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Preparing for the Next Disease: The Human-Wildlife Connection. Marguerite Pappaioanou, DVM, PhD Centers for Disease Control and Prevention. The Centers for Disease Control and Prevention. Protects the health and safety of the people of the United States- at home and abroad

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Preparing for the next disease the human wildlife connection l.jpg

Preparing for the Next Disease:The Human-Wildlife Connection

Marguerite Pappaioanou, DVM, PhD

Centers for Disease Control and Prevention


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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


Emerging and re emerging zoonoses 1996 2003 source who and pappaioanou l.jpg
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


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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


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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


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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


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Factors Promoting Transmission of Infectious Diseases from Animals to Humans

  • Changing climates and ecosystems

  • Increases in arthropod vector populations and their resistance to insecticides


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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


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Factors Promoting Transmission of Infectious Diseases from Animals to Humans

  • Globalization of the food supply

  • Centralized processing of food


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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


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Public Health Detection, Prevention, Control Animals to Humans

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



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Rapid Laboratory Diagnosis Level

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


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Laboratory Response Network Level

  • Agent-Specific Protocols

  • Standardized Reagents & Controls

  • Lab Referral Directory

  • Secure Communications & Electronic Laboratory Reporting

  • Training & Technology Transfer

  • Proficiency Testing

  • Appropriate Vaccinations for Lab Workers


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LRN Partnership with Veterinary Diagnostic Laboratories Level

  • 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



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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



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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


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Additional information about WNV activity States

is available from CDC athttp://www.cdc.gov/ncidod/dvbid/westnile/index.htmand

http://westnilemaps.usgs.gov







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Investigation States

Of Human

Cases


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Animal States

Trace back

and

Trace forward


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Public Health Strategies to Control Epidemic States

  • 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


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Preventing and Controlling Zoonoses – Wildlife Connection States

  • 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


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Preparing for the Next Disease: StatesThe 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


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