Surveillance of Zoonoses in livestock and humans: a note from the post-doc

Surveillance of Zoonoses in livestock and humans: a note from the post-doc

After many months of careful planning and preparation, the main ZooLinK surveillance project has set sail! We have been sampling in the twelve selected live-stock markets, four each in the counties of Busia, Bungoma and Kakamega. At each market, we are collecting data on, and biological samples from, up to ten randomly selected cattle and small ruminants. Sampling in livestock markets can be challenging as traders are busy people who want to sell their animals. Moreover, some shared with us the perception that having their animal sampled may send the wrong message to future buyers. We are reminded once again of the importance of engaging local stakeholders at an early stage to help explain the study purpose and facilitate study participation.

Public engagement session in one of our sampling sites

We then expanded our sampling by including cattle, small ruminants and pigs that are taken for slaughter at selected slaughterhouses and slaughter slabs in the surroundings of the included livestock markets. Concurrently, we are also sampling outpatients at the three County referral hospitals and other selected health centres in the study area. All collected biological samples are processed and tested for fifteen selected zoonotic diseases at our field lab in Busia. Some of the animal samples shall also be used for genetic studies to identify changes in breeds as farming systems intensify over time.

We are all looking forward to working and learning together during our ZooLinK journey!

This article was authored by Dr Laura Falzon who is the Post-doctoral scientist (surveillance component) in the ZooLinK suite of projects.

An account of the 11th TAWIRI conference featuring presentations from our team

An account of the 11th TAWIRI conference featuring presentations from our team

The eleventh Tanzania Wildlife Institute (TAWIRI) conference themed, “People, livestock, and climate change: Challenges for sustainable biodiversity conservation”, was held from 6th to 8th December 2017 at the Arusha International Conference Centre (Fig.1). The conference had over 300 local and global participants with diverse knowledge on wildlife conservation with 4 keynote papers, 3 symposia, and 7 parallel sessions amounting to 167 oral and 19 poster presentations whose findings are intended to contribute to wildlife conservation in Tanzania and the region.

Figure 1: 11th TAWIRI conference information banner

The opening speech by the guest of honour, Deputy Minister-Tanzania Ministry of Natural Resources and Tourism (Fig.2), noted that the ever-increasing demand for land is a concern to all of us and puts preservation of natural resources in limbo and that there’s a danger of forgetting the fundamental principle that natural resources are not invulnerable and will be vulnerable indefinitely. In this regard, he urged wildlife scientists to continue providing scientific information to the government, wildlife management authorities, conservation and management partners to help reduce anthropogenic impacts on nature as well as information that will help guide effective development and conservation strategies.

Figure 2: Opening speech session – Guest speaker (5th from the right among seated)

The conference was timely to address the current conservation challenges facing Tanzania characterised by an increasing trend of livestock that interact with wildlife within protected areas. It was reiterated that scientific information has been and should be the backbone of the country’s success story in wildlife conservation. Thus, more scientific information is needed and required on how to improve the livelihood of communities around protected areas by enhancing economic growth by preserving natural resources and mitigating climate change impacts for sustainable conservation of biodiversity.

A key message from the conference presentations, as noted by Prof Sinclair (Fig.3), was that both protected areas and human-based areas are necessary but neither is sufficient for conservation. All ecosystems change continuously and therefore static boundaries will not solve conservation problems since they cannot accommodate change. It was reiterated that what is applicable today would be obsolete in 100 years and therefore important to improve human-dominated landscapes to make them more suitable for biodiversity for the future of protected areas and the stability of human ecosystems.

Figure 3: Keynote address by Prof Anthony Sinclair on, “The future of conservation”

Two of our ZED Group members were involved in organizing and participating in one of the 11th TAWIRI conference symposium themed, “Wildlife Diseases and Ecosystem Health” in collaboration with the Wildlife Disease Association, Africa and the Middle East (WDA-AME) section.

Dr Annie Cook (Fig.4) presented a collaborative work entitled, “a successful vaccine trial to control wildebeest-associated Malignant Catarrhal Fever in cattle.” The vaccine was noted to have an efficacy 92.2%.

Figure 4: Presentation on a successful vaccine trial to control wildebeest-associated Malignant Catarrhal Fever in cattle by Dr Annie Cook

Dr Kelvin Momanyi (Fig.5) presented a collaborative work as part of the NEOH case study entitled, “Evaluation of the implementation of One Health in Kenya: A case study of the Zoonotic Disease Unit”. The presentation noted that the One Health office in Kenya (the Zoonotic Disease Unit) had performed moderately from the evaluation applying the NEOH One Health framework with a One Health Index of 0.73269.

