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One Health faces enormous pressure and challenges as it attempts to mitigate dynamic, surprising and complex global events that threaten the health and sustainability of human and animal populations and the biosphere. One Health practitioners and researchers need every advantage to developing working solutions to the world's imminent complex issues. Heath promotion and harm reduction, interrelated approaches that have seen much success over decades of use in global public health, may be important models to consider. Both use an upstream socioecological determinant of health approach to reach beyond the health sector in all health efforts, and encourage active community participation and empowerment to attain and sustain human and ecological health. This scoping review of 411 documents, believed to be the first to relate health promotion and harm reduction to One Health, searched self-declared One Health research literature for evidence of health promotion and harm reduction policies, principles and methodologies. It sought to answer the questions: “What is the scope of practice of One Health in self-declared One Health publications?” and “Are attributes of health promotion and harm reduction found in self-declared One Health-reviewed research literature?” Over half of the papers revealed no health promotion or harm reduction attributes while 7% were well-endowed with these attributes. These 7% of papers focused on deep-seated, complex health issues with systemic knowledge gaps and decision-making issues revolving around specific population vulnerabilities, social inequities and competing stakeholders. Implementing ‘on the ground change’ was a common theme in the strongest health promotion/harm reduction papers we identified. Alternatively, papers lacking health promotion or harm reduction attributes focused on managing proximate risks, primarily for infectious diseases. The addition of health promotion and harm reduction to One Health practices may help the field rise to the growing expectations for its involvement in complex global issues like pandemics and climate change., Highlights • One Health is being increasingly called on to contribute to grand challenges of global health security. • Health promotion and harm reduction have been successful over decades to advance interventions in public health. • Health promotion and harm reduction approaches have proved valuable when used in contemporary One Health. • Health promotion and harm reduction may be transferable models for One Health to work on complex health issues.

Early warning systems for climate change adaptation, preparedness and response will need to take into consideration the range of factors that can drive risk and vulnerability. There are no data from which to nominate the most effective, efficient and reliable wildlife health signals for public health planning, but there is growing opinion that wildlife health could signal public health vulnerability related to climate change. The objective of this commentary is to explore the potential for wildlife to contribute to climate change early warning for public health protection in Canada. Wildlife impact many determinants of human health through both direct and indirect mechanisms; several of which are strongly interconnected. There is a long history of wildlife serving as bio-sentinels for environmental pollutants and pathogens. Wildlife health could support public health threat detection, risk assessment and risk communication by detecting and tracking infectious and non-infectious hazards, being bio-sentinels of effects of new or changed hazards, providing biologically understandable information to motivate changes in personal risk behaviours and providing insights into new and unanticipated threats. Public health risk communication and strategic planning priorities for climate change could benefit from a wildlife health intelligence system that collects data on incidents of disease and hazard discovery as well as information on social and environmental conditions that affect risk perception and likelihoods of human exposure or harms.

The unprecedented threats to the health and sustainability of wildlife populations are inspiring conversations on the need to change the way knowledge is generated, valued, and used to promote action to protect wildlife health. Wildlife Health 2.0 symbolizes the need to investigate how to improve connections between research expertise and policy or practices to protect wildlife health. Two imperatives drive this evolution: 1) growing frustrations that research is inadequately being used to inform management decisions and 2) the realization that scientific certainty is context specific for complex socioecologic issues, such as wildlife health. Failure to appreciate the unpredictability of complex systems or to incorporate ethical and cultural dimensions of decisions has limited the contribution of research to decision making. Wildlife health can draw from scholarship in other fields, such as public health and conservation, to bridge the knowledge-to-action gap. Efforts to integrate science into decisions are more likely to be effective when they enhance relevance, credibility, and legitimacy of information for people who will make or be affected by management decisions. A Wildlife Health 2.0 agenda is not a rejection of the current research paradigm but rather a call to expand our areas of inquiry to ensure that the additional contextual understanding is generated to help decision makers make good choices.

