IPE4 - Public Health

P U B L I C H E A LT H , O N E H E A LT H C O U R S E
COMPETENCIES
• Competency #1
• Understand public health practice and its
relationship to One Health
• Competency #2
• Understand the interrelationships between
government authorities, policy makers, industry,
and researchers related to implementation of
public health programs
• Competency #3
• Evaluate the effectiveness of One Health actions in
infectious disease management
• Competency #4
• Analyze national or local public health policies
WHAT IS PUBLIC HEALTH?
Public health is the practice of

preventing disease and promoting
good health within groups of
people, from small communities
to entire countries.
American Public Health Association
•
PUBLIC HEALTH PROFESSIONALS
• Work focuses on: the effect on genetics on health, issues
of personal choice and preventing high risk behaviors, as
well as environmental protection, and programs that
promote well-being and protect the health of families and
the community
• Priorities include: health promotion, disease prevention,
implementing educational programs, developing policies,
administering services, regulating health systems and
practices, and conducting ethical research
• Committed to limiting health disparities, and advocating
for health care equity, quality, and access
• In contrast, clinicians more often focus on the health of the
individual (rather than the population), and the treatment
of disease and injuries (rather than prevention)
American Public Health Association
WHAT IS VETERINARY
PUBLIC HEALTH?
According to the World Health Organization
(WHO) “Veterinary Public Health is a component
of public health activities devoted to the
application of professional veterinary skills,
knowledge and resources to the protection and
improvement of human health.”
Integration and animal

of human health
VETERINARY CONTRIBUTIONS
TO PUBLIC HEALTH
• Commitment to provision of safe food

and freedom from malnutrition
• Control of zoonoses
• Epidemiology/population medicine
• Maintenance of environmental quality
• Committed to humane treatment of
animals
• Support for medical research
Veterinarians play a vital public health
role through commitment to food safety,
zoonotic disease surveillance, disease
prevention and control, scientific
research, biosecurity, quarantine, animal
production, commitment to ethics, and
support for the key role of pets and
companion animals in society
ECOHEALTH
The Ecohealth approach focuses above all on

the place of human beings within their
environment. It recognizes that there are
inextricable links between humans and their
biophysical, social, and economic
environments, and that these links are
reflected in a population's state of health.
International Development Research Centre (IDRC)
8
ONE HEALTH
ONE HEALTH: MANY DEFINITIONS
The One Health Office at CDC* focuses on activities

that promote an integrated approach to public
health, reflecting the interconnectedness of a
larger ecological system. To achieve this, this Office
builds partnerships and promotes trust-based
relationships among multiple sectors and
disciplines, internal and external to CDC, to more
precisely address this convergence of human and
animal health
*CDC: U.S. Centers for Disease Control and Prevention

ONE HEALTH: MANY DEFINITIONS
The concept of One Health has been

characterized using various approaches but
all involve the convergence of health risks at
the human - animal - ecosysytem interface.
One Health is about working inclusively
across disciplines, professions, and sectors
from the local to the global level, to improve
the health of humans, animals, and the
environment.
One Health Talk

MORE ONE HEALTH DEFINITIONS
One Health is the collaborative effort of

multiple health science professions, together
with their related disciplines and institutions
– working locally, nationally, and globally – to
attain optimal health for people, domestic
animals, wildlife, plants, and our
environment.
One Health Commission
MORE ONE HEALTH DEFINITIONS
One Health is the integrative effort of

multiple disciplines working locally,
nationally, and globally to attain optimal
health for people, animals, and the
environment. Because of their expertise,
veterinarians play critical roles in the health
of animals, humans, and even the
environment, but these roles are often
overlooked or unrecognized.
American Veterinary Medicine Association
A ONE HEALTH APPROACH…
. . . encourages the collaborative efforts of

multiple disciplines working locally,
nationally, and globally, to attain optimal
health for people, animals, and our
environment.
Source: handmadecharlotte.com
THE BENEFITS OF THE
ONE HEALTH APPROACH
• Improving animal and human health globally
through collaboration among all the health
sciences, especially between the veterinary
and human medical professions to address
critical needs
• Meeting new global challenges head-on
through collaboration among multiple
professions—veterinary medicine, human
medicine, environmental, wildlife and public
health One Health Initiative Task Force: Final
Report
July 15, 2008
BENEFITS OF THE
ONE HEALTH APPROACH
• Developing centres of excellence for
education and training in specific areas
through enhanced collaboration among
colleges and schools of veterinary medicine,
human medicine, and public health
• Increasing professional opportunities for
veterinarians
• Add to scientific knowledge to create
innovative programs useful to improving
One Health Initiative Task Force: Final
public health Report
July 15, 2008
SECTORS CONTRIBUTING TO ONE HEALTH
• Physicians
• Public health
professionals
Human
Health • Government and
Sector non-governmental
organizations
focused on health
education
• Environmental
Health science
disciplines in • Biology, ecology,
the
Environment zoology
al Sector • Medical entomology,
wildlife biology
• Private & public-

Agricultural, sector veterinarians
Animal
• Village and
Production
& community animal
Veterinary health and public
Medicine health workers
Sector • Animal producers,
food systems
Virchow was an outspoken advocate for public health. He opposed
excessive military spending in Germany, causing Bismark to challenge
him to a duel. Virchow, being entitled to select the weapons, chose two
pork sausages: a cooked sausage for himself and an uncooked one,
loaded with Trichinella, for Bismarck. Bismarck declined the proposition
as too risky.
Rudolph Virchow, founder of comparative
medicine and veterinary pathology was an
advocate of ‘One Medicine.’ His early research
laboratory was provided by the School of
Veterinary Medicine where he taught veterinary
students
“Between animal and human
medicine there are no dividing lines
– nor should there be”
The German physician and statesman Rudolf

Virchow, son of a butcher, noted the link
between diseases of humans and animals and
coined the term ‘zoonosis’ to indicate the
Rudolf Virchow infectious disease links between animal and
“Father of One human health. He discovered Trichinella and
Health” linked it to trichinosis P.A. Conrad et al. Preventive Veterinary
(1821-1902) Medicine 92 (2009) 268–274
Sir William Osler, Canadian
physician, the founder of modern
medicine and veterinary
pathology, is credited with
coining the term ‘One Medicine.’
Osler studied with Virchow, and
founded the McGill School of
Veterinary Medicine.
William Osler (1849-

1919)
Osler reduced the role of didactic lectures
and said: "I desire no other epitaph than the
statement that I taught medical students in
the wards, as I regard this as by far the
most useful and important work I have been
called upon to do."
Painting by
(Osler Library Photography Collection, Osler Thomas Corner
Library of the History of Medicine, McGill
University, Montreal, QC, Canada).
Louis Pasteur is regarded as one of
the three main founders of
microbiology, along with Ferdinand
Cohn & Robert Koch
…he created the first
vaccines for rabies and
anthrax
Pasteur was absolutely
fearless. To secure a
sample of saliva
straight from the jaws
Louis Pasteur of a rabid dog, he used
(1822-1895) a glass tube held
Microbiologist between his lips to
& Chemist draw a few drops of the
Three of his deadly saliva from the
children died mouth of a rabid bull-
of typhoid dog, held on the table
fever by two assistants, their By Albert
hands protected by Edelfelt
leather gloves.
Calvin Schwabe, veterinary
epidemiologist and parasitologist,
described and promoted ‘One Medicine’
and proposed a unified human and
veterinary approach to zoonoses in his
1964 book ‘Veterinary Medicine and
Human Health’
Calvin
Schwabe
(1927-2006)
Veterinarian
(Courtesy of the School of Veterinary Medicine, University of

California, Davis vetmed.ucdavis.edu)
EXAMPLES OF WHERE ONE
HEALTH HAD TO BE USED
LEPTOSPIROSIS
• Disease described in dogs in 1850

• Weil’s disease described in humans in 1880
• By 1940 leptospirosis established as a
major animal and public health problem
• Occupational disease
• Associated with natural disasters (e.g.,
during floods)
RISK OF LEPTOSPIROSIS
• Occupational hazard: in rice-growing
communities
(e.g., July 2008 in Thailand: 578 infections, 15
fatalities)
• Cattle, pigs and rodents possible reservoirs, via urine
contaminating paddy fields
• Recreational risks: Eco-challenge race
(e.g. 2000 in Sabah, Malaysia: 50 of 80
participants contracted leptospirosis)
• Natural disasters: Typhoon - Ketsana
(e.g., 2009 in Manila, Philippines: ~170 deaths,
hundreds infected, 1 million doses of
prophylactic doxycycline distributed, health
system stressed by crisis)
ENVIRONMENTAL HEALTH:
IMPORTANT EXAMPLE, NIGERIA 2010
• In Zamfara area, dozens of children under 5 years
of age died following an illness characterized by
abdominal pain, fever, vomiting, coma and
seizures
• Possible etiology: malaria, meningitis or typhoid
• Villages affected involved in artisinal (informal)
mining for gold
• Environmental contamination by dust and smoke
due to mining and smelting; local water sources
contaminated
• Laboratory testing confirmed childhood illness
caused by Pb (Lead) toxicity -- causing severe
anemia, coma, seizures and death
LEAD TOXICITY, NIGERIA 2010
“Illegal gold mining has left at least 2,000

children with lead (Pb) poisoning (toxicity) in
several northern Nigerian villages, where 400
children have already died from
contamination, an official said Friday. The
2,000 children under 5 have shown signs of
lead levels in the blood far exceeding
international standards due to exposure to
lead-rich gold ore, with some areas yet to be
cleaned up despite repeated warnings.”
Vanguard October 29, 2011
NEWLY RECOGNIZED VIRUS:
MIDDLE EAST RESPIRATORY SYNDROME
• In 2012 a new illness in humans (MERS-CoV):
Middle East Respiratory Syndrome –
Coronavirus
• Novel coronavirus was identified in Saudi Arabia
• Three strains of Coronaviruses
• 1. Bat, human & porcine viruses
• 2. Murine viruses (rodents)
• 3. Avian and marine mammal viruses
• Additional MERS-CoV cases identified (2012-
2014)
• MERS-CoV identified in Europe, among travelers
to Middle East
MERS-COV
• May 2013 – Middle East Respiratory

Syndrome Coronavirus
• August 2013 – MERS-CoV found in one bat
out 1003 tested. However, 227 test positive
for coronavirus
• September 2013 – 90% of camels tested are
positive for MERS-CoV antibodies –
suggesting camels are exposed to MERS-
CoV, but do not necessarily transmit it.
Camels had been brought to Egypt from
Sudan. Unclear where camels became
infected.
WHAT DO YOU THINK?
• How does taking a One Health approach to

