The role of wildlife in transboundary animal diseases in Kenya

The role of wildlife in transboundary animal diseases in Kenya

by | Jul 28, 2016 | My Write Ups, Transboundary diseases

The role of wildlife in transboundary animal diseases in Kenya

SUMMARY OF RECENT HISTORY (SINCE 2000) OF SELECTED TRANSBOUNDARY DISEASES IN KENYA

Avian influenza A (H7N9 & H1N1)

The 2009 Pandemic influenza A (H1N1) was first characterized in Kenya on 29th June, 2009 (Matheka et al., 2013). Thereafter sentinel data from ten sites in Kenya have identified both influenza type A and B circulating in Kenya (Muthoka, 2012). The distribution of these influenza types between 2006 to 2011 was as follows: Type A pandemic (H1N1) 2009 (28%), Type A (H1N1) seasonal (10%), Type A (H3N3) seasonal (24%), Type B (31%) and uncharacterized (7%) (Muthoka, 2012). In 2012 the predominant strain in Kenya was H3N2 with a seasonal occurrence (Achilla et al., 2009, Muthoka, 2012).

Foot and Mouth Disease

The Foot and Mouth disease outbreaks (see Figure 1 and 4) that have occurred in Kenya during the period 2004-2006 have involved serotypes: O, A, C, SAT1 and SAT2 (Sangula, 2006, CDC, 2007). The outbreak serotype distribution over the years has been as follows: 1 outbreak of SAT 1 and 19 of SAT2 reported in 2004; 3 of SAT1 and 10 of SAT2 reported in 2005; and 7 of SAT 1 and 4 of SAT 2 reported in 2006 (Sangula, 2006).

Figure 1: Map of Kenya showing reported FMD Outbreaks per province: 2004-2006 (Sangula, 2006)

Rift Valley Fever

The most recent outbreak of Rift Valley Fever in Kenya occurred between November 2006 to January 2007 (see Figure 4) that affected 6 provinces and 29 administrative districts (see Figure 2 & 3) out of the total 8 provinces and 69 administrative districts, respectively (Munyua et al., 2010) as a result of extraordinarily heavy rainfall during October-December 2006 (CDC, 2007). Following the El-nino development advisory that was issued by Kenya Meteorological Department on 22nd September, 2015 (Kenya, 2015a), as of 19th February, 2016 (time of writing this assignment) there has not been any confirmed RVF case in Kenya preceding the late-2015 El-Nino rains.

Figure 2: Districts in Kenya with confirmed RVF cases in humans and animals during 2006/07 outbreak (Munyua et al., 2010)

 

Figure 3: Number and percentage of reported RVF cases by district in Kenya Nov 2006-January 25th 2007 (CDC, 2007)

Figure 3: Number and percentage of reported RVF cases by district in Kenya Nov 2006-January 25th 2007 (CDC, 2007)

 The last known outbreak of Rinderpest in Kenya was of cattle reported in Meru National Park in 2001 (Omiti and Irungu, 2010) and a buffalo (AVMA, 2011). Since then Kenya has been free of Rinderpest (see Figure 4)

Figure 4: OIE-WAHIS Disease timelines for FMD, RVF and Rinderpest in Kenya between 2005-2015 (OIE, 2016b)

RISK OF WILDLIFE IN THE EPIDEMIOLOGY OF FMD IN KENYA

Records at the Kenya national Foot-and-Mouth Disease Laboratory show that previous studies on FMD in Kenya have mainly focused on cattle and rarely on other susceptible domestic species (Wekesa et al., 2014) and only to a minor extent on wildlife. However, in 1979, a field survey isolated SAT1 and SAT2 FMDVs from buffalo populations in the southern part of Kenya (Anderson et al., 1979).

(Bronsvoort et al., 2008) demonstrated a high and increasing seroprevalence of Foot and Mouth Disease Virus (FMDV) between the years 1994-2002 among the African buffalo (Syncerus caffer) in Eastern Africa (Kenya inclusive) with a high sero-conversation early in life (1-2 years). The study also found that the dominant serotypes were SAT2, SAT1 and then SAT3 in that order, although the buffalo seemed to be more associated to maintain the SAT2 as compared to the other serotypes.

FMDV has also been shown to infect several wild species that are found in Laikipia, with the African elephant proposed to play a potential transmission role (Aftosa, 2014). This potential transmission is further purported by (Benka, 2012) where 92.2% of the respondents in Laikipia-Kenya noted an increased contact time and population of wildlife in the recent past, especially the elephants and the buffaloes. The OIE WAHIS database also shows existence of FMD outbreaks in Kenya among wildlife (refer to Figure 4), with suspected cases in 2009 and confirmed cases between 2010-2011 that were limited to one or more zones (OIE, 2016b).

A study by (Wekesa et al., 2015) found that the Buffalo harbored SAT1 and SAT2 serotypes (see Figure 5). Wildlife have been implicated, through molecular epidemiology, as a possible culprit for the upsurge of the SAT1 and SAT2 epidemics in Kenya because of the intimate interaction of livestock and wildlife in the pastoral ecosystem (Sangula, 2006, CDC, 2007). This makes it imperative to undertake antigenic comparison to determine if the current vaccines confer protection against these co-shared serotypes at the livestock-wildlife interface.

The cross-border movement of wildlife from Kenya to Tanzania (see Figure 6) could be facilitating the complex and trans-boundary nature of this disease and further complicating its epidemiology. This could mean that control measures need to be collaborative between the governments of Kenya and Tanzania, employing a One Health concept.

