Tenth EDCTP Forum | Mozambique, 18-21 October 2020

The Tenth EDCTP Forum will be held at the Joaquim Chissano International Conference Centre in Maputo, Mozambique from 18-21 October 2020.

The biennial EDCTP Forum provides an international platform for the presentation and discussion of clinical studies for everyone involved in combating poverty-related diseases and the appropriate capacity development and networking activities. The Forum has established itself as a valuable opportunity to develop and reinforce cooperation and synergy among the EDCTP Association stakeholders at various levels including scientific and policy. Scientists involved in EDCTP2-funded projects are particularly encouraged to use this opportunity to share new developments and results from their projects.

The Tenth EDCTP Forum will take place in 2020 in Mozambique.

All you need to know about the novel 2019 coronavirus

All you need to know about the novel 2019 coronavirus

WHAT ARE CORONAVIRUSES?

Coronaviruses are a large family of RNA (ribonucleic acid) viruses that are known to cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). They are called coronaviruses because the virus particle exhibits a characteristic ‘corona’ (crown) of spike proteins around its lipid envelope.

Coronavirus infections are common in animals and humans. Some strains of CoV are zoonotic, meaning they can be transmitted between animals and humans, but many strains are not zoonotic.

In humans, coronaviruses can cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (caused by MERS-CoV), and Severe Acute Respiratory Syndrome (caused by SARS-CoV). Detailed investigations demonstrate that SARS-CoV was transmitted from civets to humans, and MERS-CoV from dromedary camels to humans.

WHAT ARE THE SYMPTOMS OF THIS NOVEL CORONAVIRUS?

The symptoms can include a cough, possibly with a fever and shortness of breath. There are some early reports of non-respiratory symptoms, such as nausea, vomiting, or diarrhea. Many people recover within a few days. However, some people — especially the very young, elderly, or people who have a weakened immune system — may develop a more serious infection, such as bronchitis or pneumonia.

What is this novel coronavirus 2019?

The new Coronavirus 2019 is a zoonotic virus, which means it is a pathogen that spreads from one species to another, however it is unclear exactly what the origin of this virus is, but the genetic sequence is already being studied (https://www.sciencedaily.com/releases/2020/01/200131114748.htm)

A novel coronavirus (CoV) was identified in 2019 in Wuhan, China. This is a new coronavirus that has not been previously identified in humans.

On 31 December 2019, human cases of pneumonia of unknown etiology were reported in Wuhan City, Hubei Province of China. A coronavirus, named 2019-nCoV acute respiratory disease (2019-nCoV), was identified as the causative virus by Chinese authorities on 7 January 2020. Since then, human cases with travel history to Wuhan have been reported by several provinces in China and by a number of countries outside China.

For up to date information please consult the WHO website https://www.who.int/emergencies/diseases/novel-coronavirus-2019

How is this novel coronavirus treated?

Scientists are working hard to understand the virus, and Chinese health authorities have posted its full genome in international databases. Currently, there are no approved antivirals for this particular coronavirus, so treatment is supportive. For the sickest patients with this illness, specialized, aggressive care in an intensive care unit (ICU) can be lifesaving.

How can we combat new viruses?

Professor Eric Fevre explained the way to combat new viruses is being prepared and doing more routine and regular surveillance at places, which are a breeding ground for these viruses. “It’s very difficult to develop a drug or vaccine for something we don’t know about, so we always have to start the development process after those events have occurred,” he explained. But typically, it takes between four to five years to develop a vaccine for a new virus. Several groups are working on a vaccine right now, but there is no guarantee it will be ready before the end of the current outbreak.

What can we do to stay safe?

  • Avoiding unprotected contact with farm or wild animals.

  • People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands).

  • Within healthcare facilities, enhance standard infection prevention and control practices in hospitals, especially in emergency departments

  • Based on currently available information, travel or trade restrictions are not recommended.

Are animals responsible for the 2019 novel coronavirus infections in people?

  • The source of this outbreak has yet to be confirmed but it could be any number of animal carriers from snakes to pigs.

  • Genetic sequence data reveals that 2019-nCoV is a close relative of other coronaviruses found circulating in Rhinolophus bat (Horseshoe Bat) populations.

  • There is suspicion that the 2019-nCoV may have had an animal source, but further investigations are required to confirm this.

  • Although there is suspicion that the initial introduction of 2019-nCoV to humans may have come from an animal source, the predominant route of subsequent transmission appears to be from human to human.

  • Ongoing investigations are important for identifying the animal source (including species) and establishing the potential role of an animal reservoir in this disease.

Why is One Health so important in situations involving emerging diseases such nCoV2019?

