VPH Journal 5th edition 1 5th Veterinary Public Health Journal by the International Veterinary Students Association, IVSA The fight against rabies in both hu- mans and animals IN THIS EDITION Interview with Prof. Dr. Jakob Zinsstag, author of the book ‘One Health‘
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VPH Journal 5th edition 1
5th Veterinary Public Health Journal by the International Veterinary Students Association, IVSA
The fight against rabies in both hu-mans and animals
IN THIS EDITION
Interview with Prof. Dr. Jakob Zinsstag, author of the book ‘One Health‘
VPH Journal 5th edition 2
Caroline Bulstra Lawal Temitope
Dear all,
Some weeks ago I walked across two bill boards at the Central Station in Utrecht, The Netherlands and I stopped myself for a few seconds to have a closer look. One of the bill boards was a commercial by our natio-nal Health Centre saying ‘Can you recognize a malaria mosquito?’ The other one was by the Food Safety Cen-tre and it was showing two delicious looking meals while stating ‘you don’t see the pathogens’. Public health and food safety are in our everyday lifes and I once more realized how big of a role vets can play in tackling these human health risks, since 70% of pathogens arise from an animal source. We can do this following the One Health spirit and applying a coordinated, collaborative, multidisciplinary and cross-sector approach to address potential or existing risks that originate at the animal-human-ecosystems interface.
Known and unknown disease pathogens pop up everywhere on our planet, on top of that globalization and increased traveling have made it easier for pathogens to spread faster and further. The ebola crisis is still fresh in our minds and there is always a significant risk of new emerging infectious disease outbreaks. The IVSA brings together veterinary students from over 50 countries worldwide. I feel that together we build a powerful network that is able to fight public health issues, both locally and globally.
The Veterinary Public Health Journal is compromised by students and brings up some of the latest trends and events in the field of Public Health. In this issue the main focus is on rabies, the zoonotic disease with the hig-hest fatality rate after the onset of clinical signs. Also various other veterinary public health related topics will be covered in this edition of the journal.
Enjoy!
Best regards,
Caroline
Publications Team member - Standing Committee on One Health 2015-2016
VPH Journal 5th edition 3
The VPH Journal is edited and published by the Standing Committee on One Health (SCOH), part of the International Veterinary
Students Association (IVSA).
5th editionDecember 2015
SCOH 2015-2016
Chair Elizabeth Malcolm
Official MemberTaylor Calloway
Publications TeamCaroline BulstraLawal Temitope
Regional CoordinatorSung il Kim
Policy Statement Liaison OfficerGiorgos Polyzois
Project ManagersClara Buxbaum
Claudine Girardo
Webmaster/Social Media DirectorMathijs Knipscheer
VPH Journal 5th edition 4
In this issue
6
10
12
15
LATEST NEWS
NEW RABIES CASES REPORTED IN MALAYSIA
STUDENTS INVOLVED IN THE FIGHT AGAINST
RABIES
REPORT FROM THE VET STUDENTS OF IBADAN, NIGERIA
MILK, THE PUBLIC AND ECONOMIC DISASTER OF
SRI LANKA
SRI LANKA DAIRY FARMING INDUSTRY VS. MILK POWDER
PRODUCTION
RABIES IN SHORT
LECTURE BY PROFESSOR A.B. OGUNKOYA
17
iNTERVIEW WITH KATINKA DE BALOGH
FROM THE FOOD AND AGRICULTURE ORGANIZATION
(UNFAO)
VPH Journal 5th edition 5
20
22
26
30
32
INTERVIEW
PROF. DR. JAKOB ZINSSTAG
ONE OF THE AUTHORS OF THE BOOK ‘ONE HEALTH‘
SENT IN BY OUR MEMBERS
CHIKUNGUNYA FEVER OUTBREAKS IN INDONESIA
AMR DAY
ANTIMICROBIAL RESISTANCE DAY, THE IMPORTANCE OF
RAISING AWARENESS
JOBS IN THE FIELD OF VETERINARY PUBLIC
HEALTH
INTERVIEW WITH BARBARA JONES, FOUNDER OF THE
COMPANY ONE HEALTH CONSULTING
IVSA POLICY STATEMENTS
ANTIMICROBIAL RESISTANCE WEEK AND INTERNATIO-
NAL STUDENTS DAY
BRUCELLOSIS AND INFERTILITY IN HUMANS
PROF. CADMUS (DVM, MVPH, PhD)
34
VPH Journal 5th edition 6
From the December 10 to December 11, the world leading
experts in rabies gathered in a joint conference held by
the WHO, OIE with support of the FAO and GARC. The
outcomes of the meeting was a 5 pillar framework in wor-
king towards total elimination of human dog-mediated
rabies by the year 2030. IVSA were proud to have been
invited and was the voice of not just veterinary students,
but students of all fields.