Figure 5: Cross-border movement of wildlife between Kenya and Tanzania (Rovi film, 2013)

Figure 6: Circles with numbers indicate geographic origins of the 15 SAT 1 and SAT 2 foot-and-mouth disease viruses (FMDVs) isolated from buffalo and cattle (Wekesa et al., 2015)

Figure 6: Circles with numbers indicate geographic origins of the 15 SAT 1 and SAT 2 foot-and-mouth disease viruses (FMDVs) isolated from buffalo and cattle (Wekesa et al., 2015)

BIOLOGIC, SOCIOLOGIC, AND ECONOMIC FACTORS IMPORTANT IN THE CONTROL AND/OR ELIMINATION OF FMD IN KENYA

BIOLOGIC FACTORS

Wide array of serotypes: There are several serotypes for the FMDV with antigenic variations within each serotype making it impossible for one serotype to confer immunity against another serotype (OIE, 2012), and therefore in practice vaccine matching becomes necessary with the field strains  (Chepkwony, 2011).

FMDV is highly contagious: Transmission can be facilitated through contact with infected animals, their excretions, secretions, or contaminated fomites and products (OIE, 2012, USDA, 2013). It has also been shown that humans can possibly transmit the FMDV to susceptible animals during FMD outbreaks (USDA, 2013) and therefore responders should uphold biosecurity measures.

Wide range of susceptible hosts: Many of the cloven-hoofed wildlife and domestic species at the wildlife-livestock interface in Kenya, including: cattle, goats, sheep, and pigs are susceptible to FMDV, and this presents a possible spillover of infection into livestock or sympatric cloven-hoofed wildlife (OIE, 2012 1512).

Carrier state: Cattle, sheep, and goats can become carriers or persistently infected even after successful vaccination (Chhetri et al., 2010). The carrier state is a complication which should be considered during outbreak situations (Grubman and Baxt, 2004).

FMDV is moderately stable in the environment: Under certain conditions the FMDV can maintain infectivity in the environment for extended periods of time (USDA, 2013). It is essential for livestock owners and producers to maintain sound biosecurity practices as outlined by (OIE, 2016a) to prevent introduction/spread of the virus during outbreaks.

Illegal movement routes: Illegal stock routes for trade as a result of drought, forced cattle movement due to cattle rustling and across the borders are some of the main causes of FMDV spread in Kenya (Chepkwony, 2011). Therefore there should be coordinated livestock movement control at borders and stop cattle rustling.

Pastoralism: Pastoral long distance movement of animals, and high stocking densities facilitates the widespread of viral particles (OIE and FAO, 2012) within and across borders.

Several differential diagnosis: FMD cannot be differentiated clinically from other similar diseases and therefore an suspected case is best confirmed through laboratory diagnosis (OIE, 2012).

SOCIAL FACTORS

The social factors to be considered are:

  • Effective, timely and accurate communications with the affected premises, stakeholders, farmers and animal keepers, the public and the media so as to reduce the impact and spread of disease and to provide accurate and timely updates on latest situation
  • Timely risk communication to the public, region and international community during an outbreak or incident to ensure effective representation of Kenya disease control activities.
  • Background knowledge on the structure of livestock production systems to understand epidemiology and control options suitable at the local setting
  • Public health implications since FMD can cause mild disease in humans and accompanied by floods during the rains
  • Assurance to the public and international community of safe commodities for trade
  • Public acceptance especially when it comes to: culling of animals and animal welfare perspectives
  • Provision of support services e.g. psychological support during mass death
  • How to counter misinformation and misconceptions especially through media
  • Supporting legal framework in Kenya: The animal diseases Act Chapter 364; Public Health act cap 242; Meat Control Act cap 356; Procurement and audit act

ECONOMIC FACTORS

Some of the economic factors to consider are (OIE, 2014):

  • Costs and benefits of intervention
  • Availability of resources
  • Logistics and ease of implementation
  • Stakeholder engagement especially the public-private partnerships
  • Environmental impact
  • Political will
  • Incentives and compensation
  • Budget and financial resources planning

IMPORTANT STAKEHOLDERS TO BE INVOLVED IN THE CONTROL

Ministry of Agriculture, Livestock and Fisheries: Kenya’s economy is dominated by the agricultural sector and FMD poses a great threat to it both as production losses and indirect losses.

Ministry of Health: FMD has public health implications e.g. flooding & zoonotic.

Ministry of Tourism and other local & international travel organisations: The African wildlife are a major tourist attraction and if there is a risk of infection from wildlife this may impact negatively on the tourism industry

Devolved local government administration: have the responsibility to enforce disease control measures, offer administrative and information technology resources such as administered movement licensing, provide advice and support to affected sectors.

Central Veterinary Laboratory: has the capacity to provide and interpret diagnostic and surveillance data and provide disease-specific expert knowledge in terms of the epidemiology and control measures of FMD.

Regional or Local NGOs, CBOs, FBOs, youth groups, churches etc.:  These groups will help inform local decision making as appropriate and will assist with ensuring that developments in local operations are communicated to all relevant parties, including those who are not engaged with industry groups and sector councils, and can be a challenge to reach.

Ministry of Defence and Police:  They will play the role of organization and logistical arrangements especially when it comes to intensifying biosecurity patrols and protecting the public order with individual roles such as: enforcement of movement controls with local authorities, policing of control zones, coordination of legal entry to premises etc.

