Public Health and Vector‐Borne Diseases – A New Concept for Risk Governance

Public Health is defined as an interdisciplinary multilevel approach that deals with questions of preventing diseases at the population level. In this context, this paper focuses on vector‐borne diseases as an important threat with an increasing impact on human and animal health. Emphasis is laid on an integrated health approach (‘One‐Health’ initiative) as it recognizes the interrelated nature of both human and animal health. The importance of vector‐borne diseases to new and emerging diseases in Europe was demonstrated, for example, by the recent outbreak of West Nile virus infections in Greece, Northern Italy and Hungary; the spread of Crimean‐Congo haemorrhagic fever virus across Turkey, south‐western countries of the former USSR and the Balkans; the dramatic increase in hantavirus infections in Germany in 2012; and the dengue virus outbreak in Portugal in the same year. This paper provides a systematic approach for the analysis, assessment and governance of emerging health risks attributed to vector‐borne diseases by using a holistic approach developed by the International Risk Governance Council (IRGC), called the ‘IRGC Risk Governance Framework’. It can be used by decision‐makers and general Public Health authorities in order to evaluate the situation regarding any specific pathogen or Public Health risk and to decide if additional measures should be implemented.     

Occurrence of rift valley fever in cattle in Ijara district,Kenya

Ijara district in Kenya was one of the hotspots of rift valley fever (RVF) during the 2006/2007 outbreak which led to human and animal deaths causing huge economic and public health losses. The main constraint in the control and prevention of RVF is inadequate knowledge on its occurrence during the interepidemic period. This study was aimed at understanding the occurrence of RVF in cattle in Ijara to enable the development of improved community-based disease surveillance, prediction, control and prevention.     

Economic Assessment of Zoonoses Surveillance in a ‘One Health’ Context: A Conceptual Framework

Collaboration between animal and public health sectors has been highlighted as a means to improve the management of zoonotic threats. This includes surveillance systems for zoonoses, where enhanced cross‐sectoral integration and sharing of information are seen as key to improved public health outcomes. Yet, there is a lack of evidence on the economic returns of such collaboration, particularly in the development and implementation of surveillance programmes. The economic assessment of surveillance in this context needs to be underpinned by the understanding of the links between zoonotic disease surveillance in animal populations and the wider public health disease mitigation process and how these relations impact on the costs and benefits of the surveillance activities. This study presents a conceptual framework of these links as a basis for the economic assessment of cross‐sectoral zoonoses surveillance with the aim of supporting the prioritization of resource allocation to surveillance. In the proposed framework, monetary, non‐monetary and intermediate or intangible cost components and benefit streams of three conceptually distinct stages of zoonotic disease mitigation are identified. In each stage, as the final disease mitigation objective varies so does the use of surveillance information generated in the animal populations for public health decision‐making. Consequently, the associated cost components and benefit streams also change. Building on the proposed framework and taking into account these links, practical steps for its application are presented and future challenges are discussed.     

Social and Economic Aspects of the Transmission of Pathogenic Bacteria between Wildlife and Food Animals: A Thematic Analysis of Published Research Knowledge

Wildlife is a known reservoir of pathogenic bacteria, including Mycobacterium bovis and Brucella spp. Transmission of these pathogens between wildlife and food animals can lead to damaging impacts on the agri‐food industry and public health. Several international case studies have highlighted the complex and cross‐sectoral challenges involved in preventing and managing these potential transmission risks. The objective of our study was to develop a better understanding of the socio‐economic aspects of the transmission of pathogenic bacteria between wildlife and food animals to support more effective and sustainable risk mitigation strategies. We conducted qualitative thematic analysis on a purposive sample of 30/141 articles identified in a complementary scoping review of the literature in this area and identified two key themes. The first related to the framing of this issue as a ‘wicked problem’ that depends on a complex interaction of social factors and risk perceptions, governance and public policy, and economic implications. The second theme consisted of promising approaches and strategies to prevent and mitigate the potential risks from transmission of pathogenic bacteria between wildlife and food animals. These included participatory, collaborative and multidisciplinary decision‐making approaches and the proactive incorporation of credible scientific evidence and local contextual factors into solutions. The integration of these approaches to address ‘wicked problems’ in this field may assist stakeholders and decision‐makers in improving the acceptability and sustainability of future strategies to reduce the transmission of pathogenic bacteria between wildlife and food animals.     

