5/10/2012 Me M la l mi m n i e 3

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1 One Health trails of mice and men Carina Blackmore DVM, PhD, Dipl. ACVPM State Public Health Veterinarian State Environmental Epidemiologist Florida Department of Health Environmental Epidemiology and Toxicology Analytical Food and Waterborne Epidemiology Disease Aquatic toxins Hazardous Waste Asthma Site Assessment Birth defects registry Toxicology Chemical poisoning Vector-borne Disease surveillance Zoonotic Disease Environmental Public Health Tracking Who works on our team? MPH MPA PA Dr.PH MD DVM PhD in toxicology, epidemiology, biology BS MS/ MSPH 1

2 Why work in Public Health? Connects theory and practice Meaningful work On the front line In the news Disaster response Policy priority Cutting edge public health science One Health What? The collaborative effort of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals and our environment. Animal-human interface 2

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4 American pets and people share growing pains! Known Zoonotic Diseases Cats: 27 Dogs: 32 Rodents: 50 Horses: 10 Rabbits: 15 Cattle: 20 Birds: 17 4

5 Known Zoonotic Diseases Dermatophytosis E coli 0157:H7 Campylobacter Leptospirosis Rabies Salmonellosis Toxoplasmosis Known Zoonotic Diseases Anthrax Brucellosis Plague Tularemia Q fever VEE Reportable Diseases In Florida statute MDs/ DVMs Case definitions 5

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7 Rabies Pathogenesis Virus in muscle Spreads to nerve endings Migrates to spinal cord and brain Migrates down to salivary glands and into saliva Animal Rabies in Florida Year Total Year Average Raccoon Bat Fox Cat Dog Skunk Bobcat Horse Otter Cow Total

8 Dog and cat injuries 4.5 million dog bites per year, US 18,000 require medical attention, FL Responsible ownership Human behavior Feral cat problem Overpopulation of roaming cats Public health concern Animal welfare concern Wildlife conservation concern Animal control ineffective 8

9 Emerging Diseases a result of changing ecology Annual Global Trade in Exotic Animals 4 million birds 640,000 reptiles 40,000 primates Illegal trade? Reverse zoonoses 9

10 Whales, environmental disease sentinels P H1N1 influenza in swine (and other critters) May 2, commercial swine herd, Alberta July, show pig Minnesota August, turkey farm Chile October, ferret Oregon November, commercial swine herd, Indiana November, cat, Iowa November, cat, Oregon (fatal case) November, dogs, China November, turkey farm, Virginia December, cheetah, California 10

11 Cycles of the Asian H5N1 Virus in Animals and Humans Waterfowl Humans Domestic birds Mammals (primarily swine) Waterfowl Swine Influenza in North America 1930 Common respiratory illness in swine Usually mild 1-2 human cases/ year Swine infected by human influenza viruses Swine flu vaccines Swine influenza 11

12 E coli 0157:H7 (STEC-Shiga toxin producing E coli) Primary habitat: large intestine, rectoanal junction? warm, constant nutrient rich vigorous growth Excretion Secondary habitat: water, soil, sediment cool, fluctuating nutrient limiting survival Re-colonization Death Environment Spinach, CA, 06 12

13 Direct contact transmission Indirect contact (environmental) transmission 13

14 MRSA in animals Horses Dogs Cats Cattle Sheep Rabbits Pigs Chickens Parrots Seal Florida Ecology Supports Arbovirus Warm Climate Regular Rainfall Vectors Identified Suitable Hosts for Amplification Historical Data SLEV, EEEV, WNV Transmission Cycle Mosquito vector Virus Bird reservoir hosts Incidental infections EEEV, WNV 14

15 West Nile Virus Spread, Incidence of WNV neuroinvasive disease by state,

16 West Nile Virus in Florida, 2011 Through 10/19/11 22 locally acquired human cases 3 horses 115 sentinel chickens MWTD values GIS RISK Maps -endemic arboviruses RISK model comparison RISK values Dr. Jonathan Day Dengue in Key West Monroe County Health Department notified of a New York resident diagnosed with dengue after travel to Key West Issued a press release to the public and notified area physicians of potential for local transmission of dengue Florida Keys Mosquito Control District implemented enhanced trapping and spraying of Aedes aegypti 16

17 World distribution in 2008 Epi curve, Dengue fever, Key West, Extrinsic Incubation Period Case Aug 8-Aug 15-Aug 22-Aug 29-Aug 5-Sep 12-Sep Onset date 17

18 Obstacles No vaccine (prospects in development) Free movement of people from endemic areas (repeated introduction) Difficult to control mosquito-borne diseases 1 1 Imported dengue, 2010 Locally acquired cases 2011 (n=5)

19 Climate Change: Potential Negative Health Impacts Climate change: -Temperature rise -Sea level rise -Hydrologic changes HEAT SEVERE WEATHER AIR POLLUTION ALLERGIES VECTOR-BORNE AND OTHER ZOONOTIC DISEASES WATER-BORNE DISEASES WATER AND FOOD SUPPLY MENTAL HEALTH ENVIRONMENTAL REFUGEES/ CIVIL CONFLICT Heat stress, cardiovascular failure Injuries, fatalities Asthma, cardiovascular disease Respiratory allergies, poison ivy Malaria, dengue, hantavirus, Rift Valley fever, Cholera, cryptosporidiosis, campylobacter, leptospirosis, vibriosis, naegleria Malnutrition, diarrhea, harmful algal blooms, hygiene-related disease Anxiety, despair, depression, post-traumatic stress Morbidity, mortality and migration CNN, September 2007 Amoeba lurks in Florida lakes 3 boys die from deadly amoeba in Orlando-area area lakes this summer Bathers warned to stay out of water warmer than 80 degrees Fahrenheit Officials: Flu-like like symptoms after swimming in a lake should spark alarm Primary Amebic Meningoencephalitis (PAM) Naegleria fowleri Rare Symptoms Abrupt headache, Fever, Vomiting, URI, Meningitis Coma-Death in 7-10 d Naturally occurring in most Florida lakes (> 86 F) Chlorination effective control 19

20 Harmful algal blooms Cyanobacteria Puffer Fish Poisoning Surveillance Research Education Public Health Strategies Ciguatera Fish Poisoning (Gamberdiscus toxicus) One Health Disaster 20

21 Opportunities for One Health Cute pic? Internship 21

22 Employment People First Emory Public Health Employment Connection Friends and Contacts Florida One Health Newsletter Elizabeth Radke, Editor Questions? Dr. Carina Blackmore,

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