Global facilitation/technical assistance bodies: such as GARC (Global Alliance for Rabies Control) who can act as a liaison body between national governments, community stakeholders and the international FAO-OIE-WHO tripartite.

Regional banks and stakeholders: they have contributed and still contribute significantly to FMD control efforts in Africa.

Ministry of Environment and Natural Resources: Will contributed to development of carcass transport arrangements and advice on planning, air and environment quality issues relating to disposal of carcasses and cleanup.

Foot and Mouth Disease champion: Having an FMD champion from a country that has successfully eradicated FMD so as to provide ‘good practices’ that can locally be adopted in the prevention and control of FMD

Kenya Veterinary Vaccines Production Institute (KEVEVAPI): Since they produce the FMD vaccine they will play a valuable contribution in its control through vaccine provision

Local community: They have and are already suffering because of the production losses as a result of FMD and therefore will be a direct beneficiary and implementer of prevention/control strategies proposed.

The media:  They will disseminate key messages on the prevention and control of FMD to the public

CONCLUSIONS AND RECOMMENDATIONS

It is clear that wildlife have a potential role in the epidemiology of Foot and Mouth Disease in Kenya and the neighboring regions, although the existing information is still limited. Hence, Foot and Mouth Disease control in Kenya should principally target on reducing the high burden of disease among livestock and consequently limit the livestock-wildlife interaction through collaborative efforts with stakeholders and between countries that share a border with Kenya that facilitate cross-border movement of livestock and wildlife. This can be achieved through a number of ways:

  • Strengthen surveillance systems: Build the capacity of local laboratories and promote regional integrated surveillance systems so as to facilitate early detection and rapid response to any FMD outbreak. At the same time develop multivalent vaccines targeting the shared serotypes between livestock and wildlife.
  • Disease prevention and infection control: with the aim of slowing the spread of FMD and end the outbreak so as to prevent new cases from arising. This can be at the:
    • Human level through: public health education; behavior change communication especially targeting the pastoralists to avoid risky practices that propagate transmission between communities and across borders
    • Animal level through: strategic livestock vaccination in specific hot spots; imposition of quarantines in affected areas and slaughter bans.
  • Cross-border mitigation: The cross-border movement of livestock and wildlife necessitates that control measures need to be collaborative between the governments employing a One Health concept.
  • Support services: Contingency plans to be in place to provide support in regard to floods that can result to partial/full harm to humans which may require provision of temporary support facilities and relief aid to both humans and animals
  • Targeted and coordinated communication: The aim is to provide accurate, timely and easy to understand information through coordinated communication among all relevant stakeholders to ensure consistent messages to the general public and at the same time address the circulating rumours, misinformation and conflicting information.
  • Standard Operating Procedures and protocols: Should be available before the outbreak and address: simulation and training, quarantine measures, handling of samples, vaccination of livestock, surveillance, rapid response teams, biosecurity and biosafety, communication protocol, and allocation of responsibilities.

 REFERENCES

ACHILLA, R. A., BULIMO, W. D., MAJANJA, J. M. & WADEGU, M. O. 2009. Decline of Pandemic (2009) H1N1 Influenza Cases in Sentinel Surveillance Sites in Kenya January 2012-May 2012. ISIRV Conference.  Available at: http://creativestage.nucleusclient.com/isirv/Incidence/Poster_Presentations.pdf [Accessed 15 February, 2016].

AFTOSA, F. 2014. Foot and Mouth Disease. The Centre for Food Secueity and Public Health Institute for International Cooperation in Animal Biologics Available at: http://www.cfsph.iastate.edu/Factsheets/pdfs/foot_and_mouth_disease.pdf [Accessed 15 February, 2016].

ANDERSON, E. C., DOUGHTY, W. J., ANDERSON, J. & PALING, R. 1979. The pathogenesis of foot-and-mouth disease in the African buffalo (Syncerus caffer) and the role of this species in the epidemiology of the disease in Kenya. Journal of Comparative Pathology, 89, 541-549 Available at: http://www.sciencedirect.com/science/article/pii/0021997579900458 [Accessed 15 February, 2016].

AVMA. 2011. Rinderpest eradicated [Online]. American Veterinary and Medical Association. Available at: https://www.avma.org/News/JAVMANews/Pages/110701a.aspx.

BENKA, V. A. W. 2012. Human-wildlife conflict, interspecies disease, and justice in a wildlife-rich region of Kenya. Master of Science Msc, University of Michigan.  Available at: http://deepblue.lib.umich.edu/bitstream/handle/2027.42/96190/benka%20thesis%20final.pdf?sequence=1.

BRONSVOORT, B. M., PARIDA, S., HANDEL, I., MCFARLAND, S., FLEMING, L., HAMBLIN, P. & KOCK, R. 2008. Serological survey for foot-and-mouth disease virus in wildlife in eastern Africa and estimation of test parameters of a nonstructural protein enzyme-linked immunosorbent assay for buffalo. Clin Vaccine Immunol, 15, 1003-11.http://dx.doi.org/10.1128/CVI.00409-07:

CDC 2007. Rift Valley Fever Outbreak  Kenya, November 2006 January 2007. Morbidity and Mortality Weekly Report.  Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5604a3.htm [Accessed 11 February, 2016].

CHEPKWONY, E. C. 2011. An Epidemiological Survey Of The Serotypes Of Foot and Mouth Disease Virus In Circulation In The Somali-ecosystem In Kenya. Applied Veterinary Microbiology Msc, University of Nairobi.  Available at: http://erepository.uonbi.ac.ke/bitstream/handle/11295/13995/An%20Epidemiological%20Survey%20Of%20The%20Serotypes%20Of%20Footand-mouth%20Disease%20Virus%20In%20Circulation%20In%20The%20Somali-ecosystem%20In%20Kenya.pdf?sequence=4.

