16. UN shall adopt a ‘one health approach’ integrating veterinary medicine and environmental science to mitigate disease emergence and antimicrobial resistance and to ensure the continuation of agriculture and civilization

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Rapporteur: Laura H. Kahn, MD, MPH, MPP; Research Scholar, Princeton University

One Health is the concept that human, animal, environmental/ecosystem, and atmospheric health are linked. It is a relatively new term but an ancient concept intuitively understood by indigenous peoples around the world. The One Health concept provides a useful framework for analyzing and addressing complex, interdisciplinary problems such as foodborne and waterborne illnesses, antimicrobial resistance, food security, and even climate change.

We live in a microbial world. We need to learn how to live better in it. We need to learn how to sustainably co-exist with the microbes living in us, on us, and around us.

For example, over 7 billion humans and almost 30 billion domesticated animals produce trillions of kilograms of fecal matter that contain billions of microbes. Each year, the massive amounts of fecal matter produced could fill an estimated 1.6 million Olympic-sized swimming pools. According to the World Bank(1), over 2 billion people don’t have access to basic sanitation systems, and almost 9 million of them practice open defecation. Open defecation, as the name suggests, means squatting and defecating out in the open. Many developing countries lack basic sanitation systems for human fecal matter, much less for animal fecal matter which makes up 80 percent of the total fecal matter produced.

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Especially during the pandemic crisis, I’ve heard too many platitudinous praises of Canada’s supposed universality of healthcare.
I, one who champions truly comprehensive health-services coverage, had tried accessing, for example, essential therapy coverage in our public system; within, however, there were/are important health treatments that are either universally non-existent or, more likely, universally inaccessible, except to those with relatively high incomes and/or generous employer health insurance coverage.
Furthermore, Canada is the only universal-health-coverage country (theoretically, anyway) that doesn’t also cover medication. The bitter irony is, many low-income outpatients cannot afford to fill their prescriptions and resultantly end up back in the hospital system, thus burdening the system far more than if the outpatients’ generic-brand medication was also covered. This lesson was learned and implemented by enlightened European nations with genuinely universal all-inclusive health care systems that also cover necessary medication.
Why Canada has to date steadfastly refused to similarly do so, I know not.
But I do know that the only two health professions’ appointments for which I’m fully covered by the public health plan are the readily pharmaceutical-prescribing psychiatry and general practitioner health professions. Such non-Big-Pharma-benefiting health specialists as dentists, counsellors, therapists and naturopaths (etcetera) are not covered.

AN OLD TB VACCINE FINDS NEW LIFE IN CORONAVIRUS TRIALS
BY ANTHONY KING, May 4, 2020

Studies are underway to test whether giving a shot of BCG vaccine could protect doctors and nurses against COVID-19.

One of the oldest vaccines could protect us against our newest infectious disease, COVID-19. The vaccine has been given to babies to protect them against tuberculosis for almost a century, but has been shown to shield them from other infections too, prompting scientists to investigate whether it can protect against the coronavirus.

This Bacille Calmette-Guérin (BCG) vaccine, named after two French microbiologists, consists of a live weakened strain of Mycobacterium bovis, a cousin of M. tuberculosis, the bacterium that causes tuberculosis. BCG has been given to more than 4 billion individuals, making it the most widely administered vaccine globally.

Because BCG protects babies against some viral infections in addition to TB, researchers decided to compare data from countries with and without mandatory BCG vaccination to see if immunization policies are linked to the number or severity of COVID-19 infections. A handful of preprint publications in the last two months noted that countries with an ongoing BCG vaccination program are experiencing lower death rates from COVID-19 than those without.

One study, for instance, found that mandatory BCG was associated with a significantly slower climb in both confirmed cases and deaths during the first 30-day period of an outbreak. Another modeled mortality in two dozen countries and reported that those without universal BCG vaccination, such as Italy, the US, and the Netherlands, were more severely affected by the pandemic than those with universal vaccination. Read more

A downside with the preprints is that they show a statistical correlation, not cause and effect. “There are many sources of bias inherent in these cross-country comparisons,” warns Zoë McLaren, a professor of public health at the University of Maryland. For example, she says, the types of countries implementing the BCG vaccine may be more likely to also take proactive measures to protect their people against COVID-19, such as “shelter in place” orders. McLaren says she can think of almost 20 sources of bias in these studies. In another example, those who get a BCG vaccine may be more likely to have had a better start in life, putting them on a healthier trajectory. The studies cannot account for all confounding factors.

Epidemiologist Christine Stabell Benn of the University of Southern Denmark has studied BCG vaccine for the last two decades and reported that it reduces overall childhood mortality from infectious diseases. She warns against reading too much into the preprint papers. “This is the weakest kind of evidence that we have in our evidence pyramid,” she says. “It just links prevalence of one thing with the prevalence of another.”

