Beyond One Health
Description
* Presents critical population health topics, written by an international group of experts
* Addresses the technical aspects of the subject
* Offers potential policy solutions to help mitigate current threats and prevent additional threats from occurring
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Persons
The Editors
John A. Herrmann, DVM, MPH, DACT, is Director of the DVM-MPH Program and the Center for One Health Illinois at the College of Veterinary Medicine, University of Illinois at Urbana-Champaign in Urbana, Illinois, USA and Affiliate Professor at the School of Public Health, University of Illinois at Chicago, in Chicago, Illinois, USA.
Yvette J. Johnson-Walker, DVM, MS, PhD, is Lecturer of Epidemiology at the College of Veterinary Medicine, University of Illinois at Urbana-Champaign in Urbana, Illinois, USA.
Content
List of Contributors xiii
Foreword by Chadia Wannous and David Nabarro xvii
Foreword by Lonnie King xix
Preface xxi
Section 1 The Science of One Health 1
1 Epidemiology: Science as a Tool to Inform One Health Policy 3 Yvette J. Johnson?]Walker and John B. Kaneene
1.1 Introduction 3
1.2 Enhancing Our Understanding of Health and Disease 5
1.2.1 Causes of Disease 5
1.2.1.1 Deterministic Models of Disease 6
1.2.1.2 Hill's Causal Criteria 7
1.2.1.3 Multifactorial Models of Disease Causation 8
1.2.1.4 Breaking the Chain of Transmission 8
1.2.2 Assessing the Impact of Disease 10
1.2.3 Natural Course of Disease 13
1.2.3.1 Reservoirs of Disease 13
1.2.3.2 Humans as a Reservoir 14
1.2.3.3 Domestic Animal Reservoirs 14
1.2.3.4 Wildlife Reservoirs 17
1.2.3.5 Environmental Reservoirs 17
1.3 From Understanding Epidemiology to Public Policy 19
1.3.1 Assessments of Diagnostic Test Reliability 20
1.3.2 Determination of Safety and Effectiveness of New Treatments and Vaccines 20
1.3.3 Assessment of Health at the Level of the Individual, Community, or Ecosystem and Establish Standards of Care for Prevention and Treatment Protocols/Programs 21
1.3.4 Establishing Disease Response Regulations and Control Standards 22
1.4 Examples of the Benefits of Using a One Health Approach 23
1.4.1 Overall Summary of Practical Experiences Applying a One Health Approach 25
References 28
2 Health Impacts in a Changing Climate 31 Donald J. Wuebbles
2.1 Introduction 31
2.2 Our Changing Climate 32
2.2.1 Climate Change Effects on Temperature 33
2.2.2 Climate Change Effects on Precipitation 34
2.2.3 Climate Change Effects on Severe Weather 37
2.3 The Basis for a Human Cause for Climate Change 41
2.4 Twenty?]first Century Projections of Climate Change 43
2.5 Climate and Health 49
2.5.1 Temperature?]Related Death and Illness 49
2.5.2 Air Quality Impacts 50
2.5.3 Vector?]Borne Diseases 50
2.5.4 Water?]Related Illnesses 52
2.5.5 Food Safety, Nutrition, and Distribution 52
2.5.6 Extreme Weather?]Related Impacts 54
2.5.7 Mental Health and Well?]being 54
2.5.8 Climate-Health Risk Factors and Populations of Concern 55
2.6 Summary and a Look Forward 55
References 56
3 Food Safety and Security 61 Megin Nichols, Lauren Stevenson, Casey Barton Behravesh, and Robert V. Tauxe
3.1 Evolution of Food Production 61
3.2 Foodborne Illness 63
3.3 A One Health Approach to Foodborne Illness Detection and Response 68
3.4 Antibiotic Resistance and Food Safety 75
3.5 Zoonotic Disease and Foodborne Pathogens 78
3.6 Outbreak Response Communication 80
References 83
4 Water Security in a Changing World 89 Jeffrey M. Levengood, Ari Hörman, Marja?]Liisa Hänninen, and Kevin O'Brien
4.1 Introduction 89
4.2 Waterborne Pathogens and Contaminants : Technologies for Drinking Water Treatment and Management of Water Safety 90
