EMERGING VIRAL DISEASES
THE ONE HEALTH CONNECTION
Workshop Summary
Eileen R. Choffnes and Alison Mack, Rapporteurs
Forum on Microbial Threats
Board on Global Health
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
Financial support for this activity was provided by the U.S. Department of Health and Human Services: National Institutes of Health, National Institute of Allergy and Infectious Diseases, Centers for Disease Control and Prevention, and the Food and Drug Administration; U.S. Department of Defense: Armed Forces Health Surveillance Center, and U.S. Army Medical Research and Materiel Command; U.S. Department of Justice: Federal Bureau of Investigation; U.S. Department of Veterans Affairs; U.S. Department of Homeland Security; U.S. Agency for International Development; Uniformed Services University of the Health Sciences; Alfred P. Sloan Foundation; American Society for Microbiology; Infectious Diseases Society of America; Johnson & Johnson; Merck Company Foundation; and sanofi pasteur. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for this activity.
International Standard Book Number-13: 978-0-309-31397-1
International Standard Book Number-10: 0-309-31397-X
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Copyright 2015 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
Cover image: Global hotspot map of emerging infectious diseases (EIDs). This map illustrates the relative risk of a zoonotic emerging infectious disease of wildlife origin spilling over into the human population. It was produced by analyzing with logistic regression the presence/absence of all known wildlife-origin EIDs since 1940 against a series of known drivers, including human population density, change in human population density, and wildlife diversity (mammalian species richness), gridded at 1km2 resolution, and corrected for reporting bias by including a measure of the global distribution of infectious disease researchers. Map produced by EcoHealth Alliance and research funded by USAID-EPT PREDICT.
Suggested citation: IOM (Institute of Medicine). 2015. Emerging Viral Diseases: The One Health Connection. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Victor J. Dzau is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE FOR THE WORKSHOP
ON EMERGING VIRAL DISEASES1
PETER DASZAK, EcoHealth Alliance, New York, New York
JEFFREY DUCHIN, Public Health–Seattle & King County, Seattle, Washington
CAROLE HEILMAN, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
JAMES M. HUGHES, Global Infectious Diseases Program, Emory University, Atlanta, Georgia
RIMA KHABBAZ, Centers for Disease Control and Prevention, Atlanta, Georgia
DAVID SWAYNE, Agricultural Research Service, U.S. Department of Agriculture, Athens, Georgia
JOHN WATSON, Public Health England, London, United Kingdom
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1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests solely with the workshop rapporteurs and the institution.
FORUM ON MICROBIAL THREATS1
DAVID A. RELMAN (Chair), Stanford University, and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
JAMES M. HUGHES (Vice chair), Global Infectious Diseases Program, Emory University, Atlanta, Georgia
LONNIE J. KING (Vice chair), Ohio State University, Columbus, Ohio
KEVIN ANDERSON, Biological and Chemical Defense Division, Science and Technology Directorate, U.S. Department of Homeland Security, Washington, DC
ENRIQUETA C. BOND, Burroughs Wellcome Fund (Emeritus), QE Philanthropic Advisors, Marshall, Virginia
ROGER G. BREEZE, Lawrence Livermore National Laboratory, Livermore, California
ARTURO CASADEVALL, Albert Einstein College of Medicine, Bronx, New York
ANDREW CLEMENTS, U.S. Agency for International Development, Washington, DC
PETER DASZAK, EcoHealth Alliance, New York, New York
JEFFREY S. DUCHIN, Public Health–Seattle and King County, Seattle, Washington
JONATHAN EISEN,2 Genome Center, University of California, Davis, California
MARK B. FEINBERG, Merck Vaccine Division, Merck & Co., Inc., West Point, Pennsylvania
AARON M. FIROVED,3 Office of Health Affairs, U.S. Department of Homeland Security, Washington, DC
JACQUELINE FLETCHER, Oklahoma State University, Stillwater, Oklahoma
CLAIRE FRASER, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland
JESSE L. GOODMAN,4 Georgetown University, Washington, DC
EDUARDO GOTUZZO, Instituto de Medicina Tropical–Alexander von Humboldt, Universidad Peruaña Cayetano Heredia, Lima, Peru