CHHETRI, B. K., PEREZ, A. M. & THURMOND, M. C. 2010. Factors associated with spatial clustering of foot-and-mouth disease in Nepal. Trop Anim Health Prod, 42, 1441-9.http://dx.doi.org/10.1007/s11250-010-9573-7:

GRUBMAN, M. J. & BAXT, B. 2004. Foot-and-Mouth Disease. Clinical Microbiology Reviews, 17, 465-493.http://dx.doi.org/10.1128/cmr.17.2.465-493.2004:

KENYA, G. O. 2015a. Advisory on development of El-Nino. In: RESOURCES, M. O. E. A. N. (ed.). Nairobi-Kenya: Kenya Meteorological Department Available at: http://www.meteo.go.ke/pdf/elnino_2.pdf [Accessed 16 February, 2016].

KENYA, G. O. 2015b. Kenya Veterinary Policy (draft). In: MINISTRY OF AGRICULTURE, L. A. F. (ed.). Nairobi:  Available at: http://www.kilimo.go.ke/wp-content/uploads/2015/06/Draft-Veterinary-Policy.pdf [Accessed].

MATHEKA, D. M., MOKAYA, J. & MARITIM, M. 2013. Overview of influenza virus infections in Kenya: past, present and future. Pan Afr Med J, 14, 138.http://dx.doi.org/10.11604/pamj.2013.14.138.2612:

MUNYUA, P., MURITHI, R. M., WAINWRIGHT, S., GITHINJI, J., HIGHTOWER, A., MUTONGA, D., MACHARIA, J., ITHONDEKA, P. M., MUSAA, J., BREIMAN, R. F., BLOLAND, P. & NJENGA, M. K. 2010. Rift Valley fever outbreak in livestock in Kenya, 2006-2007. Am J Trop Med Hyg, 83, 58-64.http://dx.doi.org/10.4269/ajtmh.2010.09-0292:

MUTHOKA, P. 2012. Influenza Epidemiology in Kenya. 3rd Annual African Network for Influenza Surveillance and Epidemiology(ANISE) Nairobi-Kenya:  Available at: https://www.team-psa.com/anise/2012/pres/WEDFEB1/InfluenzaSurvUpdates/Muthoka_Influenza%20Epidemiolgy%20in%20Kenya.pdf [Accessed 16 February, 2016].

OIE 2012. Foot and Mouth Disease. Terrestrial Manual 2012. 7 ed.: World Organisation for Animal Health Available at: http://www.oie.int/international-standard-setting/terrestrial-manual/access-online/ [Accessed].

OIE 2014. Guidelines for Animal Disease Control. World Organisation For Animal Health,  Available at: http://www.oie.int/fileadmin/Home/eng/Our_scientific_expertise/docs/pdf/A_Guidelines_for_Animal_Disease_Control_final.pdf [Accessed 16 February, 2016]. 1-10

OIE 2016a. Foot and Mouth Disease Portal: Prevention and control. World Organisation for Animal Health Available at: http://www.oie.int/animal-health-in-the-world/fmd-portal/prevention-and-control/ [Accessed].

OIE 2016b. WAHIS-Disease Information-disease timelines for FMD, RVF and Rinderpest. World Organisation for Animal Health Available at: http://www.oie.int/wahis_2/public/wahid.php/Diseaseinformation/Diseasetimelines [Accessed].

OIE & FAO 2012. The Global Foot and Mouth Disease Control Strategy: Strengthening animal health systems through improved control of major diseases, World Organisation for Animal Health

Food and Agriculture Organisation of  the United Nations.

OMITI, J. & IRUNGU, P. 2010. Socio-economic Benefits of Rinderpest Eradication from Ethiopia and Kenya. In: OMITI, J. & IRUNGU, P. (eds.) Consultancy Report. African Union InterAfrican Bureau for Animal Resources Available at: file:///C:/Users/MomanyiNK/Desktop/doc_20100301_serecu_socioecobenefits_en.pdf [Accessed 11 February, 2016].

ROVI FILM 2013. The Serengeti gnu migration route.  Available at: http://www.rovifilm.tv/index.php/press-articles/item/between-tanzania-and-kenya-the-serengeti [Accessed 16 February, 2016].

SANGULA, A. K. 2006. Foot-and-Mouth disease serotypes SAT1 and SAT2 Epidemiology in East Africa. Food and Agriculture Organisation of the United Nations: Foot and Mouth Disease Laboratory, Embakasi-Kenya Available at: http://www.fao.org/AG/AGAInfo/commissions/en/documents/reports/paphos/App18.pdf [Accessed 11 February, 2016].

USDA 2013. Foreign Animal Disease Preparedness & Response Plan: Foot and Mouth Disease Standard Operating Procedures-Overview of Etiology and Ecology. In: SERVICE, A. A. P. H. I. (ed.). United States Department of Agriculture Available at:  [Accessed 16 February, 2016].