1. You are a veterinarian by training. Where
did you study, and why were you drawn into be-
coming a veterinarian?
I started my studies in (West) Berlin, in the part that
belonged to West Germany, I then moved to Munich
for my clinical years. For my doctorate I conducted re-
search in Jamaica to study ticks and blood parasites of
goats before moving to do a specialization in tropical
diseases and animal production at the L’Institut d’Ele-
vage et de Medecine Veterinaire des pays Tropicaux in
Maisons Alfort, France and later specialized in veteri-
nary public health in the Netherlands. I have wanted to
be a veterinarian since I was 5 years old. I had grown up
in South America, and used to go out in the field with
my father who worked with the FAO as a marketing ex-
pert. He used to go into the indigenous communities
and try to find markets for them to sell their fruits and
vegetables in cities. Working with communities in deve-
loping countries was something I always wanted to do,
and before taking up my first job in Africa as a District
Veterinary Officer in rural Zambia I had spent one and a
half years working in a zoo in Utrecht, the Netherlands.
2. You have been at the FAO for many years,
and you just finished your last day at the Rome
head office of the FAO and are moving off to
South East Asia. What drew you to joining FAO
initially?
Well, I actually also worked at the WHO-HQ in Geneva,
doing work on rabies prevention and control. My post
as a district veterinary surgeon in rural Zambia, I was
confronted with rabies cases in dogs and livestock. This
is where my passion for rabies started. I also noticed
that the dog population in Africa was different to that
in Asia and Latin America where most of the research
was being done. When I moved back to Zambia to work
at the University of Lusaka we conducted dog ecology
studies which provided us with valuable insights about
dog-human linkages and accessibility of dogs for vacci-
nations and I also was part of the 1st SARC meeting in
1991 in Lusaka. It was during this time that I connected
with people who have remained in contact over time
and was able to meet again during the (ongoing) Global
Rabies Conference in Geneva.
Interview with Dr Katinka de Balogh, UNFAO
By Aqil Jeenah, IVSA ExCo menber and previous Chair of the Standing Committee on One Health
VPH Journal 5th edition 7
3. The FAO is a large organization with many
different sections. What are your tasks at FAO
and how does your training as a veterinarian as-
sist you in this?
So I have been working in the Animal Health Service
at FAO-HQ in Rome since 2002. The last seven years I
have been leading the veterinary public health activi-
ties of the organization and have become very enga-
ged in One Health and in closely collaborating with the
OIE and WHO. I am able to use my veterinary know-
ledge on a daily basis for my job, but the most impor-
tant element that helps me is the field experience that
I have had. In reality I don’t just have an average desk
job, and having been able to see various realities and
my practical experience helps me a lot. It also assists
me when writing up policies as I can relate to what this
could mean for countries and their communities. I have
also been very privileged to travel to over 100 coun-
tries, which has been an invaluable experience to me.
4. We are having this interview at the side-
lines of the Rabies conference which highlights
the tripartite alliance of the WHO, OIE and
FAO. What are your thoughts on the meeting
so far?