Work that addresses the cumulative impacts of resource extraction on environment, community, and health is necessarily large in scope. This paper presents experiences from initiating research at this intersection and explores implications for the ambitious, integrative agenda of planetary health. The purpose is to outline origins, design features, and preliminary insights from our intersectoral and international project, based in Canada and titled the &ldquo, Environment, Community, Health Observatory&rdquo, (ECHO) Network. With a clear emphasis on rural, remote, and Indigenous communities, environments, and health, the ECHO Network is designed to answer the question: How can an Environment, Community, Health Observatory Network support the integrative tools and processes required to improve understanding and response to the cumulative health impacts of resource development? The Network is informed by four regional cases across Canada where we employ a framework and an approach grounded in observation, &ldquo, taking notice for action&rdquo, and collective learning. Sharing insights from the foundational phase of this five-year project, we reflect on the hidden and obvious challenges of working across scales, sectors, and sites, and the overlap of generative and uncomfortable entanglements associated with health and resource development. Yet, although intersectoral work addressing the cumulative impacts of resource extraction presents uncertainty and unresolved tensions, ultimately we argue that it is worth staying with the trouble.

The need to adequately predict, prevent and respond to infectious diseases emerging unexpectedly from human-animal-environmental systems has driven interest in multisectoral, socio-economic, systems-based, collaborative (MSC) research approaches such as EcoHealth and One Health. Our goals were to document how MSC research has been used to address EIDs in Asia, and to explore how MSC approaches align with current priorities for EID research in Asia. We gathered priorities for EID research from the peer-reviewed and grey literature, documented organizational descriptions of MCS research approaches, and analysed a series of EID MSC projects. We found that priority areas for EID research in Asia included (1) understanding host-pathogen-environment interactions; (2) improving tools and technologies; (3) changing people's behaviour; and (4) evaluating the effectiveness of interventions. We found that the unifying characteristics of MSC research were that it was action-oriented and sought to inspire change under real-world conditions at the complex interface of human and natural systems. We suggest that MSC research can be considered a type of 'pragmatic research' and might be most useful in describing change in complex human-animal-environmental systems, accelerating research-to-action, and evaluating effectiveness of interventions in 'real world' settings.

Limited surveillance programs and lack of diagnostic laboratory testing capacity in many low and middle income Asian countries have made it difficult to validate epidemiological patterns and anticipate future changes in disease risk. In this study, we consider the case of Japanese Encephalitis in Asia and examine how populations of human hosts and animal reservoirs are expected to change over the next three decades. Growth was modelled at the sub-national level for rural and urban areas to estimate where high-density, susceptible populations will potentially overlap with populations of the virus' amplifying host. High-risk areas based on these projections were compared to the current distribution of Japanese Encephalitis, and known immunization activities in order to identify areas of highest priority for concern. Results indicated that mapping JE risk factors at the sub-national level is an effective way to contextualize and supplement JE surveillance data. New patterns of risk factor change occurring in Southeast Asia were identified, including around major urban areas experiencing both urbanization and growth in pig populations. A hotspot analysis of pig-to-population ratio found a significant spatial cluster extending northward through Southeast Asia and interior China. Mapping forecasted changes in risk factors for JE highlights regions vulnerable to emerging zoonoses and may be an important tool for developing effecting transnational health policies.

Investment in wild animal health has not kept pace with investment in health programs for agriculture or people. Previous arguments of the inherent value of wildlife or the possible public health or economic consequences of fish or terrestrial wildlife diseases have failed to motivate sufficient, sustained funding. Wildlife health programs are often funded on an issue-by-issue basis, most often in response to diseases that have already emerged, rather than being funded to protect and promote the health of wild animals on an ongoing basis. We propose that one explanation for this situation is the lack of business cases that explains the value of wild animal health programs to funders. This paper proposes a set of building blocks that inform the creation of wildlife health business cases. The building blocks are a series of questions derived from a literature review, the experience of directors of two large national wildlife health programs and lessons learned in developing a draft business case for one of those programs. The six building blocks are: (1) Know what you are trying to achieve; (2) Describe your capabilities; (3) Identify factors critical to your success; (4) Describe the value you can bring to supporters; (5) Identify who needs your services and why; and (6) Share the plan.

Highlights • One Health emphasizes the interdependence of human, animal, and environmental health. • Wildlife parasites are ubiquitous; how do we decide which are One Health issues? • We propose questions to help to prioritize wildlife parasites in a One Health context. • We suggest principles for taking action on wildlife parasites with One Health significance., One Health has gained a remarkable profile in the animal and public health communities, in part owing to the pressing issues of emerging infectious diseases of wildlife origin. Wildlife parasitology can offer insights into One Health, and likewise One Health can provide justification to study and act on wildlife parasites. But how do we decide which wildlife parasites are One Health issues? We explore toxoplasmosis in wildlife in the Canadian Arctic as an example of a parasite that poses a risk to human health, and that also has potential to adversely affect wildlife populations of conservation concern and importance for food security and cultural well-being. This One Health framework can help communities, researchers, and policymakers prioritize issues for action in a resource-limited world.

