Zoonotic Disease

• Altizer S, Bartel R, Han BA. (2011). Animal Migration and Infectious Disease Risk. Science, 331(6015), 296-302.  
  • Animal migrations are often spectacular, and migratory species harbor zoonotic pathogens of importance to humans. Animal migrations are expected to enhance the global spread of pathogens and facilitate cross-species transmission. This does happen, but new research has also shown that migration allows hosts to escape from infected habitats, reduces disease levels when infected animals do not migrate successfully, and may lead to the evolution of less-virulent pathogens. Migratory demands can also reduce immune function, with consequences for host susceptibility and mortality. Studies of pathogen dynamics in migratory species and how these will respond to global change are urgently needed to predict future disease risks for wildlife and humans alike.

• Belay ED, Kile JC, Hall AJ, et al. (2017). Zoonotic Disease Programs for Enhancing Global Health Security. Emerging Infectious Diseases, 23(s1), s65-70.  
  • Most infectious diseases that recently emerged in humans originated in animals. Besides close contact between animals and humans, other factors likely contribute to the cross-species transmission of infectious diseases. It is critical to establish effective mechanisms for coordination and collaboration between the animal, human, and environmental health sectors before new threats emerge by bringing the different sectors together to tackle endemic zoonotic diseases of greatest concern. Such multisectoral partnerships should begin by identifying priority zoonotic diseases for national engagement with equal input from the different sectors. Improvements in surveillance and data sharing for prioritized zoonotic diseases and enhancements of laboratory testing and joint outbreak response capacities in the human and animal health sectors will create and strengthen the mechanisms necessary to effectively detect and respond to emerging health threats, and thereby enhance global health security.

• Bengis RG, Leighton FA, Fischer JR, et al. (2004). The role of wildlife in emerging and re-emerging zoonoses. Rev Sci Tech, 23(2), 497-512.
  • There are huge numbers of wild animals distributed throughout the world and the diversity of wildlife species is immense. Infectious pathogens that originate in wild animals have become increasingly important throughout the world in recent decades, as they have had substantial impacts on human health, agricultural production, wildlife-based economies and wildlife conservation. The emergence of these pathogens as significant health issues is associated with a range of causal factors, most of them linked to the sharp and exponential rise of global human activity. Two different patterns of transmission of pathogens from wild animals to humans are evident among these emerging zoonotic diseases. In one pattern, actual transmission of the pathogen to humans is a rare event but, once it has occurred, human-to-human transmission maintains the infection for some period of time or permanently. In the second pattern, direct or vector-mediated animal-to-human transmission is the usual source of human infection. Wild animal populations are the principal reservoirs of the pathogen and human-to-human disease transmission is rare. These zoonotic diseases from wild animal sources all have trends that are rising sharply upwards. This paper discusses the causal factors associated with the emergence or re-emergence of zoonoses, and highlights a selection to provide a composite view of their range, variety, and origins.

• Bird BH, Mazet JA. (2017). Detection of Emerging Zoonotic Pathogens: An Integrated One Health Approach. Annual Review of Animal Biosciences, 6, 121-39.
  • The emergence of novel zoonotic pathogens is one of the greatest challenges to global health security. The advent of increasingly sophisticated diagnostics tools has revolutionized our capacity to detect and respond to these health threats more rapidly than ever before. Yet, no matter how sophisticated these tools become, the initial identification of emerging infectious diseases begins at the local community level. It is here that the initial human or animal case resides, and it is here that early pathogen detection would have maximum benefit. Unfortunately, many areas at highest risk of zoonotic disease emergence lack sufficient infrastructure capacity to support robust laboratory diagnostic systems. Multiple factors are essential for pathogen detection networks, including an understanding of the complex sociological and ecological factors influencing disease transmission risk, community engagement, surveillance along high-risk human-animal interfaces, and a skilled laboratory workforce. This paper discusses factors relevant to the emerging disease paradigm, recent technical advances in diagnostic methods, and strategies for comprehensive and sustainable approaches for disease detection.

• Bogich TL, Chunara R, Scales D, et al. (2012). Preventing Pandemics Via International Development: A Systems Approach. PLoS Medicine, 9(12), e1001354-58.      
  • The way in which public health programs are designed and funded has changed significantly; however, the trend toward establishing vertical, disease-specific global health programs may be at the cost of strengthening basic public health infrastructure and development in the long term. This review found that a breakdown or absence of public health infrastructure was the driving factor in the largest fraction of outbreaks. No single other driving factor accounted for more than 10% of outbreaks. The relative roles of emergency response versus long-term development strategies to mitigate infectious disease threats are being debated within bilateral and intergovernmental aid agencies. The authors propose a systems approach within development agencies to address pandemic prevention at the intersection of people and their environment where the risk of disease emergence is highest. To achieve this goal, mainstream development funding, rather than emergency funding, is required.

• Capps B, Bailey MM, Bickford D, et al. (2015). Introducing One Health to the Ethical Debate About Zoonotic Diseases in Southeast Asia. Bioethics, 29(8), 588-96.           
  • Pandemic plans recommend phases of response to an emergent infectious disease (EID) outbreaks and are primarily aimed at preventing and mitigating human-to-human transmission. These plans carry presumptive weight and are increasingly being operationalized at the national, regional and international level with the support of the World Health Organization. The conventional focus of pandemic preparedness for EIDs of zoonotic origin has been on public health and human welfare. However, this focus on human populations has resulted in strategically important disciplinary silos. As the risks of zoonotic diseases have implications that reach across many domains outside traditional public health, including anthropological, environmental, and veterinary fora, a more inclusive ecological perspective is paramount for an effective response to future outbreaks.

• Castillo-Chavez C, Curtiss R, Daszak P, et al. (2015). Beyond Ebola: lessons to mitigate future pandemics. The Lancet Global Health, 3(7), e354-55.
  • Ecological, social, political, and economic contexts play an important role in determining which diseases emerge. Increasing anthropogenic environmental changes, coupled with a globalized network, allow zoonotic pathogens to spill over into human beings with increasing frequency, and leave the world supremely vulnerable to their international spread. This commentary discusses the need to consider strategies to prevent future outbreaks of zoonotic diseases and mitigate the risks they pose.

• Causey D, Edwards SV. (2008). Ecology of Avian Influenza Virus in Birds. Journal of Infectious Diseases, 197(s1), S29-33.    
  • Avian influenza A virus is a zoonotic pathogen with a natural reservoir entirely in birds. The influenza virus genome is a single-stranded RNA with high potential for in situ recombination. The avian immune system differs from that of humans in several important features but little is known about the immunogenetics of pathogenic response. Postbreeding dispersal and migration and a naturally high degree of environmental vagility mean that wild birds have the potential to be vectors that transmit highly pathogenic variants great distances from the original sources of infection.

• Centers for Disease Control and Prevention. One Health Zoonotic Disease Prioritization Workshop. Atlanta: CDC.

  • Conducting this workshop allows a country to (i) bring together multisectoral, One Health representatives to connect human, animal, and environmental health sectors; (ii) prioritize endemic and emerging zoonoses of greatest national concern using equal input from all represented sectors; (iii) support the creation of One Health coordination mechanisms to improve health outcomes for humans and animals; and (iv) focus the use of limited resources to build capacity and reduce the impact of prioritized zoonoses.

• Childs JE, Richt JA, Mackenzie JS. (2007). Introduction: Conceptualizing and Partitioning the Emergence Process of Zoonotic Viruses from Wildlife to Humans. In: Wildlife and Emerging Zoonotic Diseases: The Biology, Circumstances and Consequences of Cross-Species Transmission. 1-33.
  • This introduction provides a telegraphic overview of the processes of zoonotic viral emergence, the intricacies of host-virus interactions, and the distinct role of biological transitions and modifying factors. The process of emergence is conceptualized as two transition stages which are common and required for all disease emergence, (i) human contact with the infectious agent and (ii) cross-species transmission of the agent; and two transition stages which are not required for emergence and appear unavailable to many zoonotic pathogens, (i) sustained human-to-human transmission and (ii) genetic adaptation to the human host. The latter two transitions are presumably prerequisites for the pandemic emergence of a pathogen. Each author explores the mechanisms and unique circumstances by which evolution, biology, history, and current context have contrived to drive the emergence of different zoonotic agents.

