CONNECTING ECO-HEALTH COMMUNITY TO WILDLIFE ZOONESES

Shukor Md Nor (DVM, PHD) School of Environment and Natural Resources Faculty of Science and Technology University Kebangsaan Malaysia

ECOHEALTH VS ONE HEALTH

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ONE HEALTH “One World One Health” was first launched at The IUCN World Conservation

Congress in Bangkok on 11-25 November 2004

One Health concept Strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment.

One Health Definitions

One Health is the collaborative effort of multiple disciplines working locally, nationally, and globally, to address critical challenges and attain optimal health for people, domestic animals, wildlife, and our environment.

One Health Commission (http://www.onehealthcommission.org/)

The One Health concept is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans and animals.

One Health Initiative (http://onehealthinitiative.com/)

The One Health concept is the realization that human, animal, and environmental health are interrelated.

Powdrill TF, Nipp TL, Rinderknecht JL. 2010

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Ecohealth Definitions

Ecosystem approaches to public health issues acknowledge the complex, systemic nature of public health and environmental issues, and the inadequacy of conventional methodologies for dealing with them.

Dr. David Walter-Toews, University of Guelph

The Ecohealth approach focuses above all on the place of human beings within their environment. It recognizes that there are inextricable links between humans and their biophysical, social, and economic environments, and that these links are reflected in a population's state of health.

International Development Research Centre (IDRC)

Its approach is inherently transdisciplinary and recognizes complex biophysical, social, cultural, political and economic relationships between the ecosystem and human health.

-National Council for Science and the Environment

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Ecohealth is a ‘new’ field that has encouraged innovative, cross-disciplinary work both locally and internationally

6 Ecohealth principles

Systems thinking

Transdisciplinarity

Participation

Sustainability

Gender and Social Equity

Knowledge-to-Action

Encourages dialogue and partnerships between different groups and recognizes the relationships between human and ecological health

Ecohealth Principles

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One Health VS Ecohealth

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One Health VS Ecohealth

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Ecohealth Vs Ecosystem Health

One Health VS Ecohealth

Many similarities

Different traditions/backgrounds

Tentative steps toward integration

In this talk I considered both created for the same puproses.

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KEY FACTORS Human

Animal

Environment

Their interactions

Understanding based on transdisciplinary approach

Human

Animal Environment

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WILDLIFE ZOONOSES

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BACKGROUND

Wildlife serves as a reservoir for many diseases common to domestic animals and humans. Generally, wildlife zoonotic disease is more easily prevented than treated. Many wildlife zoonotic diseases are so common in nature, so rare in humans, or so mild in their symptoms, that wild animals pose a minimal health risk to people. However there are important and need to understand and study due to possible emergence – Emergence need to be controlled via surveillance.

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BACTERIAL DISEASES Leptospirosis Brucellosis Bubonic Plague Psittacosis Salmonellosis Tetanus Tularemia MYCOTIC DISEASES Aspergillosis Histoplasmosis VIRAL DISEASES Rabies

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HELMINTH PARASITIC DISEASES Baylisascaris procyonis PROTOZOAL DISEASES Giardiasis Toxoplasmosis TICK-BORNE DISEASES Lyme disease Rocky Mountain Spotted Fever PHYSICAL TRAUMA

LIST OF DISEASES GROUPED ACCORDING TO THEIR CAUSATIVE AGENT OR MODE OF TRANSMISSION

HOWEVER NOTE THAT THERE ARE SEVERAL ZOONOTIC DISEASES THAT NEED ATTENTION ALTHOUGH MIGHT NOT CONSIDERED ENDEMIC/ PENDEMIC. THERE ARE ALSO POTENTIAL EMERGENCE AND REMERGENCE HAS DIRECTLY AND INDIRECTLY MAY HAS IMPACT ON WILDLIFE AND HUMAN

ONE HEALTH PROGRAM FOR MALAYSIA

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UNDERSTANDING LINKAGE OF PATHOGEN, WIDLLIFE

HOST AND DISEASES EMERGENCE

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Connecting the Health of Wildlife, People and their Animals

One Health triad that encompasses humans, domestic animals, wildlife and the changing ecosystems in which they live.

