Kahn IntlSocietyDiseaseSurvConf 12-3-09

7/26/2019 Kahn IntlSocietyDiseaseSurvConf 12-3-09

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One Health: A Concept forthe 21stCentury

Laura H Kahn, MD, MPH, MPP, FACPResearch Scholar

Prora! on Sc"ence an# $lo%al Secur"ty, Pr"nceton &n"'ers"ty("hth Annual )nternat"onal Soc"ety for D"sease Sur'e"llanceConference

Dece!%er *, 2++


2/51

Ac-no.le#!ents Present Colla%orators:

/ruce Kaplan D0M, D"pl A0(S Hon34o! Monath MD5ac- 6oo#all, PhD

Past Lea#ers: Cal'"n Sch.a%e D0M, DSc 1thcentury: 0"rcho., Osler


3/51

Many oran"7at"ons an#"n#"'"#uals support the One

Health )n"t"at"'e A!er"can 0eter"nary Me#"cal Assoc"at"on A!er"can Me#"cal Assoc"at"on A!er"can Soc"ety for M"cro%"oloy A!er"can Soc"ety of 4rop"cal Me#"c"ne

an# Hy"ene

A!er"can Phytopatholo"cal Soc"ety Assoc"at"on of Schools of Pu%l"c Health


4/51

Outl"ne 4he One Health )n"t"at"'e A /r"ef H"story of One Health 4he Challene of 8oonot"c D"seases 9at"onal an# )nternat"onal Hu!an an# An"!al D"sease

)nfrastructures an# Sur'e"llance Act"'"t"es A 4ale of 4hree Out%rea-s Challenes Ahea#


5/51

) 4he One Health )n"t"at"'e Recon"7"n the "nterconnecte#ness

%et.een hu!an, an"!al, an# ecolo"cal

health, the OH) see-s to "ncreaseco!!un"cat"on, colla%orat"on, an#cooperat"on across a ."#e 'ar"ety of#"sc"pl"nes "nclu#"n hu!an !e#"c"ne,

'eter"nary !e#"c"ne, pu%l"c health,!"cro%"oloy, ecoloy, an# others

http:;;...onehealth"n"t"at"'eco!
http://www.onehealthinitiative.com/http://www.onehealthinitiative.com/


6/51

A /r"ef H"story of One Health:/e"nn"ns of 0eter"nary

Me#"c"ne Pope Cle!ent


7/51

An"!al D"sease Control

Measures Lanc"s"

reco!!en#e# thatall "ll an# suspectan"!als %e#estroye#

Pr"nc"ples .ere a!"lestone "n

controll"n thesprea# ofconta"ous#"seases "n an"!als


8/51

One Health "n the 1th

Century Ru#olf 0"rcho.

1=211+23, a

$er!an phys"c"anan# patholo"stsa"#, >%et.eenan"!al an# hu!an

!e#"c"ne there areno #"'"#"n l"nesnor shoul# there%e?


9/51

(arly Meat )nspect"on

Prora!s 0"rcho.@s father

.as a %utcher

An"!aleper"!ents on l"fecycle of 4r"ch"nellasp"ral"s "n porc"ne!uscular t"ssue

Cyst"cercos"s an#tu%erculos"s "ncattle


10/51

4he Challene of 8oonot"c

D"seases
http://www.onehealthinitiative.com/map.php


11/51

Many (!er"n )nfect"ous

D"seases are 8oonot"c Pan#e!"c )nBuen7a A H)0;A)DS 6est 9"le '"rus SARS

Mon-eypo '"rus /o'"ne Spon"for! (ncephalopathy R"ft 0alley Fe'er


12/51

Many of the Aents of

/"oterror"s! are 8oonot"cCDC Cateory A Aents:

Anthra Bacillus anthracis3

Plaue Yersinia pestis3

4ulare!"a Francisella tularensis3

0"ral He!orrha"c Fe'er 0"ruses(%ola, Mar%ur, Lassa,Machupo3


13/51

Reasons for the(!erence of 8oonot"cD"seases /etter Report"n an# 4echnoloy M"cro%"al A#aptat"on

Hu!an Populat"on Pressures Po'erty an# Suscept"%"l"ty to )nfect"on (cono!"c De'elop!ent an# Lan# &se /ush Meat Consu!pt"on )nternat"onal 4ra'el (ot"c An"!al 4ra#e )ntent to Cause Har!


