UQ Spatial Epidemiology Laboratory, School of Veterinary Science, University of Queensland, Gatton, Australia.
Queensland Alliance for One Health Sciences, School of Veterinary Science, University of Queensland, Gatton, Australia.
Ann Glob Health. 2022 Oct 21;88(1):93. doi: 10.5334/aogh.3770. eCollection 2022.
While zoonotic diseases are defined by transmission processes between animals and humans, for many of these diseases the presence of a contaminated environmental source is the cause of transmission. Most zoonoses depend on complex environmentally driven interactions between humans and animals, which occur along an occupational and recreational environmental continuum, including farming and animal marketing systems, environmental management systems, and community leisure environments. Environmentally driven zoonoses (EDZs) are particularly challenging to diagnose and control as their reservoirs are in the natural environment and thus often escape conventional surveillance systems that rely on host monitoring. Changes in the environment as a result of climate change [1], human population density [2], and intensification of agriculture [3] have been linked to increasing transmission events for this group of infections. As such, there is a recognised need to be able to detect the presence of EDZs in the environment as a means to better anticipate transmission events and improve source attribution investigations. Finally, the recognition that a One Health approach is needed to combat these infections is signalling to governments the need to develop policy that optimises trade-offs across human, animal, and environmental health sectors. In this review, we discuss and critically appraise the main challenges relating to the epidemiology, diagnosis, and control of environmental zoonotic disease. Using a set of exemplar diseases, including avian influenza and antimicrobial resistant pathogens, we explore the epidemiological contexts (risk factors) within which these infections not only impact human health but also contribute to animal health and environmental impacts. We then critically appraise the surveillance challenges of monitoring these infections in the environment and examine the policy trade-offs for a more integrated approach to mitigating their impacts.
虽然人畜共患病是通过动物和人类之间的传播过程来定义的，但对于许多此类疾病来说，受污染的环境源是传播的原因。大多数人畜共患疾病依赖于人类和动物之间复杂的环境驱动相互作用，这些相互作用发生在职业和娱乐环境连续体中，包括农业和动物营销系统、环境管理系统以及社区休闲环境。受环境驱动的人畜共患病（EDZ）特别难以诊断和控制，因为它们的宿主在自然环境中，因此往往逃避依赖宿主监测的传统监测系统。气候变化[1]、人口密度[2]和农业集约化[3]导致环境变化，与这组感染的传播事件增加有关。因此，人们认识到需要能够在环境中检测到 EDZ 的存在，以便更好地预测传播事件并改善来源归因调查。最后，认识到需要采取一种“同一健康”方法来对抗这些感染，这向各国政府发出了一个信号，即需要制定政策，在人类、动物和环境健康部门之间实现最佳权衡。在这篇综述中，我们讨论并批判性地评估了与环境人畜共患病的流行病学、诊断和控制相关的主要挑战。使用一组示例疾病，包括禽流感和抗微生物药物耐药病原体，我们探讨了这些感染不仅影响人类健康，而且还影响动物健康和环境影响的流行病学背景（风险因素）。然后，我们批判性地评估了在环境中监测这些感染的监测挑战，并研究了更综合的方法来减轻其影响的政策权衡。
