Weekly epidemiological record / Relevé épidémiologique hebdomadaire
22 SEPTEMBER 2017, 92th YEAR / 22 SEPTEMBRE 2017, 92e ANNÉE
No 38, 2017, 92, 557–572
There are 4 main forms of the disease: visceral leishmaniasis (VL, also known as kala-azar); post-kala-azar dermal leishmania...sis (PKDL); cutaneous leishmaniasis (CL); and mucocutaneous leishmaniasis (MCL). While cutaneous leishmaniasis is the most common form of the disease, visceral leishmaniasis is the most serious and can be fatal if untreated. Additionally, leishmaniasis can be classified as anthroponotic or zoonotic depending on whether the natural reservoir of the parasite is human or animal.
This report updates global epidemiological information on VL and CL to 2015, based on the main indicators published in the GHO, as of 1st September 2017.
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The strategic plan reflects shared commitments to enhance collaboration between environmental, animal (wildlife and domestic) and human health, and building new One Health workforce capacity through higher institutions of learning. The strategy also outlines interventions to be undertaken by governm...ent institutions and other partners to enhance existing structures and pool together additional resources to prevent and control zoonotic diseases and other events of public health importance. Successful implementation of the strategy will contribute to the realization of vision 2020 by improving public health, food safety and security, and hence significantly improve the socioeconomic status of the people of Rwanda. It is in this regard that we call upon implementing institutions, bilateral and multilateral partners, civil society and the private sector to join us in implementing the One Health strategy in Rwanda.
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Fact Sheet, May 2018.
Nipah virus (NiV) is a zoonotic virus (it is transmitted from animals to humans) and can also be transmitted through contaminated food or directly between people. In infected people, it causes a range of illnesses from asymptomatic (subclinical) infection to acute respiratory ...illness and fatal encephalitis. The virus can also cause severe disease in animals such as pigs, resulting in significant economic losses for farmers
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Taking a multisectoral, One Health approach is necessary to address complex health threats at the human-animal-environment interface, such as rabies, zoonotic influenza, anthrax, and Rift Valley fever. Such zoonotic diseases continue to have major impacts on health, livelihoods, and economies, and c...annot be effectively addressed by one sector alone.
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Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o...r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
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Clinical Microbiology and Infection Volume 21, Issue 5, May 2015, Pages 433-443;
The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries, but remain major causes of ill-health and mortality across Africa, Asia, and Latin America. This neglect is, in part, a conse...quence of under-reporting, resulting in an underestimation of their global burden that downgrades their relevance to policy-makers and funding agencies. Increasing awareness about the causes of NZDs and how they can be prevented could reduce the incidence of many endemic zoonoses.
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Over the next 8 weeks, you will explore and learn about some of the major and current Global Health Challenges at the Human-Animal-Ecosystem Interface: zoonotic emerging infections (e.g. Ebola, Nipah, MERS, Avian Influenza), antimicrobial resistance, neglected tropical diseases (e.g. rabies, leishma...niasis, zoonotic TB), snakebite and other human-animal conflicts etc. You will learn new concepts from the field of epidemiology, social anthropology, disease ecology, veterinary sciences, global health policy etc. and approaches such as One Health, Eco-Health and Planetary Health. Also, you will learn about innovative tools and frameworks used to study and tackle some of these Global Health challenges of the Sustainable Development Goals era.
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The One Health Commission is a globally focused organization dedicated to implementing One Health and One Health actions around the world.
The goal of the One Health Research, Education and Outreach Centre in Africa (OHRECA) is to improve the health of humans, animals and ecosystems through capacit...y building, strengthening of local, regional and global networks and provision of evidence-based policy advice on One Health in sub-Saharan Africa. The centre has four thematic areas: control of neglected tropical zoonotic diseases; emerging infectious diseases; food safety and informal markets; and prevention and control of antimicrobial resistance.
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Schistosomiasis is a neglected tropical disease of global medical and veterinary importance. As efforts to eliminate schistosomiasis as a public health problem and interrupt transmission gather momentum, the potential zoonotic risk posed by livestock Schistosoma species via viable hybridisation in s...ub-Saharan Africa have been largely overlooked. We aimed to investigate the prevalence, distribution, and multi-host, multiparasite transmission cycle of Haematobium group schistosomiasis in Senegal, West Africa.
