Browsing by Subject "One Health"

Diarrheal diseases continue to be one of the most significant killers of children throughout the world, and many diarrheal diseases are zoonotic in nature. In Malaysia, not much is known about the viruses causing disease in humans and animals, and there is little evidence describing the role noroviruses play in diarrheal disease in the state of Sarawak. This study aimed to estimate the prevalence of noroviruses in children admitted to Sibu Hospital with acute diarrhea and the prevalence of norovirus in swine environments in Sarawak. We collected stool samples from children admitted to the hospital for acute gastroenteritis and by convenience sampling from registered pig farms. Stool samples were tested for norovirus genogroups I and II/IV. At the time of sample collection, information was collected about prior animal exposure and medical history including previous hospitalization for diarrhea. Of the 70 participants enrolled in the study, 3 tested positive for norovirus G.II/IV. None of the swine stool samples tested positive for noroviruses. None of the animal exposure variables were statistically associated with increased odds of previous hospitalization for diarrhea, but prior cat exposure non-significantly increased the odds of previous hospitalization by 3.78 (95% CI 0.89, 16.11). Although norovirus is not highly prevalent in children in Sibu, Malaysia, diarrheal disease causes significant disease burden in the study population. Future work should aim to elucidate risk factors for severe diarrhea and to determine the prevalence of other disease-causing pathogens. This information will help clinicians better treat their patients and public health officials design programs to minimize the risk exposure to prevent diarrheal disease.

Introduction: Global pandemics are major contributors to human morbidity and mortality, economic downturn, and lost productivity. In extraordinary circumstances like the COVID-19 pandemic, we see a showcase of these staggering costs. It has been proposed that surveillance for zoonotic infectious diseases will be integral for limiting the next pandemic. In this pilot project, we employ a group of molecular assays to study bioaerosol samples for evidence of viruses that might pose a zoonotic threat.

Methods: Bioaerosol samples and swine farm characteristics were collected from eight farms in Northern Vietnam during the years of 2019 to 2021. We evaluated 256 specimens using conventional PCR/RT-PCR pan-species coronaviridae and paramyxoviridae molecular assays for evidence of viral presence. Amplicons that appeared to represent a targeted virus family were subsequently sent for sequencing and characterized.

Results: The farms surveyed had an average temperature of 26.3oC and relative humidity of 65.0%. Among the 256 bioaerosol samples studied, 2 showed molecular evidence for paramyxoviruses (0.78%) and none were positive for coronaviruses. Sequencing attempts of the positive samples confirmed evidence of paramyxovirus presence.

Conclusions: Compared to previous publications of viral presence on swine farms, the rates in our study were slightly lower than expected. This might suggest that the swine farms surveyed in this experiment had fewer circulating viruses than typically seen. Despite this, our work suggests that molecular studies of bioaerosol samples can be used to non-invasively screen for novel zoonotic pathogens within swine farm facilities.

Background: Despite long term control efforts, Malaria remains a significant health burden in Peru. The largest number of cases of both P. vivax and P. falciparum occur in the department of Loreto. Climatic variability has been found predictive of malaria incidence. Fish production is similarly affected by environmental variability, and fishers are a reservoir of malaria. Thus, by accounting for environmental variables, fish production may serve as a potential predictor of malaria incidence. Methods: Malaria incidence, weekly fish production and climatic information was drawn for the years 2014-2019 and organized by fishing port, one of four buffer levels and species of Plasmodium. Fish production and environmental variables were lagged as to be predictive of incidence of malaria. An UCM was used to model the relationship between weekly malaria incidence, fish collection, and hydrometeorological variables with a seasonality component. Results: This study found no conclusive evidence that fish production can serve as a predictor of malaria incidence for either P. vivax or P. falciparum. Although there are some trends in best fit lag, there is no clear best lag of fish production as a predictor malaria incidence based on these models. Conclusions: This study does not establish fish production as a predictor of malaria regardless of the relationship between occupational fish production migration and malaria risk. A call for further analysis would establish an improved measure of fish collection which accounts for person-time spent fishing.