• Clarke C. (2009). Seeking and Processing Information about Zoonotic Disease Risk: A Proposed Framework. Human Dimensions of Wildlife, 14(5), 314-25.
  • As part of zoonotic disease management, wildlife officials strive to communicate health and safety information to promote individual behavior change and facilitate collaborative decision-making. Understanding how individuals search for and attend to information about disease risk can assist both efforts. Drawing on the risk information seeking and processing (RISP) model, this article articulates a framework that explores how individuals seek and engage with information about zoonotic disease risk in different ways. The framework includes concepts such as a need for information, social pressure to remain informed, beliefs about information channels, perceived risk and trust, and personal capacity to learn. The article extends the RISP model by exploring the role of values, wildlife value orientations, and opinion leadership. Overall, the framework synthesizes research from a variety of fields, with the goal of furthering inquiry on the human dimensions of disease management, particularly the importance of risk communication.

• Cleaveland S, Lankester F, Townsend S, et al. (2014) Rabies control and elimination: a test case for One Health. Veterinary Record, 175, 188-93.
  • One Health approaches have already been shown to be successful in controlling rabies in different parts of the world. In this article, the authors discuss why integrated strategies are needed to enhance the cost-effectiveness of measures to control and eliminate rabies, particularly in low-income countries. An open-minded, pragmatic and flexible attitude will be required to explore novel strategies and approaches.

• Coetzer A, Kidane AH, Bekele M, et al. (2016). The SARE tool for rabies control: Current experience in Ethiopia. Antiviral Research, 135, 74-80.
  • The Stepwise Approach towards Rabies Elimination (SARE) tool was developed to provide a standard mechanism for countries to assess their rabies situation and measure progress in eliminating the disease. Because the African continent has the highest per capita death rate from rabies, and Ethiopia is estimated to have the second largest number of rabies deaths of all African countries, Ethiopia undertook a self-assessment by means of the Stepwise Approach towards Rabies Elimination (SARE) tool. The SARE assessment identified a number of critical gaps, including poor inter-sectoral collaboration and limited availability and access to dog vaccine, while the existence of a surveillance system for rabies and legislation for outbreak declaration and response were among the strengths identified. The SARE tool enabled key criteria to be prioritized, thereby accelerating the National Strategy and ensuring that Ethiopia will progress rapidly in line with the goals set by the global community for the elimination of human rabies deaths by 2030.

• Coghlan B, Hall D. (2012). The Development of One Health Approaches in the Western Pacific. One Health: The Human-Animal-Environment Interfaces in Emerging Infectious Diseases, 93-111.
  • The Western Pacific Region has seen the emergence of a series of novel zoonotic infections in the last decade. This has focused attention on addressing underlying risks and vulnerabilities in the complex interactions among people, animals, and environments as a better way to counter emerging diseases. This One Health approach is pertinent to the region because, it is a hot spot for the emergence of novel diseases from wildlife, because unexpected epidemics of re-emerging zoonotic diseases have caused morbidity and mortality in urban and periurban communities, and because it remains a sanctuary for well-known zoonotic infections. In this chapter, selected regional, multicountry, and national steps to operationalize One Health are discussed. While the region is well positioned to exploit the opportunities that have come with outbreaks of new diseases, the array of disconnected and overlapping initiatives from various consortia, donors, research institutes, and UN agencies is to some extent impeding the development of better ways of managing both new and old infections for the local, regional, and global good.

• Cutler SJ, Fooks AR, van der Poel WHM. (2010). Public Health Threat of New, Reemerging, and Neglected Zoonoses in the Industrialized World. Emerging Infectious Diseases, 16(1), 1-8.
  • Microbiologic infections acquired from animals, known as zoonoses, pose a risk to public health. An estimated 60 percent of emerging human pathogens are zoonotic, and of these pathogens, over 70 percent have wildlife origins. These pathogens can switch hosts by acquiring new genetic combinations that have altered pathogenic potential or by changes in behavior or socioeconomic, environmental, or ecologic characteristics of the hosts. These authors discuss causal factors that influence the dynamics associated with emergence or reemergence of zoonoses, particularly in the industrialized world, and highlight selected examples to provide a comprehensive view of their range and diversity.

• Deliberto TJ, Swafford SR, Nolte DL, et al. (2009). Surveillance for highly pathogenic avian influenza in wild birds in the USA. 4(4), 426-39.       
  • As part of the USA’s National Strategy for Pandemic Influenza, an Interagency Strategic Plan for the Early Detection of Highly Pathogenic H5N1 Avian Influenza in Wild Migratory Birds was developed and implemented. samples from wild birds and wild bird fecal samples were collected in the USA and no highly pathogenic avian influenza was detected. More than 250 species of wild birds in all 50 states were sampled. The highly pathogenic early detection system for wild birds developed and implemented in the USA represents the largest coordinated wildlife disease surveillance system ever conducted. This effort provided evidence that wild birds in the USA were free of highly pathogenic avian influenza virus at the 99.9% confidence level during the surveillance period.

• Duckett D, Wynne B, Christley R, et al. (2015). Can Policy Be Risk-Based? The Cultural Theory of Risk and the Case of Livestock Disease Containment. Sociologia Ruralis, 55(4), 379-99.     
  • This article explores the nature of calls for risk-based policy present in expert discourse from a cultural theory perspective. Semi-structured interviews with professionals engaged in the research and management of livestock disease control provide the data for a reading proposing that the real basis of policy relating to socio-technical hazards is deeply political and cannot be purified through ‘escape routes’ to objectivity. Scientists and risk managers are shown calling, on the one hand, for risk-based policy approaches while on the other acknowledging a range of policy drivers outside the scope of conventional quantitative risk analysis including group interests, eventualities such as outbreaks, historical antecedents, emergent scientific advances and other contingencies. Calls for risk-based policy are presented, following cultural theory, as ideals connected to a reductionist epistemology and serving particular professional interests over others rather than as realistic proposals for a paradigm shift.

• Dzingirai V, Bett B, Bukachi S, et al. (2017). Zoonotic diseases: who gets sick, and why? Explorations from Africa. Critical Public Health, 27(1), 97-110.
  • Global risks of zoonotic disease are high on policy agendas. Increasingly, Africa is seen as a ‘hotspot’, with likely disease spillovers from animals to humans. This paper explores the social dynamics of disease exposure, demonstrating how risks are not generalized but are related to occupation, gender, class and other dimensions of social difference. Through case studies of Lassa Fever in Sierra Leone, Henipah virus in Ghana, Rift Valley Fever in Kenya and Trypanosomiasis in Zimbabwe, the paper proposes a social difference space-time framework to assist the understanding of and response to zoonotic diseases within a One Health approach.

• Estrada-Peña A, Ostfeld RS, Peterson AT, et al. (2014). Effects of environmental change on zoonotic disease risk: an ecological primer. Trends in Parasitology, 30(4), 205-14.
  • The impacts of environmental change on zoonotic disease risk are the subject of speculation and lack a coherent framework for understanding the drivers of pathogen transmission from animal hosts to humans. This article reviews how environmental factors affect the distributions of zoonotic agents and their transmission to humans, exploring the roles they play in zoonotic systems. Of importance is capturing the distributional ecology of any species involved in pathogen transmission, defining the environmental conditions required, and the projection of that niche onto geography. The authors further review how environmental changes may alter the dispersal behavior of populations in zoonotic disease systems. 

• FAO, OIE, WHO. (2010). A Tripartitite Concept Note: Sharing Responsibilities and Coordinating Global Activities to Address Health Risks at the Animal-Human-Ecosystems Interfaces. Rome: FAO.
  • While FAO, OIE and WHO have long-standing experience in direct collaboration, the tripartite partners realize that managing and responding to risks related to zoonoses and some high impact diseases is complex and requires multi-sectoral and multi-institutional cooperation. This document sets a strategic direction for FAO-OIE-WHO to take together and proposes a long-term basis for international collaboration aimed at coordinating global activities to address health risks at the human- animal-ecosystems interfaces. A complementary agenda and new synergies between FAO, OIE, and WHO will include normative work, public communication, pathogen detection, risk assessment and management, technical capacity building and research development.