Review of Rabies Epidemiology and Control in South,South East and East Asia: Past,Present and Prospects for Elimination

Rabies is a serious public health problem in Asia. It causes substantial animal welfare, economic and human health impacts, with approximately 39 000 human deaths each year. Domestic dogs are the main reservoir and source of rabies in Asia. Common constraints for the control of rabies in the countries of Asia include inadequate resources; lack of political commitment to control programs; lack of consensus on strategy; weak intersectoral coordination and inadequate management structure; insensitive surveillance systems; limited accessibility to modern rabies vaccine and supply problems; lack of public awareness and public cooperation; and the existence of myths and religious issues. In this review, we summarize the epidemiology of rabies in both human and animals in each South and South East Asian country, the past and current approaches to control and the prospect for rabies elimination. We conclude that defining the cost of rabies to society and communicating this to decision‐makers might be the key to achieving such an advance.     

Economic and health burden of brucellosis in Kazakhstan

Brucellosis is a widespread zoonotic disease considered as an emerging and re‐emerging disease with a resulting threat of public health and animal health. Official reports document an animal incidence in Kazakhstan of about 0.6% per year, and the country still registers high number of human cases annually . The main objective of this paper was to evaluate the distribution and economic impact of brucellosis in Kazakhstan. We analysed human disease incidence data obtained from the Government Sanitary & Epidemiological Service with the aim to estimate the burden of disease in terms of disability‐adjusted life years (DALYs). We also estimated the economic impact in terms of monetary losses. Additionally, we mapped the geographical distribution of the disease throughout Kazakhstan. In total, 1,334 human cases of brucellosis were registered in 2015 in Kazakhstan that resulted in 713 DALYs. Around $21 million was spent on compensation for animals that had to be slaughtered due to brucellosis, and an additional $24 million was spent on testing animals. Animal brucellosis and human brucellosis occur throughout the whole country, some trends of which are reviewed in this paper. We estimated the burden of the disease and explored possible explanation for high human incidence rates. This paper is the first to estimate the human burden of disease and the economic costs in Kazakhstan. Both of these are substantial.     

Animal Health Policy Principles for Highly Pathogenic Avian Influenza: Shared Experience from China and Canada

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.     

Rift Valley fever virus(Bunyaviridae: Phlebovirus): an update on pathogenesis, molecular epidemiology, vectors, diagnostics and prevention

Rift Valley fever(RVF) virus is an arbovirus in the Bunyaviridae family that, from phylogenetic analysis, appears to have first emerged in the mid-19th century and was only identified at the beginning of the 1930's in the Rift Valley region of Kenya. Despite being an arbovirus with a relatively simple but temporally and geographically stable genome, this zoonotic virus has already demonstrated a real capacity for emerging in new territories, as exemplified by the outbreaks in Egypt (1977), Western Africa (1988) and the Arabian Peninsula (2000), or for re-emerging after long periods of silence as observed very recently in Kenya and South Africa. The presence of competent vectors in countries previously free of RVF, the high viral titres in viraemic animals and the global changes in climate, travel and trade all contribute to make this virus a threat that must not be neglected as the consequences of RVF are dramatic, both for human and animal health. In this review, we present the latest advances in RVF virus research. In spite of this renewed interest, aspects of the epidemiology of RVF virus are still not fully understood and safe, effective vaccines are still not freely available for protecting humans and livestock against the dramatic consequences of this virus.     

Benefits and costs of using an orally absorbed vaccine to control rabies in raccoons.

