International Health Regulations and COVID-19 pandemic, challenges and gaps.

International Health Regulations 2005 contributed to the development of public health emergency control programs of international concern. The aim of their application was to mitigate the effects of the spread of such emergencies by proactive measures, stemming from risk assessment and expanding to epidemiological modeling systems that allow a logical extrapolation of what these emergencies can cause, and develop codified international strategies to avoid the occurrence of public health emergencies of international concern as soon as they are early discovered. The COVID­19 pandemic came to be a model in which these regulations were tested in the biggest challenge that human societies have faced since the Second World War. The implementation of these IHR 2005 had a great positive role in limiting the spread of the disease, but some gaps, that could have been overcome and mitigate its consequences, appeared during the application of the precautionary economic, social and health quarantine systems. This study examines the importance of IHR 2005 and the main challenges it faced in general, focusing on the results of their application in the area of the COVID­19 pandemic and the gaps that have emerged in the technical, educational and political field and proposals to address them.

Stray animal populations and public health in the South Mediterranean and the Middle East regions.

Uncontrolled urban growth in South Mediterranean and the Middle East regions involves city dwellers and stray animals (mainly dogs and cats) creating a dense and downgraded environment, in which irregular street garbage collection disposes sufficient food for survival and proliferation of stray animals. Under such conditions serious public health hazards are expected due to the increase of animal bites, the multiplication of insects and rodents vectors of different viral, bacterial, fungal and parasitic agents to which humans are exposed. Traditional national stray animal eradication programs and occasional small animals' humane elimination campaigns are insufficient to avert human and veterinary health risks when not coupled with modern technologies. In such environments, multiple foci of emerging and re-emerging zoonoses easily spread, i.e. rabies, hydatidosis, leishmaniasis and toxoplasmosis. Upgrading urban and peri-urban situations requires integrated/coordinated management programmes, in which public and animal health services as well as municipalities have a crucial role. Control and upgrading programmes should be flexible and able to adapt to the specific conditions of the given country/region. In this context, intersectoral/interprofessional collaborations and community participation are crucial for any national and regional development strategies. In this respect, a global approach considering both public health and socio-economic problems shows to be extremely adequate and effective.

Population displacements as a risk factor for the emergence of epidemics.

Wars and civil conflicts have been terrible experiences since ancient times but, regretfully, they are always present even in the 21st century. Their catastrophic effects are still lived by many populations displaced from their native areas. Conflicts, particularly the civil ones, create disruption in most aspects of national structures and populations, which are forced to move to more or less safer or even distant areas, survive under downgraded conditions. They are usually housed in temporary shelters in overcrowded camps and contaminated environment. Water and food are neither safe nor sufficient. Malnutrition, lack or weak sanitary care and long-term stress lead these populations to being vulnerable to severe infections. Under such conditions there are high rates of morbidity and mortality, with elders and children being the main victims. Public health, animal health, municipalities and other inter-related sectors should work on preparedness plans well in advance in order to provide ways and means to face emergencies. Zoonotic and other communicable disease outbreaks should not be left uncontrolled, as their impact would be an additional burden for the country under unrest. Guidance should be provided on how to best articulate an emergency management plan from the early detection of outbreaks up to their control. These aspects are briefly exposed together with the imperative request for alleviation of suffering and of the multitude of hazards conflict-affected populations have to face.

Molecular and serological prevalence of Babesia bovis and Babesia bigemina in cattle from central region of Syria.

A total of 207 bovine blood samples were collected from clinically healthy cattle bred in central region of Syria and examined by Giemsa-stained blood smears, nested PCR, ELISA, and IFAT to determine the molecular and serological prevalence of Babesia bovis and B. bigemina. All samples were negative to Babesia spp. by microscopic examination of blood smears. On the other hand, the overall prevalence of B. bovis and B. bigemina was 9.18% and 15.46% by nPCR, 15.46% and 18.84% by ELISA, and 18.36% and 21.74% by IFAT, respectively. Mixed infections were detected in a total of 5 samples (2.4%) by nPCR, 16 (7.73%) by ELISA and 27 (13.04%) by IFAT. Statistically significant differences in the prevalence of the two infections were observed on the basis of age and location. These data provide valuable information regarding the occurrence and epidemiology of B. bovis and B. bigemina infections in Syrian cattle, which can be employed in developing rational strategies for disease control and management.

Control of zoonoses in emergency situations: lessons learned during recent outbreaks (gaps and weaknesses of current zoonoses control programmes).

In emergency situations, domestic animals and wildlife are, like people, exposed to infectious diseases and environmental contaminants in the air, soil, water and food. They can suffer from acute and/or chronic diseases from such exposure. Often animals serve as disease reservoirs or early warning systems for the community in regard to the spread of zoonotic diseases. Over 100 years of experience have shown that animal and human health are closely related. During the past few years, emergent disease episodes have increased; nearly all have involved zoonotic agents. As there is no way to predict when or where the next important new zoonotic pathogen will emerge or what its ultimate importance might be, investigation at the first sign of emergence of a new zoonotic disease is particularly important. Today, in many emerging situations, different activities involving zoonotic disease control are at risk because of failed investigative infrastructures or financial constraints. Considering that zoonotic diseases have their own characteristics, their prevention and control require unique strategies, based more on fundamental and applied research than on traditional approaches. Such strategies require cooperation and coordination between animal and public health sectors and the involvement of other disciplines and experts such as epidemiologists, entomologists, environmentalists and climatologists. Lessons learned from the avian influenza pandemic threat, the Crimean-Congo haemorrhagic fever and rabies outbreaks are presented and the gaps and weakness of current control programmes are discussed.