A Call for One Health in Medical Education: How the COVID-19 Pandemic Underscores the Need to Integrate Human, Animal, and Environmental Health.

During the early stages of the COVID-19 pandemic in 2020, the first author, then a fourth-year student at Harvard Medical School, was enrolled in a One Health clinical experience at Zoo New England where he was introduced to a transdisciplinary approach to integrate human, animal, and ecosystem health. Seeing the vast impact of the pandemic and knowing its roots as a zoonotic disease, he realized this approach was critical to his medical education and for preparation against future novel infectious diseases. Zoonotic diseases have been emerging into human populations with increasing frequency, leading to public health emergencies such as Ebola, avian influenza, and SARS. The SARS-CoV-2 narrative, starting in bats and then mutating through an intermediate host into humans, is another striking example of the interconnectedness between human, animal, and ecosystem health that underlies these infections. Preventing future pandemics will require a transdisciplinary One Health approach, and physicians should be prepared to participate in these discussions while advocating for One Health initiatives for the benefit of their current and future patients. Integration of One Health education into medical school curricula will also prepare future physicians for other complex and urgently important health issues such as climate change, antimicrobial resistance, and the impact of biodiversity loss. As the consequences of the COVID-19 pandemic persist, education in One Health must become a priority; it is essential to break down the conventional disciplinary silos of human medicine, veterinary medicine, environmental health, public health, and the social sciences, so that future health crises can be prevented and mitigated collaboratively.

The Expectations and Challenges of Wildlife Disease Research in the Era of Genomics: Forecasting with a Horizon Scan-like Exercise.

The outbreak and transmission of disease-causing pathogens are contributing to the unprecedented rate of biodiversity decline. Recent advances in genomics have coalesced into powerful tools to monitor, detect, and reconstruct the role of pathogens impacting wildlife populations. Wildlife researchers are thus uniquely positioned to merge ecological and evolutionary studies with genomic technologies to exploit unprecedented "Big Data" tools in disease research; however, many researchers lack the training and expertise required to use these computationally intensive methodologies. To address this disparity, the inaugural "Genomics of Disease in Wildlife" workshop assembled early to mid-career professionals with expertise across scientific disciplines (e.g., genomics, wildlife biology, veterinary sciences, and conservation management) for training in the application of genomic tools to wildlife disease research. A horizon scanning-like exercise, an activity to identify forthcoming trends and challenges, performed by the workshop participants identified and discussed 5 themes considered to be the most pressing to the application of genomics in wildlife disease research: 1) "Improving communication," 2) "Methodological and analytical advancements," 3) "Translation into practice," 4) "Integrating landscape ecology and genomics," and 5) "Emerging new questions." Wide-ranging solutions from the horizon scan were international in scope, itemized both deficiencies and strengths in wildlife genomic initiatives, promoted the use of genomic technologies to unite wildlife and human disease research, and advocated best practices for optimal use of genomic tools in wildlife disease projects. The results offer a glimpse of the potential revolution in human and wildlife disease research possible through multi-disciplinary collaborations at local, regional, and global scales.

Causes of mortality in anuran amphibians from an ex situ survival assurance colony in Panama.

The success of ex situ survival assurance populations as tools for amphibian conservation depends on the health and reproductive success of founder populations. Necropsy examination and histopathology of animals that die in assurance populations are useful for the identification of population-limiting disease problems and can help to direct applied research efforts in areas such as amphibian husbandry and nutrition. This study reviewed postmortem findings in 167 frogs from 13 species that died in a large Panamanian rescue and survival assurance population between 2006 and 2011. Common problems identified in long-term captive animals, especially in Atelopus species, were epithelial squamous metaplasia suggestive of vitamin A deficiency and a polycystic nephropathy resembling lesions seen in laboratory animals with electrolyte imbalances. Metabolic bone disease was a significant contributor to morbidity in captive-bred juvenile frogs of Gastrotheca cornuta, Hemiphractus fasciatus, and Hylomantis lemur. Findings common to multiple species included poor overall nutritional condition that was sometimes attributable to maladaptation to captive husbandry and epidermal hyperplasia and hyperkeratosis possibly reflecting environmental skin irritation. Infectious diseases and endoparasitism were most common in recently captured animals and included chytridiomycosis and Rhabdias sp. lungworms. Applied research efforts to improve sustainability of survival assurance populations should focus on elucidating optimal husbandry practices for diverse species, improving methods for nutritional supplementation of cultured insects and examination of the role of water composition in disease development.

