Excessive use of antimicrobials in intensive livestock farming as One Health issue

One of a series of blogs written by CABI editors for One Health Day November 3rd 2016

Most antibiotics in livestock farming are used in aquaculture, but significant amounts are also used in terrestrial livestock species, particularly in poultry and pigs.

Livestock

Most antibiotics in intensive livestock farming are used for non-therapeutic purposes

Approximately 70% of antibiotics are used for non- therapeutic purposes, i.e. many antibiotics are used in sub- therapeutic doses and over prolonged periods, which leads to the development of genes that confer antimicrobial resistance to animal pathogens. These genes can subsequently be transferred to human pathogens and it is estimated that 75% of recently emerging diseases in humans are of animal origin.

Antimicrobial resistance (AMR) problems are further exacerbated by the fact that antibiotic resistance genes were found in bacteria long before antibiotics were ever used on super-pathogens in farm animals.

AMR is a worldwide problem, which clearly affects both animal and human health, and hence it is truly One Health issue.

 

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Different explanations of mental illness in Jamaica: can we combine the traditional and biomedical to heal body and spirit?

  Gordon Town Health Centre
Gordon Town Health Centre, Kingston, Jamaica. Image: H. Schwartz

Today is World Mental Health Day [October 10th 2016], whose theme is "psychological first aid and the support people can provide to those in distress". An apt moment to publish the insights into Jamaican community mental health of our summer intern, Harpur Schwartz. In her opinion piece below, Harpur addresses the role of traditional health beliefs in expressing mental distress, and identifies a role for traditional medicine in supporting recovery.

Have you been hearing any voices by Harpur Schwartz, edited by Wendie Norris

I could barely make out his answer to the question, “Have you been hearing any voices”, as he was speaking an English based creole language commonly known as Patwa. From what I could understand, spirits come to him during the night and tell him the ‘truth’ of the world around him. He said that his madness was caused by a spirit or Obeah. It was clear that this man had a mental illness that he strongly believed was caused by supernatural factors. The psychiatrist in the room asked patient number 23, “But you understand these voices are not real, right?” His response was “Yes”. Satisfied with his answer, the psychiatrist administered his medicine and handed him his appointment card without a second thought.

While working with the mental health services unit at the Gordon Town Health Centre in Kingston, I noticed a pattern to each patient’s appointment: the patient would be called in by number, he or she would be asked a series of questions about mood and symptoms, an injection of medicine was always administered, and the patient would leave with an appointment card stating the date for when he or she should return the following month. There was a rhythm to this process, one with emphasis placed on drug administration.

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Veterinary visits to become mandatory in European farming

By Miroslav Djuric, DVM, CAB International, Wallingford, UK

The European Agriculture Council has formally approved a draft law on animal diseases that are transmissible among animals and potentially to humans (zoonoses).

Blog-farm visits1

The provisions in the law on farm animal health visits stipulate that professional animal owners are to receive regular animal health visits from a veterinarian for disease prevention, detection and biosecurity. This new piece of legislation aims to merge and update existing scattered directives and regulations into a single and coherent law.

It is announced as an important step forward, since visits by vets are the cornerstone of the ‘prevention is better than cure’ strategy and indispensable for the prevention and early detection of known and emerging transmissible diseases. The role of the veterinarian in achieving this is defined and highlighted. The veterinary profession also has an active part to play in raising awareness of animal health and of One Health, or the interaction between animal health, animal welfare and public health.

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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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