Emerging Disease Threats Research Articles

From information to intervention: connecting risk communication to individual health behavior and community-level health interventions during the 2016 Zika outbreak

Emerging disease threats are on the rise. Risk communication in an emerging threat is used by public health officials to reach the population in a timely and effective manner. However, limited research has drawn on data gathered during an emerging threat to understand how risk communication shapes intervention perceptions. This analysis examines the relationship between risk communication, especially where information comes from, and receptivity to individual-level and community-level health interventions in an emerging threat using evidence from the 2016 rise of Zika. Data comes from a repeat cross-sectional survey conducted three times in 2016, representative of the United States population. Drawing on leading theories of risk communication, a structural model (SEM) is used to measure the relationships of interest. Two distinct SEMs are used to compare and contrast the relationship between source of information and individual health behavior change and community-level health interventions while also exploring the role of knowledge, perceived risk, and demographics. Results of both direct and indirect SEM pathways show different sources of information may be more effective in promoting particular interventions. Promoting community-level interventions can be accomplished through dissemination of information in print news to increase knowledge and ultimately receptivity. However, there is a far more complex relationship between risk communication and personal intervention receptivity. With a more nuanced understanding of the way information from a particular source effects intervention receptivity, communicators can reach the public more effectively to limit the consequences of an emerging public health threat.

Distribution of Haemaphysalis longicornis and associated pathogens: analysis of pooled data from a China field survey and global published data

Haemaphysalis longicornis, a vector of various pathogens with medical and veterinary importance, is native to eastern Asia, and recently reached the USA as an emerging disease threat. In this study, we aimed to identify the geographical distribution, hosts, and associated pathogens of H longicornis. Data were collected from multiple sources, including a field survey, reference book, literature review, and related websites. The thematic maps showing geographical distribution of H longicornis and associated pathogens were produced by ArcGIS. Hosts of H longicornis and positive rates for H longicornis-associated pathogens were estimated by meta-analysis. Ecological niche modelling was used to predict potential global distribution of H longicornis. H longicornis was found to be present in ten countries, predominantly in eastern Asia, the USA, Australia, and New Zealand. The tick was known to feed on a variety of domestic and wild animals, and humans. At least 30 human pathogens were associated with H longicornis, including seven species of spotted fever group rickettsiae, seven species in the family of Anaplasmataceae, four genospecies in the complex Borrelia burgdorferi sensu lato, two Babesia species, six species of virus, and Francisella, Bartonella, Coxiella, and Toxoplasma, which were mainly reported in eastern Asia. The predictive modelling revealed that H longicornis might affect more extensive regions, including Europe, South America, and Africa, where the tick has never been recorded before. H longicornis is relatively common in the world, and is associated with various human and animal pathogens. Authorities and health-care workers should be aware of the threat of the tick species to public health and veterinary medicine. Surveillance and further investigations should be enhanced globally. National Natural Science Foundation of China and National Key Research and Development Program of China.

First Isolation of a Novel Aquatic Flavivirus from Chinook Salmon (Oncorhynchus tshawytscha) and Its In Vivo Replication in a Piscine Animal Model.

The first isolation of a flavivirus from fish was made from moribund Chinook salmon (Oncorhynchus tshawytscha) from the Eel River, California, USA. Following the observation of cytopathic effect in a striped-snakehead fish cell line, 35-nm virions with flaviviral morphology were visualized using electron microcopy. Next-generation sequencing and rapid amplification of cDNA ends obtained the complete genome. Reverse transcriptase quantitative PCR (RT-qPCR) confirmed the presence of viral RNA in formalin-fixed tissues from the wild salmon. For the first time, in vivo replication of an aquatic flavivirus was demonstrated following intracoelomic injection in a Chinook salmon model of infection. RT-qPCR demonstrated viral replication in salmon brains up to 15 days postinjection. Infectious virus was then reisolated in culture, fulfilling Rivers' postulates. Only limited replication occurred in the kidneys of Chinook salmon or in tissues of rainbow trout (Oncorhynchus mykiss). The proposed salmon flavivirus (SFV) has a 10.3-kb genome that encodes a rare dual open reading frame, a feature uncharacteristic of classical flaviviruses. Phylogenetic analysis places SFV in a basal position among a new subgroup of recently recognized aquatic and bat flaviviruses distinct from the established mosquito-borne, tick-borne, insect-only, and unknown-vector flavivirus groups. While the pathogenic potential of the virus remains to be fully elucidated, its basal phylogeny and the in vivo infection model will allow SFV to serve as a prototype for aquatic flaviviruses. Ongoing field and laboratory studies will facilitate better understanding of the potential impacts of SFV infection on ecologically and economically important salmonid species.IMPORTANCE Chinook salmon are a keystone fish species of great ecological and commercial significance in their native northern Pacific range and in regions to which they have been introduced. Threats to salmon populations include habitat degradation, climate change, and infectious agents, including viruses. While the first isolation of a flavivirus from wild migrating salmon may indicate an emerging disease threat, characterization of the genome provides insights into the ecology and long evolutionary history of this important group of viruses affecting humans and other animals and into an expanding group of recently discovered aquatic flaviviruses.