Introduction: Pneumonia, despite its stereotype as a routine disease, remains the leading cause of morbidity and mortality among children under five worldwide, responsible for nearly 16% of all childhood deaths(1). With an imprecise definition and multiple etiologies, diagnosis and treatment of the disease is difficult when based solely on clinical and symptomatic manifestations(2). This study was conducted as a subset of an ongoing year-long study aimed to determine the viral etiology of and risk factors for pneumonia among 600 patients admitted to Sibu and Kapit Hospitals in Sarawak, Malaysia. Specifically, this sub-study examined molecular diagnostics for two common respiratory pathogens, which often infect children seen at these hospitals and which lacked any such diagnostic capability. We sought to determine the prevalence of respiratory syncytial virus (RSV) subtypes A and B and parainfluenza virus (PIV) types 1- 4. The study describes demographic, viral and behavioral risk factors for these admissions. Additionally, the study aimed to assess viral transmission in the air in hospital wards.

Methods: To determine the viral etiology of pneumonia cases, this cross-sectional study enrolled 129 patients over the age of one month, who had been diagnosed and hospitalized with pneumonia at Sibu or Kapit Hospital in Sarawak, Malaysia between June 15 and July 27, 2017. Nasopharyngeal (NP) swabs were collected and analyzed using real-time reverse transcription polymerase chain reaction (qRT-PCR) at Sibu Hospital’s Clinical Research Centre laboratory. A multivariable model was used to assess risk factors for the presence of different respiratory viruses.

Results: Of 129 specimens collected, 40 samples tested positive for RSV-A (31.01%), two were positive for RSV B (01.55%), one was positive for PIV-3 (0.78%) and one was positive for PIV-4 (0.78%). No samples were positive for PIV-1 or PIV-2. The prevalence of RSV-A was 46% (23/50) at Kapit Hospital and 21.52% at Sibu Hospital (17/79). In Sibu Hospital’s pediatric wards, one bioaerosol tested positive for adenovirus and two tested as suspect-positives for adenovirus. One (1) bioaerosol sample from an adult ward at Sibu Hospital tested as a suspect-positive for RSV-A. A multivariable analysis found risk factors of age (>1 year and 1-5 years vs > 5 years) and location of hospitalization (Kapit vs Sibu) potentially important predictors of RSV-A molecular detection.

Conclusions: During this brief demonstration study, we found a high prevalence of RSV-A among pneumonia patients admitted to the two hospitals. Having routine diagnostic capability for these viruses, particularly RSV, could help clinicians prescribe antiviral therapies which could reduce RSV morbidity and mortality.

Introduction: An estimated 75% of emerging infections in humans are zoonotic, posing a serious risk of future pandemics. The large livestock operations and dense human population of Southeast Asia are considered a hot-spot for the generation of novel viruses. The primary objective of this pilot study is to employ novel molecular laboratory analyses to examine evidence that swine pathogens including porcine circovirus 2, porcine rotaviruses, encephalomyocarditis virus, and porcine reproductive and respiratory syndrome virus, may be aerosolized at the animal-interface and that humans working in these environments may be carrying these viruses in their nasal airways.

Methods: This study took place in Sarawak, Malaysia among 11 pig farms, two slaughter houses, and three animal markets in June and July of 2017. Pig fecal, pig oral secretion, bioaerosol, and worker nasal wash samples were collected and analyzed via qRT-PCR for swine viruses. Workers were also surveyed for the nature of their occupational exposure with animals and their perceptions and use of personal protective equipment. Fisher’s Exact p-values and odds ratios were used to identify predictors of virus positivity.

Results: In all, 55 pig fecal, 49 pig oral or water, 21 bioaerosol, and 78 worker nasal wash samples were collected across 16 sites. Of these, 21 (38.2%) pig fecal, 43 (87.8%) pig oral or water, 3 (14.2%) bioaerosol, and 4 (5.1%) worker nasal wash samples were positive for PCV2 by qPCR. Porcine rotavirus C was detected in one (1.8%) pig fecal sample. No porcine rotavirus A or encephalomyocarditis virus was detected. The SYBR-based qRT-PCR assay used for PRRSv resulted in high levels of non-specific binding, omitting its inclusion in this write up. Statistically significant risk factors for PCV2 positivity among humans included having a household member with contact with pigs, farms with 1000 or more pigs, and a higher frequency of spotting rodents on the site. The personal protective equipment perceived as most effective at preventing cross-species infection and with the highest use were showering out of work and wearing dedicated boots. Among the equipment where use differed significantly from perception of efficacy were safety glasses, flu vaccination, showering out, and disposable boots.

