A brief review of foodborne zoonoses in China

The complexity and increasing burden of zoonotic diseases create challenges for the health systems of developing nations. Public health systems must therefore be prepared to face existing and future disease threats at the human–animal interface. The key for this is coordinated action between the human and the animal health systems. Although some studies deal with the question of how these two systems interact during unforeseen circumstances such as outbreaks, a dearth of literature exists on how these systems interact on early detection, prevention and control of zoonotic diseases; assessing this problem from the health system perspective in a developing nation adds further complexity. Systems thinking is one of the promising approaches in understanding the factors that influence the system’s complexity and dynamics of health maintenance. Therefore, this study aims to understand the generic structure and complexity of interaction between these actors within the domain of One Health for the effectual prevention and control of zoonotic diseases in India.The present study will be executed in Ahmedabad, located on the Western part of India, in Gujarat state, using a mixed methods approach. For the first step, zoonotic diseases will be prioritised for the local context through semi-quantitative tools. Secondly, utilising semi-structured interviews, stakeholders from the human and animal health systems will be identified and ranked. Thirdly, the identified stakeholders will be questioned regarding the current strength of interactions at various levels of the health system (i.e. managerial, provider and community level) through a quantitative network survey. Fourthly, utilising a vignette method, the ideal convergence strategies will be documented and validated through policy Delphi techniques. Finally, through a participatory workshop, the factors that influence convergence for the control and prevention of zoonotic diseases will be captured.This study will provide a comprehensive picture of the current strength of collaboration and network depth at various levels of the health system. Further, it will assist different actors in identifying the relevance of possible One Health entry points for participation, i.e. it will not only contribute but will also develop a system convergence model for the effectual prevention and control of zoonotic diseases.

Foodborne disease (food poisoning) tends to be regarded as a comedy illness—not pleasant to have, or talk about, but little more than an inconvenience. Yet trivialising foodborne disease ignores the...

Traffic safety and public health in China – Past knowledge, current status, and future directions

Zoonoses are a significant public health concern and cause considerable socioeconomic problems globally. The emergence of severe acute respiratory syndrome (SARS), highly pathogenic avian influenza (HPAI), and Ebola virus disease (EVD) has had a significant effect on the national economy and public health in China, and other countries. This review analyzed zoonotic disease issues faced by China, and the main factors contributing to the risk of zoonotic disease. The Chinese government has devised new strategies and has taken measures to deal with the challenges of these diseases, and the prevention and control of zoonoses at their source. A strategy that is suited to China's national conditions, is proposed.

The 2021 China report of the Lancet Countdown on health and climate change: seizing the window of opportunity

The agricultural value chain concept refers to the interaction between multiple manufacturing stages involved in the production process of a specific nourishment. The earned value of the final product is generated due to the operational or transactional costs through agro-food linear diagram and there is a livestock commodities dynamics pattern to meet expectations of consumers.1 This productive scheme takes and enforces many of the principles of quality management and incorporates them into the livestock production system. Accordingly, this approach aimed to guarantee the suitability of the final product is classified in primary chains involving the initial stages of production from breeding, nursing, weaning and growth of animals in livestock farms to the slaughter process. Secondary chains include all the subsequent stages of the primary chain, where the animal by-product is transformed, pitted, chopped, processed, stored, transported and retailed to the final consumer.2 The agreement on sanitary and phytosanitary measures (SPS agreement) of the world trade organization (WTO) recognizes the World Organization for Animal Health (OIE) standards as the reference codes for control and prevention of trans-boundary animal diseases and zoonoses, including food-borne zoonoses.3 Under the approach ''from farm to fork'' the OIE promotes harmonization of sanitary regulations for trade of animals and their products as well as the management of sanitary risks where veterinary professionals play a pivotal role. Thus, throughout the productive and value chain puzzle, veterinarians play key role in: 1) the application of risk analysis procedures,4 2) quickly and efficiently detecting diseases listed by the OIE, including those that lead to a significant risk in terms of food safety and public health; and 3) international trade of livestock inputs, as veterinary certification is a crucial requirement to export animal products. Thereby, there is a mutualistic and synergistic partnership between the agri-food production chain structure and public health veterinarian, where the functionality and competitiveness of the agricultural value chain structure to access the global markets, is a primary responsibility of veterinarians. Whereas, the interaction and partnership of each stake-holder across the horizontal chain structure ensures the integration, strengthened and correct implementation of public health policies at public and private level carried out by the veterinary services. For example, by evaluating the microbiological risks and estimating the appropriate level of protection (ALOP), food safety objectives (FSO) and performance objectives (PO); or enforcing and developing traceability programs for livestock or animal by-products.5 Moreover, agro-terrorism and bioterrorism prevention, changes in socio-demographic trends in developing countries, dietary and agricultural exporter patterns promoted by globalization of livestock markets, will evolve with a consistent and progressive parallelism towards more robust and strong food security surveillance schemes.6 Likewise, one of the most significant impacts of globalization is the need to upgrade veterinary services to promote and protect human and animal health and adjust local nourishment production to international trade models under the SPS Agreement standards. Therefore, agricultural value chains constitute an alternative to enhance the utilization of resources, afford compliance with environmental protocols, improve sanitary management of trans-boundary animal diseases and food-borne zoonoses, increase access to global markets, strengthen rural development paths, and establish an integral framework for the exchange of tools to reduce poverty, food insecurity and social inequality. In this scenario, veterinary professionals serve as catalysts to bolster rural economies by enabling the development of a sustainable livestock activity and guarantee food hygiene.7 Hence, it is essential to strengthen both academic and professional training programs at undergraduate and postgraduate level of veterinary public health and food safety programs,8 where particular importance should be granted to manufacturing and value chain structures, as holistic and trans-disciplinary systems that contribute in a practical and tangible way to safeguard and improve the competitiveness of our local agri-food markets.

