One Health: free online course from FutureLearn features CABI authors

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One Health is about connectedness: "the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, plants and our environment”.

On One Health Day, November 3rd 2016, CABI's editors held a One Health (#OneHealth) Blogathon to focus attention, contributing a total of 6 blogs to Handpicked… and Carefully Sorted, each written from the viewpoint of a different sector.   Our Plantwise Blog contributed One Health: Plantwise’s ambition to improve the health of people, plants and animals.

We hope you found them informative but your learning need not be confined to our blogs!

Sign up to a free online One Health course from FutureLearn: starts November 7th 2016, runs for 6 weeks. Lecturers are the CABI authors Esther Schelling,  Jakob Zinsstag and Bassirou Bonfoh of Swiss Tropical & Public Health Institute.

Esther, Jakob  and Bassirou are all authors of chapters in CABI’s  book One Health: The Theory and Practice of Integrated Health Approaches [2015].  Indeed Esther and Jakob are also co-editors.

FutureLearn  courses are easy to follow and well-paced: you get one unit per week.  I speak from experience as because of my interest in evidence-based medicine, in October 2015, I took "Informed Health Consumer: Making Sense of Evidence". 

I hope you can make use of this One Health course.

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Prove it! Evidence based health blogs.

One Health working will improve health and well-being of us all: plant, animal, human and ecosystem!

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    Pastoralists, Mongolia. Image courtesy of Esther Schelling, Swiss TPH.

 One of a series of blogs written by CABI editors for One Health Day on November 3rd 2016
 
It's always nice to meet up with a CABI author at a conference especially when they are giving a talk around a theme dear to CABI‘s heart,  namely “One Health”: the concept of working across the interface of animal, plant, human  and environment  to achieve health  & development  which is sustainable and fair. CABI has been gathering, managing and generating research information across all these sectors since 1912.  We know “its all connected”.

The conference was the RSTMH biennial meeting [Cambridge UK, Sept 12-16th, 2016], and the author in question, Esther Schelling, co-editor  of CABI’s  book One Health: The Theory and Practice of Integrated Health Approaches [2015].    To read a  free e-chapter, use this link.

In One Health beyond early detection and control of zoonoses Esther talked about her long-time project with nomadic pastoralists in Chad and a rift valley fever (RVF) control project in Kenya.  She drew attention to the need for:

  • more interdisciplinary studies to include an evaluation of One Health working
  • involvement of social scientists
  • engagement of key stakeholders

And tellingly she provided a cost-benefit analysis to society of controlling zoonoses when the disease is in its animal host before it infects human beings. 

Those cost-benefit analyses made a deep impression on the delegates, many of whom were involved in zoonotic neglected tropical diseases. Perhaps for the first time they were appreciating the added benefits and synergies that a transdisciplinary approach between science, society, humanities and medicine could bring.

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Workshop on “Food Security: Infectious Diseases in Farm Animals”- Invited Lectures, Day 2

St. Catherine’s College, Manor Road, Oxford,  UK,  4-7th April 2016 

Attended by M Djuric, CAB International, Wallingford, UK, on 5th April 2016 (Day 2)

This workshop meeting was jointly organised by the Pirbright Institute, Woking, UK and Cairo University, Egypt and was sponsored by the British Council Research Links Programme.

The aims of the workshop were to build long-term and sustainable links between scientists in the UK and Egypt working in the field of infectious diseases of poultry and livestock.

The second day of the workshop  consisted of two sessions and included  four invited expert and engaging presentations by Professor Mohamed Shakal, Professor Fiona Tomly,  Professor Javier Guitian and Dr Roberto La Regione.

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Venue: St. Catherine's College, Manor Road, Oxford

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Accurate and timely communication is key to stopping transmission of Ebola

Ebola on TDB
Ebolavirus: coverpage for CABI's print journal Tropical Diseases Bulletin

Ebola brings out the worst and the best in mankind.

Global coverage of the Ebola outbreak in West Africa began with (the best) courageous foreign health care workers (HCWs) being flown home by their governments in a desperate attempt to save their lives, and rapidly moved on to the sheer panic amongst the local populations experiencing the outbreak: riots, health care workers and government officials abandoning their posts (the worst). Somewhere imbetween mention was made, usually by the foreign HCWS, of their local colleagues left behind who struggled on without resources and personal protection (the best).

Medicin Sans Frontiers highlighted the slow response of the international community.

Misinformation, public panic and stigma

Ebola haemorrhagic fever (caused by different ebola virus strains) has been around since 1976, with regular self-limiting outbreaks, usually in remote areas of one country. Index cases always involve some contact with animal reservoirs (bushmeat (wild animal meat), bats, rodents, monkeys), and its then spread by person-to-person transmission through contact with bodily secretions or with objects contaminated with secretions. It’s infamous for its high case-fatality rate and the ease with which it spreads among contacts of the diseased.

What makes this time different is the Zaire strain has now reached West Africa: there  it has spread from remote regions into highly populated urban areas, and it has crossed borders so that there are escalating outbreaks in 3 adjacent countries (Guinea, Sierra Leone and Liberia), with no end in sight. The epidemic (for that is what it is now), has resulted from sustained person-to-person transmission.