Urban Norway rat (Rattus norvegicus) populations can carry the bacteria methicillin-resistant Staphylococcus aureus (MRSA). There are numerous knowledge gaps in the epidemiology of MRSA in these populations that limit understanding of its ecology in urban environments. For example, fecal shedding of MRSA, which may increase environmental contamination, has been reported in other species; however, it is unknown whether Norway rats carry the bacteria rectally. Furthermore, while intermittent MRSA shedding has been shown in other species and may dictate when the risk of transmission is highest, duration of carriage has not been examined for Norway rats. Previous work has shown that lethal animal-control methods may increase the level of pathogens within reservoir populations, possibly by disrupting ecological patterns. However, the impact of rodent-control on potentially environmentally acquired pathogens like MRSA has not been tested. Using capture-mark-recapture methods in an inner-city neighborhood in Vancouver, Canada, we show that rats intermittently carry MRSA both in the rectum and oropharynx. By assessing the prevalence of MRSA before and after enacting a pest-control intervention, we report that kill-trapping had no impact on the prevalence of carriage of this environmentally-acquired agent.

SUMMARYThere is interest in the potential of companion animal surveillance to provide data to improve pet health and to provide early warning of environmental hazards to people. We implemented a companion animal surveillance system in Calgary, Alberta and the surrounding communities. Informatics technologies automatically extracted electronic medical records from participating veterinary practices and identified cases of enteric syndrome in the warehoused records. The data were analysed using time-series analyses and a retrospective space–time permutation scan statistic. We identified a seasonal pattern of reports of occurrences of enteric syndromes in companion animals and four statistically significant clusters of enteric syndrome cases. The cases within each cluster were examined and information about the animals involved (species, age, sex), their vaccination history, possible exposure or risk behaviour history, information about disease severity, and the aetiological diagnosis was collected. We then assessed whether the cases within the cluster were unusual and if they represented an animal or public health threat. There was often insufficient information recorded in the medical record to characterize the clusters by aetiology or exposures. Space–time analysis of companion animal enteric syndrome cases found evidence of clustering. Collection of more epidemiologically relevant data would enhance the utility of practice-based companion animal surveillance.

We inventoried and assessed historical anthrax outbreak data from 1962-2008 in wild wood bison (Bison bison athabascae) in Wood Buffalo National Park and the Slave River Lowlands (SRL), Northwest Territories, Canada. We compared these results with a 2010 outbreak in the SRL. Anthrax outbreaks have occurred in 12 of the years between 1962 and 2008 in wild wood bison with 1,515 anthrax deaths detected. The average number of carcasses found each outbreak year was 126 (range 1-363), though local averages varied. The numbers of animals found dead per outbreak declined over the past four decades. Outbreaks varied in duration from 16-44 days (average length 25.5 days). The length of an outbreak was not a determinant of the number of dead bison found, but outbreaks starting in July had more deaths than those staring in June. Males were more likely to be detected in an outbreak, outbreaks were likely not random events, and there was no relationship between outbreak size or length and location. Future surveillance activities may benefit from targeting bulls and planning surveillance activities for more than 3 wk after outbreak detection. Coordinating data collecting and recording efforts between jurisdictions may overcome historical challenges in inconsistent record keeping.

Our objectives were to establish if the determinant of health model used in the fields of human population and public health could be adapted to wildlife health; if it was applicable to more than one species; and if it reflected how fish and wildlife managers conceptualized health in practice. A conceptual model was developed using a scoping review on fish and wildlife health and resilience coupled with a participatory process with experts on barren ground caribou ( Rangifer tarandus groenlandicus) and sockeye salmon ( Oncorhynchus nerka) health. Both the literature and experts supported the concept of wildlife health as a cumulative effect involving multiple factors that extend beyond the disease and pathogen focus of many wildlife health studies and legislation. Six themes were associated with fish and wildlife health: 1) the biologic endowment of the individual and population; 2) the animal's social environment; 3) the quality and abundance of the animal's needs for daily living; 4) the abiotic environment in which the animal lives; 5) sources of direct mortality; and 6) changing human expectations. These themes were shared between salmon and caribou and conformed to expert perceptions of health. Determinants of health used in human public health are used for planning, development of policy, and guiding of research. The model we produced may also have use as a wildlife health planning tool to help managers identify health protection priorities and to promote actions across the determinants of health.

