Control and Prevention of Control and Prevention of Animal Animal –– Human Disease Human Disease

TransmissionTransmissionDr Dusan

VeterinarianZoonotic Disease Consultant WHO, China.

OutlineOutline

• Surveillance and risk assessment• Control

• Prevention• WHO activities

Surveillance and Risk Surveillance and Risk AssessmentAssessment

• China’s list of notifiable diseases: 13/37 are zoonotic

• Are we looking hard enough?• Measurable challenge motivates political

commitment• Challenges of surveillance in China• Challenges of interventions to benefit

subsistence farmers

Notifiable Diseases of ChinaNotifiable Diseases of China

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200

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600

800

1000

1200

1400

1600

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2000

1996 1997 1998 1999 2000 2001 2002

Year

Inci

denc

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Non-zoonotic Diseases

Zoonotic Diseases

Emerging / ReEmerging / Re--emerging diseasesemerging diseases1996 to 20041996 to 2004

Cryptosporidiosis

Lyme Borreliosis

Reston virus

VenezuelanEquine Encephalitis

Denguehaemhorrhagicfever

Cholera

E.coli O157

West Nile Fever

Typhoid

Diphtheria

E.coli O157

EchinococcosisLassa feverYellow fever

Ebola haemorrhagicfever

O’nyong-nyong feverHumanMonkeypox

Cholera 0139

Denguehaemhorrhagicfever

Influenza A(H5N1)

Cholera

RVF/VHF

nvCJD

Ross River Virus

Equinemorbillivirus

HendraVirus

BSE

Multidrug-resistant Salmonella

E.coli non-O157

West Nile VirusMalaria

Nipah Virus

Reston Virus

Legionnaire’s Disease

Buruli ulcer

Influenza A (H7N7)

SARS

Risk characteristics of Risk characteristics of ruralrural farmers farmers in Chinain China

Facilities and animal care:• Storage and housing materials can be minimal• Different animal species are often housed together

in close vicinity • Food animals are kept in close proximity to

humans, even indoors sharing the same airspace.• Minimal input farming – little feed is bought in

and nutrients are often recycled e.g. animals scavenging and use of excrement.

• Veterinary medicines, vaccines and diagnostics are limited

•Water sources may be limited or unclean

Risk characteristicsRisk characteristics continuedFood preparation:• Poor economic conditions so sick or dead animals

may be eaten without precaution• Animals slaughtered close to or inside the home• Food preparation is undertaken nearby this• Majority of the animal is eaten• Individual cultural practices can add to risk e.g.

eating undercooked meat.Access to health care, education and

medicines including human vaccines:• Limited by either availability or cost

ControlControl

Community Access to Basic Community Access to Basic AmenitiesAmenities

• Clean water• Soap and hygiene

products• Safe housing (esp

Vector-borne diseases)• Education

Community Access to Community Access to Appropriate HealthcareAppropriate Healthcare

• Affordable and accessible• Good diagnostics (training, facilities and

technologies)• Quality medications (not fakes)

Community Education About Community Education About RisksRisks

• Targeted• Realistic• Simple and non-

conflicting• Short-term (outbreak)

vs.• Long-term

(behavioural changes).

4 S4 S’’s to reduce risk of animals to reduce risk of animal--human disease transmissionhuman disease transmission

• Surveillance• Sanitation• Species separation• Safe consumption and

waste disposal

E.g BSE, Strep. suis

PreventionPrevention

Agricultural Extension and Agricultural Extension and Veterinary ServicesVeterinary Services

• Public and private partnerships towards disease control

• Greater knowledge dissemination to rural communities / best farming practices

• Improved surveillance• Establishment of robust animal health systems• Access to appropriate medications• Monitoring of antibiotic resistance

Food Marketing SystemsFood Marketing Systems

• Species separation during transport and in the market place

• Reduction in live markets/ increased cleanliness• Market rest days (FAO recommendations)• Reduction in bush food consumption• Reduction in foodborne diseases through

improved quality assurance systems/ trace back: FARM-to-FORK

WHO ActivitiesWHO Activities

APSEDAPSED• International Health Regulations (IHR) revised

2005 = policy statement• Asia pacific strategy for emerging diseases

(APSED) = strategy document.• Objective 1: reduce risk

– Strategic risk communication and community participation.

– Reducing risk of emerging diseases acquired from animals.

– Strengthened containment of antimicrobial resistance.

APSEDAPSED continued

• Objective 2: Strengthen early detection of outbreaks– Strengthened early warning systems.– Coordinated and integrated surveillance

systems.– Strengthened local capacity for surveillance and

risk assessment.– Strengthened information management.

• Objective 3: Strengthen early response

APSEDAPSED continued

• Objective 4: Strengthen preparedness– Strengthened preparedness and capacity to

respond.• Objective 5: Develop sustainable technical

collaboration within the Asia Pacific Region– Development and strengthening of technical

partnerships in the Asia pacific region.

Building animal and public health capacity to deal with influenza will lead to strongernational systems for alert and response linked to a comprehensive global alert and response system that will serve to protect us from whatever nature has in store!

WPRO & Emerging Infectious DiseasesWPRO & Emerging Infectious Diseases

ChallengesChallenges

• Utilising available resources effectively –integrated projects

• Improved disease surveillance and early warning especially in the poorest areas (research, training, compensation)

• Long term, sustainable changes • Engaging on local, national, regional and

global levels

Thank you!Thank you!