Control and Prevention of Animal Human Disease Transmission

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Control and Prevention of Animal Human Disease
Transmission

• Dr Dusan
• Veterinarian
• Zoonotic Disease Consultant WHO, China.

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Outline

• Surveillance and risk assessment
• Control
• Prevention
• WHO activities

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Surveillance and Risk Assessment

• Chinas list of notifiable diseases
• 13/37 are zoonotic
• Are we looking hard enough?
• Measurable challenge motivates political
  commitment
• Challenges of surveillance in China
• Challenges of interventions to benefit
  subsistence farmers

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Notifiable Diseases of China
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Emerging / Re-emerging diseases1996 to 2004
Multidrug-resistant Salmonella
Influenza A (H7N7)
E.coli non-O157
E.coli O157
Cryptosporidiosis
Legionnaires Disease
BSE
E.coli O157
Typhoid
nvCJD
Lyme Borreliosis
Malaria
West Nile Virus
Diphtheria
SARS
Dengue haemhorrhagic fever
Reston virus
West Nile Fever
Influenza A(H5N1)
Echinococcosis
Lassa fever
Nipah Virus
Yellow fever
Cholera 0139
Venezuelan Equine Encephalitis
Reston Virus
RVF/VHF
Buruli ulcer
Hendra Virus
Onyong-nyong fever
Ebola haemorrhagic fever
Human Monkeypox
Equine morbillivirus
Cholera
Ross River Virus
Dengue haemhorrhagic fever
Cholera
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Risk characteristics of rural farmers in China

• Facilities and animal care
• Storage and housing materials can be minimal
• Different animal species are often housed
  together in close vicinity
• Food animals are kept in close proximity to
  humans, even indoors sharing the same airspace.
• Minimal input farming little feed is bought in
  and nutrients are often recycled e.g. animals
  scavenging and use of excrement.
• Veterinary medicines, vaccines and diagnostics
  are limited

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• Water sources may be limited or unclean

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Risk characteristics continued

• Food preparation
• Poor economic conditions so sick or dead animals
  may be eaten without precaution
• Animals slaughtered close to or inside the home
• Food preparation is undertaken nearby this
• Majority of the animal is eaten
• Individual cultural practices can add to risk
  e.g. eating undercooked meat.
• Access to health care, education and medicines
  including human vaccines
• Limited by either availability or cost

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Control
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Community Access to Basic Amenities

• Clean water
• Soap and hygiene products
• Safe housing (esp Vector-borne diseases)
• Education

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Community Access to Appropriate Healthcare

• Affordable and accessible
• Good diagnostics (training, facilities and
  technologies)
• Quality medications (not fakes)

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Community Education About Risks

• Targeted
• Realistic
• Simple and non-conflicting
• Short-term (outbreak) vs.
• Long-term (behavioural changes).

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4 Ss to reduce risk of animal-human disease
transmission

• Surveillance
• Sanitation
• Species separation
• Safe consumption and waste disposal
• E.g BSE, Strep. suis

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Prevention
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Agricultural Extension and Veterinary Services

• Public and private partnerships towards disease
  control
• Greater knowledge dissemination to rural
  communities / best farming practices
• Improved surveillance
• Establishment of robust animal health systems
• Access to appropriate medications
• Monitoring of antibiotic resistance

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Food Marketing Systems

• Species separation during transport and in the
  market place
• Reduction in live markets/ increased cleanliness
• Market rest days (FAO recommendations)
• Reduction in bush food consumption
• Reduction in foodborne diseases through improved
  quality assurance systems/ trace back
• FARM-to-FORK

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WHO Activities
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APSED

• International Health Regulations (IHR) revised
  2005 policy statement
• Asia pacific strategy for emerging diseases
  (APSED) strategy document.
• Objective 1 reduce risk
• Strategic risk communication and community
  participation.
• Reducing risk of emerging diseases acquired from
  animals.
• Strengthened containment of antimicrobial
  resistance.

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APSED continued

• Objective 2 Strengthen early detection of
  outbreaks
• Strengthened early warning systems.
• Coordinated and integrated surveillance systems.
• Strengthened local capacity for surveillance and
  risk assessment.
• Strengthened information management.
• Objective 3 Strengthen early response

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APSED continued

• Objective 4 Strengthen preparedness
• Strengthened preparedness and capacity to
  respond.
• Objective 5 Develop sustainable technical
  collaboration within the Asia Pacific Region
• Development and strengthening of technical
  partnerships in the Asia pacific region.

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WPRO Emerging Infectious Diseases
Building animal and public health capacity to
deal with influenza will lead to
stronger national systems for alert and response
linked to a comprehensive global alert and
response system that will serve to protect us
from whatever nature has in store!
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Challenges

• Utilising available resources effectively
  integrated projects
• Improved disease surveillance and early warning
  especially in the poorest areas (research,
  training, compensation)
• Long term, sustainable changes
• Engaging on local, national, regional and global
  levels

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Thank you!