Abstract
The effect of newly emerging or re-emerging infectious diseases of zoonotic origin in human populations can be potentially catastrophic, and large-scale investigations of such diseases are highly challenging. The monitoring of emergence events is subject to ascertainment bias, whether at the level of species discovery, emerging disease events, or disease outbreaks in human populations. Disease surveillance is generally performed post hoc, driven by a response to recent events and by the availability of detection and identification technologies. Additionally, the inventory of pathogens that exist in mammalian and other reservoirs is incomplete, and identifying those with the potential to cause disease in humans is rarely possible in advance. A major step in understanding the burden and diversity of zoonotic infections, the local behavioral and demographic risks of infection, and the risk of emergence of these pathogens in human populations is to establish surveillance networks in populations that maintain regular contact with diverse animal populations, and to simultaneously characterize pathogen diversity in human and animal populations. Vietnam has been an epicenter of disease emergence over the last decade, and practices at the human/animal interface may facilitate the likelihood of spillover of zoonotic pathogens into humans. To tackle the scientific issues surrounding the origins and emergence of zoonotic infections in Vietnam, we have established The Vietnam Initiative on Zoonotic Infections (VIZIONS). This countrywide project, in which several international institutions collaborate with Vietnamese organizations, is combining clinical data, epidemiology, high-throughput sequencing, and social sciences to address relevant one-health questions. Here, we describe the primary aims of the project, the infrastructure established to address our scientific questions, and the current status of the project. Our principal objective is to develop an integrated approach to the surveillance of pathogens circulating in both human and animal populations and assess how frequently they are exchanged. This infrastructure will facilitate systematic investigations of pathogen ecology and evolution, enhance understanding of viral cross-species transmission events, and identify relevant risk factors and drivers of zoonotic disease emergence.
Highlights
The burden of infectious diseases in human populations in low- and middle-income countries remains high (Sepulveda and Murray 2014); in the majority of cases, disease etiologies are never determined (Kotloff et al 2012; Mulholland 2003; Susilawati and McBride 2014), often due to inadequate laboratory diagnostic capacity
While the third category accounts for the smallest number of infections, the impact of emerging pathogens, those with potential for human-tohuman transmission, may range from disruptive to catastrophic
60% of all human pathogen species are known to be zoonotic (Woolhouse and Gowtage-Sequeria 2005) and pathogens that infect multiple species are three times as likely to emerge into human populations than host-restricted pathogens (Taylor et al 2001)
Summary
The burden of infectious diseases in human populations in low- and middle-income countries remains high (Sepulveda and Murray 2014); in the majority of cases, disease etiologies are never determined (Kotloff et al 2012; Mulholland 2003; Susilawati and McBride 2014), often due to inadequate laboratory diagnostic capacity. Emerging pathogens in low- to middle-income countries are likely to originate from an animal source. Other pathogens display human-to-human transmission after spillover and may result in large epidemics (Drosten et al 2013; Gire et al 2014; Janies et al 2008). Some of these emerging pathogens may eventually adapt to circulate exclusively among humans, leading to epidemic or endemic transmission cycles (Holmes and Twiddy 2003; Taubenberger 2006). The frequency with which such zoonotic transmission events occur and the likelihood that a pathogen will adapt to exclusively human transmission are largely determined by behavioral and immunological factors in the host, along with ecological and evolutionary factors of the pathogen (Karesh et al 2012)
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