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[Can emerging zoonoses be controlled?].

The report 'Emerging zoonoses' of the Health Council of the Netherlands was written on request from the Minister of Health, Welfare and Sport. It gives an expert view on how to anticipate zoonoses that could emerge in the near future by addressing questions regarding risk assessment, prevention, early detection, control and communication. Further emphasis in the report is given to developments within the European Union (EU). The report had to serve as the basis for a European policy conference on 16 and 17 September 2004 during the Dutch presidency of the EU. Some important developments announced by the Minister are: establishment of a National Centre for Infectious Diseases to advise the Minister and coordinate crisis control during outbreaks, measures to strengthen the regional structure of public health in the Netherlands, and a budget for the strengthening of public health research.

Communicable Diseases, Emerging↗

[Have we defeated the principal zoonoses?].

Following an overview of some successful campaigns against zoonoses, this paper examines other zoonotic diseases that are likely to be brought under control in industrialized countries, such as brucellosis, tuberculosis and canine or wildlife rabies. The author goes on to explain the reasons for the failure to eradicate some other zoonoses in developing countries, and concludes by examining reasons for optimism or pessimism, taking into account new methods of prevention and control.

Animals↗

Epidemiology of marine fish-borne parasitic zoonoses.

Most parasites of marine animals are of little public health concern; however, some helminths are capable of infecting humans. Marine zoonotic infections in humans result from consumption of contaminated edible tissues or products of seafood or, to a lesser extent, from physical contact with contaminated seafood. Worldwide, over 50 species of helminth parasites from fishes, crabs, crayfishes, snails, and bivalves are known to produce human infections. Most helminth zoonoses are rare and invoke only slight to moderate injury; however, some are more prevalent and pose serious potential health hazards. Worldwide, the majority of seafood zoonoses occur along coastal regions where seafood products are commonly consumed. Continuing improvements in transportation, technology, and food handling, however, allow fresh seafood to be shipped throughout the world; thus, the potential for acquisition of parasitic infections from marine products is not limited to coastal populations. Although the number of documented cases continue to increase, the overall risk of human infection is slight. The increasing exploitation of the marine environment by humans, changing dietary habits incorporating "natural" seafood dishes (eg, sushi and sashimi), and tendency to reduce cooking times when preparing seafood products, all increase the chances of becoming infected with these parasites.

Animals↗

Epidemiological assessment of parasitic zoonoses in Malaysia.

Food-borne parasitic zoonoses are emerging as major public health problems in most countries because they are widespread and pose a medical challenge. Not only are they important from an economic standpoint, but they also cause severe sequalae in all those affected. The extent of parasitic zoonoses in Malaysia is considered a "tip of the iceberg" problem. Cases of zoonotic diseases, like porocphaliasis, sarcocystosis, toxoplasmosis, cysticercosis, hydatidosis, echinostomiasis, and gnathostomiasis are traced and documented. An epidemiologic reassessment of methods is suggested to determine the extent of these parasitoses in Malaysia.

Animals↗

Current status of food-borne parasitic zoonoses in Hong Kong.

Although there have been no recent epidemiological studies on parasitic zoonoses in Hong Kong, the following diseases are known to occur locally: toxoplasmosis, clonorchiasis, fasciolopsiasis, cysticercosis, hydatidosis, sparganosis, trichinellosis, angiostrongyliasis, gnathostomiasis and trichostrongylosis. Most of them are due to the consumption of infected animals imported from China. Due to the general unawareness of parasitic diseases by physicians and health authorities, the importance of zoonoses has been under recognized.

Animals↗

Current status of food-borne parasitic zoonoses in the United States.