4.2.1 Waterborne Pathogens 90
4.2.2 Antibiotic?]Resistant Bacteria in Source and Drinking Water 91
4.2.3 Chemical Hazards in the Drinking Water 93
4.2.4 Pharmaceuticals in Wastewater and Raw Water Sources 93
4.2.5 Water Treatment Methods 93
4.2.5.1 Thermal Treatment 94
4.2.5.2 Chemical Disinfection 94
4.2.5.3 Filtration 95
4.2.5.4 Other Treatment Methods 96
4.2.6 Surveillance for Waterborne Diseases 96
4.2.7 Requirements for Drinking Water Quality 96
4.2.8 Water Safety Plans (WSPs) 97
4.3 The Water/Energy/Food Nexus: Mitigating Global Risks 99
4.3.1 Water/Energy Nexus 99
4.3.1.1 Nuclear 102
4.3.1.2 Coal 103
4.3.1.3 Natural Gas 103
4.3.1.4 Renewables 103
4.3.1.5 Water/Energy Nexus Summary 104
4.3.2 Water/Food Nexus 104
4.3.2.1 Water/Food Nexus Summary 107
4.3.3 Water/Energy/Food Nexus: Summary and Next Steps 107
Acknowledgments 108
References 108
5 One Toxicology, One Health, One Planet 115 Daniel Hryhorczuk, Val R. Beasley, Robert H. Poppenga, and Timur Durrani
5.1 Introduction 115
5.1.1 History 115
5.1.2 Toxic Chemicals in Our Environment 117
5.1.3 One Toxicology 118
5.2 Key Concepts 120
5.2.1 Dose?]Response Relationships 120
5.2.2 Differences in Susceptibility 120
5.2.3 Periods of Increased Susceptibility 122
5.2.4 Receptors 122
5.2.5 Toxicokinetics and Toxicodynamics 123
5.3 Ecotoxicology and Human Exposures 124
5.3.1 Everyday Toxicology and Ecotoxicology: Contrasts, Complexities, and Challenges 124
5.3.2 Toxicant Fate in the Environment 125
5.3.3 Contrasts in Feasibility: Examinations and Interventions 129
5.3.4 Indirect Effects of Chemicals 132
5.3.5 Direct Immunotoxicity and Indirectly Mediated Immunosuppression 137
5.3.6 Neurotoxicity 138
5.3.7 Endocrine Disruption 138
5.3.8 Reproductive and Developmental Toxicity 140
5.4 Toxicological Risk Assessment and One Health 141
5.4.1 Risk Assessment 141
5.4.2 Regulatory Toxicology 141
5.4.3 One Health and One Toxicology on One Earth 142
5.5 Conclusions 143
References 144
6 Biodiversity and Health 153 Dominic A. Travis, Jonathan D. Alpern, Matteo Convertino, Meggan Craft, Thomas R. Gillespie, Shaun Kennedy, Cheryl Robertson, Christopher A. Shaffer, and William Stauffer
6.1 Introduction 153
6.2 Connectivity 155
6.2.1 Biodiversity as an Indicator of Health 155
6.2.2 Social Factors 158
6.3 Grand Challenges, Development Goals, Global Health Security, and Ecosystem Health 159
6.3.1 The Case of Agriculture, Food Security, and Biodiversity 161
6.3.2 The Case of Wildlife Trade, Bushmeat, and Biodiversity 162
6.3.3 The Case of Infectious Diseases and Biodiversity 165
6.3.4 The Case of Climate Change, Conflict, and Human and Animal Migration 166
6.4 Conclusions and a Way Forward 168
6.4.1 The Application of Complexity Science and Technology Tools to Optimize Health and Environmental Outcomes 168
References 170
7 Emerging Infectious Diseases: Old Nemesis, New Challenges 177 Ronald C. Hershow and Kenneth E. Nusbaum
7.1 Introduction 177
7.2 Rabies 180
7.2.1 Natural History 180
7.2.2 The Epizoology of Rabies Virus 181
7.2.3 Global Burden 181
7.3 Avian Influenza 182
7.3.1 Natural History 182
7.3.2 Recent Outbreaks 183
7.4 Zika Virus 186
7.5 Ebola Virus Disease (EVD) 188
7.6 Summary 189
Acknowledgments 190
References 190
8 Reigning Cats and Dogs: Perks and Perils of Our Courtship with Companion Animals 195 Sandra L. Lefebvre and Robert V. Ellis
8.1 Introduction 195
8.2 Benefits and Hazards of Human?]Pet Relationships 197
8.2.1 Physical and Mental Health 197
8.2.1.1 Impacts on Humans 197
8.2.1.2 Impacts on Pets 200
8.2.2 Overweight and Obesity 202
8.2.3 Feeding Practices and Illness 203
8.2.3.1 Human Illness Related to Pet Feeding Practices 203
8.2.3.2 Pet Illness Related to Feeding Practices 205
