Financial influence on global risks of zoonotic emerging and re-emerging diseases: an integrative analysis.

BACKGROUND: Emerging and re-emerging infectious diseases (EIDs), such as Ebola virus disease and highly pathogenic influenza, are serious threats to human health and wellbeing worldwide. The financial sector has an important, yet often ignored, influence as owners and investors in industries that are associated with anthropogenic land-use changes in ecosystems linked to increased EIDs risks. We aimed to analyse financial influence associated with EIDs risks that are affected by anthropogenic land-use changes. We also aimed to provide empirical assessments of such influence to help guide engagements by governments, private organisations, and non-governmental organisations with the financial sector to advance a planetary health agenda. METHODS: For this integrative analysis, we identified regions in the world where there was evidence of a connection between EIDs and anthropogenic land-use changes between Nov 9, 1999, and Oct 25, 2021, through a targeted literature review of academic literature and grey literature to identify evidence of drivers of anthropogenic land-use change and their association with commodity production in these regions. We only included publications in English that showed a connection between deforestation and the production of one or more commodities. Publications merely describing spatial or temporal land-use change dynamics (eg, a reduction of forest or an increase of palm-oil plantations) were excluded. As we were assessing financial influence on corporate activities through ownership specifically, we focused our analysis on publicly listed companies. Equity data and data about ownership structure were extracted from Orbis, a company information database. We assessed financial influence by identifying financial entities with the largest equity ownership, descriptively mapping transboundary connections between investors and publicly listed companies. FINDINGS: 227 public and private companies operating in five economic sectors (ie, production of palm oil, pulp and wood products, cocoa, soybeans, and beef) between Dec 15, 2020, and March 8, 2021, were identified. Of these 227, 99 (44%) were publicly listed companies, with 2310 unique shareholders. These publicly listed companies operated in six geographical regions, resulting in nine case-study regions. 54 (55%) companies with complete geographical information were included in the countries network. Four financial entities (ie, Dimensional, Vanguard, BlackRock, and Norway's sovereign wealth fund) each had ownership in 39 companies or more in three of the case-study regions (ie, north America, east Asia, and Europe). Four large US-based asset managers (ie, Vanguard, BlackRock, T Rowe Price, and State Street) were the largest owners of publicly listed companies in terms of total equity size, with ownership amounts for these four entities ranging from US$8 billion to $21 billion. The specific patterns of cross-national ownership depended on the region of interest; for example, financial influence on EIDs risks that was associated with commodity production in southeast and east Asia came from not only global asset managers but also Malaysian, Chinese, Japanese, and Korean financial entities. India, Brazil, the USA, Mexico, and Argentina were the countries towards which investments were most directed. INTERPRETATION: Although commodity supply chains and financial markets are highly globalised, a small number of investors and countries could be viewed as disproportionally influential in sectors that increase EIDs risks. Such financial influence could be used to develop and implement effective policies to reduce ecological degradation and mitigate EIDs risks and their effects on population health. FUNDING: Formas and Networks of Financial Rupture-how cascading changes in the climate and ecosystems could impact on the financial sector.

Health and economic burden of foodborne zoonotic diseases in Amhara region, Ethiopia.

Diseases from food of animal origin are common health problems in Ethiopia. A cross-sectional study was carried out to estimate health and economic burden, and to identify demographic factors associated with community awareness of foodborne zoonotic diseases in Amhara region, Ethiopia. Data was collected from 435 households in three towns: Gondar, Lalibela and Debark. A retrospective data was also collected from health records in each town. The health burden due to zoonotic diseases was estimated at 0.2, 0.1 and 1.3 DALYs per household per year and at 73.2, 146.6 and 1,689.5 DALYs out of 100,000 populations per year in Gondar, Lalibela and Debark, respectively. The overall health burden due to foodborne zoonotic diseases (aggregated over the 435 households in the three towns) was estimated to be 89.9 DALYs per 100,000 populations per year. The economic impact of foodborne zoonotic diseases in the three towns of Amhara regional state was 278.98 Ethiopian Birr (ETB) (1ETB = 0.025 US Dollar) per household per year and 121,355.68 ETB per year. Costs of preventive measures followed by costs of patients' time made the highest contribution while costs of diagnosis made the lowest contribution to the total economic burden of foodborne zoonotic diseases. From a total of 435 respondents, 305 (70.1%) had known the presence of zoonotic diseases. Level of education, number of families in the house and income were highly associated with awareness of zoonosis. Although majority of respondents had known zoonotic diseases exists (70.1%) and disease can be acquired from animal source food (63.2%), the health and economic burden associated to foodborne zoonotic diseases are still high. Therefore, changing mindset and practical training aiming in controlling foodborne zoonotic diseases may be suggested to the community in the health improvement extension service.

