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      The Global One Health Paradigm: Challenges and Opportunities for Tackling Infectious Diseases at the Human, Animal, and Environment Interface in Low-Resource Settings

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          Abstract

          Zoonotic infectious diseases have been an important concern to humankind for more than 10,000 years. Today, approximately 75% of newly emerging infectious diseases (EIDs) are zoonoses that result from various anthropogenic, genetic, ecologic, socioeconomic, and climatic factors. These interrelated driving forces make it difficult to predict and to prevent zoonotic EIDs. Although significant improvements in environmental and medical surveillance, clinical diagnostic methods, and medical practices have been achieved in the recent years, zoonotic EIDs remain a major global concern, and such threats are expanding, especially in less developed regions. The current Ebola epidemic in West Africa is an extreme stark reminder of the role animal reservoirs play in public health and reinforces the urgent need for globally operationalizing a One Health approach. The complex nature of zoonotic diseases and the limited resources in developing countries are a reminder that the need for implementation of Global One Health in low-resource settings is crucial. The Veterinary Public Health and Biotechnology (VPH-Biotec) Global Consortium launched the International Congress on Pathogens at the Human-Animal Interface (ICOPHAI) in order to address important challenges and needs for capacity building. The inaugural ICOPHAI (Addis Ababa, Ethiopia, 2011) and the second congress (Porto de Galinhas, Brazil, 2013) were unique opportunities to share and discuss issues related to zoonotic infectious diseases worldwide. In addition to strong scientific reports in eight thematic areas that necessitate One Health implementation, the congress identified four key capacity-building needs: (1) development of adequate science-based risk management policies, (2) skilled-personnel capacity building, (3) accredited veterinary and public health diagnostic laboratories with a shared database, and (4) improved use of existing natural resources and implementation. The aim of this review is to highlight advances in key zoonotic disease areas and the One Health capacity needs.

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          Most cited references7

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          Food-borne diseases — The challenges of 20 years ago still persist while new ones continue to emerge

          The burden of diseases caused by food-borne pathogens remains largely unknown. Importantly data indicating trends in food-borne infectious intestinal disease is limited to a few industrialised countries, and even fewer pathogens. It has been predicted that the importance of diarrhoeal disease, mainly due to contaminated food and water, as a cause of death will decline worldwide. Evidence for such a downward trend is limited. This prediction presumes that improvements in the production and retail of microbiologically safe food will be sustained in the developed world and, moreover, will be rolled out to those countries of the developing world increasingly producing food for a global market. In this review evidence is presented to indicate that the microbiological safety of food remains a dynamic situation heavily influenced by multiple factors along the food chain from farm to fork. Sustaining food safety standards will depend on constant vigilance maintained by monitoring and surveillance but, with the rising importance of other food-related issues, such as food security, obesity and climate change, competition for resources in the future to enable this may be fierce. In addition the pathogen populations relevant to food safety are not static. Food is an excellent vehicle by which many pathogens (bacteria, viruses/prions and parasites) can reach an appropriate colonisation site in a new host. Although food production practices change, the well-recognised food-borne pathogens, such as Salmonella spp. and Escherichia coli, seem able to evolve to exploit novel opportunities, for example fresh produce, and even generate new public health challenges, for example antimicrobial resistance. In addition, previously unknown food-borne pathogens, many of which are zoonotic, are constantly emerging. Current understanding of the trends in food-borne diseases for bacterial, viral and parasitic pathogens has been reviewed. The bacterial pathogens are exemplified by those well-recognized by policy makers; i.e. Salmonella, Campylobacter, E. coli and Listeria monocytogenes. Antimicrobial resistance in several bacterial food-borne pathogens (Salmonella, Campylobacter, Shigella and Vibrio spp., methicillin resistant Staphylcoccus aureas, E. coli and Enterococci) has been discussed as a separate topic because of its relative importance to policy issues. Awareness and surveillance of viral food-borne pathogens is generally poor but emphasis is placed on Norovirus, Hepatitis A, rotaviruses and newly emerging viruses such as SARS. Many food-borne parasitic pathogens are known (for example Ascaris, Cryptosporidia and Trichinella) but few of these are effectively monitored in foods, livestock and wildlife and their epidemiology through the food-chain is poorly understood. The lessons learned and future challenges in each topic are debated. It is clear that one overall challenge is the generation and maintenance of constructive dialogue and collaboration between public health, veterinary and food safety experts, bringing together multidisciplinary skills and multi-pathogen expertise. Such collaboration is essential to monitor changing trends in the well-recognised diseases and detect emerging pathogens. It will also be necessary understand the multiple interactions these pathogens have with their environments during transmission along the food chain in order to develop effective prevention and control strategies.
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            Estimating child mortality due to diarrhoea in developing countries.

