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Integrated Early Warning Surveillance: Achilles' Heel of One Health?

ABSTRACT: Emerging and re-emerging infectious diseases and zoonoses indicate the importance of the One Health (OH) approach for early warning. At present, even when surveillance data are available, they are infrequently timeously shared between the health sectors. In the context of the MediLabSecure (MLS) Project, we investigated the collection of a set of surveillance indicators able to provide data for the implementation of integrated early warning systems in the 22 MLS countries of the Mediterranean, Black Sea and Sahel regions. We used an online questionnaire (covering vector, human, and animal sectors), focusing on seven relevant arboviruses, that was submitted to 110 officially appointed experts. Results showed that West Nile virus was perceived as the most relevant zoonotic pathogen, while Dengue virus was the most relevant non-zoonotic pathogen in the study area. Data collection of early warning indicators is in place at a different level for all the investigated pathogens and in almost all the MLS Countries. Further assessments on the reliability of the collection in place and on the feasibility of piloting an integrated early warning system for arbovirus could verify if integrated early warning really represents the Achilles' heel of OH.

SUBMITTER: Amato L

PROVIDER: S-EPMC7022449 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Integrated Early Warning Surveillance: Achilles' Heel of One Health?

Amato Laura L Dente Maria Grazia MG Calistri Paolo P Declich Silvia S On Behalf Of The MediLabSecure Working Group

Microorganisms 20200108 1

Emerging and re-emerging infectious diseases and zoonoses indicate the importance of the One Health (OH) approach for early warning. At present, even when surveillance data are available, they are infrequently timeously shared between the health sectors. In the context of the MediLabSecure (MLS) Project, we investigated the collection of a set of surveillance indicators able to provide data for the implementation of integrated early warning systems in the 22 MLS countries of the Mediterranean, B ...[more]

PMID: 31936412

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Project description:BackgroundEffective animal health surveillance systems require reliable, high-quality, and timely data for decision making. In Tanzania, the animal health surveillance system has been relying on a few data sources, which suffer from delays in reporting, underreporting, and high cost of data collection and transmission. The integration of data from multiple sources can enhance early detection and response to animal diseases and facilitate the early control of outbreaks. This study aimed to identify and assess existing and potential data sources for the animal health surveillance system in Tanzania and how they can be better used for early warning surveillance. The study used a mixed-method design to identify and assess data sources. Data were collected through document reviews, internet search, cross-sectional survey, key informant interviews, site visits, and non-participant observation. The assessment was done using pre-defined criteria.ResultsA total of 13 data sources were identified and assessed. Most surveillance data came from livestock farmers, slaughter facilities, and livestock markets; while animal dip sites were the least used sources. Commercial farms and veterinary shops, electronic surveillance tools like AfyaData and Event Mobile Application (EMA-i) and information systems such as the Tanzania National Livestock Identification and Traceability System (TANLITS) and Agricultural Routine Data System (ARDS) show potential to generate relevant data for the national animal health surveillance system. The common variables found across most sources were: the name of the place (12/13), animal type/species (12/13), syndromes (10/13) and number of affected animals (8/13). The majority of the sources had good surveillance data contents and were accessible with medium to maximum spatial coverage. However, there was significant variation in terms of data frequency, accuracy and cost. There were limited integration and coordination of data flow from the identified sources with minimum to non-existing automated data entry and transmission.ConclusionThe study demonstrated how the available data sources have great potential for early warning surveillance in Tanzania. Both existing and potential data sources had complementary strengths and weaknesses; a multi-source surveillance system would be best placed to harness these different strengths.

Project description:Human norovirus frequently causes outbreaks of acute gastroenteritis. Although discovered more than five decades ago, antiviral development has, until recently, been hampered by the lack of a reliable human norovirus cell culture system. Nevertheless, a lot of pathogenesis studies were accomplished using murine norovirus (MNV), which can be grown routinely in cell culture. In this study, we analyzed a sizeable library of nanobodies that were raised against the murine norovirus virion with the main purpose of developing nanobody-based inhibitors. We discovered two types of neutralizing nanobodies and analyzed the inhibition mechanisms using X-ray crystallography, cryo-electron microscopy (cryo-EM), and cell culture techniques. The first type bound on the top region of the protruding (P) domain. Interestingly, this nanobody binding region closely overlapped the MNV receptor-binding site and collectively shared numerous P domain-binding residues. In addition, we showed that these nanobodies competed with the soluble receptor, and this action blocked virion attachment to cultured cells. The second type bound at a dimeric interface on the lower side of the P dimer. We discovered that these nanobodies disrupted a structural change in the capsid associated with binding cofactors (i.e., metal cations/bile acid). Indeed, we found that capsids underwent major conformational changes following addition of Mg2+ or Ca2+ Ultimately, these nanobodies directly obstructed a structural modification reserved for a postreceptor attachment stage. Altogether, our new data show that nanobody-based inhibition could occur by blocking functional and structural capsid properties.IMPORTANCE This research discovered and analyzed two different types of MNV-neutralizing nanobodies. The top-binding nanobodies sterically inhibited the receptor-binding site, whereas the dimeric-binding nanobodies interfered with a structural modification associated with cofactor binding. Moreover, we found that the capsid contained a number of vulnerable regions that were essential for viral replication. In fact, the capsid appeared to be organized in a state of flux, which could be important for cofactor/receptor-binding functions. Blocking these capsid-binding events with nanobodies directly inhibited essential capsid functions. Moreover, a number of MNV-specific nanobody binding epitopes were comparable to human norovirus-specific nanobody inhibitors. Therefore, this additional structural and inhibition information could be further exploited in the development of human norovirus antivirals.

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Integrated Early Warning Surveillance: Achilles' Heel of One Health?

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Integrated Early Warning Surveillance: Achilles' Heel of One Health?

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