Public Health strengthen a community’s
ability to address complex health issues?
Ecosystem Health, Climate Change
and Pubic Health
LEARNING OBJECTIVES
• Be able to define ecosystems and to

understand its importance with respect to
human and animal health
• Be able to describe examples and be familiar
with the ecological and social changes that
affect global health
• Be able to describe why environmental
changes (such as climate change) affect
global health
ECOSYSTEMS
ECOSYSTEM HEALTH
Ecosystem Health is a transdisciplinary

approach. It bridges the natural, social and
health sciences. It recognizes that ecosystems
must be used sustainably to maintain human
and animal health. It can incorporate human
values and perceptions that are important in
the management of the environment and
disease.
WHAT ARE ECOSYSTEMS?
• What is an
ecosystem?
• What is an
ecosystem
composed of?
• Name some parts of
ecosystems
WHAT ARE ECOSYSTEMS?
An ecosystem is a community of living

organisms (plants, animals and microbes) in
conjunction with the nonliving components of
their environment (things like air, water and
mineral soil), interacting as a system. These
biotic and abiotic components are regarded
as linked together through nutrient cycles
and energy flows.
Wikipedia(http://en.wikipedia.org/wiki/Ecosystem)
HEALTHY ECOSYSTEM
A healthy ecosystem is
stable and sustainable,
maintaining its
character in
composition,
organization and
function over time, and
its resilience to stress
SOUTHEAST ASIA
ECOSYSTEM SERVICES
Mangroves Coral Reefs

• Fisheries/Food web • Raw materials
• Water quality • Coastal protection
• Flood protection • Maintenance of fisheries
• Coastal protection • Nutrient Cycling
• Fuel wood • Tourism Recreation
• Material – wood
• Carbon sequestration Tropical Rainforest
• Biodiversity • Air quality
• Water quality
• Flood protection
• Material – wood,
medicine
• Biodiversity
ECOSYSTEM DISRUPTORS/STRESSORS
Direct Indirect
 Changes in local land use • Population growth
and cover
• Economic (e.g.,
 Changes in climate
globalization, trade,
 Species introduction or
market and policy
removal
framework)
 Fishing
• Sociopolitical (e.g.,
 Nutrient loading from
activities such as fertilizer, governance, institutional
pest control, irrigation and legal framework)
 Modification of rivers • Science and technology
 Water withdrawal • Cultural and religious (e.g.,
 Pollution beliefs, consumption)
SPECIFIC DISRUPTERS
Mangroves Tropical Rainforest
• Deforestation
• Pollution (industrial
• Agricultural conversion (oil
discharge, sediment loading,
palm)
chemical from mining, heavy
• Subsistence agriculture
metal)
• Urban expansion
• Sedimentation
• Cattle ranching
• Organic waste (municipal
• Fuel wood
and industrial )
• Dams
• Agricultural runoff (nitrogen
• Mining
and phosphorus loading,
• Industry
pesticides)
• Tourism
• Salt Production
• Fire
• Oil spills
• Volcanic Activity
• Deforestation
• Drought
• Seafood farming
• Tropical Storms
• Illegal use
• Tsunami
SIGNS OF ECOSYSTEM STRESS
• Loss of biodiversity
• Increase in “generalist” opportunist species
over “specialists” e.g. seagulls, sparrows,
pigeons, rats and mice versus more specialized
animal species
• Decline in natural predators
• Proliferation of algal blooms along coastlines
and waterways
• Appearance of emerging infectious diseases
ECOSYSTEM SERVICES AND
PUBLIC HEALTH
Corvalan, C. et al. 2005. Ecosystems and Human
Well-Being: Health Synthesis
ECOSYSTEM SERVICES
Corvalan, C. et al. 2005. Ecosystems and Human

Well-Being: Health Synthesis
ECOSYSTEM SERVICES BENEFITING
PUBLIC HEALTH
• Half of all synthetic
medicines originate from
natural precursors
• Fresh water - essential
for life, shortage of water www.fhiredekha.com
or pollution of waterways
leads to disease
• Biodiversity inhibits
population explosions of
pest species
Patz, J.A., P. Daszak, G. M. Tabor, A. A. Aguirre, M. Pearl, J. Epstein, N. D. Wolfe, A. M. Kilpatrick, J.
Foufopoulos, D. Molyneux, D. J. Bradley, and Members of the Working Group on Land Use Change
Disease Emergence. 2004. Unhealthy Landscapes: Policy Recommendations on Land Use Change
and Infectious Disease Emergence. Environ Health Perspect. 2004 July; 112(10): 1092–1098.
Published online 2004 April 22. doi: 10.1289/ehp.6877
AGRICULTURAL EXPANSION
Intensive agricultural
practices: result in
monocultures, e.g. palm
oil plantations impinging
on orangutan habitats,
change in vector and
reservoir species, e.g.
www.treehugger.com
bats and fruit trees
POPULATION GROWTH AND
RESOURCE EXTRACTION
Expansion into previously
uninhabited areas - increased
synanthropic animal species
(ecologically associated with
humans)
Road building:
allows access store.applebazaar.co
m/blog/tag/solio
to wildlife and
wilderness
areas
DEFORESTATION
• Removes habitat
• Fragment habitat
• Predisposes
areas to floods
and landslides
• Changes vector
habitat
CLOSER CONTACT BETWEEN HUMANS
AND OTHER ANIMAL SPECIES
Chickens and pigs mingling,

Monkey drinking from tap
can predispose to spread of
avian influenza viruses
SURFACE WATER AVAILABILITY
Affects ranges of
wildlife and insect
vectors
Surface Water Availability
Changes in surface water availability provide
more opportunities for vector multiplication and
disease transmission (e.g., Japanese
encephalitis)
www.medindia.net http://projectdisaster.com
Patz, J.A. et al., 2005 Human Health: Ecosystem Regulation of
Infectious Disease (Chapter 14) in Hassan R, R. Sholes, and N. Ash
(ed.s) Millennium
Ecosystem Assessment. Island Press. Washington .
Patz, J.A. et al., 2005 Human Health: Ecosystem Regulation of
Infectious Disease (Chapter 14) in Hassan R, R. Sholes, and N. Ash
(ed.s) Millennium Ecosystem Assessment. Island Press. Washington .
CLIMATE CHANGE AND
HEALTH
McMichael et al. (eds) 2003 Climate change and human health: risks and
responses. World Health Organization. Geneva, Switzerland.
CLIMATE CHANGE
• Increased temperatures
• Increase in natural disasters
• Floods, rats and leptospirosis
Flooding in Hanoi
http://i.telegraph.co.uk
Flooding in Manila
news.bbc.co.uk
CLIMATE CHANGE EFFECTS
• Food production
and population
nutrition
• Range of disease
carriers
• Loss of biodiversity
www.kuleuven.be/ rega/mvr/research.html
Source: adapted from Patz et al., 2000 (22).
McMichael et al. (eds) 2003 Climate change and
human health: risks and responses. WHO
McMichael et al. (eds) 2003 Climate change and human health:
risks and responses. World Health Organization. Geneva,
Switzerland.
McMichael et al. (eds) 2003 . Climate change and human health:
Switzerland.
McMichael et al. (eds) 2003 Climate change and
human health: risks and responses. World Health
Organization. Geneva, Switzerland.
Kovats, S., K.L. Ebi, and B. Menne 2003. Methods of assessing human health vulnerability and public health
adaptation to climate change. Health and Global Environmental Change Series No. 1. World Health
Switzerland.
Animals and Public Health:
Human-Wildlife Interactions
LEARNING OBJECTIVES
By the end of this session, the participant

should be able to:
• Define zoonoses and emerging diseases
• Explain the importance of zoonoses to One
Health and Public Health
• Discuss the key reasons for disease
emergence and re-emergence
• Describe selected zoonoses important in the
region
ZOONOSES
• Infections which are naturally transmitted

between vertebrate animals and humans
• Derived from the Greek terms “ZOON”
(animals) and “NOSES” (diseases)
• People, animals, birds, arthropods and the
inanimate environment are all involved in
cycles of zoonotic infection
Agent
Environment Host
Zoonotic diseases are multifactorial and

their occurrence is affected by interactions
between the host, the agent and the
environment
DEFINITIONS
• Vector: an organism, often an invertebrate

arthropod, that transmits a pathogen from
reservoir to host (e.g., mosquito and Japanese
Encephalitis virus – JEV)
• Reservoir: a long-term host of a pathogen
(e.g., mouse and hantavirus). In this instance
the host can also be the vector as the virus is
transmitted via mouse excreta.
• Fomite: an inanimate object that can transmit
an infectious agent (e.g., medical equipment
[syringe, needle] and Ebola virus
EMERGING AND
RE-EMERGING INFECTIOUS DISEASES
“An emerging zoonosis is a zoonosis

that is newly recognised or newly
evolved, or that has occurred
previously but shows an increase in
incidence or expansion in geographical,
host or vector range.”
WHO/FAO/OIE definition
MODES OF TRANSMISSION
Transmission of infections may be direct,

indirect via arthropod vectors, or from
environmental foci
www.who.int
ZOONOSES
• Currently 1461 infectious diseases

are recognized in humans
• Of these approximately 60% are due
to zoonoses
• Approximately 75% of recently
emerging infectious diseases (EIDs)
have been caused by zoonotic
pathogens
HISTORICAL EVENTS LEADING TO
DISEASE EMERGENCE
• 10,000 years ago, shift from hunter-
gatherers to agrarian settlement; animals
domesticated; urban pest species
emerged; closer contact between animals
and humans. New diseases emerged
(e.g., measles, rinderpest/distemper, TB)
• 2,000 to 3,000 years ago, wars and trade
between Eurasian nations facilitated
transmission of dominant diseases from
each group (e.g., measles)
HISTORICAL EVENTS LEADING TO
DISEASE EMERGENCE
• 1300 -1500 AD, transmission of bubonic
plague between the Far East and Europe
due to expansion of trade
• 1500 AD, European expansionism and
colonization facilitated trans-oceanic
spread of lethal infectious agents around
the globe, including smallpox, yellow
fever, measles, plague and influenza
HISTORICAL EVENTS LEADING
TO DISEASE EMERGENCE
Development of more rapid methods of

travel and the occurrence of two world
wars allowed faster spread of diseases,
including newly emerging diseases,
e.g. typhus, malaria, yellow fever.
“DDT banned in the US in

1972, sprayed in US aircraft
until 1989”
HOW DO PEOPLE INTERACT WITH
WILDLIFE?
• Ecotourism
• Hunting/Bushmeat
• Subsistence
• Encroachment into habitat – timber,
agriculture, mining,
• Vermin
• Pets
• Zoos
LINKS BETWEEN HUMANS, ANIMALS
AND THE ENVIRONMENT
Zoonotic disease
Adapted from: Tabor GM. 2002. Defining conservation medicine. In: Conservation
Medicine: Ecological Health in Practice (Aguirre AA, Ostfeld RS, Tabor GM, House CA, Pearl
MC, eds). New York:Oxford University Press, 8-16.
REASONS FOR DISEASE EMERGENCE
• Genetic drift and shift (influenza)

