One health insights to prevent the next HxNy viral outbreak: learning from the epidemiology of H7N9

Zhe Zheng,Yi Lu,Kirsty R Short,Jiahai Lu

doi:10.1186/s12879-019-3752-6

Abstract

BackgroundWith an increased incidence of viral zoonoses, there is an impetus to strengthen collaborations between public health, agricultural and environmental departments. This interdisciplinary cooperation, also known as the ‘One Health’ approach, has received significant support from various stakeholders. However, current efforts and policies still fall short of those needed for an effective One Health approach towards disease control and prevention. The avian-origin H7N9 influenza A virus outbreak in China serves as an ideal case study to emphasise this point.DiscussionHere, we present the features and epidemiology of human infections with H7N9 influenza virus. At the early stages of the H7N9 epidemic, there was limited virus surveillance and limited prevention measures implemented in live poultry markets. As a result, zoonotic infections with H7N9 influenza viruses continued to enlarge in both numbers and geographic distribution. It was only after the number of human infections with H7N9 influenza virus spiked in the 5th wave of the epidemic that inter-departmental alliances were formed. This resulted in the rapid control of the number of human infections. We therefore further discuss the barriers that prevented the implementation of an effective One Health approach in China and what this means for other emerging, zoonotic viral diseases.SummaryEffective implementation of evidence-based disease management approaches in China will result in substantial health and economic gains. The continual threat of avian influenza, as well as other emerging zoonotic viral infections, emphasizes the need to remove the barriers that prevent the effective implementation of One Health policies in disease management.

Highlights

With an increased incidence of viral zoonoses, there is an impetus to strengthen collaborations between public health, agricultural and environmental departments
The continual threat of avian influenza, as well as other emerging zoonotic viral infections, emphasizes the need to remove the barriers that prevent the effective implementation of One Health policies in disease management
These events prompted the Chinese Ministry of Agriculture (MoA) to issue an emergency notice, asking to strengthen national H7N9 prevention and controls [8, 9]. This cross-disciplinary effort from numerous government department led to a rapid decline in the number of human H7N9 influenza virus infections and only 3 cases have been reported since July 2017 [1]

Summary

Discussion

Influenza H7N9 virology Influenza A virus H7N9 is a negative sense RNA virus with two key surface glycoproteins, the haemagglutinin (HA) and the neuraminidase (NA). After the HPAI virus H7N9 was identified and caused significant poultry morbidity and mortality, animal and public health authorities organized various conferences to bring together veterinary, epidemiology and virology experts These conferences helped establish strong inter-departmental collaborations to prevent and control the spread of H7N9 influenza viruses [42]. Diagnostic teams in the veterinary system should use highthroughput viral sequencing to continually monitor and analyze the diversity of DNA/RNA viruses at the human-animal interface These technologies will extend the scope of virus surveillance, identify potential emerging infectious diseases and improve early warning capabilities. Summary Since 2018, through the concerted efforts of the disease control department and the agricultural sector, the number of human cases of H7N9 avian influenza virus infection has fallen sharply This is a clear example of the importance of a One Health strategy in combating zoonosis.

Background

Findings

44. Association AVM