            The major objective of this study is to provide estimates of diarrhoea mortality at country, regional and global level by employing the Child Health Epidemiology Reference Group (CHERG) standard. A systematic and comprehensive literature review was undertaken of all studies published since 1980 reporting under-5 diarrhoea mortality. Information was collected on characteristics of each study and its population. A regression model was used to relate these characteristics to proportional mortality from diarrhoea and to predict its distribution in national populations. Global deaths from diarrhoea of children aged less than 5 years were estimated at 1.87 million (95% confidence interval, CI: 1.56-2.19), approximately 19% of total child deaths. WHO African and South-East Asia Regions combined contain 78% (1.46 million) of all diarrhoea deaths occurring among children in the developing world; 73% of these deaths are concentrated in just 15 developing countries. Planning and evaluation of interventions to control diarrhoea deaths and to reduce under-5 mortality is obstructed by the lack of a system that regularly generates cause-of-death information. The methods used here provide country-level estimates that constitute alternative information for planning in settings without adequate data.
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              Towards a conceptual framework to support one-health research for policy on emerging zoonoses

              Summary In the past two decades there has been a growing realisation that the livestock sector was in a process of change, resulting from an expansion of intensive animal production systems and trade to meet a globalised world's increasing demand for livestock products. One unintended consequence has been the emergence and spread of transboundary animal diseases and, more specifically, the resurgence and emergence of zoonotic diseases. Concurrent with changes in the livestock sector, contact with wildlife has increased. This development has increased the risk of transmission of infections from wildlife to human beings and livestock. Two overarching questions arise with respect to the real and perceived threat from emerging infectious diseases: why are these problems arising with increasing frequency, and how should we manage and control them? A clear conceptual research framework can provide a guide to ensure a research strategy that coherently links to the overarching goals of policy makers. We propose such a new framework in support of a research and policy-generation strategy to help to address the challenges posed by emerging zoonoses.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Negl Trop Dis
                PLoS Negl Trop Dis
                plos
                plosntds
                PLoS Neglected Tropical Diseases
                Public Library of Science (San Francisco, USA )
                1935-2727
                1935-2735
                November 2014
                13 November 2014
                : 8
                : 11
                : e3257
                Affiliations
                [1 ]Global Health Programs, College of Veterinary Medicine, The Ohio State University and VPH-Biotec Global Consortium, Columbus, Ohio, United States of America
                [2 ]Department of Parasitology, Hôspital Cochin, Paris Descartes University, Paris, France
                [3 ]Centre for Global Health Research, Brighton and Sussex Medical School, Sussex, United Kingdom
                [4 ]College of Agricultural Sciences, Federal University of Paraiba, Brazil (CCA/UFPB), Areia, Paraiba, Brazil
                [5 ]Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Columbus, Ohio, United States of America
                [6 ]Food Animal Health Research Program, The Ohio State University, Wooster, Ohio, United States of America
                [7 ]Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
                [8 ]Department of Pathology and Microbiology University of Montreal, Saint-Hyacinthe, Québec, Canada
                [9 ]Faculty of Veterinary Medicine, Sokoine University of Agriculture, Chuo Kikuu, Morogoro, Tanzania
                [10 ]United Nations Food and Agriculture Organization (FAO), Rome, Italy
                [11 ]Elanco Animal Health, Greenfield, Indiana, United States of America
                [12 ]The Ohio State University College of Public Health, Columbus, Ohio, United States of America
                [13 ]Chiang Mai University, Chiang Mai, Thailand
                [14 ]Thailand MOPH-U.S. CDC Collaboration, Bangkok, Thailand
                George Washington University, United States of America
                Author notes

                The authors have declared that no competing interests exist.

                Article
                PNTD-D-14-00885
                10.1371/journal.pntd.0003257
                4230840
                25393303
                a4de266e-c347-4b6d-b5f1-593b26f83428
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Page count
                Pages: 6
                Funding
                Funding for the organization of the ICOPHAI congress was received from: The Ohio State University, Wellcome Trust, U.S. Agency for International Development (USAID)-PREDICT, U.S. Department of Agriculture (USDA), Animal and Plant Health Inspection Services (APHIS), MTN Government Services, Battelle Endowment for Technology and Human Affairs (BETHA), Conselho Nacional de Desenvolvimento Científico e Tecnológico [Brazilian National Research Council] (CNPq), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [Brazilian Higher Education Funding Agency] (CAPES), U.S. National Science Foundation (NSF), National Institute of Health (NIH), USDA, National Institute for Food and Agriculture (NIFA), U.S. National Pork Board, Applied Maths NV, International Centre for Genetic Engineering and Biotechnology (ICGEB), United National University-Biotechnology for Latin America and the Caribbean (UNU-BIOLAC), Fundação de Amparo à Pesquisa do Estado de São Paulo [São Paulo Research Foundation] (FAPESP), Federal University of Sao Francisco Valley (UNIVASF), Fundação de Amparo a Ciência e Tecnologia do Estado de Pernambuco [Pernambuco Research Foundation] (FACEPE). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Review
                Biology and Life Sciences
                Agriculture
                Ecology
                Microbiology
                Nutrition
                Veterinary Science
                Ecology and Environmental Sciences
                Terrestrial Environments
                Medicine and Health Sciences
                Epidemiology
                Health Care
                Infectious Diseases
                Parasitic Diseases
                Public and Occupational Health
                Science Policy
                Science Education
                Science Policy and Economics

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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