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PATOGEN

WILDLIFE

HUMAN

(INFECTED)

DOMESTIC

LINKAGE AMONG WILDLIFE, DOSMESTIC ANIMAL

AND HUMAN

spilled back

spilled over

ANIMAL (host)

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PATOGEN

HOST/

RESERVOIR

(RESISTANT

– DEAD END

HUMAN

(INFECTED)

HOST/

RESERVOIR –

SPILL OVER

HOST/

RESERVOIR

(MAINTANANCE)

exposure

surveillance

emergence

reemergence

Question – What would trigger pathogens / infection agents? Random, host,

environment, all combination?

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Wildlife

Urbanization

Agricultural, land use

and animal husbandry

changes/practices

Habitat

alteration

Species’ Ecological-evolutionary Dynamics

Opportunistic habitat expansion/ecological release

Vector (domestication) Vector/reservoir species

Wildlife/reservoir transport/encroachment Human encroachment

Host-Pathogen Dynamics

Emergence Processes of ‘Host-Parasite Biology’ Host switching (host novelty) • Breaching of pathogen persistence thresholds

Transmission amplification and genetic change (pathogen novelty)

Disease Emergence ecosystem continuum

H

U

M

A

N

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C

O

S

Y

S

T

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M

N

A

T

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R

A

L

E

C

O

S

Y

S

T

E

M

Global

climate

change

Demographic Changes

Technology/Globalization

Socio-cultural organization

REGIONAL ENVIRONMENTAL CHANGE

Wilcox, B. A., & Colwell, R. R. (2005). Emerging and Reemerging Infectious

Diseases: Biocomplexity as an Interdisciplinary Paradigm. EcoHealth, 2(4), 244-

257.

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PATOGEN

HOST/

RESERVOIR

(RESISTANT

– DEAD END

HUMAN

(INFECTED)

HOST/

RESERVOIR –

SPILL OVER

HOST/

RESERVOIR

(MAINTANANCE)

exposure

surveillance

emergence

reemergence

Not all exposure will be transmitted to human ?

FACTS ABOUT WILDLIFE AND ZOONOSES

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Example 1 – Demographic Change: Increase Population to Increase Outbreak

Outbreaks were positively correlated with growing population densities where 60.3% were zoonoses and 71.8% of these originated in wildlife. Jones, Patel, Levy, et. al. Nature, 2008 Feb. 21; 451 (7181):990-3

Example 2 – Change Agriculture Pratices to Increase Emergence

Changing agricultural practices produced another outbreak of zoonotic disease, Nipah virus infection, in Malaysia in 1998–1999.8 Deforestation and intensive fruit tree cultivation combined with increased pig farming to elevate the exposure of pigs to fruit bats subclinically infected with and shedding Nipah virus. The virus rapidly spread through the country’s pig population, certainly through trade and possibly also between farms by dogs and cats. Humans in direct contact with pigs then acquired the infection and its often-fatal encephalitis.

Emergence of Diseases From Wildlife Reservoirs, J. C. Rhyan, and T. R. Spraker. 2010

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Example 3 – Decrease Host Species Diversity and Increase Prevalence

Explanation 1

Dilution effect, whereby increasing species diversity decreases disease prevalence by diluting the availability of competent hosts with increased numbers of non competent hosts.

a dilution effect could occur if 1) individuals of the host species remain as species diversity decreases, 2)the disease is spread within the host species through direct encounters (such as biting), and 3) presence of other species causes encounters among the host species to decrease.

- Implication for conservation

Increased Host Species Diversity and Decreased Prevalence of Sin Nombre Virus Laurie J. Dizney and Luis A. Ruedas (2009)

Explanation 2

Encounter reduction - as more species, and more individuals within those species, are added to the community, the number of potential disease-transmitting encounters decreases because other species are non-host (not competent, or non-amplifying) species.

Explanation 3

Competition - if increasing species diversity increases the number of competitors in an ecosystem, thereby increasing the amount of time a host species has to spend securing limited resources (food, nest sites), in turn decreasing the time spent on intraspecies encounters.

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Explanation 4

Predation – if predation and competition are decreased or absent in a community, a zoonotic release of predatory and competitive controls appears to have occurred, infection prevalence will increase drastically.

The implications of wildlife EIDs are twofold: i) emerging wildlife diseases cause direct and indirect loss of biodiversity and ii) add to the threat of zoonotic disease emergence.

35 Anthropogenic environmental change and the emergence of infectiousdiseases in wildlife. Daszak P, Cunningham AA, Hyatt AD. Acta Trop. 2001 Feb 23;78(2):10316.

