抗生素耐药防控的One Health策略

抗生素耐药作为威胁公共卫生的巨大挑战已经制约了世界经济发展。我国抗生素使用量大,是世界上抗生素滥用最严重的国家之一。文中对人群、食用动物、环境中抗生素耐药产生的原因以及抗生素耐药现状进行综述,针对我国目前抗生素使用与耐药情况,从One Health理念提出了促进抗生素的科学使用、积极探索新型抗生素研发、建立抗生素立体监测网络系统、推广抗生素耐药教育、预防感染等措施,呼吁建立跨学科、跨部门、跨地域的交流与合作,推进我国抗生素耐药防控工作进一步开展,加强环境保护,维护人类与动物的共同健康。     

One Health——应对新发传染病的新理念

近几十年来,多种新发和再发传染病在世界各地不断造成暴发流行,其中超过75%为人兽共患病,对人类和动物健康均造成威胁,同时食源性人兽共患病还引起多种食品安全问题。随着全球范围的交流越来越频繁,这些传染病的传播速度逐渐加快,传播范围也逐渐扩大,传统单一的控制策略已无法对其进行有效防控。在此背景下,One Health理念逐渐形成。该理念倡导使用多学科交流、多部门协作及跨地域合作的策略来控制传染病,已在多个国家和地区成功应用。本文就One Health理念在国内外的发展及应用实例进行简要概述。     

“One People,One Blood”: Public Health,Political Violence,and HIV in an Ethiopian-Israeli Setting

Between 1984 and 1996, public health authorities in Israel maintained a secret policy of discarding blood donations made by Ethiopian-Israeli citizens and immigrants. Officials later attempted to justify this policy on the grounds that immigrants from Ethiopia were subject to high rates of infectious disease (especially HIV). In 1996, this led to an explosive and violent confrontation between Ethiopian-Israeli protestors and agents of the state, including police and public health authorities. This essay explores the cultural and political context of that confrontation, including the discourse of political violence which it occasioned. The conflict between Ethiopian-Israelis and the state was located within a wider set of political contexts, including the Israeli-Palestinian conflict, which was linked to it through a shared trope of spilled blood common to both. Cultural analyses which ignore this dynamic political context are in danger of seriously misrepresenting the meaning of the Blood Affair to its participants. At the same time, this essay also engages a critical analysis of the public health policies which led to the crisis. Public health and nationalist discourse reinforced one another at the expense of Ethiopian immigrants in general, and so-called Feres Mura Ethiopians in particular.     

推进生物多样性保护与人类健康的共同发展——One Health

随着新冠肺炎(COVID-19)的暴发, 野生动物、生物多样性和人类健康的关系再次引起广泛讨论。近20年来, 国际社会对于生物多样性与健康的研究日益增多, 并将它作为生物多样性保护与研究的重要方向之一。One Health作为一个新的理念框架, 通过交叉学科的研究和行动来推动包括人、所有其他动物及环境的健康。这个理念被不同国家、国际组织及协定所接纳及推广, 包括《生物多样性公约》等。本文通过总结近些年生物多样性对健康的影响方式、One Health的定义与发展历史、进入生物多样性议程的过程, 提出中国应用One Health改进相关野生动物管理以降低公共卫生危机的可能性的建议, 以及One Health框架内增强生物多样性保护所需的研究方向。One Health在中国的应用与发展应重视生物多样性研究和保护在其中的作用, 利用在景观生态学、群落内物种关系动态变化、气候变化影响、土地利用变化模式与趋势的研究, 与人类健康相结合, 提高One Health在应对公共健康和环境健康风险方面的准确性与及时性。同时, 需要加强我国在野生动物管理方面的投入和力度, 增强生物多样性保护与公共健康的联系, 将预警与干预措施前移, 减少疾病暴发带来的社会经济成本。     

Bovine leptospirosis in urban and peri-urban dairy farming in low-income countries: a “One Health” issue?

Global trends in urbanization are increasing the spread of neglected zoonotic infections such as leptospirosis, and reducing the number of human cases of leptospirosis is best accomplished by controlling the infection in the animal reservoir. The aim of this study was to determine the seroprevalence of Leptospira borgpetersenii serovar Hardjo and L. interrogans serovar Hardjo (L. Hardjo) exposure and to assess the associated risk factors for infection in small-scale dairy farming in the urban and peri-urban area of Dushanbe, Tajikistan. The true individual seroprevalence among the dairy cows was 13%, and the level of seroprevalence was positively associated with older cows and with communal grazing practices. The study shows that dairy cows are commonly exposed to L. Hardjo in the study region, and this constitutes a public health risk and demonstrates the importance of including urban and peri-urban areas, where large numbers of humans and animals coexist, when investigating zoonotic infections and when planning and implementing control measures for cattle-associated leptospirosis.     

Outcomes of a ‘One Health’ Monitoring Approach to a Five-Year Beaver (Castor fiber) Reintroduction Trial in Scotland

Recent advances in noninvasive detection methods for mycobacterial infection in primates create new opportunities for exploring the epidemiology of tuberculosis in free-living species. Chimpanzees (Pan troglodytes schweinfurthii) and baboons (Papio anubis) in Gombe National Park, Tanzania, were screened for infection with pathogens of the Mycobacterium tuberculosis Complex using Fecal IS6110 PCR; none was positive. This study demonstrates the feasibility of large-scale mycobacterial screening in wild primates.     