• Change in susceptibility of populations
• Population growth and movement,
• Food habits
• Environmental changes that affect
reservoirs, vectors and victim species
dynamics
• Population expansion and urbanisation
• Increased contact between human
populations, wild and domestic animals
RELATIONSHIP BETWEEN ZOONOSES
AND ECOLOGY
Zoonoses occur where there is contact with an
animal host and/or an insect vector. Common animal
reservoir hosts/vectors involved in zoonosis cycles
include:
• Bats: Lyssa, Hendra and Nipah viruses, SARS
• Rodents: Yersinia pestis, leptospirosis, hantavirus
• Pigs: Taenia solium, Salmonella, E. coli O:157, Nipah
virus
• Birds: Highly Pathogenic Avian influenza (HPAI),
Salmonella, West Nile virus, ornithosis
• Insects: Rickettsial diseases, arboviruses, protozoans
• Non-human primates: Simian foamy virus
ECOLOGICAL AND SOCIAL CHANGES
RESULTING IN INCREASED ZOONOTIC
DISEASE
Historical zoonoses:
• Malaria: Thought to have originated from
non-human primates. Spread to humans due
to more agriculture in Africa, increasing
exposure to primate-mosquito-human
transmission
• Yellow fever: Mosquito vectors and diseased
individuals spread to America from Africa due
to slave trade. Global warming and other
factors have resulted in increased mosquito
vector range and increased range of disease
outbreaks
RESULTING IN INCREASED ZOONOTIC DISEASE
Historical epidemics involving zoonoses

• Plague: Trade with China brought rats, fleas and
the disease to Europe; intensive grain production
and import into the Byzantine empire resulted in
rat population explosion and accompanying flea
infestation.
• Plague broke out in 6thCentury AD
• Plague epidemic again in 14th and 17th Century AD
due to poor sanitary conditions, overcrowding
(and killing of cats – as thought by some to be
witches!!)
• Plague still exists today in urban and sylvatic
(wild) cycles
PLAGUE CYCLE
DRIVERS OF PANDEMIC RISK
PANDEMIC Global spread Globalization

• Global travel: people, animals,
Global travel vectors
and trade
• Global trade: animals and their
products
Amplification
EPIDEMIC Amplification • Urbanization
Human to • Population density
human • Agricultural intensification
transmissi • Technology and Industry
on
• Vector distribution and densities
• Transmission in health care
Amplification centers
• Successful A2H & H2H
OUTBREAK Emergence Emergence
transmission
• Human encroachment
Human
Ecosyste
• Exploitation
m • Translocation
Environ
ment
• Climate variability
interface • Vector density and distribution
• Ecological Pressure
RECENT EMERGING ZOONOSES
• Changing farming practices, trade and

consumer habits (Salmonella Enteritidis, E.
coli O:157)
• Live animal trade - screwworm to Libya,
Ebola-like virus in monkeys quarantined in
the USA, and monkeypox to the USA
• Epidemics of BSE due to many factors
including use of ruminant protein as feed
• Adaptation of avian influenza strain H5N1 to
people is a current cause of concern
INCREASE IN ZOONOTIC DISEASE DUE TO
• Increased contact between humans,

domestic animals and bats due to
ecosystem changes has resulted in
emergence of Australian bat
lyssavirus, Hendra virus, SARS and
Nipah virus in recent years
• Trade in wild animals resulted in
monkeypox in America
• Consumption of ‘bush-meat’ has Monkeypox virus.
Image: Armed
resulted in HIV, Ebola, etc. Forces Institute of
Pathology
THEREFORE EMERGING
INFECTIOUS DISEASES CAN BE…
• A known agent appearing in a new

geographic area
• A known agent or its close relative
occurring in a hitherto unsusceptible
species
• A previously unknown agent detected for
the first time
Wild animal reservoirs represent a
more frequent source of ‘new’ agents
VULNERABLE AREAS AND PEOPLE
• Poverty affected communities

• People with low population immunity (HIV,
age)
• Areas of altered climate and increased
vector range
• Areas of political unrest and population
migration
• Areas affected by a natural disaster
• Areas of deforestation and altered
biodiversity
• People affected by global trade and travel
IMPACT OF ZOONOTIC DISEASES
• Human health (death and disability)

• Animal health (death and disability)
• Economic losses due to livestock culling,
deaths and decreased production
• Cost of control programs
• Trade implications
• Indirect effects on people due to psychological
trauma (loss of pets, culling, loss of valuable
animals) and impact on cultural traditions,
etc.
ZOONOTIC DISEASE RESOURCES
• This presentation gives an overview of the

importance of zoonotic diseases to human and
animal health. Examples used can be varied by
trainers according to the relevance of zoonoses
in their regions
• Further information on zoonotic diseases, e.g.
statistical data, can be found in the following
websites:
• http://www.oie.int
• http://www.who.int
• http://www.fao.org
• http://www.cdc.gov 89
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BATS, RATS, PRIMATES AND ME!
Taxa Virus #1
Bats Nipah, SARS, Hendra
Rats Leptospirosis, Plague,
Hantavirus
Prima Yellow fever
tes
WHAT DO YOU THINK?
• What did all the diseases have in common?

• What made each unique?
• How could adopting a One Health Approach
help control an emerging or re-emerging
pandemic threat of the diseases?
Animals and Public Health:
Human-Domestic Animals
FROM THE PRE-READ,
WHAT DO YOU THINK?
• How much evidence is there that human
pathogens originated from humans?
• What role does the animal domestication
play in pathogen transmission to humans?
• Do you agree with the conclusion by the
author of this paper? Why not or why so?
Source: http://www.channelnewsasia.com
Source: Live poultry sellers at the market in Hanoi (Vietnam) © CIRAD, D. Hong
Source: http://www.wusa9.com
Source: http://www.readdailynews.com/news
Source: http://www.directmagonline.com
WHAT DO YOU THINK?
• From the presentations, what modifications

-- add, change or remove -- would you make
to your presentation?
• How does understanding human/domestic
animal interaction strengthen an
understanding of human health?
Foodborne Diseases, Food Safety,
and Food Production
FOODBORNE DISEASES AND FOOD
SAFETY FROM FARM TO FORK
http://www.foodtechconnect.com/
FOODBORNE ILLNESS
• Have you ever had food poisoning?

• What do you think is food poisoning?
• What were the symptoms?
• How quickly did it happen?
• How long did it last?
http://www.cosmopolitanclublahore.com/wp-
content/uploads/2011/06/fast-food-burger.jpg
DEFINITIONS
• Foodborne illness - any illness that

results from ingestion of contaminated
foods or beverages
• Foodborne disease – an intoxication or
infection that is carried or transmitted
to human beings by food
approximately
250 foodborne diseases
DISEASE BURDEN
60% of global mortalities due to infectious diseases
http://wwwnc.cdc.gov/eid/article/11/4/04-1167-f2.htm; http://www.smartglobalhealth.org/issues/entry/infectious-diseases
DISEASE BURDEN (CONTINUED)
Disease Deaths
Respiratory
3.9 The top 6
Infections
categories of
1.3 -
Malaria
3.0
infectious diseases
causing mortalities
HIV/AIDS 2.5
Diarrheal
1.8
Diseases
Tuberculosis 1.7 http://wwwnc.cdc.gov
http://www.smartglobalhealth.org
Neglected Tropical
0.5
Diseases http://wwwnc.cdc.gov/eid/article/11/4/04-1167-f2.htm;
http://www.smartglobalhealth.org/issues/entry/infectious-diseases
http://wwwnc.cdc.gov/eid/article/11/4/04-1167-f2.htm;
PRINCIPAL CONTAMINANTS
OF FOOD
Links, J. 2006. Food and Water Borne Disease Lecture. Johns Hopkins
School of Public Health Open Course Ware. Accessed from
http://ocw.jhsph.edu/courses/environmentalhealth/PDFs/Lecture13.pdf
AGENTS IMPLICATED IN
FOODBORNE OUTBREAKS
(Centers for Disease Control and Prevention)

FOODBORNE DISEASE CAUSATIVE AGENTS
• Salmonella:
typhoid fever & • Trichinella
• Hepatitis A & E
non-typhoid • Cestodes
• Rotavirus
infection (tapeworms)
• Norovirus
• Campylobacter • Trematodes
• Escherichia coli (flukes)
• Shigella
• Yersinia
• Vibrio cholerae
• Bacillus cereus
• Cryptosporidium
• Staphylococcus
• Cyclospora
aureus
• Entamoeba histolytica
• Listeria
• Giardia duodenalis
monocytogenes
• Toxoplasma gondii
• Clostridium
botulinum
• Brucellosis
http://bioweb.uwlax.edu
CATEGORY OF CAUSATIVE AGENTS
• Categories of microbial infection

• Intoxication (toxin is preformed)
• Infection (microbes multiply in body)
• Toxico-infection (organisms ingested, die, and
release toxins)
• Opportunistic infection
• Foodborne disease outbreaks: Occurrence of 2

or more cases of similar illness resulting from
ingestion of common food, or when observed
number of particular disease exceeds expected
number
SOURCES OF MAJOR FOODBORNE
DISEASE OUTBREAKS IN THE U.S.
http://online.wsj.com/news/articles/
SOURCES OF INFORMATION FOR
OUTBREAKS OF FOODBORNE ILLNESS?
• www.cdc.gov/foodnet/
• www.promedmail.org/
HABITAT OF FOODBORNE PATHOGENS
Pathogen Habitat
Bacillus cereus, Clostridium Soil and vegetables
botulinum
Campylobacter Animal, bird, and human intestines
E.coli, Salmonella Lower intestine of humans, warm-
blooded animals, and birds
Shigella Human and non-human primate
intestines
Vibrio cholerae, Hepatitis A virus, Human intestine
Norovirus
Trichinella spiralis Muscle of carnivorous and
omnivorous animals
Links, J. 2006. Food and Water Borne Disease Lecture.

