Sustaining Global Surveillance and Response to Emerging Zoonotic Diseases (2009)

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Appendix A Glossary of Terms Anthropogenic—Caused or produced by humans. Arboviruses—Viruses transmitted mainly by arthropods. Biosafety levels—Recommended containment or biosafety levels (BSL) that describe safe methods for managing infectious materials in the laboratory environment where they are being handled or maintained. Biosecurity—A strategic and integrated approach that encompasses the policy and regulatory frameworks (including instruments and activities) that analyze and manage risks in the sectors of food safety, animal life and health, and plant life and health, including associated environmental risk. Biosecurity covers the introduction of plant pests, animal pests and diseases, and zoonoses, the introduction and release of genetically modified organ- isms and their products, and the introduction and management of invasive alien species and genotypes. BSL laboratory designations (BSL 1–4)—There are four BSLs, with BSL-1 representing a basic level of containment relying on standard microbiologi- cal practices and BSL-4 representing the most advanced containment when working with dangerous and exotic agents that pose a high individual risk of life-threatening disease (which may be transmitted via the aerosol route and for which no vaccine or therapy is available). The increasing numbers correspond to the increasing levels of protection for personnel and the en- vironment. The purpose is to reduce or eliminate exposure of laboratory  

0 GLOBAL SURVEILLANCE AND RESPONSE TO zOONOTIC DISEASES workers, other persons, and the outside environment to potentially hazard- ous agents. Each combination is specifically appropriate for the operations performed, the documented or suspected routes of transmission of the infectious agents, and the laboratory function or activity. Bush animals—Species include apes, other primates, ungulates, rodents, and birds. The species hunted depends on the geographical area and the hunters’ preferences, cultural practices, and prohibitions. Bushmeat—Term commonly used for meat of terrestrial wild animals, killed for subsistence or commercial purposes throughout the humid tropics of the Americas, Asia, and Africa. CITES—The Convention on International Trade in Endangered Species of Wild Fauna and Flora is an international agreement between govern- ments. Its aim is to ensure that international trade in specimens of wild animals and plants does not threaten their survival. CITES was drafted as a result of a resolution adopted in 1963 at a meeting of members of IUCN (The World Conservation Union). The text of the Convention was agreed upon at a meeting of representatives of 80 countries in Washington, DC, on March 3, 1973, and on July 1, 1975, CITES entered in force. It is an international agreement to which countries adhere voluntarily, and is now made up of 175 parties. Codex Alimentarius—A collection of internationally recognized standards, codes of practice, guidelines, and other recommendations relating to food, food production, and food safety. Its texts are developed and maintained by the Codex Alimentarius Commission, a body that was established in 1963 by the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). The Commission’s main aims are stated as being to protect the health of consumers and ensure fair practices in the international food trade. The Codex Alimentarius is recognized by the World Trade Organization as an international reference point for the resolution of disputes concerning food safety and consumer protection. Domestic animal—Animals that have been bred selectively in captivity and thereby modified from their ancestors for use by humans who control the animals’ breeding and food supply. Driver—A factor that causes a zoonotic disease to emerge or reemerge. Emerging infection—Either a newly recognized, clinically distinct infectious 

 APPENDIX A disease, or a known infectious disease whose reported incidence is increas- ing in a given place or among a specific population. Endemic—Restricted or peculiar to a locality or region. Endemic infection refers to a sustained, relatively stable pattern of infection in a specified population. Epidemic—The occurrence of an illness (or other health-related event) in a community or region clearly in excess of normal expectancy. Food security—Comprises access, availability, and utilization issues. Nutri- tion security is achieved when reliable access to appropriately nutritious food is coupled with a sanitary environment, adequate health services, and care to ensure a healthy and active life for all household members. GDP—Gross domestic product is the market value of all final goods and services made within the borders of a nation in a year. Globalization—A widely used term to describe the process by which people of the world are unified into a single society and function together. This process is usually recognized as being driven by a combination of economic, technological, sociocultural, political, and biological factors. Host—Person or other living animal that affords subsistence or lodgment to an infectious agent under natural conditions. Hotspot—Region where factor(s) are most densely aggregated, most highly prevalent, and where risk of a (disease) event is most intense. Human–animal interface—Ways in which humans and animals interact, which may include, but are not limited to, cohabitation (domestic and exotic animals as pets or harvesting parts such as wool to make products for human use) or coexistence (with juxtaposed or integrated habitats), the production of food animals or hunting, scientific research, wildlife conser- vation, and public education (in zoos or sanctuaries). Integrated disease surveillance system for emerging zoonotic diseases—A system of shared and/or integrated, linked, clinical, epidemiological, lab- oratory, and risk behaviour components of human and animal disease surveillance systems, such that the processes of information collection, management, collation, analysis, presentation/reporting, and dissemination of data from human and animal systems are brought together to be used in 