The meeting was great and it has created a lot of mo-
mentum for the elimination of rabies. There is renewed
energy and hopefully this will translate in long-lasting
commitment to the fight. I liked the dynamic interac-
tion between panels, speakers and the participants. It
has certainly moved the rabies agenda (fast) forward.
5. There was an interesting fact that was
pointed out by the FAO about Rabies: that its
socio-economic impact, especially in the poorer
countries, that is often forgotten. What do you
think about this? Do you think this is an issue
that should be addressed in the roadmap that
comes out of the meeting?
I think this is a vital piece of the puzzle that is missing
and is extremely important. Rabies also has an impor-
tant effect on livestock and on the livelihood of people.
Unfortunately there is insufficient data on rabies and
especially in livestock due to very large under-repor-
ting. It was very interesting to note the data from North
Africa and Middle East indicating over 50% of rabies in
livestock. I have come across cases of farmers seeing
cows bellowing, and believing they were in heat. Only
when the bulls did the same rabies was suspected. Of-
ten animals had already been eaten before the sam-
ples could actually be taken. There have been cases
of multiple children bitten by a rabid dog, but some-
times families are only able to afford treatment for one
child. The grief of the parents is something that can’t
be measured. These diverse aspects make it difficult to
clearly assess the impact of rabies.
6. We both know you are an avid supporter
VPH Journal 5th edition 8
of student involvement within projects. What do
you think the role of students, no matter their
professions; play in the fight against the disease?
Students play a major role in creating awareness about
the disease; they can be important advocates for the di-
sease. Students can be involved and provide vital man
power to especially punctual massive campaigns as lon-
ger-lasting campaigns would need their involvement
over longer periods of time. Veterinary students nor-
mally should have received rabies pre-exposure prop-
hylaxis and therefore can be involved in the actual injec-
ting and handling of animals while other students could
be more involved in (organizational) aspects of a vac-
cination campaigns. I worked with students during my
time in both Zambia and Mozambique where we held
big rabies drives. We mixed teams of older and younger
students to allow the exchange of knowledge within the
student group. The students were vital by going on ra-
dio and speaking the local language to explain rabies,
but also by making and helping connect with the local
communities during the actual vaccination days. I also
advocate for not sticking to the health care profession
of students but look beyond the border to business stu-
dents who can help with the cost benefit or students in-
volved in mass-media and communication.
7. Any words to a student that has a desire of
joining FAO and following in your footsteps?
Never be afraid of taking a risk on trying something new
or going to new places. It’s always an experience, good
or bad, and you can always learn from it. Many univer-
sities push clinical work, but there is a lot more out the-
re to do as a veterinarian. Last, don’t be afraid of taking
that big decision and jumping into the cold water as the
world is a fascinating place.
VPH Journal 5th edition 9
VPH Journal 5th edition 10
Transmission
Rabies is a disease transmitted from animals to all
warm-blooded species, especially the dead-end
hosts. It induces an acute encephalitis and neurolo-
gical disorder/irritability disease. The illness rapidly
progresses to coma and death in victims. The disease
is primarily transmitted from the rabid animal saliva
through biting or scratching, but transmission is also
possible through wound licking, aerosol and organ
transplants.
Hosts
Rabies affects all warm-blooded species, both do-
mestic and wild animals. In 96-99% of human cases,
the rabies virus is transmitted by domestic dogs.
Rabies is also present in cattle and buffaloes which
serve as a dead end host.
Geographical distribution
Rabies is present on all continents with the excepti-
on of Antarctica, but more than 95% of human de-
aths occur in Asia and Africa.
Symptoms
“The incubation period for rabies is typically 1–3
months, but may vary from <1 week to >1 year. The
initial symptoms of rabies are fever and often pain or
an unusual or unexplained tingling, pricking or burn-
ing sensation (paraesthesia) at the wound site. As
the virus spreads through the central nervous sys-
tem, progressive, fatal inflammation of the brain and
spinal cord develops.
Two forms of the disease can follow. People with
furious rabies exhibit signs of hyperactivity, excited
behaviour, hydrophobia and sometimes aerophobia.