Stopping disease in humans by preventing disease in animals underpins the concept of “One Health”, an approach to public health that recognises the links between animals, people and planet. To bring this to bear and prevent similar outbreaks in the future, we need greater commitment, funding and research on these shared health threats.

By identifying disease threats and spread as early as possible, health authorities can take pre-emptive action, such as tighter biosecurity controls on farms or at food markets, or public awareness campaigns. By developing and using new and better treatments for animal disease, we can help stop their spread both among animal populations and among people.

Where and how are new diseases likely to emerge?

Our team lead, Eric Fevre, a professor of infectious diseases at the University of Liverpool, while speaking with ITV, outline that new diseases are likely to spring up in urban environments where humans have created very densely packed human populations, alongside a population of bats, rodents, birds, pets and other things living organisms. This creates an intense interaction and opportunities for pathogens to move from species to species. Other such environments, which are created as part of the economy or the way we live are slaughterhouses where individuals who work there are in intense contact not just with animals but with the different parts of the insides of animals or wet markets. Similarly, where animals are sold, cut up and cleaned and where there are a lot of people interacting with those individuals.

David Quammen, the author of “Spillover: Animal Infections and the Next Human Pandemic, in an opinion piece in the New York Times, “When people invade tropical forests and other wild landscapes, which harbor so many species of animals and plants — and within those creatures, there are so many unknown viruses. We cut the trees; we kill the animals or cage them and send them to markets. We disrupt ecosystems, and we shake viruses loose from their natural hosts. When that happens, they need a new host. Often, we are it.”

Other ways that disease emerge are current circumstances which include a perilous trade in wildlife for food, with supply chains stretching through Asia, Africa and to a lesser extent, the United States and elsewhere. That trade has now been outlawed in China, on a temporary basis; but it was outlawed also during SARS, then allowed to resume — with bats, civets, porcupines, turtles, bamboo rats, many kinds of birds and other animals piled together in markets such as the one in Wuhan. And one consequence of that abundance in human population, that power, and the consequent ecological disturbances is increasing viral exchanges — first from animal to human, then from human to human, sometimes on a pandemic scale.

What is the key take home message: Do not panic!

Given the current spread of this virus and the pace and complexity of international travel, the number of cases and deaths will likely to continue to climb. We should not panic, even though we are dealing with a serious and novel pathogen. Public health teams are assembling. Lessons learned from other serious viruses, such as SARS and MERS, will help. As more information becomes available, public health organizations like the World Health Organization (WHO) will be sharing key information and strategies worldwide.

Are there any precautions to take with live animals or animal products?

In accordance with advice offered by the World Health Organisation, as a general precaution, when visiting live animal markets, wet markets or animal product markets, general hygiene measures should be applied, including regular hand washing with soap and potable water after touching animals and animal products, avoiding touching eyes, nose or mouth with hands, and avoiding contact with sick animals or spoiled animal products. Any contact with other animals possibly living in the market (e.g., stray cats and dogs, rodents, birds, bats) should be strictly avoided. Attention should also be taken to avoid contact with potentially contaminated animal waste or fluids on the soil or structures of shops and market facilities.

Standard recommendations issued by the World Health Organisation to prevent infection spread include regular hand washing, covering mouth and nose when coughing and sneezing, and thoroughly cooking meat and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.  Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices. Further recommendations from WHO can be consulted here: https://www.who.int/health-topics/coronavirus#

What are the Veterinary Authority’s international responsibilities in this event?

The detection of 2019-nCoV in animals meets the criteria for reporting to the OIE through WAHIS, in accordance with the OIE Terrestrial Animal Health Code as an emerging disease. Therefore, any detection of 2019-nCoV in an animal (including information about the species, diagnostic tests, and relevant epidemiological information) should be reported to the OIE.

It is important for Veterinary Authorities to remain informed and maintain close liaison with public health authorities and those responsible for wildlife, to ensure coherent and appropriate risk communication messages and risk management.

Effective biosecurity risk management and cooperation with inspection authorities should be maintained at borders.

What are key lessons we have learnt?

It may seem counter-intuitive, then, but with six out of 10 infectious diseases being zoonotic, one of the best ways to protect people from diseases like coronavirus is to first protect the health of animals. But recent novel cases of human coronavirus are just the latest reminder that we are too often missing the opportunity to act before new diseases emerge in people.

As David Quammen puts it, “We are faced with two mortal challenges, in the short term and the long term. Short term: We must do everything we can, with intelligence, calm and a full commitment of resources, to contain and extinguish this nCoV-2019 outbreak before it becomes, as it could, a devastating global pandemic. Long term: We must remember, when the dust settles, that nCoV-2019 was not a novel event or a misfortune that befell us. It was — it is — part of a pattern of choices that we humans are making.”

