One Health

A few months ago I was asked to write a paragraph describing the One Health Paradigm for a regional white paper on the regional marine ecosystem. This is what I came up with, heavily borrowing from several sources. It has become a useful way for me to describe the the multifaceted approach I'm moving my lab's research toward. Specifically, an approach that includes the role of environmental factors (abiotic and biotic), human factors (health status, habits, etc.), and pathogen genetic factors, in order to understand why only a small number of strains of a given species of a marine bacterium are truly virulent.

The One Health Paradigm reflects the inter-relationships between environmental, animal, and human health. The One Health Approach for improving human health is equally applicable to terrestrial and aquatic environments. Of the 1,461 infectious diseases now recognized in humans, approximately 60% are due to multi-host pathogens characterized by their movement across species lines. Over half of all new or emerging infectious diseases since the 1940s have jumped from domestic and wild animals to humans, and it is fully expected that this trend will continue. Anthropozoonoses, diseases that effect both animals and humans, often result in animals serving as reservoirs for re-emerging or new diseases. Environmental degradation through pollution and contamination, or changes in the environment brought about by climate change, may result in favorable settings for expansion of existing infectious diseases, may increase the transmissibility of these diseases, or may lead to altered patterns of pathogen virulence as they rapidly adapt to new environmental cues. Animal and human migration patterns also shift in response to climate change, further leading to new routes of exposure. Therefore, to fully understand, forecast, and control emerging infectious diseases requires an interdisciplinary and holistic approach that combines the studies of pathogens and their virulence, animal health and zoonoses, and the role of climate change and other factors on environmental health. While the One Health approach is often used in context for the control of infectious disease, the paradigm is easily extended to include an understanding of the fate of contamination of the environment with a variety of chemicals, fertilizers, and antibiotics. These anthropogenic factors have both direct and indirect impacts on human health. In all cases, the One Health approach is aided by the incorporation of the concept of sentinel species, including the acquisition of pathogens infectious to humans as well as the impacts of chemical contaminants on development, reproduction, and overall health.

References:

King, L. (Ed). One Health: A New Professional Imperative. One Health Initiative Task Force, American Veterinary Medical Association (2008) pp. 1-76

King, D. A., C. Peckham, J. K. Waage, J. Brownlie, and M. E. J. Woolhouse. Infectious diseases: preparing for the future. Science (2006) vol. 313 (5792) pp. 1392-3

Torrey E. F., and Yolken R. H. Beasts of the Earth. New Brunswick, NJ: Rutgers University Press (2005).

other

2009 ASM General Meeting symposium description: "One Health - A New Paradigm for Microbiology and Public Health" (May 19, 2009)

MicrobeWorld (video of ASM press conference for same symposium)

Someone (and I can't remember who and where) used this image to describe how changing migration patterns of animals and humans contribute to new infectious disease spread.

Comments welcomed.

Flu vaccination

A few days ago I got vaccinated against the flu for the first time in my life. This was the "regular" type A seasonal influenza vaccine, not H1:N1. Turns out, at least with my health insurance cooperative, that at my age I don't fall into the necessary risk category for H1:N1. This is between 6 and 25 or over 60 years old, or those at risk because of other predisposing health conditions.

So why haven't I been vaccinated in the past? I think it stems from one of my early microbiology classes as an undergraduate, during the 1976 swine flu epidemic. Shortly after mass vaccination started, there were reports of Guillain-Barre syndrome affecting a small fraction of those vaccinated (~4000 out of 46 million vaccinated, or 0.01%; "Reflections on the 1976 Swine Flu Vaccination Program"). In spite of the low risk, a professor teaching a virology class I was taking (a well respected virologist) suggested that the vaccine may not have been quite ready for mass immunization, and that was enough to dissuade me.

So even though I've been an active researcher in infectious disease and completely understand the risk/benefits of vaccination, until this week I resisted the flu vaccine. I've had just about every other recommended one and never blinked, and darn well made sure my kids had all of theirs. In fact it drives me crazy when i hear the myriad excuses people make for not getting their kids vaccinated for measles, pertussis, and other highly communicable infectious agents. Maybe I resisted because I think I've only had "real" influenza a few times in my life. Or maybe it's my faith in "herd immunity." However after seeing enough reports that HI:N1 appears to be especially hard on otherwise health young people, I called both of my kids (19 and 23) and made them promise to go get it. I'll be on their backs until they do. And I'll be getting annual flu shots myself from now on.

Research change of direction

Lately, for a variety of reasons, I've been moving much of the lab research away from single gene pathogenesis studies towards the application of bacterial genomics and metagenomics to studies of microbial ecology and adaptation to the environment. Of particular interest is to examine whether environmental (climate) change may be driving adaptation and selection of the microbial community, with a focus on adaptation that leads to increased virulence of specific pathogens. We are using a variety of genetic, genomic, and phylogenetic tools for this now, and soon we will be applying comparative whole genome strategies to get at the questions we want to answer. The overall goal is to develop better sensors, forecasting tools, or add additional data to risk models that can be used to improve human health (prevention of infectious disease) or as measurements of environmental health.

Over the years I've occasionally had trouble fitting my laboratory's microbiology research into the main research and resource management focus of my immediate line office. Overall, this newer direction now fits in well with the mission of my agency, in that the results of the basic research can be more easily shown to have direct applicability to products that should benefit resource and public health managers. (Some other time I may write about ecosystem services.)

This direction has necessitated some self 're-training' in the disciplines of genomics and bioinformatics, although I've been moving into this arena for some time now (recent publication). The challenge is stimulating and energizing, something I think many of us need time to time in this profession. I'm eager to get going.

First post

If I get my act together, this will be a place I use to gather thoughts about research I'm doing, discuss interesting science by others, or whatever else I feel like writing about, at least publicly. Sometimes warts and all.