Slaughter condemnation in bovine due to parasitic lesions and their economic impact in Federal Inspection System establishments in Brazil and in State inspection System in Rio Grande do Sul State.

Slaughter condemnations are important sources of information on cattle health. The incidence of bovine parasitic diseases is still very high in Brazil. These diseases, in addition to causing harm to the animals health, are neglected zoonotic diseases in several parts of world. The study analysed not only the Carcass losses, but also the economic damage resulting from slaughter condemnations due to parasitic causes. Cattle slaughter data from the Brazilian Ministry of Agriculture, Livestock and Supply (MAPA), over the period of 2012 to 2015 and data from the Secretary of Livestock and Irrigation of the state of Rio Grande do Sul (SEAPI-RS) were analyzed between 2014 and 2018.The number of organs and carcasses condemned was multiplied by the respective values (in Brazilian Real) obtained from slaughterhouses and subsequently converted into dollars. Brazilian analysis in SIF (Federal Inspection System) establishments showed that more than 1.2 million organs (3,884,505 kg) and 20,000 carcasses (4,547,718 kg) were condemned only due to parasitic causes during post-mortem inspection. In Rio Grande do Sul, in state inspection establishments, more than 1.7 million organs (8,210,559 kg) and 5,000 carcasses (1,243,200 kg) were condemned. These data are alarming and support the need for public policies to control these parasitic diseases.

Slaughter condemnation in bovine due to parasitic lesions and their economic impact in Federal Inspection System establishments in Brazil and in State inspection System in Rio Grande do Sul State / Condenação ao abate em bovinos devido a lesões parasitárias e seu impacto econômico em estabelecimentos do Sistema Federal de Inspeção no Brasil e no Sistema Estadual de Inspeção no Rio Grande do Sul

Abstract Slaughter condemnations are important sources of information on cattle health. The incidence of bovine parasitic diseases is still very high in Brazil. These diseases, in addition to causing harm to the animals health, are neglected zoonotic diseases in several parts of world. The study analysed not only the Carcass losses, but also the economic damage resulting from slaughter condemnations due to parasitic causes. Cattle slaughter data from the Brazilian Ministry of Agriculture, Livestock and Supply (MAPA), over the period of 2012 to 2015 and data from the Secretary of Livestock and Irrigation of the state of Rio Grande do Sul (SEAPI-RS) were analyzed between 2014 and 2018.The number of organs and carcasses condemned was multiplied by the respective values (in Brazilian Real) obtained from slaughterhouses and subsequently converted into dollars. Brazilian analysis in SIF (Federal Inspection System) establishments showed that more than 1.2 million organs (3,884,505 kg) and 20,000 carcasses (4,547,718 kg) were condemned only due to parasitic causes during post-mortem inspection. In Rio Grande do Sul, in state inspection establishments, more than 1.7 million organs (8,210,559 kg) and 5,000 carcasses (1,243,200 kg) were condemned. These data are alarming and support the need for public policies to control these parasitic diseases.

Resumo Condenações durante o abate são importantes fontes de informação sobre a sanidade dos rebanhos. Ainda são altas as incidências de doenças parasitárias, as quais trazem consequências à saúde dos animais, são zoonoses e têm sua importância negligenciada em diversos países. O estudo objetivou quantificar não apenas as perdas encontradas, mas o prejuízo econômico resultante das condenações ao abate por causas parasitárias. Para isso foram analisados dados de abate de bovinos do Ministério da Agricultura Pecuária e Abastecimento, no período de 2012 a 2015, e dados da Secretaria da Agricultura Pecuária e Irrigação, do estado do Rio Grande do Sul, no período de 2014 a 2018. A quantidade de órgãos e carcaças condenados foi multiplicada pelos respectivos valores (em Reais), obtidos da indústria frigorífica e, posteriormente, convertidos para dólar. A análise brasileira de estabelecimentos com SIF (Serviço de Inspeção Federal) mostrou que mais de 1,2 milhão de órgãos (3.884.505 kg) e 20 mil carcaças (4.547.718 kg) foram condenados devido a causas parasitárias durante a inspeção. No estado do Rio Grande do Sul, nos estabelecimentos de inspeção estadual, foram condenados mais de 1,7 milhão de órgãos (8.210.559 kg) e 5 mil carcaças (1.243.200 kg). Os dados são alarmantes e ressaltam a necessidade de políticas públicas para controlar estas parasitoses.

The socio-economic burden of cystic echinococcosis in Morocco: A combination of estimation method.

