Zoonoses: The lethal gifts of livestock

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Presentation by Delia Grace at a 'livestock live' talk held at ILRI Nairobi Campus on 31 October 2012

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Zoonoses: The lethal gifts of livestock

  1. 1. Zoonoses:The Lethal Gifts of Livestock ILRI Livestock Live Seminar Delia Grace International Livestock Research Institute 31 October 2012
  2. 2. Overview• Human health and disease in the 21st century• Human diseases: legacies, souvenirs or wages?• Lethal gifts of livestock• Mapping poverty, zoonoses & emerging livestock systems• From mapping to managing
  3. 3. Human health in the 21st century• 7 billion people – 1 billion hungry; – 2 billion with hidden hunger; – 1.5 billion overweight or obese• 55 million die each year – 18 million from infection – 1.2 million from road traffic accidents – 170,000 from fatal agricultural accidents – 20,000 from extreme weather events
  4. 4. Low income countriesThree worlds Middle income countries High income countries From: WHO
  5. 5. Where do we get our diseases?• Most are Earned – Degenerative diseases: heart failure, stroke, diabetes, cancer – Allergies, asthma, autoimmune diseases – Sexually transmitted infections such as HSV-2, gonorrhea• Many are Souvenirs – Around 60% of human diseases shared with animals – 75% of emerging infectious disease zoonotic – Two of big burden diseases jumped species from animals to people• Few are Legacies – Paleolithic baseline: yaws, staph, pinworms, lice, typhoid
  6. 6. Spillover! Jones et al., PNAS forthcoming •Increasing human population and density Pathogen flow •Human behaviour Secondary •Expansion of agriculture Host •Intensification of livestock (livestock) production Spill-over Spill-overHabitat changeBiodiversityHost density Vector Sylvatic cycleVector density Reservoir Secondary Host (wildlife) Spill-over Host (human)Type of pathogen: mutation, Sustained transmission:heterogeneity, host specificity - peri-domestic or urban cycle - sub-clinical, epidemic, pandemic
  7. 7. Spillover + Great Societal Dislocations = Pandemic• Neolithic – domestication 1st epidemiological transition• 15th c Climate change & hunger – plague• 16th c New world – small pox, measles• 19th c Railways & steam ships – RP, SS• 20th c First world war – Spanish flu• 20th c Colonialisation & ubanisation – HIV• 21st c Third epidemiological transition?????
  8. 8. Cattle 7,000 bc EDog 15-30,000 bc ? G. Pig 5,000 bc SA Sahara Donkey 4,000 bc N Sheep 8,500 bc WA Pig 7,000 bc WA Africa Cat 5,800 bc Fertile Hen 6,000 bc Asia Goose 1,500 bc crescent Germany First epidemiological transition -- domestication leads to diseaseLivestock to people: Measles, mumps, diphtheria, influenzaRodents to people via camels?: SmallpoxPeople to livestock: Tuberculosis, Staph. aureus and then back again to people
  9. 9. Which zoonoses matter, why and to whom?• Neglected zoonoses• Emerging infectious diseases: 75% zoonotic• Food-borne diseases: 30-50% zoonotic• Other health risks in agro-ecosystems
  10. 10. Overview• Human health and disease in the 21st century• Human diseases: legacies, souvenirs or wages?• Lethal gifts of livestock• Mapping poverty, zoonoses & emerging livestock systems• From mapping to managing
  11. 11. Mapping poverty and zoonoses hotspots• To present data and expert knowledge on poverty and zoonoses hotspots …….to prioritise study areas in emerging livestock systems in the developing world, ……where prevention of zoonotic disease might bring greatest benefit to poor people. Commissioned by DFID
  12. 12. Methods• Update global maps of poor livestock keeper• Map rapidly emerging livestock systems• Update map of emerging infectious diseases (Jones et al., Nature)• Identify priority zoonoses• Develop first global mapping of zoonoses & poverty burden
  13. 13. 1. PLK• One billion PLK depend on 19 billion livestock• 4 countries have 44% of PLK• 75% rural, 25% urban poor depend on livestock• Livestock contribute typically 2-33% income• Livestock contribute typically 6-36% protein
  14. 14. • Poultry in South and East Asia • > poultry in South America • > bovines in South and East Asia • > poultry in sub Saharan Africa • = pigs in sub Saharan Africa2. ELS
  15. 15. • West USA & west Europe hotspots • Last decade: S America & SE Asia3. ZEID