8.2.4 Infectious Disease Transmission 206
8.2.4.1 Companion Animal?]to?]Human Transmission 206
8.2.4.2 Human?]to?]Companion Animal Transmission 216
8.2.5 Pets, People, and Antimicrobial Resistance 216
8.2.6 Social and Community Health 221
8.2.7 Domestic Health and Violence 223
8.3 Interactions Among Humans, Pets, and the Environment 223
8.3.1 Working Dogs 223
8.3.2 Environmental Toxicants 224
8.3.3 Pets and the External Environment 225
8.3.4 Disaster Preparedness 227
8.3.5 Climate Change 228
8.3.6 Zoonotic Disease Surveillance for Both People and Pets 228
8.4 Conclusion 229
Disclaimer 230
References 230
9 Zoological Institutions and One Health 243 Thomas P. Meehan and Yvonne Nadler
9.1 Introduction 243
9.2 Zoos, Aquariums, and Field Conservation 243
9.3 Zoos, Aquariums, and the Care of Animals 244
9.4 Social Aspects of Zoos and Aquariums 245
9.5 Zoonotic Disease Challenges: Protecting Visitors, Staff, and Animals 246
9.6 Case Studies in One Health from Zoological Institutions 249
9.6.1 West Nile Virus: A Case Study for the One Health Paradigm 249
9.6.1.1 Emergence of West Nile Virus in North America 249
9.6.1.2 Centers for Disease Control: ArboNET 250
9.6.1.3 A Failure of Early Coordination 251
9.6.1.4 Lessons Learned from the West Nile Virus Outbreak, 1999 252
9.6.1.5 Zoological Institutions as Forerunners to the 'One Health' Paradigm 253
9.6.1.6 Zoological Parks as Sentinels for Human Disease 253
9.6.1.7 A Model for Sentinel Surveillance: The Zoological WNV Surveillance Project 254
9.6.1.8 Lessons Learned from the Zoological WNV Surveillance Project 254
9.6.1.9 The Role of Zoological Institutions in Preparing for Pandemics 255
9.6.2 The Emergence of Highly Pathogenic Avian Influenza Virus, 1999 255
9.6.2.1 Consequences of HPAI Detection in a Zoological Institution 256
9.6.2.2 The Association of Zoos and Aquariums Prepares for HPAI 257
9.6.2.3 Lessons Learned from HPAI Surveillance System 258
9.7 Conclusion 259
References 260
Section 2 Four Perspectives on One Health Policy 265
10 One Health Leadership and Policy 267 William D. Hueston, Ed G.M. van Klink, and Innocent B. Rwego
10.1 Introduction and Definitions 267
10.2 Grand Challenges in Health (aka "Wicked Problems") 267
10.3 Implications of Grand Challenges for One Health Leadership 268
10.4 Critical Competencies for One Health Leadership 268
10.5 Policy?]Making with One Health in Mind 269
10.6 Integrating One Health Leadership Approaches in Hierarchical Organizations 270
10.7 Demonstrating One Health Leadership and Policy in Action 271
10.8 Case Study 1: National One Health Policy Development in Cameroon and Rwanda 272
10.8.1 Cameroon 272
10.8.2 Rwanda 272
10.9 Case Study 2: The Campaign for Global Elimination of Dog?]Mediated Human Rabies 273
10.10 Case Study 3: Antimicrobial Resistance - USA 274
References 276
11 Implementing One Health 277 Laura H. Kahn
11.1 Financing One Health Initiatives 277
11.2 Conclusion 279
References 279
12 The Social Cost of Carbon 281 William J. Craven
12.1 Introduction 281
12.2 Some Context on Cost?]Benefit Analyses 282
12.3 The Social Cost of Carbon (SCC) 282
12.3.1 Looking at Costs 283
12.3.2 Getting the SCC as Good as it Can Get 285
12.4 Current Challenges to Reducing and Mitigating the Effects of Climate Change 287
References 288
13 Complex Problems, Progressive Policy Solutions, and One Health 291 John A. Herrmann
13.1 One Health as Prevention 291
13.1.1 Successes 291
13.1.2 Failures 292
13.2 Translating Science: Risk Communication and Science Literacy 293
13.2.1 Communication of Science 294
13.2.2 Liberal Education and the Sciences 295
13.2.3 Community Empowerment and Participatory Democracy 299
13.3 The Economics of One Health 300