 GLOBAL SURVEILLANCE AND RESPONSE TO zOONOTIC DISEASES decisionmaking for response by human and animal health authorities from local through international levels. International Health Regulations—Originally adopted in 1969, World Health Organization (WHO) member states approved a revised set of these regulations (known as IHR 2005) that went into effect in 2007. IHR 2005 establishes WHO’s central role in coordinating the control of disease and facilitating disease surveillance and response efforts against the spread of disease at the global level. Under the regulations, WHO requires member states to report all events that may constitute a “public health emergency of international concern,” which includes a (1) human and animal health risk to other states through the international spread of disease, and (2) an event that potentially could require a coordinated international response. Necropsy—An examination and dissection of a dead body to determine cause of death or the changes produced by disease. Notifiable disease—A disease for which regular, frequent, timely informa- tion on individual cases is considered necessary to prevent and control that disease. Each year a list of nationally notifiable diseases is agreed on and maintained by the Council of State and Territorial Epidemiologists and the Centers for Disease Control and Prevention (CDC). Diseases that are con- sidered nationally notifiable may or may not be designated by a given state as notifiable (reportable) in the state. States may use the national notifiable diseases list as well as other information, such as state-specific health pri- orities, to guide their determination of which conditions/diseases to make notifiable in their state. Thus, the list of state-specific notifiable diseases may vary across states and in a given state; the list may vary over time as well. Disease reporting is currently mandated by legislation or regulation only at the local or state level. One health—The American Veterinary Medical Association defines “one health” as the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, and our environment. The concept was first proposed by veterinary epidemi- ologist and parasitologist Dr. Calvin W. Schwabe, who used the term “one medicine” in the 1960s to capture the vital importance of considering medical and veterinary issues jointly in the study of zoonotic diseases. This multidisciplinary approach has been captured by recent “one health” initia- tives. An example of such an initiative, “One world-one health,” which is a trademark of the Wildlife Conservation Society, has developed a series of symposiums under this concept. 

 APPENDIX A Pandemic—A global disease outbreak. Pathogen—Biological agent capable of causing disease. Pathogenesis—The entry, primary replication, spread to target organs, and establishment of infection. Prion—A microscopic protein particle similar to a virus but lacking nucleic acid, thought to be the infectious agent responsible for scrapie and certain other degenerative diseases of the nervous system. Production system—A production system clusters production units (herds, farms, ranches), which, because of the similar environment in which they operate, can be expected to produce according to similar production func- tions. This similar environment can be characterized by the physical (cli- mate, soils, and infrastructure) and biological environments (plant biomass production, food animal species composition), economic and social condi- tions (prices, population pressure and markets, human skills, and access to technology and other services), and policies (land tenure, trade, and subsidy policies). Reemerging—Known diseases that have reappeared after a significant de- cline in incidence. Regime—Principles, norms, rules, and decisionmaking procedures around which actor expectations converge in a given issue or area. Reservoir—Any person, animal, arthropod, plant, soil, or substance (or combination of these) in which an infectious agent may reside. Response—Interventions that involve human and animal health systems and practitioners using disease surveillance information to plan and execute activities that prevent infectious diseases from affecting human and animal populations, protect such populations against exposure to pathogenic mi- crobes that evade prevention measures, and control morbidity and mortal- ity among populations infected by pathogenic agents. Risk assessment—The process of quantifying the probability of a harmful effect to individuals or populations from certain human activities. Sanction(s)—General trade restrictions between nations. Economic sanctions include trade bans, tariffs, import duties, and import or export quotas. 