A Veterinary Vaccine Development Process Map to assist in the development of new vaccines

The UK Government recognised the importance of vaccines in the control of new emerging disease threats and in 2015 established the UK Vaccine Network to focus on specific areas of need. One of these was the understanding of what is involved in the development of a new vaccine and what are the potential bottlenecks to a rapid response in the face of an epidemic such as Ebola, MERS and more recently COVID-19. A Working Group was established to initially produce a Vaccine Development Process Map for a Human Vaccine. However, in view of the importance of animal wellbeing and the significant impact of diseases with Zoonotic potential, a similar Map has been created outlining the Veterinary Vaccine Development Process. This paper describes the production of that Map and covers the process from the generation of a Target Product Profile (TPP) through Discovery and Feasibility, and on to Product Development and Registration.

Ethical Decision-Making in Zoonotic Disease Control

To tackle zoonotic disease threats, a One Health approach is currently commonplace and generally understood as an integrated effort of multiple disciplines to promote the health of humans, animals and the environment. To implement One Health strategies in zoonotic disease control, many countries set up early warning systems, in which human and veterinary health professionals cooperate. These systems, like the Dutch Zoonoses Structure, can be successful to detect emerging disease threats. However, these systems are not well equipped to handle moral dilemmas that can arise in zoonotic disease control, like the culling of healthy animals. This research studies the role of normative presuppositions of professionals involved in zoonotic disease control policies in the Netherlands. We found that these professionals in general adhered to a holistic view of the One Health concept, however, in practice an anthropocentric approach was dominant. Public health was identified as the trumping moral value, which reveals an inherent field of tension with the core of One Health thinking. The lack of ethical expertise in control systems for zoonotic diseases can lead to misconception of ethical principles, like the precautionary principle which is frequently evoked to justify disease control measures.

Distribution of <i>Haemaphysalis longicornis</i> and Its Infected Agents: A Pooled Analysis of China Field Survey and Global Published Data

Background: Haemaphysalis longicornis, a vector of various diseases with medical and veterinary importance, is native to eastern Asia, and recently invaded the United States as an emerging disease threat. Methods: We collected multi-source data from field survey, reference book, literature search and related websites. Geographic distribution of H. longicornis and its infected agents was mapped by geographical information system techniques. Hosts of H. longicornis and infection rates of H. longicornis-borne agents were estimated by meta-analysis. Ecological niche model was used to predict potential distribution of H. longicornis around the world. Findings: H. longicornis was broadly distributed in ten countries, predominantly in eastern Asia, the United States, and countries in the southwest Pacific Ocean. The tick was known to feed on a variety of domestic and wild animals. Nearly 60 agents, including spotted fever group rickettsiae, Anaplasmataceae family, Borrelia burgdorferi sensu lato, Babesia, Theileria, Francisella, Bartonella, Coxiella, Hepatozoon, Toxoplasma, and viruses were detected in H. longicornis, over half of which were pathogenic to humans. H. longicornis-borne agents were mainly reported in eastern Asia. The predictive modeling revealed that H. longicornis might infest more extensive regions, unexpectedly in Europe, South America, and Africa. Interpretation: H. longicornis is widely distributed in the world, and infected with various pathogens. Authorities and health care workers should be aware of the threat of the tick species to public health and veterinary medicine. Expanding surveillance and further investigations should be enhanced. Funding Statement: This study was supported by the Natural Science Foundation of China (81621005) and National Key Research and Development Program of China (2019YFC1200505). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Not required.

