Emerging zoonotic viruses

Emerging infectious diseases poses a great future threat, not only to humans but also to domestic animals and wildlife. Even though the majority of these infections only cause minor health problems, the relatively recent emergence of HIV clearly illustrates that the next major human pandemic may surface at any time. Regardless of what the name indicates, most emerging human pathogens are not believed to be recently evolved, but to have existed previously in the natural environment. Most emerging pathogens are zoonotic, i.e. able to infect animals besides humans. Viruses are significantly overrepresented, which is thought to be due to the general difficulties in treating and controlling viral diseases, as well as the substantial amount of genetic diversity that viruses exhibits. Even though there is no clear association between the classification of a virus as zoonotic and its’ risk of emergence, many emerging viruses have been shown to be zoonotic or have a zoonotic history. Therefore it is probably accurate to conclude that zoonotic viruses constitute a significant risk for future emergence events. Since the majority of emerging pathogens are zoonotic, the process of cross-species transmission of a microbe from its reservoir to humans is likely to play a central role. It is probable that humans are exposed to unfamiliar pathogens regularly, but that only a few of them will possess the required genetic features to successfully cause human infection. A fraction of these pathogens may go on to acquire the ability to transmit between humans, whereof an additional few may evolve to transmit at a rate that enables major epidemics. When emergence occurs, it appears to disproportionately often happen in areas that are affected by anthropogenic activities. Some of these activities are believed to act by augmenting exposure of humans to novel pathogens, reservoirs or vectors, others by enhancing disease transmission. In order to be prepared for future emergence events, there is a great need for additional research on numerous aspects of the emergence process. Also, given the complexity and multifactorial nature of disease emergence, a multidisciplinary and internationally conjunctive approach is often advised.Infektiösa patogener som påvisats i en population för första gången, alternativt uppvisar en ökning i incidens eller geografisk spridning, utgör ett allvarligt framtida hot för såväl människor som djur. Majoriteten av dessa patogener orsakar endast mindre hälsoproblem, men risken att nästa stora pandemi kan vara nära i antågande får ej försummas. Detta illustreras tydligt av HIV, som på relativt kort tid har etablerat sig som en av världens mest fruktade infektiösa agens. Patogenerna av denna typ antas sällan vara nyutvecklade, utan förmodas oftast ha förekommit tidigare i naturen. De allra flesta är zoonotiska och därmed kapabla att infektera andra arter utöver människa. Virus är överrepresenterade, vilket dels antas bero på svårigheterna i att behandla och kontrollera virala sjukdomar, såväl som den enorma genetiska mångfald som virus uppvisar. Än så länge har ingen tydlig association kunnat påvisas mellan ett virus zoonotiska status och dess benägenhet att nyinfektera människor. Men eftersom en betydande andel trots allt innehar förmågan att infektera djur utöver människa, eller har haft historiskt, är det sannolikt att zoonotiska virus är en av de patogengrupper som utgör störst risk för framtiden. Eftersom många av de patogener som påvisats i humana populationer för första gången, alternativt uppvisar en ökning i incidens eller geografisk spridning, är sprungna ur djurpopulationer, kan överföringen av mikroorganismer från djur till människa antas spela en central roll. Troligen exponeras människan ständigt för främmande patogener, men endast ett mindre antal av dessa kommer att inneha de rätta genetiska förutsättningarna för att kunna orsaka mänsklig infektion. Av dessa är det troligen bara ett fåtal som kommer att utveckla förmågan att spridas mellan människor, varav endast en fraktion lyckas förfina detta till den grad att de kan skapa humana pandemier. Denna övergång från djurinfektion till human pandemi sker anmärkningsvärt ofta i områden som står under antropogen påverkan. Vissa av dessa aktiviteter förmodas verka genom att utöka exponeringen av människor för nya patogener, dess reservoarer eller vektorer, andra genom att underlätta spridning i populationen. För att mänskligheten i framtiden ska kunna förhålla sig till hotet som dessa infektiösa patogener utgör, finns det stora behov av forskning inom flera områden. Eftersom processen är komplex och multifaktoriell är en multidisciplinär och internationellt samordnad angreppsmetod ofta att rekommendera