  16. 16. 4. Priority zoonoses Top Zoonoses (multiple burdens)• Assessed 56 zoonoses from Deaths - annual2000000 6 listings: responsible 2.7 billion cases, 2.5 million deaths18000001600000 140000 120000• “Unlucky 13” responsible for 2.2 billion1400000 100000 illnesses and 2.4 million deaths12000001000000 80000800000 – All 13 have a wildlife interface 60000600000 – 9 have a major impact on livestock 40000400000200000 – All 13 amenable to on-farm intervention 20000 0 0 Top 13 Next 43 zoonoses
  17. 17. Official reporting systemsReporting Zoonoses ScopesystemWAHID 33 AnimalTAD Info 2 AnimalPro Med All AllGLEWS 19 All Source: HealthMapHealth All AllMap Africa • 253 million SLU • 25 million lost annually • 12-13 million from notifiable disease • 80,000 reported == 99.8% un-reported
  18. 18. Systematic literature review• Identify databases – PubMed, AJOL, CABDirect, Google• Develop criteria, search algorithms• Screen abstracts, retrieve papers, extract information• Map data• Embedded case-study to compare yield of databases with grey literature & library search
  19. 19. Greatest burden of endemic zoonoses falls on on billion poor livestock keepers• Unlucky 13 zoonoses sicken 2.4 billion people, kill 2.2 people and affect more than 1 in 7 livestock each year
  20. 20. Multiple burdens of zoonoses currently or in the last year• 12% of animals have brucellosis, reducing production by 8%• 10% of livestock in Africa have HAT, reducing their production by 15%• 7% of livestock have TB, reducing their production by 6% and from 3-10% of human TB cases may be caused by zoonotic TB• 17% of smallholder pigs have cysticercosis, reducing their value and creating the enormous burden of human cysticercosis• 27% of livestock have bacterial food-borne disease, a major source of food contamination and illness in people• 26% of livestock have leptospirosis reducing production and acting as a reservoir for infection• 25% of livestock have Q fever, and are a major source of infection of farmers and consumers
  21. 21. Hotspots• PLK: S. Asia 600 m, SSA 300 m• ELS: India, Myanmar, Bangladesh, Pakistan• ZEID: W Europe, W USA• Zoonoses: S. Asia > EC Africa• BIG SIX – S Asia: India, Bangladesh, Pakistan – Africa: Ethiopia, Nigeria, Congo
  22. 22. Overview• Human health and disease in the 21st century• Human diseases: legacies, souvenirs or wages?• Lethal gifts of livestock• Mapping poverty, zoonoses & emerging livestock systems• From mapping to managing
  23. 23. From mapping to managingAgriculture for Nutrition and HealthWHY?• More than 2 billion people worldwide are micronutrient deficient• 180 million children under the age of 5 are stunted• Agriculture associated diseases sicken billions and kill millions each yearFor these reasons, and many more, progress in improving the nutrition and health of poor farmers andconsumers (especially women and young children) is vital and urgent
  24. 24. Key development implementersAgriculture associated (public sector, private sector, NGOs) diseases (AAD) and enablers (policy makers, academia, investors) in agriculture, health and social development Human are able health (have evidence, motivation, capacity) Animal health to reduce multiple burdens of AAD in high-risk populations through effective, sustainable and equitable agricultural (including agro-ecosystem and agro- Agro- food chain) Ecosystems and innovations value chains (technological, institutional, market, and social) 24
  25. 25. Initial Research Priorities AGRICULTURE-ASSOCIATED DISEASES – BIG 5 • Food safety 1. Risk management in informal markets CROSS-CUTTING 2. Mycotoxins • Zoonoses 1. Gender & equity 3. Emerging infectious diseases 2. Capacity-building 4. Neglected zoonoses and influence 3. Communication 5. Ecohealth/ One Health
  26. 26. CRP 4.3 Ag Associated Disease Logic ASSUMPTIONS / COROLLARIES 1. Informal markets are most important for poor buyers and consumers • Current food safety regulation is ineffective and unfair • Risk and incentive based approaches have more success 2. Rapidly intensifying and urbanizing livestock systems are an important health risk for emerging systems and the world • Current ignorance of disease dynamics, drivers, and emergence • Innovative surveillance and whole-chain interventions key to reducing burden & risk 3. Neglected zoonoses impose significant, multiple burdens on the poorest • Current sectoral approaches leads to under-estimation & poor management • Integrated approaches (EH/OH) and diagnostic/control innovations needed for sustainable cost-effective control
