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      Unhealthy Landscapes: Policy Recommendations on Land Use Change and Infectious Disease Emergence

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          Anthropogenic land use changes drive a range of infectious disease outbreaks and emergence events and modify the transmission of endemic infections. These drivers include agricultural encroachment, deforestation, road construction, dam building, irrigation, wetland modification, mining, the concentration or expansion of urban environments, coastal zone degradation, and other activities. These changes in turn cause a cascade of factors that exacerbate infectious disease emergence, such as forest fragmentation, disease introduction, pollution, poverty, and human migration. The Working Group on Land Use Change and Disease Emergence grew out of a special colloquium that convened international experts in infectious diseases, ecology, and environmental health to assess the current state of knowledge and to develop recommendations for addressing these environmental health challenges. The group established a systems model approach and priority lists of infectious diseases affected by ecologic degradation. Policy-relevant levels of the model include specific health risk factors, landscape or habitat change, and institutional (economic and behavioral) levels. The group recommended creating Centers of Excellence in Ecology and Health Research and Training, based at regional universities and/or research institutes with close links to the surrounding communities. The centers’ objectives would be 3-fold: a) to provide information to local communities about the links between environmental change and public health; b) to facilitate fully interdisciplinary research from a variety of natural, social, and health sciences and train professionals who can conduct interdisciplinary research; and c) to engage in science-based communication and assessment for policy making toward sustainable health and ecosystems.

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          Most cited references 57

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          Emerging infectious diseases of wildlife--threats to biodiversity and human health.

          Emerging infectious diseases (EIDs) of free-living wild animals can be classified into three major groups on the basis of key epizootiological criteria: (i) EIDs associated with "spill-over" from domestic animals to wildlife populations living in proximity; (ii) EIDs related directly to human intervention, via host or parasite translocations; and (iii) EIDs with no overt human or domestic animal involvement. These phenomena have two major biological implications: first, many wildlife species are reservoirs of pathogens that threaten domestic animal and human health; second, wildlife EIDs pose a substantial threat to the conservation of global biodiversity.
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            Risk factors for human disease emergence.

            A comprehensive literature review identifies 1415 species of infectious organism known to be pathogenic to humans, including 217 viruses and prions, 538 bacteria and rickettsia, 307 fungi, 66 protozoa and 287 helminths. Out of these, 868 (61%) are zoonotic, that is, they can be transmitted between humans and animals, and 175 pathogenic species are associated with diseases considered to be 'emerging'. We test the hypothesis that zoonotic pathogens are more likely to be associated with emerging diseases than non-emerging ones. Out of the emerging pathogens, 132 (75%) are zoonotic, and overall, zoonotic pathogens are twice as likely to be associated with emerging diseases than non-zoonotic pathogens. However, the result varies among taxa, with protozoa and viruses particularly likely to emerge, and helminths particularly unlikely to do so, irrespective of their zoonotic status. No association between transmission route and emergence was found. This study represents the first quantitative analysis identifying risk factors for human disease emergence.
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              Anthropogenic environmental change and the emergence of infectious diseases in wildlife.

              By using the criteria that define emerging infectious diseases (EIDs) of humans, we can identify a similar group of EIDs in wildlife. In the current review we highlight an important series of wildlife EIDs: amphibian chytridiomycosis; diseases of marine invertebrates and vertebrates and two recently-emerged viral zoonoses, Nipah virus disease and West Nile virus disease. These exemplify the varied etiology, pathogenesis, zoonotic potential and ecological impact of wildlife EIDs. Strikingly similar underlying factors drive disease emergence in both human and wildlife populations. These are predominantly ecological and almost entirely the product of human environmental change. The implications of wildlife EIDs are twofold: emerging wildlife diseases cause direct and indirect loss of biodiversity and add to the threat of zoonotic disease emergence. Since human environmental changes are largely responsible for their emergence, the threats wildlife EIDs pose to biodiversity and human health represent yet another consequence of anthropogenic influence on ecosystems. We identify key areas where existing expertise in ecology, conservation biology, wildlife biology, veterinary medicine and the impact of environmental change would augment programs to investigate emerging diseases of humans, and we comment on the need for greater medical and microbiological input into the study of wildlife diseases.

                Author and article information

                Environ Health Perspect
                Environmental Health Perspectives
                National Institue of Environmental Health Sciences
                July 2004
                22 April 2004
                : 112
                : 10
                : 1092-1098
                1Center for Sustainability and the Global Environment (SAGE), Nelson Institute for Environmental Studies and the Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin, USA
                2Consortium for Conservation Medicine, Palisades, New York, USA
                3Wilburforce Foundation, Bozeman, Montana, USA
                4Wildlife Trust, Palisades, New York, USA
                5Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
                6School of Natural Resources and Environment, University of Michigan, Ann Arbor, Michigan, USA
                7Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
                8Centre on Global Change and Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
                Author notes
                Address correspondence to J.A. Patz, Center for Sustainability and the Global Environment (SAGE), Nelson Institute for Environmental Studies and the Department of Population Health Sciences, University of Wisconsin–Madison, 1710 University Avenue, Room 202A, Madison, WI 53726-4087 USA. Telephone: (608) 265-9119. Fax: (608) 265-4113. E-mail:

                Members of the Working Group on Land Use Change and Disease Emergence, convened at the biennial meeting of the International Society for Ecosystem Health: A.A. Aguirre, F.P. Amerasinghe, R.W. Ashford, D. Barthelemy, R. Bos, D.J. Bradley, A. Buck, C. Butler, E.S. Chivian, K.B. Chua, G. Clark, R. Colwell, U.E. Confalonieri, C. Corvalan, A.A. Cunningham, P. Daszak, J. Dein, A.P. Dobson, J.G. Else, J. Epstein, H. Field, J. Foufopoulos, P. Furu, C. Gascon, D. Graham, A. Haines, A.D. Hyatt, A. Jamaluddin, A.M. Kilpatrick, E.F. Kleinau, F. Koontz, H.S. Koren, S. LeBlancq, S. Lele, S. Lindsay, N. Maynard, R.G. McLean, T. McMichael, D. Molyneux, S.S. Morse, D.E. Norris, R.S. Ostfeld, J. Patz, M.C. Pearl, D. Pimentel, L. Rakototiana, O. Randriamanajara, J. Riach, J.P. Rosenthal, E. Salazar-Sanchez, E. Silbergeld, G.M. Tabor, M. Thomson, A.Y. Vittor, N.D. Wolfe, L. Yameogo, and V. Zakarov.

                Funding for the Special Colloquium, “Unhealthy Landscapes: How Land Use Change Affects Health,” was provided by the National Fish and Wildlife Foundation, V. Kann Rasmussen Foundation, Overbrook Foundation, and New York Community Trust. The colloquium was cosponsored by the World Health Organization and the United Nations Environment Program.

                The authors declare they have no competing financial interests.

                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
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