But rather than toss out the idea of BCG’s link to fewer COVID cases or deaths, she says there’s good reason to consider it seriously. She has more direct evidence that BCG vaccination can ready our immune system for viral infections. And a number of clinical trials have now begun to investigate whether a BCG shot given to those most at risk of contracting the infection can protect them from the disease.

Evidence that BCG protects against other infections

Benn’s work is among accumulating evidence, as detailed in a recent review paper, that childhood BCG vaccination protects against other diseases, so-called off target effects. Much of the evidence to support the new clinical studies is based on trials by her group and on work by Mihai Netea of Radboud University Medical Centre in the Netherlands, who came up with a mechanistic explanation as to why BCG—designed to thwart a bacterial infection—could boost immune responses to viruses.

A study in 2000 led by Benn’s spouse and long-time collaborator Peter Aaby at the Bandim Health Project reported a significant reduction in mortality that was far greater than could be explained by preventing tuberculosis in infants who received BCG in Guinea-Bissau. And a 2005 study found a reduction in lower respiratory tract infections in BCG-vaccinated infants in the same country. In later studies, including one published in 2017, Benn and Aaby randomized thousands of low–birth weight children in this west African country to receive BCG right at birth or to be vaccinated at six weeks of age, which is the usual practice there. “There was a one-third reduction in neonatal mortality in those receiving BCG [earlier]” Benn says. The benefits mostly came from reduced rates of respiratory disease and septicemia in the babies, she adds.

In Guinea-Bissau, the researchers also compared children who developed a scar after vaccination with those who received the vaccine but did not develop a scar. The scar signals an appropriate immune response to the vaccine. In 2003, Aaby and colleagues reported significantly lower mortality in children with a vaccine scar. In a subsequent meta-analysis of similar studies, they suggested that the effect of revaccinating scar-negative children should be considered.

“We saw more than 40 percent reduction in overall mortality among those who had a scar, versus those who didn’t have a scar,” says Benn.

Benn says she is hopeful that BCG might offer some benefits against severe COVID-19. She gave herself a booster shot a few weeks back. “These non-specific effects [from BCG] are strongest when we look at respiratory infection outcomes,” says Benn.

When Benn and Aaby reported that BCG reduces infectious disease rates more than a decade ago, this was dismissed as biologically implausible at the time, she recalls. Vaccines induce long-lived memory B cells, which tweak their own genes to tailor-make antibodies against a specific microbe. These B cells are then kept in reserve in bone marrow. They quickly proliferate if the host again encounters the pathogen, giving long-lived immunity. B cells do not explain why a vaccine would allow someone to respond better to an unrelated microbe.

Netea proposed in 2012 that BCG works by putting the “innate” arm of the immune system, such as macrophages, on a higher alert status, a phenomenon termed “trained immunity.” The task of macrophages is to identify, engulf, and destroy foreign entities. They can also signal for reinforcements using cytokines. It was assumed that these guards did not remember particular pathogens, but stand as a blunt frontline defense. Twenty years ago, this innate system was viewed by most as crude and non-specific, says immunologist Luke O’Neill of Trinity College Dublin. “Then there was a Copernican revolution in immunology. Suddenly, it was realized how important the innate side was.”

See “Thanks for the Memories”

Nobel prizes went in 2011 to scientists who discovered innate receptors as gatekeepers of the immune system. Their research had kindled greater research interest in innate immune cells. Netea subsequently proposed that BCG primes frontline immune cells through epigenetic changes and metabolic rewiring. This is what allows them not to be placed on higher alert.

Priming the innate immune system matters for vaccines and for future infections. “If you vaccinate first with BCG and then give an influenza vaccine, the influenza vaccine works better,” says Netea. He reported this in 2015 in a randomized, placebo-controlled study of a vaccine against the 2009 pandemic strain. The experiment involved 40 men. Benn will this autumn test whether BCG administration 14 days prior to a seasonal flu vaccine could elicit a better response in those over 65.

To get a sense of how BCG might protect against a future pathogen, Netea infected healthy human volunteers with attenuated yellow fever virus in a randomized, placebo-controlled trial. Subjects who had been BCG vaccinated one month prior to the exposure showed significantly lower amounts of circulating yellow fever virus than those injected with placebo instead. The study, published last year, concluded that BCG induced epigenetic reprogramming of human monocytes and led to a more robust response against yellow fever virus.

After BCG administration, “there is more production of pro-inflammatory cytokines. They recruit immune cells easier to the site of infection, and those cells are better at killing and eliminating the virus,” says Netea.

