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Fair JM, Al-Hmoud N, Alrwashdeh M, Bartlow AW, Balkhamishvili S, Daraselia I, Elshoff A, Fakhouri L, Javakhishvili Z, Khoury F, Muzyka D, Ninua L, Tsao J, Urushadze L, Owen J. Transboundary determinants of avian zoonotic infectious diseases: challenges for strengthening research capacity and connecting surveillance networks. Front Microbiol 2024; 15:1341842. [PMID: 38435695 PMCID: PMC10907996 DOI: 10.3389/fmicb.2024.1341842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/19/2024] [Indexed: 03/05/2024] Open
Abstract
As the climate changes, global systems have become increasingly unstable and unpredictable. This is particularly true for many disease systems, including subtypes of highly pathogenic avian influenzas (HPAIs) that are circulating the world. Ecological patterns once thought stable are changing, bringing new populations and organisms into contact with one another. Wild birds continue to be hosts and reservoirs for numerous zoonotic pathogens, and strains of HPAI and other pathogens have been introduced into new regions via migrating birds and transboundary trade of wild birds. With these expanding environmental changes, it is even more crucial that regions or counties that previously did not have surveillance programs develop the appropriate skills to sample wild birds and add to the understanding of pathogens in migratory and breeding birds through research. For example, little is known about wild bird infectious diseases and migration along the Mediterranean and Black Sea Flyway (MBSF), which connects Europe, Asia, and Africa. Focusing on avian influenza and the microbiome in migratory wild birds along the MBSF, this project seeks to understand the determinants of transboundary disease propagation and coinfection in regions that are connected by this flyway. Through the creation of a threat reduction network for avian diseases (Avian Zoonotic Disease Network, AZDN) in three countries along the MBSF (Georgia, Ukraine, and Jordan), this project is strengthening capacities for disease diagnostics; microbiomes; ecoimmunology; field biosafety; proper wildlife capture and handling; experimental design; statistical analysis; and vector sampling and biology. Here, we cover what is required to build a wild bird infectious disease research and surveillance program, which includes learning skills in proper bird capture and handling; biosafety and biosecurity; permits; next generation sequencing; leading-edge bioinformatics and statistical analyses; and vector and environmental sampling. Creating connected networks for avian influenzas and other pathogen surveillance will increase coordination and strengthen biosurveillance globally in wild birds.
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Affiliation(s)
- Jeanne M. Fair
- Genomics and Bioanalytics, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Nisreen Al-Hmoud
- Bio-Safety and Bio-Security Center, Royal Scientific Society, Amman, Jordan
| | - Mu’men Alrwashdeh
- Bio-Safety and Bio-Security Center, Royal Scientific Society, Amman, Jordan
| | - Andrew W. Bartlow
- Genomics and Bioanalytics, Los Alamos National Laboratory, Los Alamos, NM, United States
| | | | - Ivane Daraselia
- Center of Wildlife Disease Ecology, Ilia State University, Tbilisi, Georgia
| | | | | | - Zura Javakhishvili
- Center of Wildlife Disease Ecology, Ilia State University, Tbilisi, Georgia
| | - Fares Khoury
- Department of Biology and Biotechnology, American University of Madaba, Madaba, Jordan
| | - Denys Muzyka
- National Scientific Center, Institute of Experimental and Clinical Veterinary Medicine, Kharkiv, Ukraine
| | | | - Jean Tsao
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, United States
| | - Lela Urushadze
- National Center for Disease Control and Public Health (NCDC) of Georgia, Tbilisi, Georgia
| | - Jennifer Owen
- Department of Fisheries and Wildlife, Michigan State University, East Lansing, MI, United States
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Kavulikirwa OK, Sikakulya FK. Recurrent Ebola outbreaks in the eastern Democratic Republic of the Congo: A wake-up call to scale up the integrated disease surveillance and response strategy. One Health 2022; 14:100379. [PMID: 35313715 PMCID: PMC8933533 DOI: 10.1016/j.onehlt.2022.100379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 11/03/2022] Open
Abstract
Ebola virus disease (EVD) is a dangerous viral zoonotic hemorrhagic fever caused by a deadly pathogenic filovirus. Frugivorous bats are recognized as being the natural reservoir, playing a pivotal role in the epidemiological dynamics. Since its discovery in 1976, the disease has been shown to be endemic in the Democratic Republic of the Congo (DRC). So far, thirteen outbreaks have occurred, and EVD has been prioritized in the national surveillance system. Additionally, EVD is targeted by the Integrated Disease Surveillance and Response (IDSR) strategy in DRC. The IDSR strategy is a collaborative, comprehensive and innovative surveillance approach developed and adopted by WHO's African region member states (WHO/Afro) to strengthen their surveillance capacity at all levels for early detection, response and recovery from priority diseases and public health events. We provide an overview of the IDSR strategy and the issues that can prevent its expected outcome (early detection for timely response) in eastern DRC where there are still delays in EVD outbreaks detection and weaknesses in response capacity and health crisis recovery. Therefore, this paper highlights the advantages linked to the implementation of the IDSR and calls for an urgent need to scale up its materialization against the recurrent Ebola outbreaks in eastern DRC. Consequently, the paper advocates for rapidly addressing the obstacles hindering its operationalization and adapting the approach to the local context using implementation science.
