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Emerging Zoonoses and Pathogens of Public Health Concern. World Organization for Animal Health. Volume 23 (2), 2004. pp. 310. ISBN 92 9044 621 8. € 50 (airmail postage is included for all countries).
Published online by Cambridge University Press: 28 June 2005
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- © 2005 Cambridge University Press
Over the last 25 years, dramatic changes have taken place regarding the practice of preventive medicine in order to continue to meet the health needs of an ever-increasing number of consumers. Sanitation is still public health's cornerstone, but vigilance at this level, alone, has not been sufficient enough to prevent the establishment of a number of new microbial pathogens. The reasons for this are multiple, yet remain poorly understood. For example, changes in the patterns of weather, global climate change, and even the severity of a given weather event has led to the establishment or re-emergence of some infections, including the introduction of Dengue Fever into Bangladesh due to an unusual hurricane, a country that can ill afford to harbour yet another devastating infectious agent. Civil unrest and warfare have ushered in or encouraged many others back into prominence, including malaria, cholera, African trypanosomiasis and visceralizing forms of leishmaniasis. While ecological disturbance is the defining feature of our planet and the driving force in evolution, in recent years environmental change has come about at an accelerated rate, aided by human activities, in ways that have so far eluded our understanding of them. In other instances, obvious to every citizen on the planet, even knowing the cause of an outbreak has not reduced the fear factor associated with it (e.g., acts of bio-terrorism – mail laced with the spores of virulent anthrax bacteria).
Unprecedented levels of international travel have occasionally brought rarely occurring microbial infections from afar to crowded urban centres (e.g., Lassa Fever), raising the likelihood that some day in the near future, an outbreak with any of a wide variety of zoonotic viral infections in these new places will surely occur. The introduction and establishment of the West Nile virus in North America is a good example of what can happen under the right set of circumstances. The emergence of West Nile virus in that part of the world had profound ecological consequences for an extensive number of species of wildlife, and, in addition, has caused much human suffering and death. It continues to spread out in the Western hemisphere with unpredictable ramifications for all vertebrate life lying within its path.
This text deals directly with the problems outlined above. Twenty-one papers cover everything from Ebola virus to global strategies for prevention of food-borne pathogens. An excellent overview by C. Brown leads off this volume and sets the stage for the rest of the presentations. He identifies two problems applicable to all infectious agents (1) an ever-increasing human population and (2) globalization of trade. Impacted by these two issues are the uncontrolled movement of a wide variety of animal species, ecological disruption, uncultivatable organisms, and terrorism. A common theme that runs throughout is a deep concern for the process of globalization and the lack of surveillance for most zoonotic infections. All presentations dealing with microbial agents offered excellent summaries of the biology of the disease(s) in question. Some authors went on to attempt to supply explanations for their emergence or resurgence into the human population, and some succeeded admirably, given the limited space. Particularly informative, from an ecology of infectious disease perspective, were the presentations dealing with Rift Valley Fever by G. H. Gerdes, rabies by F. Cliquet and E. Picard-Meyer, and one dealing with a variety of bacterial zoonoses by R. Higgins. This reviewer was disappointed with many other presentations that did not offer even conservative speculation as to the ecological mechanisms at work that might help to maintain specific infections in the environment. Without insight into the ways in which these microbes gain a foothold in the human population, research cannot progress. Hypothesis-driven experimentation is sorely lacking in infectious disease ecology and needs to be encouraged. By refusing to go beyond the data and to suggest new avenues of approach to their biology, many presenters missed a golden opportunity to stimulate the next generation of veterinary and public health researchers into working on these important disease entities. Another area that needs immediate attention, and that was pointed out by many of the authors, is the lack of meaningful communication between veterinarians and physicians. In many instances, the veterinarian is the first to become alerted to the presence of a zoonotic agent in their local environment, but convincing the established health community (public health and physician network) to get involved early on has been a perennial problem that is still in search of a satisfactory solution. Had this problem been solved in the United States in 1999, for instance, the West Nile virus outbreak might have progressed in a much different way from the situation with which we now must deal.