• Ferguson NM, Fraser C, Donnelly CA, et al. (2004). Public Health Risk from the Avian H5N1 Influenza Epidemic. Science, 304(5673), 968-69.
  • Repeated transmission of the avian H5N1 influenza virus to humans has raised concerns that such events might initiate a global pandemic of a highly pathogenic human virus. This article provides a review of the current global mechanisms of influenza surveillance and highlights the need for improved surveillance of animal viruses. The authors demonstrate how risk assessment and surveillance can be enhanced by quantitative analysis, and emphasize that low-level human-to-human transmission is not necessarily indicative of an emerging pandemic.

• Firth C, Lipkin WI. (2013). The Genomics of Emerging Pathogens. Annual Review of Genomics and Human Genetics, 14(1), 281-300.

  • Globalization and industrialization have dramatically altered the vulnerability of human and animal populations to emerging and reemerging infectious diseases while shifting both the scale and pace of disease outbreaks. Fortunately, the advent of high-throughput DNA sequencing platforms has also increased the speed with which such pathogens can be detected and characterized as part of an outbreak response effort. It is now possible to sequence the genome of a pathogen rapidly, inexpensively, and with high sensitivity, transforming the fields of diagnostics, surveillance, forensic analysis, and pathogenesis. This article reviews advances in methods for microbial discovery and characterization, as well as strategies for testing the clinical and public health significance of microbe-disease associations. The authors conclude by discussing how genetic data can inform our understanding of the general process of pathogen emergence.

• Gibbs S. (2010). Avian biology, the human influence on global avian influenza transmission, and performing surveillance in wild birds. Animal Health Research Reviews, 11(1), 35-41.
  • There are few ecosystems in which birds are not found. Correspondingly, avian influenza viruses are equally global in distribution, relying on competent avian hosts. The immune systems, annual cycles, feeding behaviors, and migration patterns of these hosts influence the ecology of the disease. This paper takes a closer look at three interrelated areas of study: avian host biology, the role of human activities in virus transmission, and the surveillance activities centered on avian influenza in wild birds.

• Gray GC, Trampel DW, Roth JA. (2007). Pandemic influenza planning: Shouldn’t swine and poultry workers be included?. Vaccine, 25(22), 4376-81.           
  • Research has demonstrated that swine and poultry professionals, especially those who work in large confinement facilities, are at markedly increased risk of zoonotic influenza virus infections. In serving as a bridging population for influenza virus spread between animals and man, these workers may introduce zoonotic influenza virus into their homes and communities as well as expose domestic swine and poultry to human influenza viruses. Prolonged and intense occupational exposures of humans working in swine or poultry confinement buildings could facilitate the generation of novel influenza viruses, as well as accelerate human influenza epidemics. Because of their potential bridging role, such workers should be recognized as a priority target group for annual influenza vaccines and receive special training to reduce the risk of influenza transmission. They should also be considered for increased surveillance and priority receipt of pandemic vaccines and antivirals.

• Han BA, Kramer AM, Drake JM. (2016). Global Patterns of Zoonotic Disease in Mammals. Trends in Parasitology, 32(7), 565-77.          
  • As the frequency and prevalence of zoonotic diseases increase worldwide, investigating how mammal host distributions determine patterns of human disease and predicting which regions are most at risk for future outbreaks are two goals that both warrant additional research. Both will require a better understanding of the current distributions of zoonotic hosts and pathogens. This article reviews the existing data about mammalian host species, comparing and contrasting these patterns against global maps of zoonotic hosts. The authors discuss the zoonotic potential of host species from the top six most species-rich mammal groups, and review the literature to identify analytical and conceptual gaps that must be addressed to improve our ability to generate testable predictions about zoonotic diseases originating from wild mammals.

• Hendrikx P, Gay E, Chazel M, et al. (2011). OASIS: an assessment tool of epidemiological surveillance systems in animal health and food safety. Epidemiology & Infection, 139(10), 1486-96.
  • The purpose of this study was to develop a standardized tool for the assessment of surveillance systems on zoonoses and animal diseases. The authors reviewed three existing methods and combined them to develop a semi-quantitative assessment tool associating their strengths and providing a standardized way to display multilevel results. They developed a set of 78 assessment criteria divided into ten sections, representing the functional parts of a surveillance system.

• Häsler B, Gilbert W, Jones BA, et al. (2012). The Economic Value of One Health in Relation to the Mitigation of Zoonotic Disease Risks. Current Topics in Microbiology & Immunology, 365, 127-51.
  • The essence of One Health is an interdisciplinary approach combined with some degree of intersectoral integration that is aimed at mitigation of human and animal health risks, taking account of environmental, ecological, social and economic factors. While a large number of international stakeholders now consider the One Health approach necessary for more effective protection of the global community against health threats, there is still no systematic allocation of resources to integrated national or multinational programs, partly due to the inertia of existing sectoral systems and the lack of convincing economic arguments in support of the approach. These authors propose different degrees of sectoral integration depending on system types and associated economic efficiency gains to be expected from a One Health approach. International and regional organizations have an important role in facilitating the adoption of the approach since the costs and benefits are often of a regional or even a global nature.

• Heeney JL. (2006). Zoonotic viral diseases and the frontier of early diagnosis, control and prevention. Journal of Internal Medicine, 260(5), 399-408.    
  • Public awareness of the human health risks of zoonotic infections has grown in recent years. Concern of H5N1 flu transmission from migratory bird populations has increased with foci of fatal human cases. This comes on the heels of other major zoonotic viral epidemics in the last decade including severe acute respiratory syndrome (SARS), West-Nile virus, Ebola virus, monkeypox, as well as the more inapparent insidious slow viral and prion diseases. Virus infections with zoonotic potential can become serious killers once they are able to establish the necessary adaptations for efficient human-to-human transmission under circumstances sufficient to reach epidemic proportions. The monitoring and early diagnosis of these potential risks are overlapping frontiers of human and veterinary medicine. Here, current viral zoonotics and evolving threats are reviewed.

• Heymann DL, Dar OA. (2014). Prevention is better than cure for emerging infectious diseases. BMJ, 348-54.
  • Emerging infectious diseases have caused billions of dollars worth of damage in and the costs continue to rise. Emerging infections can be new infections (such as HIV when first discovered), or existing infections that are becoming more common or spreading in geographically new areas (such as West Nile fever, Dengue, and chikungunya). Many people assume that emerging infections are a matter for tropical disease specialists, but they are important to doctors and policy-makers, vets, farmers, traders, and economies globally. Although some emerging infections are specific to tropical areas, infections that emerge there can spread to other parts of the world. There are also many examples of diseases originating in non-tropical settings, including severe acute respiratory syndrome (SARS), influenza A (H5N1), and other. Over the past decades there has been increasing recognition that the way we deal with infectious disease is often reactive and too late. New diseases are often identified only after they have transferred to humans and sometimes many years after the breach in the species barrier. This article describes how doctors and other professions are collaborating to stop emerging infections earlier.

• Hughes JM, Wilson ME, Pike BL, et al. (2010). The origin and prevention of pandemics. Clinical Infectious Diseases, 50(12), 1636-40.
  • Despite most emerging diseases originating from the transmission of pathogenic agents from animals to humans, the factors that mediate this process are still ill-defined. What is known, however, is that the interface between humans and animals is of paramount importance in the process. This review discusses the importance of the human-animal interface to the disease emergence process. It provides an overview of factors that are thought to contribute to the origin and spread of emerging infectious diseases and offers suggestions that may serve as future prevention strategies.

• Jacobsen KH, Aguirre AA, Bailey CL, et al. (2016). Lessons from the Ebola Outbreak: Action Items for Emerging Infectious Disease Preparedness and Response. EcoHealth, 13(1), 200-12.           
  • As the Ebola outbreak in West Africa wanes, it is time for the international scientific community to reflect on how to improve the detection of and coordinated response to future epidemics. This article identifies key lessons learned from the Ebola outbreak that can be clustered into three areas: environmental conditions related to early warning systems, host characteristics related to public health, and agent issues that can be addressed through the laboratory sciences. In particular, it highlights the need to increase zoonotic surveillance activities, implement more effective ecological health interventions, expand prediction modeling, support medical and public health systems, improve risk communication, better understand the role of social media in outbreak awareness and response, produce better diagnostic tools, create better therapeutic medications, and design better vaccines. This list provides research priorities and policy actions the global community can take now to be better prepared for future emerging infectious disease outbreaks that threaten health security.

