ONE HEALTH APPROACH

IN ZOONOSIS
Dr. dr. Ni Nyoman Sri Budayanti, Sp.MK(K)
Microbiology Department, Faculty of Medicine, UNUD
Udayana One Health Collaborating Center

INDOHUN - Indonesia One Health University Network

Climate Change
20th Century Warming
• Historic global warming
 The global climate has been warming
rapidly since the start of industrialization
• Weather extremes: heat
waves, cold spells,  Human activities well explain this change
flooding, storms,
typhoons, smog periods  According to the Intergovernmental
Panel on Climate Change (IPCC) much of
• Sea level increases this trend is likely due to the increase in
carbon emissions resulting from human
activities
Tantangan

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Climate Sensitive Infectious Diseases
Dengue/dengue
Meningococcal Chikungunya
Cholera haemhorrhagic
meningitis virus
fever

African Japanese and St.

Yellow fever Rift Valley fever
trypanosomiasis Louis encephalitis

Ross River virus

Leishmaniasis West Nile virus and Murray Valley
encephalitis
 Climate Changes & Animal Health
Animal health may be affected by Climate Change in four ways:

Heat-related diseases and stress

Extreme weather events

Adaptation of animal production systems to new environments

Emergence or re-emergence of infectious diseases, especially vector-
borne diseases critically dependent on environmental and climatic
conditions.
Apakah model peternakan seperti ini??
Zoonoses
 Emerging and Re-emerging
Globalization Infectious Disease
 Affects movement of goods and
people, trade and transportation
 Affects consumer preferences

 Facilitates infectious disease to

spread globally
 Increases the magnitude of
spreading

Diseases can become pandemic

THE DISEASES OF TOMORROW
Overpopulation Food Crisis

Who’s
responsibility?
Climate Change Pollution
Source : Emerging & Re-Emerging Infectious Disease Challenges. Nature 430: 242-49 (Morenz. DM et al, 2004)
Source: Wilcox and Colwell, 2005; Wilcox and Gubler, 2005
 Ancaman Penyakit Zoonotik

• New zoonotic diseases, nearly three-quarters have been caused by

pathogens originating in wildlife
– SARS emerged in civet cats in Guangdong Province, China;
– Nipah virus in bats in Perak State, Malaysia;
– Ebola in West Africa,
– MERS CoV in Saudi A and South Korea
– HIV in non-human primates in Central Africa.

• Domestic animals account for approximately 20% of all new zoonotic

diseases.
Tantangan terhadap Zoonotic Diseases

• EBOLA
• MERS
• BIRD FLU/AI
• NIPAH
• SARS
• RABIES
• LEPTOSPIROSIS
• TUBERCULOSIS
• TOXOPLASMOSIS

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 Prioritas ZD di Indonesia

• Rabies (24 dari 34 Provinsi)

• Birdflu/AI (33 dari 34 Provinsi)
• Anthrax (11 dari 34 )
• Brucellosis (11 dari 34)
• Leptospirosis (5 dri 34)
Problem Kompleks: 'Sulit di atasi’
• Kekurangan pangan
• Keamanan pangan
• Kemiskinan
• Kekurangan air
• Perubahan iklim
• Ketidak berlangsungan sumber daya alam
• Kontaminasi Lingkungan
• Pembalakan hutan/alih fungsi hutan tropis
• Kekacauan politik dan konflik
• Bencana alam
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Avian ’flu, H5N1
Mad Cow Disease (BSE)
Nipah viral encephalitis, Malaysia (1997-99)
Previous ’flu epidemics (1918-19, ’57, ’68)
Tipe Industri Peternakan Unggas di Indonesia
Sector1

sector 4
SARS Severe
Acute Respiratory
Syndrome
 Rabies Epidemiology — World

* >55,000deaths worldwide, mainly Africa and Asia

* 60–70% of human cases are children 5–15 years of
age
* ~98% of human cases caused by dog bites
Rabies di Bali: Gigitan anjing penderita Rabies

sources: Badung Municipal Health 2010

 NIPAH
• 1998-1999: Peninsular Malaysia
• Human febrile encephalitis, high mortality
• New virus discovered

• 1999: Singapore
• Outbreak in abattoir workers
• Pigs imported from Malaysia
● Since 2001– Bangladesh, India

265 persons hospitalized; 105 deaths

2004: Bangladesh…..34 cases; 26 deaths

Transmission : close contact, Exposure to common source
Middle East respiratory syndrome
coronavirus (MERS-CoV)
• Globally, since September 2012, WHO has been notified of
1,367 laboratory-confirmed cases of infection with MERS-
CoV, including at least 487 related deaths.
• Korea Selatan 186 MERS-CoV cases, including 33 deaths,
• One of the 186 cases is the case that was confirmed in
China

• Two H7N9 cases reported in China (2015)

• Nigeria, Ghana, Vietnam report H5N1 outbreaks
ZOONOTIC
DISEASES

Ebola
 Ebola cases in West Afrika
Guinea has reported 7 new cases, Sierra
Leone reported 8 , Liberia has 46 new
Ebola cases
(WHO, Oct 2015)
Oct 15, 2015
Scottish nurse has a severe CNS disorder,
and her spinal fluid tested positive for Ebola
A global early-warning system for emerging zoonotic diseases in hot spots around the world. (From the PREDICT One Health
Consortium.) http://www.vetmed.ucdavis.edu/ohi/predict/publications/index.cfm
 What to do ?
Bagaimana kita mengontrol Zoonotic diseases???
ONE HEALTH APPROACH
 A worldwide strategy for expanding
interdisciplinary collaborations and
What is One Health? communications in all aspects of health care for
humans, animals and the environment.