In November 1989, the epizootic of rabies affecting raccoons in the mid-Atlantic states reached New Jersey. An economic evaluation was conducted in 2 counties first affected by the epizootic to estimate the costs of the epizootic and to assess the costs and benefits of orally administering a newly developed recombinant rabies vaccine to prevent further spread of the disease. Data on expenditures associated with prevention of rabies in human beings and domestic animals and laboratory testing of suspect animals were collected and analyzed for 1988 (before the epizootic) and 1990 (first full year of the epizootic). Benefit-cost ratios were calculated and used to evaluate the economic advisability of the vaccine at various vaccination program alternatives. Two indices of capital investment analysis, payback period and net present value, were used to evaluate the economic benefits of the rabies vaccine. Expenditures were estimated to be $1,952,014 in 1990 (primarily for pet animal vaccinations), compared with $768,488 in 1988. Benefit-cost ratios ranged from 2.21 for the most expensive vaccination program alternative to 6.80 for the least expensive alternative. The payback period varied from 0.69 to 2.11 years, and the net present value ranged from $2,105,453 to $4,877,452. The high costs of this epizootic necessitated the reallocation of scarce public health resources to various rabies prevention activities, particularly the vaccination of dogs. This study also demonstrated the usefulness of benefit-cost analysis in developing public health strategies. Although the mass application of this recombinant vaccine was found to be economically beneficial, other qualitative considerations must be used to supplement these findings.     

Prioritizing Zoonotic Diseases: Differences in Perspectives Between Human and Animal Health Professionals in North America

Zoonoses pose a significant burden of illness in North America. Zoonoses represent an additional threat to public health because the natural reservoirs are often animals, particularly wildlife, thus eluding control efforts such as quarantine, vaccination and social distancing. As there are limited resources available, it is necessary to prioritize diseases in order to allocate resources to those posing the greatest public health threat. Many studies have attempted to prioritize zoonoses, but challenges exist. This study uses a quantitative approach, conjoint analysis (CA), to overcome some limitations of traditional disease prioritization exercises. We used CA to conduct a zoonoses prioritization study involving a range of human and animal health professionals across North America; these included epidemiologists, public health practitioners, research scientists, physicians, veterinarians, laboratory technicians and nurses. A total of 699 human health professionals (HHP) and 585 animal health professionals (AHP) participated in this study. We used CA to prioritize 62 zoonotic diseases using 21 criteria. Our findings suggest CA can be used to produce reasonable criteria scores for disease prioritization. The fitted models were satisfactory for both groups with a slightly better fit for AHP compared to HHP (84.4% certainty fit versus 83.6%). Human‐related criteria were more influential for HHP in their decision to prioritize zoonoses, while animal‐related criteria were more influential for AHP resulting in different disease priority lists. While the differences were not statistically significant, a difference of one or two ranks could be considered important for some individuals. A potential solution to address the varying opinions is discussed. The scientific framework for disease prioritization presented can be revised on a regular basis by updating disease criteria to reflect diseases as they evolve over time; such a framework is of value allowing diseases of highest impact to be identified routinely for resource allocation.     

Use of Multicriteria Risk Ranking of Zoonotic Diseases in a Developing Country: Case Study of Mongolia

Many developing countries face significant health burdens associated with a high incidence of endemic zoonoses and difficulties in integrated control measures for both the human and animal populations. The objective of this study was to develop and apply a multicriteria ranking model for zoonoses in Mongolia, a country highly affected by zoonotic disease, to inform optimal resource allocation at the national level. Diseases were evaluated based on their impact on human health, livestock sector health and the wider society through affects on the economic value of livestock, as well as the feasibility of control in both the human and livestock population. Data on disease in Mongolia were collected from various government departments including the Mongolian State Central Laboratory, the Mongolian Department of Veterinary and Animal Breeding, the Mongolian Ministry of Health, Mongolian National Center for Communicable Diseases, the National Center for Zoonotic Disease and expert opinion from a workshop with a number of Mongolian Government officials and researchers. A combined score for both impact of the disease and feasibility of its control was calculated. Five zoonotic diseases were determined to be of high priority from this assessment (i.e. ovine brucellosis, echinococcosis (hydatids), rabies, anthrax and bovine brucellosis). The results supported some of the findings for high‐priority diseases (namely brucellosis, rabies and anthrax) from a previous priority setting exercise carried out in Mongolia in 2011, but also identified and ranked additional animal diseases of public health importance. While the process of model development was largely Mongolian specific, the experience of developing and parameterizing this multicriteria ranking model could be replicated by other countries where zoonoses have substantive impacts on both animal and human health.     

