Role of the Veterinarians and One Health Approach in the Fight Against Zoonoses
Dr Md Moin Ansari
Incharge, Animal Birth Control Facility
(ABC-AR Immunization Centre)
Faculty of Veterinary Sciences and Animal Husbandry
SKUAST K, Shalimar-190025. Jammu & Kashmir
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“Although notable progress had been made in various aspects of rabies, there is still a splintering of efforts in research and control and a great need to bring these efforts together”
-George M.B.,1991
Veterinarian (an animal doctor) is a qualified professional and authorized to practice veterinary medicine. They provide important role globally to build effective collaboration between animal and human health sectors, prevention and eradication of zoonoses, food safety and protection, improving surveillance and response for early detection of disease diagnosis threats in animals where disease hasn’t started spreading, strengthening laboratory diagnostic capacities for novel pathogens, improving case management and infection disease control, treat injured/sick animals, test for and vaccinate against diseases, advise animal owners about medical conditions, on proper care of their pets/livestock integrating vector control management, adding value to health research and development especially in human sector. Veterinarians are engaged in private practice, teaching, research, extension, government service, public health, military service, private industry and other related areas.
The term ‘zoonosis’ was first sued by the German physician and pathologist Rudolf Virchow (1821–1902) in 19th century. A zoonosis is an infectious disease that can be transmitted from a non-human animal to humans or, more specifically, a disease that normally exists in animals but that can infect humans. Zoonotic pathogens may be bacterial, viral or parasitic, or may involve unconventional agents and can spread to humans through direct contact or through food, water or the environment. Zoonotic diseases present challenges not only to veterinarians but also to all professions concerned with public health. More than 800 zoonotic pathogens are known to affect humans, with 20 to 30 of these resulting from contact with dogs and/or cats. An estimated 75% of emerging infectious diseases are zoonotic, primarily of viral origin and 60% of known human infectious diseases are transmitted from animals. Normal microbial changes can influence the spread of a zoonotic disease from a wildlife reservoir; this is of particular concern for veterinary professionals who work directly with wildlife, as well as for clients who live in more rural areas, where their animals may come in contact with infected wild animals or fomites. They represent a major public health problem around the world due to our close relationship with animals in agriculture, as companions and in the natural environment. With agriculture showing signs of decline and land mass being degraded and converted to non-agricultural purposes, livestock remains the only hope for a predominantly agriculture-linked economy that is ours. Urbanization and the destruction of natural habitats increase the risk of zoonotic diseases by increasing contact between humans and wild animals.
ONE HEALTH (OH) APPROACH
One Health (OH) is a new phrase, but the concept was originated as far back as to the time of Aristotle in 500 BC and Hippocrates of Cos in 340 BC. Aristotle wrote the ‘Historia Animalium’ to elaborate on the natural zoonotic history of animals. Researchers including Louis Pasteur and Robert Koch and physicians such as William Osler and Rudolph Virchow demonstrated the collaborative links between animal and human health. More recently, the term ‘One Medicine’ was developed and promoted by veterinary epidemiologist and parasitologist Calvin W. Schwabe (1927–2006) in 1984. In 2003, the term ‘One Health’ draw the attention across the globe since it was mentioned in Washington Post by Dr. William Karesh to describe the outbreaks of Ebola haemorrhagic fever in Africa. He said, ‘Human or livestock or wildlife health can’t be discussed in isolation anymore. According to Weiss, 2003, there is just OH and the solutions require everyone working together on all the different levels. This was followed by a series of conferences across the glove with the theme of ‘One World – One Health. One Health is defined by the OH Commission as “the collaborative effort of multiple disciplines to obtain optimal health for people, animals, and our environment.” In another definition, the One Health Initiative Task Force (OHITF) defines one health as “the promotion, improvement, and defense for the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, and other scientific health professionals and by promoting strengths in leadership and management to achieve these goals.” The OH approach, employing disease surveillance, management, and eradication through collaboration between veterinarians dealing with livestock and wild animal populations and ecologists examining ecosystem biodiversity and public health experts, may have yielded a more rapid resolution to the outbreak. Collaboration between veterinary, medical, and public health professionals to understand the ecological interactions and reactions to flux in a system can facilitate a clearer understanding of climate change impacts on environmental, animal and human health.