SummaryZoonoses are diseases that are transmitted naturally between animals and humans. The control of food-borne zoonoses within the European Union is a prerequisite for assuring a functional internal market and consequently represents an important item on the political agenda. Unfortunately, until recently, gaining a clear view of the current incidence of food-borne zoonoses and the prevalence of its causative agents has been frustrated by the absence of reliable monitoring and reporting systems. Similarly, it has become clear that, Europe wide, one has witnessed only limited success with regard to the control of important food-borne agents such as Salmonella spp. The European Union has adopted legislation to remedy this situation and to control food-borne zoonoses in primary production. This contribution discusses the incentives for introducing EU Directive 2003/99/EC and EU Regulation No. 2160/2003, summarises their essentials and discusses major ramifications of both pieces of legislation for the prevention of food-borne zoonoses. It is concluded that there is reason for cautious optimism concerning human salmonellosis, while for other food-borne zoonoses there should be a call for action.

A qualitative survey was conducted to assess the awareness on food borne zoonoses and its relation with veterinary public health services in Addis Ababa and its surrounding districts. Structured questionnaire was used in the study. Factors like educational level, information source, and profession, were considered for possible explanation of the results. The most frequently known zoonotic diseases were rabies (100%), followed by anthrax (94.27%), teniasis (89.06%), tuberculosis (88.54%), brucellosis (49.48%), and mentioned others (31.25%). The importance of veterinary public health in the overall public health institutions was assessed by looking at the responses to questions and it is shown that the public health institutions do not yet see the need of having veterinarians in the public health. In conclusion, this study demonstrated that the awareness and use of inspected and packed animal products is relatively low, which exposes the people to risk of food borne pathogens. The authors would like to recommend to the government and concerned bodies to raise the awareness of the public, using the appropriate communication media, and to strengthen the contribution of public health veterinarians in the public health services for better community health. Key words: Awareness, veterinarian, food borne zoonoses.

Ensuring healthy lives and promoting well-being are paramount among the priorities outlined in the 17 Sustainable Development Goals (SDGs) established by the United Nations. In China, rural revitalization stands as a pivotal national strategy aimed at fostering prosperity and sustainable development in rural areas. Despite its comprehensive evaluation system, which encompasses industry, ecology, culture, organization, and livelihood, the current index system overlooks the critical dimension of public health in rural areas. The existing body of literature predominantly focuses on the correlation between income and health, leaving a gap in understanding the relationship between income inequality and health from the perspective of villagers. This study addresses this gap by utilizing data from 3,771 villager samples and 302 village samples obtained from the 2019 China Rural Revitalization Survey (CRRS) to explore the correlation between income inequality and public health in China's rural areas. We employ the Ordered Logistic Regression (Ologit) model in the baseline regression and heterogeneity analysis. Additionally, a mediating effect analysis, using the Sobel test, examines the role of villagers' health awareness as a mediating variable in the correlation between income inequality and villagers' health. The empirical findings of this study unveil a statistically significant adverse influence of income inequality on public health in China's rural areas. Furthermore, the research identifies that participation in regular exercise and the attainment of higher education levels serve as effective measures to alleviate the detrimental impact of income inequality on the health of rural residents. Additionally, income inequality is observed to shape villagers' health awareness, thereby influencing their overall health status. The study's outcomes have significant implications for policymakers and governmental authorities, providing valuable insights into some pathways for enhancing public health in rural China. Ultimately, these insights contribute to the broader objective of achieving integrated sustainability in rural China.