Prevalence and risk factors for BVDV in goats and cattle in and around Gaborone, Botswana

SUMMARY Bovine Viral Diarrhoea Virus (BVDV) is a cause of severe deterioration in animal health as well as grave economic losses globally. Infection is often inapparent but the virus can also cause respiratory signs, diarrhoea, pyrexia, decreased production, immunosuppression and reproductive problems such as increased calving intervals and abortions. Also, when naive dams in early pregnancy are infected, before the development of fetal immune competence, the fetus is at risk of developing persistent infection. These persistently infected individuals (PI) are of particular epidemiologic interest since they shed virus in large concentrations in all their bodily secretions throughout their life. Risk factors for disease transmission include, but are not limited to, herd size, animal trade and grazing on communal pastures. For goats, contact with cattle is a significant risk factor. Several prevalence studies have been conducted on the African continent, but in the country of Botswana, the occurrence is largely unknown. Because of this, blood samples were obtained from 100 goats owned by 11 smallholder farmers, in three different villages just outside of Gaborone. Besides this, 361 blood samples from cattle collected as part of another study were analysed. The detected antibody prevalence was 0% in goats and 53.5% in cattle. In dairy cattle, the seroprevalence was 49.7% and in beef cattle 56.7%, but this difference was not statistically significant. The prevalence of virus in cattle was 0.27% on Ag-ELISA and PCR performed in Botswana, and 0.83% on PCR performed in Sweden. The viraemic animals all originated in the two herds with the highest prevalences (88.1% and 97.9% respectively). Finally, PCR analysis was performed and a short sequence of the genome of two of the detected viruses were sequenced, and found to belong to the BVDV-1a genotype. The goat farmers were also subjected to a short interview regarding risk factors for BVDV transmission, as well as the general health status in their herd. All farmers allowed their animals to graze on communal pastures, and 64% reported to also keep cattle in close proximity to their goats. Also, 18% answered that they keep sheep and goats together in the same kraal (i.e. enclosure) during the night. Approximately 55% responded that they occasionally saw wildlife ruminants in the area where their goats were kept. However, only 18% purchased goats from other farmers as the majority relied solely on raising their own kidlings. The most common health problem described was abortion, which 91% occasionally struggled with. Besides this, 64% also reported problems with diarrhoea, 36% with coughing and 18% with ocular and nasal discharge. Last but not least, all farmers stated that they depend on their goats for food and cash income and that it would affect them greatly if their animals would fall sick or die in large numbers.SAMMANFATTNING Bovint Virus Diarré Virus (BVDV) är en global orsak till nedsatt djurhälsa samt ekonomiska förluster. Infektionen är ofta subklinisk men viruset kan också orsaka respiratoriska symptom, diarré, pyrexi, nedsatt produktion, nedsatt immunförsvar samt reproduktiva störningar såsom förlängda kalvningsintervall och aborter. När seronegativa hondjur infekteras under tidig dräktighet, innan fostret bildat immunokompetens, finns en risk att avkomman utvecklar persistent infektion (PI). Dessa djur är av särskilt epidemiologiskt intresse då de utsöndrar virus i höga koncentrationer i samtliga kroppsvätskor under hela deras liv. Riskfaktorer för virusspridning är exempelvis stor besättningsstorlek och hög djurdensitet. Även driftrutiner såsom djurhandel och utnyttjande av gemensamma betesmarker inverkar. För getter är kontakt med nötkreatur en riskfaktor. Ett flertal prevalensstudier avseende BVDV har utförts på den afrikanska kontinenten, men i Botswana är förekomsten i stort sett okänd. På grund av detta utfördes blodprovstagning på totalt 100 getter, vilka ägdes av 11 småbrukande bönder hemmahörande i tre olika byar utanför Gaborone. Utöver dessa analyserades även 361 blodprover från nötkreatur, vilka tagits som en del av ett annat forskningsprojekt. Antikroppsprevalensen var 0% för get och 53,5 % för nötkreatur. För mjölkkor var seroprevalensen 49,7% och för köttkor 56,7%, men denna skillnad var ej statistiskt signifikant. Prevalensen av BVD-virus, baserat på resultat från Ag-ELISA och PCR, var 0,27%. När PCR:en senare upprepades i Sverige blev resultatet 0,83%. Samtliga viraemiska djur härstammade från de två besättningar med högst seroprevalens (88,1% resp 97,9%). Slutligen gjordes en PCR analys och en del av genomet sekvenserades för två av de detekterade virusen, och befanns tillhöra genotypen BVDV-1a. Småbrukarna fick även i en kort intervju svara på frågor avseende riskfaktorer för spridning och smitta av BVDV samt den generella hälsostatusen i deras besättning. Intervjuerna påvisade flertalet riskfaktorer för virusspridning. Samtliga av bönderna lät sina djur beta fritt på allmänna betesmarker och 64% angav att de höll nötkreatur i nära anslutning till getterna. Ungefär 18% höll getter och får i samma inhägnad nattetid. Cirka 55% angav att de då och då såg vilda idisslare i sitt närområde. Endast 18% köpte getter från andra bönder, då majoriteten enbart använde sig av egen uppfödning av killingar. Det vanligaste hälsoproblemet var aborter, vilket 91% angav att de hade problem med till och från. Av bönderna hade även 64% bekymmer med diarré, 36% med hosta och 18% med ögon- och nosflöde. Samtliga angav att de är väldigt beroende av deras getter för föda och inkomst, och att ett större sjukdomsutbrott med dödsfall skulle ha en allvarlig påverkan på deras livssituation