According to Netea’s hypothesis, BCG could prep macrophages in a way that results in a locally stronger cytokine response directed against SARS-CoV-2, focused at the site of infection. “This would prevent inefficient systemic response later, which can harm the patient,” he explains, the so-called cytokine storm. Macrophages call to arms B and T cells, which would mean that those primed with BCG should be more efficient at killing off a SARS-CoV-2 infection.

Innate immune priming after BCG is probably optimal for two or three years, says Netea, an estimate based on epidemiological data in children. In his view, “the fact that somebody has been vaccinated 50 or 60 years ago is probably non-protective.” This runs counter to the links in epidemiological data suggesting that BCG is now assisting adults in responding to COVID-19. McLaren says even the vaccine’s protection against TB probably lasts just two decades. O’Neill too is skeptical about innate priming lasting this long. He says he wonders if countries with high childhood BCG vaccination rates, such as Japan, may protect elderly people indirectly from COVID-19, because vaccinated kids don’t spread it as much to them.

Benn says she thinks innate memory may yet surprise us. “We know for sure that the [BCG] effect lasts for at least one year in children. We also have indications it can last much longer,” she says, “in principle up to forty years.” One Danish study by Aaby and Benn indicated that people who had received smallpox and/or BCG vaccine at school entry had a more than 40 percent reduced risk of dying up to the age of 45. “This was seen in infectious disease, but also cardiovascular disease and neurological disease,” Benn explains.

BCG clinical trials begin

Netea, who collaborates with Benn, is wary about suggesting that a BCG shot from decades ago protects against COVID-19 but remains open-minded about the efficacy of more recent BCG shots. “We need randomized clinical trials to be able to draw conclusions,” he says. Trials are kicking off in the Netherlands, Greece, Australia, Denmark, France, Germany, and the US, says Netea, mostly to test BCG in medical staff.

In an Australian trial among 4,000 healthcare workers, “we will measure whether those who get the vaccine get less COVID-19, and if they do get it, if they are unwell for less time or have less severe symptoms,” says Nigel Curtis, a clinician and researcher at the Murdock Children’s Research Institute and the University of Melbourne.

In the Netherlands, Netea is recruiting 1,500 volunteer healthcare providers, half of whom will be randomly selected to receive BCG. He is also starting a trial soon on 1,600 volunteers over the age of 60, half of whom will receive a placebo injection, the other half BCG. Netea advocates BCG as a possible preventive measure only for at-risk groups to avoid shortages. “It could be a bridge to a vaccine,” says O’Neill, who notes that tuberculosis bacteria live in the lungs, so BCG could perhaps boost immunity there. “I am waiting for the trials of course.”

Benn is planning a trial in Denmark to look at 1,500 healthcare workers randomized to receive BCG or placebo and then followed for COVID-19 and other infectious diseases. Denmark used BCG up until the 1980s, so there will be a subgroup among the newly vaccinated who received BCG once before, at school. Benn hypothesizes that BCG benefits will be more pronounced amongst this subset of healthcare workers than those who did not get a BCG jab as children.

A risk for BCG shortages

In the absence of clinical trial data, the World Health Organization does not recommend BCG for the prevention of COVID-19. There is concern that people might jump the gun and decide BCG is effective before the trial results come out. McLaren says she worries that the rash of preprint comparison studies could inflict harm. “If people interpret these correlation studies as high-quality evidence or jump on the bandwagon of BCG, then we might invest in polices that are ineffective and take resources away from infants and children who need BCG vaccines,” she says.

Curtis too is concerned. He says he has heard about vaccine supplies in parts of Africa meant for children being diverted to healthcare workers. “That is a tragedy,” says Curtis. “This vaccine protects babies against TB. If we start using it for something unproven, there is a danger a price will be paid by young children.”

Click for link (The Scientist)

Microplastics Have Invaded The Deep Ocean — And The Food Chain
By Christopher Joyce . June 6, 2019 . https://www.npr.org/sections/thesalt/2019/06/06/729419975/microplastics-have-invaded-the-deep-ocean-and-the-food-chain

