Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.
AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections ha...rder to treat and increasing the risk of disease spread, severe illness and death. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.
Antimicrobials - including antibiotics, antivirals, antifungals and antiparasitics - are medicines used to prevent and treat infections in humans, animals and plants. Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.
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Antimicrobial resistance (AMR) is a multifaceted, international public health problem, which poses a direct threat to the safety of the population of South Africa. A national response is required to complement the development of a global plan, as articulated in the WHO’s draft resolution EB134/37 ...“Combating antimicrobial resistance including antibiotic resistance”, adopted by theWorld Health Assembly in May 2014. The overuse of antimicrobials is driving resistance. A return to appropriate, targeted antimicrobial use in humans, animals and the environment is critical if we are to conserve the antimicrobial armamentarium. Various interventions have been put in place to address antimicrobial resistance in South Africa. However, these are insufficient to effectively tackle the threat faced by the country. The strengths of the current system are outweighed by its weaknesses.
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Climate change, increasing population densities, and intensified globalisation in trade, travel and migration are among the most important factors shaping the 21st century. Each impacts upon population health and the risk of infectious disease, particularly those originating at the human-animal-envi...ronmental interface. The recognition that many risk drivers of infectious disease fall outside of the typical domain of the health sector creates the challenge of identifying and pursuing priorities for cross-sectoral action aimed at strengthening global health security. In response, the One Health concept has emerged, as have related initiatives addressing Planetary Health and Biodiversity and Human Health. From a public health perspective and operationally speaking, the One Health approach offers great potential, emphasising as it does cooperation and coordination between multiple sectors. Yet despite having been a focal point for discussion for over a decade, numerous challenges facing the implementation of One Health preparedness strategies remain. While some are technical, related to the requirement for innovative early warning systems or new vaccines, for example, others are institutional and cultural in nature, given the transdisciplinary nature of the topic. There have thus been calls to address One Health from multiple perspectives, from ecology to the social sciences. In order to further explore this issue and to identify priority areas for action for strengthening One Health preparedness in Europe, ECDC convened an expert consultation on 11–12 December 2017.
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Antimicrobial resistance (AMR) has emerged as a major public health concern, around which the international leadership has come together to form strategic partnerships and action plans. The main driving force behind the emergence of AMR is selection pressure created due to consumption of antibiotics.... Consumption of antibiotics in human as well as animal sectors are driven by a complex interplay of determinants, many of which are typical to the local settings.
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In 2007, WHO warned that infectious diseases are emerging and re-emerging at a rate that has not been seen before. The potential for infectious diseases to spread rapidly results in high morbidity and mortality, causing a potential global public health treat of major concern.
Several factors are ...contributing to the (re)emergence of infectious diseases such as population growth, living in close contact with animals, frequent travelling, poverty, destructive ecological changes due to economic development and land use and climate change result in global warming.
Especially Africa is at a threat for (re)emerging infectious diseases due to the huge population growth (expected to reach 2.5 billion by 2050) with rapid urbanisation. Additionally, people across and beyond the continent are excessively mobile which is combined with a weak health system. Moreover, the risk of (re)emerging infectious disease is further heightened by three newly adopted continental initiatives: African Continental Free Trade Area, Free Movement of Persons and African Passport and Single African Air Transport Market.
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One Health is a collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national, and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.
Monkeypox virus is an orthopoxvirus that causes human monkeypox, a viral disease with symptoms similar to smallpox, including fever and rash. Following the worldwide eradication of smallpox in 1980, monkeypox emerged as the most significant orthopoxvirus infection in humans. Cases are most often rep...orted from rural areas of Central and West African countries, particularly in regions close to tropical rainforest where people may have contact with infected animals. Someone can become infected through direct contact with respiratory droplets of another person who has monkeypox in the home or in a health facility, or with contaminated materials such as bedding. Although these are the main modes of person-to-person transmission, monkeypox outbreaks tend to occur in small clusters of a few cases without leading to widespread community transmission. For this reason, outbreaks can be easily controlled when responded to rapidly. On several occasions, monkeypox has been reported in other regions due to importation by travelers or infected animals. This course provides a general introduction to the disease through a video and accompanying downloadable presentation that can be reviewed at your own pace. It is intended for health personnel responsible for prevention and control of monkeypox, and for the general public.
The content and scope of this course on monkeypox have been tailored for outbreaks in African countries where the disease is endemic. The course material was last updated in 2020 and may not reflect most recent WHO guidance issued for the multi-country outbreak in 2022.
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Cases of human monkeypox are rarely seen outside of west and central Africa. There are few data regarding viral kinetics or the duration of viral shedding and no licensed treatments. Two oral drugs, brincidofovir and tecovirimat, have been approved for treatment of smallpox and have demonstrated eff...icacy against monkeypox in animals. Our aim was to describe the longitudinal clinical course of monkeypox in a high-income setting, coupled with viral dynamics, and any adverse events related to novel antiviral therapies.
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Since the re-emergence of monkeypox in Nigeria in September 2017, the Nigeria Centre
for Disease Control(NCDC) has continued to receive reports and respond to cases of the
disease from States across the country. Between September 2017 when the outbreak started and November 2018, about 300 suspecte...d cases had been reported from 26 out of 36 states and the Federal Capital Territory. The highest number of cases were reported from States in the South-South region of Nigeria. Monkeypox is a zoonotic orthopox virus, which presents in humans with symptoms such as fever, headache, body pain, malaise, lymphadenopathy (enlargement of glands),
sore throat and the typical generalised vesiculopustular rash. Transmission is via direct or
indirect contact with infected animals, human, or contaminated materials.
