One-health wonders

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Dr. David Franz

We have long had these sorts of silos in disease surveillance: You look for human disease over here and animal disease over there.



Dr. David Franz is vice president and chief biological scientist for the Midwest Research Institute, where he deals with business activities concerning biodefense education and preparation, nonproliferation, cooperative threat reduction, and biosafety. Dr. Franz formerly served as a commander of the U.S. Army Medical Research Institute of Infectious Diseases. During his 27 years with the military, Dr. Franz was the chief inspector on three United Nations biological warfare inspection missions to Iraq and served as a member of the first two U.S.-U.K. teams that visited Russia in support of the Trilateral Joint Statement on Biological Weapons. Dr. Franz holds a DVM from Kansas State University ('50) and a doctorate in physiology from the Baylor College of Medicine. Dr. Franz spoke to JAVMA news about his career in public health, professional collaboration in research, and the future of disease prevention.

How have biosecurity and agrosecurity evolved?

During the Cold War, the Soviets were seen as posing the greatest biological threat. We initially believed that their doctrine was to use biological agents against troops on the battlefield, but probably in Europe. In the early '90s, we learned more about Soviet plans to use biowarfare agents against the U.S. mainland as well. Later, several incidents in the U.S. heightened our concern. In 1996, Larry Wayne Harris from Columbus, Ohio, ordered the plague bacillus from a U.S. strain collection. That and the Atlanta Olympics bomber caused us to begin thinking more about threats at home.

The combination of Sept. 11 and Oct. 4 (first case of anthrax reported) in 2001 convinced us of the biological threat to the American people. Funding for bioterrorism defense jumped from a few million to nearly $6 billion over the next couple of years. It was a paradigm shift. I think if we had just had anthrax letters and not the 9/11 attacks, we would not have responded as aggressively to the letters. In about 2003, with the increased incidence of bird flu (H5N1) we began shifting our focus to that threat. It became less about bioterrorism and more about emerging diseases again. Now we're working across the disease risk spectrum. I think it's appropriate and most efficient for us to think about both of these threats. I often define bioterrorism as emerging infectious disease plus intent.

Why is it important for collaboration in this new environment with its concerns about bioterrorism, agroterrorism, and emerging diseases?

Certainly I saw, during my education in a veterinary college and a college of medicine, how valuable sharing information on humans and animals is in research, even before I realized the importance of "one health" more broadly.

However, I think the incident that had the biggest impact on me, regarding the importance of working across species, was the West Nile outbreak of 1999 and the work of Dr. Tracey McNamara (veterinarian and former pathologist at the Bronx Zoo). In New York City, humans and birds were dying of encephalitis, and it was first thought to be the St. Louis encephalitis virus, but Dr. McNamara said it couldn't be because "Birds don't die of St. Louis." Researchers eventually confirmed Dr. McNamara's suspicion it was West Nile. If we would have all been working together and communicating closely, we probably would have made the correct diagnosis a couple of months earlier. We have long had these sorts of silos in disease surveillance: You look for human disease over here and animal disease over there. I've run into the same thing in other countries, but I think there's a new awareness of the need to just look for disease wherever you find it in whatever species around the globe.

The disciplines are all running together now. It's broader than just human and veterinary medicine. It's also chemistry, physics, and biology. We're bringing all the disciplines to the table today... and I think it's important that we work together internationally to protect our citizens from disease and improve public health. We can't remain isolated behind big oceans anymore. It's really not surprising that the concept of "one health" has come along again at this time in our history, even if we hadn't had a few very dedicated people pushing it.

What are the possibilities for accomplishments, given the increase in prevalence of the one-health concept?

If I had to pick one thing in medicine that will cross all boundaries, preclinical diagnostics will be an important change that will eventually occur. There are still some technical barriers, but early diagnosis, across species, would do much to improve human health and human security. We need to move from treating "the disease" as much as possible to diagnosing the disease as early as we possibly can. Preclinical diagnostics will have an application in human and animal medicine eventually. Let's say you expose laboratory animals to infectious agents—one animal to bacteria and one to a virus. Long before they become sick, you might take a blood sample and look at the mRNA or proteins expressed and diagnose the illness before disease is clinically apparent. Once we better understand the patterns elicited by the host response to infection, we'll be able to pick up illness in people and animals before they have clinical signs.

One day we may do the same thing for cancer by looking for proteins coming from the brain in brain cancer and pick up tumors very early, when they are much more treatable. It will work for humans and animals. I believe breakthroughs in this area and others like it—often found by veterinarians and physicians working side by side in the lab—will revolutionize health care.