After a few days, death occurs by cardiorespiratory
arrest.
Paralytic rabies accounts for about 30% of the to-
tal number of human cases. This form of rabies runs
a less dramatic and usually longer course than the
furious form. The muscles gradually become paraly-
zed, starting at the site of the bite or scratch. A coma
slowly develops, and eventually death occurs. The
paralytic form of rabies is often misdiagnosed, contri-
buting to the under-reporting of the disease” (WHO).
History
As far as known, five human patients survived rabies.
These patients were vaccinated prior to exposure and
the onset of clinical signs. They were supported by
the utility of maximum medical intervention.
Rabies prevention in human
Nearly all human rabies cases are related directly to
animal bite incidents and thus, primary disease pre-
vention requires minimization of suspected exposu-
res.
a. by eliminating the virus within animal species
b. by giving adequate post exposure treatment after
an unavoidable suspected real exposure
c. by maintaining good dog management and main
taining a rabies free status on the long run
Rabies in shortLecture by Professor A.B. Ogunkoya
VPH Journal 5th edition 11
Local treatment of the wound
Wounds from animal bites or scratches should be was-
hed and flushed immediately with soap and water for
10-15 minutes. If soap is not available, flush with water
alone. This is the most effective first-aid treatment
against rabies. Ideally wounds should be cleaned tho-
roughly with 70% alcohol/ethanol or povidone-iodine
if available. Victims should be taken to a health care
facility as soon as possible. Do not cover the wound
with dressings or bandages.
Suturing when possible. When necessary the infiltrati-
on of wounds with rabies immunoglobulin (RIG) is re-
quired. The equine origin (ERIG) or the human (HRIG)
can be used.
Indications for post-exposure rabies prophy-
laxes (PEP)
Post-exposure prophylaxis (PEP) means the treat-
ment of a bite victim that is started immediately after
exposure to rabies in order to prevent rabies infecti-
on. This treatment consists of local treatment of the
wound, initiated as soon as possible after exposure;
effective rabies vaccination; and the administration
of rabies immunoglobulin, if indicated. Effective tre-
atment soon after exposure to rabies can prevent
the onset of symptoms and death (WHO). Recent
evidence has shown that in communities where time
has been spent on rabies education and vaccinatio the
cases of PEP has actually gone up. This is due to peo-
ple bitten now seeking medical attention the moment
they are bitten.
Dog population management
“Rabies is a vaccine-preventable disease. Vaccinating
dogs is the most cost-effective strategy for preven-
ting rabies in people. Dog vaccination will drive down
not only the deaths attributable to rabies but also
the need for PEP as a part of dogbite patient care”
(WHO). Mass vaccination up to at list 70% of the dog
population is needed to development the required
“herd immunity” within the dog population.
Benefits to rabies prevention in dog populations are:
• Improvement of animal welfare
• Human health will be improved and protected
• Socio-economic benefits due to reduced sick-
ness and death of human and livestock
References:
World Health Organization (2013). WHO Expert Con
sultation on Rabies. WHO TECHNIC
AL Report Series 982. Second Rep-
ort. Geneva.
VPH Journal 5th edition 12
New rabies cases reported in Malaysia
Malaysia had been declared free from rabies by the
World Organization for Animal Health (OIE) since
2012. However, a dog bite incident in a small town in
Perlis was evoking a nationwide panic and resulting
in 3 states in the Northern of Malaysia gazetted as ra-
bies area. The drama came to its climax after an an-
nouncement made by the Chief Minister of Penang
Mr. Lim Guan Eng, advising culling all stray dogs in
the state to prevent the disease from spreading.
On 15 September, around 2000 strays had been cap-
tured and put down by the veterinary authorities.
The mass cull was widely protested by NGOs, who
together submitted a memorandum to urge the sta-
te goverment to put an end to the killing of stray ani-
mals. Within the memomrandum, alternative solu-
tions were given to deal with the crisis. Mr. Lim, the
Chief Minister insisted that the decision was made
after taking into account public health and other re-
levant interests.