Figure 5: Presentation on Evaluation of the implementation of One Health in Kenya by Dr Kelvin Momanyi

Everybody needs to work together to address antibiotic resistance

Everybody needs to work together to address antibiotic resistance

This article was authored by Judy Bettridge. (Twitter @JudyBettridge)

Not that many years ago, I went to the doctor with a chesty cough that had been hanging around for several weeks.  Normally, I wouldn’t have bothered, but it made cycling to work difficult, so I went to get it checked out. The doctor gave me a course of antibiotics. After a week, I went back to report that they had made no difference to the cough at all. So he offered me a choice – did I want an inhaler or just some more antibiotics? I was rather surprised – surely the choice to take the antibiotics should not rest with me? He was the qualified professional, after all. Responsible antibiotic use was already widely promoted, so why was the medical professional suggesting simply dishing out more of these precious drugs to prolong a treatment that wasn’t working? Maybe he was simply having a bad day, but it seemed to me to show an irresponsible attitude towards the doctor’s role of antibiotic stewardship.

There are many reports of patients putting doctors under pressure to dispense antibiotics, and this is clearly problematic. In many cases, antibiotics are simply not an appropriate treatment and will make no difference to the speed of recovery, especially for viral illness. With widespread media coverage and advertising, many patients are now better informed about the problems of antimicrobial resistance, and that taking unnecessary antibiotics can put them and their families at risk of future infections from antibiotic-resistant bacteria. Doctors are the best-placed to know what is circulating in their local area, and can advise patients when their symptoms are most likely to arise from viral infections – and patients need to be ready to listen and take their advice. However, as my experience shows, doctors may also fall into the trap of anticipating patient expectations for antibiotics where no such pressure exists. Negotiation and understanding between doctor and patient is much more likely to result in satisfaction on both sides – and better compliance with any medication that is prescribed.

Doctors are the best-placed to know what is circulating in their local area, and can advise patients when their symptoms are most likely to arise from viral infections – and patients need to be ready to listen and take their advice.

The very same issues arise in the veterinary profession, with vets and owners or farmers needing to discuss these complex decisions surrounding whether or not antibiotic use is appropriate on a case-by-case basis. Great progress has been made in many areas, especially in eliminating the use of antibiotics as growth promoters in Europe, but there is still much room for improvement. With so much information now available on the internet, it is not uncommon for people to come with very fixed ideas about what is wrong with their animal, and exactly what treatment they want. It is important to remember that many conditions that look the same can have very different causes. The bacteria in our bodies and our environment evolve and change over time, so that even two infections with identical symptoms may be caused by completely different bugs – which need a completely different antibiotic to treat them. For this reason, keeping and reusing antibiotics at a later date is never advisable –especially injectable drugs that can go off within a few weeks of opening. All antibiotics have an expiry date, and using less potent drugs to treat infections is another factor that can encourage antimicrobial resistance to develop.

keeping and reusing antibiotics at a later date is never advisable –especially injectable drugs that can go off within a few weeks of opening

Always check the expiry date of drugs

Where we work in East Africa, as in many other parts of the world, an additional problem is that antibiotic sales and use are frequently unregulated. A lot of commercial animal feed still contains antibiotics – so always check the label and ask the vet or seller if you are in any doubt. Good hygiene in animal production is much better as a preventative, as this can also help reduce viral and parasite infections that will not be helped by in-feed antibiotics in any case. If animals are sick, then involving a vet at an early stage is important to get the right treatment, rather than just buying a drug from an untrained seller and hoping for the best. Especially in remote rural areas, antibiotics may be on sale in the local kiosk, alongside the soap, candles and sweets. These are often human drugs, and so using them in animals is problematic – not only because they are not formulated to give the right dose for that species, but also because there are certain drugs that should simply not be used in animals. This may be because of dangerous residues that pass into the meat, eggs or milk, and so veterinary workers should always advise on how long to leave after treatment before animal products are safe to eat again. If they don’t offer this advice, along with clear instructions on how to use the drugs – ask!  The other reason not to buy antibiotics from unqualified sellers is that there are some drugs that we want to preserve for use in only humans. These critically important antimicrobials are needed to treat difficult and often life-threatening infections in humans that don’t respond to other drugs. Some may be used by vets as a last resort, but their use should always be closely supervised.

Good hygiene in animal production is much better as a preventative, as this can also help reduce viral and parasite infections that will not be helped by in-feed antibiotics in any case.

An antibiotic being administered to a cow

This is why this year’s theme for World Antibiotic Awareness week is “Seek advice from a qualified healthcare professional before taking antibiotics”. Wherever you are in the world, this is sound advice. Advances in science mean that rapid diagnostic tests are coming ever closer, and within a few years, genetic identification not only of the organism causing the infection but also what drugs it is likely to respond to will be possible. This will allow a diagnosis within a few hours, rather than days to weeks it can take with current laboratory methods. Accurate diagnosis, antibiotic selection tailored to every individual case and open discussions between the healthcare professional and the patient or carer as to whether antibiotic use is appropriate in every circumstance are all part of tackling antimicrobial resistance. Whether the healthcare professional is a doctor, nurse, veterinary professional or pharmacist, by making the most of their knowledge to help guide the decision to use antibiotics, everyone can play their part in helping to guard these precious resources for future generations.

Accurate diagnosis, antibiotic selection tailored to every individual case and open discussions between the healthcare professional and the patient or carer as to whether antibiotic use is appropriate in every circumstance are all part of tackling antimicrobial resistance.

