock production and reproduction performance evident by frequent episodes of abortion, still births, swollen testes, weak calves/lambs and swollen joints. However, the socio-economic impacts of these brucellosis-associated symptoms on milk, fat, meat and blood production, infertility, sale value, dowry and costs of treatment has not been evaluated extensively in developing countries. In Baringo County, Kenya, there is a continuous movement of cattle as a result of trade and grazing, which predisposes many herds to brucellosis infection. The objective of this study was to investigate the socio-economic impacts of Brucella infection on production systems for sheep, goats, cattle and camels and explore the impact of brucellosis on livestock production and reproduction performance among livestock keeping communities in Baringo County, Kenya. The study adopted a cross-sectional survey using quantitative data collection methods. Results Results demonstrated an impact on milk production in suspected brucellosis cases resulting from abortions (OR = 0.151, P < 0.0001) and swollen joints (OR = 2.881, P < 0.0001). In terms of infertility, abortion as a symptom of brucellosis (OR = 0.440, P = 0.002), still birth (OR = 0.628, P = 0.042), and weak calf or lamb (OR = 0.525, P = 0.005) had an impact on infertility. In terms of sale value, abortion (OR = 0.385, P = 0.008), weak calf/lamb (OR = 2.963, P = 0.013) had an impact on sale value. Other analyses demonstrated that for dowry, swollen testes (OR = 5.351, P = 0.032), weak calf and lambs (OR = 0.364, P = 0.019) had a likelihood of reduction of dowry value. Finally, in terms of cost of treatment, abortion (OR = 0.449, P = 0.001), still births (OR = 0.208, P = 0.015), swollen testes (OR = 0.78, P = 0.014), weak calf/lambs (OR = 0.178, P = 0.007) and swollen joints (OR = 0.217, P = 0.003) significantly increased the costs of treatments. There was no impact on fat and meat and blood production. Conclusion Even though there was a huge socio-economic impact on milk production, infertility, sale value, and dowry, it was the costs of treatment that was significantly impacted on all symptoms associated with brucellosis on this community. A ‘One Health’ approach in tackling the brucellosis menace as a holistic approach is recommended for both humans and their livestock. |
| IMPACT; INTERVENTION; READMISSIONS | BACKGROUND: One of the most vulnerable times in a patient’s encounter with a health care system is during transitions of care (TOC), defined by the Joint Commission as the movement of a patient from one health care provider or setting to another. The use of a clinical pharmacist as a member of the care transitions team has received focused attention and shown improved benefit. OBJECTIVE: To determine the effect of a large-scale pharmacist-to-pharmacist TOC model where inpatient clinical pharmacists identify patients during a hospital stay, provide evidence-based care and education, and then coordinate follow-up with an outpatient clinical pharmacist who provided comprehensive medication management (CMM) under a scope of practice. METHODS: This was a multisite, single health care system, quasi-experimental, matched interrupted time series design study conducted at an integrated Veterans Affairs (VA) health care system. Patients admitted with a primary or secondary diagnosis of diabetes, hypertension, chronic obstructive pulmonary disease (COPD) and heart failure (HF) were included for enrollment. Clinical pharmacists rounding on inpatient medical teams provided evidence-based recommendations to optimize medications while coordinating follow-up by an outpatient clinical pharmacy specialist within 10 days of discharge for CMM. The primary endpoint of this study was to determine the effect on the composite all-cause 30-day acute care utilization rate (emergency department [ED] visit or hospital readmission) for patients discharged with a primary or secondary diagnosis of diabetes, hypertension, COPD, and HF compared with a comparator group of patients with similar discharge diagnosis before implementation of the TOC program. RESULTS: 484 patients (242 in each group, with 366 heart failure, 66 COPD, 10 hypertension, and 42 diabetes) were included for analysis. For the primary outcome of composite 30-day, all-cause acute care utilization rates, no statistically significant difference was identified, with 26.9% of patients in the intervention group and 28.9% in the historical group readmitted or seen in the ED within 30 days of discharge (P = 0.6852). Outcomes for the HF index acute care utilization rate (i.e., admission for the same disease state discharged with), including 30-day index readmissions (P = 0.0014), 30-day index ED visits (P = 0.0047), and 90-day index readmissions for HF (P < 0.0001) were significantly reduced. CONCLUSIONS: Our study is one of the first to identify at-risk patients using rounding clinical pharmacists in the acute care arena and coordination of care systematically with a clinical pharmacy specialist practicing under a scope of practice targeted for CMM. Although the overall primary endpoint was not met, a reduction in acute care utilization rates for HF at 30 and 90 days can be achieved. |
| Antimicrobial stewardship program; Prescription guidelines; Antibiotics; Prescription patterns; Companion animals; HPCIA; Highest priority critically important antimicrobial; One Health | URINARY-TRACT DISEASE; RESISTANT STAPHYLOCOCCUS-AUREUS; VETERINARY PRACTICES; COMPANION ANIMALS; USE GUIDELINES; PRIMARY-CARE; DOGS; IMPACT; POPULATION; TRANSMISSION | Background Antimicrobial stewardship activities are essential to improve prudent antimicrobial use. The aim of the present study was to evaluate changes in antimicrobial prescriptions in cats after the introduction of prudent use guidelines promoted by an online antimicrobial stewardship tool (AntibioticScout.ch) in Switzerland. Data from 792 cats presented to two university hospitals and 14 private practices in 2018 were included and compared to 776 cases from 2016. Cats were diagnosed with acute upper respiratory tract disease (aURTD), feline lower urinary tract disease (FLUTD) and abscesses. Clinical history, diagnostic work-up and antimicrobial prescriptions (class, dosage, duration) were assessed. Type and proportions [95% confidence intervals] of antimicrobial prescriptions were compared between the two evaluation periods and a mixed effects logistic regression model was applied to evaluate compliance with Swiss prudent use guidelines. Results From 2016 to 2018, the proportion of antimicrobial prescription in all included cases decreased from 75.0% [71.8-78.0] to 66.7% [63.3-69.9]; this decrease was most pronounced for treatments at university hospitals (67.1% [59.5-74.0] to 49.3% [40.9-57.8]) and for cats with FLUTD (60.1% [54.6-65.4] to 48.8% [43.2-54.4]). Use of 3rd generation cephalosporins in private practices declined from 30.7% [26.5-35.1] to 22.1% [18.4-26.2], while overall use of non-potentiated aminopenicillins increased from 19.6% [16.4-23.0] to 27.8% [24.1-31.9]. In cases where antimicrobial therapy was indicated, compliance with guidelines did not increase (33.3% [26.6-40.6] to 33.5% [27.2-40.2]), neither at universities nor in private practices. On the other hand, antimicrobial treatment was more often withheld in cases with no indication for antimicrobial therapy (35.6% [30.1-41.4] to 54.0% [47.6-60.4]); this was found for private practices (26.7% [20.8-33.4] to 46.0% [38.4-53.7]) and for aURTD cases (35.0% [26.5-44.2] to 55.4% [44.7-65.8]). Conclusions Overall proportions of antimicrobial prescription, unjustified antimicrobial therapy and, in private practices, use of 3rd generation cephalosporins decreased from 2016 to 2018 for the investigated feline diseases. However, overall compliance with Swiss prudent use guidelines was still low, implying that further efforts are required to foster prudent antimicrobial use in cats. |