Encourages the collaborative efforts of multiple

disciplines working locally, nationally, and globally,
to attain optimal health for people, animals, and our
environment.
Optimizing the One Health Approach is
important…….
• To ensure that each One Health professional is well-trained
1 for their roles and appropriately equipped

• To ensure that professions have the skills to work

2 collaboratively with each other and with government, the
private sector and the community

3 • To work together to develop and restructure Health systems

to benefit from One Health
 The One Health Approach
Medical Doctor
protects people
from infectious Infectious
diseases Diseases

Veterinarian protects animal

from infectious diseases

Public Health prevents

the infectious disease
transmissions through
health system
improvement
Some disciplines who might work together in
response to an outbreak of a new zoonosis
Physicians Human Health
Sociologists
Veterinarians Economists
Nurses Anthropologists
Ecologists
One Pathologists
Zoologists
Entomologists
Health Microbiologists
Environmental Animal Epidemiologists
Health Health
Politicians!

Many other “ologists”!!

 Human-Animal-Environment Interface

Human One Health is a ‘top down’

Key risk factors philosophy using
for important quantitative methods,
EIDs multiple disciplines and
applied knowledge to solve
complicated problems
Environment Animal
 How to Deal the zoonotic Infectious Diseases?
Identify Predict Prevent Respond
• Identify the • Predict the • Effort to • Action to
agent, source, disease prevent respond and
mode of manifestation, transmission to mitigate
transmission, potential & outbreak by the outbreak
and outbreak, minimizing by working
associated risk through contact & collaboratively
of disease epidemiology exposure with across-
investigation the risks professions &
& surveillance sectors
COLLABORATION
World organizations who Work in One Health

produce health guidelines achieve food security, make sure

and standards, help people have regular access to
countries to address public enough high-quality food, healthy
Infectious
health issues, tackle global lives and to raise levels of nutrition,
Diseases
health problems and improve agricultural productivity,
improve people’s well- better the lives of rural populations
being. and contribute to the growth of the
world economy.

The OIE is the intergovernmental

organisation responsible for
improving animal health
worldwide.
Connecting
Organizations for SEEHN – Southeastern
Europe Health Network

Regional Disease MECIDS – Middle east Consortium

MBDS – Mekong Basin
Disease Surveillance Network

Surveillance
on Infectious Disease Surveillance
EAIDS – East African Integrated
Disease Surveillance Network
APEIR- Asia Partnership on Emerging
Infectious Disease Research
SACIDS – Southern Africa Center for
Infectious Disease Surveillance

http://www.cordsnetwork.org/

CORDS
SEAOHUN
was established
in 2011
INDOHUN
Indonesia One Health University Network

THOHUN
Thailand One Health University Network

VOHUN
Vietnam One Health University Network
MYOHUN
Malaysia One Health University Network

SEAOHUN
 SEAOHUN Core Universities
Hanoi School of Public Health
Hanoi Medical University
Hanoi University of Agriculture
Chiang Mai University
Mahidol University
Universiti Kebangsaan Malaysia
Universiti Putra Malaysia
Institut Pertanian Bogor
Universitas Indonesia
Universitas Gadjah Mada
4 countries/10 universities/14 faculties
Vision
A South East Asia One Health University Network fostering
sustainable trans-disciplinary capacity building to respond to
emerging and re-emerging infectious and zoonotic diseases
INDONESIA NETWORK
 INDOHUN
The Indonesia One Health
University Network (formally
known as INDOHUN) was
established in January 2012
as a platform where leading
academicians, stakeholders,
scientists, communities, and
professionals from Indonesia
to address issues of regional
and global concern.
Legal Entity
Based on a Decision of Ministry of Law and Humanity of Republic of Indonesia number
AHU-0000633.AH.01.07.TAHUN 2015, INDOHUN is incorporated as a legal association.
Vision
INDOHUN fostering sustainable
trans-disciplinary capacity
building to respond to emerging
and re-emerging infectious and
zoonotic diseases and to improve the
people, animals, and ecosystem
health in Indonesia.
Mission
To leverage the capacity building
of the university network with
training, education and research to
build the skills, knowledge and
attitude based on OH concept for OH
leaders.
Strategic Objectives
1. To build cadres of trained professionals to
be OH current and future true leaders
2. To improve the competencies of OH
professionals and students
To promote and advance the OH approach
3.
for control of emerging and re-emerging
infectious and zoonotic diseases
4. To improve the people, animals, and
ecosystem health and well-being in
Indonesia through research, surveillance
and capacity building
5. To foster resource mobilization by
expanding INDOHUN network in national,
regional, and international level through an
established good governance institution
TERIMA KASIH