Establishing National Multisectoral Coordination and collaboration mechanisms to prevent, detect, and respond to public health threats in Guinea, Liberia, and Sierra Leone 2016\u20132018

BackgroundThe governments of Guinea, Liberia, and Sierra Leone have acknowledged that weak health systems and poor coordination of efforts hampered effectiveness of the 2014–2016 Ebola outbreak response. The bitter experience of the Ebola outbreak response served as an important catalyst for increased efforts to comply with World Health Organization (WHO) International Health Regulations (IHR 2005), Performance of Veterinary Services (PVS) Pathway capacities, and Global Health Security Agenda (GHSA) goals. In November 2016, an interministerial meeting held in Dakar, Senegal, resulted in formalized commitments from the three nations to strengthen resilience to health threats by establishing a Regional Strategic Roadmap to institutionalize the One Health approach. Since then, each country has made significant progress towards establishing National One Health Platforms to coordinate health security interventions, in collaboration with international partners. This paper outlines the methodology and results of these efforts for the period June 2016–January 2019, with a specific focus on activities supported by the US Agency for International Development (USAID)-funded Preparedness & Response (P&R) project.ObjectivesIn support of the West African Health Organization’s November 2016 Regional Strategic Roadmap for institutionalization of the One Health approach, the Preparedness & Response (P&R) project worked in coordination with national partners in Guinea, Liberia, and Sierra Leone to establish multisectoral, One Health coordinating mechanisms.MethodologyThe global USAID-funded P&R project was launched in 2014 to support the achievement of this objective, and began coordinating with partners in Guinea, Liberia, and Sierra Leone in 2016 to tailor its multi-step conceptual framework to fit the priorities and operating constraints of national stakeholders. Organized in phases of Collaboration (building key relationships), Formalization (defining and establishing a coordination structure), and Implementation (using newfound coordination to produce better health security outcomes), the framework features steps such as One Health sensitizations for multisectoral national stakeholders, development of One Health platform terms of reference and other operating guidelines, and application of these tools to coordination of technical assistance during outbreaks.ResultsIn Guinea, Liberia, and Sierra Leone, in less than 3 yrs there has been a marked improvement in cross-sectoral coordination on health security actions. All three countries have passed legislation establishing permanent multisectoral coordination mechanisms referred to in this document as National One Health Platforms, or simply Platforms; instituted an annual mechanism for assessing capacity and performance of these platforms to lead health security actions; and have undertaken key steps towards developing and updating National Preparedness & Response Plans which truly reflect the multisectoral nature of emerging disease threats. However, multisectoral coordination is a work in progress: government stakeholders and their international partners continue to work together to further strengthen national ownership and investment in the newly established Platforms.Conclusion and next stepsNewly established Platforms in Guinea, Liberia, and Sierra Leone offer a long-term structure for coordinating health security actions. However, given the short period of time since their formalization, they depend on continued national, regional, and international resources to build from recent progress and further improve capacity and performance. Regional programs such as the World Bank Regional Disease Surveillance Systems Enhancement (REDISSE) project are of critical importance in keeping the momentum going. The highlighted progress and outputs to date provide reasons and motivation for continued, longer-term investment in the Platforms.

A mathematical model of the transmission of middle East respiratory syndrome coronavirus in dromedary camels (Camelus dromedarius)

Purpose: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) remains an emerging disease threat, with regular reports of human cases on the Arabian Peninsula, driven by recurring camel-to-human transmission events. A prophylactic vaccine under development has been found to greatly reduce shedding in dromedaries, but there are major gaps in our quantitative understanding of the epidemiology of MERS-CoV in dromedary populations. The purpose of our work is to develop a mathematical model of MERS-CoV transmission in camels in order to address these gaps and to eventually inform the development of evidence-based animal vaccination strategies.

Identification of T-cell epitopes in African swine fever virus CD2v and C-type lectin proteins.

African swine fever (ASF) is an emerging disease threat for the swine industry worldwide. No ASF vaccine is available, and progress is hindered by lack of knowledge concerning the extent of ASF virus (ASFV) strain diversity and the viral antigens conferring type-specific protective immunity in pigs. Previously, we demonstrated that ASFV serotype-specific proteins CD2v (EP402R) and/or C-type lectin (EP153R) are important for protection against homologous ASF infection. Here, we identified six discrete T-cell epitope regions present on CD2v and C-type lectin using IFN-γ ELISpot assay and PBMCs from ASF immune animals, indicating cellular reactivity to these proteins in the context of ASFV infection and protective immunity. Notably, three of the epitope regions map to previously described serotype-specific signature regions of these proteins. Improved understanding of ASFV protective antigens, relevant epitopes and their diversity in nature will facilitate ASFV subunit vaccine design and development.