| Precision clinical pharmacology; Research agenda; Eurpean Association for Clinical Pharmacology and Therapeutics (EACPT) | TRIAL | Background and methods This opinion paper expanded on the WHO six-step approach to optimal pharmacotherapy, by detailed exploration of the underlying pharmacological and pathophysiological principles. This exercise led to the identification of a large number of domains of research that should be addressed to make clinical pharmacology progress toward precision clinical pharmacology, as a prerequisite for precision medicine. Result In order to improve clinical efficacy and safety in patient groups (to guide drug development) as well as in individuals (to guide therapeutic options and optimize clinical outcome), developments in clinical pharmacology should at least tackle the following: (1) molecular diagnostic assays to guide drug design and development and allow physicians to identify the optimal targets for therapy in the individual patient in a quick and precise manner (to guide selection of the right drug for the right patient); (2) the setting up and validation of biomarkers of target engagement and modification as predictors of clinical efficacy and safety; (3) integration of physiological PK/PD models and intermediate markers of pharmacological effects with the natural evolution of the disease to predict the drug dose that most effectively improves clinical outcome in patient groups and individuals, making use of advanced modeling technologies (building on deterministic models, machine-learning, and deep learning algorithms); (4) methodology to validate human or humanized in vitro, ex vivo, and in vivo models for their ability to predict clinical outcome with investigational therapies, including nucleic acids or recombinant genes together with vectors (including viruses or nanoparticles), cell therapy, or therapeutic vaccines; (5) methodological complements to the gold-standard, large Phase 3 randomized clinical trial to provide clinically relevant and reliable data on the efficacy and safety of all treatment options at the population level (pragmatic clinical trials), as well as in small groups of patients (as low as n = 1); (6) regulatory science, so as to optimize the ethical review process, documentation, and monitoring of clinical trials, improve efficiency, and reduce costs of clinical drug development; (7) interventions to effectively improve patient compliance and to rationalize polypharmacy for the reduction of adverse effects and the enhancement of therapeutic interactions; and (8) appraisal of the ecological and societal impact of drug use to safeguard against environmental hazards (following the One Health concept) and to reduce drug resistance. Discussion and conclusion As can be seen, precision clinical pharmacology aims at being highly translational, which will require very large panels of complementary skills. Interdisciplinary collaborations, including non-clinical pharmacologists, will be key to achieve such an ambitious program. |
| Clostridium difficile; home gardens; community-associated C. difficile infection; esculin hydrolysis negative | LABORATORY-BASED SURVEILLANCE; PCR RIBOTYPES; INFECTION; ENVIRONMENT; CONTAMINATION; EPIDEMIOLOGY; VEGETABLES; COMMUNITY; PIGS | In recent years, community-associated Clostridium difficile infection (CACDI) has emerged as a significant health problem, accounting for similar to 50% of all CDI cases. We hypothesized that the home garden environment could contribute to the dissemination of C. difficile spores in the community and investigated 23 homes in 22 suburbs of Perth, Western Australia. We identified a high prevalence of toxigenic C. difficile in this environment. In total, 97 samples consisting of soil (n = 48), compost (n = 15), manure (n = 12), and shoe sole swabs (n = 22) were collected. All samples were cultured anaerobically on C. difficile ChromID agar and enriched in brain heart infusion broth, and isolates were characterized by toxin gene PCR and PCR ribotyping. Two-thirds (67%; 95% confidence interval [CI], 57 to 76%) of home garden samples, including 79% (95% CI, 68 to 91%) of soil, 67% (95% CI, 43 to 90%) of compost, 83% (95% CI, 62% to 100%) of manure, and 32% (95% CI, 12 to 51%) of shoe sole samples, contained C. difficile. Of 87 isolates, 38% (95% CI, 28 to 48%) were toxigenic, and 26 PCR ribotypes (RTs), 5 of which were novel, were identified. The toxigenic C. difficile strain RT014/020 was the most prevalent RT. Interestingly, 19 esculin hydrolysis-negative strains giving white colonies were identified on C. difficile ChromID agar, 5 of which were novel toxigenic RTs that produced only toxin A. Clearly, there is the potential for transmission of C. difficile in the community due to the contamination of home gardens. Our findings highlight the importance of a One Health approach to dealing with CDI. IMPORTANCE Recently, community-associated Clostridium difficile infection (CA-CDI) has emerged as a significant problem, accounting for similar to 50% of all CDI cases and reported to affect a younger population without traditional risk factors. Possible sources of CA-CDI are soil, food, and water contaminated by animal feces, and recent reports show overlapping ribotypes of C. difficile in animals, humans, and the environment; however, the epidemiology of CA-CDI and related risk factors need to be better understood. Our research aimed to determine the prevalence of C. difficile in home gardens and on the shoe soles of homeowners in Perth, Western Australia. There were high rates of contamination with C. difficile in gardens, and some of the ribotypes identified had been isolated from human cases of CDI in Western Australia. This study shows that home gardens and shoes may be a source of C. difficile in CA-CDI. |
| Animal agriculture; Aquaculture; Antibiotics; Atlantic salmon; Bacteria; Drug policy; Resistance; Veterinary drug | ANTIMICROBIAL RESISTANCE GENES; ANTIBIOTIC-RESISTANCE; SEA-LICE; NORWEGIAN AQUACULTURE; ANTIBACTERIAL AGENTS; MARINE-BACTERIA; WILD FAUNA; ONE HEALTH; FISH; SEDIMENTS | Aquaculture now produces nearly half of the seafood consumed globally. Atlantic salmon (Salmo salar) is one of the top aquaculture products and the most valuable farmed marine finfish species in the United States (U.S.). The aim of this study is to better understand veterinary drug use in U.S. net pen Atlantic salmon aquaculture and compare these findings to other salmon producing countries and U.S. livestock. We collected and analyzed records on Atlantic salmon production and veterinary drug use in Maine (2003 to 2017) and Washington (2012 to 2017). Antimicrobial medicated feeds were used in 8% and 93% of production cycles in Maine and Washington, respectively. Oxytetratcycline was the primary drug used in both states. Maine used no antimicrobials in eight of the past 15 yrs., including none in 2017. Emamectin benzoate, an antiparasitic medicated feed, was used in 28% production cycles in Maine (2014 to 2017; avg. 1.1 kg/yr) and no emamectin benzoate was administered in Washington over the time period studied. From 2014 to 2016, the U.S. farmed salmon industry contributed 0.8% +/- 0.1% to annual global farmed salmon production and administered 1.2% +/- 0.6% of antimicrobials used in global salmon farming. Over the same time period, Norway and Chile accounted for 53% +/- 3% and 35% +/- 3% of annual global production, and administered 0.06% +/- 0.02% and 96% +/- 0.09% of antimicrobials used in global salmon farming. Compared to U.S. terrestrial agriculture in 2016, the U.S. Atlantic salmon industry contributed 0.031% to U.S. food animal production and administered 0.057% of antimicrobials available to U.S. food animals. Based on the data we collected, the U.S. Atlantic salmon aquaculture industry is a relatively small user of antimicrobials compared to U.S. beef, pigs, poultry, and Chilean salmon industries. There are relatively few approved drugs in the U.S. to treat aquaculture diseases and more options are needed as well as continued work on vaccines. Antimicrobial resistance is a worldwide public health concern; the overuse or misuse of antimicrobials in any setting can compromise the treatment of bacterial infections. The U.S. net pen Atlantic salmon aquaculture industry appears to be the first U.S. food animal industry to report monthly antimicrobial use at the farm-level to the government. These data are critical to assess public health risks associated with antimicrobial use and resistance, and therefore, are needed from all U.S. food animal industries. |
