University Distinguished Professor John B. Kaneene DVM, MPH, PHD, FAES, FAVES

Global and Veterinary Perspectives of Integrated Management of Transboundary Animal Diseases and Zoonoses University Distinguished Professor John B. Kaneene DVM, MPH, PHD, FAES, FAVES Center for Comparative Epidemiology Michigan State University

PRESENTATION OUTLINE • Forms of Integration • Essential Elements for Integration • Challenges to Integration • Benefits of Integration • Examples where Integration Works • Conclusions

FORMS OF INTEGRATION • Integration between Human and Animal Health Programs • ONE HEALTH • Integration between Regional Animal Disease Programs • Global Integration of Disease Management

Integration ONE HEALTH Global Integration of Disease Management Integration of Animal and Human Health Programs Integration Of Animal Health Programs Integration Of Human Health Programs

ESSENTIAL ELEMENTS FOR INTEGRATION • Coordinated Surveillance Programs • Information Sharing • Shared Training Programs

ESSENTIAL ELEMENTS FOR INTEGRATION • Shared Laboratory Facilities • Frequent Joint Meetings and Exercises • Professional Respect

CHALLENGES TO INTEGRATION • Professional Culture • National Pride • Communication Between Partners • Openness • Timeliness

BENEFITS OF INTEGRATION • Efficiency in Dealing with Disease Outbreaks • Beyond Community Levels • National • Regional • International • Coordinated Human/ Animal Responses Rift Valley Fever Distribution Map http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/rvfmap.htm Countries with endemic RVF Countries with sporadic RVF

BENEFITS OF INTEGRATION • Efficiency in Training Students • Shared Resources • Course Materials • Faculty and Staff • Laboratory and Other Facilities • Participation in Joint Exercises • Undergraduate, Graduate, Professional Students

BENEFITS OF INTEGRATION • Efficiency in Dealing with Zoonotic Disease • At Community, National, Regional, Global levels • Combined Veterinary and Public Health Approaches • Disease Surveillance and Detection • Joint strategies to reduce disease in human and animal populations through disease control and prevention programs

BENEFITS OF INTEGRATION • Positive Impacts on Community Economics, Health, and Well-being • Improved human and animal productivity • Improved health • Improved quality of life

EXAMPLE: Brucellosis in Rural East Africa • Brucellosis: infection by Brucella spp. • Gram-negative, non-motile, non-spore-forming, rod shaped • Facultative intracellular parasites • Hosts • Small ruminants (goats, sheep): B. melitensis • Cattle: B. abortus • Other animal hosts (e.g., swine, dogs) http://www.nature.com/news/2008/080206/full/451618b.html

EXAMPLE: Brucellosis in Rural East Africa (cont.) • Human brucellosis • Symptoms • Undulating fever, flu-like symptoms, joint pain, etc. • Misdiagnosed as malaria or other acute febrile diseases • Treatment • Antibiotics: e.g., doxycycline, rifampin • Duration: 6-9 weeks

EXAMPLE: Brucellosis in Rural East Africa (cont.) • Livestock Brucellosis • Symptoms • Abortions • Orchitis • Arthritic symptoms • Treatment • No practical treatment exists • Prevention: vaccination http://theriogenology.multiply.com/photos/album/30 http://www.vet.uga.edu/vpp/archives/NSEP/Brazil2002/brucella/Eng/clinicalsigns.htm

EXAMPLE: Brucellosis in Rural East Africa (cont.) • Routes of Transmission • Highly contagious between animals • Direct contact with contaminated materials • Abortion materials • Milk • Ingestion of contaminated milk

EXAMPLE: Brucellosis in Rural East Africa (cont.) • Breaking the Cycle of Transmission • In Humans • Educate farmers, community members • Governmental awareness: policy change • Surveillance • Treatment/Prevention programs • In Livestock • Surveillance • Prevention/control programs: vaccination, etc.

EXAMPLE: Bovine Tuberculosis • Infection by Mycobacterium tuberculosis-complex bacteria • Slow-growing, long incubation period • Acid-fast • Obligate intracellular pathogen • Hosts • M. tuberculosisin humans • M. bovis in cattle

EXAMPLE: Bovine Tuberculosis (cont.) • Human bovine tuberculosis (TB) • Symptoms • Fever, sweating • Gastrointestinal, dermal symptoms • Co-infection with HIV/AIDS • Treatment • Antibiotics: e.g., doxycycline, rifampin • Duration: 6-7 weeks

EXAMPLE: Bovine Tuberculosis (cont.) • Livestock TB • Symptoms • Early infection asymptomatic • Mild fever, weakness, reduced appetite • Late infection: abscesses, cough, emaciation, death • Treatment: No practical treatments • Prevention: No effective vaccines

EXAMPLE: Bovine Tuberculosis (cont.) • Routes of Transmission (human and animal) • Respiratory • Aerosols • Sputum • Gastrointestinal • Feces • Urine http://content.nejm.org/content/vol359/issue15/images/large/12f1.jpeg • Integumental • Mammary gland: Milk • Abscesses

EXAMPLE: Bovine Tuberculosis(cont.) • Breaking the Cycle of Transmission • In Humans • Educate farmers, community members • Surveillance • Treatment/Prevention programs • In Livestock • Surveillance • Prevention/control programs http://www.meridianmedcons.com/Tuberculin2.asp

CONCLUSIONS • Integrating the management of transboundary infectious diseases and zoonoses needs to be practiced at local, national, regional, and global levels. • Integration could be within the Veterinarycontext and/or using a One Health approach.

Thank you

University Distinguished Professor John B. Kaneene DVM, MPH, PHD, FAES, FAVES