Local Preparedness for Infectious Disease Outbreaks: A Qualitative Exploration of Willingness and Ability to Respond.

As ecologic, social, and economic conditions continue to facilitate the emergence and transmission of infectious diseases, local health department workers' willingness to respond will remain vital to the United States' ability to recognize and respond to new and emerging disease threats. As demonstrated by heavy occupational morbidity and mortality associated with the 2014 Ebola outbreak, infectious disease response can pose serious risks to the health workforce and presents many ethical and logistical challenges. To explore willingness to respond to an infectious disease outbreak among local health departments-the hub of the public health emergency preparedness system-we conducted focus groups with 46 local health department staff attending 2 national conferences. We examined perspectives from our participants on how local health department employees learn about and articulate their professional commitment to the department, the ways in which local health department leaders support local health department employees in responding to an outbreak, and how local health department staff articulate their responsibilities to their families. We conclude with a proposal for how a web of ethical commitments likely influences willingness to respond. These commitments and their relationship to willingness to respond should be explored further.

Variations in Healthcare Provider Use of Public Health and Other Information Sources by Provider Type and Practice Setting During New York City's Response to the Emerging Threat of Zika Virus Disease, 2016.

The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) used multiple methods to provide guidance to healthcare providers on the management and prevention of Zika virus disease during 2016. To better understand providers' use of information sources related to emerging disease threats, this article describes reported use of information sources by NYC providers to stay informed about Zika, and patterns observed by provider type and practice setting. We sent an electronic survey to all email addresses in the Provider Data Warehouse, a system used to maintain information from state and local health department sources on all prescribing healthcare providers in NYC. The survey asked providers about their use of information sources, including specific information products offered by the NYC DOHMH, to stay informed about Zika during 2016. Trends by provider type and practice setting were described using summary statistics. The survey was sent to 44,455 unique email addresses; nearly 20% (8,711) of the emails were undeliverable. Ultimately, 1,447 (5.8%) eligible providers completed the survey. Most respondents (79%) were physicians. Overall, the most frequently reported source of information from the NYC DOHMH was the NYC Health Alert Network (73%). Providers in private practice reported that they did not use any NYC DOHMH source of information about Zika more frequently than did those working in hospital settings (29% vs 23%); similarly, private practitioners reported that they did not use any other source of information about Zika more frequently than did those working in hospital settings (16% vs 8%). Maintaining timely and accurate databases of healthcare provider contact information is a challenge for local public health agencies. Effective strategies are needed to identify and engage independently practicing healthcare providers to improve communications with all healthcare providers during public health emergencies.

Infectious disease in fish: global risk of viral hemorrhagic septicemia virus

As the global human population continues to increase and become more industrialized, the need for safe, secure, and sustainable protein production is critical. One sector of particular importance is seafood production, where capture fishery and aquaculture industries provide 15–20% of the global protein supply. However, fish production can be severely affected by diseases. Notably, viral hemorrhagic septicemia, caused by the viral hemorrhagic septicemia virus (VHSv; Rhabdoviridae), may be one of the most devastating viral diseases of fishes worldwide. We explored the ecology and epidemiology of VHSv using an ecological niche modeling approach to identify vulnerable disease-free regions. Results showed an impressive ecological plasticity of VHSv. The virus was found in > 140 fish species in marine and freshwater ecosystems, with high diversity of lineages in Eurasia. Sub-genotypes from marine and fresh waters were ecologically similar, suggesting broad ecological niches, rather than rapid evolutive adaptation to novel environments. Ecological niche models predicted that VHSv may have favorable physical (e.g., temperature, runoff), chemical (e.g., salinity, pH, phosphate), and biotic (i.e., chlorophyll) conditions for establishing into areas with important fish industries that, so far, are believed to be disease-free (i.e., freshwater and marine ecosystems of Africa, Latin America, Australia, and inland China). The model and our review suggest fish species from the Perciformes, Salmoniformes, and Gadiformes orders are likely to be infected with VHSv in novel regions as the virus expands its range to areas predicted to be at risk. In conclusion, VHSv remains an emerging disease threat to global food security and aquatic biodiversity.