Rabies, brucellosis, bovine tuberculosis, leptospirosis and anthrax are important zoonoses widely prevalent in India and other developing countries. Among these zoonoses, rabies is of utmost public health significance due to its lethality. Rabies is a viral zoonotic disease of mammals. Approximately, 55,000 people are reported to die of rabies every year throughout the world. Rabies is mainly transmitted by roaming dogs, and the rabies virus is also believed to be harbored by them. Gangs of stray dogs often inflict injuries during fight with fellow members, some of which are also rabid. The newly infected victims develop signs and symptoms of various incubation times and thus, in turn, transmit the virus to other stray dogs at different times. In this way, the transmission of the virus is sustained in an area, region, state or country. Despite being a classic preventable zoonotic disease with an almost 100 % case fatality ratio rabies remains one of the notoriously under reported and neglected disease in the modern world. Each and every case of human rabies is not only a tragic event for the family and community, however, the tools to prevent such terrible deaths have been available ever since rabies can be prevented and managed efficiently by “OH Approach” which involves inter-sectoral collaboration from human, animal, and environmental health disciplines at local, national, and global levels to a make program successful by a comprehensive, strategic, and targeted control and prevention approach with collaborative efforts of veterinarians, clinician, epidemiologist, laboratory scientists and nursing experts can help generate public awareness about prevention of Rabies along with Government who can formulate policies. With this background the strategic action plan has four priority deliverables instrumental to the success of the plan viz: dog mass vaccination (DMV- is the most important component), access to timely post-exposure prophylaxis, robust human and dog disease surveillance and community mobilization. Increasing awareness of rabies prevention and control in communities is an integral part of any successful rabies control and or elimination programme. Rabies is 100 % vaccine preventable. Optimizing the supply and access to safe, efficacious and affordable dog and human rabies vaccines and rabies immunoglobulin is key to achieving zero human rabies death. Veterinarians can help in managing the biting canine/dog and help in its monitoring by adopting Animal Birth Control (ABC) Programme. They can also play a key role in rabies prevention by vaccinating anti-rabies vaccine (ARV) to stray dogs in urban and peri-urban areas. Municipal corporations certainly also work hand in hand with veterinary service providers for registering the number of stray dogs in an area and their neutering or sterilization. Anti-rabies vaccines are outstandingly effective, no one should die of dog-transmitted infection. Eliminating rabies in dogs is now feasible and would dramatically reduce human mortality. The high current economic burden of human prophylaxis would then be largely relieved. World Rabies Day (WRD) takes place each year on September’ 28 the anniversary of the death of Louis Pasteur, who, with the collaboration of his colleagues, developed the first efficacious rabies vaccine. As the world is celebrating the World Rabies Day on Tuesday’ 28 September’ 2021, efforts and aims to focus on awareness about the impact of rabies on humans and animals, provide information and advice on how to prevent the disease in at-risk communities, and provide supports for implementation efforts in rabies control. The importance of wildlife as reservoirs of human diseases has also been widely recognized for most of the parasitic zoonoses, including American and African trypanosomiasis, leishmaniasis, giardiasis, cryptosporidiosis, balantidiasis, fascioliasis, opisthorchiasis, clonorchiasis, paragonimiasis, schistosomiasis, echinococcosis, taeniasis, diphyllobothriasis, sparganosis, dipylidiasis, trichinellosis, toxocariasis, strongyloidiasis, and Ancylostoma caninum and A. braziliense infections. The OH approach has successfully replaced the disease cantered approach to zoonoses with a system-based approach that aligns multiple disciplines, working locally, nationally, and globally, to attain optimal health for people, domestic, and wild animals and the environment. For vector-borne diseases, effective vector control is an integral part of any intervention strategy. Integrated pest management is a comprehensive approach used to prevent and control various pests that can transmit diseases. Rodent traps should be maintained and monitored, and potential vector nesting materials and breeding sites should be eliminated. Use of insecticides and pesticides should be part of a whole plan, not the only tactic used to control pests. In case of Bird Flu or Avian Influenza caused by H5N1 Influenza virus, veterinarians should promptly demarcate the area of infected zone and start culling and burial activities along with municipality workers. OH, professionals including doctors and nurses professionals should generate awareness about bird flu in the local population and ensure their cooperation by telling them not to consume eggs and meat in the immediate vicinity. In case of possible bioterrorism attack by Bacillus anthracis spores, similar collaborative approach is needed between veterinarians and one health promulgators. Leptospirosis is another zoonotic disease caused by Leptospira spp., a spirochaete, which urgently needs a OH viewpoint. Rodents, rice fields and rainfall are epidemiologically play very significant role for spread of the infection. Various sectors like Health sector, agriculture and others need to be integrated via OH to diagnose cases accurately, properly control rodents and stop spread of the infection. Still others, such as the novel coronavirus that causes COVID-19, have the potential to cause global pandemics. COVID-19, caused by SARS-CoV2 or novel Coronavirus is also a zoonosis. It spread in December 2019 via bats and pangolins to man, in Hubei, China. Now it is spreading rapidly from man to man as a full- fledged pandemic. World Health Organization, NGO’s and national governments are working together for formulation and implementation of stringent OH approach for successful application of OH approach in COVID-19. Preventive measures like social distancing, frequent hand washing and wearing face masks while venturing outside are relevant and significant.
Conclusion
The one health approach continues to be a highly integrated efforts in research, which involves inter-sectoral collaboration from human, animal, and environmental health disciplines at local, national, and global levels to a make program successful by a comprehensive, strategic, and targeted control and prevention approach with collaborative efforts of veterinarians, clinicians, epidemiologists, laboratory scientists and nursing experts have a very important role to play in generate public awareness about preventive measures of zoonotic infections in animal reservoirs and enable early outbreak detection to ensure safe health and a better world.
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