It’s one of the most confounding sights of California’s recent firestorms: One home is completely destroyed, and another right next door is still standing, even untouched.
Cal Fire inspected just 17% of properties in 2018 in areas where the agency is responsible for checking defensible space, according to a KQED analysis of almost a half-million inspection records. That is just over half of the agency’s 33% goal.
Might be luck. Or it could be because that homeowner took care of the property’s “defensible space,” an area around the building where flammable brush and grass have been cut back, depriving the fire of fuel.
Experts say even a few homes surrounded by too much growth can put an entire neighborhood at risk. So in many parts of the state, inspectors go door to door, checking a home’s defensible space and issuing citations for violations.
But a KQED investigation has found homes and buildings in Northern California, in some of the most at-risk fire areas in the state, are rarely inspected by Cal Fire, the state firefighting agency responsible for checking defensible space in much of California.
In one Cal Fire region in the Sierra Nevada, just 6% of properties were inspected in 2018. In the Bay Area, Cal Fire inspected just 12% of properties in its jurisdiction that includes Napa and Sonoma counties.
Meanwhile, in Southern California coastal counties, county fire departments are checking homes at much higher rates, with some counties looking at 100% of properties and sending homeowners multiple reminders to make their houses safer.
“We should be doing more, doing better,” said Max Moritz, a wildfire specialist with the University of California Cooperative Extension, after reviewing the findings. “We need to have more people aware they live on a fire-prone landscape and taking action.”
‘Having one property that’s badly out of compliance can put an entire neighborhood at risk.’Assemblymember Laura Friedman, D-Glendale
Cal Fire, for its part, says it’s struggling to meet its inspection goals due to a lack of inspectors and resources.
For many Californians, a defensible space inspection will be the only exposure to wildfire planning they get.
“There’s not too many other ways people will learn about the vulnerability of their own home other than having an inspector or firefighter at their property,” Moritz said.
Lake County: Many Fires, Few Inspections
One place struggling to enforce defensible space is also one of the hardest hit by wildfires in recent years: Lake County, just north of the Bay Area.
The Cal Fire unit that covers Lake County inspected just 12% of properties in its overall region in 2018. Local fire departments have also tried to do inspections, but have been busy with the catastrophic fires of recent years.
In 2015, the Valley Fire burned almost 2,000 homes and structures in the county. Then came the Clayton Fire in 2016, the Sulphur Fire in 2017 and the Mendocino Complex in 2018. That four-county blaze was the largest in state history, scorching 717 square miles, a bigger area than is taken up by the cities of Houston or Phoenix.
“We’ve burned up about 45 percent of our county land mass,” said Willie Sapeta, fire chief for the Lake County Fire Protection District. “Lake County as a whole is suffering from PTSD just because everyone is so traumatized by it.”
Sapeta has seen first-hand the difference that maintaining defensible space can make. In 2015, the Clayton Fire was racing through tall grass and brush on the outskirts of the town of Lower Lake. But it slowed down when it approached the Lower Lake Historic Schoolhouse Museum; there, the grasses had been mowed within 100 feet of the wooden building, creating a buffer. The shrubs around the museum also had large gaps between them, another important defensible space tactic.
The museum, and the buildings behind it, were left untouched by the fire.
“Definitely a big part of Lower Lake was saved by having that defensible space in place,” Sapeta said.
Today, the hills remain covered with dead, blackened trees, but the undergrowth has sprung back, fed by this winter’s abundant rain.
Even with the scars of wildfire still visible, Sapeta says, many homeowners still haven’t cleared their defensible space.
“Life happens,” he said. “They’ve got kids. They’ve got jobs. And then all of a sudden they don’t realize we’re in June and all that brush is right up against their home.”
The firefighters in Sapeta’s fire district, one of several covering the county, try to make defensible space inspections when they can. But mostly they’re responding to emergency calls like fires, car crashes and heart attacks.
Lake County, where Willie Sapeta leads the fire protection district, passed a defensible space ordinance for the first time this year. (Lauren Sommer/KQED)
To really educate homeowners and enforce the rules, Sapeta says, he needs dedicated inspectors.
“I would love to have a fire prevention program where I’ve got a staff of six or eight people,” he said. “Nothing more in the world I’d love, to be able to do that.”
He says the funds, however, aren’t there. “It takes everything we have just to keep our doors open. The small rural counties just don’t have the resources.”
Lake County’s Board of Supervisors passed its first defensible space ordinance earlier this year, despite the opposition of some members of the public concerned about the cost of clearing their properties.
Now, even without additional funding, inspectors are visiting homes for the first time. To do that, the planning department is temporarily pulling building inspectors off their jobs to focus on vegetation.
“Other counties are in the same boat, particularly like Butte and Shasta counties,” said Mary Jane Montana, Lake County’s chief building official. “None of us have a lot money, and we’re faced with the same thing. So, we kind of just had to say, ‘We’re doing it this year.’ ”
‘Everybody Wants to Save Their Community’
Fire safety is very different in other parts of California.
‘It takes everything we have just to keep our doors open. The small rural counties just don’t have the resources.’Fire Protection District Chief Willie Sapeta, on the lack of defensible space inspections in Lake County