Example 4 – Decrease Habitat size (fragment) Increase Prevalence

Landuse change for development reduced habitat size. Resources availability are reduced and increased stress on wildlife. High stress allow to increase prevalence.

WILDLIFE ZOONOSES – RODENT HOST OR RESERVOIR

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Rodents have proven to be of increasing importance in transmitting diseases to humans in recent decades, through the emergence of worldwide epidemics trough the emergence of diseases (e.g. leptospirosis and scrub typhus).

From wild to anthropized habitats, rodents can be reservoirs, hosts or vectors of infectious organisms.

Occupying almost all biotopes and by rapidly adapting to environmental changes, rodents are fundamental in the maintenance and transmission of an impressive number of infectious organisms to humans.

Investigations of parasites and pathogens in murine rodents have helped to describe the implication of the main species and understand the different ways of transmission.

Sathaporn Jittapalapong1*, Vincent Herbreteau2, Jean-Pierre Hugot, Peera Arreesrisom, Anamika

Karnchanabanthoeng, Worawut Rerkamnuaychoke and Serge Morand, 2013

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Why Rodents ?

They are known to transmit diseases and act as reservoir host for many zoonotic pathogens including parasites that pose a health risk to humans (Walsh et al., 1993; Mayer et al., 1995; Singleton et al., 2003).

Endo-parasites of rodents play an important role in the zoonotic cycles of many diseases, e.g. schistosomiasis and angiostrongyliosis. Several studies on endoparasites of commensal and forest rodents have been carried out in Malaysia

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Why Rodents ?

Why Rodents?

Some rodent-reservoir zoonoses are ‘sleeping giants’ that may awake at any time.

A crucial point here is that zoonotic pathogens that are virulent in humans are typically avirulent in their natural reservoirs: the same pathogens are therefore often medically important but archetypically ‘endemic’ in a rodent population.

Disease: health effects on humans, population effects on rodents Michael Begon

Rodents are a key mammalian group and are highly successful in adapting to many environments throughout the world.

There are more than 1700 species of rodents identified in the world (RatZooMan, 2006).

How about Bats?

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EXAMPLE WILDLIFE ZOONOSES STUDY 1:

Leptospira

Prevalence and serovars

distribution

Molecular detection

Molecular epidemiology

Virulent gene

identification

Target gene identification

Clinical parameters & predictors

Production and clinical course

of biomarkers

Host immune response

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GROUP 1

Diagnostic and Prognostic Biomarker

GROUP 2

Determination of

Epidemiology & Molecular

characteristics of Leptospira

GROUP 3

Socio behavioural & Risk Perception

GROUP 4

Identification and control of

Leptospira hosts

Sociobehavioural risk factors

Risk perception

Interactive health education

Host biology

Host diversity

Methods of

population control

LINKS AMONG PROJECT GROUPS

Project 4 – Prevention and

control

Source: Nature Reviews Microbiology 7, 736-747 (October 2009)

MODE OF TRANSMISSION (MOT)

Reservoir

MOT

Mus msuculus, Asian House Mouse (house and buildings)

Rattus rattus, House Rat (house, garden)

Rattus tiomanicus, Malayan Field Rat (Plantation, garden)

Rattus norvegicus, Norway Rat

(Town and port)

Rattus exulans, Pacific Rat

(Paddy, garden, house)

POTENTIAL SPECIES

UNANSWERED QUESTIONS

1. Is there any specific host species for leptospira,

2. How do the hosts become the major carrier of transmitting leptospira to the human within a specific habitat,

3. What is the pattern of leptospirosis occurrence (prevalence) at specific habitat and time?,

4. What are the important environmental factors contributing to the occurrence of the leptospirosis cases?

5. Is the prevalence of the leptospirosis cases associated with the host population, or human negligence?,

6. What are the best options in reducing the occurrence of the leptospirosis cases in this country?

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HYPOTHESES AND ASSUMPTIONS

1. Rodent (rats) is an important wildlife reservoir for leptospira compare to other wildlife (WHY)

2. Rapid population growth of this group contribute to the rapid transmission of the leptospira (HOW)

3. Rodent species closely associated with human (habitat) potentially is the main carrier and reservoir for the transmission (WHY and HOW)

4. Water (not direct contact) an important mode of transmission from the reservoir to the human (HOW)

5. There are many compounding factors determining the transmission of leptospira (HOW)

STUDY SITES AND DESIGN

• High prevalence areas in Perak, Selangor, and Kelantan.