 GLOBAL SURVEILLANCE AND RESPONSE TO zOONOTIC DISEASES Smallholder poultry keeper—Describes the practice of individuals and fami- lies keeping small flocks of poultry or other fowl in their backyards for their consumption or as a means of economic livelihood. Spillover—Spillover occurs when epidemics in a host population are driven not by transmission within that population but by transmission from a reservoir population. A pathogen typically reaches high prevalence in a reservoir and then spills over into the other host. SPS Agreement—The Agreement on the Application of Sanitary and Phyto- sanitary Measures is an international treaty of the World Trade Organiza- tion (WTO). It was negotiated during the Uruguay Round of the General Agreement on Tariffs and Trade (GATT) and entered into force with the establishment of WTO at the beginning of 1995. Under the SPS Agreement, WTO sets constraints on member states’ policies relating to food safety as well as animal and plant health about imported pests and diseases. It contains specific rules for countries that want to restrict trade to ensure food safety and the protection of human life from zoonoses, although it is a fundamental requirement that member states have a scientific basis to justify trade measure aimed at mitigating a health risk. Surveillance system—A system for public health surveillance is a group of integrated and quality-assured, cost-effective, and legally and professionally acceptable processes designed for the purpose of identifying in an ongo- ing, flexible, standardized, timely, simple, sensitive, and predictive manner the emergence of meaningful epidemiologic phenomena and their specific associations. These processes include human, animals, laboratory, and in- formatics activities to skillfully manage information derived from an entire defined community (or a subgroup thereof that is sufficiently representative and large) and to disseminate that information in a timely and useful man- ner to those able to implement appropriate public health interventions. Sustainability—In a broad sense, sustainability refers to the capacity for systems to remain diverse and productive over time. It requires the integra- tion of social, economic, and environmental spheres such that the needs of the present are met without compromising the needs of future generations. A sustainable surveillance system would include long-term financial invest- ment and infrastructure development and maintenance. TBT Agreement—The Agreement on Technical Barriers to Trade is an international treaty of the World Trade Organization (WTO). It was nego- tiated during the Uruguay Round of the General Agreement on Tariffs and Trade (GATT) and entered into force with the establishment of WTO at 

 APPENDIX A the beginning of 1995. It is in place to ensure that regulations, standards, testing, and certification procedures do not create unnecessary obstacles to trade. The agreement prohibits technical requirements created in order to limit trade, as opposed to technical requirements created for legitimate purposes such as consumer or environmental protection. Transboundary—Diseases that are of significant economic, trade, and/or food security importance for a considerable number of countries, which can easily spread to other countries and reach epidemic proportions and where control or management, including exclusion, requires cooperation between several countries. TRIPS Agreement—The Agreement on Trade Related Aspects of Intel- lectual Property Rights is an international agreement administered by the World Trade Organization (WTO) that sets down minimum standards for many forms of intellectual property regulation. It was negotiated at the end of the Uruguay Round of the General Agreement on Tariffs and Trade (GATT) in 1994. It contains several provisions that enable governments to implement their intellectual property regimes in a manner which takes ac- count of immediate and longer-term public health considerations. Vector—An organism, such as an insect, that transmits a pathogen from one host to another. Vector-borne disease—A disease in which the pathogenic microorganism is transmitted from an infected individual to another individual by an arthro- pod or other agent, sometimes with other animals serving as intermediary hosts. Virulence—Degree of pathogenicity of an infectious agent, indicated by the case fatality rates and/or its ability to invade and damage tissue of the host. Xenotransplantation—Any procedure that involves the transplantation, implantation, or infusion into a human recipient of either (1) live cells, tis- sues, or organs from a nonhuman animal source, or (2) human body fluids, cells, tissues, or organs that have had ex vivo contact with live nonhuman animal cells, tissues, or organs. Wild animal—Terrestrial animals that are untamed or undomesticated. They are killed for subsistence or commercial purposes throughout the humid tropics of the Americas, Asia, and Africa. 

 GLOBAL SURVEILLANCE AND RESPONSE TO zOONOTIC DISEASES Zoonoses—Any infection or infectious disease transmissible under natural conditions from animals to humans or those shared between humans and animals. Zoonoses may be bacterial, viral, or parasitic, or may involve unconventional agents. Zoonotic disease surveillance—The ongoing systematic and timely collec- tion, analysis, interpretation, and dissemination of information about the occurrence, distribution, and determinants of diseases transmitted between humans and animals. Zoonotic disease surveillance reaches its full poten- tial when it is used to plan, implement, and evaluate responses to reduce infectious disease morbidity and mortality through a functionally integrated human and animal health system.