A severe outbreak of scuticociliatosis occurred in Australian pot-bellied seahorse, Hippocampus abdominalis (Lesson, 1872), kept at the Vancouver Aquarium Marine Science Centre (Vancouver, British Columbia, Canada). Clinical signs included anorexia, lethargy, irregular respiration, and death. Cytology and histopathology revealed a high number of histophagous ciliated protozoa within the tissues. The parasite, identified as Philasterides dicentrarchi, was observed in several internal organs that appeared edematous and hemorrhagic upon postmortem examination. Severe histopathologic lesions were reported in particular in the ovary, the kidney, and the intestine. This infection was successfully treated with metronidazole via bath therapy. No further evidence of this parasite was found in the treated fish.

Japanese encephalitis (JE) is the single largest cause of viral encephalitis in the world and has been endemic in Nepal since the early 1980s. Since then, it has spread from its origins in lowland plains to the Kathmandu Valley as well as in hill and mountain districts. Pigs are amplifying hosts for the virus. The Nepal government has been encouraging the development of pig farming as a means of poverty alleviation. Whereas other countries have reduced JE through vaccination programmes and improvements in pig husbandry, these options are not economically possible in Nepal. The objective of this study was to examine the occupational risk of pig farmers in Nepal and to determine their level of knowledge and practice of JE prevention techniques. We surveyed 100 randomly selected pig farmers in the Kathmandu District and found that pig farmers were exposed to many JE risk factors including poverty and close proximity to pigs, rice paddy fields and water birds, which are the definitive hosts for the virus. Forty-two percent of the farmers had heard of JE, 20% associated it with mosquito bites and 7% named pigs as risk factors. Few protective measures were taken. None of the farmers were vaccinated against JE nor were any pigs, despite an ongoing human vaccination campaign. This farming community had little ownership of land and limited education. JE education programmes must consider gender differences in access to public health information as there were an equal number of male and female farmers. We provide findings that can inform future JE education programmes for this vulnerable population.

SUMMARYLeptospirosis is one of the most widespread zoonoses in the world. A large outbreak of suspected human leptospirosis began in Sri Lanka during 2008. This study investigated spatial variables associated with suspected leptospirosis risk during endemic and outbreak periods. Data were obtained for monthly numbers of reported cases of suspected clinical leptospirosis for 2005–2009 for all of Sri Lanka. Space–time scan statistics were combined with regression modelling to test associations during endemic and outbreak periods. The cross-correlation function was used to test association between rainfall and leptospirosis at four locations. During the endemic period (2005–2007), leptospirosis risk was positively associated with shorter average distance to rivers and with higher percentage of agriculture made up of farms

Animal health policy for highly pathogenic avian influenza (HPAI) must, for the time being, be based on expert opinion and shared international experience. We used the intellectual capital and knowledge of experienced Chinese and Canadian practitioners and policy makers to inform policy options for China and find shared policy elements applicable to both countries. No peer-reviewed comprehensive evaluations or systematic regulatory impact assessments of animal health policies were found. Sixteen guiding policy principles emerged from our thematic analysis of Chinese and Canadian policies. We provide a list of shared policy goals, targets and elements for HPAI preparedness, response and recovery. Policy elements clustered in a manner consistent with core public health competencies. Complex situations like HPAI require complex and adaptive policies, yet policies that cross jurisdictions and are fully integrated across agencies are rare. We encourage countries to develop or deploy capacity to undertake and publish regulatory impact assessments and policy evaluation to identify policy needs and provide a basis for evidence-based policy development.

Canadian Wildlife Health Cooperative, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, Canada Veterinary Public Health Institute, University of Bern, Schwarzenburgstrasse 155, 3097, Liebefeld, Switzerland; john.berezowski@gmail.com Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, Canada; vikram.misra@usask.ca

The purpose of this investigation was to identify factors associated with the clinical diagnosis of foot and mouth disease during the 2001 epidemic in the United Kingdom. Using logistic regression, we compared: (1) reports of suspect disease that resulted in the declaration of FMD to reports that did not, and (2) laboratory-positive cases to laboratory-negative cases. From 6801 reports of suspect disease, 2026 cases of FMD were identified. Suspect cases were more likely to become clinical cases if: (1) the report originated from the disease control authorities (‘active surveillance’) rather than the public, usually farmers (‘passive surveillance’); (2) cattle were the species suspected of disease, as opposed to sheep; (3) the report was filed during the peak of the epidemic; (4) the reporting premises was within 3 km of an FMD case detected within the previous 2 weeks; or (5) the report originated from certain local disease control centres. There were significant two-way interactions between: type of surveillance and species suspected of disease, type of surveillance and proximity of other infected premises, species suspected and time in the epidemic, and time in the epidemic and proximity of other infected premises. Clinical cases were more likely to be laboratory positive if: (1) they were found by passive versus active surveillance, (2) cattle were suspected of disease (versus sheep), (3) oldest lesions were less than 3 days, (4) the report was filed at any time other than the peak of the epidemic, or (5) the report originated from certain local disease control centres. Significant two-way interactions were found between: type of surveillance and species suspected of disease, and type of surveillance and time in the epidemic.