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The Global guidance framework for the responsible use of the life sciences: mitigating biorisks and governing dual-use research (the framework) aims to provide values and principles, tools and mechanisms to support Member States and key stakeholders to mitigate and prevent biorisks and govern dual-u...se research.
The framework adopts the One health approach and focuses on the role that responsible life sciences research can play in preventing and mitigating risks caused by accidents, inadvertent or deliberate misuse with the intention to cause harm to humans, nonhuman animals, plants and agriculture, and the environment.
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Chagas disease is caused by Trypanosoma cruzi, a protozoal organism primarily transmitted by triatomine insect vectors, also known as “kissing bugs.” It is a zoonotic disease originally described by Brazilian physician Dr. Carlos Chagas in 1909 and is widespread in Latin America. Although triato...mines and T. cruzi have long been endemic to the southern United States, awareness and identification of infected vectors and animals have recently increased throughout the United States. Canine Chagas disease can be acute or chronic and is predominantly characterized by inflammation and fibrosis of the heart, resulting in arrhythmias, myocardial dysfunction, heart failure, and sudden death, although many infected dogs are asymptomatic.
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Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid di...agnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
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Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is traditionally acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae, but in recent years also appears increasingly to be transmitted by eating fish or other aquatic anima...ls. The worm typically emerges through the skin on a lower limb of the host 1 year after infection, causing pain and disability.
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The objectives of the meeting were:
1. To step up the commitment of national authorities and technical and financial partners toWHO’s elimination objective for g-HAT.
2. To share achievements, challenges and views on the elimination goal among countries and implementing partners.
3. To assess t...he status of critical technical aspects to be solved in research and development of drugs and diagnostic tools, epidemiology, vector control and animal reservoirs.
4. To define the mechanisms for strengthening and organizing collaboration and coordination among stakeholders.
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The objectives of the meeting were:
1. To update the current status of the disease transmission, country capacities and plans for tackling the disease.
2. To understand the epidemiology including disease distribution and risk, the models
for estimating under-detection, the geographical variati...ons of in clinical presentation,
the roles of domestic and wild animal reservoirs and the subsequent different
transmission patterns and control approaches, including vector control.
3. To update current research and development efforts for improving diagnostic and
treatment tools.
4. To define the goals for achieving the control of r-HAT, the need for a multisectoral
approach and to discuss the strategy for controlling r-HAT and the coordination
mechanisms.
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Snakebite envenoming is a potentially life-threatening disease that typically results from the injection of a mixture of different toxins (“venom”) following the bite of a venomous snake. Envenoming can also be caused by venom being sprayed into a person’s eyes by certain species of snakes tha...t have the ability to spit venom as a defence measure. Not all snakebites result in envenoming: some snakes are non-venomous and venomous snakes do not always inject venom during a bite. About 50–55% of all snakebites result in envenoming. Snake venoms are complex mixtures of protein and peptide toxins, varying from one species to another, and even within species. The toxins in snake venoms are evolutionarily adapted to interact with a large variety of cellular targets in the organisms exposed to them. In humans and animals, snakebite envenoming affects multiple organ systems (depending on the particular species of snake and the classes of toxins present in the venom) and can cause, among other things: haemorrhage and prolonged disruption of haemostasis, neuromuscular paralysis, tissue necrosis, myolysis (muscle degeneration), cardiotoxicity, acute kidney injury, thrombosis and hypovolaemic shock.
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Taenia saginata is a zoonotic tapeworm that is of economic importance in countries where cattle are kept. The parasite is transmitted from human tapeworm carriers (taeniosis) to bovines (cysticercosis) by excretion of eggs or proglottids containing eggs into the environment via the stool. Bovines ca...n then ingest the eggs through contaminated feed or water. After ingestion, the eggs hatch and release oncospheres in the small intestines, where the oncospheres penetrate the intestinal wall to reach the blood circulation. This distributes them throughout the body, but primarily to muscle tissue, where they develop into cysticerci. For humans to become infected with T. saginata, raw or undercooked bovine meat or offal containing infective cysts must be consumed. Bovine cysticercosis has been associated with various environmental factors related to water sources, such as animals having access to surface water, flooding of pastures and proximity to wastewater sources.
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The incubation period (the time the virus spreads from the peripheral nerves near the site of the bite via the spinal cord to the brain – see transmission and pathogenesis) ranges in general between 2 and 3 month (2 weeks to 6 years are reported) depending on the site of infliction, the amount of ...virus and the virus strain. Due to its neurotropism all known lyssaviruses cause severe neurological symptoms as a result of an acute encephalitis. Therefore, clinical signs in humans and animals are very similar.
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Rabies is a vaccine-preventable, zoonotic, viral disease affecting the central nervous system. Once clinical symptoms appear, rabies is virtually 100% fatal. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans. Yet, rabies can affect both domestic and wild an...imals. It spreads to people and animals via saliva, usually through bites, scratches or direct contact with mucosa (e.g. eyes, mouth or open wounds). Children between the age of 5 and 14 years are frequent victims.
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This document aims to assist countries to take the first step towards better considering gender and equity issues in their efforts to tackle antimicrobial resistance (AMR), to inform the implementation of strategies in national action plans and contribute to improved reach and effectiveness of AMR e...fforts in the longer term. It is part of a series of papers being developed y WHO, FAO and OIE to build a better global evidence base for implementing AMR national action plans. This version is illustrated by examples from the health sector predominantly but
will be updated with advice from the food and animal sectors in due course.
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