ONE HEALTH: TALES ACROSS THE DISCIPLINES Prof Lucille Blumberg
Deputy-‐Director: Na8onal Ins8tute for Communicable Diseases Head: Division of Public Health Surveillance and Response
Presented by Dr. Clara Bocchino AHEAD-‐GLTFCA Network Coordinator
• Underdiagnosed
• Passive surveillance
• Non-‐ specific signs and
symptoms
• Limited laboratory
diagnos8cs
Zoonosis at the human/animal interface!
Background of TB -‐ HIV -‐ MALARIA , Water –borne and respiratory infec8ons
Ebola Virus Disease !• First iden8fied in 1976, DRC • 12 outbreaks to date • Major outbreak: 2013/14
(Sierra Leone; Guinea; Liberia)-‐ > 10,000 cases
with 60% mortality • Bats likely reservoir • Bush meat important in
transmission to humans • Human to human
transmission – exposure to pa8ent blood, body fluids
• Community living on border of Greater Kruger Na8onal Park
• Majority are agro-‐pastoralists • Weekly dip tank for cadle for 8ck control • Zoonoses are an important cause of acute
febrile illness: • Tick bite fever • Q fever • Bartonellosis • Leptospirosis
Zoonoses: human and domestic/wild life interface – Limpopo Transfrontier National Park!
ISID 2014 Quan Blumberg Simpson Knobel Frean Rossouw Weyer
RABIES OUTBREAK: LIMPOPO, SOUTH AFRICA 2005!
• No previous human cases in area • Major increase in dog rabies in preceding year • Spill over from Zimbabwe into local dog popula8on
(poor vaccine coverage) • Poor communica8on between veterinary and
human health • Limited rabies preven8on programme for exposed
humans • Fatal encephaliAs-‐ iniAally unrecognised by
physicians as rabies (total 31 cases over 9 months)
Response: • Dog vaccina8on campaign intensified • Community awareness raised • Health care worker educa8on • Provision of rabies vaccine and immunoglobulin EID 2007
Outbreak of Highly Pathogenic Avian influenza (H5N2) Eastern Cape 2004 !
Animal response • Farms within 30km radius of
affected farms quaran8ned • All ostriches and poultry in infected
zone culled • Voluntary ban on the export of
poultry ins8tuted
Human health response Sero-‐epidemiological study • HPAI (H5N2) is transmissible to highly
exposed humans but no severe illness
Outbreak of RiJ Valley fever South Africa 2008
• Outbreak affec8ng disease-‐free
buffalo on border of Kruger
Na8onal Park
• 18 human cases in veterinary
and farm workers
• Predominantly mild disease
• Combined human and veterinary
response
‘BETWEEN ANIMALS AND HUMANS THERE IS NO DIVIDING LINE’ Virchow 19th century
• Good communica8on is cri8cal
• Combined resources for outbreak response, preven8on and control is
advantageous
• Veterinary alert to human health prac88oners is cri8cal for recogni8on of
clinical cases
What makes it work? !