Module 12 (One Health as a Public Health Paradigm)

Question 1

What is OneHealth’s Mission Statement?

Answer 1

Recognizing that human health (including mental health via the human-animal bond phenomenon), animal health, and ecosystem health are inextricably linked, One Health seeks to promote, improve, and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals and by promoting strengths in leadership and management to achieve these goals.

Question 2

What is Zoonosis?

Answer 2

A zoonosis is an infectious disease that has jumped from a non-human animal to humans. Zoonotic pathogens may be bacterial, viral or parasitic, or may involve unconventional agents and can spread to humans through direct contact or through food, water or the environment.

Question 3

What is a Vector?

Answer 3

Vectors are living organisms that can transmit infectious pathogens between humans, or from animals to humans. Many of these vectors are bloodsucking insects, which ingest disease-producing microorganisms during a blood meal from an infected host (human or animal) and later transmit it into a new host, after the pathogen has replicated. Often, once a vector becomes infectious, they are capable of transmitting the pathogen for the rest of their life during each subsequent bite/blood meal.

Question 4

What are the 3 forms of plague?

Answer 4

Bubonic

Septicemic

Pneumonic

Question 5

What are the symptoms of Bubonic Plague?

Answer 5

Bubonic plague: The incubation period of bubonic plague is usually 2 to 8 days. Patients develop fever, headache, chills, and weakness and one or more swollen, painful lymph nodes (called buboes). This form usually results from the bite of an infected flea. The bacteria multiply in a lymph node near where the bacteria entered the human body. If the patient is not treated with the appropriate antibiotics, the bacteria can spread to other parts of the body.

Question 6

What are the symptoms of Septicemic Plague?

Answer 6

Septicemic plague: The incubation period of septicemic plague is poorly defined but likely occurs within days of exposure. Patients develop fever, chills, extreme weakness, abdominal pain, shock, and possibly bleeding into the skin and other organs. Skin and other tissues may turn black and die, especially on fingers, toes, and the nose. Septicemic plague can occur as the first symptom of plague or may develop from untreated bubonic plague. This form results from bites of infected fleas or from handling an infected animal.

Question 7

What are the symptoms of pneumonic plague?

Answer 7

Pneumonic plague: The incubation period of pneumonic plague is usually just 1 to 3 days. Patients develop fever, headache, weakness, and a rapidly developing pneumonia with shortness of breath, chest pain, cough, and sometimes bloody or watery mucous. Pneumonic plague may develop from inhaling infectious droplets or may develop from untreated bubonic or septicemic plague after the bacteria spread to the lungs. The pneumonia may cause respiratory failure and shock. Pneumonic plague is the most serious form of the disease and is the only form of plague that can be spread from person to person (by infectious droplets).

Question 8

What is Hantavirus?

Answer 8

Hantaviruses are a family of viruses spread mainly by rodents and can cause varied disease syndromes in people worldwide. Infection with any hantavirus can produce hantavirus disease in people. Hantaviruses in the Americas are known as “New World” hantaviruses and may cause hantavirus pulmonary syndrome (HPS). Other hantaviruses, known as “Old World” hantaviruses, are found mostly in Europe and Asia and may cause hemorrhagic fever with renal syndrome (HFRS).

Question 9

Why are American Indians more susceptible to plague?

Answer 9

Their outdoor / connected to nature lifestyles

Their location (usually southwest) typically houses many wild rodents

Question 10

What is the definition of “One Health,” per the One Health High Level Expert Panel (OHHLEP)?

Answer 10

One Health is an integrated, unifying approach that aims to sustainably balance and
optimize the health of people, animals and ecosystems.
It recognizes the health of humans, domestic and wild animals, plants, and the wider
environment (including ecosystems) are closely linked and inter-dependent.
The approach mobilizes multiple sectors, disciplines and communities at varying
levels of society to work together to foster well-being and tackle threats to health and
ecosystems, while addressing the collective need for clean water, energy and air, safe
and nutritious food, taking action on climate change, and contributing to sustainable
development.