Zoonoses are fundamental determinants of community health. Preventing, identifying and managing these infections must be a central public health focus. Most current zoonoses research focuses on the interface of the pathogen and the clinically ill person, emphasizing microbial detection, mechanisms of pathogenicity and clinical intervention strategies, rather than examining the causes of emergence, persistence and spread of new zoonoses. There are gaps in the understanding of the animal determinants of emergence and the capacity to train highly qualified individuals; these are major obstacles to preventing new disease threats. The ability to predict the emergence of zoonoses and their resulting public health and societal impacts are hindered when insufficient effort is devoted to understanding zoonotic disease epidemiology, and when zoonoses are not examined in a manner that yields fundamental insight into their origin and spread.Emerging infectious disease research should rest on four pillars: enhanced communications across disciplinary and agency boundaries; the assessment and development of surveillance and disease detection tools; the examination of linkages between animal health determinants of human health outcomes; and finally, cross-disciplinary training and research. A national strategy to predict, prevent and manage emerging diseases must have a prominent and explicit role for veterinary and biological researchers. An integrated health approach would provide decision makers with a firmer foundation from which to build evidence-based disease prevention and control plans that involve complex human/animal/environmental systems, and would serve as the foundation to train and support the new cadre of individuals ultimately needed to maintain and apply research capacity in this area.

An epidemiological study of infectious hematopoietic necrosis viral disease (IHN) in farmed Atlantic salmon in British Columbia was conducted to better understand the management of this disease. The study consisted of a descriptive retrospective investigation of 18 IHN outbreaks on farms between 1992 and 1996, and a prospective surveillance program for the viral disease, after an area management plan was implemented to reduce the viral load around farms and farm-to-farm spread of the virus. The crude cumulative mortality associated with IHNV in Atlantic salmon was high (average 47%), and outbreaks lasted 5.8 months on average. On the two farms where the virus was detected during the surveillance program, IHNV was confirmed in all pens within 1 month. On two of three sites where fish were kept on farms after the initial disease outbreak subsided, IHN reoccurred within 30 weeks. The presentation of IHNV on farms, the spatial and temporal patterns of the outbreaks between 1992 and 1996, and the genetic similarity between isolates collected from nine outbreaks spanning a 5-year period, all supported the plausibility of farm-to-farm spread of the virus. Furthermore, the marked decrease in the incidence rate of IHN in farmed Atlantic salmon after the implementation of an area-based management plan aimed at reducing farm-to-farm spread of the virus also supported this hypothesis. Although the source of IHNV for the index case was not determined in this study, secondary spread of the virus between farms via management practices, such as movement of fish, co-habiting naive fish with survivors of the viral disease, and movement of equipment, likely accounted for some farm outbreaks. This suggested that many cases of IHN may be preventable using good on-farm biosecurity.

There has been, to date, little discussion about the defining features and measures of wildlife health in the literature or legislation. Much wildlife health work focuses on the detection and response to infectious or parasitic diseases; this perspective has been reinforced by the focus of the One Health initiative on wildlife as sources of emerging infections. The definition of health as "the absence of disease" lags 70 yr behind modern concepts of human health and emerging concepts of wildlife health in terms of vulnerability, resilience, and sustainability. Policies, programs, and research that focus on the integration of wildlife health with natural resource conservation, ecosystem restoration, and public health need a working definition of health that recognizes the major threats to fish and wildlife are the result of many other drivers besides pathogens and parasites, including habitat loss, globalization of trade, land-use pressure, and climate change. A modern definition of wildlife health should emphasize that 1) health is the result of interacting biologic, social, and environmental determinants that interact to affect capacity to cope with change; 2) health cannot be measured solely by what is absent but rather by characteristics of the animals and their ecosystem that affect their vulnerability and resilience; and 3) wildlife health is not a biologic state but rather a dynamic social construct based on human expectations and knowledge.

