Evaluating risks of paramyxovirus and coronavirus emergence in China

Viruses such HIV, SARS Coronavirus, Ebola, and influenza A virus pose significant burdens globally to human health due to their continued emergence from wildlife reservoirs such as birds, bats, and rodents. In southern China, animal markets, wildlife trade, and human activity create unique opportunities for zoonotic emergence as wild animals frequently come into contact with domestic animals and humans. Influenza A H7N9 virus and SARS emerged from live and wild animal markets in south China where frequent mixing and high volume of species enabled rapid viral evolution and emergence. This research aims to examine zoonotic viral emergence by testing the following hypotheses: • there are novel Coronaviruses (CoVs) and Paramyxoviruses (PMVs) in wildlife reservoirs in south China • human behaviour may result in viral spillover from wildlife reservoirs • market and other wildlife trade activities may be drivers of disease emergence • CoVs and PMVs circulating in wild animal populations may be closely related with or ancestral to known pathogenic viruses. Over a five-year period, oral and anal swabs and blood samples were collected from 3,146 wild-caught bats and 559 rodents from more than 30 different species primarily focused on wildlife trade pathways in southern China. RT-PCR assays were performed to screen for CoVs and PMVs. 39 CoVs (1.2%) and 114 PMVs (3.6%) were confirmed from bat samples by sequencing. Of the latter, 80 were novel bat PMVs. No rodent samples were positive for either virus. An online survey was conducted to assess 2,238 Chinese millennials’ attitudes about wildlife consumption and perceived health-risks. The results suggest that although this population is currently the primary driver of demand for wildlife trade in China, it may also be the most effectively targeted with campaigns to educate about zoonotic emergence from wildlife reservoirs. Diverse mammalian wildlife species including two listed by IUCN as vulnerable and one on China’s endangered species list were observed to be maintained in circulation over three years in two of the largest live animal wildlife markets in south China. An overall increase in the volume of wildlife traded in the two markets was also observed. Through 87 ethnographic interviews and 685 structured interviews with rural residents observed to be exposed at some level to wildlife, strong evidence was provided that local consumption of wildlife has reduced, but exposure and awareness of the commensurate health-risks have not. Additionally, exposure to bats, poultry, and rodents as well as handling, hunting and raising animals were all activities positively correlated with self-reported symptoms of viral infections of unknown aetiology and potentially of zoonotic pathogens. The information garnered in this study about the current status of wildlife trade, people’s attitudes and actions, as well as the ecology of these viruses and their hosts in south China, provides data that may be used towards predicting and preventing the emergence of these and other as-yet-unknown viruses. If patterns of human behaviour, wildlife trade, and viral ecology may be quantified, then a relative level of risk may be predicted and evaluated

Preventing Pandemics via International Development: A Systems Approach

Tiffany Bogich and colleagues find that breakdown or absence of public health infrastructure is most often the driver in pandemic outbreaks, whose prevention requires mainstream development funding rather than emergency funding

Wild animal and zoonotic disease risk management and regulation in China : examining gaps and One Health opportunities in scope, mandates, and monitoring systems

Emerging diseases of zoonotic origin such as COVID-19 are a continuing public health threat in China that lead to a significant socioeconomic burden. This study reviewed the current laws and regulations, government reports and policy documents, and existing literature on zoonotic disease preparedness and prevention across the forestry, agriculture, and public health authorities in China, to articulate the current landscape of potential risks, existing mandates, and gaps. A total of 55 known zoonotic diseases (59 pathogens) are routinely monitored under a multi-sectoral system among humans and domestic and wild animals in China. These diseases have been detected in wild mammals, birds, reptiles, amphibians, and fish or other aquatic animals, the majority of which are transmitted between humans and animals via direct or indirect contact and vectors. However, this current monitoring system covers a limited scope of disease threats and animal host species, warranting expanded review for sources of disease and pathogen with zoonotic potential. In addition, the governance of wild animal protection and utilization and limited knowledge about wild animal trade value chains present challenges for zoonotic disease risk assessment and monitoring, and affect the completeness of mandates and enforcement. A coordinated and collaborative mechanism among different departments is required for the effective monitoring and management of disease emergence and transmission risks in the animal value chains. Moreover, pathogen surveillance among wild animal hosts and human populations outside of the routine monitoring system will fill the data gaps and improve our understanding of future emerging zoonotic threats to achieve disease prevention. The findings and recommendations will advance One Health collaboration across government and non-government stakeholders to optimize monitoring and surveillance, risk management, and emergency responses to known and novel zoonotic threats, and support COVID-19 recovery efforts

Using network theory to identify the causes of disease outbreaks of unknown origin.