• Two habitats – Recreational areas and urban and semi-urban areas

• Two study plots for each habitat.

• Live trapping with 100 traps each

• Intervals of 10m apart

• Trapping intervals with 3-5 days per month

• Examination and identification (weighing and external measurement)

• Ear tagging and radio collar (if selected),

• Urine sample

• Release and monitoring

METHODOLOGY 1

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METHODOLOGY 1 – WHAT CAN BE ACHIEVED

Understanding home range, habitat preference, activity and movement patterns of potential leptospira hosts.

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METHODOLOGY 2

50 RELEASE MONTHLY MONITORING

METHODOLOGY 2 – WHAT CAN BE ACHIEVED

Determination the small mammal diversity and species composition

Population structure of small mammals

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METHODOLOGY 3

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Education

environmental control

• Choice depend on the test either one or combination of many control methods

• Educating communities also required ?

METHODOLOGY 4

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Collection of urine for leptospira screening Drink and fasting overnight

LAB RELEASE

CONCLUSION

It is uncertain if the leptospiras are transmitted from specific animal species or all the animals are the potential reservoir for the leptospiras.

It is still uncertain if the outbreak of leptospiras are initiated from the host/ reservoir or environment or combination of all factors.

This study will uncover the general pattern of how the leptospiras are transmitted to human.

The population and ecological data will be used to generate a suitable (and practical) control method of the hosts/ reservoirs, thus the leptospirosis cases can be controlled.

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EXAMPLE WILDLIFE ZOONOSES STUDY 2:

Ticks and Mites

Movements and home range of a common species

of tree-shrew, Tupaia glis surrounding houses of

otoacariasis cases in Kuantan, Pahang

Dr Mariana Hj Ahamad

Acarology Unit, IMR

Ticks inside human ear canal

Literatures

Cases of ticks entering ear canal of human

(Indudharan et al., 1986; 1995; 1999; Srinovianti & Raja Ahmad, 2003,

Mariana et al., 2008)

Biological dynamics of ticks involved (Mariana et al., 2008)

Common small animals caught inside houses & compounds of affected human (Mariana et al., 1996; Mariana et al., 2010)

Research Questions: Source of tick infestation

Human otoacariasis is not a natural occurrence but rather accidental

Human may be infested when living, working or conducting activities in close contact with tick-infested animals or close to the environment where ticks naturally occur

There are also possibilities for animals (shrews & rodents)

to introduce the ticks into houses and compounds (Mariana, pers. comm)

Objectives

To obtain information on activity and movement patterns,

home range, nesting behaviour and social organization of 5

individuals of a common tree-shrews, T. glis caught

surrounding houses of otoacariasis cases in Felda Bukit

Goh, Kuantan.

To document these information for spatial distribution of

tree-shrews with ticks for public health research.

Study Area

The study was conducted in

Lorong Bukit Goh 3/1, Felda

Bukit Goh, Kuantan, Pahang

(N03º54’ E103º15’), an area

with high number of new

and repeat otoacariasis

cases (adult & children)

Bukit Goh

Tick species

distribution

GIS

Identification & body

engorgement index

Cases related to

Meteorological Factors

Survey of ticks

surrounding

house of cases

Study on movements of animals with ticks

Catch, mark &

release

Movements & Home range of shrews with ticks

using Mark-Recapture Techniques

Toe nail-clipping method to mark shrews (Yasuma & Andau, 1999)

3 times in a period of 3 months

(Apr – Jun 2008)

5 – 7 consecutive nights

130 wire-traps, laid 10m apart

5 shrews (3 , 2) were monitored

Chip track with portable telemetry receiver fitted with a 3-element Yagi antenna

Observation period: time exit from nest till enter nest

Fixes plotted on graph paper for coordinates

Analyse coordinates using Ecological Software Solutions (Biotas Version 1.03)

Population Study Telematry study

Epidemiological studies

Tick species

distribution

Epidemiological studies

GIS

Clinical study Identification & body

engorgement index

Cases related to

Meteorological Factors

Survey of ticks

surrounding

house of cases

Study on movements of animals with ticks

Transmitter chip radio-collar

Ticks Battery

(operates between frequencies of 154.13 -154.21 MHz)

Modal (mode) time of exit and entry into nest for T. glis in Bukit Goh.