Johns Hopkins School of Public Health Open Course Ware.
COMMON FOODS ASSOCIATED WITH
FOODBORNE PATHOGENS
Food Microorganism
Beef and pork Salmonella, S. aureus, E. coli, T. spiralis, L.
monocytogenes
Poultry Salmonella, Campylobacter, S. aureus, L.
monocytogenes
Dairy Products Salmonella, Campylobacter, E. coli, L. monocytogenes,
Brucella
Eggs Salmonella, S. aureus
Dried cereal B. cereus and other Bacillus spp.
Vegetables C. botulinum, C. perfringens, Salmonella, Shigella, B.
cereus, Norwalk virus
Fish C. botulinum, C. perfringens, ciguatera and scombroid
toxins
Shellfish V. parahaemolyticus, V. cholerae, Hepatitis A,
Norovirus, toxic algae (neurotoxic and paralytic
shellfish poisoning)
WHY ARE CERTAIN FOODS MORE
COMMONLY IMPLICATED?
• Raw vs. finished foods

• Food environment favors the growth of a
pathogen
• No quality control
• More handling
http://kokotaru.com
me food sources associated with foodborne disea
FACTORS CONTRIBUTING TO
FOODBORNE DISEASE
37.00%
19.00%
11.00%
16.00% 11.00%
6.00%

Origin of foodborne disease

Food Production
CDC 2010. The Food Production Chain. Foodborne Outbreak Investigations. Accessed from
http://www.cdc.gov/outbreaknet/investigations/figure_food_production.html
FOOD SUPPLY CHAIN ISSUES
• Production – animals and farmers

come in contact with manure,
industrial food animal production,
fertilizing, composting
• Processing – mixing foods from
different sources can spread
pathogens - ground beef
• Distribution – contaminated if not Source:
www.agricultureinformation.com
properly stored, if temperatures are
not maintained or if containers are
not properly cleaned
• Preparation and handling – contact
with surfaces that are
contaminated; contaminated food
Factors in microbial growth
FACTORS FOR MICROBIAL GROWTH
• Food – microorganisms need a food
source or nutrients (sugar, protein,
minerals) to replicate
• Acidity – Very acidic foods can prevent
pathogenic microorganism growth
• Time and temperature – bacteria
replicate between 40oF and 135oF
• Oxygen – presence or absence of O2
(oxygen)
• Moisture – water content of food
http://www.fcs.ext.vt.edu/fnh/food-innovations/basics/
ACIDITY
TIME AND TEMPERATURE
http://www.fcs.ext.vt.edu/fnh/food-innovations/basics/
MOISTURE
http://www.fcs.ext.vt.edu/fnh/food-
innovations/basics/
GROUPS AT RISK OF
FOOD BORNE DISEASE
• Individuals with poor hygiene

• Infants & young children
• Pregnant women
• Elderly
• Immunocompromised individuals
• Individuals with malnutrition
OTHER RISK FACTORS
• Age: Young children and elderly are at higher risk.
• Medications: e.g., antibiotics and antacids
• Food traditions: intentionally undercooked or raw
meats and fish (e.g., steak tartare, sushi, oysters)
increase risk
• Hygiene: environments where clean water not
available, infected food handlers expose others
to infection, hand washing not possible or
improperly done
• Survival of pathogens due to improper cooking
• Cross-contamination
• Unsafe food sources
FOOD HYGIENE AND SANITATION IN THE FOOD INDUSTRY
http://www.veelite.com/food-industry-lighting
http://rightgroup.net/
/
THE BASICS
WHAT ARE FOOD SAFETY, HYGIENE AND SANITATION?
All the conditions and measures

necessary to ensure the safety and
suitability of food at all stages of the
food supply chain
http://www.theage.com.a
Good Farming Practices Safe from farm to
fork
Good Transportation Practices
Good Handling/
Slaughtering Practices
Good Distribution Practices GHPs
Good Manufacturing Practices Good Hygienic

Practices (GHP)
Good Retailing Practices
Good Catering Practices

GOOD HYGIENIC PRACTICES (GHP)
• Buildings and facilities

• Plant and grounds
• Location and grounds
• Plant construction and design
• Production and process control
• Equipment
• Personal hygiene
• Food storage
GOOD HYGIENIC PRACTICES
(CONTINUED)
• Food transportation
• Waste management/disposal
• Sanitation operation/pest control
• Sanitation facilities and control
• Sanitary procedures for cleaning and
sanitizing
• Hazard analysis and critical control
point (HACCP)
HAZARD ANALYSIS AND CRITICAL
CONTROL POINTS (HACCP) PROGRAM
A system which identifies,

evaluates, and controls hazards
which are significant for food
safety
Codex Alimentarius Commission 1997
7 Principles of
HACCP
Critical Control Points are identified for each stage
in a process of making a food, from purchase to
serving, as illustrated in the above diagrams
This first series illustrates CCPs before food

preparation starts.
http://www.highfield.co.uk/x/i/_db/posters/previews/postersHACCPbig.png
These 4 procedures usually take place in
the food preparation environment – and
show the flow from preparation to chilled
storage, followed at some stage by
cooking and processing and cooling
following cooking
Finally in a restaurant or home
environment, hot holding, reheating and
serving all have their own CCPs to
ensure food safety
BASIC FOOD SAFETY
http://trialx.com/
Food Safety and Sanitation
Good Manufacturing Practices
Checklists
FIELD ASSIGNMENT
Use the Food Hygiene and

Sanitation Good
Manufacturing Practices
Checklists to assess the
facility
WHAT DO YOU THINK
 What are the impacts of good hygiene and

sanitation in food industry on human
health?
 How do these relate to the hazard analysis
and critical control point and public health?
 What are the zoonotic diseases that can be
transmitted through foods from animal
origin?
Water Quality, Sanitation and
Waterborne Disease
WATER SOURCE AND USES
• Take 5 minutes with a partner to list at least

three:
• Sources of water
• Uses of water
WATER CYCLE
http://pmm.nasa.gov/education/sites/default/files/article_images/Water-Cycle-Art2A.png
TYPES OF WATER USES
• Drinking water
• Irrigation/food production
• Industry
• Aesthetics
• Cleaning
• Recreation/exercise
• Support of ecosystems
WHY WE SHOULD CARE ABOUT WATER
WHO 2001
DRINKING WATER
AVAILABLE DRINKING WATER
DRINKING WATER SUPPLIES
Drinking Water Ladder
• Urban SE Asia
90% in 1990,
94% in 2011
• Rural SE Asia
62% in
1990,88% in
2011
COVERAGE FOR
IMPROVED
WATER SOURCES
SANITATION
SANITATION
• The provision of facilities and services

for the safe disposal of human urine
and faeces
• The word 'sanitation' also refers to the
maintenance of hygienic conditions,
through services such as garbage
collection and wastewater disposal
SANITATION COVERAGE
OPEN DEFECATION
SANITATION LADDER
Changes from
1990 to 2011 in
SE Asia
Improved sanitation
• 69 to 81% in
urban areas
• 37% to 62%
in rural areas
WATER INFRASTRUCTURE AND THREATS
TO WATER QUALITY
WATER DISTRIBUTION SYSTEM
http://www.pacificwater.org
HOW WATER CAN GET CONTAMINATED
MORE THREATS TO WATER QUALITY
• Sanitation/Septic • Storm water runoff

Systems • Sedimentation
• Pet Waste
• Chemical use
• Fertilizer
• Leaking
• Pesticide application underground
• Livestock and poultry storage tank
waste
• Aboveground
• Sewer overflow storage tanks
• Eutrophication • Leaks in water
distribution lines
WATERBORNE DISEASE
WATER-RELATED DISEASES
• Waterborne diseases are caused by drinking water
contaminated by infectious viruses or bacteria that originate
from human or animal waste. These include cholera,
dysentery, and typhoid.
• Water-washed diseases, such as skin and eye infections
including scabies and trachoma, are caused by lack of clean
water for washing.
• Water-based diseases are spread by parasites that can persist
in water. They are spread by consumption of, or contact with
contaminated water (e.g., schistosomiasis), or by eating
insufficiently cooked fish.
• Water-related insect vectors (e.g., mosquitoes) that breed in
or near water and spread diseases, including dengue and
malaria.
•
PATHOGENS INCLUDE:
• Bacteria – Salmonella, Shigella, E. coli, Vibrio

cholerae, Clostridium botulinum
• Parasites – Trichinella spiralis, Cyclospora, Giardia
lamblia
• Virus – Hepatitis A, Rotavirus, Norovirus
• Toxic plants and animals
• Chemicals
TYPES OF WATERBORNE DISEASES
Type Transmission route Diseases
Waterborne – Drinking water Cholera, giardiasis,
fecal-oral containing viruses or salmonellosis, typhoid, E. coli,
bacteria from human shigellosis, cryptosporidium,
and animal waste poliomyelitis
Water Caused by lack of Scabies, trachoma, lice
washed water for washing
Water-based Organisms that Schistosomiasis, dracunculiasis,
develop in water and leptospirosis
become parasites or
that live in water
(bathing, washing,
swimming)
Water- Insects breed or need Malaria, yellow fever, dengue
related insect water fever, filiariasis
vector
PUBLIC HEALTH ISSUES OF WATER
AND SANITATION
IN CLASS EXERCISE – OPTION 1
• Take 10 minutes and using the internet

determine what is the burden of disease
associated with water-borne disease occur
in your area
• http://
apps.who.int/gho/data/node.main.168?lang=en
• What are some of the important water-

borne diseases (check Promed-mail, the
country’s epidemiological website)?
IN-CLASS EXERCISE – OPTION 2
• Divide into two groups

• Pick a waterborne disease fact sheet
• Become familiar with how the pathogen is
transmitted
• How does your government regulate the
transmission pathways?
Pathogens
• Cholera - http://www.cdc.gov/cholera/index.html
• Leptospirosis - http://www.cdc.gov/leptospirosis/
ANSWER THE FOLLOWING QUESTIONS:
• What regulatory control measures are there for the pathogen

where it naturally resides?
• Are there control measures to prevent the pathogen from
entering water bodies or the food supply chain?
• Are there measures to effectively prevent the pathogens
transmission if it enters the food supply chain?
• Are there measures to prevent transmission of the pathogen
in the water supply?
• Are there measures to prevent the pathogen from infecting
when you go out to eat?
• What happens if there is an outbreak?
Monitoring and Surveillance: Basic
Epidemiological Terms and Disease Investigation
DEFINITIONS
• Epidemiology – Study of how disease is

distributed in populations, and the factors
that influence or determine this distribution
• Endemic – habitual presence of a disease
within a given geographic area
• Epidemic – the occurrence in a community
or region of illness of similar nature, clearly
in excess of normal expected rate, and
derived from a common or from a
propagated source
OUTBREAK DEFINITION
The occurrence of cases of disease in excess of what

would normally be expected in a defined community,
geographical area or season. An outbreak may occur in
a restricted geographical area, or may extend over
several countries; duration may be days, weeks, or for
several years.
A single case of a communicable disease long absent

from a population, or caused by an agent (e.g.
bacterium or virus) not previously recognized in that
community or area, or the emergence of a previously
unknown disease, may also constitute an outbreak and
should be reported and investigated.
CYCLOSPORA OUTBREAK, USA 2013
CYCLOSPORA OUTBREAK, USA 2013
Number of Number of
Number of
Week of Cases in: Cases
Cases
Illness Onset IA and NE in Other
in TX
(states) States
6/1/2013 - 1 4
6/8/2013 8 1 5
6/15/2013 13 9 3
6/22/2013 140 18 15
6/29/2013 42 9 37
7/6/2013 10 29 71
7/13/2013 7 16 45
7/20/2013 2 14 44
7/27/2013 1 8 25
8/3/2013 - 1 11
8/10/2013 - 2 -
8/17/2013 - - -
8/24/2013 - - -
8/31/2013 - - -
DEFINITIONS
• Incidence – the number of new cases of a

disease that occur during a specific period
of time in a population at risk for
developing the disease
• Prevalence – the number of affected
persons present in the population at a
specific time divided by the number of
persons in the population at that time
DEFINITIONS
• Morbidity – the relative incidence of a

particular disease (illness) in an area
• Mortality – the incidence of deaths in a

population
• case fatality rate: number of people dying during
a specified period of type after the onset of
disease (numerator) divided by the number of
people with the disease (denominator)
DEFINITIONS
• Passive Surveillance – routine reporting of

cases of disease
• Notifiable diseases – Every country has a list
of diseases that must be reported to health
departments
• Active Surveillance – proactively seeking
out cases of specific disease in an area – it
could be through door to door surveys or by
contacting health care providers or health
facilities
THE CONTAGIOUS CLASSROOM
Monitoring and Surveillance:
Global and Local Surveillance
MONITORING AND SURVEILLANCE
• To be completed by facilitator – what are

the mechanisms for monitoring and
surveillance in their country – who is doing
and how effective is it?
GLOBAL MONITORING AND
DISEASE SURVEILLANCE
• WHO – Global Health Observatory: http
://www.who.int/gho/publications/world_health_statistics
/2013/en
/
• Morbidity and Mortality Weekly Report (MMWR): http
://www.cdc.gov/mmwr/
• Promed: http://www.promedmail.org/
• Health Map: http://healthmap.org/en/
• Global alert and response: http://www.who.int/csr/en/
• Google flu -
http://www.google.org/flutrends/about/how.html
• Mekong Basin Disease Surveillance: http://
www.mbdsoffice.com/index_vn.php
HOMEWORK EXERCISE
• Describe what the website does
• Find out what is the source of the information
that they are using
• Do you think that it would be reliable in
determining if there was an outbreak?
• When would use the website?
• Find a resource so that you monitor what is
going on in an area that you care about
• Can you find incidence and prevalence data for
your area?
REFERENCES
• CDC 2013. Parasites – Cyclosoiriasis (Cyclospora Infection)