Mixing Languages during Learning? Testing the One Subject—One Language Rule

In bilingual communities, mixing languages is avoided in formal schooling: even if two languages are used on a daily basis for teaching, only one language is used to teach each given academic subject. This tenet known as the one subject-one language rule avoids mixing languages in formal schooling because it may hinder learning. The aim of this study was to test the scientific ground of this assumption by investigating the consequences of acquiring new concepts using a method in which two languages are mixed as compared to a purely monolingual method. Native balanced bilingual speakers of Basque and Spanish—adults (Experiment 1) and children (Experiment 2)—learnt new concepts by associating two different features to novel objects. Half of the participants completed the learning process in a multilingual context (one feature was described in Basque and the other one in Spanish); while the other half completed the learning phase in a purely monolingual context (both features were described in Spanish). Different measures of learning were taken, as well as direct and indirect indicators of concept consolidation. We found no evidence in favor of the non-mixing method when comparing the results of two groups in either experiment, and thus failed to give scientific support for the educational premise of the one subject—one language rule.     

A Step Forward in Precision Medicine on “One Belt One Road”

<正>The story started nearly a year ago.On October 13 in 2016,a NewsViews article entitled ‘‘Precision medicine:what challenges are we facing?",written by a group of 21 bioinformaticians in China,who are actively involved in the relevant research,was released online in Genomics Proteomics Bioinformatics[1].A month later,an invitation arrived from a Thai col-     

One For All,All For One? Collective Representation in Healthcare Policy

Healthcare collectives, such as patient organizations, advocacy groups, disability organizations, professional associations, industry advocates, social movements, and health consumer organizations have been increasingly involved in healthcare policymaking. Such collectives are based on the idea that individual interests can be aggregated into collective interests by participation, deliberation, and representation. The topic of collectivity in healthcare, more specifically collective representation, has only rarely been addressed in (Western) bioethics. This symposium, entitled: “Collective Representation in Healthcare Policy” of the Journal of Bioethical Inquiry draws attention to this understudied topic from a variety of disciplines, within a variety of socio-cultural contexts. We draw attention to important ethical, cultural, and social questions, and into the practices, justifications for, and implications of collective representation of patients in healthcare policy.     

Epidemiology of Leptospirosis in Africa: A Systematic Review of a Neglected Zoonosis and a Paradigm for ‘One Health’ in Africa

BackgroundLeptospirosis is an important but neglected bacterial zoonosis that has been largely overlooked in Africa. In this systematic review, we aimed to summarise and compare current knowledge of: (1) the geographic distribution, prevalence, incidence and diversity of acute human leptospirosis in Africa; and (2) the geographic distribution, host range, prevalence and diversity of Leptospira spp. infection in animal hosts in Africa.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we searched for studies that described (1) acute human leptospirosis and (2) pathogenic Leptospira spp. infection in animals. We performed a literature search using eight international and regional databases for English and non-English articles published between January 1930 to October 2014 that met out pre-defined inclusion criteria and strict case definitions.

Results and Discussion

We identified 97 studies that described acute human leptospirosis (n = 46) or animal Leptospira infection (n = 51) in 26 African countries. The prevalence of acute human leptospirosis ranged from 2 3% to 19 8% (n = 11) in hospital patients with febrile illness. Incidence estimates were largely restricted to the Indian Ocean islands (3 to 101 cases per 100,000 per year (n = 6)). Data from Tanzania indicate that human disease incidence is also high in mainland Africa (75 to 102 cases per 100,000 per year). Three major species (Leptospira borgpetersenii, L. interrogans and L. kirschneri) are predominant in reports from Africa and isolates from a diverse range of serogroups have been reported in human and animal infections. Cattle appear to be important hosts of a large number of Leptospira serogroups in Africa, but few data are available to allow comparison of Leptospira infection in linked human and animal populations. We advocate a ‘One Health’ approach to promote multidisciplinary research efforts to improve understanding of the animal to human transmission of leptospirosis on the African continent.     

Focus: Zoonotic Disease: Health System Contact and Awareness of Zoonotic Diseases: Can it Serve as One Health Entry Point in the Urban Community of Ahmedabad, India?

One Health (OH) is emphasized globally to tackle the (re)emerging issues at the human-animal-ecosystem interface. However, the low awareness about zoonoses remain a challenge in global south, thus this study documented the health system contact and its effect on the awareness level of zoonoses in the urban community of Ahmedabad, India. A community-based household survey was conducted between October 2018 and July 2019. A total of 460 households (HHs) were surveyed from two zones and 23 wards of the city through cluster sampling. A structured, pilot-tested, and researcher-administered questionnaire in the vernacular language was used to collect the information on demographic details, socio-economic details, health-seeking behavior for both the humans and their animals, human and animal health system contact details and the participants’ awareness on selected zoonotic diseases based on the prioritization (rabies, brucellosis, swine flu, and bird flu). Out of 460 surveyed households, 69% of HHs and 59% of HHs had a health system contact to the human and animal health system respectively at the community level. There are multiple health workers active on the community level that could potentially serve as One Health liaisons. The investigation of the knowledge and awareness level of selected zoonotic diseases revealed that 58.5%, 47.6%, and 4.6% know about rabies, swine and/or bird flu, and brucellosis, respectively. The mixed-effect linear regression model indicates that there is no significant effect on the zoonotic disease awareness score with the human health system contact; however, a minimal positive effect with the animal health system contact was evident.