Further resources and references

Resources
References
More resources on the novel coronavirus 2019

Trypanosomatid Parasites Meeting VI: from the lab to the field

When: 28-29 October 2019
Where: Auditorium Jacques Monod at the Institut Pasteur in Paris!

In order to cover a large panel of research topics, a total of 6 sessions are planned. Each session will be composed of an invited keynote presentation followed by 4 selected talks:

  • Epidemiology, Public Health and Epistemology: Marleen BOELAERT (ITM, Antwerp, Belgium)
  • Diagnosis, Drug and Vaccine Development: Veerle LEJON (IRD, Montpellier, France)
  • Ecology and Medical Entomology: Steve TOR (LSTM, Liverpool, UK)
  • Immunology and Physiology: Guy CALJON (University of Antwerp, Belgium)
  • Cell Biology and Metabolism: Dolorez GONZALEZ PACANOWSKA (Instituto de Parasitología y Biomedicina, Granada, Spain)
  • Genetics and Evolution: Virginie ROUGERON (IRD, Montpellier, France)

Register here: https://www.eventbrite.com/e/trypanosomatid-parasites-meeting-vi-from-the-lab-to-the-field-tickets-50864283441

Letter from the Co-Principal Investigator: Prof Mark Woolhouse

Prof Mark Woolhouse

It is hard to believe that, as I write this, ZooLinK is almost four years old. During those four years, the topic of surveillance has risen even higher up the infectious diseases agenda. There are two main reasons for this. First, there is the recurring threat of emerging viral diseases, such as Ebola and Lassa fever in Africa, where early detection is a key element of a successful public health response. Second, there is a greatly increased global awareness of the public health threat posed by antimicrobial resistance (AMR), leading to the realisation that AMR surveillance is challenging and, often, is not being done particularly well. Despite this, diagnostics and surveillance are not priority topics for many funders; though thankfully some, such as our own BBSRC and others such as B&MGF, do ‘get it’. So projects such as ZooLinK have an opportunity (and perhaps a responsibility) to make the case for surveillance by demonstrating actual or potential public health benefits. I believe that we are doing that although, in these late stages of the project, it is important that we put our arguments out there in the form of conference talks and publications.

I frequently use the Busia lab as an example of what can be done when I am speaking on infectious disease surveillance at conferences and meetings. That small facility has a great deal going for it. First and foremost, it’s in a very appropriate location, a densely populated largely rural area where the infectious disease burden is high and local resources are inevitably overstretched. Second, it’s appropriately set up and equipped so that we can do what needs to be done even when working in less than ideal conditions, just as you would find in so many other locations in Africa and elsewhere. Third, we have a small but very skilled team, without whom nothing could be done at all but with whom so much is possible. Many thanks to Laura and everyone else in the Busia team for all their hard work.

I’m particularly excited by the fact that we can use the Busia lab to generate genome sequences. Stefan Rooke’s work with the Minion portable sequencing system has proved the principle. It wasn’t so long ago that genome sequencing was a multi-million dollar activity requiring considerable investment in equipment, infrastructure and technical support. Now we can do it in Busia!

Stefan is working on bacteria, especially plasmids carrying antimicrobial resistance genes, but the technology will work for any kind of genome we might be interested in. That said, turning proof of principle into routine practice is not going to be easy. There are many challenges in making genome sequencing directly relevant to patients and local communities in a setting like Busia – cost and ease of use come to mind immediately. But we have to start somewhere, and I believe that ZooLinK taking the first steps down a path that will one day make a real difference to infectious disease surveillance right across Africa.

Letter from the Co-Principal Investigator: Prof Mark Woolhouse

Kenya’s urban poor federation Muungano wa Wanavijiji is working with food vendors in informal settlements to reveal their challenges and explore how to promote food security. Muungano is a member of Slum Dwellers International (SDI), a network that aims to improve shelter, services, and government responsiveness to the urban poor. The ongoing project is complement-ing other Urban Zoo activities, as well as building upon Muungano’s past experience with grassroots data-collection and advo-cacy. Working alongside Muungano are community residents, pro-poor financial analysts at Akiba Mashinani Trust (Muungano’s financial wing), and researchers at University College London and UC Berkeley.

This action-research project is utilizing participatory methods to understand vendors in Nairobi’s informal settlements of Korogocho and Viwandani. Vendors sell a variety of items in these settlements such as fresh produce; meat, fish, and eggs; cooked and uncooked foods; beverages; and snacks. A mobile phone application is capturing vendors’ demographic and business profile, while base-maps and balloon-mapping (low-cost aerial photography with balloons and a simple camera) are generating detailed spatial data on their locations. Finally, focus group discussions (FGDs) are delving into traders’ constraints, coping strategies, and priorities for change.  