Cases have also been reported in Nigeria and Senegal but these countries seem to have contained the transmission of the virus. DR Congo  has an outbreak.   An up-to-date Ebola Healthmap can be found here.

Ignorance and fear, drivers of disease

Misinformation among health workers and the public fuelled panic and contributed to the spread of Ebola-zaire over the last 6 months.  HCWs abandoned their posts or were the source of rumours that created riots, government officials got out whilst they could. [The index case for Nigeria, was an official who left Liberia, who knowingly had had contact with an Ebola victim].

Fear has not just caused civil breakdown.  It is masking the magnitude of the outbreak, especially in Liberia and Sierra Leone. Families fear stigma so hide sick relatives or consider the hospitals as death sentences (breaking relatives out!) or indeed consider them the cause of the illness in the first place. Cases being cared for outside hospitals do not enter the statistics.   

Unlike the “Black Death” in medieval Europe, it’s not lack of real clinical knowledge that’s the problem but:

  1. Weak health systems, lacking skilled HCWs and resources
  2. Lack of knowledge amongst the general public
  3. Lack of community involvement & mistrust of government
  4. Misinformation among health workers, ministries of health and the public
  5. Lack of effective drugs and vaccines…supportive therapy only is current medical response.

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One medicine; in practice

The
‘One-medicine’ movement has been boosted by the launch of a new web site at http://www.onehealthinitiative.com.
It aims to promote the idea of ‘one
medicine’ throughout the world and provide information on this initiative for
the public, political and governmental leaders, news media, and all ‘One Health’
professionals, advocates, and supporters.

The concept of ‘one
medicine’ is now well established having been adopted by both the American
Veterinary Medical Association (AVMA) and the American Medical Association. It
seeks to enhance collaboration between veterinarians and physicians, and other
health professionals, to promote the health and well being of all species. More
recently, the health of the environment has been included in the ‘one medicine’
concept reflecting the facts that all three are interlinked. The term one medicine
was first used by the pioneering veterinary epidemiologist, Calvin Schwabe, who
sought to break down the barriers between human and veterinary medicine.
Professor Schwabe set up the Department of Epidemiology and Preventive Medicine
at the University of California, Davis, in 1966, which was the first veterinary epidemiology department in the world.
He developed his ideas from his experiences in researching into hydatid disease
and other parasitic zoonoses while he was teaching at the American University in Beirut.

The idea of ‘one
medicine’ sounds very worthy and laudable, but it is not always easy to
envisage how in practice to impact on the lives humans and animals and the
environment. If anyone wanted a really good example of how the ‘one
medicine’ approach can benefit all three, they would have done well to have
attended an excellent talk delivered by Dr Sarah Cleaveland on rabies control in
Africa, given at the British Veterinary Association Congress in London on Friday
26 September. Those of us who were fortunate to be there heard how the health of
livestock, wild animals and humans in the Serengeti are woven together in a
dynamic relationship, and how measures to control infectious diseases affect the
humans, livestock, wild animals and the environment. Dr Cleaveland has been
based at the veterinary school in Edinburgh, was awarded the Trevor Blackburn Award in recognition of her work on zoonotic,
livestock and wildlife diseases in East Africa and for her outstanding
contributions to animal and human health, wildlife conservation and animal
welfare in Africa and beyond. The talk covered the effects of
disease and its control in the Serengeti region of Tanzania, known to viewers of wildlife programmes as the site of spectacular wildebeest
migrations, followed by lions and other carnivores that live off them. Dr
Cleaveland spoke about the control of a number of zoonotic diseases such as
brucellosis, tuberculosis, and echinococcosis, but it was her account of the campaign
to control rabies which really showed the value of the ‘one medicine’ approach.
Rabies is a very serious problem in many parts of the world and it is
estimated that 55,000 people die from the disease each year. Most of the victims
are children, and poor children in remote areas are the most likely to die if
infected, because the cost of the post-exposure vaccine and time taken to reach
a clinic. We heard how epidemiological techniques were used to prove that dogs
were the reservoir host (and not the wild carnivores that were also affected),
and how a mass dog vaccination campaign that she directed and implemented, currently vaccinating
200,000 dogs annually, has prevented hundreds of human and animal rabies deaths.
We also learnt that one of the most difficult parts of the control programme was
persuading the Masai dog owners to wait in an orderly line to have their dogs
vaccinated, and that the commonest pet names for their dogs were ‘Osama’ and
‘Bush’. As well as saving at least 50 human lives saved each year, at a
fraction of the cost of post exposure vaccination, the measures have also
protected endangered wildlife species, such as the African wild dog.

We also learned how the wildebeest numbers, a dominant
feature of the ecology of the Serengeti, have grown since the control of
rinderpest in cattle in the 1960s, and that as reservoirs of malignant catarrhal
fever virus, the arrival of the wildebeest to the lush lowlands of the Serengeti
drives the Masai to take their herds, to higher more marginal grazing, which can
lead to environment problems from overgrazing.

A search of the CAB Abstracts database for information on
‘one medicine’ shows that not only is the concept helpful in improving the
lives of pastoralists in developing countries, but can also help deal with
global problems such as obesity and heart disease through the benefits of the
animal human bond.