CAROLE A. HEILMAN, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
DAVID L. HEYMANN, Public Health England, London, United Kingdom
PHILIP HOSBACH, sanofi pasteur, Swiftwater, Pennsylvania
_______________
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
2 Forum member until July 31, 2014.
3 Forum member since November 14, 2014.
4 Forum member since August 7, 2014.
STEPHEN ALBERT JOHNSTON, Arizona BioDesign Institute, Arizona State University, Tempe, Arizona
GERALD T. KEUSCH, Boston University School of Medicine and Boston University School of Public Health, Boston, Massachusetts
RIMA F. KHABBAZ, Centers for Disease Control and Prevention, Atlanta, Georgia
MARK KORTEPETER, Uniformed Services University of the Health Sciences, Bethesda, Maryland
STANLEY M. LEMON, University of North Carolina, Chapel Hill, North Carolina
MARGARET McFALL-NGAI, University of Wisconsin, Madison, Wisconsin
EDWARD McSWEEGAN, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
PAULA J. OLSIEWSKI, Alfred P. Sloan Foundation, New York, New York
STEPHEN OSTROFF, Food and Drug Administration, Silver Spring, Maryland
JULIE PAVLIN, Armed Forces Health Surveillance Center, Silver Spring, Maryland
GEORGE POSTE, Complex Adaptive Systems Initiative, Arizona State University, SkySong, Scottsdale, Arizona
DAVID RIZZO, Department of Plant Pathology, University of California, Davis, California
GARY A. ROSELLE, Veterans Health Administration, Department of Veterans Affairs, Cincinnati, Ohio
KEVIN RUSSELL, Armed Forces Health Surveillance Center, Silver Spring, Maryland
JANET SHOEMAKER, American Society for Microbiology, Washington, DC
JAY P. SIEGEL, Johnson & Johnson, Radnor, Pennsylvania
P. FREDERICK SPARLING,5 University of North Carolina, Chapel Hill, North Carolina
MARY E. WILSON, Harvard School of Public Health, Harvard University, Boston, Massachusetts
EDWARD H. YOU, Federal Bureau of Investigation, Washington, DC
IOM Staff
EILEEN CHOFFNES, Scholar and Director
KATHERINE McCLURE,6 Associate Program Officer
REBEKAH HUTTON,7 Research Associate
PRIYANKA NALAMADA, Senior Program Assistant
JOANNA ROBERTS,8 Senior Program Assistant (Temp)
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5 Forum member until June 30, 2014.
6 Staff member until December 31, 2014.
7 Staff member until November 14, 2015.
8 Staff member until March 31, 2014.
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BOARD ON GLOBAL HEALTH1
THOMAS C. QUINN (Chair), Associate Director for International Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Professor of Medicine, International Health, Epidemiology, and Molecular Biology and Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland
JO IVEY BOUFFORD (Ex-Officio), President, New York Academy of Medicine, New York, New York
GARY DARMSTADT, Director, Family Health Division, Global Health Program, The Bill & Melinda Gates Foundation, Seattle, Washington
JACOB A. GAYLE, Vice President, Community Affairs, Executive Director, Medtronic Foundation, Minneapolis, Minnesota
GLENDA E. GRAY, Executive Director, Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Diepkloof, South Africa
STEPHEN W. HARGARTEN, Professor and Chair, Emergency Medicine, Director, Medical College of Wisconsin, Milwaukee, Wisconsin
CLARION JOHNSON, Global Medical Director, Medicine and Occupational Medicine Department, ExxonMobil, Fairfax, Virginia
ALAN LESHNER, Chief Executive Officer, Executive Publisher, American Association for the Advancement of Science, Washington, DC
MYRON LEVINE, Simon and Bessie Grollman Distinguished Professor and Director Center for Vaccine Development, University of Maryland at Baltimore, Baltimore
GUY PALMER, Regents Professor of Pathology and Infectious Diseases, Director of the School for Global Animal Health, Washington State University, Pullman, Washington
ANNE PETERSEN, Research Professor, Center for Human Growth and Development, University of Michigan, Ann Arbor
DAVID VLAHOV, Dean and Endowed Professor of Nursing Education School of Nursing, University of California, San Francisco, Schools of Nursing and Medicine
IOM Staff
PATRICK KELLEY, Director
ANGELA CHRISTIAN,2 Program Associate
_______________
1 Institute of Medicine boards do not review or approve individual workshop summaries. The responsibility for the content of the workshop summary rests with the workshop rapporteurs and the institution.