| Salmonella enterica; WGS; ESBL; serovars; IncM2; bla(CTX-M-3); MDR plasmid; horizontal transfer | SPECTRUM-BETA-LACTAMASE; FOOD-PRODUCING ANIMALS; UNITED-STATES; SUBSP ENTERICA; CERRO; ENVIRONMENT; INFECTIONS; PREVALENCE; OUTBREAK; CATTLE | Salmonella enterica is a major causative pathogen of human and animal gastroenteritis. Antibiotic resistant strains have emerged due to the production of extended-spectrum beta-lactamases (ESBLs) posing a major health concern. With the increasing reports on ESBL-producing Enterobacterales that colonize companion animals, we aimed to investigate ESBL dissemination among ESBL-producing Salmonella enterica (ESBL-S) in hospitalized horses. We prospectively collected ESBL-S isolates from hospitalized horses in a Veterinary-Teaching Hospital during Dec 2015-Dec 2017. Selection criteria for ESBL-S were white colonies on CHROMagarESBL plates and an ESBL phenotypic confirmation. Salmonella enterica serovars were determined using the Kaufmann-White-Le-Minor serological scheme. ESBL-encoding plasmids were purified, transformed and compared using restriction fragment length polymorphism (RFLP). Whole genome sequencing (Illumina and MinION platforms) were performed for detailed phylogenetic and plasmid analyses. Twelve ESBL-S were included in this study. Molecular investigation and Sequence Read Archive (SRA) meta-analysis revealed the presence of three unique Salmonella enterica serovars, Cerro, Havana and Liverpool, all reported for the first time in horses. PFGE revealed the clonal spread of S. Cerro between seven horses. All twelve isolates carried bla(CTX-M-3) and showed an identical multidrug resistance profile with co-resistance to trimethoprim/sulfamethoxazole and to aminoglycosides. Plasmid RFLP proved the inter-serovar horizontal spread of a single bla(CTX-M-3)-encoding plasmid. Complete sequence of a representative plasmid (S. Havana strain 373.3.1), designated pSEIL-3 was a -86.4 Kb IncM2 plasmid, that encoded nine antibiotic resistance genes. pSEIL-3 was virtually identical to pCTX-M3 from Citrobacter freundii, and showed high identity (>95%) to six other bla(CTX-M-3) or bla(NDM-1) IncM2 broad host range plasmids from various Enterobacterales of human origin. Using a specific six gene-based multiplex PCR, we detected pSEIL-3 in various Enterobacterales species that co-colonized the horses’ gut. Together, our findings show the alarming emergence of ESBL-S in hospitalized horses associated with gut shedding and foal morbidity and mortality. We demonstrated the dissemination of CTX-M-3 ESBL among different Salmonella enterica serovars due to transmission of a broad host range plasmid. This report highlights horses as a zoonotic reservoir for ESBL-S, including highly transmissible plasmids that may represent a ‘One-Health’ hazard. This risk calls for the implementation of infection control measures to monitor and control the spread of ESBL-S in hospitalized horses. |
| nile perch; food safety; extended-spectrum beta-lactamase; antimicrobial resistance; Escherichia coli | GRAM-NEGATIVE BACTERIA; ANTIBIOTIC-RESISTANCE; ANTIMICROBIAL RESISTANCE; (ESBL)-PRODUCING ENTEROBACTERIACEAE; MOLECULAR CHARACTERIZATION; FOOD ANIMALS; CHICKEN MEAT; PREVALENCE; GENES; WATER | Extended-spectrum beta-lactamase (ESBL)-producing bacteria constitute an emerging global health issue with food products being vehicles of transmission and the aquatic environments serving as potential reservoirs. This study aimed to characterize ESBL-producing Escherichia coli in Nile perch and water from Lake Victoria in Tanzania. A total of 180 samples of Nile perch and 60 water samples were screened for ESBL-producing E. coli on MacConkey agar supplemented with 2 mu g/ml of cefotaxime and confirmed by bla(CTX-M) and bla(TEM) PCR. Antimicrobial resistance was determined by the disk diffusion method, and the ESBL-producing isolates were whole genome sequencing (WGS). ESBL-producing E. coli were detected in eight of the 180 analyzed Nile perch samples, and only one water sample was positive (1.7%, n = 60). Isolates were resistant to sulfamethoxazole-trimethoprim (100%), ampicillin/cloxacillin (100%), erythromycin 72.7% (8/11), tetracycline 90.9% (10/11), and nalidixic acid 63.6% (7/11). This mostly corroborates the resistance genes that they carried for sulfonamides (sul1 and sul2), trimethoprim (dfrA and dfrB), aminoglycosides [aac(3)-IId, strA, and strB], tetracycline [tet(B) and tet(D)], and fluoroquinolones (qepA4). They harbored plasmid replicon types IncF, IncX, IncQ, and Col and carried bla(CTX-M-15) and bla(TEM-1B) genes generally found on the same contigs as the IncF plasmid replicon. Although epidemiologically unrelated, the strains formed three separate sequence type-phylogroup-serotype-specific clusters: C1, C2, and C3. Cluster C1 included five strains (3 to 13 SNPs) belonging to ST167, phylogroup A, and serotype O9:H21; the two C2 strains (11 SNPs) belong to ST156, phylogroup B1, and serotype ONT:H28; and C3 was made up of four strains (SNPs ranged from 4 to 17) of ST636, phylogroup B2, and serotype O45:H7. The common virulence gene gad was reported in all strains. In addition, strains in C2 and C3 possessed iss, lpfA, and nfaE virulence genes, and the vat gene was found only in C3. The present study reports the occurrence of multidrug-resistant ESBL-producing E. coli carrying plasmid-mediated ESBL genes in offshore water and Nile perch in Lake Victoria. Strains formed three clonal clusters of unknown origin. This study reveals that the Lake may serve as reservoir for ESBL-producing bacteria that can be transmitted by fish as a food chain hazard of One-Health concern. |
| DIAGNOSIS | Taenia soliumis endemic in Madagascar and presents a significant burden on the population and the health system. The parasite cycles through humans who host the adult tapeworm, and pigs that host the larval stages. Accidental infection of humans may occur with the larval stages which encyst in the nervous central system causing neurocysticercosis, a major cause of seizure disorders and a public health problem. One of the interventions to facilitate the control of the disease is mass drug administration (MDA) of the human population with taeniacide. Here we describe a pilot project conducted in Antanifotsy district of Madagascar from 2015 to 2017 where three annual rounds of MDA (praziquantel, 10mg/Kg) were undertaken in 52 villages. Changes in the prevalence of taeniasis were assessed before, during and after the treatments. A total of 221,308 treatments were given to all eligible people above 5 years of age representing a 95% coverage of the targeted population. No major adverse effects were notified related to the implementation of the MDA. The prevalence of taeniasis was measured using Kato-Katz and copro-antigen techniques. Analyses undertaken combining the results of the Kato-Katz with copro-antigen, or using the Kato-Katz results alone, showed that there was a significant reduction in taeniasis 4 months after the last MDA, but 12 months later (16 months after the last MDA) the taeniasis prevalence had returned to its original levels. Results of the pilot project emphasize the need of a multi-sectorial One-Health approach for the sustained control ofT.solium. Author summary The parasiteTaenia soliumcauses neurocysticercosis in humans in its larval stage and is the main cause of seizure disorders in poor communities that keep pigs (the intermediate host). Diagnosis and treatment of neurocysticercosis remains beyond the reach of the general population in Madagascar. Prevention is therefore the most suitable strategy for combating this disease. Mass drug administration (MDA) is used to treat communities for several parasitic diseases such as schistosomiasis. Infection with theT.soliumtapeworm in people can be treated with MDA using praziquantel. Here, we conducted a pilot project in Madagascar, giving over 220,000 treatments to people in 52 villages once per year, for 3 consecutive years. The effects on taeniasis seemed to be encouraging when assessed 4 months after finishing the treatment, but 16 months later, the parasite’s prevalence had returned to its original level. MDA was effective in providing temporary control of taeniasis, but parasite transmission was not interrupted. With respect toT.solium, this highlights the need of incorporating other interventions such as vaccination and medication in pigs, improved pig husbandry and meat inspection to tackle the whole cycle of the parasite. |