A study of the risk factors associated with mastitis in Sri Lankan dairy cattle was conducted to inform risk reduction activities to improve the quality and quantity of milk production and dairy farmer income. A cross-sectional survey of randomly selected dairy farms was undertaken to investigate 12 cow and 39 herd level and management risk factors in the Central Province. The farm level prevalence of mastitis (clinical and subclinical) was 48 %, similar to what has been found elsewhere in South and Southeast Asia. Five cow level variables, three herd level variables, and eight management variables remained significant (p

Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals.

Japanese Encephalitis (JE) is a vector-borne disease of major importance in Asia. Recent increases in cases have spawned the development of more stringent JE surveillance. Due to the difficulty of making a clinical diagnosis, increased tracking of common symptoms associated with JE-generally classified as the umbrella term, acute encephalitis syndrome (AES) has been developed in many countries. In Nepal, there is some debate as to what AES cases are, and how JE risk factors relate to AES risk. Three parts of this analysis included investigating the temporal pattern of cases, examining the age and vaccination status patterns among AES surveillance data, and then focusing on spatial patterns of risk factors. AES and JE cases from 2007-2011 reported at a district level (n = 75) were examined in relation to landscape risk factors. Landscape pattern indices were used to quantify landscape patterns associated with JE risk. The relative spatial distribution of landscape risk factors were compared using geographically weighted regression. Pattern indices describing the amount of irrigated land edge density and the degree of landscape mixing for irrigated areas were positively associated with JE and AES, while fragmented forest measured by the number of forest patches were negatively associated with AES and JE. For both JE and AES, the local GWR models outperformed global models, indicating spatial heterogeneity in risks. Temporally, the patterns of JE and AES risk were almost identical; suggesting the relative higher caseload of AES compared to JE could provide a valuable early-warning signal for JE surveillance and reduce diagnostic testing costs. Overall, the landscape variables associated with a high degree of landscape mixing and small scale irrigated agriculture were positively linked to JE and AES risk, highlighting the importance of integrating land management policies, disease prevention strategies and promoting healthy sustainable livelihoods in both rural and urban-fringe developing areas.

Marine anemia (plasmacytoid leukemia) is a histologically defined syndrome affecting farmed chinook salmon (Oncorhynchus tshawytscha) in British Columbia, Canada. Although the disease has received recent attention and has been diagnosed in many fish farms, past criteria for diagnosis have limited the depth and breadth of epidemiological investigations. By identifying a repeatably diagnosable subset of signs and symptoms of affected fish, a new working case definition of marine anemia was developed. This definition relied exclusively on histological features to achieve the diagnosis. The intra-observer repeatability of diagnoses using the new definition was high ( κ = 0.84). An algorithm employing gross pathological signs was created for field investigation of the disease. The algorithm was capable of predicting histological diagnosis with a reasonable level of accuracy, and was judged to be a valuable tool for diagnostic decisions. We concluded that by using the case definition created in this study together with the algorithm, the comparability and accuracy of clinical and epidemiological research of marine anemia could be improved.

Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia and a significant public health problem in Nepal. Its epidemiology is influenced by factors affecting its amplifying hosts (pigs), vectors (mosquitoes), and dead-end hosts (including people). While most control efforts target reduced susceptibility to infection either by vaccination of people or pigs or by reduced exposure to mosquitoes; the economic reality of Nepal makes it challenging to implement standard JE control measures. An ecohealth approach has been nominated as a way to assist in finding and prioritizing locally relevant strategies for JE control that may be viable, feasible, and acceptable. We sought to understand if Nepalese experts responsible for JE management conceived of its epidemiology in terms of a socio-ecological system to determine if they would consider ecohealth approaches. Network analysis suggested that they did not conceive JE risk as a product of a socio-ecological system. Traditional proximal risk factors of pigs, mosquitoes, and vaccination predominated experts’ conception of JE risk. People seeking to encourage an ecohealth approach or social change models to JE management in Nepal may benefit from adopting social marketing concepts to encourage and empower local experts to examine JE from a socio-ecological perspective.