At this point of the crists, a heavily debated point
Yee Nin, November 2015
came into play. Within a public health emergency,
what is the balance between animal welfare and pu-
blic health? It must be noted, that multiple studies
and experts agree that the killing of animals has no
significant effect on the spread of the diseases.
Within this context, we needed to consider the
amount of resources available in the country. Accor-
ding to the veterinary department, Malaysia has a
shortage of vaccines against Rabies. There was only
a very limited stock of dog vaccines available to ma-
nage vaccination in the set ‘immune belt area’. The
belt is bordered by Thailand where rabies is ende-
mic after Malaysia was declared free of the disease
in 1999. As the episode reccured, Malaysia was re-
quired to purchase batches of vaccine from OIE to
control the outbreak. In the meantime, the push by
NGOs for mass vaccination of strays instead of mass
culling was having no effect as there was an inade-
quate supply of dog vaccines within the country.
NGOs came up with other alternatives, such as qua-
rantine of infected animals.
VPH Journal 5th edition 13
This method was meant to be more humane as ani-
mals are allowed to die due to progression of disease
instead of being put down straight away, as Rabies is
usually fatal in 3 to 10 days after presentation of cli-
nical signs. One can doubt if this would be an ethical
solution.
There were several challenges to overcome when
we were talking about putting a batch of animals in
quarantine. Holding a group of strays in a confined
space increased the likelihood of disease transmissi-
on via fighting behavior due to stress (by apparently
healthy individuals), unless the animals were qua-
rantined separately. Note that stress in confinement
also exaggerated other underlying complications.
Vaccination only offers effective cure before mani-
festation of clinical signs, therefore it is pointless to
offer vaccination to rabid animals. In terms of the
five freedoms for animals (freedom from hunger
and thirst, from discomfort, from pain, injury or di-
sease, freedom to express normal behaviour and
the freedom from fear and distress), quarantined
rabid dogs had gone against at least the freedom
from pain, discomfort and disease. In addition, this
is an expensive solution. The process needed con-
sistent human resources and funding for mainte-
nance, as well as achieving optimum welfare.
State government and veterinary authorities had
been placed to lead the steps in resolving the out-
VPH Journal 5th edition 14
break. It was undeniable that funds allocated, human
power and available resources were always the limi-
ting factors in the decision making processes on how
to deal with the disease. To compensate for the scare
resources, mass culling of stray and free roaming dogs
was the ‘cheapest last minutes measure’, and the im-
mediate action to remove the etiological agent out
of the human population, with the human population
being the main concern of the goverment. However,
this incident should serve as a good lesson for not only
the government, but the citizens themselves to incre-
ase awareness on rabies and other potential zoonosis
and always be well prepared for an outbreak. Going
forward, primary goals are aimed towards reducing
the stray population and revamping the public educa-
tion drastically.
Public awareness and education were major issues to
be tackled in this situation. The panic among citizens
seemed to adversely affect the outbreak since animal
dumping increased. Also people outside of the immu-
ne belt started buying rabies vaccines due to overall
panic and the lack of correct information on the di-
sease. This led to an increased lack of vaccines in the
areas where the were needed.
The risk of disease transmission in human and animals
can be elimated by having a well managed control and
maintaince program in a country. The Department of
Veterinary Services had established a series of pro-
tocols for vaccination of pet dogs. These protocols
should be disseminated and explained to the general
public in coherence with the execution to avoid mis-
understandings and unnecessary circumstances.
According to the Ipoh Society for the Prevention of
Cruelty to Animals president Ricky Soong and Dr. Ran-
jit Kaur Mendhir, founder of the no-kill Noah’s Ark Ipoh
animal sanctuary, lacking of correct information and ir-
responsible ownership had lead many people to act of
dumping their pet dogs, instead of vaccinating them.