• Jonas O, Warford L. (2014). Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response: Project Accomplishments. Washington, DC: The World Bank.       
  • This report reviews several accomplishments of the Global Program for Avian Influenza Control and Human Pandemic Preparedness and Response (GPAI). This multisectoral program received financing from the World Bank – one example of the World Bank’s contributions to a coordinated global response to the threats of avian and pandemic influenzas. As a result of these efforts, developing countries strengthened their capacity for early and effective disease control, bringing substantial public health and economic benefits to the countries and to the world. The report presents a brief background on the global program and cross-country accomplishments and then highlights specific accomplishments for each capacity building project, by region.

• Jones KE, Patel NG, Levy MA, et al. (2008). Global trends in emerging infectious diseases. Nature, 451(7181), 990-93.   
  • Emerging infectious diseases (EIDs) are a significant burden on global economies and public health. Their emergence is thought to be driven largely by socio-economic, environmental and ecological factors but no comparative study has explicitly analyzed these linkages to understand global temporal and spatial patterns of EIDs. These authors analyze a database of 335 EID events between 1940 and 2004, and demonstrate non-random global patterns. EID events have risen significantly over time after controlling for reporting bias, with their peak incidence concomitant with the HIV pandemic. EID events are dominated by zoonoses, the majority of these originating in wildlife, and are increasing significantly over time. They estimate that 54.3% of EID events are caused by bacteria or rickettsia, reflecting a large number of drug-resistant microbes. They also confirm that EID origins are significantly correlated with socio-economic, environmental and ecological factors, and provide a basis for identifying regions where new EIDs are most likely to originate. Ultimately, global resources to counter disease emergence are poorly allocated, with the majority of the scientific and surveillance effort focused on countries from where the next EID is unlikely to originate.

• Kakkar M, Abbas SS. (2011). One health: moving from concept to reality. The Lancet Infectious Diseases, 11(11), 808.           
  • Proponents of the One Health initiative have recognized the need to move the concept from vision to implementation. Other work has admirably drawn attention to the importance of, and possible mechanisms for, incorporation of a systemic perspective into One Health discussions about changes in human, livestock, and wildlife populations and their effect on infectious diseases. We must welcome the development of a conceptual framework for informing these discussions and acknowledge its usefulness in unifying perspectives from the animal, wildlife, and human sectors to guide assessments of specific sets of one-health interventions.

• Karesh WB, Dobson A, Lloyed-Smith JO, et al. (2012). Ecology of zoonoses: natural and unnatural histories. The Lancet, 380(9857), 1936-45.
  • More than 60% of human infectious diseases are caused by pathogens shared with wild or domestic animals. Zoonotic disease organisms include those that are endemic in human populations or enzootic in animal populations with frequent cross-species transmission to people. Some of these diseases have only emerged recently. Together, these organisms are responsible for a substantial burden of disease, with endemic and enzootic zoonoses causing about a billion cases of illness in people and millions of deaths every year. Emerging zoonoses are a growing threat to global health and have caused hundreds of billions of US dollars of economic damage in the past 20 years. This article reviews how zoonotic diseases result from natural pathogen ecology, and how other circumstances, such as animal production, extraction of natural resources, and antimicrobial application change the dynamics of disease exposure to human beings. In view of present anthropogenic trends, a more effective approach to zoonotic disease prevention and control will require a broad view of medicine that emphasizes evidence-based decision making and integrates ecological and evolutionary principles of animal, human, and environmental factors. 

• Klement E, Shpigel N, Balicer RD, et al. (2009). ‘One Health’, from science to policy: examples from the Israeli experience. Veterinaria Italiana, 45(1), 45-53.
  • The concept of ‘One Health’ aims to help bring about the integration of animal, human and environmental health for the mutual benefit of all. This multidisciplinary approach is of great importance in a variety of fields, from enhancement of breakthroughs in biomedical research, to epidemiological studies and public health policy decision‐making. This article demonstrates the strengths embedded in this approach by using three case studies from Israel. The benefits gained by applying the ‘One Health’ concept in these three examples should encourage further collaboration between veterinarians and physicians.

• Kloeze H, Mukhi S, Kitching P, et al. (2010). Effective Animal Health Disease Surveillance Using a Network-Enabled Approach. Transboundary & Emerging Diseases, 57(6), 414-19.
  • There are many benefits that derive from real-time knowledge of the health status of the national livestock population. Effective animal disease surveillance is a requirement for countries that trade in live animals and their products in order to comply with the World Organization for Animal Health (OIE) guidelines. Rapid identification of introduced and emerging disease allows rapid response and mitigation of the economic consequences. Connections between animal and human disease caused by a common pathogen can be recognized and control measures implemented, thereby protecting public health and maintaining public confidence in the food supply. Production-limiting diseases can be monitored, and control programmes be evaluated with benefits accruing from decreased economic losses associated with disease as well as reducing the welfare concerns associated with diseased animals. Establishing a surveillance programme across a wide area with diverse ecosystems and political administrations can be a complex challenge. Canada is one such area. This paper describes the genesis of the Canadian Animal Health Surveillance Network (CAHSN), its current capability and governance, and potential for future development.

• Kshirsagar DP, Savalia CV, Kalyani IH, et al. (2013). Disease alerts and forecasting of zoonotic diseases: an overview. Veterinary World, 6(11), 889-96.         
  • Epidemiologists are adopting new techniques by the use of Geographical Information System (GIS) to study a variety of animal and zoonotic diseases. Associations between satellite-derived environmental variables such as temperature, humidity, land cover type and vector density are used for disease prediction. Early warning systems rapidly detect the introduction or sudden increase in incidence of any disease of livestock which has the potential to develop into epidemic proportions and/or cause serious socioeconomic consequences or public health concerns. Early warning activities, mainly based on disease surveillance, reporting, and epidemiological analysis, are supported by information systems that enable integration, analysis and sharing of animal health data combined with relevant layers of information such as socioeconomic, production and climatic data. The convergence of factors such as the availability of multi-temporal satellite data and georeferenced epidemiological data, collaboration between scientists, biologists and the availability of sophisticated, statistical GIS creates a fertile research environment. This paper reviews the Global Early Warning System (GLEWS), which formally brings together human and veterinary public health systems and application of environmental data for study of diseases like avian influenza and Rift valley fever. An emphasis is also given on components of early warning system and its use for forecasting of animal and zoonotic diseases in India.

• Lee K, Brumme ZL. (2012) Operationalizing the One Health approach: the global governance challenges. Health Policy & Planning, 28(7), 778-85.      
  • While there has been a wide-ranging commitment to the One Health approach, its operationalization has proven challenging thus far. One Health calls upon the human, animal and environmental health sectors to cross professional, disciplinary and institutional boundaries, and to work in a more integrated fashion. At the global level, this paper argues that this vision is hindered by dysfunctions characterizing current forms of global health governance (GHG), namely institutional proliferation, fragmentation, competition for scarce resources, lack of an overarching authority, and donor-driven vertical programmes. This has contributed, in part, to shortcomings in how One Health has been articulated to date. An agreed operational definition of One Health among key global institutions, efforts to build One Health institutions from the ground up, comparative case studies of what works or does not work institutionally, and high-level global support for research, training and career opportunities would all help to enable One Health to help remedy, and not be subsumed by, existing dysfunctions in GHG.

• Lipsitch M, Riley S, Cauchemez S, et al. (2009). Managing and Reducing Uncertainty in an Emerging Influenza Pandemic. New England Journal of Medicine, 361(2), 112-15.
  • The early phases of an epidemic present decision-makers with predictable challenges that were evident as the novel influenza A (H1N1) virus spread. The scale of the problem is uncertain when a disease first appears but may increase rapidly. Early action is required, but decisions about action must be made when the threat is only modest — and consequently, they involve a trade-off between the comparatively small, but nearly certain, harm that an intervention may cause and the uncertain probability of much greater harm from a widespread outbreak. This combination of urgency, uncertainty, and the costs of interventions makes the effort to control infectious diseases especially difficult.