The impact of global environmental change on vector-borne disease risk: a modelling study

BackgroundVector-borne diseases, such as dengue virus, Zika virus, and malaria, are highly sensitive to environmental changes, including variations in climate and land-surface characteristics. The emergence and spread of vector-borne diseases is also exacerbated by anthropogenic activities, such as deforestation, mining, urbanisation, and human mobility, which alter the natural habitats of vectors and increase vector–host interactions. Innovative epidemiological modelling tools can help to understand how environmental conditions interact with socioeconomic risk factors to predict the risk of disease transmission. In recent years, climate-health modelling has benefited from computational advances in fitting complex mathematical models; increasing availability of environmental, socioeconomic, and disease surveillance datasets; and improved ability to understand and model the climate system. Climate forecasts at seasonal time scales tend to improve in quality during El Niño-Southern Oscillation events in certain regions of the tropics. Thus, climate forecasts provide an opportunity to anticipate potential outbreaks of vector-borne diseases from several months to a year in advance. The aim of this study was to develop a framework to incorporate seasonal climate forecasts in predictive disease models to understand the future risk of vector-borne diseases, with a focus on dengue fever in Latin America. MethodsA Bayesian spatiotemporal model framework that quantifies the extent to which environmental and socioeconomic indicators can explain variations in disease risk was designed to disentangle the effects of climate from other risk factors using multi-source data and random effects, which account for unknown and unmeasured sources of spatial, seasonal, and inter-annual variation. The model was used to provide probabilistic predictions of monthly dengue incidence and the probability of exceeding outbreak thresholds, which were established in consultation with public health stakeholders. FindingsThis disease model framework, combined with seasonal climate forecasts, successfully produced real-time, probabilistic estimates of dengue outbreak risk ahead of a mass gathering in Brazil in June, 2014, for all 550 microregions. Additionally, the model predicted dengue outbreak risk after a major El Niño event in southern coastal Ecuador from January to November, 2016. Forecasts from the new model framework did better than those from benchmark models based on historical seasonal dengue averages. InterpretationThis flexible model framework can be adapted to predict any climate-sensitive disease at various spatiotemporal scales and in diverse ecological settings. Incorporating sub-seasonal and seasonal climate forecasts in disease prediction models could support public health decision makers in implementing timely disease-control and prevention strategies months in advance to mitigate the risk of imminent disease epidemics and emerging disease threats. FundingRoyal Society Dorothy Hodgkin Fellowship.

A qualitative inquiry on the status and adequacy of legal instruments establishing infectious disease surveillance in Nigeria.

IntroductionThe threat of devastating disease outbreaks is on the rise with several outbreaks recorded across the world in the last five years. The intractable Ebola Virus Disease outbreak in West Africa which spread to Nigeria was a reawakening point. This study aims to review the status and adequacy of the legal framework for disease surveillance in Nigeria. Methods: a mixed methods approach comprising of document reviews and key informant interviews was used in data collection.MethodsA mixed methods approach comprising of document reviews and key informant interviews was used in data collection.ResultsFourteen key informants from the federal ministry of health (FMOH) and six States were interviewed. Five legal instruments were identified and reviewed. The Quarantine Act of 1926 remains the active National Law on disease surveillance in Nigeria. An Integrated Disease Surveillance and Response Policy (IDSR) was developed in 2005 as the means for achieving the International Health Regulations (IHR). All six states claimed to have adopted the national IDSR policy though none could present a domesticated version of the policy. Key informants were concerned that Nigeria does not yet have an adequate legal framework for disease surveillance.ConclusionThe legal instruments establishing disease surveillance in Nigeria require strengthening and possibly enactment as a National Law in order to address emerging disease threats.

Polymers in the Delivery of siRNA for the Treatment of Virus Infections.