ID Sex

Nest

Modal time of

exit from nest

(hour system)

Modal time of

entry into nest

(hour system)

13 Male House No. 197 (kitchen) 0601-0700 1901-2000

15 Male Jack fruit tree with bushes around 0601-0700 1901-2000

17 Female House No. 197 0601-0700 1901-2000

19 Female House No. 211 0601-0700 1901-2000

21 Male Long Bushes and scrubs behind

House No 211

0601-0700 1901-2000

2 houses were identified as nests

2 shrews of different sex shared the same house as their nest.

Beginning of activity between 6.01 -7.00 am. By 8.00 pm, shrews were already in their nest

Layout of houses (numbered 196 to 213; house # 207 was no longer

exist during study) and designated points (T1 to T7) for taking

compass bearing for telemetry.

Fruit orchard

Land for

rearing

cows &

chicken

Long bushes

at the back

Coconut

trees

Secondary

forest

Small village road

T1 T2 T3 T4

T5

T6 T7

209 210 211

212

213

196

197

198 199 200 201

202 203

204 205 206

208

Table 4. Total length of active period, mean and range of total daily

distances moved by every individual of T. glis.

ID Sex Number of

days

Mean total

active period

(hour)

Mean total

daily

distances

moved (m)

Range of

total daily

distance (m)

13 Male 74 5.75 372.01 2976.08

15 Male 116 6.30 273.78 3285.36

17 Female 54 5.00 349.99 2449.93

19 Female 141 7.00 382.59 4591.08

21 Male 93 4.90 270.11 2971.21

Mean active period = 4.9 – 7.0 hrs / day

Mean total daily distances moved = 270 – 383 m

Range of total daily distance = 2445 – 4591 m

Table 5. Mean daily rate of movement and maximum observed rate of movement

by each individual of T. glis.

ID Sex Number of

days

Mean daily

rate of

movements

(m/hour)

Maximum

observed rate

of movement

(m/hour)

13 Male 74 64.69 113.11

15 Male 116 43.46 136.12

17 Female 54 69.99 174.09

19 Female 141 54.66 201.31

21 Male 93 55.12 197.73

Mean daily rate of movement = 44 – 70 m / hr

Maximum observed rate of movement = 113 – 201 m / hr

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Conclusion

1. Their total active periods spent moving around from vegetations / trees in fruit orchards or from a nearby secondary forest to trees in compound of 4 – 7 houses and vice versa

2. Evidences of shrews having close contact with human in this area:

Nest for 3 shrews were found in 2 houses

Presence of a shrew in kitchen of a house

A dead drowned shrew in water pool of a house

Shrews are potential carriers of tick from the wild into

houses and their compounds based on ….

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EXAMPLE WILDLIFE ZOONOSES STUDY 3:

Blood Meals

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EXAMPLE WILDLIFE ZOONOSES STUDY :

Effect of fragmentation on Blood parasite prevalence

Effects of forest fragmentation on

parasite prevalence in avian blood

Farah Shafawati Binti Mohd Taib

Fakuti Sains & Teknologi,

Universiti Kebangsaan Malaysia

Bangi, Selangor MALAYSIA

INTRODUCTION

Recently, number of Emerging infectious disease-EIDs

especially from wildlife have risen in the last few

decades.

The main factor that brought in EIDs include

urbanization, rising human population, agricultural

activities, wildlife trade, loss of biodiversity, pathogen

from invasive species and global warming.

Blood parasites play a fundamental role in the ecology

and evolution of birds as they are able to affect the

fitness and survival of their hosts.

Forest fragmentation

Forest fragmentation??

Forest fragmentation occurs when a large

continuous forest reduced to smaller fragments

that are isolated by surrounding due to

anthropogenic activities.

It also includes a subdivision of forest patches

into more isolated fragments by expanding urban

areas, agriculture and other types of land uses

(Navjot et al., 2011).

Parasite prevalence vs Forest

fragmentation

Fragmentation process which increase edge effect may alter host-parasite relationship through:

1) Enhancing the ability of parasite which easily infected edge areas to infect the interior community.

2) Increasing edge effect allows contact between bird species that nesting in nearby habitat which resulting to exposure of fragment inhabitants towards new species or vector.

3) Loss of habitat for nesting forcing nest re-use.

4) Social and physiological preassure which related to reduction in habitat quality resulted in pathogenesis which consequently affecting fitness.

