Emerging global health threats of animal origin

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Oliver Nichols
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1 Emerging global health threats of animal origin Ahmed El Idrissi Senior Officer Transboundary Animal Diseases and zoonoses Animal Production and Health Division FAO - Rome 9 th meeting of the REMESA JPC Tunis 3-4 November, 2014

2 Context disease emergence Pathogens constantly evolving and changing their host range Over 60%of emerging infectious diseases in humans have their origin in animals (75% of these from wildlife) More animal borne diseases can be expected in the future Worldwide pathogen emergence at the animal-humanecosystem interface for an issue of growing importance Managing the risk of emerging health threats has become an imperative

3 Questions and Focus Why and how pathogens of animal origin have become a major global public health threat? What are disease dynamics at the human-animalecosystems interface and how to curb these?

6 billion people Rapid economic development Twentyfold increase in GDP

5 Global changes Human demographic growth By 2050, the world population is expected to increase to over 9.6 billion people Rapid economic development Twentyfold increase in GDP ( ) Pressure on the earth s natural resources and on agriculture Increasing demand for animal source food

pathogen-host interactions Pandemic influenza H1N1 (2009) Trade

6 Globalization & disease Increased international travel Increased global trade Worldwide distribution of pathogens and vectors Novel pathogen-host interactions Pandemic influenza H1N1 (2009) Trade related diseases: Rift Valley Fever crisis ( ) FMD, ASF, HPAI

Land use changes & disease Deforestation

Species jump Diseases of wildlife origin:

7 Land use changes & disease Deforestation Agricultural encroachment of forests Hunting of bush meat Contact between wildlife, domestic animals and humans Species jump Diseases of wildlife origin: AIDS/HIV 1 SARS Nipah virus Hendra virus Ebola virus

8 Agriculture changes and disease Rapid livestock intensification (Avian influenza: H5N1, H7N9) Expanding international food supply networks Antimicrobial resistance

Climate related Vector-borne viral diseases: Rift Valley

9 Climate and environmental change El Nino- Triggers natural disasters Global warming Rainfall / flooding Examples of Climate related Vector-borne viral diseases: Rift Valley Fever Bluetongue Schmallenberg virus West Nile virus Chikungunya Dengue

10 Disease Pressure-State-Response framework

11 Disease outbreak timeline One Health approach to better managing the risk of emerging global health threats

risk of spread is still high Human cases: 664 out of which 391 deaths H5N1

12 H5N1 Highly Pathogenic Avian Influenza Since 2003, 60 countries across Asia, Europe, Middle-East & Africa In 2104 only 6 infected countries (endemic) but risk of spread is still high Human cases: 664 out of which 391 deaths H5N1 HPAI outbreaks reported in poultry and wild birds from November 2013 to April 2014

Newly emerging AI viruses in Asia 2013-2014 Reports of new re-assortant AI viruses in Asia since 2013: Sub-type Location Human cases Clinical signs in poultry Poultry cases First report H7N9 China

13 Newly emerging AI viruses in Asia Reports of new re-assortant AI viruses in Asia since 2013: Sub-type Location Human cases Clinical signs in poultry Poultry cases First report H7N9 China 455 No 195 March 2013 H10N8 China 3?? December 2013 H5N8 H5N6 China, Korea, Japan China, Lao PDR, Viet Nam The H5 of both viruses is closely related to H5N1 HPAI viruses belonging to clade Yes 40 January Yes 10 May 2014 FAO promotes integrated AI surveillance, i.e. investigating Flu A positive samples for different subtypes of concern

sharing Contingency planning Biosecurity improvement in LBMs Laboratory capacity

14 H7N9 projects what FAO is doing Targeted surveillance in high-risk countries in Asia since April 2013: Risk assessment Communication and awareness raising Information sharing Contingency planning Biosecurity improvement in LBMs Laboratory capacity building Provision of reagents FAO guidance for H7N9 is available on the internet at

Prepared by FAO AGAH/GLEWS 450 400 350 300 250 200 150 100 50 0 MERS- CoV in Humans 904 confirmed cases, 365 confirmed deaths (29/10/2014) Number of cases and deaths Figure 1.

Cases Deaths First confirmed positive cases in camels 450 400 350 300 250 200 150 100 50 0 41 41 83 87 18 93 3 30 54 31 23 13 Family cluster Hospital cluster Clusters and previous pathologies

15 Prepared by FAO AGAH/GLEWS MERS- CoV in Humans 904 confirmed cases, 365 confirmed deaths (29/10/2014) Number of cases and deaths Figure 1. Number of confirmed cases of MERS CoV reported from March 2012 to October Cases Deaths First confirmed positive cases in camels Family cluster Hospital cluster Clusters and previous pathologies Sporadic case No data * Asymptomatics /No data about previous ill Asymptomatics no previous ill Symptomatics Prev. Pathologies Symptomatics NO prev. Pathologies * No data refers to cases for which there are not enough epidemiological Information at the moment. Iran 5 USA 2 Oman 2 Netherlands 2 U.K. 3 Kuwait 3 Tunisia 3 Algeria 2 France 2 U.A.E 70 Jordan 9 Qatar 8 Countries Saudi Arabia 780 Countries with 1 confirmed case each: Austria Egypt Germany Greece Italy Lebanon Malaysia Philippines Figure 2. Number of cases classified according to their origin (Family vs. Hospital vs. Sporadic/Index) and previous health condition of the patient (Source: WHO). Figure 3. Number of confirmed cases reported by country (Source: WHO, National Authorities).

19 Ebola cases in West Africa (as of 28 September 2014, source WHO) As of 24 Octobre cases; 4952 deaths and rising

approach FAO's Priorities 1- Help stop the spread to avoid further loss of life 2- Boost incomes

20 FAO Response Programme SNAPSHOT 30 million USD 90,000 families Next 12 months Immediate action Long-term Impact Multidimensional approach: Innovation Inclusive and cross-sectoral Twin-track approach FAO's Priorities 1- Help stop the spread to avoid further loss of life 2- Boost incomes and agricultural production 3- Build resilience of communities to disease threats 4- Strengthen coordination

21 Conclusion Human Health, animal health and environment health are interlinked Global health threats are anticipated to continue unless more effective actions are taken to address the variety of underlying causes Need to act on the root causes of disease emergence: Shift to the left Need to find a common vision to bring global health risk down while meeting the challenge of the increasing demand on earth natural resource and agriculture Strategic changes in risk management and biosecurity (improved policies and governance) Multidisciplinary and integrated approaches: One Health

22 Thank you

Global and Regional Strategies for HPAI and CSF

Global and Regional Strategies for HPAI and CSF 2 Key Strategic Approach Strengthening of Veterinary Services and related national capacity, including compliance with OIE standards and guidelines on quality