“All these homes have chimneys,” said Charles Butler, code enforcement officer for San Diego Fire-Rescue, squinting at a row of suburban homes. “Another thing I look for is tree canopy up over the chimney. That is a violation.”
Butler enters the information on an iPad, something he does at thousands of homes every year. He’s one of five inspectors responsible for about 45,000 homes in San Diego’s wildland-urban interface, where houses are nestled against open space or rugged canyons.
When he finds dead brush or tall weeds, he leaves the homeowner a notice about what to fix, with several weeks to comply. The city then does another inspection, and if the work still isn’t complete, follows up a third time.
If problems persist, the city hires a contractor to clear the brush. The owner is then on the hook for the cost, and a lien is put on their property. The city has to resort to this process, called “forced abatement,” on a few dozen properties each year, often at considerable cost to the owner.
Most people who don’t follow the rules are elderly or financially burdened, says Marcy Garcia, San Diego Fire-Rescue’s code compliance supervisor. In those cases, the city tries to connect violators with local fire-safe councils, the community-led groups that have grants or have other resources available to help get the work done.
San Diego code enforcement officer Charles Butler enters defensible space inspection data. (Lauren Sommer/KQED)
Garcia says the overall compliance rate is high because the city provides crucial reminders to homeowners who may care about fire safety but haven’t gotten around to fixing their property.
“Especially in the areas where there have been fires before, they’re very receptive to it,” said Garcia. “Everybody wants to save their community.”
Cal Fire Struggling
In addition to local governments, Cal Fire is also responsible for enforcing defensible space regulations, for more than 750,000 homes and buildings within 31 million acres that fall outside city and town limits.
But across that territory, Cal Fire is struggling to meet its inspection goals, especially in rural Northern California.
A defensible space law, passed in 2005, requires a 100-foot buffer around homes in fire zones. From zero to 30 feet, homeowners must create a “lean and green” zone by trimming trees so they don’t hang over roofs and clearing dead grass and brush. Between 30 and 100 feet, they must keep shrubs spaced apart and grasses mowed to 4 inches or less.
“Our goal is to inspect every property in our responsibility area every three years,” said Steven Hawks, deputy chief for Cal Fire’s wildland fire-prevention engineering program. “Defensible space is a critical component to a home surviving a wildland fire.”
Cal Fire reports it’s close to its goal. From July 2017 through June 2018, it completed 217,666 inspections.
But doesn’t mean Cal Fire visited 217,666 properties.
A KQED analysis of almost a half- million inspection records shows the agency’s inspection rate was just 17% of properties in 2018, far below the agency’s 33% goal.
One reason for the discrepancy is that Cal Fire includes multiple trips to the same properties that failed a first inspection.
It also includes visits in areas where responsibility for inspections has been handed to county fire departments. And those rates are dramatically higher than Cal Fire’s.
The Orange County and Ventura County fire departments each inspect 100% of properties in risky fire zones every year. The Los Angeles County and Santa Barbara County fire departments get to around 60%.
While Cal Fire sends money to those counties, as well as Marin and Kern, because they do their own firefighting, it generally doesn’t cover the costs of their entire defensible space programs.
California’s defensible space law requires managing vegetation 100 feet around structures. (Teodros Hailye/KQED)
Achieving those high inspection rates takes substantial county investment. Some county fire departments have dedicated teams of year-round inspectors, while others rely on firefighting engine crews.
“It does take resources and commitment, but we do it because it’s one of the most important programs in the department,” says Ventura County Fire Marshal Massoud Araghi. “This is what we believe will save structures and will help our firefighters be safe.”
Araghi estimated a 99.9% compliance rate from the county’s homeowners, something he attributes to annual inspections.
“It’s very important the time period is consistent,” he said. “Everyone knows they have to have it clean by a certain time. If you have long periods of time in between, you won’t be successful.”
Resources Lacking
In some high-risk fire areas where Cal Fire does inspections, properties receive dramatically few inspections.
At the low end, just 6% of properties received inspections in 2018 by the Cal Fire unit that covers the Sierra Nevada counties of Amador, El Dorado, Sacramento and Alpine. At that rate, which has remained mostly consistent since 2010, each property would be visited about once every 16 years.
The same pattern is found in the nearby rural counties of Nevada, Yuba, Placer, Sierra and Sutter, where 7% of properties were inspected in 2018.
Even in Sonoma, Napa and Lake counties, where recent fires have been historically devastating, Cal Fire inspected just 12% of properties last year.
Cal Fire gives several reasons for the low numbers.
Every year, the agency hires between four and six defensible space inspectors in each of its 21 units throughout the state, but those inspectors are only funded to work three months.
Beginning in 2011, that money came from a $152 annual fee on homeowners within Cal Fire’s jurisdiction. But the levy was opposed by many in rural counties who saw it as an added tax, and in 2017, Gov. Jerry Brown signed a bill to suspend it.
Since then, Cal Fire’s defensible space funding has come from revenue generated by the state’s cap-and-trade program, designed to lower carbon emissions.
Without more funding, Cal Fire Deputy Chief Hawks says, it will be tough to increase the inspection rate.
Another issue is that inspectors are not distributed in proportion to the number of properties in each region. A Cal Fire unit that covers 35,000 properties has four seasonal inspectors, for example, but one with double that number has just six.
