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

1. 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

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

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

4. 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

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

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

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

8. 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

9. 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

10. 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

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

12. 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

13. 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

14. 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

15. 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

16. 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.

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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.

23. Thank you