Viral diseases remain a major cause of death worldwide. Despite advances in vaccine and antiviral drug technology, each year over three million people die from a range of viral infections. Predominant viruses include human immunodeficiency virus, hepatitis viruses, and gastrointestinal and respiratory viruses. Now more than ever, robust, easily mobilised and cost-effective antiviral strategies are needed to combat both known and emerging disease threats. RNA interference and small interfering (si)RNAs were initially hailed as a “magic bullet”, due to their ability to inhibit the synthesis of any protein via the degradation of its complementary messenger RNA sequence. Of particular interest was the potential for attenuating viral mRNAs contributing to the pathogenesis of disease that were not able to be targeted by vaccines or antiviral drugs. However, it was soon discovered that delivery of active siRNA molecules to the infection site in vivo was considerably more difficult than anticipated, due to a number of physiological barriers in the body. This spurred a new wave of investigation into nucleic acid delivery vehicles which could facilitate safe, targeted and effective administration of the siRNA as therapy. Amongst these, cationic polymer delivery vehicles have emerged as a promising candidate as they are low-cost and easy to produce at an industrial scale, and bind to the siRNA by non-specific electrostatic interactions. These nanoparticles (NPs) can be functionally designed to target the infection site, improve uptake in infected cells, release the siRNA inside the endosome and facilitate delivery into the cell cytoplasm. They may also have the added benefit of acting as adjuvants. This chapter provides a background around problems associated with the translation of siRNA as antiviral treatments, reviews the progress made in nucleic acid therapeutics and discusses current methods and progress in overcoming these challenges. It also addresses the importance of combining physicochemical characterisation of the NPs with in vitro and in vivo data.

Working towards consensus: the need for coordinated policies to assist control of foot and mouth disease and emerging disease threats in South-East Asia.

Foot and mouth disease (FMD) is an important transboundary disease in South-East Asia. Its control has been a priority in the region for at least 20 years, with extensive institutional support and capacity-building being provided by the international community through the World Organisation for Animal Health. This paper describes the FMD control and eradication programme in the Mekong region (Myanmar, Thailand, the Lao People's Democratic Republic, Cambodia and Vietnam) of South-East Asia and evaluates the FMD control programme in one of the region's countries, namely Cambodia. Significant progress has been made, and the strategy for eradication is now both clearly understood and feasible in the Mekong. However, FMD control in this region requires more than just an effective vaccination strategy and regulatory support. Success will also depend on obtaining consensus and buy-in at all levels of the value chain, from input suppliers to consumers. Culturally and economically acceptable incentives must be in place to ensure that control measures are implemented, and those stakeholders who are expected to bear the risk and costs of control programmes must also be the main beneficiaries. The present institutional environment in the Mekong, and in particular in Cambodia, makes control and eradication of transboundary diseases difficult. Further work is required to ensure that control strategies are aligned with stakeholder needs and priorities, and actively improve smallholder welfare. Cattle producers and traders are crucial to the control of FMD in Cambodia. Economic incentives and education as well as regulation are required to ensure these stakeholders participate in this important transboundary disease eradication programme.

Mozambique field epidemiology and laboratory training program: a pathway for strengthening human resources in applied epidemiology.

IntroductionIn the last decades, Mozambique has been undergoing demographic, epidemiological, economic and social transitions, which have all had a notable impact on the National Health System. New challenges have emerged, causing a need to expand the preparation and response to emerging disease threats and public health emergencies.MethodsWe describe the structure and function of the Mozambique Field Epidemiology Training Program (MZ-FELTP) and the main outputs achieved during the first 6 years of program implementation (consisting of 3 cohorts). We also outline the contribution of the program to the National Health System and assess the retention of the graduates.ResultsThe MZ-FELTP is a post-graduate in-service training program, based on the acquisition of skills, within two tracks: applied epidemiology and laboratory management. The program was established in 2010, with the objective of strengthening capacity in applied epidemiology and laboratory management, so that events of public health importance can be detected and investigated in a timely and effective manner. The program is in its seventh year, having successfully trained 36 health professionals in the advanced course. During the first six years of the program, more than 40 outbreaks were investigated, 37 surveillance system evaluations were conducted and 39 descriptive data analyses were performed. Surveillance activities were implemented for mass events and emergency situations. In addition, more than 100 oral and poster presentations were given by trainees at national and international conferences.ConclusionThe MZ-FELTP has helped provide the Ministry of Health with the human and technical resources and operational capacity, to rapidly and effectively respond to major public health challenges in the country. The continuous involvement of key stakeholders is necessary for the continuation, expansion and ongoing sustainability of the program.

Evidence in Practice - A Pilot Study Leveraging Companion Animal and Equine Health Data from Primary Care Veterinary Clinics in New Zealand.