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Schistosomiasis is an infectious disease caused by helminth parasites of the genus Schistosoma. Worldwide, an estimated 250 million people are infected with these parasites with the majority of cases occurring in sub-Saharan Africa. Within Asia, three species of Schistosoma cause disease. Schistosom...a japonicum is the most prevalent, followed by S. mekongi and S. malayensis. All three species are zoonotic, which causes concern for their control, as successful elimination not only requires management of the human definitive host, but also the animal reservoir hosts. With regard to Asian schistosomiasis, most of the published research has focused on S. japonicum with comparatively little attention paid to S. mekongi and even less focus on S. malayensis. In this review, we examine the three Asian schistosomes and their current status in their endemic countries: Cambodia, Lao People’s Democratic Republic, Myanmar, and Thailand (S. mekongi); Malaysia (S. malayensis); and Indonesia, People’s Republic of China, and the Philippines (S. japonicum). Prospects for control that could potentially lead to elimination are highlighted as these can inform researchers and disease control managers in other schistosomiasis-endemic areas, particularly in Africa and the Americas.
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Leishmaniasis is an important worldwide disease with a
zoonotic potential that presenting visceral and cutaneous
clinical forms. The domestic dog is seen as the main reservoir of Leishmania spp. and for this reason, it is the target of
the control program in some countries. The health professiona...ls’ knowledge about prevention and control of leishmaniasis was investigated. Through interviews with health
professionals from endemic regions, it was observed that
there are several conceptuais gaps about leishmaniasis.
Therefore, it is essential to put into practice the concepts
of single health, bringing human, animal and environmental
health, next to population.
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Leishmaniasis is a parasitic disease caused by intracellular protozoan parasites of the genus Leishmania (Trypanosomatidae family); it is endemic in more than 98 countries worldwide [1]. Visceral (VL) and cutaneous (CL) leishmaniasis are the most common forms of the disease. VL causes a systemic dis...ease characterised by fever, hepatosplenomegaly, anaemia and lymph node enlargement and may be fatal without appropriate treatment, while CL mainly causes skin ulcers and is considered a less severe form of the disease [2]. The incubation period for VL varies from 10 days up to nearly 3 years and for CL from 2 weeks to 3 years [3]. The natural route of transmission is a bite of blood-feeding phlebotomine sandflies; it may be zoonotic or anthroponotic, depending on the parasite species and the geographical location
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Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly exi...sting as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil’s disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.
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Leishmaniasis is a major vector-borne disease caused by obligate intramacrophage protozoa of the genus Leishmania, and transmitted by the bite of phlebotomine female sand flies of the genera Phlebotomus and Lutzomyia, in the old and new worlds, respectively. Among 20 well-recognized Leishmania speci...es known to infect humans, 18 have zoonotic nature, which include agents of visceral, cutaneous, and mucocutaneous forms of the disease, in both the old and new worlds. Currently, leishmaniasis show a wider geographic distribution and increased global incidence. Environmental, demographic and human behaviors contribute to the changing landscape for zoonotic cutaneous and visceral leishmaniasis. The primary reservoir hosts of Leishmania are sylvatic mammals such as forest rodents, hyraxes and wild canids, and dogs are the most important species among domesticated animals in the epidemiology of this disease. These parasites have two basic life cycle stages: one extracellular stage within the invertebrate host (phlebotomine sand fly), and one intracellular stage within a vertebrate host. Co-infection with HIV intensifies the burden of visceral and cutaneous leishmaniasis by causing severe forms and more difficult to manage. The disease is endemic to Ethiopia, and the clinical signs are not pathognomic. The visceral form (Kala-azar) may be confused with other similar conditions such as malaria, tropical splenomegaly, schistosomiasis, milliary tuberculosis, and brucellosis. Similarly, cutaneous leishmaniasis should be differentiated from disease like tropical ulcers, impetigo and leprosy. There are several methods of laboratory diagnosis of leishmaniasis, including parasitological, immunological and molecular. Different forms of treatments are available including oral, parenteral, and topical medications such as pentavalent antimonials, liposomal amphotericin B, miltefosine and paromomycin. Methods of control are largely limited to destruction of animal reservoirs, treatment of infected humans, and management of sand fly populations. Development of an effective vaccine against leishmaniasis has been largely unsuccessful and hinders its prevention.
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Rabies is a devastating and societally important zoonotic disease, which is transmitted principally to humans through the bite of infected dogs. This acute, progressive viral encephalitis has the highest case fatality of any infectious disease and kills tens of thousands of people annually, with chi...ldren and impoverished communities being affected disproportionately.