Cal Fire firefighter Tony Kochis discusses defensible space with a homeowner in Yountville, California in 2014. (Justin Sullivan/Getty Images)
“We should look at the numbers like you’re looking at them,” Hawks told KQED. “We may have some units that have a larger number of parcels than others, and they should get more of the resources.”
Cal Fire has the power to hire contractors to clean up properties when homeowners don’t comply, but it’s not something the agency currently does.
“We don’t really have the staff to accomplish that mission,” Hawks said.
In general, Hawks says, Cal Fire hasn’t been able to hire enough people to take care of its defensible space responsibilities.
“We have not been able to fill our defensible space inspectors in every unit every year,” he said. “So having enough qualified people on the list to fill our positions is important.” Hawks could not provide numbers for how many positions have gone unfilled or the reasons why.
Typically, some inspections are done by the agency’s firefighters during down times. But with fire seasons getting longer and more intense, there hasn’t been much of that in recent years.
“It’s difficult with the fire seasons being the way they’ve been,” Hawks said.
The largest habitat for life on Earth is the deep ocean. It’s home to everything from jellyfish to giant bluefin tuna. But the deep ocean is being invaded by tiny pieces of plastic — plastic that people thought was mostly floating at the surface, and in amounts they never imagined.
Very few people have looked for microplastic concentrations at mid- to deep-ocean depths. But there’s a place along the California coast where it’s relatively easy: The edge of the continent takes a steep dive into the deep ocean at Monterey Bay. Whales and white sharks swim these depths just a few miles offshore.
The Monterey Bay Aquarium Research Institute perches on the shoreline. At an MBARI dock, you can see one of their most sophisticated tools for doing that: a multimillion-dollar machine called Ventana sitting on the deck of the research vessel Rachel Carson. “It’s a massive underwater robot,” explains Kyle Van Houtan, chief scientist with the Monterey Bay Aquarium, which collaborates with MBARI. “Robotic arms, a lot of sensors, machinery, lights, video cameras.”
The team they created has been sending Ventana up to 3,000 feet deep into the Bay in search of plastic.
“The deep ocean is the largest ecosystem on the planet,” says Van Houtan, “and we don’t know anything about the plastic in the deep ocean.” Scientists do know about plastic floating on the surface, and have tried to measure how much there is. The Great Pacific garbage patch is just one of many giant eddies in the oceans where enormous amounts of plastic waste collects.
But beneath the surface? Not much. So Ventana made several dives to collect water samples at different depths. Technicians filtered the water, looking for microplastic, the tiny fragments and fibers you can barely see.
“What we found was actually pretty surprising,” Van Houtan says. “We found that most of the plastic is below the surface.” More, he says, than in the giant floating patches.
And also to their surprise, they found that submerged microplastics are widely distributed, from the surface to thousands of feet deep.
Moreover, the farther from shore they sampled, the more microplastics they found. That suggests it’s not just washing off the California coast. It’s coming from all over.
“We think the California current is actually carrying some of the microplastic debris from the north Pacific Ocean,” he says — kind of like trash washing down off a landfill that’s actually in the ocean.
And that trash gets eaten. Marine biologist Anela Choy is an assistant professor at the Scripps Institution of Oceanography in San Diego and was lead scientist on the study. She says the deep ocean is like a giant feeding trough. “It’s filled with animals,” she says, “and they’re not only moving up and down in the water column every day, forming the biggest migration on the planet, but they’re also feasting upon one another.”
For example, the deep ocean is filled with sea creatures like larvaceans that filter tiny organisms out of the water. They’re the size of tadpoles, but they’re called “giant larvaceans” because they build a yard-wide bubble of mucus around themselves — “snot houses,” Choy calls them. The mucus captures floating plankton. But it also captures plastic. “We found small plastic pieces in every single larvacean that we examined from different depths across the water column,” Choy says. Another filter feeder, the red crab, also contained plastic pieces — every one they caught.
Choy also has looked beyond Monterey Bay and higher up the food chain. In earlier research she did in the Pacific, she collected creatures called lancetfish — several feet long, with huge mouths and lots of saber-sharp teeth. They’re called the “dragons of the deep.”
“We’ve looked now at over 2,000 lancetfish,” says Choy, “and we’ve found that about one in every three lancetfish has some kind of plastic in its stomach. It’s really shocking, because this fish actually doesn’t come to the surface as far as we know.” That suggests that plastic has spread through the water column.
Bruce Robison, a senior scientist with the Monterey Bay Aquarium Research Institute, says he was shocked at how much plastic they found. “The fact that plastics are so pervasive, that they are so widespread, is a staggering discovery, and we’d be foolish to ignore that,” he says. “Anything that humans introduce to that habitat is passing through these animals and being incorporated into the food web” — a web that leads up to marine animals people eat.
The Monterey Bay findings appear Thursday in the journal Nature Scientific Reports and only represent a local sample. But Robison says 70 years of manufacturing plastic may have created a global ocean problem. “We humans are constantly coming up with marvelous ideas that eventually turn around and bite us on the butt,” he says with a dry laugh.
And scientists are just beginning to diagnose the extent of that wound.