This was mainly the case in Ipoh, the closest town to the
immune belt. Pet owners in other states, such as Kuala
Lumpur and Johor, created a panic wave by rushing to
get their pets vaccinated. Thus, responsible ownership
should be educated to the Malaysian citizens, especial-
ly the management of animals in certain endemic out-
breaks. Apart from proper vaccination, owners should
restrict the movement of animals instead of leaving
them roaming as usual, in order to reduce contact with
rabid animals. Correct information regarding rabies vi-
rus transmissions and precaution steps upon bite inci-
dents should be spread more effectively.
In short, the chaos that resulted from the outbreak of
rabies in Malaysia happened due to the lack of public
awareness on the zoonotic disease, lack of correct and
reliable information on the disease agent and transmis-
sion and the lack of general knowledge on crisis ma-
nagement. Meanwhile, this provides a clear example
for the younger generations on how the control of di-
sease outbreaks can fail. Hopefully their roles get clea-
rer when a outbreak occurs in the near future so that we
can effectively address new rabies outbreaks together.
Resources:
WHO, ProMED-mail, The Malaysian Insider, Asia One,
The Straits Times
VPH Journal 5th edition 15
Students involved in the fight against rabiesReport from the vet students of Ibadan, NigeriaBy Mogbojuri Oluwatobi A (Local Chairman Organizing Committee, World Rabies Day 2015)
The International Veterinary Students Association (IVSA) Ibadan Chapter organised a 3-day event on the occa-
sion of World Rabies Day on the 29, 30 September and 10 October 2015. The events were focussed on creating
awareness, spreading information on rabies and fighting the disease by vaccinating dogs and cats.
On the first day we had organized a public seminar on rabies at our own university (University of Iba-
dan, Nigeria). Students and all other inhabitants of Ibadan who were interested in joining the seminar were
invited. Around 600 people attented the seminar.
On the second day seminars for three secondary schools in the area were given on ‘the zoonotic impli-
cations of rabies’. The main goal was to educate the public on rabies transmission and possible prevention
and control measures to be taken. Another important goal was to make the communities aware of the free
VPH Journal 5th edition 16
vaccination programme being offered by the IVSA Ibadan Chapter. A lot of secondary school students attended
this day. During the evening session of day 2 an awareness rally took place at a rural area, Egbeda Local Gover-
nment, Ibadan, Oyo State, Nigeria.
On day three there was the awareness rally in Egbeda Local Government (Bankesa, Erunmu, and Oree),
which is a typical rural community. The awareness rally was aimed to sensitize the community and educate them
on the importance of rabies prevention and control and so why their dogs should be vaccinated. We commu-
nicated with them one on one. We tried to answer as many questions as possible, because the majority of the
population does not understand what rabies is exactly and how to prevent the disease from spreading further.
We were able to talk to them in their own language, which ofcourse was a really great advantage.
Rabies is known as “aja digbolugi” in the Yoruba Language which means “mad dog”, literally it means “dog
that bites trees or that hits a tree with his head”. This is similar to the furious form of rabies and the name is based
on the clinical manifestations in dogs affected with the rabies virus.
Finally, the vaccination activities took place on the 10th of October in the same rural area. Twohundred lo-
cal strain anti-rabies vaccines were offered by the Nigerian Veterinary Research Institute (NVRI). Dogs and cats
of various species ranging from our indigenous breeds to exotic breeds were vaccinated. Additional veterinary
services such as deworming, treatment for ectoparasites and advice on pet management and health care prac-
tices were carried out as well. It was a great event an hopefully we have more to follow!
VPH Journal 5th edition 17
Taylor Calloway, US Davis University of Carlifornia, School of Veterinary Medicine, IVSA SCOH Official
Member
Sri Lanka is an island nation located south of India. The country is known for its rich farming culture of tea
and rice plantations. These practices are a vital part of family income and food consumption throughout
the nation. Livestock farming is also a practice among the people and provides the main intake of multi-
ple protein sources such as chicken, fish and cattle meat or products.