2013 Outbreak. Accessed from http
://www.cdc.gov/parasites/cyclosporiasis/
• CDC 2013. Parasites – Cyclosoiriasis (Cyclospora Infection)

Investigation of an Outbreak of Cyclosporiasis in the
United States. Last Updated September 24, 2013 10 AM
EDT. Accessed from http://
www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigat
ion-2013.html
• CDC 2013. Investigation of an Outbreak of Cyclosporiasis in
the United States Epi Curve Last Updated September 24,
2013 10:00 AM EDT Previous Epi Curves by Month Current
Epi Curves Accessed from http://
www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigat
ion-2013-epicurve.html
Monitoring and Surveillance:
Local and Global Surveillance
GLOBAL MONITORING AND
DISEASE SURVEILLANCE
• WHO – Global Health Observatory: http
://www.who.int/gho/publications/world_health_statistics/2013/
en
/
• Morbidity and Mortality Weekly Report (MMWR): http
://www.cdc.gov/mmwr/
• Promed: http://www.promedmail.org/
• Health Map: http://healthmap.org/en/
• Global alert and response: http://www.who.int/csr/en/
• Google flu - http://www.google.org/flutrends/about/how.html
• Mekong Basin Disease Surveillance: http://
www.mbdsoffice.com/index_vn.php
ASSIGNMENT
Using the ProMed report, summarize the

events associated with the Nipah outbreak in
Malaysia from November 1998 to 1999 using
a One Health Approach
Note: You will need to collaborate as a class…divide into

four groups and each group should study the data for a
three month period. Then regroup and compare the data
and create a class summary.
ASSIGNMENT
Month What is What is Are What is What is going right?
happening happening environmenta going Why?
with with Human l factors wrong?
Animal health and being Why?
Health and who are the considered? If
who are stakeholders? yes, how so
the
stakeholde
rs
November
1998
December
1998
January 1999
February 1999
March 1999
April 1999
May 1999
June 1999
July 1999
August 1999
September
1999
Community Health
ASSIGNMENT
Perform an assessment of your campus’

community health from a One Health
perspective by answering the following
questions:
• What is the relationship of the on-campus
community with the environment?
• What is the relationship of the on-campus
community with wildlife and domestic animals?
NUISANCE ANIMAL CONTROL/MANAGEMENT Yes N N/A Notes
– Rodents and other “pest” wildlife can o
carry zoonotic disease and are attracted
food storage, agriculture, and waste areas.
1. Do on-site features exist that could attract
wildlife (food storage, food waste storage,
waste accumulation, open water sources,
agricultural production – grain or fruit
production, livestock, pets)?
1. Are pest control/management measures in
place to minimize interaction with wildlife or
to prevent wildlife from accessing the
facilities?
a. Do they address: Create
an
assessment checklist.
o Food storage protection
provisions
o Food waste storage and See
your
student
guide for an example.
disposal
o Housing protection
o Safe removal of animal
droppings and nests
o Controls at disposal areas
o Food crop protection
o Livestock protection
1. Are specific measures in place to address
the following species:
o Rodents
o Bats
o Non-human primates
o Other species of concern
WHAT DO YOU THINK?
• Share and compare your observations.

• As a class, come to agreement on the three
top issues that the campus needs to
address to become more “One Healthy”
• What would be your recommendations to
address these issues?
Policies and Programs
HOMEWORK
POLICIES AND PROGRAMS
• Identify the different governmental
organizations in your country that have policies
on one of the following topics.
• Water consumption/use
• Grains/Fruits/vegetables
• Cows/pig/poultry
• Cat/dogs/exotic animals
• Bats/primates
• Rodents
• Provide an example of a program and policy for
each category
PUBLIC HEALTH POLICIES AND PROGRAMS
Resource Topic Ministry Policy Implementin Program Stakeholde

g Agency rs
Water
Sanitation
Fruits and
Vegetables

Cows and Pigs

Cats and Dogs
Rodents
Bats
Taking a One Health Approach to
Public Health Policies and Programs
POLICIES AND PROGRAMS
CLASS PRESENTATIONS (CONTINUED)
For each public health policy presented:
• Did the policy makers use One Health (OH)
approaches?
• Which policies used a OH approach?
• Which policies did not use a OH approach?
• Is a OH approach appropriate for updating this

policy?
• If a OH approach has not been used to date, think of
why it has not?
• What are the potential obstacles to using a OH
approach for this policy?
PUBLIC HEALTH POLICIES AND PROGRAMS
Resource Topic Ministry Policy Implementin Program Stakeholde

g Agency rs
Water
Sanitation
Fruits and
Vegetables

Cows and Pigs

Cats and Dogs
Rodents
Bats
HOMEWORK ASSIGNMENT
Select an existing public health program or a public

health issue or concern you feel would benefit from
One Health approach and write a paper describing:
• An existing program that would benefit from a One
Health approach, including who implements and who
are the recipients of the program
• The success and failures of the current program
• Gaps in coverage of the program
• How this program could be improved using a One
Health approach and how could that be realized.

Systems Thinking: Building Stakeholder
Consensus Using a One Health Approach to a
Public Health Issue
USING SYSTEMS THINKING FOR
BAT CONSERVATION/MANAGEMENT/CONTROL
Stakeholder Groups:
• Environmental NGOs -Bat Conservation International,
World Wildlife Fund
• Ministry of Health
• Ministry of Commerce and Tourism
• Ministry of Agriculture/ Fruit Crop Growers
• Ministry of Natural Resources
• Indigenous Population/Guano harvesters
• University Department of Wildlife/National research
center
• Others
Scenario:
Atangua is an island nation that is located 20 miles offshore of
Mathaindoviet. It is known for its natural beauty because it is covered with
rainforests and encircled by mangroves. It has several indigenous groups
that subsist on forest and sea products. There are two urban centers that
are growing. Industries on the island include tourism, fisheries, flower
production, mango production, and guano mining. A developer is proposing
to build a high-end luxury resort within the rainforest.
Recently, as a result of fires in the tropical rainforest, some bats have
begun to eat mangos in the mango orchards. Angry farmers have begun
shooting at the bats to discourage them from eating the mangos. Bats are
protected species and only indigenous populations are allowed to hunt
them for rituals and for eating. Bats play an important role in pollinating
and seed dispersal for rainforest trees.
Among the indigenous population, fruit bats are considered sacred.

They also harvest guano as a source of income.
An outbreak of Nipah has occurred on the mainland among people
who harvest date palms sap. Date palm sap is consumed widely
among the population of Atangua.
The tourism bureau of the country is afraid that the fear of Nipah
will discourage tourists from coming to the island. The resort
developer is threatening to not build the resort unless bats are
removed from a 10 square mile radius from the resort area.
The Governor has assembled a group of committee to address the
bat conservation management issue with the mandate that by the
end of the session they must have a framework for the bat policy.
ASSIGNMENT
Prepare for the simulation by thinking about:

• What is your position?
• What would you like done in an ideal world?
• Where are you willing to compromise?
• What issues will you not compromise on?
• What suggestions do you have for a public
health policy?
Creating a framework
for a bat policy.
WHAT DO YOU THINK?
• What happened during the meeting?

• What was the result?
• Are you satisfied with the outcome?
• If “YES” why? it “NO”, why not?
• Were you able to successfully reach
consensus and create a One Health policy?
• What do you feel are the strengths of the policy?
• What are areas you feel still need to be
strengthened?
Module Review
M A N A G E M E N T, O N E H E A LT H C O U R S E
ONE THING…
• That you liked/believed was a

strength of the module
• That you would suggest be changed
Thank you.
This publication was made possible in part through the support provided by
the United States Agency for International Development. The opinions
expressed herein are those of the author(s) and do not necessarily reflect the
views of the US Agency for International Development or the US Government.
USAID reserves a royalty-free nonexclusive and irrevocable right to
reproduce, publish, or otherwise use, and to authorize others to use the work
for Government purposes.
Source: ian.umces.edu
E C O S Y S T E M H E A LT H , O N E H E A LT H
COURSE
MODULE COMPETENCIES
• Competency #1
• Understand ecological/ecosystem principles
• Competency #2
• Understand that the interrelationships between
ecosystems, animal health, and human health
• Competency #3
• Analyze the far reaching affects direct impacts on
the environment have.
MODULE OVERVIEW
Time Topic
60 minutes Introduction to Ecosystem Health
60 minutes Abiotic Cycles – Overview & Specifics of Water, Carbon &
Nitrogen
60 minutes Biotic Cycles Food Web and Southeast Asian Ecosystems
90 -110 Ecosystems of Southeast Asia: Values and Services
Minutes
80 Minutes Factors that Disrupt Ecosystems : Natural and Man Made
60 minutes Effect of Disruption of Ecosystems and the Impacts on

Human and Animal Health
60 minutes Climate Change, Ecosystems, Human and Animal Health
60 minutes Gold Mining Simulation
60 minutes Learning Reflections, Evaluation and Optional Exam