Cystic echinococcosis (CE) is a major zoonosis in Morocco despite the launch of a national control programme in 2005. As its economic consequences have not been studied yet in Morocco, this study estimated CE impact in terms of monetary losses, disability-adjusted life years (DALY), and DALY for zoonotic diseases (zDALY) in the entire country and in specific regions for the 2011 to 2014 period. The direct monetary losses were related to organ seizure from infected animal in slaughterhouses, and to healthcare expenses as well as lost wages for infected humans. Animal production losses concerned milk yield, fertility, carcass weight, and wool production. Losses due to human infection were also composed of disability and productivity losses at work. Monte Carlo simulations were used to estimate monetary losses and zDALY values. Nationwide, the estimated DALY was 0.5 years per 100,000 persons per year, and the zDALY was 55 years per 100,000 persons per year. Total yearly losses were estimated at 73 million USD (54-92 million USD). However, losses differed significantly among regions. Most of the economic losses consisted of unperceived consequences, i.e. decreased animal production and reduced productivity of asymptomatic individuals. Future studies should determine the socioeconomic and epidemiological factors underlying the differences in economic losses among regions to develop better adapted control programmes.

Zoonotic and vector-borne parasites and epilepsy in low-income and middle-income countries.

Zoonotic and vector-borne parasites are important preventable risk factors for epilepsy. Three parasitic infections - cerebral malaria, Taenia solium cysticercosis and onchocerciasis - have an established association with epilepsy. Parasitoses are widely prevalent in low-income and middle-income countries, which are home to 80% of the people with epilepsy in the world. Once a parasitic infection has taken hold in the brain, therapeutic measures do not seem to influence the development of epilepsy in the long term. Consequently, strategies to control, eliminate and eradicate parasites represent the most feasible way to reduce the epilepsy burden at present. The elucidation of immune mechanisms underpinning the parasitic infections, some of which are parasite-specific, opens up new therapeutic possibilities. In this Review, we explore the pathophysiological basis of the link between parasitic infections and epilepsy, and we consider preventive and therapeutic approaches to reduce the burden of epilepsy attributable to parasitic disorders. We conclude that a concerted approach involving medical, veterinary, parasitological and ecological experts, backed by robust political support and sustainable funding, is the key to reducing this burden.

Costs and Benefits of Alternative Strategies to Control the Spread of Livestock-Acquired Methicillin-Resistant Staphylococcus Aureus From Pig Production.

BACKGROUND: Livestock-acquired methicillin-resistant Staphylococcus aureus (LA-MRSA) is a concern in healthcare and a political priority in some countries. OBJECTIVE: This study investigates the net societal costs of 2 alternative strategies for controlling LA-MRSA in Denmark: (1) eradicating LA-MRSA in all pig housing units, and (2) containing LA-MRSA within the units. METHODS: Benefits and costs are considered for affected economic sectors: healthcare, pig production, pig-related industries, and public administration. RESULTS: The cost to society of eradication is estimated at €2.3 to €2.5 billion (present value). Containment will cost €55 to €93 million. For both strategies, the main cost lies in primary pig production-for containment this is mainly due to establishing and operating anterooms and shower rooms, and for eradication it is due to production losses, loss of genetic resources, and costs of cleaning and disinfection. CONCLUSION: Compared with these costs, health economic benefits are moderate for both strategies. Containment is superior to eradication when measured by a benefit-cost ratio.

Placing a monetary value on the human health component of zoonotic diseases: A methodological note with an application to cysticercosis in Africa.

Ideally, policies aiming to tackle zoonotic diseases in animals and reduce the burden of disease in humans should be based on an assessment of the cost and benefits of alternative interventions. However, while the cost of actions targeting diseases in animals and humans and the benefits in terms of increased livestock production can be monetized, it is a challenge to monetize improvements in the quality of life or to life expectancy extensions in humans in zoonotic policy evaluations. This paper proposes a method to monetize the human health benefits derived from zoonotic disease reduction and applies it to cysticercosis in Burkina Faso, Egypt, Ethiopia, Kenya, Nigeria and Uganda. We propose a three-step approach to estimate the human health component of the monetary impact of zoonoses. First, we proxy society's willingness to pay to avoid a disability adjusted life year (DALY) using the annualized value of statistical life (VSL) estimated by of the United States Department of Health and Human Services. Second, we implement a benefit transfer methodology to transfer the US value into the context of the sampled countries, accounting for differences in income levels. Finally, we use the 2016 Global Burden of Disease (GBD, 2018) data on cysticercosis to estimate its monetary impact on human health. All results are estimated in current international dollars using purchasing power parity (USD PPP) exchange rates. In the sampled countries, willingness to pay to avoid a DALY is estimated between USD PPP 2 000 and USD PPP 12 700. In most cases, these estimates fall within the range of 1 and 3 times the GDP per capita. The estimated monetary value of the DALYs due to human infections of cysticercosis per 100 000 people ranges between USD PPP 18 000 and USD PPP 98 000 per year. The proposed methodology might represent a first step towards providing a consistent and unbiased measure of the benefits of interventions targeting prevention, detection and control of zoonotic diseases.