Question 11

What is Anthrax?

Answer 11

Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. It occurs naturally in soil and commonly affects domestic and wild animals around the world. People can get sick with anthrax if they come in contact with infected animals or contaminated animal products. Anthrax can cause severe illness in both humans and animals.

Question 12

What is rabies?

Answer 12

Rabies is a fatal but preventable viral disease. It can spread to people and pets if they are bitten or scratched by a rabid animal. In the United States, rabies is mostly found in wild animals like bats, raccoons, skunks, and foxes. However, in many other countries dogs still carry rabies, and most rabies deaths in people around the world are caused by dog bites.

The rabies virus infects the central nervous system. If a person does not receive the appropriate medical care after a potential rabies exposure, the virus can cause disease in the brain, ultimately resulting in death. Rabies can be prevented by vaccinating pets, staying away from wildlife, and seeking medical care after potential exposures before symptoms start.

Question 13

What is Bovine Tuberculosis?

Answer 13

In the United States, the majority of tuberculosis (TB) cases in people are caused by Mycobacterium tuberculosis
(M. tuberculosis). Mycobacterium bovis (M. bovis) is another mycobacterium that can cause TB disease in people.
M. bovis is most commonly found in cattle and other animals such as bison, elk, and deer. In people, M. bovis causes

TB disease that can affect the lungs, lymph nodes, and other parts of the body. However, as with M. tuberculosis,
not everyone infected with M. bovis becomes sick. People who are infected but not sick have what is called latent TB
infection (LTBI). People who have LTBI do not feel sick, do not have any symptoms, and cannot spread TB to others.
However, some people with LTBI go on to get TB disease.

Controlled / Eliminated in most developed countries by pasteurization

Question 14

Who coined the term “Zoonosis?”

Answer 14

Dr. Rudolf Virchow was a German pathologist who became interested in the linkages between human and veterinary medicine while studying a roundworm, Trichinella spiralis, in swine. He coined the term “zoonosis” to indicate an infectious disease that is passed between humans and animals.

Question 15

What are exotic pets?

Answer 15

any native or non-native wildlife kept in human households, including domestic reptiles and amphibians.

An exotic pet is a pet which is relatively rare or unusual to keep, or is generally thought of as a wild species rather than as a domesticated pet

Question 16

What is disease spillover?

Answer 16

crossing of a pathogen from one species to another species. Often used to imply that a pathogen has been transmitted to humans without having the ability (at least initially) to be transmitted from person to person

One of the most famous and common examples of spillover events is the flu. Migratory birds are an original reservoir of the influenza virus, with spillover events affecting other birds, pigs, and humans. However, humans are now also a primary reservoir host species of influenza A.

Question 17

What is an RNA virus?

Answer 17

a virus in which the genetic material is RNA (not DNA) and may be double or single stranded

Question 18

What are the Top 10 RNA Viruses causing infectious diseases?

Answer 18

1. HIV / AIDS
2. Chikungunya
3. Dengue
4. Ebola
5. Hantavirus
6. Influenza A
7. Middle Eastern Respiratory Syndrome (MERS)
8. Severe Acute Respiratory Syndrome (SARS)
9. West Nile Virus
10. Zika

Question 19

What is Sentinel Surveillance?

Answer 19

A sentinel surveillance site is a single or small number of health facilities that are responsible for collecting data on cases enrolled with the case definition under surveillance including global networks surveying for diarrhea or pneumonia. Most sentinel sites do not have a predefined catchment population (or denominator to calculate incidence), and therefore data at these sites are simply numbers of cases (numerators).

Question 20

What is Chikungunya?

Answer 20

Chikungunya virus is spread to people by the bite of an infected mosquito. The most common symptoms of infection are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Outbreaks have occurred in countries in Africa, Americas, Asia, Europe, and the Caribbean, Indian and Pacific Oceans. There is a risk the virus will be spread to unaffected areas by infected travelers. There is currently no vaccine to prevent or medicine to treat chikungunya virus infection.

Question 21

What is Dengue?