Veterinary practitioners have extensive knowledge of animal health from their day-to-day observations of clinical patients. There have been several recent initiatives to capture these data from electronic medical records for use in national surveillance systems and clinical research. In response, an approach to surveillance has been evolving that leverages existing computerized veterinary practice management systems to capture animal health data recorded by veterinarians. Work in the United Kingdom within the VetCompass program utilizes routinely recorded clinical data with the addition of further standardized fields. The current study describes a prototype system that was developed based on this approach. In a 4-week pilot study in New Zealand, clinical data on presentation reasons and diagnoses from a total of 344 patient consults were extracted from two veterinary clinics into a dedicated database and analyzed at the population level. New Zealand companion animal and equine veterinary practitioners were engaged to test the feasibility of this national practice-based health information and data system. Strategies to ensure continued engagement and submission of quality data by participating veterinarians were identified, as were important considerations for transitioning the pilot program to a sustainable large-scale and multi-species surveillance system that has the capacity to securely manage big data. The results further emphasized the need for a high degree of usability and smart interface design to make such a system work effectively in practice. The geospatial integration of data from multiple clinical practices into a common operating picture can be used to establish the baseline incidence of disease in New Zealand companion animal and equine populations, detect unusual trends that may indicate an emerging disease threat or welfare issue, improve the management of endemic and exotic infectious diseases, and support research activities. This pilot project is an important step toward developing a national surveillance system for companion animals and equines that moves beyond emerging infectious disease detection to provide important animal health information that can be used by a wide range of stakeholder groups, including participating veterinary practices.

One Health proof of concept: Bringing a transdisciplinary approach to surveillance for zoonotic viruses at the human-wild animal interface

As the world continues to react and respond inefficiently to emerging infectious diseases, such as Middle Eastern Respiratory Syndrome and the Ebola and Zika viruses, a growing transdisciplinary community has called for a more proactive and holistic approach to prevention and preparedness – One Health. Such an approach presents important opportunities to reduce the impact of disease emergence events and also to mitigate future emergence through improved cross-sectoral coordination. In an attempt to provide proof of concept of the utility of the One Health approach, the US Agency for International Development’s PREDICT project consortium designed and implemented a targeted, risk-based surveillance strategy based not on humans as sentinels of disease but on detecting viruses early, at their source, where intervention strategies can be implemented before there is opportunity for spillover and spread in people or food animals. Here, we share One Health approaches used by consortium members to illustrate the potential for successful One Health outcomes that can be achieved through collaborative, transdisciplinary partnerships. PREDICT’s collaboration with partners around the world on strengthening local capacity to detect hundreds of viruses in wild animals, coupled with a series of cutting-edge virological and analytical activities, have significantly improved our baseline knowledge on the zoonotic pool of viruses and the risk of exposure to people. Further testament to the success of the project’s One Health approach and the work of its team of dedicated One Health professionals are the resulting 90 peer-reviewed, scientific publications in under 5 years that improve our understanding of zoonoses and the factors influencing their emergence. The findings are assisting in global health improvements, including surveillance science, diagnostic technologies, understanding of viral evolution, and ecological driver identification. Through its One Health leadership and multi-disciplinary partnerships, PREDICT has forged new networks of professionals from the human, animal, and environmental health sectors to promote global health, improving our understanding of viral disease spillover from wildlife and implementing strategies for preventing and controlling emerging disease threats.

Challenges for African swine fever vaccine development—“… perhaps the end of the beginning.”

African swine fever (ASF), an acute, viral hemorrhagic disease in domestic swine with mortality rates approaching 100%, is arguably the most significant emerging disease threat for the swine industry worldwide. Devastating ASF outbreaks and continuing epidemic in the Caucasus region and Russia (2007–to date) highlight significance of this disease threat. There is no vaccine for ASF, thus leaving animal slaughter the only effective disease control option. It is clear, however, that vaccination is possible since protection against reinfection with the homologous strain of African swine fever virus (ASFV) has been clearly demonstrated. Vaccine development has been hindered by large gaps in knowledge concerning ASFV infection and immunity, the extent of ASFV strain variation in nature and the identification of viral proteins (protective antigens) responsible for inducing protective immune responses in the pig. This review focuses on the challenges surrounding ASF vaccine design and development, with an emphasis on existing knowledge gaps.