food chain microplastic.jpg

This looks to me like a definite “One Health” case–it has human, animal, and environmental aspects, though it is not a zoonotic pathology. It isn’t a virus jumping from animals to humans, but a human-made substance jumping into animals and then back into humans. So if that counts as “One Health,” radioactive contamination would as well, wouldn’t it? What are the boundaries? (Not that I’m trying to confine One Health within boundaries.)

I was alarmed to hear one such proposal to reduce the albedo effect in the Arctic was to release millions of small glass and plastic orbs onto the ice fields. Surely this would have significant long-term environmental impacts as these objects weather down and release fragments into surrounding ecosystems?

Satish Srivastava notes:

SurgeonSo far, a total of 200 zoonotic diseases have been identified. Important among them are tuberculosis, Crohn’s disease, salmonellosis, anthrax, brucellosis, shigellosis and many more. Consumption of milk, meat, eggs from animals infected with any of such disease results in similar disease in humans. A constant monitoring of the health status of farm animals and birds by veterinarians minimize the risk of transmission of diseases to human population.

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ISOHA
A great organization called ISOHA — International Student One Health Alliance — has a mentorship program . Here’s part of their blurb about it on their Facebook page. We heartily encourage them!
“International Student One Health Alliance
“July 31 at 9:41 AM ·
“We launched our pilot ISOHA Mentorship Program this year after receiving strong interest from both mentors and mentees. Ultimately, we matched over 230 students representing 34 countries with over 150 professionals from 41 different countries and with a vast range of backgrounds including veterinarians, doctors, engineers, and social scientists. Thanks to their hard work and dedication to the program, interdisciplinary One Health networks expanded around the world….”

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There is a very lively Facebook group called “One Health Approaches” that many practitioners and researchers can benefit from following. There seems to be a lot going on in Africa.

‘A death trap’: Measles blamed in Malaysia indigenous deaths
Some 15 indigenous people from marginalised Batek group have died in the past six weeks with scores more in hospital.
by Chris Humphrey, Al-Jazeera News, 19 Jun 2019

15 FREE ONLINE ONE HEALTH COURSES

The Global One Health initiative has launched a collection of 15 online courses that are being offered under the online Canvas Network. 12 are currently live and accepting new students i.e.

1. Foundations of evidence-based practice in healthcare
2. Biology and management of weeds and invasive plants
3. Environmental public health
4. Media writing and editing
5. Fundamentals of pharmacology
6. Farm to table food safety
7. Introduction to the science of cancer
8. Molecular epidemiology
9. Life on earth: biomes, climates, ecology, and evolution
10. Introduction to pharmacy
11. Earths environment: soil, water and air
12. Energy and earth: fossil fuels, alternative and renewal energy

These courses are free and open to the public and cover aspects of agriculture, human biology, veterinary medicine and public health.

The collection can be found online here: https://www.canvas.net/browse/osu/global-one-health

Interested in the latest travel health recommendations Check out the CDC Yellow Book, Health Information fort International Travel. to answer your patients’, employees’, or your own travel health questions.

The Yellow Book offers readers current U.S. government travel health guidelines, including pre-travel vaccine recommendations, destination-specific health advice, and easy-to-reference maps, tables, and charts.
https://wwwnc.cdc.gov/travel/page/yellowbook-home-2014?deliveryName=USCDC_1164-DM6015

News: the Guelph One Health Institute

From heading off the next global pandemic to improving food security in Canada’s North, tackling some of humanity’s most pressing health problems is the purpose of a new research and teaching institute being launched at the University of Guelph (U of G).

One Health has long been promoted at U of G as an interdisciplinary approach to promoting health and curbing infectious diseases.

Read the full article here: https://news.uoguelph.ca/2019/06/new-institute-at-u-of-g-to-focus-on-one-health/

The global ‘One Health’ concerns have long been knocking the doors of our present civilization. It needs immediate attention and concrete action without social, political,demographic and subject bias. A great and timely initiative by the UN.

