Emerging and zoonotic disease risk mitigation: Rabies prevention as a template for best practices

The introduction of non-native species and deforestation are both important drivers of environmental change that can also facilitate the geographic spread of zoonotic pathogens and increase disease risk in humans. With ongoing trends in globalization and land-use conversions, introduced species and deforestation are ever more likely to pose threats to human health. Here, we used rat lungworm disease, an emerging zoonotic disease caused by Angiostrongylus cantonensis and maintained by invasive rats and snails, to explore how these two forms of environmental change can impact zoonotic disease risk. We used logistic regressions to examine the role of global trade in the introduction of A. cantonensis at a country level and used model estimates to predict the probability of introduction as a function of trade. We then used hurdle-based regression models to examine the association between deforestation and rat lungworm disease in two regions where A. cantonensis is already established: Hawaii and Thailand. At the global scale, we found the trade of horticultural products to be an important driver in the spread of A. cantonensis and that the majority of countries at high risk of future A. cantonensis introduction are islands. At country scales, we found deforestation to increase the per-capita risk of A. cantonensis exposure in Hawaii and Thailand. Our study provides a preliminary view of the associations between species introductions, deforestation, and risk of A. cantonensis exposure in people. Better understanding how these two widespread and overlapping forms of environmental change affect human health can inform international biosecurity protocols, invasive species management, and land-use policies.

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Adolescent alcohol, nuts, and fiber: combined effects on benign breast disease risk in young women

npj Breast Cancer ◽

10.1038/s41523-020-00206-4 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Catherine S. Berkey ◽

Rulla M. Tamimi ◽

Walter C. Willett ◽

Bernard Rosner ◽

Martha Hickey ◽

...

Keyword(s):

High School ◽

High School Students ◽

Lower Risk ◽

Benign Breast Disease ◽

Disease Risk ◽

Risk Mitigation ◽

Peanut Butter ◽

Breast Disease ◽

School Students ◽

Total Dietary Fiber

AbstractAdolescent drinking is associated with higher risks of proliferative benign breast disease (BBD) and invasive breast cancer (BC). Furthermore, adolescent nut and fiber consumptions are associated with lower risks of benign lesions and premenopausal BC. We hypothesize that diet (nuts, fiber) may mitigate the elevated BBD risk associated with alcohol. A prospective cohort of 9031 females, 9–15 years at baseline, completed questionnaires in 1996–2001, 2003, 2005, 2007, 2010, 2013, and 2014. Participants completed food frequency questionnaires in 1996–2001. In 2005, participants (>=18 years) began reporting biopsy-confirmed BBD (N = 173 cases). Multivariable logistic regression estimated associations between BBD and cross-classified intakes (14–17 years) of alcohol and peanut butter/nuts (separately, total dietary fiber). Only 19% of participants drank in high school; drinking was associated with elevated BBD risk (OR = 1.75, 95% CI: 1.20–2.56; p = 0.004) compared to nondrinkers. Participants consuming any nuts/butter had lower BBD risk (OR = 0.64, 95% CI: 0.45–0.90; p = 0.01) compared to those consuming none. Participants in top 75% fiber intake had lower risk (OR = 0.57, 95% CI: 0.40–0.81; p = 0.002) compared to bottom quartile. Testing our hypothesis that consuming nuts/butter mitigates the elevated alcohol risk, analyzing alcohol and nuts combined found that those who consumed both had lower risk (RR = 0.47, 95% CI: 0.24–0.89; p = 0.02) compared to drinkers eating no nuts. Our analysis of alcohol and fiber together did not demonstrate risk mitigation by fiber. For high school females who drink, their BBD risk may be attenuated by consuming nuts. Due to modest numbers, future studies need to replicate our findings in adolescent/adult females. However, high school students may be encouraged to eat nuts and fiber, and to avoid alcohol, to reduce risk of BBD and for general health benefits.

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A qualitative study of zoonotic risk factors among rural communities in southern China

International Health ◽

10.1093/inthealth/ihaa001 ◽

2020 ◽

Vol 12 (2) ◽

pp. 77-85 ◽

Cited By ~ 7

Author(s):

Hong-Ying Li ◽

Guang-Jian Zhu ◽

Yun-Zhi Zhang ◽

Li-Biao Zhang ◽

Emily A Hagan ◽

...