WEKESA, S. N., NAMATOVU, A., SANGULA, A. K., DHIKUSOOKA, M. T., MUWANIKA, V. B. & TJORNEHOJ, K. 2014. A serological survey for antibodies against foot-and-mouth disease virus (FMDV) in domestic pigs during outbreaks in Kenya. Trop Anim Health Prod, 46, 575-81.http://dx.doi.org/10.1007/s11250-013-0530-0:

WEKESA, S. N., SANGULA, A. K., BELSHAM, G. J., TJORNEHOJ, K., MUWANIKA, V. B., GAKUYA, F., MIJELE, D. & SIEGISMUND, H. R. 2015. Characterisation of recent foot-and-mouth disease viruses from African buffalo (Syncerus caffer) and cattle in Kenya is consistent with independent virus populations. BMC Vet Res, 11.http://dx.doi.org/10.1186/s12917-015-0333-9:

 

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Researchers confirm link between schistosomiasis and HIV acquisition

Researchers confirm link between schistosomiasis and HIV acquisition

by | Apr 2, 2016 | Infectious Diseases, Public health, Research

Researchers confirm link between schistosomiasis and HIV acquisition

WWF

Photo by John Bett, WWF

A comprehensive review of secondary data sources has confirmed a long-suspected link between female genital schistosomiasis (FGS) and HIV infection for women in southern Africa. Researchers confirmed the link in Mozambique, finding that exposure to schistosomiasis, combined with HIV prevalence, increases the odds of HIV infection by three times. Researchers also conclude that treating young girls for schistosomiasis could avert millions of new cases of HIV infection at far less cost than treating HIV infection once it has occurred.

Schistosomiasis is a fresh water-borne parasitic infection, usually contracted in childhood through activities such as swimming, bathing, fishing, and fetching water. It affects 261 million people worldwide and is known to be highly endemic in sub-Saharan Africa. Domestic chores can place girls and women at greater risk of contracting FGS, which, the researchers say, may help explain the fact that only in sub-Saharan Africa are HIV infections higher among females than among males.

The authors, Paul Henry Brodish and Kavita Singh, conducted the study for MEASURE Evaluation, funded by the U.S. Agency for International Development (USAID) and the President’s Emergency Plan for AIDS Relief (PEPFAR), a project of the Carolina Population Center of the University of North Carolina at Chapel Hill (UNC).

Researchers confirmed the link in Mozambique by investigating two high-quality secondary data sources on HIV prevalence and FGS: the 2009 National Survey on Prevalence, Behavioral Risks, and Information about HIV and AIDS in Mozambique (INSIDA) and the Global Neglected Tropical Diseases (GNTD) open source database. Their results can reasonably be applied generally to sub-Saharan Africa and perhaps especially to South Africa, Tanzania, and Zimbabwe, where field studies showed woman whose vaginal mucosal barrier tissue was compromised due to FGS were three times as likely as their neighbors to be infected with HIV.

School children in Niger with gross hematuria (blood in urine) caused by schistosomiasis (photo by Jurg Utzinger)

School children in Niger with gross hematuria (blood in urine) caused by schistosomiasis (photo by Jurg Utzinger)

In fact, two decades of studies have indicated that HIV/AIDS can be exacerbated by co-infection with neglected tropical diseases (including schistosomiasis), which weaken immune systems, increase susceptibility to other infections, and lower the effectiveness of antiretroviral therapy (ART).

The study’s findings also offer a significant potential cost savings for governments and global donors, as treatment for FGS would cost significantly less than treating HIV infection. The authors cite estimates that de-worming 70 million African children twice a year for a decade would cost about $112 million, versus an estimated $38 billion PEPFAR would expend in the same period.

These results are additional evidence supporting the link between neglected tropical diseases (NTD) and HIV and the need to scale up treatment for NTD and for increased access to improved water sources. The authors suggest further studies are necessary in other locales where there is high HIV prevalence and endemic NTDs.

The researchers say the study is limited by its indirect assessment of exposure to FGS (S. haematobium) and that the availability of mass drug administration in various survey regions is not known. However, both of these limitations would tend to make it more difficult to draw an association between FGS and HIV infections.

The study is also significant on a global scale as the Sustainability Development Goals (SDG), USAID’s goal of an AIDS-free generation (AFG), and prevention of mother-to-child transmission of HIV (PMTCT), will be that much more attainable if HIV infection can be curtailed in sub-Saharan Africa—where 60 percent of new cases are female and mostly young.

This article originally appeared on the Measure Evaluation website, authored by WWF CHAPEL HILL, NC. Available at: http://www.cpc.unc.edu/measure/news/schistosomiasis-and-hiv-acquisition

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Role of mapping in preventing epidemics like Ebola

Role of mapping in preventing epidemics like Ebola

by | Jan 12, 2016 | Infectious Diseases, Research, Zoonoses

Role of mapping in preventing epidemics like Ebola

A review in The International Journal of Epidemiology has offered some practical suggestions for preventing a future epidemic like the recent Ebola crisis.
stop-ebola

In a future epidemic, more effective strategies must be put in place to stop the spread.

Prof. Tom Koch, of the University of British Columbia, asks how it could be that many of the best minds in infectious disease, epidemiology and disaster medicine missed the early spread of the Eboladisease so that it became a regional epidemic.

While insisting that all parties involved “labored heroically, often at great personal risk, to restrict the original outbreak and treat those affected by it,” Prof. Koch believes there are lessons to learn about containing future disease outbreaks in rural areas with minimal resources.

In his review, he focuses on the potential of mapping as a tool to help deal with future disasters.

Prof. Koch points out that limits on data relating to patient location and travel mapping made it harder to contain the Ebola crisis.

At the same time, regional disease protocols were not implemented soon enough, as nobody anticipated such an expansive epidemic.

