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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Workshop on “Food Security: Infectious Diseases in Farm Animals” brings together animal and veterinary scientists from Egypt and the UK

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.

There were 50-60 delegates in attendance at the meeting, with approximately one-half of delegates coming from various faculties and Research Institutes of Cairo University. The other half of participants came from the UK, including the Pirbright Institute, Woking, Royal Veterinary College (RVC), University of London, Surrey University and Roslin Institute, Edinburgh.

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

In total, 21 oral presentations, excluding invited speakers, and 17 posters were included in the meeting programme.               

A representative of the British Council, Shaun Holmes, was scheduled to provide information on Newton Fund News and Future Funding Opportunities on day three of the meeting. I attended on behalf of CABI on day two of the event.

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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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Dengue situation in a Southern Indian state (Andhra Pradesh) – Gaps and opportunities in Community Awareness

  Who_029547_usedtyres_WHO_JGusmo
Photo: WHO/J.Gusmao. Used tyes are an ideal habitat and breeding ground for mosquitoes carrying dengue

Our guestblogger is Dr Manoj Aravind, a researcher in Community Medicine, Hyderabad, India and member of the health information forum HIFA2015.  Under World Health Day 2014's theme "Small bite, big threat" with its goal of better protection against vector-borne diseases, he describes the case for community action against dengue in his home state of Andras Pradesh. He can be contacted directly by email: aravindbm@gmail.com

Dengue is the fastest growing vector-borne disease (VBD) worldwide, and Andhra Pradesh (a Southern Indian state) is no exception. Here, the cases of dengue reported have been steadily rising from 313 in 2008 to 2299 in 2012. The issue of missed cases due to the partial reporting of dengue positive cases by private hospitals and clinics, which are the most commonly used heathcare facilities in our state, make us sceptical of the true burden of this potentially deadly disease. Having a tropical climate, with increasing urbanization, mostly unplanned, and not much “people participation” in health issues increases our cause for concern.1

Mosquitoes are the most common insects today that city dwellers encounter and one species, Aedes aegypti,  are the vector for dengue, transmitting the disease to people via their bite: they are day-biting and breed in clean water collected inside and around houses, especially in urban areas.2 As dengue does not have vaccine or cure, the emphasis is on prevention. The World Health Organization is using this year's World Health Day to build awareness about VBDs and reinforce the need for community empowerment in terms of protecting against these small creatures which are a huge threat to the health of the entire community.3 Andhra Pradesh’s state health machinery is using this opportunity to reach out & empower different stakeholders with effective communication and information.

Awareness of people regarding dengue

When there is no biological vaccine for a disease, knowledge of how this disease spreads and how to prevent this becomes very important. It may then be apt to say that health education leading to healthy behaviours acts as a social vaccine.

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The 2014 World Health Day focuses on Vector-Borne diseases

WHO_SHollyman_woman&net Tanzania
Image : WHO/S.Hollyman

From guest blogger: Dr Joseph Ana, Editor-in-Chief, BMJ West Africa and member of the steering group of the health information forum HIFA2015 . He can be contacted directly by email: jneana@yahoo.co.uk

It
is right that the World Health Organisation (WHO) should focus on vector borne diseases this year, and by so doing raise awareness, disseminate information and improve, hopefully prompt, more effort at preventing and managing the myriad diseases that vectors inflict on man, especially in the Tropics and Sub-tropics.

Whether it is from the arthropod invertebrates of mosquitoes (malaria, dengue, yellow fever), sandflies (skin and systemic Leishmaniasis), bugs (Louse-borne typhus), and ticks (Lyme disease); or from crabs/crayfish (paragonimiasis) and snails (schistosomiasis), or from vertebrate vectors like bats (rabies, ebola disease), vectors are responsible for a large chunk of the disease burden thathealth systems across the globe have to deal with, particularly in the poorer tropical and sub-tropical parts. There is a popular saying that the Traditional African way of cooking all meals ‘well done’ and avoiding eating raw sea food (crabs and crayfish) has helped to keep to a minimum diseases from these vectors.  Snail is also a very popular delicacy which is served ‘well cooked’ for the same reason.

The World has experienced increased incidence of arthropod borne disease since the 1970s 1,2,4, especially in the regions with the weakest health systems such as the tropics and subtropics. But for several reasons the temperate parts of the globe are also affected, which is why it is apt and timely that the WHO is focusing world attention on vector-borne diseases this year (2014). The reasons that account for the global nature of the menace of vector-borne diseases include increased travel by all modes; poor public health practice and infrastructure; massive population increases with urbanization and slums; poor surveillance and control measures; changing agricultural practices and deforestation; lack of effective drug and insecticide control leading to resistant vectors and pathogens; inadequate political will;  etc.

The World should recognize, support and assist those countries where good public health practice has shown that control (and elimination) of vectors leads to decrease in vector borne diseases and help to extend such best practices to regions that are lagging behind. A good example of such best practice in the tropics is Cross River State of Nigeria which has a deliberate Public Health Policy of making its major urban areas ‘Clean and Green’ beginning from Calabar, the state capital.

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Handwashing: harnessing the yuck factor to improve public health

The recent E. coli O104:H4 outbreak has set us thinking about handwashing again. (We've tackled it before in  Now wash your hands)

It’s very difficult to change people’s behaviour  and to prove my point,  just watch this video
Do Shocking Images Change Hygiene Behavior”.  The video refers to a study from University of Denver "Using a relevant threat, EPPM and interpersonal communication to change hand-washing behaviours on campus" which found that making you feel awful about what might be on your hands works better than appealing to the conscience.

But as well as “yuck” factor signs which seem to work on the Denver students,  I wondered what else could be done..

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