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Preparing for the Next Disease: The Human-Wildlife Connection

Preparing for the Next Disease: The Human-Wildlife Connection

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Preparing for the Next Disease: The Human-Wildlife Connection

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  1. Preparing for the Next Disease:The Human-Wildlife Connection Marguerite Pappaioanou, DVM, PhD Centers for Disease Control and Prevention

  2. The Centers for Disease Control and Prevention • Protects the health and safety of the people of the United States- at home and abroad • Provides credible information to enhance health decisions • Promotes health through strong partnerships • Develops and applies disease prevention and control, environmental health, and health promotion and education activities

  3. Emerging and re-emerging Zoonoses, 1996–2003 (Source: WHO and Pappaioanou) Recent outbreaks Influenza / Madagascar West Nile / USA, Canada Ebola / Gabon, Congo Monkeypox / DRC/ US CCHF / Afghanistan, Iran Tularemia / USA, Kosovo Yellow fever / Ivory Coast Brucellosis / Mongolia E. coli 0157 / Canada Hantavirus / US BSE-vCJD/ UK Nipah virus / Malaysia Avian Influenza / Hong Kong SARS / Global Multidrug resistant Salmonella E.coli O157 Cryptosporidiosis E.coli non-O157 Nv-CJD Brucellosis West Nile Virus West Nile E.coli O157 Hantavirus pulmonary syndrome NV-CJD Reston virus Influenza A(H5N1) Lyme Borreliosis Reston Virus Leptospirosis Lassa fever Nipah Virus Venezuelan Equine Encephalitis Rift valley Fever Yellow fever Ebola Monkeypox Ross River virus Equine morbillivirus Hendra virus

  4. Transmission of Emerging Infectious Diseases Translocation Encroachment Introduction “Spill over” & “Spill back” Human encroachment Ex situ contact Ecological manipulation Human behaviors Wildlife EID Domestic Animal EID Human EID Global travel Urbanization Biomedical manipulation Agricultural Intensification Food processing/distribution Technology and Industry Dasazak P. et.al. Science 2000 287:443

  5. Source: United Nations, World Population Prospects, The 1998 Revision; and estimates by the Population Reference Bureau. Factors Promoting Transmission of Infectious Diseases from Animals to Humans • Rapidly Increasing Human Population • 6.1 Billion people in 2000 • ~9.4 to 11.2 Billion in 2050

  6. Factors Promoting Transmission of Infectious Diseases from Animals to Humans • Human population expanding into changing and overlapping wildlife habitat • Increasing human interaction with domestic and wild/exotic animals

  7. Factors Promoting Transmission of Infectious Diseases from Animals to Humans • Changing climates and ecosystems • Increases in arthropod vector populations and their resistance to insecticides

  8. Factors Promoting Transmission of Infectious Diseases from Animals to Humans • Increasing international travel and trade, civil wars, political unrest, famines, human-made and natural disasters • Increasing movement of people and animals

  9. Factors Promoting Transmission of Infectious Diseases from Animals to Humans • Globalization of the food supply • Centralized processing of food

  10. Factors Promoting Transmission of Infectious Diseases from Animals to Humans • Human behaviors • Consumption of bushmeat/wildlife • Wild animal game ranches • Exotic wildlife as pets • Feed stations to increase wildlife populations for hunting

  11. Public Health Detection, Prevention, Control Emerging Infectious Diseases • Early disease detection; rapid, timely reporting • Ongoing disease surveillance • Rapid laboratory diagnosis/confirmation • Rapid epidemiologic investigations • Timely and effective public health interventions • Public health research • Partnerships and communications • Infrastructure/capacity building

  12. Early Detection—Begins on the Front Line at the Local Level

  13. Rapid Laboratory Diagnosis Clinical Labs, State & Local Public Health Labs, Military Labs, Veterinary Labs, Agricultural, Water & Food-Testing Labs, APHL & ASM, FDA, NIH, & International Labs, FBI, DoD, DOE, USDA, EPA

  14. Laboratory Response Network • Agent-Specific Protocols • Standardized Reagents & Controls • Lab Referral Directory • Secure Communications & Electronic Laboratory Reporting • Training & Technology Transfer • Proficiency Testing • Appropriate Vaccinations for Lab Workers

  15. LRN Partnership with Veterinary Diagnostic Laboratories • 1999: National Veterinary Services Laboratory/USDA (Ames) and U. of Texas Veterinary Laboratories LRN members • 2002: LRN state public health labs propose funding for 8 veterinary laboratories for membership • 2002: CDC/NCID proposes phased collaboration to address concerns with zoonotic diseases, build LRN infrastructure capacity, link animal and human health • 2003 - University of Minnesota Veterinary Diagnostic Laboratory joins LRN • National Testing Site to screen for monekypox in animals

  16. West Nile Virus, 1999

  17. West Nile Virus leads to New Approaches for Disease Surveillance • Epidemic/Epizootic West Nile Virus in the United States: Revised Guidelines for Surveillance, Prevention, and Control, 2003 • Humans, birds, horses, mosquitoes • Multidisciplinary • ArboNET • National Zoo Surveillance System

  18. CDC – ArboNET (9/8/03)

  19. Partnerships on West Nile Virus Activities in the United States • State and Local Health Depts • State and Local Veterinarians • State and Local Wildlife Veterinarians and Biologists • State and Local Mosquito Control • CDC • US Geological Survey • USDA • Department of Defense • EPA

  20. Additional information about WNV activity is available from CDC athttp://www.cdc.gov/ncidod/dvbid/westnile/index.htmand http://westnilemaps.usgs.gov

  21. USGS/CDC – Wild Birds (9/3/03)

  22. USGS/CDC – Mosquitoes (9/3/03)

  23. USGS/CDC- Veterinary (9/3/03)

  24. USGS/CDC – Humans (9/3/03)

  25. Rapid Epidemiologic Investigation

  26. Investigation Of Human Cases

  27. Animal Trace back and Trace forward

  28. Public Health Strategies to Control Epidemic • FDA-CDC joint order banning importation and prohibiting movement of implicated exotic animals • State enacted measures to further restrict intrastate animal shipment and trade • Premise quarantine • Animal euthanasia • Pre- and post-exposure vaccination of potentially exposed persons with small pox vaccine

  29. Preventing and Controlling Zoonoses – Wildlife Connection • Vaccination of humans and animals • Regulation of importation and movement of exotic animals • Control of feral/stray populations • Regulation of bush meat trade • Testing and culling infected wildlife • Other

  30. Preparing for the Next Disease:The Human-Wildlife Connection • Expect the unexpected • Form and strengthen human-animal health partnerships • Link human and animal surveillance • Disease reporting; laboratory networks • Communication • Coordinate evidence-based public health action • Develop multidisciplinary infectious disease centers • Conduct research, e.g., ecology of diseases, risk factors for human exposure • Develop, test, implement plans for integrated disease detection and response • Roles, responsibilities, actions, coordination