Records now show that the 2014 epidemic probably began in 2013, when a 2-year-old boy in the village of Meliandou in Guinea’s Gue ́ckédo Prefecture first became infected.

Infections need to be appropriately mapped

However, local, national and international health officials assumed that, as in previous cases, this outbreak would be a static, and thus controllable, localized disease event.

Prof. Kock explains that infectious diseases have a spatial structure and that their spread depends on individual features that either promote or hinder their progress. Based on this, he argues that various forms of mapping could help to contain such diseases.

In the case of the Ebola epidemic, having no maps or census data for the region where the outbreak occurred made it difficult to apply aggressive quarantine programs, which could have isolated the villages where Ebola was active and protected those at risk from villagers who did not display symptoms.

Prof. Koch discusses the need to involve the community in mapping and education.

He says:

“Employing community members in the mapping also serves anthropologically, involving community members in the disease response, teaching them about an expanding viral event and its local effects. In areas where there is distrust of foreign or official health workers, this can be critical.”

Prof. Koch gives the example of the Nepal earthquake in 2015, where resources of Humanitarian Open Street Map and Digital Globe satellite data enabled 39 volunteers to create Quakemap.org, a crowd-sourced mapping program that enabled correlation of reports of earthquakes in individual villages to help ensure that supplies were directed where they were needed.

In connection with the Ebola crisis, he focuses on a strategy called diffusion mapping. In this approach, smaller scale maps are used in patient interviews to identify travel patterns of patients before they become symptomatic. This could be helpful in anticipating the number of patients likely to present with symptoms in time.

He describes the approach as “a potentially invaluable, if so far untested, approach that would rapidly characterize local travel patterns and thus the potential for regional disease expansion.”

Prof. Koch hopes that the review will help shape ideas about how mapping could help significantly in future outbreaks by contributing toward a prompt response.

Medical News Today recently reported on trials into the effectiveness and safety ofusing convalescent plasma to treat Ebola patients.

Source
Article originally appeared on the Medical News Today website on 11th January, 2016 and authored by . Available at: http://www.medicalnewstoday.com/articles/304890.php?
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Preventive malaria treatment for Ebola contacts cost-effective

Preventive malaria treatment for Ebola contacts cost-effective

by | Jan 12, 2016 | Infectious Diseases, Research, Zoonoses

Preventive malaria treatment for Ebola contacts cost-effective

Public health officials should consider preventive malaria treatment for contacts of patients with Ebola virus disease in areas where malaria transmission is high, according to a study published in The Lancet Infectious Diseases.

“Malaria is endemic in West Africa, so accurate diagnosis of Ebola virus disease is difficult when the disease is in the early stages, since symptoms resemble those of febrile malaria,” Cristina Carias, PhD, of the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, and colleagues wrote. “As a result, 33% to 54% of patients admitted to [Ebola treatment units (ETUs)] during the 2014-2015 West Africa outbreak did not have Ebola virus disease. The provision of preventive malaria treatment to all contacts of patients with Ebola virus disease has thus been proposed as an option to prevent the onset of malaria fever and consequent inefficient allocation of ETU beds to patients with malaria, and exposure of these patients to Ebola virus.”

Carias and colleagues used a decision tree model to assess the economic feasibility of administering artemisinin-based combination treatment (ACT) to all contacts of patients with Ebola virus disease in West Africa.

The analysis lasted 1 year, roughly aligning with the West Africa Ebola outbreak. The researchers calculated the intervention’s cost per ETU admission averted by season (wet or dry), country (Liberia, Sierra Leone or Guinea) and age of contact (aged younger than 5 years, aged 5 to 14 years or aged 15 years and older). Sensitivity analyses were used to assess how results varied with malaria parasite prevalence in children aged 2 to 10 years, the daily cost of ETU stay, and the effectiveness of preventive malaria treatment and patients’ adherence to it.

From a health care perspective, administering ACTs to Ebola contacts resulted in cost savings for those of all ages in Liberia, Sierra Leone and Guinea, regardless of season, according to the researchers. In the wet season, preventive malaria treatment was estimated to reduce the chances of a contact being admitted to an ETU by 10% to 36%. Assuming 85% adherence to ACTs and taking into account the African population pyramid, the researchers expect ACTs to be cost saving in Ebola contacts across all age groups, even when malaria parasite prevalence in children aged 2 to 10 years is as low as 10%. During the wet season in Liberia, malaria preventive treatment was cost saving even as the average daily bed-stay costs were as low as $5 for children aged younger than 5 years, $9 for those aged 5 to 14 years, and $22 for those aged 15 years and older.

“This study provides a very strong justification for public health providers responding to an Ebola virus disease outbreak to consider distribution of preventive malaria treatment to contacts of patients with Ebola virus disease, in the context of an emergency response to Ebola virus disease outbreaks in malaria endemic areas,” Carias and colleagues wrote.

In a related editorial, Azra C. Ghani, PhD, and Patrick G. Walker, PhD, of the School of Public Health, Imperial College London, said extending ACT to areas with less intense seasonal transmission would not only be cost-effective as a malaria intervention, but it would reduce the burden on the health care system. This would, in turn, enable a more rapid response to future Ebola outbreaks.

“Any reduction in unnecessary admission to ETUs also has substantial benefits in terms of controlling the Ebola epidemic. Reducing the number of individuals in ETUs would not only be cost saving but also substantially relieve the pressure on an overburdened epidemic response,” Ghani and Walker wrote. “Additionally, it will reduce the potential for further transmission of Ebola virus disease within the ETUs.” – by Jason Laday

Study links

Carias C, et al. Lancet Infect Dis. 2015;doi:10.1016/S1473-3099(15)00465-X
Ghani CG, et al. Lancet Infect Dis. 2015;doi:10.1016/S1473-3099(15)00481-8.