13.4 From Here to There 302
References 302
Section 3 Conclusion 305
14 The Long and Winding Road 307 John A. Herrmann and Yvette J. Johnson?]Walker
14.1 One Health: Many Facets, All Interrelated 307
14.2 One Health Policy Development 310
14.2.1 Policy Basics and Challenges to Enacting One Health?]based Policies 310
14.2.2 Microeconomic One Health Dilemmas 311
14.2.3 One Health Research in Emerging Infectious Diseases: Macroeconomic Dilemmas 312
14.2.4 The Long and Winding Road Forward 313
References 321
Index
1
Epidemiology: Science as a Tool to Inform One Health Policy
Yvette J. Johnson-Walker1 and John B. Kaneene2
1 University of Illinois Urbana-Champaign, Urbana, IL, USA
2 Michigan State University, East Lansing, MI, USA
1.1 Introduction
Epidemiology is the study of disease dynamics in populations. It seeks to understand patterns of disease as a means of identifying potential prevention and control measures. It has been described as "an interesting and unique example of cross-fertilization between social and natural sciences" (Vineis, 2003). The basic principle of epidemiology is that disease is not a random event. Each individual in a population has a unique set of characteristics and exposures (risk factors) that determine his or her probability of disease. Clinical medicine is focused on the health of the individual while epidemiology and public health seek to apply assessment of risk factors at the community level. Understanding how those risk factors impact a community provides public health officials with the tools to develop policies and interventions for disease control and prevention in the community as a whole.
The One Health concept is coherent with the principles of epidemiology because risk factors for many diseases occur at the interface between humans, animals, and the environment. Failure to consider the interactions between them may result in public health policies that fail to effectively control disease and protect the environment. The One Health triad (Figure 1.1) of humans, animals, and the environment is analogous with the other triads that epidemiologists use to describe disease dynamics within a population:
- The host, agent, environment triad (Figure 1.2) is used to describe the interplay between these three key components of infectious disease transmission. Changes in any of these components alters the probability of disease.
- The three states of infectious disease status are illustrated by the susceptible, infected, removed (SIR) triad (Figure 1.3).
- Outbreaks of disease are characterized in terms of person or animal, place, and time as the first step of identifying the population at risk.
- Risk factors for disease causation are categorized as: necessary, sufficient, and component causes (Figure 1.4).
Figure 1.1 The One Health triad.
Source: Thompson, 2013. Reproduced with permission of Elsevier.
Figure 1.2 The "epidemiologic triad" of infectious disease summarizes the factors that influence an infection, and the measures you might take to combat the infection.
Source: Used with permission from Ian McDowell (http://www.med.uottawa.ca/SIM/data/Pub_Infectious_e.htm#epi_triad).
Figure 1.3 Infection modeling: the SIR model. Susceptible nodes - have not been infected yet and are therefore available for infection. They do not infect other nodes. Infectious nodes - have been infected and infect other nodes with a certain probability. Removed (recovered) nodes - have gone through an infectious period and cannot take part in further infection (neither actively nor passively).
Source: Used with permission from Michael Jaros (http://mj1.at/articles/infection-modelling-the-sir-model/).