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Rabies is a vaccine-preventable, zoonotic, viral disease affecting the central nervous system. Once clinical symptoms appear, rabies is virtually 100% fatal. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans. Yet, rabies can affect both domestic and wild an...imals. It spreads to people and animals via saliva, usually through bites, scratches or direct contact with mucosa (e.g. eyes, mouth or open wounds). Children between the age of 5 and 14 years are frequent victims.
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Leishmaniases are a group of diseases of zoonotic importance caused by over 20 species of protozoa of the genus Leishmania, in which domestic dogs are considered to be the main reservoir for the disease. However, the involvement of other vertebrates as reservoirs for these parasites has also been in...vestigated. Therefore, the objective of the present study was to carry out a systematic review with meta-analysis on occurrences of leishmaniasis in equids. The case reports described animals with cutaneous symptoms of leishmaniasis (papules, nodules, ulcers or crusts) that regressed spontaneously, located mainly on the head and limbs, from which three species of protozoa were identified in the lesions: Leishmania braziliensis, Leishmania infantum and Leishmania siamensis. In turn, the meta-analysis showed a combined prevalence of 25%, although with high heterogeneity among the studies, which was attributed to the use of different methods for diagnosing the disease. Leishmaniasis in equids is a benign disease but it should be included in the differential diagnosis of cutaneous diseases among these species. Seroepidemiological studies are important in investigating and monitoring suspected exposure of these hosts to the parasite, especially in endemic areas. However, there is also a need to standardize diagnostic methods.
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A group of enzootic and zoonotic protozoan infections, the leishmaniases constitute among the most severely neglected tropical diseases (NTDs) and are found in all continents except Oceania. Representing the most common infectious diseases, NTDs comprise an open-ended list of some 20 parasitic, bact...erial, viral, protozoan and helminthic infections. Called “diseases of the poor,” because of their characteristic prevalence in poor populations regardless of a country's income status, they infect over one billion people in over 140 countries, with about 90% of the global burden in Africa. While NTDs do not contribute significantly to global deaths, they are debilitating and remain the most common infections among the poor worldwide, preventing them from escaping poverty by impacting livelihoods such as agriculture and livestock, and affecting cognitive, developmental and education outcomes.
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Leishmaniasis is a vector-borne disease with a broad global distribution and an increasing number of recorded cases worldwide. However, it is still one of the world's most neglected diseases. Over the last decades, the disease has been found to expand geographically with a global increase of cases o...f visceral and cutaneous leishmaniasis increasing the public health problems associated with the disease epidemics. The reported range expansion of the diseases has been associated with range expansions of vector populations in response to climate change. Leishmaniasis is caused by protozoan parasites of the genus Leishmania. The transmission can either be zoonotic and/or anthroponotic through the bite of an infected female phlebotomine sandfly. In Eurasia and Africa, all vector-competent sandfly species belong to the genus Phlebotomus. Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis. In the ‘old world’, it is caused by five currently recognized Leishmania species: L. major, L. tropica and L. aethiopica (being main causative parasites) as well as L. infantum and L. donovani. Visceral leishmaniasis (VL), another common and more severe form of leishmaniasis, is only associated with the Leishmania species L. infantum and L. donovani. The specific Leishmania species cause different clinical symptoms in humans.
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Mpox continues to affect people around the world. A new framework released today by WHO will guide health authorities, communities and other stakeholders in preventing and controlling mpox outbreaks, eliminating human-to-human transmission of the disease, and reducing spillover of the virus from ani...mals to humans.
Mpox is a viral illness caused by the monkeypox virus (MPXV). It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick. The virus transmits from person to person through close, including sexual, contact. It also has animal reservoirs in east, central and west Africa, where spillovers from animals to humans can occasionally occur, sparking further outbreaks.
There are two different clades of the virus: clade I and clade II. Clade I outbreaks are deadlier than clade II outbreaks.
A major emergence of mpox linked to clade II began in 2017, and since 2022, has spread to all regions of the world. Between July 2022 and May 2023, the outbreak was declared a Public Health Emergency of International Concern. While that outbreak has largely subsided, cases and deaths continue to be reported today, illustrating that low-level transmission continues around the world.
Currently, there is also a major outbreak of clade I virus in the Democratic Republic of the Congo (DRC), where cases have been on the rise for decades. Since the beginning of the year, over 6500 cases and 345 deaths have been reported in the DRC. Almost half of these are among children under the age of 15 years.
The Strategic framework for enhancing prevention and control of mpox (2024–2027) provides a roadmap for health authorities, communities, and stakeholders worldwide to control mpox outbreaks in every context, advance mpox research and access to countermeasures, and to minimize zoonotic transmission.
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