The global public health community is facing the challenge of emerging infectious diseases. Historically, the majority of these diseases have arisen from animal populations at lower latitudes where many nations experience marked resource constraints. In order to minimize the impact of future events, surveillance of animal populations will need to enable prompt event detection and response. Many surveillance systems targeting animals rely on veterinarians to submit cases to a diagnostic laboratory or input clinical case data. Therefore understanding veterinarians’ decision-making process that guides laboratory case submission and their perceptions of infectious disease surveillance is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance initiatives. A focused ethnographic study was conducted with twelve field veterinary surgeons that participated in a mobile phone-based surveillance pilot project in Sri Lanka. Each participant agreed to an individual in-depth interview that was recorded and later transcribed to enable thematic analysis of the interview content. Results found that field veterinarians in Sri Lanka infrequently submit cases to laboratories – so infrequently that common case selection principles could not be described. Field veterinarians in Sri Lanka have a diagnostic process that operates independently of laboratories. Participants indicated a willingness to take part in surveillance initiatives, though they highlighted a need for incentives that satisfy a range of motivations that vary among field veterinarians. This study has implications for the future of animal health surveillance, including interpretation of disease patterns reported, system design and implementation, and engagement of data providers.

In 2005, World Health Organization member countries agreed to the revised International Health Regulations which require countries to detect, report, and respond to any event that may represent a public health emergency of international concern. Forecasting the risk posed by hazards, including incidents in animal populations, requires an intelligence-based approach. We propose an emerging infectious disease intelligence framework informed by literature from the fields of surveillance, epidemic intelligence, and military intelligence. This framework highlights the need for situational awareness and can be used to assess emerging infectious disease intelligence capacity in lower resource settings. To illustrate the utility of this framework we applied it to the Infectious Disease Surveillance and Analysis System, a mobile phone-based surveillance pilot project supplementing diagnostic laboratory-based surveillance in Sri Lanka. Application of the framework was feasible and useful in illuminating the strengths and deficits in the current surveillance infrastructure in Sri Lanka for emerging infectious disease early warning. The approach also demonstrated how a mobile phoned-based system could improve Sri Lanka’s emerging infectious disease intelligence capabilities. Finally, the framework allowed us to recommend steps to take in order to strengthen Sri Lanka’s emerging infectious disease early warning capacity, enabling more timely and complete identification of events in the animal population that could pose a human health risk.

The purpose of the present review was two fold: to give an overview of the modern feedlot industry in North America to provide context, and to search the scientific literature to identify alternative practices for antimicrobial use for disease control in that same industry. A fundamental assumption of the review was that reducing antimicrobial use would reduce the potential for antimicrobial-resistant bacteria to emerge and persist in the feedlot setting. To most effectively reduce antimicrobial use in the feedlot, one needs to find alternatives to prevent or effectively manage bacterial pneumonia in calves (often the principle reason for antimicrobial use) around the time of their arrival at the feedlot, as well as other bacterial diseases (eg, liver abscesses). Therefore, our key review question was the following: Are there management practices that do not involve the administration of antimicrobials that reduce the incidence of illness and mortality due to pneumonia, especially in high-risk feedlot calves? To answer this question, we set out to document the known risk factors for the emergence and maintenance of antimicrobial resistance (AMR) on feedlots, and the critical control points for these risk factors. We sought evidence for the effectiveness, efficiency and/or acceptability of various infection control points in a feedlot setting. We questioned whether the metaphylactic use of antimicrobials would affect the emergence of resistant bacteria in a feedlot setting, and asked what impact, if any, different drug use implementation strategies (including rotation of drugs used within a feedlot) might have on AMR. We also searched for management practices that reduce the incidence of liver abscesses in feedlot cattle, but that do not rely on in-feed or subtherapeutic antimicrobial use.

Objective—To determine risk factors associated with Cryptococcus gattii infection in dogs and cats residing on Vancouver Island in British Columbia, Canada. Design—Matched case-control study. Animals—20 dogs and 29 cats with C gattii infection and matched controls. Procedure—Dogs and cats with a confirmed or probable diagnosis of cryptococcosis resulting from infection with C gattii were enrolled by veterinarians, and owners completed a questionnaire designed to obtain information pertaining to potential risk factors for the disease. Owners of matched control animals were also interviewed. Odds ratios and 95% confidence intervals or paired t tests were calculated to determine significant associations. Results—Animals were enrolled during 2 noncontiguous periods in August 2001 to February 2002 (8 dogs and 9 cats enrolled) and May to December 2003 (12 dogs and 20 cats enrolled). Risk factors significantly associated with development of cryptococcosis included residing within 10 km of a logging site or other area of commercial soil disturbance, above-average level of activity of the animal, travelling of the animal on Vancouver Island, hunting by the animal, and owners hiking or visiting a botanic garden. Conclusions and Clinical Relevance—Results indicated that dogs and cats that were active or that lived near a site of commercial environmental disturbance had a significantly increased risk of developing C gattii infection. Veterinarians should communicate these risks to owners in context because cryptococcosis was an uncommon disease in this population.