• Lipton BA, Hopkins SG, Koehler JE, et al. (2008). A survey of veterinarian involvement in zoonotic disease prevention practices. Journal of the American Veterinary Medical Association, 233(8), 1242-49.    
  • Veterinarians recognize their important role in zoonotic disease prevention and suggest that veterinarians would welcome stronger partnerships with public health agencies and other health professionals in this endeavor. Methods to increase veterinarians’ involvement in zoonotic disease prevention include discussing zoonotic diseases more frequently with clients, physicians, and public health agencies; encouraging higher risk individuals to discuss zoonotic diseases; having educational materials on zoonotic diseases available for clients; improving infection-control practices; and ensuring that continuing education courses on zoonotic diseases are regularly available.

• Lloyd-Smith JO, George D, Pepin KM, et al. (2009). Epidemic Dynamics at the Human-Animal Interface. Science, 326(5958), 1362-67.         
  • Few infectious diseases are completely human-specific – most human pathogens also circulate in animals or else originated in non-human hosts. Influenza, plague, and trypanosomiasis are classic examples of zoonotic infections that transmit from animals to humans. The multihost ecology of zoonoses leads to complex dynamics, and analytical tools, such as mathematical modeling, are vital to the development of effective control policies and research agendas. Much attention has focused on modeling pathogens with simpler life cycles and immediate global urgency, such as influenza and severe acute respiratory syndrome. Meanwhile, vector-transmitted, chronic, and protozoan infections have been neglected, as have crucial processes such as cross-species transmission. Progress in understanding and combating zoonoses requires a new generation of models that address a broader set of pathogen life histories and integrates across host species and scientific disciplines.

• Lloyd-Smith JO, Funk S, McLean AR, et al. (2015). Nine challenges in modelling the emergence of novel pathogens. Epidemics, 10, 35-39.
  • Studying the emergence of novel infectious agents involves many processes spanning host species, spatial scales, and scientific disciplines. Mathematical models play an essential role in combining insights from these investigations and drawing robust inferences from field and experimental data. This article describes nine challenges in modeling the emergence of novel pathogens, emphasizing the interface between models and data.

• Machalaba C, Smith KM, Awada L, et al. (2017). One Health Economics to confront disease threats. Transactions of The Royal Society of Tropical Medicine and Hygiene, 111(6), 235-37.
  • Global economic impacts of epidemics suggest a high return on investment in prevention and One Health capacity. However, such investments remain limited, contributing to persistent endemic diseases and vulnerability to emerging ones. An interdisciplinary workshop explored methods for country-level analysis of added value of One Health approaches to disease control. Key recommendations include: (i) systems thinking to identify risks and mitigation options for decision-making under uncertainty; (ii) multisectoral economic impact assessment to identify wider relevance and possible resource-sharing; and (iii) consistent integration of environmental considerations. Economic analysis offers a congruent measure of value complementing diverse impact metrics among sectors and contexts.

• Miller M, Olea-Popelka F. (2013). One Health in the shrinking world: Experiences with tuberculosis at the human–livestock–wildlife interface. Comparative Immunology Microbiology & Infectious Diseases, 36(3), 263-68.   
  • Tuberculosis (TB) is a global anthropozoonotic infection that has raised awareness of the impact of disease at the human–livestock–wildlife interface. There are examples of transmission from livestock resulting in the establishment of reservoirs in wildlife populations, and exposures from interactions between humans and wildlife that have resulted in disease outbreaks. A One Health approach is crucial to managing and protecting the health of humans, livestock, wildlife and the environment. Although still in its infancy in many areas of the world, the use of transdisciplinary teams to address wildlife–human–livestock boundary diseases will broaden the scope of options for solutions. This paper reviews some less commonly known examples of threats and outcomes using lessons learned from tuberculosis.

• Morens DM, Folkers GK, Fauci AS. (2004). The challenge of emerging and re-emerging infectious diseases. Nature, 430(6996), 242-49.     
  • Infectious diseases rival wars and famine as major challenges to human progress and survival. They remain among the leading causes of death and disability worldwide. Against a constant background of established infections, epidemics of new and old infectious diseases periodically emerge, greatly magnifying the global burden of infections. Studies of these emerging infections reveal the evolutionary properties of pathogenic microorganisms and the dynamic relationships between microorganisms, their hosts and the environment.

• Morgan D, Kirkbride H, Hewitt K, et al. (2009). Assessing the risk from emerging infections. Epidemiology & Infection, 137(11), 1521-30.
  • Emerging infections pose a constant threat to society and can require a substantial response. Thus, systems to assess the threat level and inform prioritization of resources are essential. A systematic approach to assessing the risk from emerging infections to public health in the UK has been developed. This qualitative assessment of risk is performed using algorithms to consider the probability of an infection entering the UK population, and its potential impact, and to identify knowledge gaps. The risk assessments are carried out by a multidisciplinary, cross-governmental group of experts working in human and animal health. This approach has been piloted on a range of infectious threats identified by horizon scanning activities. A formal risk assessment of this nature should be considered for any new or emerging infection in humans or animals, unless there is good evidence that the infection is neither a recognized human disease nor a potential zoonosis.

• Mwacalimba KK, Green J. (2014). One health and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia. Health Policy & Planning, 30(2), 215-22.    
  • One World, One Health has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of trade and development issues remain relatively unexamined, and few studies to date have explored the implications of global disease governance for resource-constrained countries outside the main centers of zoonotic outbreaks. This article draws on a policy study of national level avian and pandemic influenza preparedness between 2005 and 2009 across the sectors of trade, health and agriculture in Zambia. It highlights the challenges of integrating disease control interventions amidst trade and developmental realities in resource-poor environments and demonstrates how locally important trade and development imperatives were marginalized in Zambia, limiting the effectiveness of pandemic preparedness. 

• Okello AL, Welburn SC. (2014). The Importance of Veterinary Policy in Preventing the Emergence and Re-Emergence of Zoonotic Disease: Examining the Case of Human African Trypanosomiasis in Uganda. Frontiers in Public Health, 2, 218-23.
  • Rapid changes in human behavior, resource utilization, and other extrinsic environmental factors continue to threaten the current distribution of several endemic and historically neglected zoonoses in many developing regions worldwide. There are numerous examples of zoonotic diseases which have circulated within relatively localized geographical areas for some time, before emerging into new regions as a result of changing human, environmental, or behavioral dynamics. This article uses zoonotic human African trypanosomiasis (HAT) as a case study for demonstrating this point. There is an important role for veterinary policy in mitigating the severe human health and economic impacts of zoonotic disease. The systemic challenges surrounding the development and enforcement of veterinary policy described here are similar across sub-Saharan Africa, highlighting the necessity to consider and support zoonotic disease control in broader human and animal health systems strengthening and associated development programs on the continent.

• Okello AL, Bardosh K, Smith J, et al. (2014). One Health: Past Successes and Future Challenges in Three African Contexts. PLoS Neglected Tropical Diseases, 8(5), e2884-91.
  • The recent emergence of zoonotic diseases such as Highly Pathogenic Avian Influenza (HPAI) and Severe Acute Respiratory Syndrome (SARS) have contributed to dominant Global Health narratives around health securitization and pandemic preparedness, calling for greater co-operation between the health, veterinary and environmental sectors in the ever-evolving One Health movement. A decade later, One Health advocates face increasing pressure to translate the approach from theory into action.

• Osburn B, Scott C, Gibbs P. (2009). One World – One Medicine – One Health: emerging veterinary challenges and opportunities. Rev Sci Tech, 28(2), 481-86.
  • The interdependence of humans, animals, and their environment has never been more important than now. The most prominent issues putting pressure on global health today include the dramatic emergence and spread of zoonotic diseases, contamination of food, water and soil, bioterrorist events, and degradation of resources and habitats. Current global health challenges have prompted a call for more holistic, collaborative, action-oriented approaches toward the goal of logical and practical solutions. Veterinarians have pivotal obligations, opportunities, and contributions to make in enhancing public health, recognizing and responding to zoonotic disease transmission, maintaining food and water quality, and promoting wildlife and ecosystem health.