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A generalizable one health framework for the control of zoonotic diseases. Sci Rep 2022; 12:8588. [PMID: 35597789 PMCID: PMC9124177 DOI: 10.1038/s41598-022-12619-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/13/2022] [Indexed: 11/08/2022] Open
Abstract
Effectively preventing and controlling zoonotic diseases requires a One Health approach that involves collaboration across sectors responsible for human health, animal health (both domestic and wildlife), and the environment, as well as other partners. Here we describe the Generalizable One Health Framework (GOHF), a five-step framework that provides structure for using a One Health approach in zoonotic disease programs being implemented at the local, sub-national, national, regional, or international level. Part of the framework is a toolkit that compiles existing resources and presents them following a stepwise schematic, allowing users to identify relevant resources as they are required. Coupled with recommendations for implementing a One Health approach for zoonotic disease prevention and control in technical domains including laboratory, surveillance, preparedness and response, this framework can mobilize One Health and thereby enhance and guide capacity building to combat zoonotic disease threats at the human-animal-environment interface.
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Bartlow AW, Middlebrook EA, Romero AT, Fair JM. How Cooperative Engagement Programs Strengthen Sequencing Capabilities for Biosurveillance and Outbreak Response. Front Public Health 2021; 9:648424. [PMID: 33732679 PMCID: PMC7956948 DOI: 10.3389/fpubh.2021.648424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/09/2021] [Indexed: 11/21/2022] Open
Abstract
The threat of emerging and re-emerging infectious diseases continues to be a challenge to public and global health security. Cooperative biological engagement programs act to build partnerships and collaborations between scientists and health professionals to strengthen capabilities in biosurveillance. Biosurveillance is the systematic process of detecting, reporting, and responding to especially dangerous pathogens and pathogens of pandemic potential before they become outbreaks, epidemics, and pandemics. One important tool in biosurveillance is next generation sequencing. Expensive sequencing machines, reagents, and supplies make it difficult for countries to adopt this technology. Cooperative engagement programs help by providing funding for technical assistance to strengthen sequencing capabilities. Through workshops and training, countries are able to learn sequencing and bioinformatics, and implement these tools in their biosurveillance programs. Cooperative programs have an important role in building and sustaining collaborations among institutions and countries. One of the most important pieces in fostering these collaborations is trust. Trust provides the confidence that a successful collaboration will benefit all parties involved. With sequencing, this enables the sharing of pathogen samples and sequences. Obtaining global sequencing data helps to identify unknown etiological agents, track pathogen evolution and infer transmission networks throughout the duration of a pandemic. Having sequencing technology in place for biosurveillance generates the capacity to provide real-time data to understand and respond to pandemics. We highlight the need for these programs to continue to strengthen sequencing in biosurveillance. By working together to strengthen sequencing capabilities, trust can be formed, benefitting global health in the face of biological threats.