This is very effective approach in term of resource utilization. It also increase specialisation among fields. Which is keep for innovations.
Makerere University in Uganda has been involved in one health approach with student led initiatives and we have registered successes. For example medical camp, which formally used to for college of health sciences only now has veterinary included. And communities appreciate

In our group the orientation of research on AMR is one health approach. All our research project proposals center on this theme.
As far as bacteria are concerned the diversity known to us too less. All our assumptions are based on few studies. This needs more depth .
With regard to measures of mitigation of slowing down climate change.
1. Are we ready to give rest to all vehicles at least once in a week?
2. Leaving aside diabetics are we ready to skip meals in toto for one day in a week? . If we do itis going to have telling impact on so many aspects.

We need to own the policy making positions and keep on influencing those already there, towards healthier interconnectedness we all are part of.

THE CONVERSATION
How the DRC’s Ebola Crisis has Led to Children Dying from Measles

Forty-five years ago, the World Health Organisation launched the Expanded Programme on Immunisation. It covered six diseases – measles, tuberculosis, polio, diphtheria, pertussis and tetanus. Since then, anti-measles vaccines have been distributed to millions of children across the world, leading to a massive reduction in illness and death. For example, between 2000 and 2017, it was estimated that global deaths from measles had reduced by about 80% due to vaccination.

Success in the fight against measles is down to the delivery of at least two doses of vaccines to about 95% of children in the world. Vaccination is critical to preventing the disease because there’s no treatment for measles. During an outbreak, measles mainly affects unvaccinated children, but also adults who have never been vaccinated. The measles virus spreads when patients cough or sneeze, and remains active in the environment for several hours. The symptoms include high fever, dry cough, runny nose, inflamed eyes and skin rash.

The global measles elimination target was set to be achieved by 2020. Sadly, this target is increasingly looking unattainable. There’s been such a deterioration in vaccine reach that this year the World Health Organisation declared refusal or delay in agreeing to be vaccinated (vaccine hesitancy) as one of the top ten threats to global health. Hotspots include Ethiopia, Georgia, Kazakhstan, Kyrgyzstan, Madagascar and Sudan.

The Democratic Republic of Congo (DRC) is on that list too, due to the Ebola crisis in parts of the country, which has fuelled a measles outbreak of unimaginable proportions.

The main reason for this is that healthcare resources have been diverted to deal with the Ebola outbreak, which still hasn’t been brought under control. As a result, people don’t have access to routine healthcare such as vaccination programmes.

A combination of factors – increased violence, growing mistrust towards medical teams in the wake of the Ebola outbreak as well as the diversion of resources to deal with Ebola – have resulted in reduced vaccination coverage in general. When measles vaccination coverage is low, the disease outbreak is always imminent.

Ebola and measles
How could an Ebola outbreak fuel a measles outbreak?

The most recent Ebola outbreak in the DRC was declared in August 2018. Despite the Ebola response teams in the country having more advanced tools and prior experience relative to previous outbreaks, new cases continue to be reported.

Community mistrust towards the outbreak response team has been cited as one of the challenges. Another is the high levels of insecurity due to battles between the army and armed groups. This has affected access to health services by communities.

In addition, resources – including human resources – have been diverted from routine services, such as vaccination programmes, to the Ebola response task.

According to the latest measles surveillance data from the World Health Organisation, new cases of measles rose by 300% in the first four months of this year. Across Africa, the number of cases rose by 700%.

And, according to Médecins Sans Frontières (MSF), between January and May 2019, more than 1,500 measles-related deaths were officially recorded in the DRC. Numbers like this would be considered unimaginable in any other country outside Africa.

Compare these figures with the US, where in the first four months of this year 704 cases – not deaths – of measles were reported, according to the Centres for Disease Control and Prevention.

What next
A massive response to the measles outbreak in the DRC is currently underway.

A key step to any disease outbreak is an establishment of strong partnerships to mobilise resources and coordinate the response. The DRC’s Ministry of Health has received considerable support from several partners, among them, the World Health Organisation.

The response plan has included setting up emergency response strategies, strengthening surveillance, investigations and preparedness response. Given that safe and effective vaccines against measles are available, the ultimate success of the response team will depend on the ability to supply and administer these lifesaving interventions to all those who need them.

To achieve this, the MSF is appealing for a massive and urgent mobilisation of national and international partners.

A key lesson must be learnt from the loss of thousands of children’s lives in the DRC due to measles. Vaccine programmes in Africa are vulnerable to crises, yet, these immunisation programmes are a key strategy to reducing infant mortality. African leaders have endorsed the regional immunisation strategic plan, in recognition of the vaccination benefits. But they need to go further: they must urgently develop effective policies that can mitigate the negative effects of crises on vaccination programmes in the future.

Viruses travel across species. Don’t feed the monkeys. They may bite. Don’t let your dog or cat sleep in bed with you. (Actually, about half of all pet owners do.)