Epidemiological Scenario of Anisakidosis in Spain Based on Associated Hospitalizations: The Tip of the Iceberg.

BACKGROUND: The risk of infection with Anisakis has been recognized for some time, but it is now emerging due to major awareness, better diagnostic techniques, and increasing preference for raw or lightly cooked food. Spain has the second-highest reported incidence after Japan, though the real anisakidosis burden is unknown because of the scarcity of epidemiological data. This study provides a 19-year review of anisakidosis-related hospitalizations describing epidemiological trends and patient characteristics. METHODS: We performed a retrospective descriptive study using the Spanish Hospitalization Minimum Data Set from 1997 to 2015. Hospitalization rates were calculated and spatial distribution of cases and their temporal behavior were assessed. Clinical characteristics were described, including related codiagnoses and procedures. RESULTS: A total of 2471 hospital discharges were identified. A continuous increasing trend was observed, with several peaks. Most affected communities were located in the northwest inland part of the country. Almost 54% of hospitalized patients were male, with a mean age of 51.3 years. Median length of stay was 5 days, and the hospitalization median cost around €2900. Fatal outcome occurred in 0.5%. Most frequent codiagnoses were digestive diseases, mainly intestinal obstruction. Urticaria, anaphylactic reaction, and angioneurotic edema were only recorded in 2.2%, 2.4%, and 1.2%, respectively. CONCLUSIONS: Knowing that hospitalization is unusual in anisakidosis, we offer calculations of the real disease burden. Improving disease surveillance in parallel to disease control will be useful both in gaining extended disease knowledge and reducing morbidity and related costs.

Improved methods to capture the total societal benefits of zoonotic disease control: Demonstrating the cost-effectiveness of an integrated control programme for Taenia solium, soil transmitted helminths and classical swine fever in northern Lao PDR.

BACKGROUND: Control and elimination of zoonotic diseases requires robust information about their effect on both human and livestock health in order to enable policy formulation and the allocation of resources. This study aimed to evaluate the cost-effectiveness of controlling Taenia solium taeniasis/cysticercosis in both humans and pigs, and soil-transmitted helminths (STH) in humans by integrating their control to on-going human and animal health control programmes in northern Lao People's Democratic Republic. METHOD: A cross-sectional study was carried out in 49 households, focusing on the prevalence of T. solium taenias/cysticercosis and soil transmitted helminths before and after a twelve month intervention. The village data was collected using a semi-structured questionnaire through a door-to-door survey. The village data was then projected to the wider northern Lao PDR population using stochastic modelling and cost-effectiveness ratio (after aggregating the net cost to capture both human and animal health parameters) and GDP per capita as a threshold, to determine the cost-effectiveness of the integrated control of T. solium taeniasis/ cysticercosis and STH, assuming linear scaling out of the intervention. The zoonotic DALY (zDALY) approach was also used as an alternative method of estimating the cost-effectiveness ratio of controlling T. solium taeniasis/cysticercosis in humans and pigs. FINDINGS: Using cost-effectiveness analysis after aggregating the net cost and control of T. solium taeniasis/cysticercosis alone as the base case, the study found that simultaneous control of T. solium taeniasis/cysticercosis in humans and pigs, STH in humans and Classical Swine Fever (CSF) in pigs was USD 14 per DALY averted and USD 234 per zDALY averted using zDALY method hence considered highly cost-effective whereas controlling T. solium taeniasis/cysticercosis without incorporating STH and CSF was the least cost-effective (USD 3,672 per DALY averted). Additionally, the cost-effectiveness of controlling T. solium taeniasis/cysticercosis in people and pigs using zDALY as an alternative method was USD 3,662 per zDALY averted which was quite close to our findings using the aggregate net cost method. CONCLUSION: The study showed that control of T. solium taeniasis/cysticercosis alone in humans and pigs is not cost-effective in northern Lao PDR whereas control of STH is. Consequently, integrating T. solium taeniasis/cysticercosis control with other cost-effective programmes such as STH and CSF markedly improved the cost-effectiveness of the intervention. This is especially important in low resource countries where control of zoonotic neglected tropical diseases could be integrated with the human and animal health sectors to optimize use of the limited resources. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614001067662.

Taenia solium from a community perspective: Preliminary costing data in the Katete and Sinda districts in Eastern Zambia.