We described the clinical diagnostic process utilized during the 2001 epidemic of foot-and-mouth-disease in the United Kingdom (UK), and considered it as a series of diagnostic tests. Premises were classified according to these diagnostic-test results and actual disease status, determined by the reference test, which in this case was one or more internationally accepted laboratory tests. The herd-level sensitivity (HSe) and herd-level specificity (HSp) of the clinical diagnostic process were calculated directly, relative to these internationally accepted reference tests. In this process, the first diagnostic test was 'routine monitoring', which resulted in the identification of suspect cases based solely on the clinical observations of farmers or veterinarians. 6762 suspect cases were identified, and the test had a HSe of 97.6% (95% C.I.: 96.7, 98.3) and a HSp of 95.2% (95% C.I.: 95.0, 95.3). Suspect cases were then subject to the second diagnostic test, termed 'declaration', which consisted of a review of a description of the clinical signs by government veterinarians. Premises that tested positive became 'clinical cases'. The HSe of this test was 97.1% (95% C.I.: 96.2, 97.9), and the HSp was 90.9% (95% C.I.: 90.1, 91.6). During the epidemic, these tests were combined and applied in series, with an overall HSe of 94.7% (95% C.I.: 93.5, 95.7) and an overall HSp of 99.6% (95% C.I.: 99.5, 99.6). We also examined the effect of a policy shift that prohibited delaying the diagnosis pending laboratory testing where the animals exhibited equivocal clinical signs.

Japanese encephalitis (JE) is a mosquito-borne zoonotic disease that has pigs as the major amplifying hosts. It is the most important cause of viral encephalitis in people in Nepal and is spreading in its geographic distribution in that country. Pig farming is increasing in Nepal due to reducing cultural biases against pigs and government programs to support pig farming for poverty alleviation. Major strategies for JE prevention and control include education, vector control, and immunization of people and pigs. This study used a survey of 400 pig farmers in 4 areas of Nepal with different JE and pig farming histories to explore regional variations in farmer awareness and actions towards JE, the association of awareness and actions with farm and farmer variables, and the implications of these associations for public health education. Exposure to JE risk factors was common across pig farms and pig farming districts but there were significant district level differences in knowledge and practices related to on-farm JE risk reduction. Social factors such as literacy, gender, and cultural practices were associated with farmer attitudes, knowledge and practices for JE control. JE vaccine uptake was almost non-existent and mosquito control steps were inconsistently applied across all 4 districts. Income was not a determining factor of the differences, but all farmers were very poor. The low uptake of vaccine and lack of infrastructure or financial capacity to house pigs indoors or away from people suggest that farmer personal protection should be a priority target for education in Nepal. This study re-enforces the need to attack root causes of people's personal disease prevention behaviours and take into account local variation in needs and capacities when designing health or agriculture education programs.

The animal and public health communities need to address the challenge posed by zoonotic emerging infectious diseases. To minimize the impacts of future events, animal disease surveillance will need to enable prompt event detection and response. Diagnostic laboratory-based surveillance systems targeting domestic animals depend in large part on private veterinarians to submit samples from cases to a laboratory. In contexts where pre-diagnostic laboratory surveillance systems have been implemented, this group of veterinarians is often asked to input data. This scenario holds true in Alberta where private cattle veterinarians have been asked to participate in the Alberta Veterinary Surveillance Network-Veterinary Practice Surveillance, a platform to which pre-diagnostic disease and non-disease case data are submitted. Consequently, understanding the factors that influence these veterinarians to submit cases to a laboratory and the complex of factors that affect their participation in surveillance programs is foundational to interpreting disease patterns reported by laboratories and engaging veterinarians in surveillance. A focused ethnographic study was conducted with ten cattle veterinarians in Alberta. Individual in-depth interviews with participants were recorded and transcribed to enable thematic analysis. Laboratory submissions were biased toward outbreaks of unknown cause, cases with unusual mortality rates, and issues with potential herd-level implications. Decreasing cattle value and government support for laboratory testing have contributed to fewer submissions over time. Participants were willing participants in surveillance, though government support and collaboration were necessary. Changes in the beef industry and veterinary profession, as well as cattle producers themselves, present both challenges and opportunities in surveillance.