Disclosure: The researchers report no relevant financial disclosures. Please see the full editorial for a list of the authors’ relevant financial disclosures.

Source

Article originally appeared at the Halio website on 11th January, 2016. Available at: http://www.healio.com/infectious-disease/emerging-diseases/news/online/%7B06d52d61-fd9c-4f74-999a-07eb553260b6%7D/preventive-malaria-treatment-for-ebola-contacts-cost-effective

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Scientists Study Slums for Signs of Spreading Superbugs

Scientists Study Slums for Signs of Spreading Superbugs

by | Jan 12, 2016 | Infectious Diseases, One Health, Zoonoses

Scientists Study Slums for Signs of Spreading Superbugs

NAIROBI, KENYA-The next superbug could emerge from the slums of the developing world, researchers warn.

Rapid, unplanned growth in many urban areas has people, livestock and wildlife living in close proximity and with inadequate sanitation. These are ideal conditions for microbes to evolve and spread.

So a major project is underway, designed to shed light on how microbes move through the slums of Nairobi and beyond.

It’s known as the Urban Zoo project. “Zoo” is short for zoonosis, the spread of diseases from animals to humans. From salmonella to swine flu, that’s how we get most of our diseases.

Slum farm

But “zoo” also suggests the menagerie of creatures found in Nairobi’s slums that could carry those diseases.

At the garbage dump in Nairobi’s Viwandani neighborhood, people, goats and Marabou storks pick through the trash side by side. (Credit: S. Baragona/VOA)

At the garbage dump in Nairobi’s Viwandani neighborhood, people, goats and Marabou storks pick through the trash side by side. (Credit: S. Baragona/VOA)

Fenced in by sheets of rusting corrugated metal in Nairobi’s Viwandani neighborhood, Joseph Mwai and his family share a couple thousand square feet with three cows, a handful of chickens, about a dozen goats and a small herd of pigs.

These are far from optimal conditions for raising livestock. But Mwai says he doesn’t have much of a choice.

“It’s important to me because I don’t have any job to do,” he said. “I make a living from them.”

A garbage dump smolders behind Mwai’s tiny homestead, across a stream polluted with raw sewage. People, goats and Marabou storks pick through the trash side by side, looking for anything useful or edible. Plastic bags are pulled from the heaps, rinsed in the contaminated river and resold.

It’s a rich environment for the spread of bacteria and other microbes.

Gene swappers

The Urban Zoo project is watching one microbe in particular: E. coli.

Mostly harmless, E. coli usually leads a quiet life in the digestive tract of warmblooded animals, from humans to birds to mice.

But some strains cause disease. And it’s of special interest to researchers for two other reasons.

Molecular biologist John Kiiru studies drug-resistant bacteria spreading in Nairobi’s slums at the Kenya Medical Research Institute. (Credit: S. Baragona/VOA)

Molecular biologist John Kiiru studies drug-resistant bacteria spreading in Nairobi’s slums at the Kenya Medical Research Institute. (Credit: S. Baragona/VOA)

First, it can spread easily and widely, according to molecular biologist John Kiiru with the Kenya Medical Research Institute. He explained, “E. coli is able to survive in the environment and it can also be shared between humans and animals.”

And E. coli are exceptionally good at swapping genes with other microbes, including genes that transform harmless bacteria into dangerous germs, or that render them immune to antibiotics.

These genes “can actually be transferred to other organisms which could be pathogenic,” Kiiru said.

That’s not a hypothetical. Kiiru says his team has identified E. coli that are resistant to four antibiotics, then found that same resistance pattern spreading to another germ, salmonella.

“And when we sequenced and analyzed these resistances,” he said, “we found that the same block of resistance genes that we had found in E. coli were actually now in salmonella.”

Even more concerning: Cholera germs may have picked up those resistance genes as well. “What you end up creating is a superbug” that’s highly virulent and highly resistant, Kiiru said.

Germ movement

But scientists know very little about how any bacteria move through this complex environment.

So the Urban Zoo project is visiting 99 households across Nairobi, rich and poor, with livestock and without. They’re taking samples from people, their animals, and whatever wildlife they can find nearby (and catch): storks, mice, bats, et cetera. They’re sampling the ground around homes, yards and livestock pens with white paper booties.

The aim, says University of Liverpool veterinarian Judy Bettridge, is “to try and understand on a small scale how those bacteria are shared” among each household’s people, livestock and environment. “And then when we scale it up, are the bacteria here being shared with the household that’s 50 meters over there? Or 100 meters over there? So, how far can they actually spread?”

Once they find out, Kiiru says, the researchers need to be sensitive about how they present their results. Livestock are technically illegal in the city, but they are important sources of food and income.

And they don’t want to make pariahs of people who are already marginalized.

“We are not necessarily investigating who is spreading the resistant or the virulent organisms,” he said. “But actually we are trying to solve a problem.”

Food networks

Another question is the role that food plays in spreading those bacteria. Mwai’s city livestock are one small part of the vast network that delivers meat, milk and eggs throughout Nairobi.

The Urban Zoo project is mapping those routes. In this modernizing East African capital, that includes everything from shiny, modern supermarkets to grimy street-food stalls.

Street food and other informal vendors are especially important in communities like Viwandani, where many people don’t have time — or kitchens — to prepare their own meals.