The tapeworm Taenia solium is endemic in Zambia, however its socioeconomic cost is unknown. During a large-scale interventional study conducted in Zambia, baseline economic costs of human and porcine T. solium infections were measured. Questionnaire surveys were conducted within three neighbourhoods in Zambia's Eastern province in 2015 and 2016. A human health questionnaire, capturing costs of clinical symptoms commonly attributable to human cysticercosis and taeniasis, was conducted in randomly selected households (n = 267). All pig-keeping households were administered a pig socioeconomic questionnaire (n = 271) that captured pig demographic data, costs of pig-keeping, and economic losses from porcine cysticercosis. Of all respondents 62% had reportedly experienced at least one of the surveyed symptoms. Seizure-like episodes were reported by 12%, severe chronic headaches by 36%, and vision problems by 23% of respondents. These complaints resulted in 147 health care consultations and 17 hospitalizations in the five years preceding the study, and an estimated productivity loss of 608 working days per year. Of all pigs 69% were bought within villages. Nearly all adult pigs were sold to local traders, and tongue palpation for detection of cysticerci was commonly performed. Reportedly, 95% of pig owners could not sell tongue-positive pigs, while infected pigs fetched only 45% of the normal sale value. These preliminary costing data indicate that human and porcine T. solium infections substantially impact endemic areas of Eastern Zambia. A full socioeconomic burden assessment may enable improved T. solium management in sub-Saharan Africa.

The challenges of implementing an integrated One Health surveillance system in Australia.

As 75 per cent of emerging infectious diseases are of animal origin, a One Health approach that integrates the health of humans, animals and the environment could provide an earlier opportunity for zoonotic disease detection and prevention. In Australia, human, animal and ecological health are managed by separate sectors with limited communication. This study aims to explore how professionals in these fields perceive a One Health approach to zoonotic disease surveillance, aiming to identify the challenges to the implementation of an integrated system in Australia. Using a qualitative research method, ten semistructured interviews were conducted with academic experts to gain insight into the possibility of developing an integrated surveillance system in Australia. A thematic analysis of the data was undertaken. Findings showed the absence of a clear definition and subsequent vision for the future of One Health act as a barrier to interdisciplinary collaboration, and that siloed approaches by different sectors restrict the ability for professionals to work collaboratively across disciplines. An understanding of disease transmission was considered by participants to be a necessary requirement for a successful One Health approach. Finally, participants considered political will an essential requirement for the integration of surveillance systems. This study demonstrates that for a One Health approach to be implemented in an Australian setting, those working in the fields of human, animal and ecological health must agree on several aspects. The establishment of a formal governance body with representatives from each sector could assist in overcoming long-standing barriers of privacy and distrust. Further, developing interdisciplinary training in One Health concepts for medical, environmental and veterinary students may encourage cross-disciplinary collaboration. Finally, demonstrating to policymakers the economic benefit of improved and timely detection of zoonoses may help in facilitating a structured One Health approach to disease surveillance in Australia.

A review of bovine fasciolosis and other trematode infections in Nigeria.

Trematode infections cause serious economic losses to livestock worldwide. Global production losses due to fasciolosis alone exceed US$3 billion annually. Many trematode infections are also zoonotic and thus a public health concern. The World Health Organization has estimated that about 56 million people worldwide are infected by at least one zoonotic trematode species, and up to 750 million people are at risk of infection. Fasciolosis caused by the fluke Fasciola gigantica is endemic in Nigeria and is one of the most common causes of liver condemnation in abattoirs. Total cattle losses from Fasciola infection in Nigeria have been estimated to cost £32.5 million. Other trematode infections of cattle, including paramphistomosis, dicrocoeliasis and schistosomiasis, have all been reported in various parts of Nigeria, with varying prevalence. Most publications on trematode infections are limited to Nigerian local and national journals, with very few international reports. This paper therefore summarized the current data on distribution, control and zoonotic trematode infections in Nigeria and other African countries. We also identified research gaps and made recommendations for future research and areas for funding for policy/planning.

Estimates of the burden of illness for eight enteric pathogens associated with animal contact in Canada.