• Pearson GS. (2005). United Kingdom: Bioterrorism Defense. Encyclopedia of Bioterrorism Defense. In: Encyclopedia of Bioterrorism Defense. Hoboken: John Wiley & Sons, Inc.
  • There has long been a necessity in the United Kingdom (UK) to be able to respond to outbreaks of disease that may affect humans, animals, or plants. The response to bioterrorism is primarily based upon the capability to respond to terrorist incidents and upon the capability to respond to such outbreaks. The United Kingdom’s integrated approach to a major emergency provides the background to the examination of the effectiveness of that approach in preparedness to counter deliberate releases of biological materials.

• Pedersen K, Deliberto TJ, Nolte DL, et al. (2012). The Role of the National Wildlife Disease Program in Wildlife Disease Surveillance and Emergency Response. U.S. Department of Agriculture: Animal and Plant Health Inspection Service, Proceedings of the 14th WDM Conference.
  • The National Wildlife Disease Program (NWDP), overseen by the U.S. Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services (WS), was established to develop a nationally coordinated wildlife disease surveillance and emergency response system. Since its inception in 2003, the NWDP has developed collaborations with over 200 national and international partners. The national partners include state, tribal, federal, and private organizations and these partnerships have resulted in the surveillance and management of over 100 pathogens, toxins, and disease syndromes affecting animals and humans. Several of these pathogens, including avian influenza, plague, tularemia, bluetongue, and other pathogens carried by feral swine, are monitored on a national or regional scale. The NWDP maintains an archive of select wildlife disease samples. Archived samples are available to scientists at universities and other entities with approved research protocols. The NWDP also serves as Wildlife Services’ primary emergency response unit. The program’s wildlife disease biologists are trained as all-hazard first responders, and the national office coordinates training and mobilization of these and other personnel. Internationally, the NWDP has worked with over 30 countries, developing close relationships with many organizations. This paper provides an overview of the NWDP structure and its activities. 

• Pieracci EG, Hall AJ, Gharpurea R, et al. (2016). Prioritizing zoonotic diseases in Ethiopia using a one health approach. One Health, 2, 131-35.      
  • Ethiopia has the second largest human population in Africa and the largest livestock population on the continent. About 80% of Ethiopians are dependent on agriculture and have direct contact with livestock or other domestic animals. As a result, the country is vulnerable to the spread of zoonotic diseases. As the first step of the country’s engagement in the Global Health Security Agenda, a zoonotic disease prioritization workshop was held to identify significant zoonotic diseases of mutual concern for animal and human health agencies.

• Pike J, Aadland D, Daszak P, et al. (2015). Valuing a pandemic: Exploring trade-offs in rational risk reduction. New York: EcoHeath Alliance.
  • Emerging infectious diseases are on the rise, increasing the probability of a costly pandemic outbreak. Policymakers must decide how to prepare for a potential pandemic given scarce resources and competing risks. This paper presents a survey to elicit the opportunity cost of these choices based on two measures: (i) the risk-risk tradeoffs between pandemics and environmental/terrorist events, and (ii) the risk policy effectiveness based on the number of lives saved per dollar expenditure. Based on a nationally representative US web-based panel, the authors found three key results. First, the sample values the prevention of environmental disaster deaths or terrorist attack deaths approximately 3.5 times more than the prevention of pandemic outbreak deaths. Second, respondents who are educated about or have experienced a catastrophe, are more vulnerable to a particular catastrophe, and are closer to a prior catastrophic event affect valuations as expected. Third, the average respondent said she would require at least 457,000 saved lives for a $5/year contribution to a pandemic risk policy. These results suggest that people at the time of our survey undervalued infectious diseases, which in turn contributes to the current lack of preparedness in the United States.

• Rabinowitz P, Conti L. (2013). Links among human health, animal health, and ecosystem health. Annual Review of Public Health, 34, 189-204.            
  • In the face of growing world human and animal populations and rapid environmental change, the linkages between human, animal, and environmental health are becoming more evident. Because animals and humans have shared risk to health from changing environments, it seems logical to expand the perspective of public health beyond a single species to detect and manage emerging public health threats. Mitigating the effects of climate change, emerging pathogens, toxicant releases, and changes in the built environment requires a retooling of global public health resources and capabilities across multiple species. Furthermore, human and animal health professionals must overcome specific barriers to interprofessional collaboration to implement needed health strategies. This review outlines the relationships between human, animal, and ecosystem health and the public health challenges and opportunities that these links present.

• Rock M, Buntain BJ, Hatfield JM, et al. (2009). Animal–human connections, one health, and the syndemic approach to prevention. Social Science & Medicine, 68(6), 991-95.
  • A syndemic involves two or more afflictions that, by interacting synergistically, contribute to excess burdens of disease. A syndemic approach to prevention, meanwhile, focuses on connections among health-related problems, considers those connections when developing health policies, and aligns with forces for social change. In this short report, the authors expand the syndemic concept to acknowledge the extent to which animal health connects with human health and, with reference to existing publications, demonstrate the pertinence of this expanded definition for a syndemic approach to prevention. 

• Shapiro M, London B, Nigri D, et al. (2016). Middle East respiratory syndrome coronavirus: review of the current situation in the world. Disaster and Military Medicine, 2(1), 9-14.
  • This article reviews the current epidemiology and clinical presentation of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection and describes the preparedness plan of several countries. The MERS-CoV was first reported in 2012 and has since infected more than 1600 patients in 26 countries, mostly in Saudi Arabia and the Middle East. The epidemiology of the infection is compatible with multiple introductions of the virus into humans from an animal reservoir, probably dromedary camels. The clinical presentation ranges from no symptoms to severe pneumonitis and respiratory failure. Most confirmed cases so far were part of MERS-CoV clusters in hospital settings, affecting mainly middle-aged men and patients with a chronic disease or immuno-suppressed status. There is no vaccine or anti-viral medication available. Viral epidemics can occur anywhere in today’s global village. MERS-CoV is a relatively new virus, and this work is intended to add to the still-sparse data on its epidemiology, modes of transmission, natural history, and clinical features as well as to describe the preparedness plan for MERS-CoV infection in several countries. Effective national and international preparedness plans are essential to predict and control outbreaks, improve patient management, and ensure global health security.

• Shiferaw ML, Malekani J, et al. (2017). Frameworks for Preventing, Detecting, and Controlling Zoonotic Diseases. Emerging Infectious Diseases, 23(S1), S71-77.  
  • Preventing zoonotic diseases requires coordinated actions by government authorities responsible for human and animal health. Constructing the frameworks needed to foster intersectoral collaboration can be approached in many ways. This paper highlight three examples of approaches to implement zoonotic disease prevention and control programs. The first, rabies control in Ethiopia, was implemented using an umbrella approach: a comprehensive program designed for accelerated impact. The second, a monkeypox program in Democratic Republic of the Congo, was implemented in a stepwise manner, whereby incremental improvements and activities were incorporated into the program. The third approach, a pathogen discovery program, applied in the country of Georgia, was designed to characterize and understand the ecology, epidemiology, and pathogenesis of a new zoonotic pathogen. No one approach is superior, but various factors should be taken into account during design, planning, and implementation.

• Sims LD. (2013). Intervention strategies to reduce the risk of zoonotic infection with avian influenza viruses: scientific basis, challenges and knowledge gaps. Influenza and Other Respiratory Viruses, 7(S2), 15-25.
  • A range of measures have been recommended and used for the control and prevention of avian influenza. These measures are based on the assessment of local epidemiological situations, field observations and other scientific information. Other non-technical factors are taken into account when developing and recommending control measures. The precise effects under field conditions of most individual interventions applied to control and prevent avian influenza have not been established or subjected to critical review, often because a number of measures are applied simultaneously without controls. In most cases, the combination of measures used results in control or elimination of the virus although there are some countries where this has not been the case. In others, especially those with low poultry density, it is not clear whether the link between the adoption of a set of measures and the subsequent control of the disease is causative. This article discusses the various measures recommended, with particular emphasis on stamping out and vaccination, examines how these measures assist in preventing zoonotic infections with avian influenza viruses and explores gaps in knowledge regarding their effectiveness.