Figure 1.4 Necessary, sufficient, and component causes. The individual factors are called component causes. The complete pie (or causal pathway) is called a sufficient cause. A disease may have more than one sufficient cause. A component that appears in every pie or pathway is called a necessary cause, because without it, disease does not occur.
Source: Rothman, 1976. Reproduced with permission of Oxford University Press.
The goal of public health policy is to prevent transmission of disease agents to the susceptible segment of the population by controlling and treating disease among the infected and increasing the segment of the population that is removed (recovered or resistant). Identification and isolation of cases, quarantine of the exposed, and vaccination of the susceptible are the primary tools employed by public health practitioners for infectious disease control. Development of effective programs to accomplish these goals requires an understanding of the:
- Causes of disease (etiologic agent, pathophysiology, and risk factors.
- Impact of the disease on the population (number of cases, ease of transmission, economic and social impact).
- Natural course of the disease (reservoirs for the agents of disease, means of introduction of the agent into the population, period of infectivity, severity of disability, length of immunity, and potential for long-term sequelae) (Figure 1.5).
Figure 1.5 Natural history of disease timeline.
Source: CDC, 1992.
The goals of this chapter are to elucidate how epidemiology can 1) provide a tool for understanding the causes, impacts, and course of disease in human and animal populations within various ecosystems, and 2) form the basis for evidence-based health and environmental policy development.
1.2 Enhancing Our Understanding of Health and Disease
1.2.1 Causes of Disease
Epidemiology is unique among biomedical investigative approaches because of the observational nature of many of the study designs. Unlike laboratory studies, the epidemiologist often studies a naturally occurring disease within a free-living population in which study subjects are not assigned to intervention groups (except in the case of clinical trials). Individuals may have a variety of independent exposures during the study period. Whether studying human or animal populations, the epidemiologist seeks to identify exposures that are associated with the probability of disease using statistical analysis of data from carefully documented exposures and outcomes. However, even if a statistically significant association between an exposure and disease outcome has been identified, that does not necessarily mean that a cause and effect relationship has been established. Much more rigorous standards have been set for establishing a causal relationship between a risk factor and the probability of disease.
1.2.1.1 Deterministic Models of Disease
Criteria for establishing causation for infectious disease have been described since the nineteenth century. Research by Robert Koch, Friedrich Loeffler, and Jakob Henle resulted in the Koch-Henle postulates published in 1882 (Sakula, 1983; Gradmann, 2014) (Figure 1.6). While this approach is useful when seeking to identify the etiologic agent responsible for an infectious disease, it has many limitations. The simplistic approach of a deterministic model for establishing disease causation is insufficient for identifying risk factors for chronic noninfectious diseases (such as type II diabetes) or even infectious diseases with a multifactorial etiology (such as new variant Creutzfeldt-Jakob disease, or CJD). In more recent years more complex models have been used to establish a causal relationship between a putative risk factor and disease.
Figure 1.6 The steps for confirming that a pathogen is the cause of a particular disease using Koch's postulates.
1.2.1.2 Hill's Causal Criteria
Austin Bradford Hill published "The environment and disease: association or causation?" in 1965 (Hill, 1965). The manuscript describes nine criteria necessary for establishing a causal relationship between a risk factor and a disease:
- Strength of association: the greater the magnitude of the association between the risk factor and the outcome, the more likely the relationship is to be causal.
- Temporality: the risk factor must precede the onset of the disease.
- Consistency: the same association should be observed in multiple studies with different populations.
- Theoretical plausibility: the association should be biologically plausible and consistent with the pathophysiology of the disease.
- Coherence: the association should be consistent with what is known about the disease.
- Specificity in the causes: a risk factor should be associated with a single disease or outcome.
- Dose-response relationship: as the dose of the risk factor is increased the probability and severity of the disease should increase in a linear fashion.
- Experimental evidence: data from in vitro studies and animal models should support the causal association between the risk factor and the disease.
- Analogy: similar causal relationships should be known.
The nature of these criteria makes it impossible for a single observational study to establish a causal relationship between an exposure and a disease outcome. The criterion of consistency requires that multiple studies, in different populations, show the same association. The criterion of temporality also requires that the association be demonstrated in prospective studies. Prospective study designs monitor the study population prior to the onset of disease and follow their...