Although not a major public health problem, food-borne parasitic zoonoses in the United States are the cause of numerous diseases that occur widely in the population. The most common food-borne parasitic diseases in the United States are trichinosis, toxoplasmosis, taeniasis/cysticercosis, diphyllobothriasis, and anisakiasis. Since 1947, when the US Public Health Service began to record statistics on trichinosis cases in humans, the numbers of reported cases in the United States have declined markedly, from an average of about 400 with 10-15 deaths reported each year in the late 1940s, to an average of 57 per year with three deaths overall in the 5 years 1982-1986. Each year throughout the world, Toxoplasma gondii infects millions of persons, who contract it either by eating raw or poorly cooked meat from infected animals such as hogs or sheep or by ingesting soil contaminated with cat feces. In the United States between 400 and 10,000 infants are born each year with congenital toxoplasmosis. Toxoplasmic encephalitis, marked by dementia and seizures, has become the most commonly recognized cause of central nervous system opportunistic infection in AIDS patients. Intestinal taeniid tapeworm infection acquired in the United States is almost entirely caused by Taenia saginata, the beef tapeworm. Neurocysticercosis, caused by larvae of the pork tapeworm Taenia solium, is diagnosed in hundreds of persons in the United States every year. Nearly all patients are immigrants or travelers from Mexico and other disease-endemic areas. Diphyllobothriasis and anisakiasis both have increased in recent years in association with increasing popularity of raw fish dishes. Adequate prevention and control of food-borne parasitic zoonoses require continued and improved programs to educate consumers, producers and medical practitioners.

Animals↗

Current status of food-borne parasitic zoonoses in Mediterranean and African regions.

Epidemiological data on food-borne parasitic zoonoses of Mediterranean and African regions are fragmentary. Several studies indicate that toxoplasmosis frequently occurs in Africa, but the epidemiological patterns in these countries are far from being complete. Serological investigations have been carried out with different methods and the results are not always comparable. Food habits, presence or absence of domestic and/or synanthropic felines, and environmental characteristics (damp or dry areas) seem to influence the prevalence of infection in man from 15 to over 60%. There are few reports on Sarcocystis infection in man, while its presence in domestic and sylvatic animals is well evidenced. Cysticercosis infection in cattle is widespread in Africa with a prevalence ranging from 2 to 50% in relation to breeding and human habits. In European countries of the Mediterranean area the prevalence of infection is below 2%. Cysticercosis infection in swine has almost disappeared in the Mediterranean area, while it is still present in some African countries. Human paragonimiasis is present in Western Africa with a prevalence ranging from 2 to 31%. Heterophyasis in man is present in Egypt, Tunisia, and Middle East. Sylvatic trichinellosis is widespread in Mediterranean (Trichinella sp.3) and African (T. nelsoni, Trichinella T8) regions. Domestic trichinellosis (T. spiralis spiralis) is present in Spain, France, Yugoslavia, Egypt, Gambia, and Nigeria in domestic and/or sylvatic animals. In Africa human trichinellosis is rare, mostly from religious and food habits. Till now very few control projects against food-borne parasitic zoonoses have been developed in Africa.

Africa↗

Zoonoses in India.

Intimate and prolong contact between man and animal facilitates the transmission of various communicable diseases between them. These diseases (zoonoses) are more prevalent in developing countries especially in the rural areas. These diseases virtually stunt the economic and social growth also. Lack of authentic data and awareness regarding the occurrence of these diseases and their true impact on public health have acted as major obstacles in instituting adequate and effective control measures. The information available regarding the current status of few important zoonoses in India is being presented in this paper.

Animals↗

Zoonoses in the world: current and future trends.

Zoonoses still represent significant health problems in many developed and developing countries. Whereas rabies, brucellosis, and echinococcosis will remain the major zoonotic diseases to be tackled in developing countries for the next 20 years, it is very likely that many developed countries will have eliminated these diseases by then. As observed repeatedly in the past few years, new zoonoses are, however, expected to emerge in the near future. Due to ever-increasing animal and human movements these new agents, whether originating from the southern or northern hemisphere, will most probably spread throughout the globe very quickly. It is very probable, in view of the foreseeable changes in the developed (e.g. population aging) and developing world (e.g. population growth, urbanization) or both (e.g. AIDS pandemic, environmental changes), that this trend will continue and even intensify.

Animals↗

[Some viral zoonoses transmitted by pets (author's transl)].