• Smith J, Taylor EM, Kingsley P. (2015). One World-One Health and neglected zoonotic disease: Elimination, emergence and emergency in Uganda. Social Science & Medicine, 129, 12-19.
  • This paper traces the emergence and tensions of an internationally constructed and framed One World-One Health (OWOH) approach to control and attempt to eliminate African Trypanosomiasis in Uganda. In many respects Trypanosomiasis is a disease that an OWOH approach is perfectly designed to treat, requiring an integrated approach built on effective surveillance in animals and humans, quick diagnosis and targeting of the vector. The reality appears to be that the translation of global notions of OWOH down to national and district levels generates problems, primarily due to a suite of interrelated interactions. These dynamics result in the global, international interventionalist mode of OWOH undermine existing domestic institutions. Supporting national bodies focused around One Health, and ensuring that external actors engage with and through those bodies can help develop a sustained, effective OWOH presence in resource-poor countries, where after all most zoonotic disease burden remains.

• Smith KF, Sax DF, Gaines SD, et al. (2007). Globalization of Human Infectious Disease. Ecology, 88(8), 1903-10.
  • Globalization has facilitated the spread of numerous infectious agents to all corners of the planet. Analysis of the Global Infectious Disease and Epidemiology Network (GIDEON) database quantitatively illustrates that the globalization of human infectious agents depends significantly on the range of hosts used. Infectious agents specific to humans are broadly and uniformly distributed, whereas zoonotic infectious agents are far more localized in their geographical distribution. Moreover, these patterns vary depending on transmission mode and infectious agent taxonomy. This dichotomy is unlikely to persist if certain aspects of globalization continue unabated. This raises a serious concern for public health and leaves nations with the task of determining the infectious agents that have the greatest potential to establish within their borders. At the advent of a century characterized by an apparent increase in emerging infectious diseases, these results have critical implications for public-health policy and future research pathways of infectious disease ecology.

• Vercauteren KC, Ellis C, Chipman R, et al. (2012). Rabies in North America: A model of the One Health approach. Proceedings of the 14th WDM Conference. U.S. Department of Agriculture: Animal and Plant Health Inspection Service.        
  • The One Health concept merges environmental, wildlife, domestic animal, and human health into a global, interconnected context. This approach to managing infectious diseases aims to promote and implement meaningful collaboration and communication between multiple allied disciplines working locally, nationally, and internationally to attain optimal health for people, domestic animals, wildlife, and our environment. Rabies is an ancient disease that results in more than 55,000 human deaths worldwide each year. Historic and current emphasis on interdisciplinary approaches to rabies control provides a prime example of a zoonotic disease that is being managed more effectively via the One Health approach. In North America, a few meso-carnivores and bats serve as reservoirs of rabies, perpetuating continual infection of humans, pets, and livestock. Increased emphasis on surveillance and control of rabies in wildlife is the key to local, regional, and continental elimination strategies.

• Wallace R, Etheart M, Ludder F, et al. (2017). The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010–2015. American Journal of Tropical Medicine & Hygiene, 97(S4), 76-83.       
  • Haiti is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate post-bite treatment, have not been fully implemented at a national scale. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. Since that time, Haiti has seen improvements in the program infrastructure for canine rabies control as a result of the efforts of Haiti’s health and agriculture sectors with assistance from multiple international organizations. Haiti is well situated to eliminate canine-mediated human rabies deaths in the near future and should serve as a great example to many developing countries struggling with similar barriers and limitations.

• Weaver J, Leon E, Edan M, et al. (2012). Initial assessment of strategic plans for improving the performance of Veterinary Services in developing countries: a review of OIE PVS Gap Analysis reports. Rev Sci Tech, 31(2), 631-45.    
  • The World Organisation for Animal Health (OIE) carries out Gap Analysis missions as part of its programme to assess and improve the Performance of Veterinary Services (the PVS Pathway) in Member Countries. These Gap Analysis missions have found that many national Veterinary Services comply to only a limited extent with the international standards established by the OIE and that their competence is compromised by poor governance. This failure threatens animal and public health not only nationally but also internationally. The OIE PVS Gap Analysis reports reviewed found that all the Veterinary Services have a strong vision and commitment to improvement but are held back by a weak chain of command, inadequate and outdated legislation, insufficient funding, weak technical competencies, compromised technical independence, poor communications, and limited joint programs. There are weaknesses across all the core technical areas of trade, animal health, veterinary public health and veterinary laboratories and also in the overall management of the Veterinary Services. The OIE PVS Gap Analysis missions recommend significant increases in budget in all countries.

• Webster RG. (2002). The importance of animal influenza for human disease. Vaccine, 20, S16-20.
  • Influenza is a zoonotic disease requiring continuous surveillance. Our knowledge indicates that the intermittent pandemics of influenza originate from influenza viruses in lower animals and birds. These pandemics can be mild to catastrophic. While we have learned a great deal about the ecology and molecular properties of animal influenza viruses, we do not have a system for comprehensive international surveillance. The 1918 Spanish influenza pandemic that originated from lower animals and the H5N1 bird flu incident in Hong Kong serves to remind us that influenza continues to be an emerging disease. The current challenge is to accumulate the necessary epidemiological data on animal influenza viruses so that an international surveillance system can be devised. This epidemiological data may provide clues on how to reduce interspecies transmission of influenza.

• Weigler BJ, Di Giacomo RF, Alexander S. (2005). A National Survey of Laboratory Animal Workers Concerning Occupational Risks for Zoonotic Diseases. Comparative Medicine, 55(2), 183-91.
  • In study reports on a cross-sectional survey of laboratory animal workers in the United States.  Logistic regression analysis found various characteristics of persons and their employers that were significantly associated with the likelihood of having been medically evaluated for exposure to a zoonotic agent from laboratory animals. Most persons working with laboratory animals or their tissues indicated they knew whom to talk to for medical evaluation and care should they be concerned about the possibility of an occupationally acquired zoonotic disease. However, occupational illnesses and exposures among laboratory animal workers was underreported, as alleged zoonotic disease cases were not communicated to the employee’s supervisor. Lack of concern about the potential significance to their health and the perception of punitive consequences to the employee were some of the reasons cited for underreporting, an issue which must be vigorously addressed in the interests of continuing progress toward zoonotic disease prevention in this field.

• Welburn SC, Coleman PG, Maudlin I, et al. (2006). Crisis, what crisis? Control of Rhodesian sleeping sickness. Trends in Parasitology, 22(3), 123-28.       
  • There is an urgent need for cost-effective strategies for the sustainable control of Rhodesian sleeping sickness – a fatal zoonotic disease that has caused devastating epidemics over the past century. Sleeping sickness continues to be controlled by crisis management, using active case detection, treatment, and vector control. However, these activities only occur during major epidemics and during the intervening periods, farmers and communities must fend for themselves. There are several methods for assessing the burden of this disease and there is a series of farmer-led methodologies that can be applied to reduce the burden of disease.

• Wendt A, Kreienbrock L, Campe A. (2015). Zoonotic Disease Surveillance – Inventory of Systems Integrating Human and Animal Disease Information. Zoonoses & Public Health, 62(1), 61-74.
  • Although 65% of recent major disease outbreaks have a zoonotic origin, there is still a sharp division among the disciplines in the human and animal health sectors. In the last few decades, a global integrative concept, often referred to as ‘One Health’, has been strongly endorsed. Surveillance and monitoring efforts are major components for effective disease prevention and control. As human health and animal health are inextricably linked, it is assumed that a cross-sectoral data interpretation of zoonotic disease information will improve their prevention, prediction, and control. This literature review provides an overview of existing systems throughout the world which integrate information from humans and animals on zoonotic diseases. Projects vary widely depending on their surveillance purpose, their structure and the source of information they use. What they generally have in common is that they quite often use data which have already been collected for another purpose. Therefore, the challenges of how to make use of such secondary data are of great interest.