14/51

Hu!an an# An"!al

D"sease )nfrastructures &S 9at"onal

Co!par"son of Hu!an an# An"!al

Health )nfrastructures Sur'e"llance Act"'"t"es

)nternat"onal

Co!par"son of Hu!an an# An"!alHealth )nfrastructures

Sur'e"llance Act"'"t"es


15/51

&S Fe#eral Hu!an Health

)nfrastructure &S Depart!ent of Health an# Hu!an

Ser'"ces DHHS3 "s lea# aency at

fe#eral le'el &S Depart!ent of Ho!elan# Secur"ty

DHS3 "s "n'ol'e# "n hu!an health &S Depart!ent of Defense DoD3 helps

"n t"!es of cr"s"s


16/51

&S Depart!ent of Health

an# Hu!an Ser'"ces


17/51

&S Fe#eral An"!al Health

)nfrastructure &S Depart!ent of Ar"culture &SDA3 An"!al Plant Health

)nspect"on Ser'"ce APH)S3 "s lea# aency for l"'estoc- &S Depart!ent of Ho!elan# Secur"ty DHS3 no. has

parts of APH)S &S Depart!ent of Health an# Hu!an Ser'"ces HHS3

esta%l"she# 9at"onal Center for 8oonot"c, 0ector%orne an#(nter"c #"seases at CDC

&S Depart!ent of )nter"or DO)3 F"sh an# 6"l#l"fe Ser'"ce

"s respons"%le for ."l#l"fe, en#anere# spec"es, an# ."l#l"fe"!porte# "nto the &S &S Depart!ent of Co!!erce DOC3 o'ersees sher"es

!anae!ent


18/51

&S fe#eral aenc"esa##ress"n an"!al#"seasesAn"!al Health at the Crossroa#s, 9at"onal Aca#e!"es Press 2++, pae *E


19/51

A 4ale of 4hree Out%rea-s:

6est 9"le 0"rus 1 9C 6est 9"le 0"rus out%rea-4.o s"!ultaneous out%rea-s: one "n

an"!als an# one "n hu!ans Out%rea- h"hl"hte# the "!portance

of #"sease sur'e"llance "n ."l#l"fe

an# 7oo an"!als An"!als .ere sent"nels for hu!an

health %ut .ere larely "nore#


20/51

&S Response to 6est 9"le '"rus

Out%rea-

)n 1, the CDC

esta%l"she# Ar%o9(4A success storyG


21/51

Mosu"to 690 )nfect"ons 2++2http:;;.estn"le!apsusso';2++2;usaI!osu"toIaprI22ht!l


22/51

690 Pos"t"'e 6"l# /"r#s 2++2http:;;.estn"le!apsusso';2++2;usaIa'"anIaprI22ht!l


23/51

Hu!an 690 Cases 2++2http:;;.estn"le!apsusso';2++2;usaIhu!anIaprI22ht!l


24/51

8oos as a pu%l"c health

resource D"str"%ute# throuhout the &S Locate# "n ur%an an# rural areas

Close to hu!ans Stat"onary populat"on Populate# ."th 'ar"ety of spec"es ."th

#"Jerent le'els of suscept"%"l"ty Ser"al sa!pl"n H"hly tra"ne# 'eter"nar"ans closely !on"tor

the an"!als@ health


25/51

Assoc"at"on of 8oos an#Auar"u!s


26/51

6est 9"le Sur'e"llanceSyste! for 8oolo"cal)nst"tut"ons )n"t"ally fun#e# %y CDC an# operat"onal