Background: Zoonotic diseases pose a significant public health challenge globally, with developing countries like Pakistan facing heightened risks due to various factors such as climate change, environmental degradation, and socio-economic disparities. These diseases, transmitted between animals and humans, have profound implications for healthcare systems, food safety, and public health policies. Objective: This study aims to identify the key risk factors associated with the prevalence of zoonotic diseases in Pakistan and evaluate the effectiveness of the 'One Health' approach in addressing these multifaceted challenges. Methods: A comprehensive review of existing literature was conducted, focusing on zoonotic disease outbreaks in Pakistan, their associated risk factors, and the impact of integrated health strategies. Data from government reports, peer-reviewed articles, and international health organization databases were analyzed to assess the current state of zoonotic diseases in Pakistan. Results: The findings indicate that climate change, environmental issues, lack of public awareness, and socio-economic inequities are the primary drivers of zoonotic disease transmission in Pakistan. Despite some progress in disease surveillance and public health education, gaps in food and water safety practices, vector control, and environmental management persist. The 'One Health' approach has shown potential in improving cross-sectoral collaboration and enhancing disease prevention measures, yet its implementation remains inconsistent. Conclusion: Effective management of zoonotic diseases in Pakistan requires a concerted effort that encompasses improved surveillance, enhanced public awareness, and robust environmental and food safety policies. The 'One Health' approach emerges as a critical framework for fostering collaboration across human, animal, and environmental health sectors to mitigate the risks and impacts of zoonotic diseases. Keywords: Zoonotic Diseases, One Health Approach, Public Health, Pakistan, Climate Change, Environmental Health, Disease Surveillance, Food Safety, Vector Control, Socio-economic Factors.

A survey qualitative survey was conducted to assess the awareness on food borne zoonosis and its relation with Veterinary Public Health Services in Addis Ababa and its surrounding districts from November 2008 to May 2009. Structured questionnaire was used in the study. Questionnaires were distributed to 384 individuals, of which 196 were elementary and high school students, and 196 were Graduates. Factors like education level, information source and profession were considered for possible explanation of the results. The use of inspected animal products is found statistically different (P<0.05) among health and non health professionals while no difference is seen between students and graduates. The majority (85.42%) of the students get their information from other information sources like their families in the form of advice and 67.71% of health professionals get their information from their medical schools. The most frequently mentioned zoonotic diseases were Rabies 384(100 %), followed by Anthrax 362(94.27%), Teniasis 342 (89.06%), Tuberculosis 340 (88.54%) and Brucellosis 190(49.48%) and 120(31.25%) mentioned other infectious diseases of zoonotic importance. The importance of veterinary public health in the overall public health institutions was assessed by looking at the responses to questions and shown that yet the public health institutions don’t see the need of having veterinarians in the public health. In conclusion this study demonstrated that the awareness and use of inspected and packed animal products is relatively low that expose the people to risk of food borne pathogens and the awareness of health institutes on the importance of veterinary public health service is relatively low. The authors would like to recommend to the government and concerned bodies to raise the awareness of the public using the appropriate communication media, and to strengthen the contribution of public health veterinarians in the public health services for better community health.

Global Health Security Implementation: Expanding the Evidence Base.