Unfortunately, Sri Lanka is not self-sufficient in its dairy industry, requiring a supplementation of impor-
ted powdered and condensed milk products. Local demand of milk requires 70% of outsourced products
from other countries (Perera et al, 2008). Most recent statistic studies report the cost of imported pro-
ducts to be Rs 27 billion annually (Ministry of Social Services, Welfare and Livestock Development, 2012).
The amount tops the list of one of the largest country expenditures.
The Department of Census and Statistics in Sri Lanka reported in the 2012/2013-year, the average house-
hold expenditure was Rs. 41,444 monthly. Over a third (Rs. 15,651) of the monthly expenditures were
spent on food consumption. The Sri Lankan residents consume rice, wheat flour and bread in the largest
Milk, the public and economicdisaster of Sri LankaSRI LANKA DAIRY FARMING INDUSTRY VS. MILK POWDER PRODUCTION
VPH Journal 5th edition 18
quantities. This aspect places them at the top of the greater food expenditure list. However the largest ex-
penditure on a protein source is powdered milk by the national household expenditure decile of 2012/2013-
year.
There are various explanations for the countries need of imported powdered milk products. The reasons
include but are not limited to political, technical and socio-economic factors, and a low farm gate price (Pe-
rera et al, 2008). The Ministry of Social Services, Welfare and Livestock Development had plans in 2009 to
increase the country’s milk production (240 million) 300 times by the end of 2015. The plans included impro-
vement in policy support, developmental programs, research, disease control, and strategies to improve
breeding, production, marketing, industrial development and social aspects. In the past ten years, there
has been an increase in the country’s own milk production and consumption. Although there is improve-
ment in the years, there is still a high demand for more planning, implementation of new strategies, and
sustainability of these ideas for the dairy industry in Sri Lanka to succeed.
One Health is a multidisciplinary topic that covers many aspects in the communication between human, en
vironmental and animal health. There are many opportunities to use One Health strategies in issues invol-
ving local or global health. The example of Sri Lanka’s dairy industry is multifaceted with disease issues, cul-
tural necessities, nutritional implications within both animal and human sides and economical problems.
These all require a team of diverse specialists to work together and organized large, detailed policies to
set Sri Lanka up for success. So when you think of One Health, remember that it is to solve problems to
promote the health of all.
References:Cow and Buffalo Milk Production (2014). Retrieved November 19, 2015, from http://www.statistics.gov.lk/agriculture/Livestock/MilkProduction.html
Gardew, L., Berhanu, A., Mengesha, D., and Tsegay, G. (2012). Identification of gram-negative bacteria from critical control points of raw and pasteurized cow milk consumed at Gondar town and its suburbs, Ethiopia. BMC Public Health, 12:950
Income and Expenditure (2013). Retrieved November 19, 2015, from http://www.statistics.gov.lk/page.asp?page=Income and Ex-penditure
Milk Collection, Production and Milk Powder Imports. (2013). Retrieved November 19, 2015, from http://www.livestock.gov.lk/site/en/statistics
Perera, B., & Jayasuriya, M. (2008). The dairy industry in Sri Lanka. Retrieved November 19, 2015, from https://www.academia.edu/11428439/The_dairy_industry_in_Sri_Lanka
Ranaweera N F C. (2007). Improved Market Access and Smallholder Dairy Farmer Participation for Sustainable Dairy Development. Central Bank of Sri Lanka, Colombo, Sri Lanka
Ranaweera, N. F C. (2007). Sri Lanka: Opportunities for dairy sector growth. Retrieved November 19, 2015, from http://www.fao.org/docrep/011/i0588e/I0588E08.htm
VPH Journal 5th edition 20
In 2013, just taking into account the USA, antibiotic resistance was estimated to be
responsible for
How can antimicrobial resistance happen?
This is a worldwide issue
In the world, E. coli is significantly resistant to third generation cephalosporins and fluoroquinolo-
nes, two important and commonly used types of antibacterial medicine. In the world, according to
the regions, from 25% to 90% of Staphyloccocus aureus infections are methicillin-resistant.
VPH Journal 5th edition 21
WHAT CAN WE DO TO TACKLE ANTIMICROBIAL RESISTANCE?