2 Staff member until January 31, 2015.
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Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
CLAIRE FRASER, Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland
JAMES M. HUGHES, Global Infectious Diseases Program, Emory University, Atlanta, Georgia
STANLEY M. LEMON, University of North Carolina, Chapel Hill, North Carolina
MICHAEL WOROBEY, University of Arizona, Tucson, Arizona
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Melvin Worth. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
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Acknowledgments
The Forum on Emerging Infections was created by the Institute of Medicine (IOM) in 1996 in response to a request from the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The purpose of the Forum is to provide structured opportunities for leaders from government, academia, and industry to regularly meet and examine issues of shared concern regarding research, prevention, detection, and management of emerging, reemerging, and novel infectious diseases in humans, plants, and animals. In pursuing this task, the Forum provides a venue to foster the exchange of information and ideas, identify areas in need of greater attention, clarify policy issues by enhancing knowledge and identifying points of agreement, and inform decision makers about science and policy issues. The Forum seeks to illuminate issues rather than resolve them. For this reason, it does not provide advice or recommendations on any specific policy initiative pending before any agency or organization. Its value derives instead from the diversity of its membership and from the contributions that individual members make throughout the activities of the Forum. In September 2003, the Forum changed its name to the Forum on Microbial Threats.
The Forum on Microbial Threats, and the IOM, wish to express their sincere appreciation to the individuals and organizations who contributed their valuable time to provide information and advice to the Forum. Their participation in the planning and execution of this workshop made it greater than the sum of its parts. A full list of presenters, and their biographical information, may be found in Appendix E.
The Forum gratefully acknowledges the contributions of the members of the planning committee1: Peter Daszak (EcoHealth Alliance), Jeffrey Duchin (Public Health–Seattle & King County), Carole Heilman (National Institute of Allergy and Infectious Diseases, NIH), James M. Hughes (Emory University), Rima Khabbaz (CDC), David Swayne (U.S. Department of Agriculture), and John Watson (Public Health England).
The Forum is also indebted to the IOM staff who tirelessly contributed throughout the planning and execution of the workshop and the production of this workshop summary report. On behalf of the Forum, we unreservedly acknowledge these efforts led by Dr. Eileen Choffnes, Scholar and Director of the Forum; Katherine McClure,2 Associate Program Officer; Rebekah Hutton,3 Research Associate; Priyanka Nalamada, Senior Program Assistant; and Joanna Roberts,4 Senior Program Assistant (Temp). Without the contributions and dedication of the staff to the work of the Forum in developing this workshop’s agenda and for their thoughtful and insightful approach and skill in planning for the workshop and in translating the workshop’s proceedings and discussion into this workshop summary report, this report would not have been possible. We would also like to thank the following IOM staff and consultants for their invaluable contributions to this activity: Laura Harbold DeStefano, Chelsea Frakes, Rosalind Gomes,5 Greta Gorman, Faye Hillman, Sarah Kelley, Alison Mack, and Julie Wiltshire.
Finally, the Forum wishes to recognize the sponsors that supported this activity. Financial support for this activity was provided by the U.S. Department of Health and Human Services: National Institutes of Health, National Institute of Allergy and Infectious Diseases, Centers for Disease Control and Prevention, and the Food and Drug Administration; U.S. Department of Defense: Armed Forces Health Surveillance Center, and U.S. Army Medical Research and Materiel Command; U.S. Department of Justice: Federal Bureau of Investigation; U.S. Department of Veterans Affairs; U.S. Department of Homeland Security; U.S. Agency for International Development; Uniformed Services University of the Health Sciences; Alfred P. Sloan Foundation; American Society for Microbiology; Infectious Diseases Society of America; Johnson & Johnson; Merck Company Foundation; and sanofi pasteur. The views presented in this workshop summary are those of the workshop participants and have been summarized by the rapporteurs. They do not necessarily reflect the views of the Forum on Microbial Threats, its sponsors, or the IOM.
_______________
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests solely with the workshop rapporteurs and the institution.
2 Staff member until December 31, 2014.
3 Staff member until November 14, 2015.
4 Staff member until March 31, 2014.
5 Staff member until January 9, 2015.
Contents
A1 Animal Reservoirs of Middle East Respiratory Syndrome Coronavirus
Jonathan H. Epstein and Kevin J. Olival
A2 Chikungunya at the Door—Déjà Vu All Over Again?