• Wilcox BA, Gubler DJ. (2005). Disease ecology and the global emergence of zoonotic pathogens. Environmental Health and Preventive Medicine, 10(5), 263-72.
  • The incidence and frequency of epidemic transmission of zoonotic diseases, both known and newly recognized, have increased dramatically in the past 30 years. It is thought that this dramatic emergence is primarily the result of the social, demographic, and environmental transformations. However, the causal linkages have not been elucidated. Investigating emerging zoonotic pathogens as an ecological phenomenon can provide significant insights as to why some of these pathogens have jumped species and caused major epidemics in humans. A review of concepts and theory from biological ecology and of causal factors in disease emergence previously described suggests a general model of global zoonotic disease emergence. The model links demographic and societal factors to land use and land cover change whose associated ecological factors help explain disease emergence. The scale and magnitude of these changes are more significant than those associated with climate change, the effects of which are largely not yet understood. Unfortunately, the complex character and non-linear behavior of the human-natural systems in which host-pathogen systems are embedded makes specific incidences of disease emergence or epidemics inherently difficult to predict. Employing a complex systems analytical approach, however, may show how a few key ecological variables and system properties, including the adaptive capacity of institutions, explains the emergence of infectious diseases and how an integrated, multi-level approach to zoonotic disease control can reduce risk.

• Wilson SJ, Ward MP, Garner MG, et al. (2013). A framework for assessing the intangible impacts of emergency animal disease. Preventative Veterinary Medicine, 111(3), 194-99.     
  • Intangible elements can have a great impact on the response, control and prevention strategies that are ultimately used to address emergency animal diseases (EADs). These intangible elements have value and worth, although these are difficult express in dollar terms. Consequently, these elements are often lost in the scope of traditional economic analysis. Without the inclusion of these intangibles, the bottom-line for decision-making related to animal-health emergencies would be based only on financial measures. This article presents a framework for addressing the intangible impacts of EADs that allows a measurement of the trade-offs that stakeholders are willing to accept under different control scenarios.

• Wohl JS, Nusbaum KE. (2007). Public health roles for small animal practitioners. Journal of the American Veterinary Medical Association, 230(4), 494.
  • The veterinary medical profession has been involved in the protection of public health since the late 19th century. In recent years, the profession has changed toward a greater number of small animal veterinarians and diminishing numbers of veterinarians practicing in fields traditionally associated with public health responsibilities, such as food animal, agricultural, regulatory, and public health practice. Policies that expand the public health role of small animal veterinarians can address the current and anticipated shortage of public health veterinary services. Doing so would position the veterinary profession in a manner that more accurately reflects the integration of animal and health in the 21st century. 

• Wood JL, Cunningham AA., Suu-Ire RD, et al. (2016). Ebola, Bats and Evidence-Based Policy. EcoHealth, 13(1), 9-11.

  • During the 2014 Ebola outbreak, the international focus was on reducing the disease transmission rate. However, scientific attention should now be re-directed to the prevention of future zoonotic outbreaks. There already has been much written on how the West African epidemic might have been sparked, but speculation often has been presented as fact and in some cases has been contrary to evidence. Such inaccurate reporting on the drivers of emergence is unfortunate, as it can influence policy decisions while failing to identify how serious zoonoses should be controlled.

• Wood JL, Leach M, Waldman L, et al. (2012).  A framework for the study of zoonotic disease emergence and its drivers: spillover of bat pathogens as a case study. Phil Trans R Soc Bio, 367(1604), 2881-92.
  • Many serious emerging zoonotic infections have recently arisen from bats, including Ebola, Marburg, SARS-coronavirus, Hendra, Nipah, and a number of rabies and rabies-related viruses, consistent with the overall observation that wildlife are an important source of emerging zoonoses for the human population. Mechanisms underlying the recognized association between ecosystem health and human health remain poorly understood and responding appropriately to the ecological, social and economic conditions that facilitate disease emergence and transmission represents a substantial societal challenge. In this article, the authors propose a novel framework for the holistic and interdisciplinary investigation of zoonotic disease emergence and its drivers, using the spillover of bat pathogens as a case study. This study has been developed to gain a detailed interdisciplinary understanding, and it combines cutting-edge perspectives from both natural and social sciences, linked to policy impacts on public health, land use, and conservation.

• World Health Organization. (2014). Emerging infectious diseases: Novel coronaviruses: Report of a regional workshop. Colombo, Sri Lanka, 8-10 October 2013. New Delhi: World Health Organization.
  • Over 40 emerging infectious diseases (EIDs) have been identified globally since the 1970s. For the South-East Asia Region, the newly emerging infectious diseases, among many important infectious diseases, avian influenzas (H5N1 & H7N9) and Middle East Respiratory Syndrome coronavirus (MERS-CoV) pose serious public health threats. To strengthen regional capacity to respond to EIDs, the Regional Workshop on Emerging Infectious Diseases: Novel Corona Viruses was organized during 8-10 October 2013, in Colombo, Sri Lanka. The report provides the summary of the deliberations of the workshop and outlines the need to develop and sustain IHR core capacities to strengthen national and regional health security.

• World Health Organization. (2018). Managing Epidemics: Key facts about major deadly diseases. Geneva: World Health Organization.
  • The 21^st century has already been marked by major epidemics. Old diseases – cholera, plague and yellow fever – have returned, and new ones have emerged – SARS, pandemic influenza, MERS, Ebola and Zika. This manual provides concise and up-to-date knowledge on 15 infectious diseases – including several zoonotic diseases – that have the potential to become international threats, and tips on how to respond to each of them.

• World Health Organization, Food and Agriculture Organization of the United Nations, World Organisation for Animal Health. (2008). Zoonotic Diseases a Guide to Establishing Collaboration between Animal and Human Health Sectors at the Country Level. Geneva: World Health Organization.     
  • This guide was developed to assist countries and areas in achieving sustainable and functional collaboration between animal and human health sectors, which is crucial to addressing the challenges posed by endemic, emerging and re-emerging zoonoses. It outlines step-by-step actions to develop appropriate collaborations in the following four key areas identified in the Asia Pacific Strategy for Emerging Diseases (APSED) zoonoses work plan: (i) surveillance and information sharing, (ii)coordinated response, (iii) risk reduction, (iv) collaborative research. Once strong collaboration has been established in these areas, it may also be applied to specific zoonoses control programmes.

• World Organisation for Animal Health (OIE). (2013). OIE Tool for the Evaluation of Performance of Veterinary Services (OIE PVS Tool). Paris: World Organisation for Animal Health .

  • In this era of globalization, the development and growth of many countries, as well as the prevention and control of major biological disasters, depend on the performance of their agricultural and food policies and economies, and this, in turn, directly relates to the quality of their Veterinary Services (VS). Important roles for VS include veterinary public health – including food-borne diseases – and regional and international market access for animals and animal products. Strengthening of VS to help them comply with international standards requires active participation and investment by both the public and the private sector. The World Organisation for Animal Health (OIE) has refined an Evaluation Tool developed initially in collaboration with the Inter-American Institute for Cooperation on Agriculture (IICA) to produce the OIE Tool for the Evaluation of Performance of Veterinary Services (OIE PVS Tool). This tool is designed to assist VS to establish their current level of performance, to identify gaps and weaknesses in their ability to comply with OIE international standards, to form a shared vision with stakeholders, and to establish priorities and carry out strategic initiatives.

• Wright JG, Jung S, Holman RC, et al. (2008). Infection control practices and zoonotic disease risks among veterinarians in the United States. Journal of the American Veterinary Medical Association, 232(12), 1863-72.      
  • Generally, respondents did not engage in protective behaviors or use personal protective equipment considered appropriate to protect against zoonotic disease transmission. Small animal and equine veterinarians employed in practices that had no written infection control policy were significantly more likely to have low precaution awareness. Male gender was associated with low precaution awareness ranking among small animal and large animal veterinarians; equine practitioners not working in a teaching or referral hospital were more likely to have low precaution awareness than equine practitioners working in such institutions.

• Xie T, Liu W, Anderson BD,et al. (2017). A system dynamics approach to understanding the One Health concept. PLoS One, 12(9), e0184430-41.
  • There have been many terms used to describe the One Health concept, including movement, strategy, framework, agenda, approach, among others. However, the inter-relationships of the disciplines engaged in the One Health concept have not been well described. To identify and better elucidate the internal feedback mechanisms of One Health, we employed a system dynamics approach. A systematic literature review was conducted and 19 studies were selected for evaluating the inter-relationships of disciplines engaged in One Health. Herein, the authors report a visually rich, theoretical model regarding interactions of various disciplines and complex problem descriptors engaged in One Health problem-solving. This report provides a conceptual framework for future descriptions of the interdisciplinary engagements involved in One Health.