Besides dogs and cats, various other animals are more or less popular as pets in the Netherlands. It is importance to the veterinary practitioner to know which diseases may be transmitted to man by these animals. Of the viral zoonoses. rabies constitutes a menace to man, in which dogs and, to a less extent, cats supply a link between man and free-living wild animals. Another viral zoonosis in which interest was centered in recent years, is lymphocytic choriomeningitis (LCM) caused by a virus which often is latent in mice but which may also be detected in young hamsters. A human disease caused by a pathogenic agent which should not be classified with the viruses, is chlamydiosis (psittacosis, ornithosis), which disease is usually transmitted to man by psittacine birds or pigeons. Of the above disease, the pathogenic agents, the clinical pictures in man and animals, the mode of transmission and possible preventive and therapeutic measures are discussed. Finally, the risk of transmission of viral zoonoses by less current "pets" is stressed.

Animals↗

[Pets as permanent excretors of zoonoses pathogens].

When scrutinizing zoonoses with regard to risks for human beings, the spectrum of pathogens with dogs, cats and birds leading to persistent infections and consequently to the fact that the animals become carriers and permanent excretors is relatively small. Most of the zoonoses cause clinical symptoms and will be taken care of correspondingly. With regard to dogs there is a multitude of persistent infections that are transferred from the pet to the human being and vice versa. In reality, however, the importance of the dog as permanent excretor of zoonosis pathogens endangering human health is minimal, except for some parasitoses. As far as cats are concerned, the situation is totally different. Cats are carriers and permanent excretors of pasteurella, the pathogens of the so-called cat-scratch disease, trichophyton and microsporum species, toxoplasmosis and orthopox viruses. The new zoonosis feline pox serves as an example of the necessity of a permanent observation of persistently infected pets. Healthy, but persistently infected birds form a source of infection not to be underestimated. Through the beat of their wings they constantly stir up dried infectious excrements and dust and thus favour the airborn infection of human beings. Chlamydia psittaci, the Newcastle disease virus and Mycobacterium avium are of major importance in this context. The risk of transferring zoonosis pathogens from persistently infected pets to human beings can be minimized through prophylactic diagnosis, strict measures of hygiene, observation of the schedule of vaccinations for the respective species and regular use of anthelmintica.

Animals↗

Zoonoses in the meat industry: a review.

Zoonoses are diseases, the infections of which can be transmitted between man and animals. Only a few are of importance with respect to poultry meat and meat from cattle, sheep, horses and goats. Advances in the control of diseases such as tuberculosis, brucellosis and trichinosis in animals have reduced the hazards posed to workers in the meat industry and to consumers of meat. However, inspection of animals ante- and post-mortem cannot detect all infectious agents present. This applies particularly to bacteria such as Campylobacter, Salmonella, verotoxigenic and other pathogenic Escherichia coli and Yersinia. Protection of meat workers from infection depends upon taking normal hygienic precautions, which also protect the meat from contamination from the workers. Consumers are exposed to a smaller range of zoonoses than meat workers because they encounter only meat that has passed inspection. In addition, heavily contaminated parts of the animal, such as the hide, feathers and viscera have been removed. Further advances in making meat safer are likely to result from the introduction of Integrated Quality Assurance systems. These involve identifying, monitoring and keeping records of the disease status and treatment of each animal (or poultry flock) so that its history is known when it reaches the abattoir. They should also include programmes aimed at minimising colonisation by zoonotic bacteria such as camplyobacters, salmonellas and verotoxigenic Escherichia coli.

Abattoirs↗

The seroprevalence of ten zoonoses in two villages of Crete, Greece.

The seroprevalence and incidence of 10 zoonoses due to Rickettsia typhi, R. conorii, Coxiella burnetii, Burcella sp., Borrelia sp., Toxoplasma sp., Leishmania sp., Entamoeba histolytica, Echinococcus granulosus and Fasciola hepatica were studied in an animal husbandry and a farming village in Crete, Greece. The serum conversion incidence of each infectious agent was determined by testing 2 blood samples, collected in 1985 and in 1987. The surveillance was conducted using detailed transparent maps of the 2 villages studied, on which epidemiological data were interrelated to the results obtained from the serological tests. Thus the importance and spread of each infection were visualized. C. burnetii, Toxoplasma sp., R. conorii, and E. granulosus, were the most common infectious agents encountered during this study.

Adult↗

[Parasitic zoonoses transmitted by drinking water. Giardiasis and cryptosporidiosis].