Kota

Damansara

(KD)

Ayer Hitam

(AH)

Bangi

(Bangi)

Bukit

Nanas

(BN)

Bkt. Sungei

Puteh (SP)

& Sg. Besi

(SB)

Pangsun

Sg. Tua (ST)

Materials & Method

In the field

In the lab: Staining blood smears (Giemsa Stainning)

Parasite prevalence among sites

Plasmodium

Trypanosoma

Haemoproteus

Leucocytozoo

n

Babesia Aegyptianella

Erlichia Microfillarea

0

10

20

30

40

50

60

70

AH Bangi BN KD SB SP Pgsn ST

Fragmented Continuous

Para

site

pre

vale

nce (

%)

Forest type

Infection (%) Multiple infection (%)

Parasite prevalence among sites

Site

Num. of

captured

birds

Num. of

Infected

birds Infection

(%)

Multiple

infection

(%) Pla

smodiu

m

Haem

opro

teus

Leukocyto

zoon

Try

panoso

ma

Babesi

a

Aegypti

anella

Erl

ichia

Mic

rofi

llare

a

AH 31 20 64.5 37.5 9 8 10 0 9 9 1 1

Bangi 7 4 57.1 42.9 2 3 1 0 1 2 0 0

BN 10 4 40 20 0 0 2 1 1 0 2 1

KD 45 14 31.1 15.6 4 4 4 0 5 9 2 0

SB 26 11 42.3 15.4 1 1 5 1 5 5 0 0

SP 26 13 50 18.5 4 2 2 3 7 0 0 0

Pgsn 98 19 19.4 6.25 7 5 6 0 0 5 0 4

ST 71 20 28.2 14.1 6 2 2 0 0 13 0 8

Plasmodium

16%

Haemoproteus 14%

Leucocytozoon 19%

Trypanosoma 4%

Babesia 22%

Aegyptianella

20%

Erlichia 4%

Microfillarea 1%

Forest fragment Continuous forest

Plasmodium 22%

Haemoproteus 12%

Leucocytozoon

14%

Trypanosoma 0%

Babesia 0%

Aegyptianella 31%

Erlichia 0%

Microfillarea 21%

Parasite prevalence vs Diet type

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9

1 1 2

4 3

42

10

3

1 2

14

10

0

5

10

15

20

25

30

35

40

45

Num

ber

of

indiv

idual

Number of species infected total

52%

90%

33.3%

100%

100%

29%

30%

0 20 40 60 80 100 120

Insectivores

Carnivores

Picivores

Generalist

Granivores

Frugivores

Nectarivores

Percentage (%)

% infected

Parasite prevalence vs Forest-

dependency

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13

4

52

22

6

0

10

20

30

40

50

60

High Medium Low

Num

ber

of

indiv

idual

Number of species infected Total

46%

59%

67%

0 20 40 60 80 100

High

Medium

Low

Percentage (%)

% infected

Conclussion Parasite prevalence is higher in fragmented forest compared to continuous

forest.

In general, parasite prevalence is higher in small patches compared to

larger patches. But, there were exception in Ayer Hitam forest (largest

fragment with highest parasite prevalence).

Aegyptianella showed the highest prevalence with 41%, followed by

Plasmodium (31.4%) and Leucocytozoon (30.5%), whereby Trypanosoma

and Ehrlichia have the lowest prevalence of 4.8% respectively.

Oriental scops-owl (Otus Sunia) was found to be the highest infected

species where 7 from 8 individuals sampled were infected primarily with

Plasmodium and Leucocytozoon. This was followed by olive-winged bulbul

(Pyncnonotus plumosus) and White-rumped shama (Copsychus

malabaricus) with 57.1% and 53% respectively.

HAS SENT FOR PUBLICATION

HOW TO CONNECT ECO-HEALTH COMMUNITY TO WILDLIFE

ZOONOSES

1. Continue with OneHealth Program – at Country level

2. Establish Research Sub-group at Department level

3. Research Sub-group need to communicate at national

level

4. Enhance the existing research (wildlife zoonoses)

e.g. MyOHUN

5. Organise meeting, seminar and training.

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CHALLENGES

Research funding

Lack of cooperation

Lack of expert

Lack of leading expert

Lack of awareness

Lack of focus

But ALL problem can be solved ??

SEKIAN TERIMA KASIH