| Enterobacteriaceae; antimicrobial agents; efflux pumps; mechanisms of resistance; multidrug resistance; plasmid-mediated resistance | COMPLETE GENOME SEQUENCE; MEXC-MEXD-OPRJ; PSEUDOMONAS-AERUGINOSA; ANTIBIOTIC-RESISTANCE; SUSCEPTIBILITY; COLI; OVEREXPRESSION; ACRAB | Transporters belonging to the chromosomally encoded resistance-nodulation-division (RND) superfamily mediate multidrug resistance in Gram-negative bacteria. However, the cotransfer of large gene clusters encoding RND-type pumps from the chromosome to a plasmid appears infrequent, and no plasmid-mediated RND efflux pump gene cluster has yet been found to confer resistance to tigecycline. Here, we identified a novel RND efflux pump gene cluster, designated tmexCD1-toprJ1, on plasmids from five pandrug-resistant Klebsiella pneumoniae isolates of animal origin. TMexCD1-TOprJ1 increased (by 4- to 32-fold) the MICs of tetracyclines (including tigecycline and eravacycline), quinolones, cephalosporins, and aminoglycosides for K. pneumoniae, Escherichia coli, and Salmonella. TMexCD1-TOprJ1 is closely related (64.5% to 77.8% amino acid identity) to the MexCD-OprJ efflux pump encoded on the chromosome of Pseudomonas aeruginosa. In an IncFIA plasmid, pHNAH8I, the tmexCD1-topril gene cluster lies adjacent to two genes encoding site-specific integrases, which may have been responsible for its acquisition. Expression of TMexCD1-TOpr11 in E. coli resulted in increased tigecycline efflux and in K. pneumoniae negated the efficacy of tigecycline in an in vivo infection model. Expression of TMexCD1-TOprJ1 reduced the growth of E. coli and Salmonella but not K. pneumoniae. tmexCD1-toprJ1-positive Enterobacteriaceae isolates were rare in humans (0.08%) but more common in chicken fecal (14.3%) and retail meat (3.4%) samples. Plasmid-borne tmexCD1-topril-like gene clusters were identified in sequences in GenBank from Enterobacteriaceae and Pseudomonas strains from multiple continents. The possibility of further global dissemination of the tmexCD1-toprJ1 gene cluster and its analogues in Enterobacteriaceae via plasmids may be an important consideration for public health planning. IMPORTANCE In an era of increasing concerns about antimicrobial resistance, tigecycline is likely to have a critically important role in the treatment of carbapenemresistant Enterobacteriaceae, the most problematic pathogens in human clinical settings-especially carbapenem-resistant K. pneumoniae. Here, we identified a new plasmid-borne RND-type tigecycline resistance determinant, TMexCD1-TOprJ1, which is widespread among K. pneumoniae isolates from food animals. tmexCD1-toprJ1 appears to have originated from the chromosome of a Pseudomonas species and may have been transferred onto plasmids by adjacent site-specific integrases. Although tmexCD1-toprJ1 still appears to be rare in human clinical isolates, considering the transferability of the tmexCD1-toprJ1 gene cluster and the broad substrate spectrum of TMexCD1-TOprJ1, further dissemination of this mobile tigecycline resistance determinant is possible. Therefore, from a One Health perspective, measures are urgently needed to monitor and control its further spread. The current low prevalence in human clinical isolates provides a precious time window to design and implement measures to tackle this. |
| welfare assessment; equid; animal-based indicators; evidence-based practice; equid welfare; one health | ANIMAL-WELFARE; EQUUS-ASINUS; DAIRY-CATTLE; BEHAVIORAL INDICATORS; URINE INDUSTRY; FERAL DONKEYS; HORSE-MEAT; MANAGEMENT; SCIENCE; QUALITY | Simple Summary Animal welfare is a global concern which receives close public scrutiny. Numerous non-profit and non-governmental organisations exist to address problems relating to poor animal welfare, but there are multiple challenges surrounding how animal welfare is measured and recorded. We focus on the specific challenges around assessing equid welfare worldwide, and identify how stakeholders in this field of work are often unable to collaborate or pool resources due to differences in the welfare assessment tools they use. There is a need for a single welfare assessment tool which can be used across multiple contexts, yet which can yield comparable datasets to coordinate the approach to, and understanding of, global equid welfare. In response, we developed the Equid Assessment, Research and Scoping (EARS) tool which builds upon previously validated techniques, but extends them in a new framework which is applicable to multiple contexts. We have developed nine protocols, based upon 19 welfare indicators, and we describe the process of development here. We present the results from field-trialling three of the most frequently used protocols during the course of our work, assessing equids globally in farms and working environments, and equids on sanctuaries and properties in the UK and Europe. We found that the tool offered an easy and relatively quick way of collecting welfare data across multiple contexts, and propose that if developed further, it could be adopted by other organisations working to assess, understand and improve equid welfare worldwide. The assessment of animal welfare poses numerous challenges, yet an emerging approach is the consolidation of existing knowledge into new frameworks which can offer standardised approaches to welfare assessment across a variety of contexts. Multiple tools exist for measuring the welfare of equids, but such tools have typically been developed for specific contexts. There is no ‘one size fits all’ which means that resulting datasets are generally non-comparable, creating a barrier to knowledge-sharing and collaboration between the many organisations working to improve equid welfare around the globe. To address this, we developed the Equid Assessment, Research and Scoping (EARS) tool, which incorporates pre-existing validated welfare assessment methods alongside new welfare indicators to deliver a larger and more comprehensive series of welfare indicators than currently exists, creating a single resource that can be used to assess equid welfare in any context. We field-trialled three welfare assessment protocols within the EARS tool, and applied these to welfare assessment of equids in a variety of contexts across nineteen countries. The EARS tool proved a useful, versatile and rapid method for collecting welfare assessment data and we collected 7464 welfare assessments in a period of fifteen months. We evaluate the EARS tool and provide ideas for future development. |
| SAO-PAULO STATE; INTESTINAL PARASITES; GIARDIA; RISK; EPIDEMIOLOGY; PREVALENCE; SALVADOR | Author summary The maintenance of high prevalence of enteric parasitic diseases in human and animal populations is an indisputable fact in the current scientific context. Despite all the advances in ecology, pathology, epidemiology and treatment, the control of these diseases remains ineffective and is a major problem in public health management. New control strategies should be tested in order to optimize the actions of current preventive programs and thus reduce prevalence. These strategies should include identification and mapping of geopolitical areas experiencing a greater frequency and overlap of enteric parasitic infections, and they must include the prevalence in both canine and human populations. This study indicates that poverty is strongly associated with the parasite’s frequency. In a One Health approach, it demonstrates that affirmative actions of citizenship and income can be preventive health measures, and it also demonstrates the areas in which deworming actions must be a priority through control actions based on risk. The aim of this study was to determine the prevalence and risk factors of the main enteric parasitic infections that affect children and dogs in the municipality of Ilheus, Bahia, Brazil; and to identify the geopolitical areas that should receive priority interventions to combat them. Between March and November 2016, fecal samples of 143 dogs and 193 children aged 1 month to 5 years were collected in 40 rural and semirural communities using a systematic sampling approach, stratified by district. Samples were collected by legal guardians of the children and / or dog owners. Eggs, larvae, cysts and oocysts of parasites were concentrated by centrifugal-flotation and centrifugal-sedimentation, and acid-resistant staining was used to visualize parasites. One hundred and thirty-two children (68.4%), 111 dogs (77.6%) and 199 (73.7%) dog fecal samples collected from streets were parasitized. Giardiasis, cryptosporidiosis, amoeba infections and hookworm were the most frequent infections in all studied populations, in addition to trichuriasis in dogs and ascaridiasis in children. A predominance of Giardia and hookworms was observed in children and dogs, respectively. The coastal districts of Aritagua, Olivenca and the main district had a higher parasitic diversity and overlapping of important potential zoonotic infections. Age over one year (p<0.001), adjusted OR = 3.65; 95% CI = 1.86-7.16) and income below the minimum monthly salary (p = 0.02, adjusted OR = 2.78, 95% CI = 1.17-6.59) were the main factors associated with intestinal parasitic infections in children and dogs, respectively. The coastal districts of Aritagua and Olivenca and the main district should be prioritized through enteric disease control programs, and the factors associated with infections must be considered in the design of health interventions in these districts. The integration between affirmative income actions and investments to improve the health infrastructure of these communities may work more effectively than current preventive measures to combat enteric parasites. |