Conclusions: Porcine circovirus has been posited as a zoonotic pathogen but limited studies have presented mixed results. Our data support the possibility of conducting a future prospective occupational study of pig workers for infection (not just nasal carriage) with this pathogen. Our data also shed light on contradictions between perception and use of personal protective equipment, stressing a need for education in farm biosecurity.

Anthropogenic effects on ecosystems have expanded in their scope and intensity, with significant consequences for global environmental, wildlife and human health. As human encroachment into wildlife habitat grows, habitat degradation and fragmentation intensify, leading to increased contact among wildlife, humans and domestic animals. Due to this increasing frequency of interaction, and the emergence of several high-profile diseases, global concern has grown over the risk of emerging infectious disease from zoonotic origins.

Due to Madagascar's rampant rate of human population growth and deforestation, its incredible species diversity, the widespread presence of domestic and invasive species, and its evolutionary isolation, it can be viewed as a high risk region for potential disease emergence. There is a need for assessment of the zoonotic and reverse zoonotic disease potential within this country.

To contribute to this assessment, consistent baseline health monitoring provides an effective tool for evaluating wildlife health and preparing for future disease occurrences. Limited, disconnected surveys of lemur health have occurred, yet there remained a need for more extensive, country-wide evaluations that also addresses invasive species, domestic animal and human health, as well shifting patterns of environmental and climatic change.

This research has investigated the connections among human, animal (both domestic and wildlife) and ecosystem health in Madagascar. I have examined current trends in anthropogenically-driven environmental change in Madagascar--including deforestation, illegal logging of precious hardwoods, mining, hunting, and agriculture--and evaluated how this change affects patterns of lemur, domestic animal and human health by evaluating a suite of health measures and parasite prevalence and richness. I have also examined how predicted global climate changes may influence the spatial patterns of lemur parasites and human infectious disease by assessing their shifts in distributions and geographic extent.

To assess the risk of disease transmission among lemur, domestic animal and human hosts, I have modeled the areas of geographic overlap among these parasites and their hosts and identified high-risk areas for disease emergence using geospatial analysis. This information can help to develop predictive statistical and spatial tools, which can inform both environmental management and public health planning.

Through this work, I have evaluated the severe loss of distribution that rosewood species have undergone, which highly qualifies them for international trade protection. We predicted areas of high risk for future logging, many of which occurred within protected areas in the biodiverse northeast.

Secondly, I have compiled the most comprehensive record of parasites of lemurs to date. Building upon the Prosimian Biomedical Survey Project data and the published literature, we have recorded 88 parasites that have been documented in lemurs. These are composed of helminths, bacteria, ectoparasites and protozoa. Of the 23 focal parasite species studied more in depth in this study, we noted high variability in prevalence measures for unique parasites at different sites. Parasite coinfection occurred quite commonly, with up to as many as 7 parasites concurrently. On average, lemur parasites tend to be less species-, genus-, or family-specific than other parasites across all primates.

Thirdly, I documented highly significant differences in health measures from two populations of Indri that exist under differing levels of anthropogenic pressure. Of note, the parasite richness, leukocyte count and differential, and nickel and cobalt levels were significantly higher in the more exposed population, while the total protein measures were significantly lower. These data suggest that the exposed population experiencing more anthropogenic pressure suffered from elevated health and nutritional stress.

Fourthly, I have documented strong correlations among environmental drivers (temperature, precipitation and landscape-scale features) and lemur parasite distributions. Striking shifts in their distributions are predicted to occur with projected climate change in Madagascar, including an expansion of helminth, virus and ectoparasite distributions, but a contraction of bacteria distributions due to warming and drying in the south.

Fifthly, I have examined 10 human and domestic animal parasites that hold great consequence for lemur, human and domestic animal health in Madagascar. I have similarly demonstrated strong correlations among environmental drivers (temperature, precipitation and landscape-scale features) and the distributions of these human parasites. Shifts in the distributions are also predicted to occur with projected climate change, including an expansion of helminth parasites, and a contraction of viruses and bacteria due to warming and drying in the south. I have identified areas of high risk for the transmission of parasites from human hosts to lemurs, as well as conversely from lemur hosts to humans. These risk indices will serve to highlight geographic areas at particular risk, and will also help to direct limited funds and staff to those areas most in need of attention.

Sixthly, I have demonstrated a need to train a growing cadre of One Health professionals from many different disciplines. I have offered several suggestions to integrate One Health training into graduate education, and have identified several geographic regions of potential to be a Center of One Health Excellence, of which the North Carolina Triangle area is one of great promise.