Katherine A. Mason, Infectious Change: Reinventing Chinese Public Health After an Epidemic. Stanford: Stanford University Press, 2016. 272 pp.Severe acute respiratory syndrome (SARS) first appeared in late 2002 in southern China. Symptoms of infection with the novel coronavirus include high fever, body aches, and a dry, nonproductive cough. A proportion of cases require intensive care services, including mechanical ventilation. Fatalities not uncommon. Following cases reported in Guangdong Province and Hong Kong during February-March 2003, more cases emerged in Beijing and farther afield, with infected travelers seeding hotspots in global centers such as Toronto, Singapore, and Hanoi. By the end of July 2003, more than 8,000 suspected and confirmed cases of were identified in 29 countries, resulting in 774 deaths.In Infectious Change, Katherine A. Mason provides a captivating analysis of public health in China in the wake of SARS. Mason's research is situated at the regional epicenter of the pandemic, in the city of Tianmai (pseudonym), nestled on the border with Hong Kong. Once a conglomeration of quiet fishing villages, Tianmai rapidly developed through statesponsored economic liberalization initiated in the early 1980s. Now a thriving megapolis, Mason takes Tianmai as representative of China's future: busy, mobile, and cosmopolitan (32). Working from the Tianmai Center for Disease Control and Prevention (CDC), Mason is ideally placed to research the reinvention of public health in China after SARS, and her work is further informed by public health experts in Guangzhou, Hong Kong, and Beijing.Mason locates her analysis of public health in China after within the intersection between the literature on governance, science studies, public health ethics, and the global. Broadly, she examines the tension between service and governance during an era of scientization and global health. This tension exposes new problematics in the lives, work, and aspirations of public health professionals, as they seek to serve commons locally and afar. Mason's work also offers an important underrepresented vantage to understand global health, one that is neither from the perspective of the drivers of global health nor from the recipients of global health assistance. Mason's Chinese informants are non-Western, but they aspire in some ways to be included in the Western world (28). She argues that local public health professionals' efforts to serve and govern must be understood within both local and global webs of engagement. Her work follows as a skillful navigation of disparate fields of engagement, local and non-local, which in combination provides a comprehensive, grounded analysis of public health practices in China.Mason begins by laying down the historical and contextual foundation from which to understand what is meant by a reinventing of Chinese public health. Soon after the founding of the People's Republic in 1949, China implemented a public health system drawing on Soviet expertise. The public health system focused on improving hygiene and sanitation, with the aim of eliminating the primary causes of morbidity and mortality. Since the market reforms initiated in the late 1970s and 1980s, the public health system, like many other public services, was dismantled. Funding was dramatically reduced, health insurance coverage levels plummeted, and marketization painted a new healthcare landscape. By the turn of the century, Chinese officials sought to reincarnate public health as a modern, science-driven system, fashioned after the US CDC. The emergence of dovetailed with reforms already underway, and as Mason aptly points out, SARS and the [Chinese] CDC system were 'co-produced' (13), as SARS ultimately functioned...to provide not so much a threat or a push but an opportunity (33).Mason's work captures the tensions, aspirations, and possibilities engendered by this critical turning point. …

Brucellosis, rabies, salmonellosis, anthrax and hydatidosis are among the main zoonotic diseases which constitute a threat to human health and welfare. Surveillance, prevention and control of such zoonoses and related food-borne diseases are problems of considerable magnitude. Despite their obvious importance, relatively few systematic control efforts have been made by national authorities. Major constraints include the scarcity of public health veterinarians and related sub-professional staff to plan and implement adequate surveillance and control of zoonoses, and the lack of appropriate legislation and adequate laboratory services. Veterinarians have been contributing to public health for many years, but despite considerable efforts by the World Health Organisation (WHO), the Food and Agriculture Organisation of the United Nations (FAO) and other organisations in establishing veterinary public health (VPH) programmes over several decades, the veterinarian as a career specialist in public health is a relatively new phenomenon. In the last decade, emphasis has been placed on: --supporting the training and development of human resources to promote VPH services and cover all its components --promoting and upgrading national epidemiological surveillance and control programmes for the major zoonotic and food-borne diseases --cooperating and assisting in local production of safe and effective vaccines, primarily for the control of rabies and brucellosis. The most encouraging aspects of the present situation is the growing awareness among governments of the need to develop programmes for the control of zoonoses and related food-borne diseases.

Contrary to what most alarmist reports would imply, China has not witnessed a measurable decline in the overall public health status. What explains the continuous improvement in some important domains of public health despite the pertinacious pricing, financing and institutional‐behavioral problems in China's health system change? This study provides a political economy analysis of the role the local Chinese state played in rural public health provision during the reform era. Through comparative case studies, statistical analysis, and formal modeling, the study shows that state capacity is a principal factor setting the parameters for rural public health in China. It also suggests that the post‐Mao reforms, while generating strong disincentives for the provision of public services, unleashed forces that lay down the institutional bases for sustained state engagement in the health sector.