Fighting Zoonoses in Afghanistan, Bangladesh and Nepal: Concept and Progress of the One Health Asia Programme
Relief International’s One Health Asia programme works to alleviate the impact of zoonoses on fragile rural populations. The three year project (2014-2016) is funded by the European Union under their One Health Programme in Asia. The project was designed to tackle the spread of infectious diseases at the interface between animals, humans and their various environments.
This intervention targets are the most vulnerable populations including women and girls in rural communities and the main focus is on awareness raising and capacity building activities. To ensure sustainability and to institutionalize one health concepts at the community level in the target countries, formation of project support committees, youth clubs and school health clubs are planned. The project plans to create district, provincial/regional/divisional and national level Zoonotic Control Associations (ZCAs) as well as an Asia Regional Zoonoses Network. These committees/associations are the forums/structures and the corner stones of this project to advocate zoonotic diseases awareness and concrete actions at policy level. The aim of these advocacy efforts is to generate wider support in government circles for the integration of zoonoses into the public health agenda. The associations will also help oversee the integration of grassroots level surveillance with the district, provincial and national systems.
Through an intensive inception phase, the project initiated on the 1st of January, 2014. A series of visits, meetings and consultations with key personnel from the relevant Ministries, Departments and Offices were organized to educate and ensure buy in of project activities for sustainability and to explore opportunities for collaboration. 270 Community groups and clubs are being created, and 916 meetings have been held among members to initiate the awareness raising campaign in the communities.
One Health Approach for CCHF Surveillance in Kazakhstan: Results of Open Source EIDSS Application for Risk Level Evaluation
1Black & Veatch, Overland Park, KS, USA; 2Committee of State Sanitary and Epidemiological Surveillance of the Ministry of Health of Kazakhstan; 3Kazakh Scientific Center of Quarantine and Zoonotic Infections, Almaty, Kazakhstan; 4Scientific Center of Sanitary and Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
Development of a Crimean-Congo Hemorrhagic Fever (CCHF) risk evaluation methodology based on a one health surveillance approach for the natural CCHD foci in the Republic of Kazakhstan for population epidemic risks with application of open source Electronic Integrated Disease Surveillance System (EIDSS).
Kazakhstan has several active CCHF natural foci: 3-12 human CCHF cases occur per year; infection occurs through tick bites and CCHF patient blood contact. Prediction of the CCHF epidemiological situation is extremely difficult due to a variety of natural and social factors.
EIDSS software tool was used for epidemiological and vector surveillance data processing for situation prediction for certain regions of Kazakhstan. EIDSS collects and processes epidemiological, clinical and laboratory information on pathogens in humans, animals and vectors. EIDSS was installed at 146 sites of the Ministry of Agriculture, and 8 sites of the Ministry of Health in Kazakhstan. In 2012, EIDSS was loaded with 3 groups of indicators for 2007-2011: population counts, tick infection rate and CCHF human incidence rate. A multivariate epidemiological analysis was conducted in the EIDSS to reveal areas with the highest CCHF risk. As the result, outbreak prognosis risk levels for 2013 were assigned for 25 CCHF endemic districts of Kazakhstan. This information was provided to the public health service of Kazakhstan to plan activities for 2013.
According to the actual information on CCHF foci situation in 2013 it was determined that the prognosis for districts with high outbreak risks made in 2012 is accurate for 88.9%, for districts with medium and low risks - 81.3%. The statistical significance is 0.95. The results let us consider that utilized approach for data collection and analysis using EIDSS software provides a reliable tool for prognosis of CCHF epidemic threats for specific districts, and can be used for the management decision-making support.
MediLabSecure: Laboratory Network for a One Health Approach of Vector-Borne and Respiratory Viruses in the Mediterranean and Black Sea Regions
1Institut Pasteur, France; 2Centre for Research on Animal Health (CISA- INIA), Madrid, Spain; 3Institut de Recherche pour le Développement (IRD), Montpellier, France; 4Istituto Superiore di Sanità (ISS), Roma, Italy
As (re-)emerging viruses are threatening global health, the EU-funded MediLabSecure project (2014-2017) aims at enhancing the preparedness and response to viral threats by establishing an integrated network of laboratories in 19 non-EU countries of the Mediterranean and Black Sea areas in partnership with Institutes in 3 European countries. The MediLabSecure project is reinforcing the laboratory network established by the EpiSouth Plus project (2010-2013) by involving partners from animal virology and medical entomology laboratories additionally to previous partners from human virology laboratories and public health institutions.
One laboratory per field of study (human virology, animal virology, medical entomology) and per country was selected in 2014. A first meeting held in Paris in January 2015, involved the heads of laboratories and aimed at first interdisciplinary interactions in the fields of interest. A “Needs assessment” questionnaire was implemented to assess laboratory capacities and needs regarding biosafety, diagnostic methods and integration of laboratory and epidemiological surveillance for emerging vector-borne and respiratory viruses.
Fifty laboratories were selected to actively join the project. The January meeting allowed the project partners and head of laboratories to meet and exchange on the objectives and future steps of the project, their experiences, needs and expectations. Based on these discussions and on the responses to the “Needs assessment” questionnaire, a training curriculum was set up, of which the first workshops will be organized in June 2015, enabling laboratories to implement harmonized and up-to-date techniques to perform (1) laboratory diagnosis of vector-borne viral diseases such as West Nile, Dengue, Rift Valley Fever, Chikungunya and (2) tailored training on mosquito species determination.