• Preventing infections by regularly washing hands
• Practicing good food hygiene
• Avoiding close contact with sick people
• Keeping vaccinations up to date
• Using only antibiotics when prescribed
• Taking the full prescription
• Never using left-over antibiotics
• Preventing infections by ensuring hands, instruments and environment are
clean
• Keeping patients’ vaccinations up to date
• Only prescribing and dispensing antibiotics when they are truly needed
• Choosing the right antibiotic, at the right dose, for the right duration
• Developping a robust national plan, including surveillance of antibio-
tic resistant infections, strengthening infection prevention and control
measures
• Making information on the impact of antibiotic resistance available
• Rewarding the development of new treatments, vaccines or diagnostics
• Ensure that antibiotics given to animals are only used to treat infectious disea-
ses and under veterinary supervision
• Vaccinate animals to reduce the need for antibiotics
• Develop alternatives to the use of antibiotics in plants
• Promote and apply good practices at all steps of production and processing of
foods from animal and plant sources.
• Adopt sustainable systems with improved hygiene, biosecurity and stress-free
handling of animals
• Implement international standards for the responsible use of antibiotics, set
out by OIE, FAO and WHO
VPH Journal 5th edition 22
Brucellosis is a contagious systemic bacterial disease
of wild and domestic animals. The disease has been
eradicated in developed countries like Europe, USA,
and Japan as a result of strict control and eradication
programmes. However, it is still enzootic in developing
economies of South America, Africa, Middle East and
The Mediterranean due to lack or non adherence to
control measures. The disease is present in Nigeria
and has been recorded in livestock and human popu-
lations. The presence of brucellosis in the livestock
population translates to human population infection
because brucellosis is zoonotic. The different Brucel-
la species and the animals they commonly infect are,
Brucella melitensis: sheep and goats; B. abortus: cat-
tle; B. suis: pigs; B. canis: dog; B ovis: ram and marine
mammal Brucella species. Of these, B. melitensis, B.
abortus and B. suis commonly infect humans.
In animal populations, brucellosis is transmitted
through contact with infected uterine discharges, suc-
kling of infected milk or in-utero maternal transfer. In
humans, the common routes of infection include direct
contact with infected animals and uterine discharges,
direct and accidental inoculation through cuts and
abrasions in the skin, inhalation of infectious aerosols,
and consumption of unpasteurized milk or other dairy
products, consumption of uncooked offals from infec-
is the aetiological agent most frequently reported as a
cause of human disease and the most frequently isola-
ted. Brucella abortus on the other hand, is the most wi-
Brucellosis and infertility in humans
Prof. S.I.B. Cadmus (DVM, MVPH, PhD) Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medi-cine, University of Ibadan, Ibadan, Nigeria
VPH Journal 5th edition 23
despread cause of infection but associated with much
less human disease.
In contrast to animals, abortion due to brucello-
sis is not common in pregnant women (O’Callaghan.,
2013), however when it occurs, spontaneous abortion
is observed mostly in the first and second trimesters
of pregnancy (Teshager et al., 2014; Addis, 2015). The
first large series about correlation between abortion
and brucellosis was reported in 1954 by Criscuolo and
di Carlo with a total abortion rate of 10% reported in
200 cases of B. melitensis infection in pregnant women
(Kurdoglu, 2015). Spontaneous abortion has been as-
sociated, by different schools of thought, with bacte-
remia or vaginal bleeding at presentation (Memish,
2011). Rare cases of pelvic abscesses and salpingitis
(inflammation of the fallopian tube) due to brucellosis
have also been reported. Brucella may also be localized
in the ovaries and fallopian tubes leading to formati-
on of abscess. Infertility is a common sequel of animal
brucellosis (Addis, 2015). The genitourinary system is
affected in 2-20% of cases having brucellosis (Hizli and
Uygur, 2006). Genitourinary involvement of brucello-
sis includes prostatitis (in which there is formation of
granuloma in the prostate gland), epididymo-orchitis,