Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Interaksi Kelelawar dan Manusia: Potensi Zoonotik di Indonesia

In the last two decades, various types of infections caused by microorganisms occurred in some countries and most of them are emerging /re-emerging infectious diseases (EID/REID). Majority of EID/REID cases are a zoonosis, a disease that is naturally transmitted from animals to human. Bats are wild animals attracting global public health attention because they are related to the transmission of infectious viral diseases, such as Ebola, Marburg, Nipah, Severe Acute Respiratory Syndrome (SARS) Co-V and the Middle East Respiratory Syndromes (Mers Co-V). This review discusses the bats as a potential source of viral zoonotic both global and Indonesia, including the research activities that have been done. In the last two decades, various types of infections caused by microorganisms occur in some countries and are generally emerging/re-emerging infectious diseases (EID / REID). Most cases of EID / REID are zoonotic, a disease that is transmitted naturally from animal to human. Bats are wild animals that attract much attention in terms of global public health as they relate to the transmission of infectious diseases caused by viruses, such as Ebola, Marburg, Nipah, Severe Acute Respiratory Syndrome (SARS) Co-V and the Middle East Respiratory Syndromes Mers Co-V.    

Occurrence of measles genotype D8 during a 2014 outbreak in Banjarmasin, South Kalimantan, Indonesia

Objectives: An outbreak of measles symptoms occurring in children in Banjarmasin, South Kalimantan, Indonesia in 2014 was investigated. Methods: Nasal swabs were collected from 23 children (median age 41 months) with fever and other symptoms of measles hospitalized in Ulin General Hospital and Islamic Hospital, Banjarmasin, South Kalimantan. Viral RNA was extracted for cDNA synthesis, followed by PCR and sequencing using paramyxovirus family consensus and N-gene primers. Results: Sixteen measles-positive patients (70%) were identified. Fifteen virus strains belonged to genotype D8 and the remaining one strain was confirmed as belonging to genotype D9. Conclusion: Measles virus genotype D8 was detected in an outbreak of measles in South Kalimantan, Indonesia, in 2014

Central nervous system infection in a pediatric population in West Java.

Central nervous system (CNS) viral infections are critical causes of morbidity and mortality in children; however, comprehensive data on etiology is lacking in developing countries such as Indonesia. To study the etiology of CNS infections in a pediatric population, 50 children admitted to two hospitals in Bandung, West Java, during 2017-2018 were enrolled in a CNS infection study. Cerebrospinal fluid and serum specimens were tested using molecular, serological, and virus isolation platforms for a number of viral and bacteriological agents. Causal pathogens were identified in 10 out of 50 (20%) and included cytomegalovirus (n = 4), Streptococcus pneumoniae (n = 2), tuberculosis (n = 2), Salmonella serotype Typhi (n = 1) and dengue virus (n = 1). Our study highlights the importance of using a wide range of molecular and serological detection methods to identify CNS pathogens, as well as the challenges of establishing the etiology of CNS infections in pediatric populations of countries with limited laboratory capacity

Detection of central nervous system viral infections in adults in Manado, North Sulawesi, Indonesia.

Central nervous system (CNS) viral infections are important causes of morbidity and mortality worldwide but the systematic survey of patients admitted to hospitals with CNS infections in many countries, including Indonesia, is limited. To obtain more information regarding the causes of CNS infections in Indonesia, this study was performed to detect and identify viral agents associated with CNS infections amongst in-patients at a referral hospital in Manado, North Sulawesi, Indonesia. Adult patients admitted to R.D. Kandou General Hospital with presumed CNS infection were enrolled. Cerebrospinal fluid, serum, and throat swab samples were collected and tested using molecular, serological, and virus isolation assays. A confirmed viral etiology was established in three and a probable/possible in 11 out of 74 patients. The most common was herpes simplex virus 1 (7/74, 9.5%), followed by Epstein-Barr virus (2/74, 2.7%), cytomegalovirus (1/74, 1.4%), enterovirus D68 (1/74, 1.4%), rhinovirus A (1/74, 1.4%), dengue virus (1/64, 1.6%), and Japanese encephalitis virus (1/64, 1.6%). There were 20 fatal cases (27.0%) during hospitalization in which eight were associated with viral causes. We identified herpes simplex virus 1 as the most common cause of CNS infection among adults in North Sulawesi with most of the cases remaining undiagnosed. Our study highlights the challenges in establishing the etiology of viral CNS infections and the importance of using a wide range of molecular and serological detection methods to identify CNS viruses

Patient enrollment and testing algorithm of CNS infection study.

Patient enrollment and testing algorithm of CNS infection study.</p

Clinical and laboratory data of pediatric patients in general and with confirmed etiology of CNS infection, Bandung, Indonesia.

Clinical and laboratory data of pediatric patients in general and with confirmed etiology of CNS infection, Bandung, Indonesia.</p