| child and adolescent; health promotion; depression; suicide | SUBSTANCE USE INITIATION; MENTAL-HEALTH; YOUNG-ADULTS; DRUG-USE; SCHOOL; PATTERNS; TRAJECTORIES; PREVALENCE; SYMPTOMS; ALCOHOL | Accessible summary What is known on the subject? Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently. Multiple HRBs might threaten adolescents’ future health in adulthood. Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. What does this paper add to existing knowledge? A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently. Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs. Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. What are the implications for practice? When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents’ engagement in multiple HRBs. Population-based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. Introduction There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods This cross-sectional study was conducted using the 2016 Korea Youth Risk Behavior Web-based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43-4.47, 95% CI = 1.37-1.49 to 3.23-6.20) and/or who had suicidal ideation (OR = 1.33-3.19, 95% CI = 1.25-1.42 to 2.25-4.51) were more likely to engage in multiple HRBs. Discussion A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self-reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents’ mental health status and needs. |
| vector-borne; PCR; seroprevalence | CYTAUXZOON SP INFECTION; DOMESTIC CATS; LEISHMANIA-INFANTUM; COXIELLA-BURNETII; INDIRECT IMMUNOFLUORESCENCE; FELINE LEISHMANIASIS; CANINE LEISHMANIASIS; PREVALENCE; GENE; PCR | Simple Summary Monitoring the health status of cats ensures their welfare and control of infections transmissible to other domestic and wild animals, as well as to humans. In the present survey, blood samples and ticks were collected, between February 2018 and October 2019, from 85 stray cats living in registered colonies in Emilia Romagna (northern Italy), with the aim of investigating the presence and infection level of a wide range of pathogens transmitted by arthropods (arthropod-borne pathogens-ABPs). The collected samples were subjected to serological and DNA-based methods. The presence of pathogens was observed in 71 cats (83.5%) using serological methods and in 47 cats (55.3%) by applying DNA-based analysis. Coinfections (presence of two or more pathogens) were observed in 21 cats (24.7%). While ABPs in privately owned cats are more easily prevented and managed through standard veterinary care, stray cats may be particularly at risk as they live outdoors, have constant exposure to arthropods such as ticks and fleas, and generally do not receive regular antiparasitic treatment. Indeed, the results of the present study show a widespread presence of ABPs, suggesting that stray cats may represent a potential health threat to companion animals and people and the need for improved management. Cats may be affected by a wide range of arthropod-borne pathogens (ABPs) of medical and veterinary interest. Between February 2018 and October 2019, 85 blood samples were collected from stray cats from the Emilia Romagna region (northern Italy). Ticks (n = 28) on the examined cats were also collected. Serological and molecular methods were applied to search for infection by Anaplasma phagocytophilum, Bartonella henselae, Coxiella burnetii, Ehrlichia canis, Leishmania spp., Babesia spp., Hepatozoon spp., and Cytauxzoon spp. A total of 71 sera (83.5%) had antibodies to at least one investigated pathogen: 39 (45.9%) were positive for B. henselae, 32 (37.6%) positive for C. burnetii, 12 (14.1%) positive for E. canis, four (4.7%) positive for A. phagocytophilum, and two (2.4%) positive for Leishmania spp. A total of 47 (55.3%) DNA samples were positive by PCR for at least one investigated pathogen: 25 (29.4%) were positive for C. burnetii, 23 (27.1%) positive for B. henselae, two (2.4%) positive for E. canis, five (5.9%) positive for Leishmania spp., and two (2.4%) positive for Cytauxzoon spp. Coinfections were observed in 21 cats (24.7%). No positivity was found for A. phagocytophilum, Babesia spp., or Hepatozoon spp. All ticks were negative. A widespread presence of ABPs in the investigated area of northern Italy was shown. Accurate information on their prevalence may be relevant for feline veterinary medicine, as well as from a One Health perspective. |
| carbapenem-resistance; POM-1; Pseudomonas otitidis; Brazil | ALGORITHM | Background: The indiscriminate use of antibiotics in food-animal production has a major impact on public health, particularly in terms of contributing to the emergence and dissemination of antimicrobial resistant bacteria in the food-animal production chain. Although Pseudomonas species are recognized as important spoilage organisms in foodstuff, they are also known as opportunistic pathogens associated with hospital-acquired infections. Furthermore, Pseudomonas can play a role as potential reservoirs of antimicrobial resistance genes, which may be horizontally transferred to other bacteria. Considering that cephalosporins (3rd and higher generations) and carbapenems are critically important beta-lactam antimicrobials in human medicine, this study reports the occurrence and genomic characterization of a meropenem-nonsusceptible Pseudomonas otitidis strain recovered from a chicken carcass in Brazil. Materials, Methods & Results: During the years 2018-2019, 72 frozen chicken carcasses were purchased on the retail market from different regions in Brazil. Aliquots from individual carcass rinses were screened for Extended Spectrum Beta-lactamase (ESBL)-producing bacteria in MacConkey agar supplemented with 1mg.L-1 cefotaxime. Phenotypically resistant isolates were further tested for resistance to other antimicrobials and confirmed as ESBL-producers by means of disk-diffusion method using Muller-Hinton agar. Only one meropenen-nonsusceptible isolate was detected and submitted to whole genome sequencing (WGS) in Illumina Miseq. The strain was identified as Pseudomonas otitidis by local alignment of the 16S rRNA sequence using BLASTn and confirmed by Average Nucleotide Identity (ANI) analysis using JspeciesWS database. Genes encoding for antimicrobial resistance were detected by means of Resfinder and Comprehensive Antibiotic Resistance Database (CARD) databases. The phenotypic non-susceptibility to meropenen was attributed to the gene bla POM-1. A total of 192 different genes encoding for quorum sensing system, antiphagocytosis, iron uptake, efflux pump, endotoxin and toxin, adherence, and secretion systems were detected by means of Virulence Factor Database (VFDB). Pseudomonas otitidis-pan genome was built using Roary-rapid large-scale prokaryote pan genome analysis using the present strain (K_25) and other two P. otitidis genomes (PAM-1, DSM 17224) publicly available at the NCBI. The core genome analysis of the two human strains resulted in similar percentages. Discussion: Carbapenems are critically important drugs for human health and bacterial strains resistant to these antimicrobials pose a public health problem. The bla POM-1 gene harbored by the Pseudomonas otitidis K_25 strain encodes a metallo-beta-lactamase (MBL) conferring resistance to carbapenems. Pseudomonas otitidis was the first confirmed pathogenic Pseudomonas species expressing MBL constitutively in the absence of inducible beta-lactamase genes. Furthermore, the several virulence genes associated with the capacity of the P. otitidis K_25 to colonize, evade the immune system and cause lesions in the human host confirm this strain as a potential opportunistic pathogen contaminating foodstuff. These reinforce the need to address antimicrobial resistance in a One Health perspective, in which resistant bacteria and resistance determinants circulate among environment, animals and humans. |