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Affiliation(s)
- Andrew W. Bartlow
- Biosecurity and Public Health, Los Alamos National Laboratory, Los Alamos, NM, United States
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Ambrosiano J, Sims B, Bartlow AW, Rosenberger W, Ressler M, Fair JM. Ontology-Based Graphs of Research Communities: A Tool for Understanding Threat Reduction Networks. Front Res Metr Anal 2020; 5:3. [PMID: 33870041 PMCID: PMC8028387 DOI: 10.3389/frma.2020.00003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/30/2020] [Indexed: 11/13/2022] Open
Abstract
Scientific research communities can be represented as heterogeneous or multidimensional networks encompassing multiple types of entities and relationships. These networks might include researchers, institutions, meetings, and publications, connected by relationships like authorship, employment, and attendance. We describe a method for efficiently and flexibly capturing, storing, and extracting information from multidimensional scientific networks using a graph database. The database structure is based on an ontology that captures allowable types of entities and relationships. This allows us to construct a variety of projections of the underlying multidimensional graph through database queries to answer specific research questions. We demonstrate this process through a study of the U.S. Biological Threat Reduction Program (BTRP), which seeks to develop Threat Reduction Networks to build and strengthen a sustainable international community of biosecurity, biosafety, and biosurveillance experts to address shared biological threat reduction challenges. Networks like these create connectional intelligence among researchers and institutions around the world, and are central to the concept of cooperative threat reduction. Our analysis focuses on a series of seven BTRP genome sequencing training workshops, showing how they created a growing network of participants and countries over time, which is also reflected in coauthorship relationships among attendees. By capturing concept and relationship hierarchies, our ontology-based approach allows us to pose general or specific questions about networks within the same framework. This approach can be applied to other research communities or multidimensional social networks to capture, analyze, and visualize different types of interactions and how they change over time.
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Affiliation(s)
- John Ambrosiano
- Information Systems and Modeling, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Benjamin Sims
- Statistical Sciences, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Andrew W Bartlow
- Biosecurity and Public Health, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - William Rosenberger
- Information Systems and Modeling, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Mark Ressler
- Information Systems and Modeling, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Jeanne M Fair
- Biosecurity and Public Health, Los Alamos National Laboratory, Los Alamos, NM, United States
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Adini B, Singer SR, Ringel R, Dickmann P. Earlier detection of public health risks - Health policy lessons for better compliance with the International Health Regulations (IHR 2005): Insights from low-, mid- and high-income countries. Health Policy 2019; 123:941-946. [PMID: 31288952 PMCID: PMC7114645 DOI: 10.1016/j.healthpol.2019.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 06/02/2019] [Accepted: 06/18/2019] [Indexed: 11/29/2022]
Abstract
The International Health Regulations (IHR 2005) require all Member States to build and maintain the capacities to prevent, detect and respond to public health emergencies. Early detection of public health risks is one of the core functions. In order to improve surveillance and detection, a better understanding of the health system conditions and their influencing factors are needed. The Israeli Ministry of Health/IHR National Focal Point held a workshop to elucidate health system conditions and their influencing factors that enable earlier detection. The workshop methodology employed a stepwise, small working group analysis approach to elucidate the conditions and their influencing factors affecting each stage of recognition, assessment, and reporting of infectious disease outbreaks, at the local, regional and national levels. In order to detect public health risks earlier, the detection process needs to be moved closer to the local communities and start with building capacity within communities. Building capacity and engaging with local and diverse communities requires significant changes in the governance approach and include information sharing, multi-sectoral communication and coordination across various levels before, during and after public health emergencies. Across the regions, low-, mid- and high-income countries seem to struggle more with governance and information sharing rather than with technical capacities and capabilities.
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Affiliation(s)
- Bruria Adini
- Department of Emergency Management and Disaster Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shepherd Roee Singer
- Ministry of Health, Tel Aviv and Jerusalem, Israel; Hebrew University, Jerusalem, Israel
| | - Ronit Ringel
- Ministry of Health, Tel Aviv and Jerusalem, Israel
| | - Petra Dickmann
- Dickmann Risk Communication Drc
- , London, UK; Jena University Hospital, Department of Anaesthesiology and Intensive Care, Jena, Germany.