fro! 2++1 to 2++E

Collecte# #ata fro! 1*,+++ an"!als 1* E**;N113 conr!e# pos"t"'e

an"!als '"rus "solate# an# PCR3 to #ate

1 11E;E+3 seropos"t"'ean"!als seru! neutral"7at"on3

An"!als teste# "n 2++1


27/51


Prel"!"nary count EN1 for 2++1

8oo an"!als teste# "n 2++1: Prel"!"nary CountEN1



28/51


Prel"!"nary count E2 for 2++2

8oo an"!als teste# "n 2++2: Prel"!"nary CountE2

8oo an"!als teste# "n 2++*: Prel"!"nary count *=1


29/51

Prel"!"nary count *=1 for 2++*

8oo an"!als teste# "n 2++*: Prel"!"nary count *=1


30/51

An"!als teste# "n 2++N

Prel"!"nary count 2++ for 2++N

8oo an"!als teste# "n 2++N: Prel"!"nary count 2++


31/51

An"!als sa!ple# "n 2++

Prel"!"nary count 11E1 for 2++

8oo an"!als sa!ple# "n 2++: Prel"!"nary count 11E1


32/51

An"!als sa!ple# "n 2++E

Prel"!"nary count =1N for 2++E

8oo an"!als sa!ple# "n 2++E: Prel"!"nary count =1N


33/51

8oo An"!al Health9et.or- 8AH93

&SDA A!er"can 8oolo"cal Assoc"at"on A8A3

L"ncoln Par- 8oo 9at"onal An"!al Health La%oratory http:;;...7ooan"!alhealthnet.or-co

!;


34/51

A 4ale of 4hree Out%rea-s:Mon-eypo

Mon-eypo out%rea- of 2++* "n &S M"#.eststarte# ."th the "!portat"on of "ant $a!%"an ratsepos"n pra"r"e #os "n a pet #"str"%ut"on center

Out%rea- h"hl"hte# the pro%le!s of "!port"n!"ll"ons of eot"c an"!als "nto the &S

L"ttle attent"on pa"# to the s"c- an# #y"n pra"r"e#os unt"l after hu!ans %eca!e s"c-

A total of 1 hu!an cases of !on-eypo .erereporte# to CDC * N13 .ere la% conr!e# 1= people .ere hosp"tal"7e# M"n"!al #"sease sur'e"llance of co!pan"on an"!als


35/51

&S Response toMon-eypo Out%rea-

CDC an# FDA "ssue# or#erproh"%"t"n "!portat"on of Afr"can

ro#ents An# proh"%"te# sale, transfer, or

release of pra"r"e #os

Replace# %y "nter"! nal rule 9o sur'e"llance syste! of pets

#e'elope#


36/51

D"sease Sur'e"llance "nCo!pan"on An"!als

Appro"!ately E* of all &Shousehol#s o.n at least one pet

Most co!!only o.ne# an"!als "nclu#e: Cats + !"ll"on3 Dos * !"ll"on3 S!all !a!!als 1=2 !"ll"on3 /"r#s 1EE !"ll"on3 Auar"u! F"sh 1N+ !"ll"on fresh.ater;

!"ll"on salt.ater3


37/51

New York Times September 21, 2009

Tie to pets has germ jumping to and froethi!i""in #esistant Staph aureus $#S%& isinfe!ting both humans and anima"s'

http:;;...nyt"!esco!;2++;+;22;health;22!rsaht!lQIr2


38/51

Pur#ue &n"'ers"ty/anel# 9at"onalCo!pan"on An"!al Sur'e"llance

Prora! (sta%l"she# "n 2++N at Pur#ue &n"'ers"ty

School of 0eter"nary Me#"c"ne

/anel#, the Pet Hosp"tal, larest pro'"#erof co!pan"on an"!al health care "n &S Ser'e appro 2 of ent"re pet #o an# cat

populat"on "n &S

)nclu#es u"nea p"s, other ro#ents, %"r#s,ra%%"ts, ferrets, an# rept"les

$l"c-!an L4, Moore $(, /l"c-!an 96, et al Pur#ue &n"'ers"ty/anel# 9at"onal Co!pan"on An"!alSur'e"llance Prora! for (!er"n an# 8oonot"c D"seases, 0ector/orne an# 8oonot"c D"seases2++E: E: 1N2*


39/51

Pur#ue &n"'ers"ty/anel# 9at"onalCo!pan"on An"!al Sur'e"llance

Prora! Stu#y /anel# hosp"tal #ata%ase searche# for

"nBuen7al"-e "llness "n cats us"n syn#ro!"csur'e"llance fe'er, couh, #"culty %reath"n3