Answer 21

Dengue is a viral infection caused by the dengue virus (DENV), transmitted to humans through the bite of infected mosquitoes.
About half of the world’s population is now at risk of dengue with an estimated 100–400 million infections occurring each year.
Dengue is found in tropical and sub-tropical climates worldwide, mostly in urban and semi-urban areas.
While many DENV infections are asymptomatic or produce only mild illness, DENV can occasionally cause more severe cases, and even death.
Prevention and control of dengue depend on vector control. There is no specific treatment for dengue/severe dengue, and early detection and access to proper medical care greatly lower fatality rates of severe dengue.

Question 22

What is MERS?

Answer 22

Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by Middle East respiratory syndrome coronavirus (MERS‐CoV) that was first identified in Saudi Arabia in 2012.
Coronaviruses are a large family of viruses that can cause diseases ranging from the common cold to Severe acute respiratory syndrome (SARS) and Coronavirus disease-2019 (COVID-19).
Typical MERS symptoms include fever, cough and shortness of breath. Pneumonia is common, but MERS patients may not always develop this condition. Gastrointestinal symptoms, including diarrhoea, have also been reported among MERS patients.
Approximately 35% of MERS cases reported to WHO have died.
MERS-CoV is a zoonotic virus, meaning it is transmitted between animals and people. MERS-CoV has been identified and linked to human infections in dromedary camels in several Member States in the Middle East, Africa and South Asia.
Human-to-human transmission is possible and has occurred predominantly among close contacts and in health care settings. Outside the health care setting, there has been limited human-to-human transmission.

Question 23

What is SARS?

Answer 23

Severe acute respiratory syndrome (SARS) is a viral respiratory disease caused by a SARS-associated coronavirus. It was first identified at the end of February 2003 during an outbreak that emerged in China and spread to 4 other countries. WHO co-ordinated the international investigation with the assistance of the Global Outbreak Alert and Response Network (GOARN) and worked closely with health authorities in affected countries to provide epidemiological, clinical and logistical support and to bring the outbreak under control.

SARS is an airborne virus and can spread through small droplets of saliva in a similar way to the cold and influenza. It was the first severe and readily transmissible new disease to emerge in the 21st century and showed a clear capacity to spread along the routes of international air travel.

SARS can also be spread indirectly via surfaces that have been touched by someone who is infected with the virus.

Most patients identified with SARS were previously healthy adults aged 25–70 years. A few suspected cases of SARS have been reported among children under 15 years. The case fatality among persons with illness meeting the current WHO case definition for probable and suspected cases of SARS is around 3%.

Question 24

What are opportunistic infections?

Answer 24

Opportunistic infections (OIs) are illnesses that occur more frequently and are more severe in people with HIV (or other immunocompromised diseases). This is because they have damaged immune systems.

Examples:
candidiasis
Invasive cervical cancer
Pneumonia
Encephalopathy
Herpes
Flu
Sarcoma
Lymphoma
Tuberculosis
Salmonella
Toxoplasmosis

Slow wound closure

Question 25

What are examples of high impact environmental health issues?

Answer 25

(all related to global warming)

Increased Ozone
Increased Wildfires
Worsened Allergy and Asthma Conditions
Changing distributions of vectors and vector borne diseases
Earlier tick activity and northward range expansion
Changing mosquito borne disease dynamics
Emergence of new vector borne pathogens

Question 26

How do animals /pets benefit humans?

Answer 26

Reduce blood pressure
Improve cardiovascular health
Reduce cholesterol and triglycerides (fat lipids in blood)
Reduce loneliness & stress
Increased opportunities for exercise and outdoor activities and socialization

Question 27

What is toxoplasmosis?

Answer 27

Toxoplasmosis (tok-so-plaz-MOE-sis) is an infection with a parasite called Toxoplasma gondii. People often get the infection from eating undercooked meat. You can also get it from contact with cat feces. The parasite can pass to a baby during pregnancy.