Pathogenesis, diagnosis, and treatment of amphibian chytridiomycosis.

Chytridiomycosis, caused by the chytridiomycete fungus, Batrachochytrium dendrobatidis, is an important pathogen of amphibians in captivity and is a major concern for global conservation of amphibians. The organism infects keratinized epithelial cells of amphibian skin and causes disease and mortality by interfering with important skin functions, especially electrolyte balance. Primary treatments are with antifungal medications applied in a topical bath solution, and itraconazole is the most commonly used agent, although several different options are available. Supportive treatment of the clinically ill patient is necessary for success, with particular attention to electrolyte therapy.

Multiple endocardial neurofibromas in a rosy-billed pochard (Netta peposaca).

Endocardial neoplasms are uncommon in veterinary species with most cases restricted to endocardial schwannomas in aged rats. A 15-year-old male rosy-billed pochard (Netta peposaca) was diagnosed following necropsy with numerous, proliferative endocardial masses. Histologically, these masses were composed of interlacing streams and bundles of neoplastic spindle cells supported by a fine fibrovascular stroma. Rare areas of cellular and nuclear palisading were present in the nodules. Approximately 60% of the neoplastic cells were strongly positive for S-100, whereas none of the neoplastic cells was positive for desmin, synaptophysin, neurofilament, and glial fibrillary acidic protein. The histologic features coupled with the S-100 immunoreactivity led to a diagnosis of endocardial neurofibroma.

Passive transfer of maternal antibodies to West Nile virus in flamingo chicks (Phoenicopterus chilensis and Phoenicopterus ruber ruber).

Passive transfer of maternal antibodies against West Nile virus (WNV) was studied in a captive population of Chilean (Phoenicopterus chilensis) and Caribbean flamingos (Phoenicopterus ruber ruber). Transfer of WNV antibodies from hens to chicks was documented and measured by plaque-reduction neutralization test. Hen titers were significantly correlated to chick titers. Mean half-life of maternal WNV antibodies was 13.4 days in chicks for which half-life was measurable.

Preliminary evaluation of blood lipid profiles in captive western lowland gorillas (Gorilla gorilla gorilla).

Published serum cholesterol values in captive western lowland gorillas (Gorilla gorilla gorilla) are much higher than human ranges, with a national mean of 7.36 mmol/L (284 mg/dl, n = 863). Complete blood lipid profiles were examined in 15 captive gorillas. High-density lipoprotein (HDL) was found to decrease more rapidly with age than total cholesterol, resulting in an increasing ratio of cholesterol HDL with age. The ratio of apolipoprotein B to apolipoprotein Al also increased with age. Establishment of a database of blood lipid values for captive gorillas with correlative analysis of animals with known atherosclerosis status may help to identify sensitive predictors of coronary heart disease risk.

Leptospirosis in Wied's marmosets (Callithrix kuhlii).

Two adult Wied's marmosets (Callithrix kuhlii) presented with jaundice, anemia, and weight loss. Death of one individual was attributed to renal tubular necrosis; liver and kidney were positive for Leptospira antigen by immunohistochemical (IHC) staining. The second animal was negative for antigen by IHC staining, but serologically positive for Leptospira borgpetersenii serovar ballum with an eightfold titer increase in paired samples, and was euthanized because of unresponsiveness to treatment. Environmental contamination by mice was suspected as the Leptospira source.

Successful treatment of atlantooccipital luxation in an alpaca (Lama pacos).

A 7-mo-old male alpaca (Lama pacos) presented with an abnormal lowered posture of the head and neck and reluctance to walk. Cervical radiographs demonstrated atlantooccipital luxation. Successful manual closed reduction was achieved while the animal was anesthetized, resulting in complete return to normal gait and posture.