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Signalling and risk assessment of emerging zoonoses in The Netherlands

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GRF 2nd One Health Summit 2013: Presentation by GIESSEN, Dr. Arjen van de, National Institute for Public Health and the Environment

GRF 2nd One Health Summit 2013: Presentation by GIESSEN, Dr. Arjen van de, National Institute for Public Health and the Environment

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Signalling and risk assessment of emerging zoonoses in The Netherlands Signalling and risk assessment of emerging zoonoses in The Netherlands Presentation Transcript

  • Signaling and risk assessment of emerging zoonoses in The Netherlands Arjen van de Giessen, Hendrik-Jan Roest, Kitty Maassen on behalf of the Dutch Signaling Forum Zoonoses Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Contents 1. Background: zoonoses outbreaks in the NL 2. One Health approach to signaling and RA of zoonoses 3. Further steps towards One Health Signaling and risk assessment of emerging zoonoses in the Netherlands | 20 November 2013
  • The Netherlands, a small and crowded country ● ● ● ● ● ● ● 33.883 km2 16.6 million inhabitants 89 million chickens 12 million pigs 4.5 million cows 1.1 million sheep 0.3 million goats Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • NL 2003: outbreak of Avian Influenza A virus subtype H7N7 20 453 cases, 89 H7 pos 349 conjunctivitis, 22% H7 78 conjunctivitis + ILI, 10% H7 37 ILI, 5% H7 3 secondary cases 25 number of cases 20 10 15 10 Fatal case 5 13 9 5 1 May 27 23 19 15 11 7 3 30 26 22 18 14 10 6 2 28 24 20 16-feb 0 Koopmans et al, 2004 4 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • NL 2004: emergence of Livestock-associated MRSA 5 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • NL 2007-2010: Q-fever epidemic related to dairy goat farming 6 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • ● Recommendations to improve early warning and control of emerging zoonoses by an One Health approach ● Implementation of an integrated humanveterinary, zoonoses risk analyses structure in 2011 7 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Integrated human-veterinary risk analysis structure for zoonoses ● Why: The last decades the Netherlands have encountered outbreaks related to (emerging) zoonoses, such as HPAI, livestockassociated MRSA and Q-fever. These events emphasized the need for a more systematic approach of sharing and assessing signals for (emerging) zoonoses. ● Goal: To identify, assess and prevent/control (potential) emerging zoonoses that may cause a threat to animal and/or human health in an integrated human-veterinary approach. ● How: At each stage of the zoonoses risk analysis structure experts from both human and veterinary health are involved. 8 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Signaling Forum Zoonoses Who: • National Institute for Public Health and the Environment (RIVM) • Community Health Services (GGD) • Netherlands Food and Consumer Product Safety Authority (NVWA) • Central Veterinary Institute of Wageningen UR (CVI) • Animal Health Service (GD) • Faculty of Veterinary Medicine of University of Utrecht (FD) • Dutch Wildlife Health Centre (DWHC) 10 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Sources of signals 11 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Signaling Forum Zoonoses (SOZ) Goal: ● Early detection of zoonotic signals in livestock, pets, vectors, wildlife, and humans ● Assessment of the (potential) risk of zoonoses to public health, especially for those which are not covered by existing control protocols How: • Monthly face to face meeting • Collected signals are discussed and, if relevant, assessed • In case of a (possible) urgent threat, an ad-hoc (tele)meeting will be organized Output: • Identification of a possible threat: reporting to the next step in the zoonosis structure (RT-Z/OMT-Z) including advice on follow-up actions • Monthly report of the most important signals is send to professionals via email • Signals can form a base for email-alerts for veterinary (vetinf@ct) and/or human (inf@ct) professionals or other publications 12 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Criteria for reporting to the Response Team Zoonoses 1. An outbreak of an endemic zoonosis which is larger (need for upscaling) or more serious than normal 2. An outbreak in which control or prevention is complicated or far-reaching • Example: Q-fever epidemic 2007-2010 • By implementation of the Signaling Forum Zoonoses, outbreaks of endemic zoonoses should be detected at an earlier stage 13 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Criteria for reporting to the Response Team Zoonoses 3. An outbreak with omissions in control and/or prevention guidelines • Low pathogenic avian influenza can cause human disease • Signaling of omissions in the guidelines for people in direct contact with poultry in an outbreak of LPAI. • As a result, monitoring of disease signs has been included in guidelines for human disease control. 14 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Criteria for reporting to the Response Team Zoonoses 4. An emerging zoonotic agent of which the impact on public health is still unknown 5. A zoonotic signal that potentially leads to social unrest • Example: Schmallenberg virus (SBV), introduced in Europe in 2011, causing serious malformations in newborn lambs. • The health consequences of this new virus were unknown at that time and therefore treated as a potential threat to public health • Fortunately, SBV appeared not to be a zoonotic agent. 15 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • Further steps towards One Health ● Development of integrated human-veterinary research programmes ● Development of integrated human-veterinary surveillance programmes in wildlife, vectors and livestock ● Cooperation between public health and veterinary authorities at the regional level ● Integration of veterinary and public health prevention/control guidelines ● Integrated risk communication on zoonoses 16 Signaling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013
  • 17 Signalling and risk assessment of emerging zoonoses in The Netherlands | 20 November 2013