World Antibiotic Awareness Week: a look at Kenya

World Antibiotic Awareness Week: a look at Kenya

This article was authored by Eric Fevre (Twitter: @EricFevre)

On 14th November, the Kenya Veterinary Association (Twitter @KVANational) hosted a Continuous Professional Development (CPD) event at the Faculty of Veterinary Medicine, University of Nairobi, Kenya.  The Faculty is a collaborator in many of the ZED group’s projects, and recently, we have been awarded funds to develop a joint programme, with a number of other partners, on Antimicrobial Resistance.  Thus, an AMR CPD event, part of #WAAW, was a good opportunity to talk to stakeholders.

The audience consisted of Veterinary Surgeons and Veterinary Paraprofessionals, medical practitioners, scientists, journalists, students and the lay public.  The combined professional experience in the auditorium with the use of antibiotics in the veterinary and medical sectors was enormous, and it was an honour to represent the livestock research agenda at such a gathering, on behalf of both the International Livestock Research Institute and the Institute of Infection and Global Health, University of Liverpool.

The Kenya Medical Research Institute kicked off with an overview of the situation in Kenya – Kenya is far advanced compared with many countries in recognizing the AMR problem, and has, for example, just released its National Action Plan and National Policy (which can be downloaded by clicking here ).  None the less, there are clearly many evidence gaps.

MoALF, CS Dr Tuimur (far left) and Health CS Dr. Cleopa Mailu (immediate far left) launching the World Antibiotic Resistance Awareness Week and Kenya AMR National Action Plan and National Policy

The Food and Agriculture Organization, represented by ex-ILRI Graduate Fellow Stella Kiambi, presented the wider policy view and the FAO approach to AMR.  The National Action Plan itself was presented by the Department of Veterinary Services, followed by two Ministry of Health presentations on the public health impacts of AMR and antimicrobial stewardship.  The NGO World Animal Protection then highlighted the issue from the animal perspective, focused on the impacts of growth promoters and housing on animal welfare. Eric Fèvre then presented a livestock research agenda on AMR in the country, focusing his presentation on the evidence needs for implementing policy on AMR.

This was a very interdisciplinary meeting, co-ordinated and managed by the Kenya Veterinary Association who demonstrably want to play their part in working towards better management and use of antimicrobials, especially in the veterinary sector.  The energy around this issue in Kenya is clear, and there are many opportunities for collaboration and research to provide policymakers with the solid evidence required to implement Kenya’s new National Action Plan.

International One Health Day

International One Health Day, 2017

This blog entry was authored by Matthew Baylis, Principal Investigator-HORN Project

November 3rd is International One Health Day. One Health is the idea that the health of people, animals, plants and the environment are interlinked, and that health will be optimised by different disciplines (such as medicine, veterinary science, social science, economics, environmental science) working together rather than independently. It goes to the heart of multidisciplinarity in science, with large gains to be made by bringing together experts who may approach the similar problems with different skill sets and approaches.

Community members at the Mara being trained about holistic land management to optimize livestock productivity with minimal environmental impact by trainers from the Savory Institute; Photo credit: ZED Group

There are innumerable examples of advances in human medicine that have led to improvements in animal health – as just one example, some of the biggest equipment in the University of Liverpool’s animal clinics (such as MRI scanners) come from human hospitals.  But there are also many examples of veterinary medicine leading to improvements in human health or medicine.  In the UK, we are now safe to eat raw or undercooked eggs owing to a major programme to eliminate salmonellosis from the layer industry. The incidence of human rabies in much of East Africa has declined, owing to vaccination not of people, but of dogs.  My favourite example relates to transmissible spongiform encephalopathies. In the early 1960s members of the Foré tribe in Papua New Guinea were dying from a novel disease called Kuru (related to variant CJD). An American medic attempted transmission experiments with chimps that were not successful, leading to the conclusion that the disease was of genetic origin. The medic spoke on this in the UK and, in the audience, was a veterinarian.  The vet recognised that the characteristics of Kuru seemed identical to that of a sheep disease called scrapie, which had been shown to be transmissible. He alerted the medic, who repeated the experiments, this time successfully, and went on to get the Nobel Prize for Physiology (the medic, not the vet, of course).

A boy keenly reading a vaccination certification after his dog had been vaccinated against rabies; Photo credit: Rabies Free Kenya

Find out more about International One Health Day here: https://www.onehealthcommission.org/en/eventscalendar/one_health_day/

The University of Liverpool is a big player in the area of One Health. We have had a string of large projects in the area of zoonotic diseases and food systems which contribute significantly to non-communicable diseases. Most recently, we have been given a large RCUK-funded Global Challenges Research Fund (GCRF) Growing Research Capability (GROW) award called One Health Regional Network for the Horn of Africa (HORN), which aims to strengthen institutions and train researchers and support staff in areas relevant to One Health in 4 countries of the Horn of Africa: Kenya, Ethiopia, Eritrea and Somalia. It is early days, but you can follow progress here: https://www.facebook.com/groups/1473530819359799/

The One Health Regional Network Logo

Follow us on Twitter: @OneHealthHORN to get our One Health Day updates at the top of every hour today.

Our website, www.onehealthHORN.net (coming soon!)

 

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