Towards integrated surveillance-response systems for the prevention of future pandemics
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(2020) 9:140
OPINION
Open Access
Towards integrated surveillance-response systems for the prevention of future pandemics Jakob Zinsstag1,2* , Jürg Utzinger1,2, Nicole Probst-Hensch1,2, Lv Shan3,4 and Xiao-Nong Zhou3,4
Abstract Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs. The transmission of such pathogens to humans may lead to self-sustaining chains of transmission. These pathogens represent the highest risk for future pandemics. For their prevention, the transmission over the species barrier — although rare — should, by all means, be avoided. In the current COVID-19 pandemic, surprisingly though, most of the current research concentrates on the control by drugs and vaccines, while comparatively little scientific inquiry focuses on future prevention. Already in 2012, the World Bank recommended to engage in a systemic One Health approach for zoonoses control, considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons. First examples, like integrated West Nile virus surveillance in mosquitos, wild birds, horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors. Provided a zoonotic origin can be ascertained for the COVID-19 pandemic, integrated wildlife, domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks. In conclusion, the earlier a zoonotic pathogen can be detected in the environment, in wildlife or in domestic animals; and the better human, animal and environmental surveillance communicate with each other to prevent an outbreak, the lower are the cumulative costs. Keywords: Integrated surveillance-response, One health, Pandemics, Transdisciplinarity, Zoonoses
Background Most human pathogens originate from non-human hosts [1]. Diseases circulating between humans and animals are known as zoonoses, which are the key drivers of emergence and re-emergence of infectious diseases [2]. Zoonoses are classified into stages, depending on the modes of transmission and their epidemiology. Stage I pathogens are microbes present in animals but have not been detected in humans und natural conditions (Table 1). Stage II pathogens, such as brucellosis [4] and rabies [5], are continuously transmitted from animals to * Correspondence: [email protected] 1 Swiss Tropical and Public Health Institute, Basel, Switzerland 2 University of Basel, Basel, Switzerland Full list of author information is available at the end of the article
humans but are not transmitted between humans [3]. Successful elimination of stage II pathogens requires interventions in the animal reservoir [6, 7]. Stage III pathogens, such as monkey pox or Leishmania donovani, are transmitted to humans and lead to limited transmission that stutter to extinction. The basic reproductive number (R0), that is the number of secondary infections of one infected human, is below 1 in stage III pathogens. Stage IV pathogens persist in anima
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