Keyword(s):

Risk Factors ◽

Rural Communities ◽

Risk Mitigation ◽

Southern China ◽

Zoonotic Disease ◽

Local Communities ◽

Mitigation Strategies ◽

Disease Emergence ◽

Ethnographic Interviews ◽

Zoonotic Risk

Abstract Background Strategies are urgently needed to mitigate the risk of zoonotic disease emergence in southern China, where pathogens with zoonotic potential are known to circulate in wild animal populations. However, the risk factors leading to emergence are poorly understood, which presents a challenge in developing appropriate mitigation strategies for local communities. Methods Residents in rural communities of Yunnan, Guangxi and Guangdong provinces were recruited and enrolled in this study. Data were collected through ethnographic interviews and field observations, and thematically coded and analysed to identify both risk and protective factors for zoonotic disease emergence at the individual, community and policy levels. Results Eighty-eight ethnographic interviews and 55 field observations were conducted at nine selected sites. Frequent human–animal interactions and low levels of environmental biosecurity in local communities were identified as risks for zoonotic disease emergence. Policies and programmes existing in the communities provide opportunities for zoonotic risk mitigation. Conclusions This study explored the relationship among zoonotic risk and human behaviour, environment and policies in rural communities in southern China. It identifies key behavioural risk factors that can be targeted for development of tailored risk-mitigation strategies to reduce the threat of novel zoonoses.

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The social benefits of private infectious disease-risk mitigation

Theoretical Ecology ◽

10.1007/s12080-015-0262-z ◽

2015 ◽

Vol 8 (4) ◽

pp. 467-479 ◽

Cited By ~ 4

Author(s):

Benjamin R. Morin ◽

Charles Perrings ◽

Ann Kinzig ◽

Simon Levin

Keyword(s):

Infectious Disease ◽

Disease Risk ◽

Risk Mitigation ◽

Social Benefits ◽

The Social

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Perceived Risks from Disease and Management Policies: An Expansion and Testing of a Zoonotic Disease Risk Perception Model

Human Dimensions of Wildlife ◽

10.1080/10871209.2014.844288 ◽

2014 ◽

Vol 19 (2) ◽

pp. 123-138 ◽

Cited By ~ 9

Author(s):

Heather A. Triezenberg ◽

Meredith L. Gore ◽

Shawn J. Riley ◽

Maria K. Lapinski

Keyword(s):

Risk Perception ◽

Disease Risk ◽

Zoonotic Disease ◽

Perceived Risks ◽

Perception Model ◽

Management Policies

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Conservation, development and the management of infectious disease: avian influenza in China, 2004–2012

Philosophical Transactions of the Royal Society B Biological Sciences ◽

10.1098/rstb.2016.0126 ◽

2017 ◽

Vol 372 (1722) ◽

pp. 20160126 ◽

Cited By ~ 3

Author(s):

Tong Wu ◽

Charles Perrings

Keyword(s):

Infectious Disease ◽

Risk Factors ◽

Avian Influenza ◽

Wildlife Conservation ◽

Disease Risk ◽

Risk Mitigation ◽

Scientific Evidence ◽

Migratory Bird ◽

Policy Implications ◽

Economic Risk

There is growing evidence that wildlife conservation measures have mixed effects on the emergence and spread of zoonotic disease. Wildlife conservation has been found to have both positive (dilution) and negative (contagion) effects. In the case of avian influenza H5N1 in China, the focus has been on negative effects. Lakes and wetlands attracting migrating waterfowl have been argued to be disease hotspots. We consider the implications of waterfowl conservation for H5N1 infections in both poultry and humans between 2004 and 2012. We model both environmental and economic risk factors. Environmental risk factors comprise the conditions that structure interaction between wild and domesticated birds. Economic risk factors comprise the cost of disease, biosecurity measures and disease risk mitigation. We find that H5N1 outbreaks in poultry populations are indeed sensitive to the existence of wild-domesticated bird mixing zones, but not in the way we would expect from the literature. We find that risk is decreasing in protected migratory bird habitat. Since the number of human cases is increasing in the number of poultry outbreaks, as expected, the implication is that the protection of wetlands important for migratory birds offers unexpected human health benefits. This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’.

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A descriptive study of zoonotic disease risk at the human-wildlife interface in a biodiversity hot spot in South Western Uganda

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0008633 ◽

2021 ◽

Vol 15 (1) ◽

pp. e0008633

Author(s):

Shamilah Namusisi ◽

Michael Mahero ◽

Dominic Travis ◽

Katherine Pelican ◽

Cheryl Robertson ◽

...