Physical capacity in physically active and non-active adolescents

Aim: The aim of this study was to investigate differences in physical capacity between physically active and non-active men and women among graduates from upper secondary school. Subject and methods: Research participants were graduates (38 women and 61 men) from upper secondary school. Physical activity was determined using the International Physical Activity Questionnaire, and participants were dichotomously characterized as being physically active or physically non-active according to the recommendations of the World Health Organization (WHO). Aerobic capacity was measured using the Åstrand cycle ergometer test. Participants also underwent tests of muscular strength and balance. Results: Maximum oxygen uptake differed significantly between physically active and non-active men (mean ± SD 3.6 ± 0.7 vs 3.0 ± 0.6 l/kg, p = 0.002) and women (3.0 ± 0.6 vs 2.5 ± 0.3 l/kg, p = 0.016). There was a difference among physically active and non-active men regarding push-ups (37.1 ± 9.0 vs 28.5 ± 7.0, p < 0.001) and sit-ups (59.2 ± 30.2 vs 39.6 ± 19.4, p = 0.010). No significant differences were found regarding vertical jump or grip strength among men, any of the muscle strength measurements among women, and balance (in any sex). Conclusion: Activity levels had impact on aerobic capacity in both sexes, but did not seem to have the same impact on muscular strength and balance, especially in women

Patient och agent: Självskattad autonomi och dess samband med funktionsnedsättning, socialt stöd och ekonomi bland patienter inom öppenvårdspsykiatrin