| CACHE VALLEY VIRUS; CALIFORNIA SEROGROUP VIRUSES; LA-CROSSE ENCEPHALITIS; CENTRAL-NERVOUS-SYSTEM; IN-UTERO INOCULATION; OROPOUCHE VIRUS; CONGENITAL-MALFORMATIONS; SCHMALLENBERG VIRUS; EPIZOOTIC ABORTION; AKABANE VIRUS | The Orthobunyavirus genus comprises a wide range of arthropod-borne viruses which are prevalent worldwide and commonly associated with central nervous system (CNS) disease in humans and other vertebrates. Several orthobunyaviruses have recently emerged and increasingly more will likely do so in the future. Despite this large number, an overview of these viruses is currently lacking, making it challenging to determine importance from a One Health perspective. Causality is a key feature of determining importance, yet classical tools are unfit to evaluate the causality of orthobunyaviral CNS disease. Therefore, we aimed to provide an overview of orthobunyaviral CNS disease in vertebrates and objectify the causality strength of each virus. In total, we identified 27 orthobunyaviruses described in literature to be associated with CNS disease. Ten were associated with disease in multiple host species of which seven included humans. Seven viruses were associated with both congenital and postnatal CNS disease. CNS disease-associated orthobunyaviruses were spread across all known Orthobunyavirus serogroups by phylogenetic analyses. Taken together, these results indicate that orthobunyaviruses may have a common tendency to infect the CNS of vertebrates. Next, we developed six tailor-made causality indicators and evaluated the causality strength of each of the identified orthobunyaviruses. Nine viruses had a ‘strong’ causality score and were deemed causal. Eight had a ‘moderate’ and ten a ‘weak’ causality score. Notably, there was a lack of case-control studies, which was only available for one virus. We, therefore, stress the importance of proper case-control studies as a fundamental aspect of proving causality. This comprehensible overview can be used to identify orthobunyaviruses which may be considered causal, reveal research gaps for viruses with moderate to low causality scores, and provide a framework to evaluate the causality of orthobunyaviruses that may newly emerge in the future. Author summary Orthobunyaviruses are commonly implicated as causes of CNS disease. Well known examples include La Crosse virus, the primary cause of encephalitis in children in the United States, and Schmallenberg virus, responsible for causing large outbreaks of CNS defects in newborn ruminants in Europe and Asia. In addition, several other less-known and novel orthobunyaviruses have also been implicated in CNS disease, yet association does not imply causality. Considering that nearly one hundred orthobunyaviruses are known to date and more are discovered every year, it is important to determine which orthobunyaviruses are relevant in the context of CNS disease, yet an overview of such information was lacking. To solve this problem, we first identified all orthobunyaviruses associated with CNS disease in literature and subsequently-given that the classical causality indicators are unfit for orthobunyaviral CNS disease-evaluated the strength of causality for each virus using tailor-made causality indicators. The results provide a comprehensible overview of orthobunyaviral CNS disease which can be used to guide future research. |
| chicken; goose; Guangdong lineage; H5N1; highly pathogenic avian influenza; inactivated vaccine; immunity; influenza vaccines; vaccines | HEMAGGLUTININ MOLECULE; CLADE 2.2.1; ANTIGENIC-DRIFT; CHICKENS; POULTRY; ANTIBODIES; CHALLENGE; EPITOPES; PROTEIN; NEURAMINIDASE | The highly pathogenic avian influenza virus (HPAIV) H5N1 A/goose/ Guangdong/1996 lineage (Gs/GD) is endemic in poultry across several countries in the world and has caused sporadic lethal infections in humans. Vaccines are important in HPAIV control both for poultry and in prepandemic preparedness for humans. This study assessed inactivated prepandemic vaccine strains in a One Health framework across human and agricultural and wildlife animal health, focusing on the genetic and antigenic diversity of field H5N1 Gs/GD viruses from the agricultural sector and assessing cross-protection in a chicken challenge model. Nearly half (47.92%) of the 48 combinations of vaccine and challenge viruses examined had bird protection of 80% or above. Most vaccinated groups had prolonged mean death times (MDT), and the virus-shedding titers were significantly lower than those of the sham vaccinated group (P <_ 0.05). The antibody titers in the prechallenge sera were not predictive of protection. Although vaccinated birds had higher titers of hemagglutination-inhibiting (HI) antibodies against the homologous vaccine antigen, most of them also had lower or no antibody titer against the challenge antigen. The comparison of all parameters and homologous or closely related vaccine and challenge viruses gave the best prediction of protection. Through additional analysis, we identified a pattern of epitope substitutions in the hemagglutinin (HA) of each challenge virus that impacted protection, regardless of the vaccine used. These changes were situated in the antigenic sites and/or reported epitopes associated with virus escape from antibody neutralization. As a result, this study highlights virus diversity, immune response complexity, and the importance of strain selection for vaccine development to control H5N1 HPAIV in the agricultural sector and for human prepandemic preparedness. We suggest that the engineering of specific antigenic sites can improve the immunogenicity of H5 vaccines. IMPORTANCE The sustained circulation of highly pathogenic avian influenza virus (HPAIV) H5N1 A/goose/Guangdong/1996 (Gs/GD) lineage in the agricultural sector and some wild birds has led to the evolution and selection of distinct viral lineages involved in escape from vaccine protection. Our results using inactivated vaccine candidates from the human pandemic preparedness program in a chicken challenge model identified critical antigenic conformational epitopes on H5 hemagglutinin (HA) from different clades that were associated with antibody recognition and escape. Even though other investigators have reported epitope mapping in the H5 HA, much of this information pertains to epitopes reactive to mouse antibodies. Our findings validate changes in antigenic epitopes of HA associated with virus escape from antibody neutralization in chickens, which has direct relevance to field protection and virus evolution. Therefore, knowledge of these immunodominant regions is essential to proactively develop diagnostic tests, improve surveillance platforms to monitor AIV outbreaks, and design more efficient and broad-spectrum agricultural and human prepandemic vaccines. |
| PET OWNERSHIP; REGISTRY; CAT | The One Health paradigm recognizes that information on infectious diseases, zoonosis and related predictors in animal populations is essential. Pets live in close contact with humans and interact with wild animals, but the lack of reliable information on pet population size, demography and ownership profiles is a constant worldwide. Reliable data must be made available in order to address proper public health policies regarding the design of surveillance plans, the management of canine welfare and stray dog phenomenon, the control of dog behaviour-related problems, and the livestock/wildlife endangerment. Dog identification & registration (I&R) have become mandatory in most European countries in recent years, but the process is far from being widely accomplished, thus resulting in an underestimation of the real canine population. To date, data on the completeness of Dog Registries is very limited. A cross-sectional survey through 630 face-to-face questionnaires was performed with the aim of investigating the dog population size, demography, ownership profiles, and the I&R rate in central Italy. Logistic regression models investigated risk factors with the following outcome variables: dog presence into the Dog Registry, veterinary care frequency, and dog ownership. The present study identified that the dog population is higher than previously reported in Italy and in Europe, whilst lower compared to countries with a poor Human Development Index (a statistic composite index of life expectancy, education, and per capita income indicators used by United Nation). Almost half of the interviewed people (47%) owned at least one dog, totalling 315 dogs. The mean number of dogs per household was 0.7 and 1.5 per dog-owning household. The Bayesian model estimated 481,294 (95% CI: 470,860-491,978) dogs (90 dogs/km(2); human:dog ratio 9.0, 95% CI: 8.8-9.2) suggesting that a high density of people does not limit the dog ownership. Dogs resulted predominant among pets. The majority of dogs were males, crossbred, acquires as a gift, lived in rural areas, outdoors and attended a veterinary visit 1-2 times per year. The percentage of neutered dogs were higher in females (55%) than in males (8%). Only 75.3% (95% CI: 73.676.9) of the dogs were correctly identified and registered. The Dog Registry completeness increased during the first decades after its establishment, but no improvement has been made afterwards. The dogs correctly identified and registered were more likely to be purebred, neutered, lived in urban areas and visited a veterinarian frequently. Several strategies are recommended to encourage I&R, including promoting responsible dog ownership, engaging private veterinarians and dog breeders, and establishing an effective control system. The present study identified also that the dog source and the kind of feeding were variables associated with the veterinary care frequency. Owning a dog was associated with living in rural areas and the presence of children. The present study reported the poor presence of reliable predictors for the dog ownership. This is the first study to provide an estimate of the canine population abundance, characteristics, and ownership profiles in a European large metropolitan area. |