  27. 27. Highlight 1. Conducting rapid, integrated assessments of food safety, zoonoses and nutrition in five high potential CRP 3.7 Livestock and Fish Value Chains Hidden hunger Food insecurity Poverty Disease THE IMPACTS Lost income Threatened market Unsafe food access CRP 4.3THE CORE PROBLEM Lost opportunities for smallholders in animal-source-food CRP 3.7 marketsTHE Low Limited value High wastage & Health risks inCAUSES productivity addition spoilage food Limited Inappropriate Lack of market Dysfunctional Inappropriate food- access to scale & information pricing & safety management & inputs technologies markets regulations INPUTS & SERVICES PRODUCTION PROCESSING MARKETING CONSUMPTION WHOLE VALUE CHAIN
  28. 28. Highlight 2. Mapping & measuring the hotspots of poverty, zoonoses and emerging livestock markets – informing donor grants
  29. 29. Highlight 3. Integrative approaches showing how to better understand and manage zoonoses and emerging infections• Published special edition on assessing • Investigating irrigation, climate • Integrated human & livestock disease & managing urban zoonoses change & disease shifts surveys: Kenya, Laos, Vietnam, China• Starting new project on pathogen • Made first estimate of DALYs for • Slaughter house surveys: Kenya, flows in Nairobi RVF in Kenya Uganda, Thailand, Vietnam • Operating platform for pathogen • Developing & testing novel • Supporting 2 EcoHealth/OH discovery & bio-repository cysticercosis diagnostic Resource Centers in SE Asia • Discovered virus in novel host: • Assessed barriers & bridges to implication for human heath? uptake of EH/OH by frontline staff
  30. 30. Conclusions• Here and now, the burden of NZDs is much higher than ZEIDs – Most are very manageable – Pareto laws apply• EIDs plus Great Societal Dislocations can be lethal – Are we farming on the brink of chaos? – When diseases is a symptom, we need to tackle the cause – Need to better synergise NZD and EID management• Agricultural research has an important role in integrative approaches to improve the ‘3 healths’
  31. 31. Bibliography• Grace D., (forthcoming), The Lethal Gifts of Livestock, Agriculture for Development• Jones B., Grace D., et al. (forthcoming), Do agricultural intensification and environmental change affect the risk of zoonoses that have a wildlife-livestock interface? PNAS• Gannon V., Grace D. and Atwill R., (2012), Zoonotic waterborne pathogens in livestock and their excreta – interventions. In: Dufour A and Bartram J (ed), Animal Waste, Water Quality And Human Health, World Health Organisation, Geneva, Unites States Environmental Protection Agency, USA and IWA publishing.• Grace D., Kang’ethe E. and Waltner-Toews D., 2012, Participatory and integrative approaches to food safety in developing country cities, Trop Anim Health Prod, 44 (1), 1-2.• McDermott J. and Grace D., (2012), Agriculture-Associated Diseases: Adapting Agriculture to Improve Human Health. Fan and Pandya-Lorch (ed). Reshaping agriculture for nutrition and health, IFPRI publications, Washington.• Grace D. and McDermott J., (2012), Livestock epidemics and disasters. In Kelman et al., ed Handbook of Hazards and Disaster Risk Reduction, Routledge.• Perry BD, Grace D and Sones K. (2011), Current drivers and future directions of global livestock disease dynamics. PNAS,. doi 10.1073/pnas.1012953108
  32. 32. AcknowledgementsMapping & Spillovers: Pam Ochungo, Flo Mutua,Mohamed Said, An Notenbaert,………. RVC, IOZ, HSPHCRP 4. 3 TeamFood Safety: Delia, Hung, Kristina, Kohei, Fred, Joseph, Apollinaire, Saskia,Amos, Lucy, Bryony, Ram, KarlMycotoxins: Pam, Elizabeth, Teresa, Daniel, AnimaEIDs: Steve, Bernard, Alan, An, Heather, George, Richard, Tabitha, John,Betty, VishZoonoses: Eric, Phil, Elizabeth, Will, Lian, IsaiahEcohealth/ One Health: Jeff G, Purvi, Hung, Rainer, Korapin, Fred, Lucy, JeffM, Solenne, AndrewSupport: Susan, Muthoni, Peter, Nancy, Rosa, Tezira, Evelyn, Tigist, Amanda,Diana, Rose, Joyce, Katie…….
  33. 33. Agriculture Associated Diseases http://aghealth.wordpress.com/

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