Den svenska psykiatrins avinstitutionalisering innefattade visionen att stärka patienters autonomi. I klinisk vardag manifesteras detta bland annat genom en ökad förväntan på att patienter ska fatta aktiva beslut om den egna vården. Föreliggande enkätstudie syftade till att undersöka självskattad grad av autonomi bland patienter inom öppenvårdspsykiatrin i Skåne (n = 63). Vidare undersöktes sambandet mellan autonomi och funktionsnedsättning, socialt stöd, ekonomisk situation och sociodemografiska och kliniska variabler. Studiens formulär distribuerades på sex öppenvårdspsykiatriska mottagningar. Autonomi mättes genom självrapporteringsinstrumentet The Index of Autonomous Functioning (IAF), vilket har sin grund i self-determination theory (SDT). Resultatet visade att patienter inom öppenvårdspsykiatrin i signifikant lägre grad skattade sig som autonoma jämfört med en engelsk normalpopulation, sett till autonomi i sin helhet och aspekten agentskap. Högre grad av autonomi samvarierade med högre grad av socialt stöd och färre år inom psykiatrin. Högre grad av agentskap korrelerade med högre grad av socialt stöd och lägre grad av funktionsnedsättning. Autonomi korrelerade inte signifikant med vare sig ekonomi eller med någon av bakgrundsvariablerna. Studien belyser att förmågan till autonomi i allmänhet, och aspekten agentskap i synnerhet, kan vara nedsatt vid psykisk sjukdom – något det inom psykiatrin bör göras en bedömning av innan patienten förväntas agera autonomt.The deinstitutionalization of Swedish psychiatry included a vision to strengthen patients’ autonomy. In clinical practice, this is manifested through increased expectations on patients to make active decisions about their own care. This study aimed to examine self-rated autonomy among psychiatric outpatients in Skåne (n = 63). Furthermore, the association between autonomy and functional impairment, social support, economy and background variables was examined. The Index of Autonomous Functioning (IAF), which is a self-report scale with its origins in self-determination theory (SDT), was used to measure autonomy. The results showed that psychiatric outpatients rated themselves as autonomous at a significantly lower degree than an English non-clinical population - when it comes to autonomy and the aspect agency. Higher degrees of autonomy were associated with higher degrees of social support and fewer years of contact with the psychiatry. Higher degrees of agency were associated with higher degrees of social support and lower degrees of functional impairment. Autonomy was neither significantly correlated with economy, nor with the background variables. This study illustrates that the capacity for autonomy may be impaired in people with mental illness – hence, the individual degree of autonomy should be assessed before there are expectations on the patient to act autonomously

Herd health and reproductive management associated with lamb weight gain and mortality in sub-Saharan drylands-a case from Ethiopia.

Sheep are important for food and livelihood security in sub-Saharan Africa, and maximizing lamb weight gain while minimizing mortality is essential to improve production. Using the Menz sheep breeding villages of Amhara region in Ethiopia as a case study, the weight gain and mortality rate of 208 lambs were monitored during their first 5 months of life. The study was conducted in intervention and control villages, where the intervention villages were part of community-based breeding programmes and had participated in various projects aiming to improve sheep production and management. Multivariable linear regression analysis was conducted to detect associations between weight gain from birth to 1 month, and birth to 5 months, and different lamb and ewe characteristics, farmer education, application of management routines, and presence of village level sheep management interventions. In general, lambs from intervention villages, without certain signs of diseases, whose mothers were 2 years or older, had a body condition score of more than 2 on a 5-point scale, and who originated from flocks where disease prevention strategies had been implemented, had gained more weight. Overall lamb mortality was 6.8% with most deaths occurring before 1 month of age. This study highlights that health interventions in ewes improve lamb survival and weight gain and that the care of lambs during the first month of life is crucial for overall herd productivity

Herd health and reproductive management associated with lamb weight gain and mortality in sub-Saharan drylands-a case from Ethiopia

Sheep are important for food and livelihood security in sub-Saharan Africa, and maximizing lamb weight gain while minimizing mortality is essential to improve production. Using the Menz sheep breeding villages of Amhara region in Ethiopia as a case study, the weight gain and mortality rate of 208 lambs were monitored during their first 5 months of life. The study was conducted in intervention and control villages, where the intervention villages were part of community-based breeding programmes and had participated in various projects aiming to improve sheep production and management. Multivariable linear regression analysis was conducted to detect associations between weight gain from birth to 1 month, and birth to 5 months, and different lamb and ewe characteristics, farmer education, application of management routines, and presence of village level sheep management interventions. In general, lambs from intervention villages, without certain signs of diseases, whose mothers were 2 years or older, had a body condition score of more than 2 on a 5-point scale, and who originated from flocks where disease prevention strategies had been implemented, had gained more weight. Overall lamb mortality was 6.8% with most deaths occurring before 1 month of age. This study highlights that health interventions in ewes improve lamb survival and weight gain and that the care of lambs during the first month of life is crucial for overall herd productivity