WATCH: Small Shops in Nairobi Get Food Safety Training

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“You can find [residents] depending entirely on the [informal] food vendors,” says Nicholas Ngomi with the African Population and Health Research Center. That makes street-food hawkers and cooks in tiny corner shops key to protecting the health of Viwandani’s residents, he adds.

But food poisoning is rampant here. As Urban Zoo researchers mapped Viwandani’s food networks, they talked with these informal cooks about foodborne disease. One request kept coming up, Ngomi said: “ ‘Teach us about how these diseases come about.’ ”

The project didn’t have much money to spare. But they set up a half-day training session for 25 neighborhood food handlers.

Lessons in food safety

They covered the basics: how to wash hands, produce and cutting surfaces, plus basic microbiology and food spoilage.

James Kuria, owner of the 11th Hour Butchery, learned that the meat that hangs in bright red slabs in his shop window goes bad quickly without refrigeration.

After learning how quickly meat spoils without refrigeration, butcher James Kuria buys less and keeps it for less time. (Credit: S. Baragona/VOA)
After learning how quickly meat spoils without refrigeration, butcher James Kuria buys less and keeps it for less time. (Credit: S. Baragona/VOA)

“If it will last here for long, it will maybe bring some diseases to my customers,” he said. Now he only buys enough to last a couple of days. That also means he throws away less, he added, which cuts his losses.

For Charity Nyambura, who sells rice, beans and vegetables at a nearby street stall, the big discovery was that her cutting boards can harbor bacteria.

“When you cut the kale there are particles that come off the board, and you unknowingly give them to the customers along with the kale,” she said. “So, they eat the particles in the food and in the long run it affects their health.”

Now she washes her cutting boards, knives and vegetables before she starts chopping.

Only a few hawkers got training. But success breeds imitation, Nyambura said.

“In this business there’s a lot of competition,” she said. “They’re always trying to copy what I’m doing so they can also try and get customers.”

Charity Nyambura was one of 25 food vendors in Viwandani who received basic food safety training. (Credit: S. Baragona/VOA)

Charity Nyambura was one of 25 food vendors in Viwandani who received basic food safety training. (Credit: S. Baragona/VOA)

The hope is that other vendors will copy Nyambura, Kuria and the other trainees, so food safety practices will spread through the neighborhood, slowing the spread of illness.

Ultimately, the Urban Zoo project aims to provide evidence that will help policymakers improve conditions in Nairobi’s slums.

They are already making worrying discoveries.

“We have started seeing resistance among organisms that are easily recovered from animals or animal food products,” Kiiru said. “This evidence is going to give us a chance to … confidently tell the government, ‘We think there’s a challenge. Let’s improve the sanitation, the hygiene.’ ”

Originally appeared at the Voice of America website: http://www.voanews.com/content/scientists-study-slums-signs-spreading-superbugs/3116155.html

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Experts meet to battle livestock diseases

Experts meet to battle livestock diseases

by | Sep 8, 2015 | Infectious Diseases

Experts meet to battle livestock diseases

Experts from more than 90 countries have met in Paris to discuss how to minimise the threat of infectious animal diseases escaping from laboratories.

The first global conference on biological threat reduction, hosted by the World Organisation for Animal Health (OIE), in collaboration with the World Health Organisation (WHO), brought together a range of participants.

Specialists from public health, animal health, scientists, veterinarians and security sectors from international organisations and national governments attended the gathering.

Among the diseases discussed were rinderpest, a deadly disease also known as cattle plague that was officially wiped out of livestock in May 2011. Samples of the virus are still stored in dozens of laboratories worldwide.

The OIE is concerned poor security or a malicious act could see the virus reintroduced to cattle stocks, which it warns, would cause food prices to rise. It wants all samples stored by laboratories to be destroyed.

Biological weapons

All animal disease agents, including those transmissible to humans, have the potential to escape by accident from laboratories or to be used as biological weapons because of their low cost and ready availability.

Once infectious diseases have been eradicated special risks arise from the potential for accidental or deliberate infection.

“Unless the international community takes meaningful action to fulfil their obligations to destroy and sequester eradicated pathogens (such as rinderpest), risks will increase over time as more diseases become eradicated,” said Dr Bernard Vallet, director general of the OIE.

Delegates stressed the importance of good governance of animal and public health national systems, allowing early detection and rapid response to any new disease outbreak. That would protect the society and neighbouring countries from potential disasters of natural, accidental or intentional origin, they concluded.

Participants agreed the health and security sectors needed to improve cooperation and speak with one voice on the urgent need to invest in strengthening health systems.

Social and economic costs

The social and economic costs and benefits of investing in health systems in peacetime far outweighed the costs of responding to a crisis linked with a preventable biological disaster, they argued. Investments in the systems needed to support these policies should be considered a priority in all countries, they agreed.

Internationally adopted standards were the basis for global infectious disease prevention and control, including early detection and rapid response to biological events, and for strong animal health and human health systems, the experts insisted.

“By complying with international standards for health systems, set by the OIE and WHO, countries demonstrate that they stand a good chance of detecting and tackling animal and human health threats,” said Vallet.

Many countries are unable to meet these standards, so the OIE, together with the WHO, has established a comprehensive global framework for strengthening in parallel public and animal health systems.

“In addition, we have made progress in establishing good governance in the animal sector, as we have already responded to requests for assistance from 133 of our 188 member countries,” Vallet added.

This article originally appeared on the GlobalMeat News webite.

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