Enteric pathogens are commonly known to be transmitted through food or water; however, contact with animals is another important transmission route. This study estimated the annual burden of illness attributable to animal contact for eight enteric pathogens in Canada. Using data from a Canadian expert elicitation on transmission routes, the proportion of enteric illnesses attributable to animal contact was estimated for each pathogen to estimate the annual number of illnesses, hospitalizations and deaths in Canada. For each estimate, a mean and probability intervals were generated. Of all illnesses caused by these eight pathogens, 16% were estimated attributable to animal contact. This estimate translates to 86 000 (31 000-166 000) illnesses, 488 (186-890) hospitalizations and 12 (2-28) deaths annually for the eight pathogens combined. Campylobacter spp. is the leading cause of illnesses annually, with an estimated 38 000 (14 000-71 000) illnesses occurring each year, followed by non-typhoidal Salmonella spp. (17 000, 6000-32 000). The majority of hospitalizations were attributable to non-typhoidal Salmonella spp. (36%) and Campylobacter spp. (31%). Non-typhoidal Salmonella spp. (28%) and Listeria monocytogenes (31%) were responsible for the majority of the estimated deaths. These results identify farm animal and pet/pet food exposure as key pathways of transmission for several pathogens. The estimated burden of illness associated with animal contact is substantial.

Vaccinia Virus Natural Infections in Brazil: The Good, the Bad, and the Ugly.

The orthopoxviruses (OPV) comprise several emerging viruses with great importance to human and veterinary medicine, including vaccinia virus (VACV), which causes outbreaks of bovine vaccinia (BV) in South America. Historically, VACV is the most comprehensively studied virus, however, its origin and natural hosts remain unknown. VACV was the primary component of the smallpox vaccine, largely used during the smallpox eradication campaign. After smallpox was declared eradicated, the vaccination that conferred immunity to OPV was discontinued, favoring a new contingent of susceptible individuals to OPV. VACV infections occur naturally after direct contact with infected dairy cattle, in recently vaccinated individuals, or through alternative routes of exposure. In Brazil, VACV outbreaks are frequently reported in rural areas, affecting mainly farm animals and humans. Recent studies have shown the role of wildlife in the VACV transmission chain, exploring the role of wild rodents as reservoirs that facilitate VACV spread throughout rural areas. Furthermore, VACV circulation in urban environments and the significance of this with respect to public health, have also been explored. In this review, we discuss the history, epidemiological, ecological and clinical aspects of natural VACV infections in Brazil, also highlighting alternative routes of VACV transmission, the factors involved in susceptibility to infection, and the natural history of the disease in humans and animals, and the potential for dissemination to urban environments.

The economic efficiency and equity of government policies on brucellosis: comparative insights from Albania and the United States of America.

Brucellosis is a zoonotic bacterial disease that causes recurring febrile illness in humans, as well as reproductive failure and reduced milk production in livestock. The cost of brucellosis is equal to the sum of lost productivity of humans and animals, as well as private and public expenditures on brucellosis surveillance, prevention, control and treatment. In Albania, Brucella abortus and B. melitensis affect humans, cattle and small ruminants. In the United States, B. abortus affects cattle and wild ungulates in the Greater Yellowstone Area. These two case studies illustrate the importance of place-specific context in developing sustainable and effective brucellosis mitigation policies. Government regulations and mitigation strategies should be designed with consideration of all costs and benefits, both to public agencies and private stakeholders. Policy-makers should, for example, weigh the benefits of a regulation that increases epidemiological certainty against the costs of compliance for producers and households. The distribution of costs and benefits amongst public agencies and private individuals can have important implications for a policy's economic efficiency and equity quite apart from their total magnitude.

La brucellose est une maladie bactérienne zoonotique responsable d'épisodes fébriles récurrents chez l'être humain ainsi que d'infertilités et d'une baisse de la production de lait chez les animaux d'élevage. Le coût de la brucellose équivaut à la somme des pertes de productivité chez l'homme et chez les animaux et des dépenses privées et publiques engagées dans la surveillance, la prévention, la prophylaxie et le traitement de la brucellose. En Albanie, Brucella abortus et B. melitensis affectent aussi bien l'être humain que les bovins et les petits ruminants. Aux États-Unis d'Amérique, B. abortus affecte les bovins et les ongulés sauvages de la région du Grand Yellowstone. Les deux études de cas présentées dans cet article illustrent l'importance de prendre en compte le contexte spécifique de chaque site particulier lors de la mise en place de politiques durables et efficaces d'atténuation de la brucellose. La réglementation et les stratégies d'atténuation mises en oeuvre par les pouvoirs publics doivent être conçues en considérant l'ensemble des coûts et des bénéfices induits pour les agences gouvernementales et les intervenants privés. Par exemple, les décideurs politiques devraient évaluer les avantages induits par une réglementation basée sur un accroissement des certitudes épidémiologiques, par rapport aux coûts supportés par les producteurs et les ménages se conformant à cette réglementation. La répartition des coûts et des bénéfices entre les agences gouvernementales et les individus privés peut avoir d'importantes répercussions sur l'efficacité économique et l'équité d'une politique sanitaire, indépendamment de leur amplitude totale.