Most people infected with the parasite do not have symptoms. Some people get flu-like symptoms. Serious disease most often affects infants and people with weakened immune systems. Toxoplasmosis during pregnancy may cause miscarriage and birth defects.

Question 28

What is cat scratch disease?

Answer 28

Cat scratch disease (CSD) is a bacterial infection spread by cats. The disease spreads when an infected cat licks a person’s open wound, or bites or scratches a person hard enough to break the surface of the skin. About three to 14 days after the skin is broken, a mild infection can occur at the site of the scratch or bite. The infected area may appear swollen and red with round, raised lesions and can have pus. A person with CSD may also have a fever, headache, poor appetite, and exhaustion. Later, the person’s lymph nodes near the original scratch or bite can become swollen, tender, or painful.

Question 29

Who was William Osler?

Answer 29

William Osler, Father of Veterinary Pathology
William Osler, MD, was a Canadian physician who is considered the father of veterinary pathology in North America. Dr. Osler had a deep interest in the linkages between human and veterinary medicine. He trained with many well-known physicians and veterinarians, including Dr. Virchow. One of his first publications was titled, “The Relation of Animals to Man.” While serving on the medical faculty of McGill University, Dr. Osler lectured to medical students and veterinary students from nearby Montreal Veterinary College.

Following his time at McGill, Dr. Osler became the Chair of Clinical Medicine at the University of Pennsylvania in Philadelphia. In 1889, he became the first Physician-in-Chief of Johns Hopkins Hospital and played an instrumental role in establishing the Johns Hopkins University School of Medicine.

Question 30

When was the Veterinary Public Health Division created at the CDC?

Answer 30

In 1947, James H. Steele, DVM, MPH, founded the Veterinary Public Health Division at CDC. Dr. Steele understood the important role of animals in the epidemiology of zoonotic diseases (the study of how these diseases are spread and how they can be controlled), and he recognized that good animal health is important for good public health. The Division played an important role in the public health response to diseases such as rabies, brucellosis, salmonellosis, Q fever, bovine tuberculosis, and leptospirosis. With this Division at CDC, the principles of veterinary public health were introduced to the United States and other countries around the world.

Question 31

Who coined the term “One Medicine” and called for unification of veterinary and medical sciences?

Answer 31

Calvin Schwabe, DVM, ScD, MPH, made many important contributions to veterinary epidemiology over his career. He began his career studying zoonotic parasitic diseases and directed the programs on hydatid disease and other parasitic diseases. In 1966, Dr. Schwabe became the founding chair of the Department of Epidemiology and Preventive Medicine at the Veterinary School at the University of California Davis. It was the first department of its kind at a veterinary school.

Question 32

Describe the Onehealth Umbrella

Answer 32

Question 33

Describe the cycle of Zoonotic spread

Answer 33

Question 34

Describe the ecology of plague

Answer 34

Question 35

Describe H1N1’s 2009 outbreak

Answer 35

Question 36

Describe the West Nile transmission cycle

Answer 36

Question 37

Describe the history of plague cases

Answer 37

Question 38

Describe various factors affecting the development of infectious disease

Answer 38

Question 39

Describe the plague life cycle

Answer 39

Question 40

Describe how climate change affects human health

Answer 40

Question 41

Describe various patterns of emerging and re emerging infectious diseases

Answer 41

Question 42

What is the “burden of proof” controversy within the Pre-cautionary principle?

Answer 42

One of the most controversial elements of the principle is the shift of the burden of proof. Traditionally, the person claiming an activity could cause harm should produce proof to back up that claim. The precautionary principle reverses the burden of proof—the individual or entity proposing the activity must prove the activity is not harmful.

Question 43

How have water drinking patterns in the US changed since the 1980s?

Answer 43

• According to the report, in 1960 we were using about 89 gallons of water per day/per person in this country. By 1980, that had jumped to 112 gallons per day/per person. But by 2015, something unexpected happened. Consumption dropped to 82 gallons of water per day/per person.

Question 44

What are past major public health emergencies?

Answer 44

Question 45

How does the US use domestic water?

Answer 45