Swine Influenza in Sub‐Saharan Africa – Current Knowledge and Emerging Insights

Pigs have been associated with several episodes of influenza outbreaks in the past and are considered to play a significant role in the ecology of influenza virus. The recent 2009 pandemic influenza A/H1N1 virus originated from swine and not only did it cause widespread infection in humans, but was also transmitted back to swine in Asia, Europe and America. What may be the prevailing situation in Africa, particularly in sub‐Saharan Africa, with respect to the circulation of classical swine or pandemic influenza? The ecology of influenza viruses, as well as the epidemiology of human or animal influenza, is poorly understood in the region. In particular, little is known about swine influenza in Africa despite the relevance of this production in the continent and the widespread pig husbandry operations in urban and rural areas. In this review, the gap in the knowledge of classical and pandemic swine influenza is attributed to negligence of disease surveillance, as well as to the economic and public health impact that the disease may cause in sub‐Saharan Africa. However, emerging serological and virological evidence of swine influenza virus in some countries in the region underscores the importance of integrated surveillance to better understand the circulation and epidemiology of swine influenza, a disease of global economic and public health importance.     

Evaluating the economic and noneconomic impacts of the veterinary medical profession in Michigan

This study reaffirms the diversity and breadth of the veterinary profession. As it turns out, some of the furthest-reaching impacts of the veterinary medical profession were largely non-quantifiable. The veterinary medical profession had a substantial direct economic impact in Michigan during 1995. The total economic contribution of the veterinary medical profession to Michigan during 1995 that was attributable to expenditures on salaries, supplies, services, and their multiplier effect was approximately $500 million. In addition, the profession was associated with nearly 8,500 jobs (combined professional and lay positions). The veterinary medical profession was also considered to have an impact on the prosperity of the live-stock, equine, and pet food industries in Michigan, even though the economic contribution in these areas could not be directly quantified. Economic well-being of the individual businesses in these industries is directly related to the health and productivity of the associated animals, and improvements in output or productivity that accompany improved animal health likely carry substantial economic benefits in these sectors. In addition, progressive animal health management provides a crucial method of managing risk in the animal industries. Similarly, although the economic contribution could not be quantified, the veterinary medical profession enhances the safety and quality of human food through research, regulation, and quality assurance programs in livestock production, minimizing the risk of drug residues and microbial contamination. During 1995, approximately 5.3 million Michigan residents benefitted from the physical, psychological, and emotional well-being that accompanies companion animal ownership. By preserving the health and longevity of companion animals, veterinarians sustain and enhance these aspects of the human-animal bond. As Michigan enters a new century, it is likely that the state's veterinary medical profession will continue to make a highly valued societal contribution. Pets, equines, and food animals will continue to have prominent roles in Michigan for the foreseeable future, as will the human-animal bond, food safety, and medical research. Clearly, for economic and noneconomic reasons, it will be in the interest of the people of Michigan to seek opportunities to maintain and enhance the vitality of the state's veterinary medical profession. It was our hope that results of this study would provide university administrators, legislators, MVMA executives, and others with information needed to justify the ongoing provision of public support for the veterinary medical profession. In addition, we expect that the results will supply useful material for public relations and marketing campaigns by the MVMA and the Michigan State University College of Veterinary Medicine and will provide the media with public interest stories to promote the veterinary profession. Although this study considered the economic and noneconomic impacts of the veterinary medical profession only in Michigan, the results can provide an important reference point for educators, policy markers, and legislators in other states. In addition, this study could serve as a methodologic model for veterinary organizations in other states, or at the national level, to emulate.     

The Potential Economic Impact of an Outbreak of Foot-and-Mouth Disease in Canada

The possibility of an outbreak of foot-and-mouth disease is of concern to Canada's livestock industry due to the resulting economic consequences. The primary economic impact of a foot-and-mouth disease outbreak would arise from the trade embargo placed on Canadian exports of animals and animal products to countries free of the disease. Agriculture Canada's Food and Agriculture Regional Model was used to estimate the economic impact of such a trade embargo. Two scenarios, a small and large outbreak, were simulated over a five year period (1986-90). The results indicate that even a small outbreak of foot-and-mouth disease would have serious economic consequences for the livestock sector with farm cash receipts declining by $2 billion. The largest impact would be on the pork sector followed by the beef sector.     

