Zero Disease Concept and Seven Sins

Dr. Bhoj R Singh, Principal Scientist (VM)I/C Epidemiology; Centre for Animal Disease Research and Diagnosis

Indian Veterinary Research Institute, Izatnagar-243122, Bareilly, UP, India. TeleFax +91-581-2302188

What is zero disease concept?

• Absence of disease in animal population or a flock mean zero disease. The base situation of no disease.

• Why needed: To estimate the losses caused by a disease. It is necessary for initiating the research or measures to develop vaccine/ drug to control or eradicate a disease. However, there is hardly any estimate about potential cost of reaching the zero disease status once the disease is there. Moreover, there is hardly any flock, free of all diseases.

• Alternate method to zero disease concept: Productivity estimates associated with disease control/ elimination from a specific flock can be applied to estimate the cost of control/ eradication.

• Productivity= Total value of output per unit of time/ total value of input per unit of time.

• It have several limits as no knowledge of diseases, no control programme ever initiated, no estimates have been made, requires too many parameters to be recorded.

Absolute Zero and Near Zero

• Absolute zero: Imaginary• Near Zero: Possible in restricted territory i.e., in

Compartments.• Compartmentalization: means one or more

establishments under a common biosecurity management system containing an animal sub-population with a distinct health status with respect to a specific disease for which required surveillance, control and biosecurity measures have been applied for the purpose of international trade..

Compartmentalization

• The main criterion for a compartment is that the animals contained in it are clearly recognizable as part of a unique subpopulation with limited or no epidemiological links to other populations of risk.

• The measures taken to ensure the identification of the sub-population and the recognition and maintenance of its health status should be documented in detail.

• For the purpose of international trade, compartments should be under the direct control and responsibility of the official Veterinary Administration in the country.

General considerations of compartmental biosecurity

• Endemic compartments: No interactions with endemic compartments.• Wild populations: provides adequate separation from other wild populations• Employees: Policy prohibiting employees’ contact with high risk animals.• Service sectors (e.g. Catching/vaccination/cleaning crews/feed delivery/service

personnel)• Congregation of sick/dead animals from multiple sources (e.g., rendering,

Compost, incinerate, or bury)• Vehicle traffic: Park away from animal housing, preferably outside farm

perimeter• Visitors: Prohibit visitors in animal area• Wild animals: No attractants such as garbage Fencing• Equipment: Do not share equipment with other farm sites, dedicated racks and

flats (e.g., colour coded) – thoroughly cleaned and disinfected between uses.• Downtime: Minimum downtime between flocks or litters. Cleaning and

disinfection, change litter for every lock.

Zero basic reproductive Ratio

• Reducing R0 can be done at any point in the transmission cycle by through:– Reducing or eliminating the shedding of the agent by the

infected host. – Reducing the duration of environmental survival of the agent.– Reducing or eliminating vehicle contamination and fomite

transmission.– For vector-borne infections reducing the vector population or

preventing exposure of susceptible animals to it. – Reducing the exposure of susceptible hosts.– Increasing the resistance of the susceptible hosts.

Seven sins associated with zero disease concept

• Sin 1: biology is the battlefield of health. It contradicts medicines theory of relativity: h = b (c + p)t,p,

Our system focuses on factor b — biological, chemical and physical hazards to our health , factor C- culture and P-politics are largely ignored. t-time, p-place.

• Sin-2– It is often assumed that by improving the parts, you serve

the whole. But so it is not. It neglects that m > ≠ p. An individual is mysteriously different from the aggregate of the parts. It is greater than the sum of the molecules, cells and organs.

• Sin-3– All are created equal, all are equally susceptible even M ≠F

• Sin-4• Substituting the question mark with an exclamation

mark. Our system oversells certainty and suppresses doubt.

• Sin-5– Health educators work on the dark side of life. They are obsessed by anomalies,

failures, disabilities and risks. They conceal that health first and foremost is joie de vivre.

• Sin-6– Health is stuck in a top–down communication model. We are the superior expert

system. We know what is best for the animals. Our tradition does not recognize health as a personal property.

• Sin-7– The last sin is an old one, called niemietas by the Romans. In wealthy Rome they

experienced that individuals living in excess demand more with no limits. They claim more money, more adventures, more safety, more health–and no risk, no sickness, no death. People and cultures infected with this attitude become, according to Roman wisdom, distressed, dangerous and sick. The Zero-vision can purify from this sin. The Zero-vision springs from a firm conviction: If we invest sufficient money and brain cells, man can design life, format society, manage nature — so why should we accept risk, accident, pain, disease, aging, death? Health system promises too much, demands too much, suffers from an

U¨ bermensch neurosis that they try to communicate to the all.

What the medicine people want?

• Healthy souls and sound bodies i.e., to force people into the postmodern prison of health perfection and body fetishism.

• However, freedom of health should be our vision, medical tolerance our trademark.

• Nietzsche -Only men who are knights of the dangerous chance, do have good health.

• John Stuart Mill - Wellbeing of man depends on his freedom to do experiments in life.

• Dostoevsky- Hero cannot find satisfaction in the order and comfort of the crystal palace world.