| MULTIDRUG-RESISTANT ENTEROBACTERIACEAE; CARBAPENEM-RESISTANT; INFECTIONS; GENE | Background The global dissemination of colistin resistance encoded by mcr-1 has been attributed to extensive use of colistin in livestock, threatening colistin efficacy in medicine. The emergence of mcr-1 in common pathogens, such as Escherichia coli, is of particular concern. China banned the use of colistin in animal feed from May 1, 2017. We investigated subsequent changes in mcr-1 prevalence in animals, humans, food, and the environment, and the genomic epidemiology of mcr-1-positive E coli (MCRPEC). Methods Sampling was done before (October to December, 2016) and after (October to December, 2017, and 2018, respectively) the colistin ban. 3675 non-duplicate pig faecal samples were collected from 14 provinces (66 farms) in China to measure intervention-related changes in mcr-1 prevalence. 15 193 samples were collected from pigs, healthy human volunteers, patients colonised or infected with Enterobacteriaceae who were admitted to hospital, food and the environment in Guangzhou, to characterise source-specific mcr-1 prevalence and the wider ecological effect of the ban. From these samples, 688 MCRPEC were analysed with whole genome sequencing, plasmid conjugation, and S1 pulsed-field gel electrophoresis with Southern blots to characterise associated genomic changes. Findings After the ban, mcr-1 prevalence decreased significantly in national pig farms, from 308 (45%) of 684 samples in 2016 to 274 (19%) of 1416 samples in 2018 (p<0.0001). A similar decrease occurred in samples from most sources in Guangzhou (959 [19%] of 5003 samples in 2016; 238 [5%] of 4489 samples in 2018; p<0.0001). The population structure of MCRPEC was diverse (23 sequence clusters); sequence type 10 clonal complex isolates were predominant (247 [36%] of 688). MCRPEC causing infection in patients admitted to hospital were genetically more distinct and appeared less affected by the ban. mcr-1 was predominantly found on plasmids (632 [92%] of 688). Common mcr-1 plasmid types included IncX4, IncI2, and IncHI2 (502 [76%] of 656); significant increases in IncI2-associated mcr-1 and a distinct lineage of mcr-1-associated IncHI2 were observed post ban. Changes in the frequency of mcr-1-associated flanking sequences (ISApl1-negative MCRPEC), 63 core genome single nucleotide polymorphisms, and 30 accessory genes were also significantly different after the ban (Benjamini-Hochberg-adjusted p<0.05), consistent with rapid genetic adaptation in response to changing selection pressures. Interpretation A rapid, ecosystem-wide, decline in mcr-1 was observed after the use of colistin in animal feed was banned, with associated genetic changes in MCRPEC. Withdrawal of antimicrobials from animal feed should be an important One Health measure contributing to the wider control of antimicrobial resistance globally. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. |
| CHILDREN; INFECTIONS | The aim of this study was to measure the prevalence of gastrointestinal parasites (GI) in domestic animals and children in high mountain populations in the districts of Combia and Toche, Valle del Cauca-Colombia. These communities have been affected by the armed conflict in Colombia and are susceptible to health risk factors related to the Colombian post-conflict. Prevalence and risk factors were measured using Bayesian methods on 45 structured interviews applied to 29 families in Combia and 16 in Toche. This inquire aimed to analyze the socio-economic and demographic factors associated with the presence of parasites. This interview was conducted with 50 children: 40 (80%) from Rita Sabogal school district of Toche, and 10 (20%) from Tablones-Atanasio Girardot schools. 23 faecal samples from asymtomatic children from these schools were collected. Subsequently, 308 animals were characterized through the analysis of 64 faecal samples from asymptomatic individuals (20,8%); 18/41 from dogs (43,9%), 18/175 from poultry (10,3%), 7/13 from cats 56,84%, 6/20 from equines (30%) and from 15/59 cattle (25,43%). The prevalence of intestinal parasites among children under six years was 60% [95% CI = 41%-78%];Endolimax nana, 24% [95% CI = 9,8%-42%];Iodamoeba buetschlii, 16% [95% CI = 4,7%-32%];Entamoeba coli, 35% [95% CI = 18%-55%];Giardia lamblia, 12% [95% CI = 2,7%-27%]. In Equids the presence ofStrongylusspp was 37% [95% CI = 10%-71%];Parascaris equorum, 37% [95% CI = 10%-71%]; in dogs,Dipyllidium caninumwas 20% [95% CI = 6%-39%];Trichuris trichiura, 9% [95% CI = 1,3%-26%];Toxocara canis, 25% [95% CI = 9%-46%]; in cats,Toxocara catihad a prevalence of 44% [95% CI = 16%-75%]; cyst of Eimeria spp, 15% [95% CI = 3,4%-33%]; in poultry andEimeria zuerniiin cattle, 50% [95% CI = 23%-77%]. There was no association with exposure of humans to animal parasites. However, we conclude that female and children under 6 years of age are more likely OR (6,72-2,3) to get parasites. Author summary The Colombian armed conflict affected vulnerable communities with already precarious governmental and health care assistance. Epidemiological surveillance applied to public health is fundamental to prevent zoonotic diseases in vulnerable Colombian populations. Systematic analysis are needed in order to diagnose the problem, to design, to implement public health practices and to evaluate the interventions associated with the identification of parasitic risk factors. In livestock there are several risks linked to human behaviors that have an impact on the occurrence, dissemination, perpetuity of parasitic agents and the quality of life of people. Therefore, it is required to study the risk of parasitic diseases for the farmer production at the high mountain rural communities of Palmira in the post-conflict period. Overall, this study represents an important approach to understand endemic parasites in high elevations of the Andes region of Colombia, to prevent zoonotic diseases and to recognize the relevance of the One Health approach considering ecosystems, domestic animals, wild animals and human health as a unit. |
| GENETIC-STRUCTURE; ENDEMIC ZOONOSES; DEFORESTATION; PATTERNS; IMPACTS; CLIMATE; TICKS; MAPS | Zoonotic diseases affect resource-poor tropical communities disproportionately, and are linked to human use and modification of ecosystems. Disentangling the socio-ecological mechanisms by which ecosystem change precipitates impacts of pathogens is critical for predicting disease risk and designing effective intervention strategies. Despite the global One Health initiative, predictive models for tropical zoonotic diseases often focus on narrow ranges of risk factors and are rarely scaled to intervention programs and ecosystem use. This study uses a participatory, co-production approach to address this disconnect between science, policy and implementation, by developing more informative disease models for a fatal tick-borne viral haemorrhagic disease, Kyasanur Forest Disease (KFD), that is spreading across degraded forest ecosystems in India. We integrated knowledge across disciplines to identify key risk factors and needs with actors and beneficiaries across the relevant policy sectors, to understand disease patterns and develop decision support tools. Human case locations (2014-2018) and spatial machine learning quantified the relative role of risk factors, including forest cover and loss, host densities and public health access, in driving landscape-scale disease patterns in a long-affected district (Shivamogga, Karnataka State). Models combining forest metrics, livestock densities and elevation accurately predicted spatial patterns in human KFD cases (2014-2018). Consistent with suggestions that KFD is an ecotonal disease, landscapes at higher risk for human KFD contained diverse forest-plantation mosaics with high coverage of moist evergreen forest and plantation, high indigenous cattle density, and low coverage of dry deciduous forest. Models predicted new hotspots