Introduction to Ecosystem Health
E C O S Y S T E M H E A LT H , O N E H E A LT H C O U R S E
AN ECOSYSTEM IS…
…“a community of living organisms (plants,

animals and microbes) in conjunction with the
nonliving components of their environment (things
like air, water and mineral soil), interacting as a
system. These biotic and abiotic components are
regarded as linked together through nutrient cycles
and energy flows.”
Wikipedia(http://en.wikipedia.org/wiki/Ecosystem)
A HEALTHY ECOSYSTEM IS…
…stable and sustainable, maintaining its

character in composition, organization and
function over time, and its resilience to
stress
WHAT DO YOU THINK
• What do you think a healthy ecosystem

looks like?
• What are some examples from the article
of things that can affect ecosystem
health?
BIODIVERSITY IS THE DIVERSITY OF LIFE
As defined in the proposed US Congressional

Biodiversity Act, HR1268 (1990):
"biological diversity means the full range of variety

and variability within and among living organisms
and the ecological complexes in which they occur,
and encompasses ecosystem or community
diversity, species diversity, and genetic diversity.“
D.B. Jensen, M. Torn, and J. Harte,
"In Our Own Hands: A Strategy for Conserving
Biological Diversity in California," 1990
There is much more
to biodiversity than
the numbers of
species and kinds of
ecosystems.
Source: sph.umn.edu
PRIMARY ATTRIBUTES OF
AN ECOSYSTEM
Ecologist Jerry Franklin portrays

ecosystems as having three primary
attributes:
 Components
 Structure
 Function
ECOSYSTEM COMPONENTS…
…the inhabiting species in all their variety

and richness. Many different species, gene-
pool abundance, and unique populations are
what most people think of when they hear
the term "biodiversity". But there is much
more to consider.
ECOSYSTEM STRUCTURE …
…refers to the physical patterns of life forms from the

individual physiognomy of a thick-barked Douglas-fir
to the vertical layers of vegetation from delicate
herbs to tree canopies within a single forest stand. An
ecosystem dominated by old, tall trees has a different
structure than one comprised of short, quaking aspen.
And there is more structure in a multilayered forest
(herbs, shrubs, young trees, canopy trees) than in a
single sagebrush grassland, prairie, or salt marsh.
ECOSYSTEM FUNCTIONS…
…are hard to see in action. "You can't hug a biogeochemical
cycle," says one ecologist. But without the part of the carbon
cycle where small invertebrates, fungi, and microorganisms
work to break down wood fiber, the downed logs in an ancient
forest would never decay. Natural disturbances also play a
role. Wildfires release nutrients to the soil, weed out weak
trees, and reset the successional clock. The energy of falling
water creates spawning beds for salmon even while it carves a
mountain's bones. Plants breathe oxygen into the atmosphere.
Ecological processes create landscapes and diverse
environmental conditions out of life itself.
Edward Grumbine, "Ghost Bears: Exploring the Biodiversity Crisis," 1993
ECOSYSTEM FUNCTIONS (CONTINUED)
Ecosystem components, structures, and functions

are all interdependent. To understand biodiversity,
one has to think like a mountain and consider not
only the biotic elements of plants, animals, and
other living beings, but also the patterns and
processes that shape volcanoes and forests.“
Edward Grumbine, "Ghost Bears: Exploring the Biodiversity Crisis," 1993

Understanding Ecosystem
Health needs a trans-
disciplinary approach. It
bridges the natural, social and
health sciences. It recognizes
that ecosystems must be used
sustainably to maintain human
and animal health.
It can incorporate human
values and perceptions that
are important in the
management of the
environment and disease.
ONE HEALTH
Env
ir o nm
Anim nts e
al Human
s
Human
Ecosystem Health System Animal Health
Plant Livesto
Economi Individual Wildlife
Healt ck
c Health Health Health
h Health
Figure 1. A system model of land use change that affects public health.This model
shows relationships between drivers of land use and subsequent levels of
environmental change and health consequences. Various level investigation are
evident and range from specific risks factors and determinants of population
vulnerability to larger institutional and economic activity
Figure 1. A system model of land use change that affects public health.This model
shows relationships between drivers of land use and subsequent levels of
environmental change and health consequences. Various level investigation are
evident and range from specific risks factors and determinants of population
vulnerability to larger institutional and economic activity
WHAT DO YOU THINK
In pairs:
• List the ecosystems that surround the

university.
• How do you derive benefits from these
ecosystems?
• How does your health depend on ecosystems?
HOMEWORK
Introduction to Abiotic Cycles
Water Carbon
Nitrogen
As homework, develop a 10 minute presentation to
describe your assigned cycle to your fellow students. It
can be presented in the form of a video, a PowerPoint
Presentation, a play, a photo essay, etc. Get creative
and have fun!
REFERENCES
• California Biodiversity Council. 2008. Scientific Definitions of

Biodiversity. California Biodiversity Council. Accessed from http://
biodiversity.ca.gov/Biodiversity/biodiv_def2.html
• Patz, J.A., P. Daszak, G. M. Tabor, A. A. Aguirre, M. Pearl, J. Epstein,

N. D. Wolfe, A. M. Kilpatrick, J. Foufopoulos, D. Molyneux, D. J.
Bradley, and Members of the Working Group on Land Use Change
Disease Emergence. 2004. Unhealthy Landscapes: Policy
Recommendations on Land Use Change and Infectious Disease
Emergence. Environ Health Perspect. 2004 July; 112(10): 1092–
1098. Published online 2004 April 22. doi: 10.1289/ehp.6877
• Rapport, D.J., R. Constanza, and A.J. McMichael. 1998. Assessing

ecosystem health. TREE v. 14 n. 10 October 1998. Accessed from
http://
www.uvm.edu/rsenr/nr385fun/reading/AssessEcosysHealth.pdf
Abiotic Cycles
Water, Carbon & Nitrogen
THE CONCEPT OF ECOSYSTEMS
• Ecology
• Individuals
• Populations
• Communities
• Ecosystem
• Abiotic components
• Biotic components
• Ecosystem Ecology
• Functional aspects Source: tx.english-ch.com/teacher/owen/level-
c/amazing-icebergs-and-their-role-in-the-
ecosystem/
ENERGY AND BIOGEOCHEMICAL
CYCLING
Main processes of ecosystem ecology

• Energy transformations
• Photosynthesis + respiration  heat energy
• Biogeochemical cycling or abiotic cycles

• Water
• Carbon
• Nitrogen
http://pmm.nasa.gov/education/sites/default/files/article_images/Water-Cycle-Art2A.png
WATER CYCLE
http://science.nasa.gov/media/medialibrary/2010/03/31/water_cycle.jpg
WATER CYCLE DISCUSSION POINTS
• Why is the water cycle important?

• What disrupts the water cycle?
• How do impacts to the water cycle affect human
health?
ADDITIONAL TERMS
• Aquifer • Sediment
• Delta • Spring
• Deposition • Surface water
• Erosion • Water molecule
• Groundwater • Watershed
• Glacier • Water vapor
CARBON CYCLE
http://www.esrl.noaa.gov/gmd/outreach/carbon_toolkit/basics.html
CARBON CYCLE
DISCUSSION POINTS
• Carbon pools and fluxes
• What are some examples of pools and fluxes?
• What are sources and sinks?
• What are some examples of carbon
containing substances and their global
locations?
• What happens if the normal movement of
carbon through the carbon cycle is disrupted?
ALL ABOUT CARBON DIOXIDE
http://swroc.cfans.umn.edu/ResearchandOutreach/SoilManagement/SoilResearch/NitrogenCycle/index.htm
NITROGEN CYCLE DISCUSSION POINTS
• Why is the nitrogen cycle important?

• What human activities have disrupted the
nitrogen cycle? How have they affected humans?
• Identify other gases besides N2 that can be
produced during denitrification. What human
activities facilitate the production of these gases?
Biotic Cycles, Food Web and
Southeast Asian Ecosystems
ECOSYSTEM COMPONENTS
Abiotic Biotic
• Sunlight • Primary producers
• Temperature • Herbivores
• Precipitation • Carnivores
• Soil cycles • Omnivores
• Nutrient cycles • Detritivores
University of Michigan 2008. The Concept of the Ecosystem. Accessed from

http://www.globalchange.umich.edu/globalchange1/current/lectures/kling/ecosystem/eco
system.html
Energy Cycle
University of Michigan 2008. The Concept of the Ecosystem. Accessed from
http://www.globalchange.umich.edu/globalchange1/current/lectures/kling/ec
osystem/ecosystem.html
PHOTOSYNTHESIS
6CO2 + 6H2O (+ light energy) C6H12O6 + 6O2
Sabali Communications 2013. About the MCAT - MCAT Biology - Cellular Respiration – Photosynthesis.
Accessed from http://www.aboutthemcat.com/biology/cellular-respiration.php
Tropic Levels, Food Chains and
Food Webs
• First Trophic Level or
Producers: Organisms that have a
capability to convert energy from sun
to chemical energy (photosyntesis),
ex. Plant (corn, rice, grass, etc.),
Phytoplankton, and seaweed.
• Second Trophic Level: Primary
consumer or herbivora
• 3rd Trophic Level: Secondary
consumer or carnivora
• Higher Trophic Level: Humans
or Omnivora. Tertiary consumers can
occupy any tropic level, except as
producers.
• Decomposers: Detritivores,
scavengers
trophic level: energy transfer through an ecosystem. [Art]. In Britannica
Online for Kids. Retrieved from http://kids.britannica.com/comptons/art-90132
MARINE TROPHIC LEVEL PYRAMID
University of Waikato. 2007-2009. Marine Trophic Pyramid. Accessed from

http://www.sciencelearn.org.nz/Contexts/Toxins/Sci-Media/Images/Marine-trophic-pyramid
Encyclopedia Brittanica 2013.http://www.britannica.com/EBchecked/topic/212636/food-
chain
Tundra Food Web
http://cougarbiology.pbworks.com/w/page/901628
8/Tundra%20Group%20B
Ecosystems of Southeast Asia
Values and Services
MANGROVES
ECOSYSTEM HEALTH, ONE HEALTH COURSE
Rekacewicz, P. 2012. Distribution of coral, mangrove, and seagrass diversity. Access
from http://www.grida.no/graphicslib/detail/distribution-of-coral-mangrove-and-
seagrass-diversity_30dc
MANGROVES
http://en.wikipedia.org/wiki/File:Mangroves.jpg
MANGROVE ANIMALS
• Habitats for terrestrial and marine animals- tree
canopy, water-filled holes in trees, soil surface, soil,
permanent and temporary pools
• Terrestrial invertebrates – insects, spiders
• Birds, reptiles, and mammals –
• Fish-eating birds, flycatchers, honey-eaters, warblers
• Saltwater crocodiles, snakes, monitor lizards
• Flying foxes, monkeys, rats
• Sediment fauna – hermit, mud, and fiddler crabs;
mud lobster
Osbourne, P.L. 2000. Tropical Ecosystems and Ecological Concepts.
Cambridge University Press. Cambridge.
Mangrove Ecosystem Food
Web
FAO 2005. Mangrove Management. http://www.fao.org/forestry/mangrove/3648/en/