By enhancing diagnostic capacities and regional multidisciplinary cooperation, the Medilabsecure network could represent the cornerstone of a corporate preparedness and response to vector-borne and respiratory viral threats in the Mediterranean and Black Sea regions based on a One Health approach.
Institut Pasteur: An International Partner to Implement One Health
Institut Pasteur, France
Human and animal health and the viability of ecosystems are inextricably linked; 75% of emerging infections are zoonotic. The emergence and re-emergence of SARS, H5N1, MERS-CoV, and Ebola have repeatedly reminded us that multi-sectorial collaboration for investigations and research of zoonotic viruses are necessary to improve the rapid detection of pathogens, identification of animal reservoirs/intermediaries, provide information on transmission between species, and provide knowledge to develop appropriate mitigation options. Much effort to achieve this has taken place at the global level between FAO, OIE and WHO. However, this high level of commitment does not necessarily translate into sufficient consideration and implementation at national and local levels.
Institut Pasteur, a not-for-profit organization based in Paris, is a key partner of the One Health Initiative. With its international network of 33 Institutes in 26 countries, its newly established Center for Global Health with a special focus on outbreak investigation, and numerous collaborations with international organizations, Pasteur is well placed to implement the One Health Initiative. Here we present examples our multidisciplinary strengths: from rabies to H5N1, Pasteur has conducted coordinated and multi-sectorial investigations of human cases in collaboration with the Ministries of Agriculture and the Ministries of Health; For MERS-CoV, members of the staff support the epidemiologic interpretation of available data, design human/animal study investigations for affected countries and provide laboratory training in the Middle East; for Ebola in West Africa, Pasteur, in collaboration with the Guinean Ministry of Health were the first to identify the virus, have provided field laboratory support in Macenta, and are working on the development of diagnostic tests, virus sequencing for mutations tracking, and vaccine development. Together with our international, national and local partners, Pasteur is working to translate knowledge learned through joint investigations and robust science into public health policy recommendations and one health actions.
Shifting the Diagnostic Paradigm for Undiagnosed Illnesses – Low-tech Lessons Emerging from the Wild
1One Health Institute, University of California, Davis, United States of America; 2EcoHealth Alliance, New York, United States of America; 3Metabiota, San Francisco, United States of America; 4Center for Infection and Immunity, Columbia University, New York, United States of America
Rapid identification of pandemic threats has recently become more feasible due to implementation of One Health approaches. In just four years, the PREDICT Project of USAID’s Emerging Pandemic Threats Program has detected more than 250 novel viruses from wildlife that are related to those that cause illness, epidemics, and pandemics in people. Most genomic approaches for viral discovery are extremely expensive and still available only in sophisticated laboratories with teams of diagnosticians and bioinformaticians. Therefore, more economical, portable, and technologically simple approaches were sorely needed to detect and forecast novel pathogen emergence. Because the PREDICT Project has focused on viral emergence from wildlife in remote areas in some of the most resource-constrained countries, we have by necessity developed a more sustainable approach to viral discovery and diagnosis of mystery illnesses that we have implemented across broad socioeconomic contexts. Employing simultaneous multiple-genus and family level, consensus PCR, we have been able to quickly and accurately identify novel viruses, previously undiagnosed as potential pathogens, for further characterization. This approach does not eliminate the need for careful clinical interpretation of patients, but does prevent severe intervention delays due to missed differential diagnoses and deficiencies in test availability for emerging and re-emerging pathogens. Combining cutting-edge surveillance techniques with practical implementation of holistic, One Health approaches, the global health community has now contributed significantly to inexpensive diagnostic improvement for the individual, while realizing the original goal of step-wise improvement of pandemic prevention.
An Investigation into the Early Detection of Psychosis and Depression in Individuals via Social Media
University of Greenwich, United Kingdom
Mental health problems, if left untreated, can impact on a young person and their family in many ways. With a rise in suicides amongst young people linked to social networking in the UK, there are concerns that young people who frequently post ‘vague’ but worrying messages may encourage online friends not to take them seriously. Mental health experts argue that ‘dark’ postings should not be hastily dismissed because they can serve as an early warning system for timely intervention. With a number of Social media sites, such as Twitter, allowing third party access to user’s posts and profile information, this is a possible area to explore in the early detection of psychosis and depression.
A pilot study was undertaken to analyse the content of UK geolocated tweets, that contained specific keywords related to depression and psychosis; Keywords were taken from Beck’s depression inventory (BDI) and the Krawiecka, Goldberg and Vaughn (KGV) assessment tools. Examples of keywords were; I look ugly, suicidal thoughts, hearing voices, I hate myself, People are talking about me.
Over 20,000 tweets posted between July and November 2013 have been collected, with a subset analysed using SPSS.
Initial results suggest that individuals feel comfortable expressing their mental health difficulties to online friends, family and other twitter users. There were some posts indicating actual or vague thoughts of self harm or suicide which may cause concern or other responses from those reading them. Low self esteem was a recurrent theme.
Further analysis of these tweets will be discussed along with implications for automated detection systems and future work exploring how to teach the public to recognise when someone who is online may need help and support.