of outbreaks in 2019, indicating their value for spatial targeting of intervention. Co-production was vital for: gathering outbreak data that reflected locations of exposure in the landscape; better understanding contextual socio-ecological risk factors; and tailoring the spatial grain and outputs to the scale of forest use, and public health interventions. We argue this inter-disciplinary approach to risk prediction is applicable across zoonotic diseases in tropical settings. Author summary Worldwide, impacts of zoonotic diseases, that cycle between animals and people, are concentrated in tropical communities and often linked to the way people use and change ecosystems. Interventions for zoonotic diseases could be targeted better using risk maps based on computer models that integrate social and ecological risk factors across degraded ecosystems. However, such predictive models often perform poorly at local scales, incorporate narrow ranges of risk factors, and are disconnected from policy, managers and interventions. Co-production brings together stakeholders and knowledge, across the human health, animal health and environmental sectors, aligning with the OneHealth Initiative, to develop more informative predictive tools for zoonotic diseases. Through co-production, we develop predictive models for a fatal tick-borne disease, Kyasanur Forest Diseases (KFD) that is spreading across the degraded Western Ghats forest in India. These models incorporating contextual risk factors identified by stakeholders, accurately predicted patterns in human cases of KFD (2014-2018) in Shivamogga district, Karnataka State, and identified new hotspots of infection during the subsequent 2019 outbreak. Landscapes at highest risk encompassed diverse forest-plantation mosaics with high coverage of moist evergreen forest and plantation, high indigenous cattle density, and low coverage of dry deciduous forest. Co-production resulted in outbreak data that reflected where exposure occurred in the landscape and outputs of value for targeting of interventions, matched to the scale of forest use and public health interventions. |
| ANHUI PROVINCE; YANGTZE-RIVER; TRANSMISSION; EXPERIENCES; PREVALENCE; RESERVOIRS; MARSHLAND; STRATEGY; ANIMALS; MANSONI | Author summary Consistent with the revised WHO Global Goals, China has set the target of complete interruption of transmission (elimination) of zoonoticSchistosoma japonicumby 2030 at the entire country level. Much remains to be known, however, regarding the complex multi-host disease dynamics of schistosomiasis. Multi-disciplinary disease control programs within China, including mass treatment with praziquantel for over 40 years, have successfully targeted human and bovine definitive hosts, significantly reducing infection prevalence to extremely low levels. However,S.japonicumhas at least 40 species of potential definitive host reservoirs. Most notably, and perhaps most challenging in terms of targeted control, high prevalence ofS.japonicumhas been detected in rodent wildlife within recent years, particularly in hilly and mountainous regions of China. Molecular/phylogenetic studies have revealed matchedS.japonicumgenotypes indicative of shared transmission between rodents and humans. Similarly, mathematical models, incorporating parasitological and molecular data, have indicated that rodents may be sufficient to maintain ongoing transmission of schistosomiasis within some Chinese regions, most notably that of hilly and mountainous habitats. In order to help elucidate further the potential association between prevalence ofS.japonicumin humans with rodent wildlife across China, and to assess whether this balance may be changing following the introduction of mass drug administration with praziquantel to humans (and bovines) in the 1980s, we performed a meta-analyses aimed to estimate the overall prevalence ofS.japonicuminfections in commensal species rodents in China over this period. Published studies onS.japonicuminfections in wild rodents in China since 1980 were searched for across five electronic bibliographic databases, together with lists of cited articles. We identified a total of 37 relevant articles involving 61 studies with eligible data on 8795 rodents. The pooled prevalence level was 3.86% (95% CI: 2.16-5.93%). No significant change in overall pooled prevalence levels within rodents was observed between 1980-2003 and 2004-current, despite the integrated control strategies performed across China within the latter period. However, whilst the prevalence estimates did decrease within marshland and lake regions since 2004, in the hilly and mountainous regions, in contrast, there was a significant increase in the rodent infection prevalence. The estimate increased from the smallest 0.58% in spring to the highest 22.39% in winter. It also increased with the density of rodents. Therefore, we suggest that future systematic monitoring of schistosome infection levels within potential wildlife reservoirs, particularly within hilly and mountainous regions within China and/or areas aiming for verification of interruption of transmission, should be incorporated in order to reliably evaluate impact, risk and ultimately help ensure the sustainability of elimination interventions across, regional, national and international scales. China once suffered greatly from schistosomiasis japonica, a major zoonotic disease. Nearly 70 years of multidisciplinary efforts have achieved great progress in disease control, with infections in both humans and bovines significantly reduced to very low levels. However, reaching for the target of complete interruption of transmission at the country level by 2030 still faces great challenges, with areas of ongoing endemicity and/or re-emergence within previously ‘eliminated’ regions. The objectives of this study were, by using meta-analytical methods, to estimate the overall prevalence ofSchistosoma japonicuminfections in abundant commensal rodent species in mainland China after the introduction of praziquantel for schistosomiasis treatment in humans and bovines in 1980s. In doing so we thereby aimed to further assess the role of wild rodents as potential reservoirs in ongoing schistosome transmission. Published studies on infection prevalence ofS.japonicumin wild rodents in mainland China since 1980 were searched across five electronic bibliographic databases and lists of article references. Eligible studies were selected based on inclusion and exclusion criteria. Risks of within and across study biases, and the variations in prevalence estimates attributable to heterogeneities were assessed. The pooled infection prevalence and its 95% confidence intervals (CIs) were calculated with the Freeman-Tukey double arcsine transformation. We identified a total of 37 relevant articles involving 61 field studies which contained eligible data on 8,795 wild rodents across mainland China. The overall pooled infection prevalence was 3.86% (95% CI: 2.16-5.93%). No significant change in the overall pooled prevalence was observed between 1980-2003 (n = 23 studies) and 2004-current (n = 38 studies). However, whilst the estimated prevalence decreased over time in the marshland and lake regions, there was an apparent increase in prevalence within hilly and mountainous regions. Among seven provinces, a significant prevalence reduction was only seen in Jiangsu where most endemic settings are classified as the marshland and lakes. These estimates changed over season, ranging from 0.58% in spring to 22.39% in winter, in association with increases in rodent density. This study systematically analyzedS.japonicuminfections in wild rodents from the published literature over the last forty years after the introduction of praziquantel for schistosomiasis treatment in humans and bovines in 1980s. Although numbers of schistosomiasis cases in humans and bovines have been greatly reduced, no such comparable overall change of infection prevalence in rodents was detected. Furthermore, there appeared to be an increase inS.japonicumprevalence in rodents over time within hilly and mountainous regions. Rodents have been projected to become the dominant wildlife in human-driven environments and the main reservoir of zoonotic diseases in general within tropical zones. Our findings thus suggest that it is now necessary to include monitoring and evaluation of potential schistosome infection within rodents, particularly in hilly and mountainous regions, if we are ever to reach the new 2030 elimination goals and to maximize the impact of future public, and indeed One Health, interventions across, regional, national and international scales. |