VIDEO - MANGROVES
Clip 1
TROPICAL RAINFORESTS
TROPICAL RAINFORESTS OF THE WORLD
National Geographic 2013. Tropical Rain Forest Map. Accessed from

http://environment.nationalgeographic.com/environment/habitats/rainforest-map/#close-modal
• Lowland tropical rainforests – world’s

most species rich communities
• Home to 90% of the world’s insects
• Number of species of trees is large with no
single species dominating
• Trees in rainforest have similar structure and
appearance throughout the world
• Forests of Southeast Asia and the Pacific
Islands – 30% of the world’s tropical forest
http://www.blueplanetbiomes.org/rainforest.htm
CHARACTERISTICS
• Climate
• >2000 mm rain annually
• Average humidity 80%
• Very short or no dry season
• Mean monthly temperatures – approximately 25 oC rarely
>35oC
• At the canopy – more temperature and humidity

(60 to 100%) variation
• Characteristics of canopy very different that life
under the canopy
• Very little changes in temperature – daily and seasonally,
always humid – 80%
VEGETATION STRUCTURE
Osbourne, P.L. 2000. Tropical Ecosystems and Ecological Concepts. Cambridge

University Press. Cambridge.
http://www.travelblog.org/Photos/5935372.
http://kikirikipics.com/rainforests-in-the-world.
http://www.rainforestoutdoor.com/p/rainforest.html’
http://www.orangutan.org/rainforest/tanjung-puting-national-park.
http://www.isan.clubs.chula.ac.th/insect_sara/index.php?transaction=insect_1.php&id_m=24780
http://www.saisawankhayanying.com/s-featured/hornbill/
RAINFOREST ANIMALS
Osbourne, P.L. 2000. Tropical Ecosystems and

Ecological Concepts. Cambridge University Press.
Cambridge.
http://www.calacademy.org/blogs/rainforest/
http://www.nature.com/emboj/journal/v22/n3/about_cover.html
http://simple.wikipedia.org/wiki/Huntsman_spider
VIDEO – RAINFOREST:
BENEATH THE CANOPY
CORAL REEFS
(http://www.marine.sc.chula.ac.th/admin/editor/file_uploads/file
s/reefbio/aboutus.html)
CORAL REEFS
• Complex biological structures
• Corals
• Composed of organisms called polyps (2 cells thick, secrete
calcium carbonate skeleton)
• Can live for centuries
• Found in deep sea, temperate and tropical areas
• Reefs only in areas where water do not fall below 18oC, clean-
clear water, moderately high salinity, and sunlight
• Live symbiotically with photosynthetic algae – essential for the
survival of the reef and provide much of the color of the reef –
algae receive nutrients form coral waste, coral receives oxygen
from algae
• Filter feeders – feed on small fish and zooplankton
Osbourne, P.L. 2000. Tropical Ecosystems and Ecological
Concepts. Cambridge University Press. Cambridge.
CORAL REEF FOOD WEB - ALGAE
• Algae
• Different than other marine algae
• Contain calcite crystals embedded in their cells
• Crystals protect from wave action and plays a role in the
formation of reefs
• Colonize areas exposed to storms
• Fish, urchins, molluscs, crustaceans – consume algae,
without these herbivores corals can be overrun with
algae

CORAL REEFS
Three types of reefs:
• Fringing
• Barrier
• Atolls

Osbourne, P.L. 2000. Tropical Ecosystems and
Ecological Concepts. Cambridge University Press.
Cambridg
THE BOUNTY OF CORAL REEFS
NEXT STEPS
ECOSYSTEM SERVICES
• Fresh water
• Food
• Timber, fiber, fuel
• Biological products
• Regulation of infectious disease
• Nutrient and waste management, processing and
detoxification
• Climate regulation
ECOSYSTEM VALUES
• Aesthetic appreciation
• Tourism
• Recreation
• Education
• Motivation
• Genetic resources
• Cultural and spirituality
ECOSYSTEMS
Identify 5 ecosystem services from:

• Mangroves
• Rain Forests
• Coral Reefs
HOMEWORK
• Divide into three groups and select an ecosystem
Tropical Rainforest Mangrove Coral Reef
Each group will give a
• Group must become experts on 5 minute presentation
on the food web
 Nutrient cycle ecosystem for your
 Food web country. Get creative!
 Status in your country (positive and negative)
 Threats to the ecosystem
 Services provide that ecosystem
 Things that disrupt the ecosystem
 How that ecosystem affects animal and human health
RESOURCES - MANGROVES
• http://www.fao.org/docrep/field/003/ab751e/AB751E01.htm#tbl6
• http://www.sciencedirect.com/science/article/pii/B9780123847195002471
• http://www.sciencedirect.com/science/article/pii/S2212041612000046
• http://www.wri.org/stories/2008/09/natural-coastline-defense-mangrove-
forests-southeast-asia
• http://www.teebweb.org/wp-content/uploads/2013/02/FLYER-ASEAN-TEEB-
Side-Event-v01-Oct-12.pdf
• http://www.slideshare.net/WetlandsInternational/status-of-mangrove-in-
south-east-asia-the-issues-and-opportunities-for-rehabilitation
• http://www.sciencedirect.com/science/article/pii/B9780123747112006069
• http://ocw.unu.edu/international-network-on-water-environment-and-
health/unu-inweh-course-1-mangroves/Importance-of-mangroves.pdf
RESOURCES –
• http://www.blueplanetbiomes.org/se_asian_rnfrst.htm
• http://learnline.cdu.edu.au/units/sbi507/introduction/ecosystems.h
tml
• http://learnline.cdu.edu.au/units/sbi507/module3/fundamentals.ht
ml
• The Forests of Southeast Asia in Vital Forest. Accessed from

http://www.unep.org/vitalforest/Report/VFG-15-The-forests-of-
southeast-asia.pdf
• http://rainforestsasia.blogspot.com/2011/11/human-impacts-on-
southeast-asian.html
RESOURCES – CORAL REEFS
• http://www.wri.org/publication/content/8246
• http://eascongress.pemsea.org/sites/default/files/document-
files/presentation-st12-chou.pdf
• http://sanctuaries.noaa.gov/about/ecosystems/coralwelcome.html
• http://www.coris.noaa.gov/about/what_are/
• http://reefrelief.org/learn/coral-reef-ecosystem/
• http://pdf.wri.org/rrseasia_full.pdfhttps://sites.google.com/site/coralreefsy
stems/videos/short-movies/reef-dynamics
• http://www.pnas.org/content/103/22/8425.abstract
• http://rspb.royalsocietypublishing.org/content/279/1744/3899.full
• http://www.sciencedirect.com/science/article/pii/S0169534700019480
• http://reefkeeping.com/issues/2006-08/cj/index.php
Factors that Disrupt Ecosystems
Natural And Man Made
ECOSYSTEM DISRUPTION
1. How does the movie Avatar portray ecosystems and

factors that disrupt ecosystems?
2. What ecosystems have you experienced and what are the
factors that can cause those to change?
3. What is biodiversity
4. Why is biodiversity important?
5. What would happen if we logged all the forests of (insert
country name)?
6. Why do we need natural areas?
7. We all know that it would be bad to remove all the forests,
but what are the reasons why?
8. How would human health be affected?
BIODIVERSITY
Biodiversity – the diversity in living things in

an ecosystem.
• Increased biodiversity increases the stability of an
ecosystem.
• Increased biodiversity increases the chance that at
least some living things will survive in the face of
large changes in the environment.
DIRECT EFFECTS ON ECOSYSTEMS
 Changes in local land  Modification of rivers
use and cover  Water withdrawal/dams
 Changes in climate  Pollution
 Species introduction,  Habitat loss/degradation/
invasion, or removal fragmentation
 Over fishing  Over hunting
 Nutrient loading from  Forest Fires
activities such as
fertilizer, pest control,  Tsunamis
irrigation
Eutrophication in Haze in Singapore –
Ping River at a haze generated
waste water from forest fires
outlet in Chiang
http://nongkhainewsonline.blogspot.com/2011/06/blog-post_8664.html
Mai, Thailand
http://www.rid-1.com/webboard/board_view.php?forum_id=18
Overfishing.
Deforestation in
Thailand
INDIRECT EFFECTS
• Indirect drivers to change in ecosystems include:

• Population growth
• Economic (e.g., globalization, trade, market and policy
framework)
• Sociopolitical (e.g., governance, institutional and legal
framework)
• Science and technology
• Cultural and religious (e.g., beliefs, consumption)
What are some examples?

Human Economic Activities and Impacts on Ecosystems
Habitat Over- Pollution Introduction Climate
Alteratio harvestin of Exotic Change
n g Species
Agriculture X X X X
Forestry X X X
Fishing X X X
Urbanization X X X
Manufacturing X X X
PALM OIL PLANTATIONS
Aerial view of oil palm developments in Kutai, East Kalimantan,

Indonesia. (Photo:Douglas Sheil) Source: Sheil, D. et al. 2009. The
impacts and opportunities of oil palm in Southeast Asia: What do we
know and what do we need to know? CIFOR. Indonesia .
Critical Drivers Affecting Changes to Human Health
Patz et al. 2004. Unhealthy Landscapes: Policy

Recommendations on Land Use Change and Infectious
Disease Emergence. Environmental Health Perspectives:
VOLUME112 NUMBER10 | July 2004
HOW DO IMPACTS TO ECOSYSTEMS
AFFECT PUBLIC HEALTH?
Two examples:
Sunlight,
Pooled
Mosquito
Deforestat Water, Malaria
Breeding
ion Temperatu Outbreaks
Habitat
re
Increase
IN-CLASS GAME
• Divide into your ecosystem teams.

• From your homework, readings and the internet
develop a list of the factors that are disrupting
your ecosystem.
• The rest of the class will evaluate your list to
determine if anything is missing
• Points will be given for each factor identified. The
other teams will get a point for any factor
identified that is missing from an ecosystem
team’s list
CLASS DISCUSSION AND PRESENTATIONS FOR NEXT CLASS
• What is the current status of the ecosystem in your

province or country in Southeast Asia? Discuss the
historical changes that have occurred.
• What function(s) does your ecosystem serve that
affect(s) animal and human health?
• What are the factors disrupting your ecosystem?
What functions are being disrupted and how do
they affect health locally, regionally, nationally?
• What actions should be taken to address the health
consequences of ecosystem change?
REFERENCES
• McMichael et al. (eds) 2006 Climate change and human health:

risks and responses
• Ostfeld, R. & F. Keesing. 2000a. The function of biodiversity in the
ecology of vector-borne zoonotic diseases. Canadian Journal of
Zoology. 78: 2061–2078.
• Ostfeld, R. & F. Keesing. 2000b. Biodiversity and Disease Risk: the
Case of Lyme Disease. Conservation Biology. 14(3): 722-728.
• Patz et al. 2004. Unhealthy Landscapes: Policy Recommendations
on Land Use Change and Infectious Disease Emergence.
Environmental Health Perspectives: VOLUME112 NUMBER10 | July
2004
• WHO. 2005. Ecosystems and Human Well-Being. Health
Synthesis.
Climate Change, Ecosystems,
Human and Animal Health
OBJECTIVES
By the end of this session, the participants should

be able to:
1. Analyze regional climate changes and their
resulting effects on ecosystem health
2. Analyze regional climate changes and their
resulting effects on human and animal health
REFERENCES
• McMichael et al. (eds) 2006 Climate change and human health:

risks and responses
• Haines et al. 2006. Climate change and human health: impacts,

vulnerability, and mitigation. The Lancet. 367:2101-09.
• WHO, 2003, methods to assess climate change effects on human

health
• WHO, 2003, Climate change and human health, risk and response
INDIVIDUAL EXERCISE
• What is climate? Is it the same as weather?