Nowadays, the parasitic zoonose organisms Giardia lamblia und Cryptosporidium spp. are among the most relevant pathogens of drinking water-associated disease outbreaks. These pathogens are transmitted via a fecal-oral route; in both cases the dose of infection is low. Apart from person-to-person or animal-to-person transmissions, the consumption of contaminated food and water are further modes of transmission. The disease is mainly characterized by gastrointestinal symptoms. In industrialized countries, the prevalence rate of giardiasis is 2-5 % and of cryptosporidiosis 1-3%. Throughout the world, a large number of giardiasis and cryptosporidiosis outbreaks associated with drinking water were published; in 2001 the first case in Germany was identified. Giardia and Cryptosporidium are detected in surface water and sporadically in unprotected groundwater. Use of these waters for drinking water abstraction makes high demands on the technology of the treatment process: because of the disinfectant resistance of the parasites, safe elimination methods are needed, which even at high contamination levels of source water guarantee safe drinking water. Further measures for prevention and control are implementation of the HACCP concept, which includes the whole chain of procedures of drinking water supply from catchment via treatment to tap and a quality management system.

Communicable Disease Control↗

Improvements in the serodiagnosis of helminthic zoonoses.

Remarkable progress has been achieved in developing improved serodiagnostic assays for a group of diseases for which other diagnostic methods are often lacking. Toxocariasis, trichinellosis, dirofilariasis, Taenia solium cysticercosis and the cystic and alveolar forms of hydatid disease are occult infections in humans and sometimes in lower animal hosts. Although Strongyloides stercoralis achieves patency in humans, parasitologic diagnosis is often very difficult. Efforts to develop reliable immunodiagnostic methods have spanned several decades but progress had been slow until recently. The complexity and nonspecificity of helminth antigens were major problems which prevented the full realization of the benefits of the highly sensitive assay systems now available. Modern immunologic methods including hybridoma technology, immunoaffinity chromatography and immunoblotting, however, have yielded improved reagents and the means to characterize their nature and function. The outcome of this research has been more sensitive and specific serologic tests based on measurement of both circulating antigens and antibodies as well as improved understanding of the nature of host-parasite interactions. Although much remains to be done, many improved immunodiagnostic procedures are already being applied in clinical diagnosis, epidemiologic studies and control programs directed against the helminthic zoonoses.

Animals↗

Viral zoonoses in Europe.

A number of new virus infections have emerged or re-emerged during the past 15 years. Some viruses are spreading to new areas along with climate and environmental changes. The majority of these infections are transmitted from animals to humans, and thus called zoonoses. Zoonotic viruses are, as compared to human-only viruses, much more difficult to eradicate. Infections by several of these viruses may lead to high mortality and also attract attention because they are potential bio-weapons. This review will focus on zoonotic virus infections occurring in Europe.

Animals↗

Monitoring of antimicrobial resistance on the basis of the E.U. Zoonoses Directive.

The new zoonoses Directive 2003/99/EC gives the opportunity for an improvement in the harmonization of antimicrobial resistance testing of zoonotic agents. The current reporting system under Council Directive 92/117/EEC was a voluntary approach leading to a limited comparability of the data. In the directive 2003/99/EC, inforced since June 2004, antimicrobial susceptibility testing is part of the legislation. The benchmarks, the zoonotic agents Salmonella spp. and Campylobacter spp., the animal species cattle, pigs and poultry, as well as products thereof are fixed. In this paper details for a harmonized monitoring scheme are proposed. The draft specifies in more detail the animal species, the production lines and the locations of the sampling. The sampling frame should ensure a representative number of isolates to meet the objectives, these are detection of occurrence of resistance patterns, estimation of the prevalence of resistance to an antimicrobial substance, and assessment of changes in the prevalence of antimicrobial resistance. Apart from isolates from monitoring schemes reflecting the healthy animal population, clinical isolates should be included to detect new emerging resistance genes. The comparability of the methods applied has to be ensured by an external quality assurance system. As the monitoring of antimicrobial resistance should be closely linked to the monitoring programs laid down in the directive 2003/99/EC to estimate the prevalence of zoonotic agents along the food chain. A stepwise implementation in accordance with the other monitoring programs is suggested. In order to support management decisions to limit the emergence and spread of resistance additional information has to be collected, i.e. resistance in animal pathogens, usage of antimicrobials, or the relevance of the import of animals or products of animal origin.

Animals↗