Climate change and other risk drivers of animal health and zoonotic disease emergencies: the need for a multidisciplinary and multisectoral approach to disaster risk management.

In recent times, there has been an increased focus on animal health and zoonotic diseases that have the potential to trigger epidemics or pandemics that disproportionately affect the poor and most vulnerable. The recent Ebola, Zika and COVID-19 outbreaks demonstrate the devastating human, social and economic impacts of such diseases if they are not prevented or controlled, ideally at source. The risk drivers for zoonoses, which are complex and often interdependent, include climate change and related disasters, antimicrobial resistance, and anthropogenic drivers such as land-use changes and animal production practices. Understanding these drivers requires a better understanding of the ecology of zoonotic diseases at the human-animal-environment interface. Biosecurity and biosafety are critical for reducing the risk of accidental or deliberate release and should be included in risk management strategies. International frameworks for sustainable development, climate change, and disaster risk reduction have all integrated health as one of the core areas of work, calling for better preparedness and response to biological hazards and increased health system resilience. To improve their ability to prevent, prepare for, and respond to emerging and re-emerging threats, countries should address these risk drivers, taking a multidisciplinary One Health approach that involves the animal and human health and environment sectors. Cross-border cooperation is also vital, as diseases know no boundaries.

Depuis quelque temps, les maladies animales et zoonotiques font l'objet d'une attention croissante du fait de leur potentiel épidémique ou pandémique qui affecte de manière disproportionnée les populations les plus pauvres et vulnérables. Les récents foyers de maladie d'Ebola, d'infection à virus Zika et de COVID-19 démontrent les conséquences humaines, sociales et économiques dévastatrices de ces maladies en l'absence d'une prévention ou d'un contrôle idéalement exercés à leur source. Parmi les facteurs de risque de zoonoses, complexes par nature et souvent interdépendants, on peut citer le changement climatique et les catastrophes qu'il induit, la résistance aux agents antimicrobiens et les facteurs anthropiques tels que les changements dans l'utilisation des terres et les pratiques de production animale. Pour bien appréhender ces facteurs de risque il est nécessaire de mieux comprendre l'écologie des maladies zoonotiques à l'interface homme­animal­ environnement. La biosûreté et la biosécurité jouent un rôle déterminant pour réduire le risque de dissémination accidentelle ou délibérée et devraient faire partie des stratégies de gestion du risque. Tous les cadres internationaux mis en place en matière de développement durable, de changement climatique et de réduction des risques de catastrophe ont mis la santé au cœur de leur champ d'action et plaident pour une meilleure préparation et intervention face aux menaces biologiques ainsi que pour une résilience accrue des systèmes de santé. Afin d'améliorer leurs capacités de prévention, de préparation et d'intervention face aux menaces émergentes et ré-émergentes, les pays doivent s'attaquer aux facteurs de risque à travers une approche multidisciplinaire Une seule santé qui associe les secteurs de la santé animale, de la santé publique et de la protection de l'environnement. La coopération transfrontalière est également vitale car les maladies ne connaissent pas les frontières.

En los últimos tiempos se viene prestando mayor atención a la sanidad animal y a enfermedades zoonóticas capaces de provocar epidemias o pandemias que afectan desproporcionadamente a las poblaciones pobres y más vulnerables. Los recientes brotes de enfermedad causados por los virus Ebola, Zika y SRASCoV-2 (la COVID-19) ponen de manifiesto las devastadoras consecuencias humanas, sociales y económicas de tales patologías si no se logra prevenirlas o controlarlas, de ser posible en su origen. Los factores de riesgo de zoonosis, complejos y a menudo interdependientes, son en particular el cambio climático y los desastres naturales que trae consigo, las resistencias a los antimicrobianos y factores antropogénicos como la evolución de los usos del suelo y los métodos de producción animal. Para desentrañar estos factores es preciso conocer mejor la ecología de las enfermedades zoonóticas en la interfaz de personas, animales y medio ambiente. La seguridad y la protección biológicas, esenciales para reducir el riesgo de liberación accidental o deliberada, deberían formar parte de toda estrategia de gestión del riesgo. En todos los textos de referencia internacionales relativos al desarrollo sostenible, el cambio climático y la reducción del riesgo de desastre la salud figura como uno de los ámbitos fundamentales de trabajo, que pasa por mejorar los niveles de preparación y respuesta ante los peligros biológicos y por conferir más resiliencia a los sistemas de salud. Para dotarse de mayor capacidad para prevenir amenazas emergentes y reemergentes, prepararse para ellas y darles respuesta, los países deben abordar los factores de riesgo desde una lógica multisectorial de Una sola salud que englobe los sectores de la sanidad animal, la salud humana y el medio ambiente. También es indispensable la cooperación transfronteriza, no en vano las enfermedades no conocen fronteras.

Use of therapeutic plasmapheresis in a case of canine immune-mediated hemolytic anemia.

OBJECTIVE: To investigate the clinical application and potential utility of plasmapheresis in canine immune-mediated hemolytic anemia. CASE SUMMARY: A 7-year-old spayed female Maltese diagnosed with immune-mediated hemolytic anemia was initially treated with prednisone, cyclosporine, and received multiple transfusions of packed RBC. Because of the progression of clinical signs despite traditional medical therapy, plasmapheresis was initiated. Plasma immunoglobulin G and immunoglobulin M levels were measured before, during, and after treatment to help determine if there had been a significant decrease in immunoglobulin levels with plasmapheresis. Plasmapheresis was successfully performed over a 2.5-hour period in this dog with minimal complications. Hypocalcemia was identified as a known complication of circuit anticoagulation, and was corrected through calcium supplementation. Post-plasmapheresis there was a decrease in immunoglobulin G and immunoglobulin M levels, and the patient showed clinical improvement. Following discharge the dog had no known complications of therapy, and had complete resolution of the anemia. NEW OR UNIQUE INFORMATION PROVIDED: Plasmapheresis was performed successfully with minimal complications. Because transfusion requirements appeared to be reduced, and the procedure was well tolerated, there may be a place for this modality in severe cases to act as a bridge until medical therapy takes full effect. Because of the cost of performing this therapy, and the potential requirement for multiple treatments, it should be reserved for selected patients.

Autotransfusion in the emergency patient.

As the need for blood products increases in the veterinary emergency setting, the technique of autologous transfusion is being re-explored. Analogous transfusions provide an immediate source of blood with known compatibility to the patient. With the advent of passive canister collection systems, the technique is becoming simplified and affordable for the veterinary community. Although complications such as coagulopathies and microemboli have been reported with the procedure, attention to patient selection, technique, and patient monitoring following transfusion greatly minimizes potential drawbacks.