Examining the Elephant: Many Views of One Health

1. Examining the Elephant: Many Views of One Health Gary Vroegindewey, DVM, MSS, DACVPM Director, Global Health Initiatives Center for Public and Corporate Veterinary Medicine Virginia Maryland Regional College of Veterinary Medicine

2. One Health Definition One Health has been defined as "the collaborative effort of multiple disciplines — working locally, nationally, and globally — to attain optimal health for people, animals and the environment" https://www.avma.org/KB/Resources/Reference/Pages/One-Health94.aspx

3. One Health Unites the entire spectrum of medical expertise with the goal of improving and protecting animals and public health worldwide

4. One Health History The recognition that environmental factors can impact human health can be traced as far back as to the Greek physician Hippocrates (c. 460 BCE – c. 370 BCE) in his text "On Airs, Waters, and Place". He promoted the concept that public health depended on a clean environment. Hippocrates

5. One Health History LuciusJunisModeratusColumella wrote a work Segregation and Quarantine, which was an early text on agriculture and lead to a basic form of One Health, in that it advised people and animals to be kept separate on farms.

6. One Health History “Between animal and human medicine there is no dividing line-nor should there be. The object is different but the experience obtained constitutes the basis of all medicine." Rudolph Carl Virchow (1821 – 1902)

7. COLUMBIAVETERINARY COLLEGE (1877-1884) “It is desired to have graduate not only a horse-doctor or a cow-doctor, but a man qualified to give medical advice upon the diseases of all domestic animals; to make him, in fact, a doctor of comparative medicine”. Professor Bates (Dean)

8. Harvard, 1882-1901 Langdon Frothingham 1889 New York-American Veterinary College, within the NYU School of Medicine 1899-1922 NYC, East 26th Street, 1924

9. “The medico in an Australian sheep district not only has to prescribe for his patients both man and beast, but has to act as his own dispenser and, in fact, combines the duties of a doctor, veterinary surgeon and a chemist.” Courtesy: C. Trenton Boyd,BS, MA, AHIP, FMLA

10. One Health History Calvin Schwabe, DVM

11. One Health Commission

12. One Health Initiative

14. Conferences

15. Courses and Degrees

16. Courses One Health Library Guide created by Duke Global Health Librarian Duke Global Health librarian, Diane Harvey, immediately reached out to the One Health course organizers to get involved. She has put together a fantastic resource for the course and our students, a One Health LibGuide. This guide will be very helpful in researching case studies and learning more about One Health. Diane has been working with her counterparts at UNC, Mellanye Lackey, and NC State, to provide resources to the students.

17. Libraries

18. One Health References

19. “The threat to human health will persist as long as the problem persists in animals.” Dr. Peter Horby World Health Organization Viet Nam

20. Greater progress in prevention and control of infectious diseases requires a more directed effort focusing on the complex interplay between human health, the health of animals, and the environment.

22. Are We Truly One Health?

23. One Health Group Hug

24. The One Health Elephant in the Room

25. Barriers to One Health in Operation

26. Barriers to Effective One Health • Legal Authority • Funding • Institutional Culture • Processes • Terminology • Facilities • Infrastructure • Information technology

27. DoD Lyme Disease Example US Army Center for Health Promotion and Preventive Medicine US Army Veterinary Command US Army Medical Centers

29. Avian Influenza

30. Avian Influenza

31. Disease Surveillance

32. Terminology/Information Technology ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. The US ICD-10 CM, for instance, has some 68,000 codes. The US also has ICD-10 PCS a procedure code system not used by other countries that contains 76,000 codes

33. ICD-10 Example

34. Veterinary Terms in Human Databases Sample of pink salmon infected with Henneguyasalminicola, caught off the Queen Charlotte Islands, Western Canada in 2009

35. Informatics

36. One Health Through Multiple Lenses "Blind monks examining an elephant“ an ukiyo-e print by HanabusaItchō (1652–1724).

37. One Health Lenses Translational and Comparative Medicine What can we learn from one species that can be translated into another species Example: Al-Mashhadi and colleagues created a large animal model of familial hypercholesterolemia FH by genetically altering Yucatan minipigs. These animals reproduce features of the human disease, and could thus be used for translational atherosclerosis research into new drugs and imaging agents. CREDIT: J. RAIS/AARHUS UNIVERSITY

38. Comparative Medicine

39. One Health Lenses Zoonotic Diseases Disease transmitted from animals to people Rabies Ebola Monkey pox Salmonella E. coli Cardinal Albrecht of Brandenburg as St. Jerome Lucas Cranach the Elder (1472-1553)

40. Emerging Infectious Diseases Hanta virus West Nile Plague FMD Ebola virus Rift Valley Fever Anthrax Monkeypox Nipah virus

43. One Health Lenses Narrow to Holistic World Bank- People, Pathogens and our Planet

44. Holistic One Health The Peaceable Kingdom- Edward Hicks 1780-1849

45. Acknowledgements C. Trenton Boyd,BS, MA, AHIP, FMLA Distinguished Librarian Curator of the Medical and Veterinary Historical Collections University of Missouri Don Smith, DVM, DACVS Professor of Surgery and Dean Emeritus Cornell University College of Veterinary Medicine

46. Gary Vroegindewey, DVM, MSS, DACVPMDirector, Global Health InitiativesVirginia-Maryland Regional College of Veterinary MedicineMaryland Campus8075 Greenmead DriveCollege Park, MD  20742-3711301.314.6821 gvroeg@umd.edu

47. Discussion