La brucelosis es una enfermedad bacteriana zoonótica que provoca dolencias febriles recurrentes en el ser humano, así como trastornos reproductores y una menor producción lechera en el ganado. Su costo es igual a la suma de las pérdidas de productividad en personas y animales, junto con el gasto público y privado dedicado a tareas de vigilancia, prevención, control y tratamiento de la enfermedad. En Albania, Brucella abortus y B. melitensis afectan a personas, ganado bovino y pequeños rumiantes. En los Estados Unidos, B. abortus afecta al ganado bovino y a ungulados salvajes de la zona del Gran Yellowstone. Los autores presentan dos estudios monográficos que ponen de relieve la importancia del contexto geográfico a la hora de definir políticas duraderas y eficaces para mitigar la brucelosis. Al elaborar tanto reglamentos como estrategias públicas de mitigación es preciso tener en cuenta la totalidad de los costos y beneficios, a la vez para los organismos oficiales y para el sector privado. Los planificadores deben, por ejemplo, sopesar los beneficios derivados de un reglamento que aporte mayor certidumbre epidemiológica en relación con los costos que entrañe su aplicación para productores y familias. La forma en que costos y beneficios se distribuyan entre organismos públicos y personas físicas puede influir sustancialmente en los niveles de eficiencia económica y equidad de una política, con independencia de su magnitud total.

DALYs, dollars and dogs: how best to analyse the economics of controlling zoonoses.

Decision-makers increasingly require comprehensive economic metrics summarising and comparing the benefits and costs of controlling zoonotic diseases. The impact of disease in people is conventionally quantified in non-monetary terms, usually a disability-adjusted life year (DALY), whereas the losses due to disease in animals, particularly livestock, are quantified in monetary terms. The potential for the development of a non-monetary metric for ill health in animals, based on life years lost and disability, is discussed and rejected. Within and across animal species and livestock production systems, maximising life spans is not a consistent goal and morbidity/disabilities have very different weights and often lead to culling. By relating livestock losses to a measure of national income forgone, the recently developed alternative of converting monetary losses due to livestock illness into an animal loss equivalent (ALE) provides a viable solution. Based on this, the literature on the economics of controlling zoonoses is revisited and four options for quantifying and comparing benefits and costs are examined and illustrated using numerical examples. These are i) the simplistic grouping of all monetary elements and their comparison to DALYs averted (described as the aggregate net cost method), ii) the separable costs method, iii) the use of ALEs to convert all benefits to a non-monetary equivalent, termed the zoonotic DALY (zDALY), or iv) the use of a full monetary cost-benefit analysis, based on converting DALYs to a monetary equivalent. The strengths and weaknesses of each are discussed. For effective prioritisation and decision-making, it is vital that an analytical approach is widely adopted which yields consistent results and which supports the control of zoonoses.

Les décideurs politiques sont de plus en plus dépendants de méthodes exhaustives de mesure économique permettant de synthétiser et de comparer les avantages et les coûts de la lutte contre les zoonoses. Par convention, l'impact des maladies humaines est quantifié en des termes non monétaires, à savoir, le plus souvent, en « années de vie corrigées de l'incapacité ¼ (DALY), tandis que les pertes dues aux maladies animales, en particulier celles affectant les animaux d'élevage, sont quantifiées en termes monétaires. Dans cet article, les auteurs envisagent (et réfutent) la possibilité de mettre en oeuvre un système de mesure non monétaire des problèmes sanitaires chez les animaux qui soit basé sur les années de vie perdues ou d'incapacité. La longévité n'est pas un objectif uniformément recherché dans tous les systèmes de production, ni pour toutes les espèces animales, voire pour tous les individus au sein d'une même espèce, et la morbidité et l'incapacité représentent des fardeaux très variables, conduisant souvent à l'abattage. Parce qu'elle relie les pertes animales à une mesure de la réduction du revenu intérieur entraînée, la récente proposition de convertir les pertes monétaires dues aux maladies du bétail en un « équivalent pertes animales ¼ (indicateur ALE : animal loss equivalent) constitue une solution viable. À partir de ces considérations, les auteurs examinent la littérature dédiée aux aspects économiques de la lutte contre les zoonoses en détaillant quatre méthodes possibles pour en quantifier et comparer les avantages et les coûts, avec des exemples chiffrés. Ces possibilités sont : i) le simple regroupement de tous les éléments monétaires et leur comparaison en termes de DALY évitées (méthode dite de la présentation agrégée des coûts nets) ; ii) la méthode des coûts séparables ; iii) l'utilisation d'un indicateur ALE pour convertir l'ensemble des bénéfices en leur équivalent non monétaire, désigné sous le terme de DALY zoonotique (zDALY) ; iv) le recours à une analyse monétaire coûts-avantages exhaustive, après avoir converti les DALY en leur équivalent monétaire. Les auteurs font ressortir les atouts et les faiblesses de chacune de ces méthodes. La priorisation et la prise de décisions gagneront en efficacité si les décideurs adoptent et appliquent largement une approche analytique permettant d'obtenir des résultats cohérents et de renforcer la lutte contre les zoonoses.

