February 01, 2002

 

 Zoonoses control: hurdles, headaches, and solutions - February 1, 2002

Posted on January 15, 2002

 

The opportunity for disease to pass from animal to human occurs daily around the globe in everyday activities. In many cases, however, little is done to reduce the transmission risk of zoonoses.

To address this issue, the Food and Agriculture Organization in Rome, in collaboration with the World Health Organization in Geneva, and the Office International des Epizooties in Paris, held an electronic conference during the month of November. The one-month conference, involving 700 participants, provided a forum to exchange information and ideas about improving zoonosis control, particularly in developing countries. It targeted health professionals, policy makers, academics, and researchers.

Conference correspondence, which was moderated by Dr. Ashley Robinson, associate dean at the College of Veterinary Medicine, Western University of Health Sciences, Pomona, Calif., can be accessed at www.fao.org/ag/aga/agah/VPHeconf/home.htm.

In many cases, educating communities about threatening pathogens is key, often leading to the implementation of strategies that decrease infection. Obtaining the information necessary for control of disease, however, can be a big hurdle.

Some veterinarians, including Dr. Niels Ole Bjerregaard, a district veterinary officer in Denmark, recommended that veterinarians in developed countries who have zoonoses training should work harder to assist colleagues in developing countries. This could include helping countries organize veterinary associations or national zoonoses centers.

Online curricula or communication via e-mail and listserv might also improve education, but not in all situations.

"One of the major problems with this approach is the lack of suitable infrastructure," wrote Dr. Bruce Gummow, head of epidemiology at the University of Pretoria in South Africa. "Most Africans will probably tell you that to access the internet can be frustrating, time consuming and an often fruitless exercise, simply because basic infrastructure that many western nations take for granted is lacking or poorly maintained."

Other conference participants commented that international organizations need to step up to the plate and get involved. These include the World Health Organization, Food and Agriculture Organization of the United Nations, and the Office International des Epizooties. Such groups could be involved in helping build electronic infrastructure, training people to use electronic resources, or distributing information, about new vaccines for example, via other methods.

While many participants offered suggestions to improve zoonoses control in developing countries, they also recognized problems that exist worldwide. Many, for example, felt that more cooperation and communication between the human medical and veterinary communities was necessary in all countries.

"If the 1999 outbreak of West Nile Virus in NYC, and this attack of anthrax on the U.S. hasn't taught us that it's one medicine, then we will never learn," wrote Dr. Jennifer A.M. Calder, director of infection control at Columbia University. "I think it is imperative that physicians and veterinarians interact with each other more at the national and provincial level."

The problem exists even at the highest level. "When we had a change of political parties running our province (Ontario), a new minister of health visited [Ministry of Health Offices] and wondered out loud what veterinarians were doing in there," wrote Dr. David Waltner Toews, a professor at the University of Guelph in Ontario. "A lot of education is needed!"

Departments of agriculture and departments of health must build stronger bonds, many participants wrote.

One final topic of note was the recognition that veterinary schools need to focus more of their curriculum on zoonoses and public health education. "Recent zoonotic disease outbreaks, like Nipah virus infection of pigs in Malaysia and the Crimean-Congo haemorraghic fever in Southern Africa region, emphasize the danger such new diseases pose for humans exposed to such infection," wrote Dr. Herbert Schneider, a veterinarian from Namibia. "All veterinary curricula should include veterinary public health as one of the core subjects. It should not be seen as an add-on course, only necessary to meet requirements, or as an optional class, only for those interested in the topic."

This conference seems timely, considering the recent zoonoses outbreaks, and it is also pertinent given the problems on the horizon: increasing risks in some countries.

In areas afflicted by the AIDS epidemic such as South Africa, Dr. Gummow wrote, immunocompromised populations are increasingly susceptible to these diseases. He fears an epidemic could be around the corner.