• What is climate change?
• What is climate variability?
DEFINITIONS
• Climate is the average state of the atmosphere and the

underlying land or water, in a particular region, over a
specific time period.
• Weather is the day-to-day manifestation of climate in a
particular place at a particular time.
• Climate change is a statistically significant variation in
either the mean state of the climate or in its variability,
persisting over an extended period (typically decades or
longer).
• Climate variability refers to variations around the mean
state, including the occurrence of extreme weather events.
CLIMATE CHANGE…
…operates over decades or longer.

Changes in climate occur as a result of
both internal variability within the
climate system and external factors
(both natural and anthropogenic).
McMichael et al. (eds) 2003 Climate change and human health: risks and responses. World Health Organization. Geneva, Switzerland.
WHAT DO YOU THINK?
• Why does climate change occur?

• Which cycles are disrupted in climate
changes?
WHY DOES CLIMATE CHANGE OCCUR?
McMichael et al. (eds) 2003 Climate change and human health: risks
and responses. World Health Organization. Geneva, Switzerland.
GREEN HOUSE EFFECT
WHAT ABIOTIC CYCLE IS DISRUPTED
CO2
SIGNS OF CLIMATE CHANGE
• Historic global warming

• Weather extremes: heat waves, cold
spells, flooding, storms, typhoons,
smog periods
• Sea level increases
20TH CENTURY WARMING
• The global climate has been warming

rapidly since the start of industrialization
• Human activities well explain this change
• According to the Intergovernmental Panel
on Climate Change (IPCC) much of this
trend is likely due to the increase in
carbon emissions resulting from human
activities
McMichael et al. (eds) 2003 Climate change
and responses. World Health Organization.
FIGURE 2.3 Observed and projected atmospheric CO2 concentrations from
1000 to 2100. From ice core data and from direct atmospheric measurement
over the past few decades. Projects of CO2 concentrations for the period
2000-2100 are based on the IS92a scenario (medium), and the highest and
lowest of the range of SRES scenarios. Source: reproduced from reference 11.
McMichael et al. (eds) 2003 Climate change and human health: risks and responses. World Health Organization. Geneva, Switzerland.
CLIMATE CHANGE AND
ECOSYSTEM HEALTH
CLIMATE CHANGE AND ECOSYSTEM
HEALTH
• Break into groups to read a paper on

climate change and ecosystem health
(homework)
• Report in class by group how climate
changes can affect ecosystem health (5
minutes)
CLIMATE CHANGE AND
HUMAN, ANIMAL HEALTH
and responses
MANY INFECTIOUS DISEASES
ARE CLIMATE SENSITIVE:
• Cholera
• Meningococcal meningitis
• Dengue/dengue haemhorrhagic fever
• Chikungunya virus
• African trypanosomiasis
• Yellow fever
• Japanese and St. Louis encephalitis
• Rift Valley fever
• Leishmaniasis
• West Nile virus
• Ross River virus and Murray Valley encephalitis
CLIMATE CHANGES &
ANIMAL HEALTH
Animal health may be affected by CC 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.
Haines et. al 2006. Climate change and human health: Impacts, vulnerability and public health. Public Health:
585 -596. Access from http://www.idpublications.com/journals/PDFs/PUHE/PUHE_MostDown_1.pdf
To address the PH and EH impacts of climate change a
multi-disciplinary team would be needed. . .

Switzerland.
PUBLIC HEALTH ADAPTATION MEASURES
FOR HEALTH IMPACTS OF CLIMATE CHANGE
Health Outcome Public Health Surveillance
Mortality and • Public-health education • Enhance health surveillance of routine
morbidity due to heat • Heat health warnings systems data for early detection of heat wave
waves • Emergence preparedness effects
Floods • Public-health education • Surveillance for flood effects with long-
• Emergency preparedness term follow-up
• Check ist of post-flood activities • Coordinated national surveillance for
flood deaths, injuries and illnesses
Air quality • Warning of high pollution days • Daily air pollution measures
Water-borne diseases • Public education • Monitoring of vectors and reservoir
hosts
• Integrated surveillance for human and
internal disease
Food-borne diseases • Maintenance and strengthening • Integrated surveillance for human and
of food hygiene measures animal diseases
Water-borne diseases • Risk assessment for extreme • Increased microbiological monitoring of
rainfall events public water supplies and private wells,
• Risk assessment of health and enhanced surveillance during and
effects of algal blooms following heavy rainfall events
WHAT DO YOU THINK?
• What adaptation strategies are

applicable in your country?
Gold Mining Simulation
WHAT WILL HAPPEN
AT THE MINE?
WHAT WILL HAPPEN AT THE MINE?
• What types of changes will happen to the

ecosystems?
• Which abiotic cycles will be affected?
• Will the food webs be affected?
• What will be the effects to animal health?
• What will be the effects to human health?
THE FOREST MAY START LIKE THIS
Wikipedia 2013. Rainforest canopy at the Forestry Research Institute Malaysia.

Accessed from http://en.wikipedia.org/wiki/Tropical_rainforest
AND CHANGE TO THIS
Freeport-McMoran Grasberg Mine – World Largest Gold mine in the world

Obel, Mike 2011. 10 Biggest Gold Mines in the World [PHOTOS]. International Business Times.
November 4, 2001. Accessed from http://www.ibtimes.com/10-biggest-gold-mines-world-photos-
553223
WHAT WILL HAPPEN AS A RESULT OF ROAD
CONSTRUCTION AND EXISTENCE OF THE ROAD?
Wikipedia 2013. East Kalimantan. Logging Road.

http://en.wikipedia.org/wiki/File:Logging_road_East_Kalimantan_2005.jpg
WHAT COULD HAPPEN AT THE
PORT SITE?
Wikipedia 2013. Sampit. Acessed from http://en.wikipedia.org/wiki/Sampit

IT COULD CHANGE TO THIS
Balikpapan View Blogspot 2010. Balikpapan Port. Accessed from

http://balikpapanview.blogspot.com/2010/11/oil-refinery-oil-refinery-in-jalan.html
WHAT HAPPENS IN A COMMUNITY?
ARTISANAL GOLD MINERS IN
INDONESIA
Pressly, Linda .2013.How mercury poisons gold miners and enters the food chain - Crossing Continents. BBC Radio 417
September 2013 Last updated at 20:59 ET Accessed from http://www.bbc.co.uk/news/magazine-24127661
Gold miners have driven
orangutans from the area
There will never be

rainforest here again
Pressly, Linda .2013.How mercury poisons gold miners and enters the food chain - Crossing
Continents. BBC Radio 417 September 2013 Last updated at 20:59 ET
Accessed from http://www.bbc.co.uk/news/magazine-24127661
WHY MERCURY IS USED?
• Miners excavate and crush large
quantities of earth or rock,
containing a small quantity of gold
• Mercury is mixed with the slurry and
amalgamates with gold - and the
amalgam sinks to the bottom
• The amalgam is separated out, some
excess mercury is removed, and the
rest is boiled off
• A ton of ore may contain less than an
ounce (28g) of gold
Pressly, Linda. 2013. How mercury poisons gold miners and enters the food chain - Crossing Continents. BBC Radio 417
Cyanide and mercury contaminated waste, next
to working rice paddies on Lombok
Pressly, Linda. 2013. How mercury poisons gold miners and enters the food chain - Crossing Continents. BBC Radio 417
REFERENCES
• McMichael et al. (eds) 2006 Climate change and

human health: risks and responses
• Haines et al. 2006. Climate change and human
health: impacts, vulnerability, and mitigation. The
Lancet. 367:2101-09.
• WHO, 2003, methods to assess climate change effects
on human health
• WHO, 2003, Climate change and human health, risk
and response
Module Review
M A N A G E M E N T , O N E H E A LT H C O U R S E
ONE THING..
• That you liked and felt was a

strength of the module.
• That you would suggest we change
(delete, alter or add)
Thank you.
This publication was made possible in part through the support provided by
the United States Agency for International Development. The opinions
expressed herein are those of the author(s) and do not necessarily reflect the
views of the US Agency for International Development or the US Government.
USAID reserves a royalty-free nonexclusive and irrevocable right to
reproduce, publish, or otherwise use, and to authorize others to use the work
for Government purposes.

IPE4 - Public Health

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P U B L I C H E A LT H , O N E H E A LT H C O U R S E

Public health is the practice of

Integration and animal

• Commitment to provision of safe food

The Ecohealth approach focuses above all on

International Development Research Centre (IDRC)

The One Health Office at CDC* focuses on activities

*CDC: U.S. Centers for Disease Control and Prevention

The concept of One Health has been

One Health Talk

One Health is the collaborative effort of

One Health is the integrative effort of

. . . encourages the collaborative efforts of

• Private & public-

The German physician and statesman Rudolf

William Osler (1849-

(Courtesy of the School of Veterinary Medicine, University of

• Disease described in dogs in 1850

“Illegal gold mining has left at least 2,000

• May 2013 – Middle East Respiratory

• How does taking a One Health approach to

• Be able to define ecosystems and to

Ecosystem Health is a transdisciplinary

An ecosystem is a community of living

Mangroves Coral Reefs

Corvalan, C. et al. 2005. Ecosystems and Human

Chickens and pigs mingling,

By the end of this session, the participant

• Infections which are naturally transmitted

Zoonotic diseases are multifactorial and

• Vector: an organism, often an invertebrate

“An emerging zoonosis is a zoonosis

Transmission of infections may be direct,

• Currently 1461 infectious diseases

Development of more rapid methods of

“DDT banned in the US in

• Genetic drift and shift (influenza)

Historical epidemics involving zoonoses

PANDEMIC Global spread Globalization

• Changing farming practices, trade and

• Increased contact between humans,

• A known agent appearing in a new

• Poverty affected communities

• Human health (death and disability)

• This presentation gives an overview of the

• What did all the diseases have in common?

• From the presentations, what modifications

• Have you ever had food poisoning?

• Foodborne illness - any illness that

(Centers for Disease Control and Prevention)

• Categories of microbial infection

• Foodborne disease outbreaks: Occurrence of 2

Links, J. 2006. Food and Water Borne Disease Lecture.

• Raw vs. finished foods

(Centers for Disease Control and Prevention)

(Centers for Disease Control and Prevention)

• Production – animals and farmers

• Individuals with poor hygiene

All the conditions and measures

Good Distribution Practices GHPs

Good Manufacturing Practices Good Hygienic

Good Catering Practices

• Buildings and facilities