Catalysts for implementation of One Health in Kenya.

The recent Zika outbreak in the Americas, Ebola epidemic in West Africa and the increased frequency and impact of emerging and re-emerging infections of animal origin have increased the calls for greater preparedness in early detection and responses to public health events. One-Health approaches that emphasize collaborations between human health, animal health and environmental health sectors for the prevention, early detection and response to disease outbreaks have been hailed as a key strategy. Here we highlight three main efforts that have progressed the implementation of One Health in Kenya.

Strong Association Between Human and Animal Brucella Seropositivity in a Linked Study in Kenya, 2012-2013.

Brucellosis is a common bacterial zoonotic infection but data on the prevalence among humans and animals is limited in Kenya. A cross-sectional survey was conducted in three counties practicing different livestock production systems to simultaneously assess the seroprevalence of, and risk factors for brucellosis among humans and their livestock (cattle, sheep, camels, and goats). A two-stage cluster sampling method with random selection of sublocations and households was conducted. Blood samples were collected from humans and animals and tested for Brucella immunoglobulin G (IgG) antibodies. Human and animal individual seroprevalence was 16% and 8%, respectively. Household and herd seroprevalence ranged from 5% to 73% and 6% to 68%, respectively. There was a 6-fold odds of human seropositivity in households with a seropositive animal compared with those without. Risk factors for human seropositivity included regular ingestion of raw milk (adjusted odds ratio [aOR] = 3.5, 95% confidence interval [CI] = 2.8-4.4), exposure to goats (herding, milking, and feeding) (aOR = 3.1, 95% CI = 2.5-3.8), and handling of animal hides (aOR = 1.8, 95% CI = 1.5-2.2). Attaining at least high school education and above was a protective factor for human seropositivity (aOR = 0.3, 95% CI = 0.3-0.4). This linked study provides evidence of a strong association between human and animal seropositivity at the household level.

Occurrence of rift valley fever in cattle in Ijara district, Kenya.

Ijara district in Kenya was one of the hotspots of rift valley fever (RVF) during the 2006/2007 outbreak which led to human and animal deaths causing huge economic and public health losses. The main constraint in the control and prevention of RVF is inadequate knowledge on its occurrence during the interepidemic period. This study was aimed at understanding the occurrence of RVF in cattle in Ijara to enable the development of improved community-based disease surveillance, prediction, control and prevention. Six herds each 700-1000 cattle were identified with participatory involvement of locals and project technical team of the project. One animal per herd was tagged with global position system (GPS) collar to enable follow up. Sero-surveys were conducted periodically to understand the herd's movement through various ecological zones and risk of exposure to RVF virus. Sixty animals less than 3 years old from each herd were randomly selected each sampling time and sero-surveyed for RVF four times (September 2012, December 2012, February 2013 and May 2013) during the study period and along the nomadic movement route. The serum samples collected were subjected to RVF inhibition ELISA test to detect if there was exposure for RVF virus (RVFV). The RVF inhibition ELISA positive samples were subjected to IgM ELISA test to determine if the exposures were current or recent (within 14 days). The result of the survey indicated that 13.1% (183/1396) of cattle sero-surveyed had RVFV antibodies by inhibition ELISA test while 1.4% (18/1396) was positive for IgM ELISA test. The highest RVFV circulation was detected after herds pass through bony forest between Lamu and Ijara and Halei forested areas. These forested areas also had the highest IgM detections. The findings indicate that even limited rainfall was able to initiate RVFV circulation in Ijara region with highest circulation detected within forested areas with potential to become epidemic if rains persist with extensive flooding. There is need to carry out regular participatory disease surveillance in domestic animals and other host systems to identify risk locations in hotspot areas and carry out community awareness and focal vaccination campaigns against RVF for preparedness, prevention and control. Additionally, monitoring of environmental conditions in risky ecological zones to detect enhanced rainfall and flooding should be prioritized for preparedness.

Perceived risk factors and risk pathways of Rift Valley fever in cattle in Ijara district, Kenya.

Ijara district in Kenya was one of the hotspots of Rift Valley fever (RVF) during the 2006/2007 outbreak, which led to human and animal deaths causing major economic losses. The main constraint for the control and prevention of RVF is inadequate knowledge of the risk factors for its occurrence and maintenance. This study was aimed at understanding the perceived risk factors and risk pathways of RVF in cattle in Ijara to enable the development of improved community-based disease surveillance, prediction, control and prevention. A cross-sectional study was carried out from September 2012 to June 2013. Thirty-one key informant interviews were conducted with relevant stakeholders to determine the local pastoralists' understanding of risk factors and risk pathways of RVF in cattle in Ijara district. All the key informants perceived the presence of high numbers of mosquitoes and large numbers of cattle to be the most important risk factors contributing to the occurrence of RVF in cattle in Ijara. Key informants classified high rainfall as the most important (12/31) to an important (19/31) risk factor. The main risk pathways were infected mosquitoes that bite cattle whilst grazing and at watering points as well as close contact between domestic animals and wildlife. The likelihood of contamination of the environment as a result of poor handling of carcasses and aborted foetuses during RVF outbreaks was not considered an important pathway. There is therefore a need to conduct regular participatory community awareness sessions on handling of animal carcasses in terms of preparedness, prevention and control of any possible RVF epizootics. Additionally, monitoring of environmental conditions to detect enhanced rainfall and flooding should be prioritised for preparedness.

Establishing a One Health office in Kenya.

A One Health (OH) approach that integrates human,animal and environmental approaches to management of zoonotic diseases has gained momentum in the last decadeas part of a strategy to prevent and control emerging infectious diseases. However, there are few examples of howan OH approach can be established in a country. Kenya establishment of an OH office, referred to asthe Zoonotic Disease Unit (ZDU) in 2011. The ZDU bridges theanimal and human health sectors with a senior epidemiologist deployed from each ministry; and agoal of maintaining collaboration at the animal and human health interface towards better prevention and control of zoonoses. The country is adding an ecologist to the ZDU to ensure that environmental risks are adequately addressed in emerging disease control.