These vendors are poorly organised and frequently overlooked or stigmatised by policy-makers, yet vending is a vital source of affordable, accessible foods and a key income-generating activity. Customers may appreciate the convenience and their personal relations with traders; food vending is also a widespread livelihood strategy, particularly for female traders seek-ing to combine work with childcare. As a female vendor explained in a Viwandani FGD, “I’ll be doing my work and also doing the house chores and also look after my kids…But if you are outside [the settlement], sometimes you have to look for someone to take care of your kids and sometimes you don’t have that money.” 

However, vendors often face multiple challenges in their settlements like overflowing drains, minimal water and sanitation, uncollected rubbish, and elevated insecurity. In turn, widespread hazards and poor infrastructure or services can threaten food security by jeopardising vendors’ livelihoods and customers’ access to food. But the project’s maps and FGDs are uncovering these concerns and, moreover, a Food Vendors’ Association (FVA) has been established to increase their collective strength, amplify their voices, and advocate for much-needed interventions in the future.

This action-research project is utilizing participatory methods to understand vendors in Nairobi’s informal settlements of Korogocho and Viwandani, with support from APHRC and ILRI team members from the Urban Zoonoses project.

This article has been written by the Muungano team

Surveillance of zoonoses in livestock and humans: experiences from AHITI interns cohort 5

Surveillance of zoonoses in livestock and humans: experiences from AHITI interns cohort 5

Our participation in the ZooLinK suite of projects will remain memorable. We have acquired sufficient knowledge and experience through the exposure given to us by ZooLinK staff and our participation in the target areas of the project. Since we joined the project on May 2018, we have rotated among the three functional units of the project, namely: (1) veterinary team who visit the livestock markets and slaughterhouses; (2) laboratory team and (3) clinicians team who visit the health centres. The following report will focus on the veterinary team. It describes the activities carried out therein and their relevance to the project.

Two of the interns working in the laboratory (foreground)

A normal ZooLinK day begins with packing the field car with the required consumables a day before the field. Such consumables include; red and purple topped vacutainers, nasal swabs, digital thermometer, heart girth measuring tape, ziplock bags, barcodes, consent forms, faecal pots, gloves, disinfectant, water, coveralls and gumboots etc.

“…our internship has equipped us with adequate disease surveillance skills in the animal field that will help us to extend the knowledge of disease control to farmers…”

In the field, the veterinary team splits into two groups; one group works at the livestock markets and the other at the slaughterhouse. Upon arrival, at the livestock market, the animal is randomly selected and the owner identified to seek consent for sampling the animal and to answer a few questions. If he/she agrees, he/she signs two consent forms one of which goes with the animal owner while the other one remains for ZooLinK records. Before sampling, the animal is humanely restrained to ensure the safety of the animal, handler and person collecting the samples. Physical examination begins before the actual sample collection. Which entails checking for any abnormal discharges from the mouth, eyes, genitals and nose. On the skin swellings and injuries are recorded when present. Nature of the ocular mucous membranes is assessed and recorded, the mouth is checked for any lesions and sores as well the ageing is done from the dentition. The pre-scapula lymph nodes are palpated on both sides to ascertain any enlargement. Lifting of the loose skin of the neck is done to test for skin elasticity. The body condition of the animal is cored in a scale of 1-5. The fleece condition is recorded as either rough or normal and a tape measure used to measure the heart-girth to estimate the weight of the animal. The temperature is taken per-rectal. After the physical examination, the actual collection of the samples begins. Blood is collected from the jugular vein into a red top vacutainer (plain blood) for serology and an EDTA-purple top vacutainer (uncoagulated blood) for parasitology and hematology.

One of the AHITI interns sampling blood from a sheep

Nasal swabs are used to collect swabs from the nose. Nasal swabs are later cultured in the lab and used to test for the presence of Staphylococcus aureus. Fresh faeces are collected per-rectal and placed into a faecal pot. The faecal sample is cultured in the lab to determine the presence of E. coli, Salmonella and Campylobacter. External parasites like ticks, lice etc. are also collected if encountered. The same procedure takes place in the slaughterhouses but in addition, post-motem lesions like cysts, flukes, are recorded and collected inclusive of mesenteric lymph nodes from the pigs.

We are glad to declare that our internship has equipped us with adequate disease surveillance skills in the animal field that will help us to extend the knowledge of disease control to farmers and other stakeholders back at home.

This article was authored by the cohort 5 interns from the Animal Health and Industry Training Institute (AHITI): Sarah Nyambura, John Parkasio and Silas Muriithi.

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