The identification of undiagnosed disease outbreaks is critical for mobilizing efforts to prevent widespread transmission of novel virulent pathogens. Recent developments in online surveillance systems allow for the rapid communication of the earliest reports of emerging infectious diseases and tracking of their spread. The efficacy of these programs, however, is inhibited by the anecdotal nature of informal reporting and uncertainty of pathogen identity in the early stages of emergence. We developed theory to connect disease outbreaks of known aetiology in a network using an array of properties including symptoms, seasonality and case-fatality ratio. We tested the method with 125 reports of outbreaks of 10 known infectious diseases causing encephalitis in South Asia, and showed that different diseases frequently form distinct clusters within the networks. The approach correctly identified unknown disease outbreaks with an average sensitivity of 76 per cent and specificity of 88 per cent. Outbreaks of some diseases, such as Nipah virus encephalitis, were well identified (sensitivity = 100%, positive predictive values = 80%), whereas others (e.g. Chandipura encephalitis) were more difficult to distinguish. These results suggest that unknown outbreaks in resource-poor settings could be evaluated in real time, potentially leading to more rapid responses and reducing the risk of an outbreak becoming a pandemic

Human-animal interactions and bat coronavirus spillover potential among rural residents in Southern China

Human interaction with animals has been implicated as a primary risk factor for several high impact zoonoses, including many bat-origin viral diseases; however, the animal-to-human spillover events that lead to emerging diseases are rarely observed or clinically examined, and the link between specific interactions and spillover risk is poorly understood. To investigate this phenomenon, we conducted biological-behavioral surveillance among rural residents in the Yunnan, Guangxi, and Guangdong provinces of Southern China, where we have identified a number of SARS-related coronaviruses in bats. Serum samples were tested for four bat-borne coronaviruses using newly developed enzyme-linked immunosorbent assays (ELISA). Survey data were used to characterize associations between human-animal contact and bat coronavirus spillover risk. A total of 1,596 residents were enrolled in the study from 2015 to 2017. Nine participants (0.6%) tested positive for bat coronaviruses. 265 (17%) participants reported severe acute respiratory infection (SARI) and/or influenza-like illness (ILI) symptoms in the past year, which were associated with poultry, carnivore, rodent/shrew, and bat contact, with variability by family income and province of residence. This study provides serological evidence of bat coronavirus spillover in rural communities in Southern China. The low seroprevalence observed in this study suggests that bat coronavirus spillover is a rare event. Nonetheless, this study highlights associations between human-animal interaction and zoonotic spillover risk. These findings can be used to support targeted biological behavioral surveillance in high-risk geographic areas in order to reduce the risk of zoonotic disease emergence

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

Knowledge, attitude, and practice regarding zoonotic risk in wildlife trade, southern China.

Current wildlife trade practices in China lead to significant interactions between humans and animals and drive the emergence of zoonotic diseases. The at-risk behaviors, knowledge, and attitudes that influence health-related behaviors in relation to animal contact and safety measures in the trade remain poorly understood. A self-administered questionnaire survey was conducted among 947 adult Internet users in three provinces in southern China to assess knowledge, perceived disease risks, at-risk behaviors, and the association of these factors with other demographic factors among the target population. Few of the participants possessed sufficient knowledge of zoonotic diseases. Although most participants were opposed to the use of wild animal resources, many reported keeping wild animals as pets (30.7%) and eating wild animals (30.5%). The majority of participants (76.3%) believed the disease transmission via wildlife trade, but few connected contact with animals to sickness (18.5%) and only slightly more than half sought post-exposure treatment (54.4%). These results reveal low levels of knowledge and perceived risk regarding disease emergence from the animal-human interactions in wildlife trade and uncover the gaps in knowledge and attitudes as key challenges to the development of health behavior change interventions pertaining to wildlife trade. [Abstract copyright: © 2021. EcoHealth Alliance.