"n 1= hosp"tals ."th"n + !"les of 6ash"ntonDC area

Co!pare# cat #ata to )L) "n hu!ans fro!

e!erency roo! #ata

$l"c-!an L4, Moore $(, $l"c-!an 96, et al Pur#ue &n"'ers"ty/anel# 9at"onal Co!pan"on An"!alSur'e"llance Prora! for (!er"n an# 8oonot"c D"seases 0ector%orne an# 8oonot"c D"seases2++E E: 1N2*


40/51

Hu!an an# Cat Flu "n6ash"nton DC, 2++N F"n#"ns


41/51

)nternat"onal Hu!anHealth )nfrastructure

6orl# Health Oran"7at"on


42/51

)nternat"onal An"!alHealth )nfrastructure

6orl# Health Oran"7at"on 6orl# An"!al Health Oran"7at"on

O)(: Oce )nternat"onal #es(p"7oot"es3

Foo# an# Ar"culture Oran"7at"on


43/51

$lo%al Sur'e"llanceSyste!s

6HOTRe'"se# 2++ )HR an# $lo%alOut%rea- Alert an# Response

9et.or- $OAR93 O)(T4errestr"al An"!al Health Co#e FAOT(!erency Pre'ent"on

Syste! for 4rans%oun#ary An"!alD"seases (MPR(S3


44/51

A 4ale of 4hree Out%rea-s:HPA) )nBuen7a A H913

1 h"hly pathoen"c a'"an "nBuen7aA H913 out%rea- "n Hon Kon

Sur'e"llance of ."l# .ater fo.l an##o!est"c poultry fac"l"tate# earlyrecon"t"on of '"rus "n hu!ans

Resurence of '"rus "n S( As"a "n 2++*pro!pte# an "nternat"onal responsean# lo%al sur'e"llance


45/51

)nternat"onal Response to HPA))nBuen7a A H913out%rea-

)n 2++E, lo%al sur'e"llance of H91a'"an "nBuen7a "n ."l# %"r#s, poultry,

an# hu!ans %ean $lo%al (arly 6arn"n an# Response

Syste! for MaUor An"!al D"seases"nclu#"n 8oonoses $L(6S3

$lo%al A'"an )nBuen7a 9et.or- forSur'e"llance $A)9S3

l " "


46/51

Cu!ulat"'e Hu!an A'"an)nBuen7a H913 Cases as of

Sept 2N, 2++http:;;a!apser'er.ho"nt;!apL"%rary;F"les;Maps;$lo%alIH91"nHu!anC&M&LA4)0(IF)MSI2+++2Npn

9 t" "th # f


47/51

9at"ons ."th conr!e# cases ofa'"an "nBuen7a H91 as of 5uly ,

2++E

http:;;...Buo';!apht!l


48/51

PR(D)C4

9e. proUect fun#e# %y &SA)D &p to V !"ll"on o'er years

&C Da'"s School of 0eter"nary Me#"c"ne."ll lea# consort"u! of oran"7at"ons

6"l#l"fe Conser'at"on Soc"ety

6"l#l"fe 4rust $lo%al 0"ral Forecast"n, )nc S!"thson"an )nst"tut"on


49/51

Challenes Ahea#

As the hu!an populat"on eplo#es, "nteract"ons."th ne. 7oonot"c aents e '"ruses3 fro!an"!al populat"ons ."ll cont"nue to "ncrease

Can epect !ore e!er"n 7oonot"c #"seases 4he One Health )n"t"at"'e a##resses the nee# forreater colla%orat"on on !any le'els "n#"'"#ual,pu%l"c health, an# research3 %et.een hu!an,an"!al, an# pu%l"c health profess"onals

Many oran"7at"ons an# "n#"'"#uals en#orse theOne Health )n"t"at"'e, %ut cons"#era%le eJortre!a"ns to "!ple!ent the concept nat"onally an#lo%ally


50/51

Challenes Ahea#

Leal Lo"st"cal F"nanc"al Oran"7at"onal

Ph"losoph"cal


51/51

4"!e to (!%race OneHealth

4han- youW

Documents

Kahn IntlSocietyDiseaseSurvConf 12-3-09