Decision support systems for monitoring and maintaining health in food animal populations

To mitigate the effects of risks to food safety and infectious disease outbreaks in farmed animals, animal health authorities need to have systems in place to identify and trace the source of identified problems in a timely manner. In the event of emergencies, these systems will allow infected or contaminated premises (and/or animals) to be identified and contained, and will allow the extent of problems to be communicated to consumers and trading partners in a clear and unambiguous manner. The key to achieving these goals is the presence of an effective animal health decision support system that will provide the facilities to record and store detailed information about cases and the population at risk, allowing information to be reported back to decision makers when it is required. Described here are the components of an animal health decision support system, and the ways these components can be used to enhance food safety, responses to infectious disease incursions, and animal health and productivity. Examples are provided to illustrate the benefit these systems can return, using data derived from countries that have such systems (or parts of systems) in place. Emphasis is placed on the features that make particular system components effective, and strategies to ensure that these are kept up to date.     

Decision support systems for monitoring and maintaining health in food animal populations

To mitigate the effects of risks to food safety and infectious disease outbreaks in farmed animals, animal health authorities need to have systems in place to identify and trace the source of identified problems in a timely manner. In the event of emergencies, these systems will allow infected or contaminated premises (and/or animals) to be identified and contained, and will allow the extent of problems to be communicated to consumers and trading partners in a clear and unambiguous manner. The key to achieving these goals is the presence of an effective animal health decision support system that will provide the facilities to record and store detailed information about cases and the population at risk, allowing information to be reported back to decision makers when it is required. Described here are the components of an animal health decision support system, and the ways these components can be used to enhance food safety, responses to infectious disease incursions, and animal health and productivity. Examples are provided to illustrate the benefit these systems can return, using data derived from countries that have such systems (or parts of systems) in place. Emphasis is placed on the features that make particular system components effective, and strategies to ensure that these are kept up to date.     

An economic evaluation of metabolic and cellular profile testing in calves to be raised in a feedlot

The economic value of the metabolic and cellular profile test as a predictor of feedlot calves' performance was determined. The economic technique used in this evaluation was decision tree analysis. Results showed that in a case study evaluation such as this one, the metabolic and cellular profile test would not be recommended. Further, under the assumptions used, even if the test were perfected, the cost of the test should not exceed $2.79. The application of decision tree analysis demonstrated how questions concerning the economics of animal health issues may be formulated and solved.     

Tuberculosis in deer: a review

In recent years tuberculosis in deer caused by Mycobacterium bovis has become a disease of economic as well as public health importance to the deer farming industries of several countries, in particular those in Denmark, New Zealand and the United Kingdom. This paper sets the disease in a historical context and reviews current knowledge about various aspects of the condition, with particular reference to diagnosis and control and to research requirements for the future.     

The role of the public sector in the development and implementation of animal health policies.

Although it is widely accepted that both the public and private sectors have a role to play in improving animal health, the debate centers on the balance between the two. The comparative advantages of each sector depend on: (i) whether the targeted disease can affect humans; (ii) its degree of contagiousness; (iii) whether it is endemic or exotic; and (iv) the economic costs associated with the disease. The rationale for public intervention is weaker for non-contagious than for contagious diseases; governments, though, can play a support role in several areas: e.g. generation and dissemination of information on health management, fostering participation of producers' organization in the eradication of endemic diseases, or helping private research institutions and funders to overcome the hurdles posed by widespread uncertainty and high costs associated with basic research. Control and eradication of contagious diseases in characterized by strong externalities; bio-security measures implemented by any producer affect his/her neighbors. A major factor affecting the design of appropriate health policies for contagious diseases is whether the disease is endemic or exotic in a particular population. The externality exists for endemic diseases--but for exotic diseases there is only the possibility of an externality (which materializes solely in the case of an outbreak). For exotic diseases, therefore, the perception of the risk of an outbreak is a major determinant of producers' behavior and of public prevention policies. The perception by producers and policy makers of the probability of occurrence of an outbreak of an exotic disease depends on the time elapsed since the last outbreak in the country or in neighboring countries. In general, perception of the risk of an outbreak will be lower than the true risk for most exotic diseases that have been absent for many years--but might be higher than the true risk if an outbreak was recently reported in the region. Taxes and private insurance have been proposed to internalize the externality; however, these policies cannot solve the health externality. Alternative programs (such as joint public-private eradication campaigns) are proposed as a means to minimize the externality.