Cada vez más, las instancias decisorias necesitan parámetros econométricos integrales, que sirvan para sintetizar y comparar los costos y beneficios de la lucha contra enfermedades zoonóticas. Convencionalmente, los efectos de una enfermedad en las personas se cuantifican en términos no monetarios, por lo general en forma de «años de vida ajustados en función de la discapacidad¼ (AVAD), mientras que las pérdidas inducidas por las enfermedades en animales, en particular el ganado, se cuantifican en valores monetarios. Los autores examinan y descartan la posible definición de parámetros no monetarios, basados en los años de vida perdidos y en la discapacidad, para cuantificar problemas zoosanitarios. Con independencia de la especie animal o el sistema de producción ganadera de que se trate, el de lograr una longevidad máxima no es un objetivo habitual, y los niveles de morbilidad o discapacidad, que suelen desembocar en el sacrificio sanitario, tienen un peso muy variable. En fechas recientes ha aparecido una alternativa que, al establecer una relación entre las pérdidas de ganado y una medida de la renta nacional prevista, ofrece una solución viable: se trata de convertir las pérdidas monetarias causadas por enfermedades del ganado en un «equivalente a las pérdidas animales¼ (animal loss equivalent: ALE). Partiendo de esta idea, los autores repasan la bibliografía sobre la economía de la lucha contra las zoonosis y examinan cuatro opciones para cuantificar y comparar beneficios y costos, ilustrándolas con ejemplos numéricos. Se trata de las siguientes: i) el simplificador procedimiento de agrupar todos los elementos monetarios y compararlos con los AVAD evitados (método que describen como del «costo agregado neto¼); ii) el método de los costos específicos; iii) el uso de «equivalentes a las pérdidas animales¼ para convertir todos los beneficios en un equivalente no monetario que denominan AVAD por zoonosis; y iv) el uso de un análisis monetario completo de la relación entre beneficios y costos, basado en la conversión de los AVAD en un equivalente monetario. A continuación examinan los puntos fuertes y débiles de cada uno de esos métodos, y concluyen que para fijar prioridades y adoptar decisiones con eficacia es vital aplicar de forma generalizada un mismo planteamiento analítico, que arroje resultados coherentes y ayude así a combatir las zoonosis.

Fatal and non-fatal animal-related injuries and illnesses to workers, United States, 2011-2014.

BACKGROUND: Study provides update of national estimates for work-related fatal injuries and non-fatal injuries and illnesses by animals in US. METHODS: Between 2011 and 2014, injuries and illnesses were retrieved from US Department of Labor and were translated to economic losses using National Safety Council estimates. RESULTS: Total of 222 fatalities (36% by cattle and other bovines) and 71 460 non-fatal injuries and illnesses (38% by insects, arachnids, mites) were identified from animal sources. For non-fatal injuries and illnesses from primary animal sources, annual incidence rates were 1.5-1.6/10 000 full-time workers and annual median days lost from work were 3-4 days. Work-related costs were $222M for fatalities and $2.8B for non-fatal injuries and illnesses that resulted in at least 1 day lost from work. CONCLUSIONS: Study provides evidence of specific animals contributing to more severe injuries and potential for more severe injuries when there is more than one source of injury.

Economic factors influencing zoonotic disease dynamics: demand for poultry meat and seasonal transmission of avian influenza in Vietnam.

While climate is often presented as a key factor influencing the seasonality of diseases, the importance of anthropogenic factors is less commonly evaluated. Using a combination of methods - wavelet analysis, economic analysis, statistical and disease transmission modelling - we aimed to explore the influence of climatic and economic factors on the seasonality of H5N1 Highly Pathogenic Avian Influenza in the domestic poultry population of Vietnam. We found that while climatic variables are associated with seasonal variation in the incidence of avian influenza outbreaks in the North of the country, this is not the case in the Centre and the South. In contrast, temporal patterns of H5N1 incidence are similar across these 3 regions: periods of high H5N1 incidence coincide with Lunar New Year festival, occurring in January-February, in the 3 climatic regions for 5 out of the 8 study years. Yet, daily poultry meat consumption drastically increases during Lunar New Year festival throughout the country. To meet this rise in demand, poultry production and trade are expected to peak around the festival period, promoting viral spread, which we demonstrated using a stochastic disease transmission model. This study illustrates the way in which economic factors may influence the dynamics of livestock pathogens.