Emerging infections build One Health urgency

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Science Speaks reported from San Diego Oct. 4 -8 covering IDWeek, a conference of the Infectious Diseases Society of America, the HIV Medicine Association, the Society for Healthcare Epidemiology of America, and the Pediatric Infectious Diseases Society

SAN DIEGO -What do a rain forest and a crowded city have in common? More than meets the eye, according to a lecture here Thursday named for leading researcher and epidemiologist Edward H. Kass.

The lecture, delivered by Dr. James Hughes of Emory University, focused on the growing understanding that recognizing links between human health, animal health and ecosystems is critical to preventing, detecting and controlling increasingly consequential emerging infectious diseases.

And what a rain forest and a city of more than one million people have in common, Dr. Hughes said, is that both are considered “hot spots” for emerging infectious diseases that pose global threats.

The recognition of animal, human and ecosystem health as components of “One Health” is not new, Dr. Hughes noted; Hippocrates noted the links between the well-being of people and their environments. In the 20th century, Dr. Hughes said, veterinary medicine as part of public health was promoted by Dr. James Steele, and the term “One Medicine” was coined by Dr. Calvin Schwabbe. But cross-discipline responses lagged until population growth, an accelerating increase of meat consumption, global travel and urbanization multiplied the links between distant places and species during the last half century.

In 1992, Dr. Hughes noted, an Institute of Medicine report on factors contributing to the emergence of Infectious Diseases highlighted the impacts of demographics and human behavior, technology and industry, economics and land use, international travel and commerce, microbial adaptations, and breakdowns in public health responses.

Then, in 2002, a virus causing severe acute respiratory syndrome — or SARS — made the jump, apparently from bats to humans in southern China, and its spread was accelerated in a Guangdong province marketplace. It wasn’t until 2003, however, when a physician who had treated patients in the province, checked into a Hong Kong hotel — exposing an international range of associates and guests there to the virus,  that the importance of an illness affecting animals in a remote rural region to people in capital cities worldwide was recognized with responses.

The global outbreak that followed, infecting more than 8,000 people and killing nearly 800 drove revisions to International Health Regulations, and the formal recognition of outbreaks with global implications as PHEICs — or Public Health Emergencies of International Concern. Of the four PHEICs recognized since — the 2009 emergence of the H1N1 virus,  2014 resurgences of polio, the 2014 West Africa Ebola crisis, and, in 2016 the spread of Zika and its neurological impacts —  Dr. Hughes noted, three are vector-borne or zoonotic.

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