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Standley CJ, Carlin EP, Sorrell EM, Barry AM, Bile E, Diakite AS, Keita MS, Koivogui L, Mane S, Martel LD, Katz R. Assessing health systems in Guinea for prevention and control of priority zoonotic diseases: A One Health approach. One Health 2019; 7:100093. [PMID: 31049389 PMCID: PMC6479159 DOI: 10.1016/j.onehlt.2019.100093] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 04/15/2019] [Accepted: 04/15/2019] [Indexed: 01/30/2023] Open
Abstract
To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014-2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries responsible for human, animal, and environmental health to identify a list of zoonotic diseases - rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza - as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems "maps" emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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Affiliation(s)
- Claire J. Standley
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States
| | | | - Erin M. Sorrell
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States
| | - Alpha M. Barry
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States
| | - Ebi Bile
- U.S. Centers for Disease Control and Prevention, Conakry, Guinea
| | | | | | | | - Seny Mane
- Ministry of Livestock, Conakry, Guinea
| | - Lise D. Martel
- U.S. Centers for Disease Control and Prevention, Conakry, Guinea
| | - Rebecca Katz
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States
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Achieving Health Security and Threat Reduction through Sharing Sequence Data. Trop Med Infect Dis 2019; 4:tropicalmed4020078. [PMID: 31091687 PMCID: PMC6631123 DOI: 10.3390/tropicalmed4020078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/04/2019] [Accepted: 05/08/2019] [Indexed: 11/17/2022] Open
Abstract
With the rapid development and broad applications of next-generation sequencing platforms and bioinformatic analytical tools, genomics has become a popular area for biosurveillance and international scientific collaboration. Governments from countries including the United States (US), Canada, Germany, and the United Kingdom have leveraged these advancements to support international cooperative programs that aim to reduce biological threats and build scientific capacity worldwide. A recent conference panel addressed the impacts of the enhancement of genomic sequencing capabilities through three major US bioengagement programs on international scientific engagement and biosecurity risk reduction. The panel contrasted the risks and benefits of supporting the enhancement of genomic sequencing capabilities through international scientific engagement to achieve biological threat reduction and global health security. The lower costs and new bioinformatic tools available have led to the greater application of sequencing to biosurveillance. Strengthening sequencing capabilities globally for the diagnosis and detection of infectious diseases through mutual collaborations has a high return on investment for increasing global health security. International collaborations based on genomics and shared sequence data can build and leverage scientific networks and improve the timeliness and accuracy of disease surveillance reporting needed to identify and mitigate infectious disease outbreaks and comply with international norms. Further efforts to promote scientific transparency within international collaboration will improve trust, reduce threats, and promote global health security.
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Suthar AB, Allen LG, Cifuentes S, Dye C, Nagata JM. Lessons learnt from implementation of the International Health Regulations: a systematic review. Bull World Health Organ 2017; 96:110-121E. [PMID: 29403114 PMCID: PMC5791773 DOI: 10.2471/blt.16.189100] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 10/26/2017] [Accepted: 11/14/2017] [Indexed: 11/27/2022] Open
Abstract
Objective To respond to the World Health Assembly call for dissemination of lessons learnt from countries that have begun implementing the International Health Regulations, 2005 revision; IHR (2005). Methods In November 2015, we conducted a systematic search of the following online databases and sources: PubMed®, Embase®, Global Health, Scopus, World Health Organization (WHO) Global Index Medicus, WHO Bulletin on IHR Implementation and the International Society for Disease Surveillance. We included identified studies and reports summarizing national experience in implementing any of the IHR (2005) core capacities or their components. We excluded studies that were theoretical or referred to IHR (1969). Qualitative systematic review methodology, including meta-ethnography, was used for qualitative synthesis. Findings We analysed 51 articles from 77 countries representing all WHO Regions. The meta-syntheses identified a total of 44 lessons learnt across the eight core capacities of IHR (2005). Major themes included the need to mobilize and sustain political commitment; to adapt global requirements based on local sociocultural, epidemiological, health system and economic contexts; and to conduct baseline and follow-up assessments to monitor the status of IHR (2005) implementation. Conclusion Although experiences of IHR (2005) implementation covered a wide global range, more documentation from Africa and Eastern Europe is needed. We did not find specific areas of weakness in monitoring IHR (2005); sustained monitoring of all core capacities is required to ensure effective systems. These lessons learnt could be adapted by countries in the process of meeting IHR (2005) requirements.
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Affiliation(s)
- Amitabh B Suthar
- South African Centre for Epidemiological Modelling and Analysis, University of Stellenbosch, Private Bag X1, Matieland, Stellenbosch, 7602, South Africa
| | - Lisa G Allen
- TMF Health Quality Institute, Austin, United States of America (USA)
| | - Sara Cifuentes
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, USA
| | - Christopher Dye
- Department of Strategy, Policy and Information, World Health Organization, Geneva, Switzerland
| | - Jason M Nagata
- Department of Pediatrics, University of California San Francisco, San Francisco, USA
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