Keyword(s):

Disease Risk ◽

Hot Spot ◽

Well Being ◽

Zoonotic Disease ◽

The Body ◽

Sub Saharan Africa ◽

Forest Fragments ◽

Cross Sectional ◽

Medicinal Uses ◽

High Dependency

Zoonotic diseases pose a significant health challenge at the human–wildlife interface, especially in Sub-Saharan Africa where ecosystem services contribute significantly to local livelihoods and individual well-being. In Uganda, the fragmented forests of Hoima district, form part of a “biodiversity and emerging infectious disease hotspot” composed of communities with high dependency on this wildlife protected areas, unaware of the associated health risks. We conducted a cross-sectional mixed methods study from March to May 2017 and interviewed 370 respondents, using a semi-structured questionnaire from eight villages neighbouring forest fragments in Hoima District, Uganda. Additionally, a total of ten (10) focus group discussions (FGDs) consisting of 6–10 men or women were conducted to further explore the drivers of hunting and perception of zoonotic disease risks at community level. Qualitative and quantitative data were analysed using content analysis and STATA version 12 respectively. We found twenty-nine percent (29.0%, CI: 24.4–33.9) of respondents were engaged in hunting of wildlife such as chimpanzee (Pan troglodytes) and 45.8% (CI: 40.6–51.0), cane rats (Thryonomyidae spp). Acquisition of animal protein was among the main reasons why communities hunt (55.3%, CI: 50.1–60.4), followed by “cultural” and “medicinal” uses of wildlife and or its parts (22.7%, CI: 18.6–27.4). Results further revealed that hunting and bushmeat consumption is persistent for other perceived reasons like; bushmeat strengthens the body, helps mothers recover faster after delivery, boosts one’s immunity and hunting is exercise for the body. However, respondents reported falling sick after consumption of bushmeat at least once (7.9%, CI: 5.3–11.1), with 5.3% (CI: 2.60–9.60) reporting similar symptoms among some family members. Generally, few respondents (37.0%, CI: 32.1–42.2) were aware of diseases transmissible from wildlife to humans, although 88.7% (CI: 85.0–92.0) had heard of Ebola or Marburg without context. Hunting non-human primate poses a health risk compared to edible rats (cane rats) and wild ruminants (cOR = 0.4, 95% CI = 0.1–0.9) and (cOR = 0.7, 95% CI = 0.2–2.1) respectively. Study suggests some of the pathways for zoonotic disease spillover to humans exist at interface areas driven by livelihoods, nutrition and cultural needs. This study offers opportunities for a comprehensive risk communication and health education strategy for communities living at the interface of wildlife and human interactions.

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Global biobank analyses provide lessons for computing polygenic risk scores across diverse cohorts

10.1101/2021.11.18.21266545 ◽

2021 ◽

Author(s):

Ying Wang ◽

Shinichi Namba ◽

Esteban Lopera ◽

Sini Kerminen ◽

Kristin Tsuo ◽

...

Keyword(s):

Best Practices ◽

Prediction Accuracy ◽

Disease Risk ◽

Association Studies ◽

Meta Analysis ◽

European Ancestry ◽

Risk Scores ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Polygenic Risk

SummaryWith the increasing availability of biobank-scale datasets that incorporate both genomic data and electronic health records, many associations between genetic variants and phenotypes of interest have been discovered. Polygenic risk scores (PRS), which are being widely explored in precision medicine, use the results of association studies to predict the genetic component of disease risk by accumulating risk alleles weighted by their effect sizes. However, limited studies have thoroughly investigated best practices for PRS in global populations across different diseases. In this study, we utilize data from the Global-Biobank Meta-analysis Initiative (GBMI), which consists of individuals from diverse ancestries and across continents, to explore methodological considerations and PRS prediction performance in 9 different biobanks for 14 disease endpoints. Specifically, we constructed PRS using heuristic (pruning and thresholding, P+T) and Bayesian (PRS-CS) methods. We found that the genetic architecture, such as SNP-based heritability and polygenicity, varied greatly among endpoints. For both PRS construction methods, using a European ancestry LD reference panel resulted in comparable or higher prediction accuracy compared to several other non-European based panels; this is largely attributable to European descent populations still comprising the majority of GBMI participants. PRS-CS overall outperformed the classic P+T method, especially for endpoints with higher SNP-based heritability. For example, substantial improvements are observed in East-Asian ancestry (EAS) using PRS-CS compared to P+T for heart failure (HF) and chronic obstructive pulmonary disease (COPD). Notably, prediction accuracy is heterogeneous across endpoints, biobanks, and ancestries, especially for asthma which has known variation in disease prevalence across global populations. Overall, we provide lessons for PRS construction, evaluation, and interpretation using the GBMI and highlight the importance of best practices for PRS in the biobank-scale genomics era.

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