David M. Morens and Anthony S. Fauci
A3 Emerging Infectious Diseases: Threats to Human Health and Global Stability
David M. Morens and Anthony S. Fauci
A4 Emerging Infectious Diseases in 2012: 20 Years After the Institute of Medicine Report
David M. Morens and Anthony S. Fauci
A5 Pandemic Preparedness and Response—Lessons from the H1N1 Influenza of 2009
Harvey V. Fineberg
A6 Studying Zoonotic Diseases in the Natural Host
John W. Lowenthal, Michelle L. Baker, Cameron R. Stewart, Christopher Cowled, Celine Deffrasnes, Lin-Fa Wang, and Andrew G. D. Bean
A7 Medusa’s Ugly Head Again: From SARS to MERS-CoV
Trish M. Perl, Allison McGeer, and Connie Savor Price
Dirk U. Pfeiffer
A9 From Risk Analysis to Risk Governance—Adapting to an Ever More Complex Future
Dirk U. Pfeiffer
A10 A One Health Perspective on HPAI H5N1 in the Greater Mekong Sub-region
Dirk U. Pfeiffer, Martin J. Otte, David Roland-Holst, and David Zilberman
A11 Zoonosis Emergence Linked to Agricultural Intensification and Environmental Change
Bryony A. Jones, Delia Grace, Richard Kock, Silvia Alonso, Jonathan Rushton, Mohammed Y. Said, Declan McKeever, Florence Mutua, Jarrah Young, John McDermott, and Dirk U. Pfeiffer
A12 Global Trends in Emerging Viral Diseases of Wildlife Origin
Jonathan Sleeman and Hon Ip
A13 Role of Poultry in Spread of Novel H7N9 Influenza Virus in China
Mary J. Pantin-Jackwood, Patti J. Miller, Erica Spackman, David E. Swayne, Leonardo Susta, Mar Costa-Hurtado, and David L. Suarez
Figures and Tables
FIGURES
WO-1 Global examples of emerging and reemerging infectious diseases
WO-3 WHO phases of pandemic alert at the time of the H1N1 pandemic
WO-4 Increases in seasonal risk to human health
WO-5 The global risks landscape, 2014
WO-6 Urbanization, globalization, and land use changes
WO-7 Risk-governance framework
WO-8 Bats and emerging viruses
WO-9 The host immune response to an infection influences the disease outcome
WO-11 SARS-CoV virion—ssRNA, single-stranded RNA
WO-12 Emerging CoVs in U.S. swine (2013 to present)
WO-13 Coronaviruses with broad host ranges
WO-14 Birds consume and contaminate livestock feed
WO-16 Arabian bat species richness
WO-17 Transmission map of outbreak of MERS-CoV infection
WO-18 Pilgrims performing Hajj—1932 to 2013
WO-19 Seasonal passenger and air traffic volume
WO-20 Country-level destinations of air travelers departing MERS-CoV source countries
WO-23 Number of confirmed human H7N9 cases by week as of July 14, 2014
WO-24 Confirmed cases and deaths from avian influenza A (H7N9) from October 1, 2013, to the present
WO-26 Live bird market (LBM) networks in Guangxi, Yunnan, and Hunan
WO-28 Ongoing surveillance for H7N9: Laos and Myanmar
A1-1 Map of the initial investigation of bats as a reservoir for MERS-CoV in Bisha and Unaizah
A1-2 The top five camel-producing countries (1992–2013)
A6-2 The outcome of disease severity is influenced by the host–pathogen interaction
A6-3 The host immune response to an infection influences the disease outcome
A8-4 Eco-social system components influencing spread of HPAIV H5N1 in parts of Asia
A8-5 A systems perspective on disease emergence
A8-6 Components of the risk governance framework
A11-1 Pathogen flow at the wildlife–livestock–human interface
A12-1 Emerging diseases investigated by the U.S. Geological Survey
A13-1 Comparison of oropharyngeal virus shedding after experimental challenge
TABLES
WO-3 Emerging Porcine Coronaviruses—Target Tissues and Diseases
WO-4 Avian Influenza A (H7N9) Update: March 17, 2014
A3-1 Some Major Factors That Underlie Disease Emergence and Reemergence
A5-1 World Health Organization (WHO) Pandemic-Phase Descriptions and Main Actions According to Phase
A11-1 Conceptual Framework of Types of Wildlife–Livestock–Human Interfaces and Their Characteristics
A12-1 Highly Pathogenic Avian Influenza Outbreaks in Poultry and Wild Birds Since 1959
A12-2 Factors That Contributed to the Success of One Health Projects
A13-1 Susceptibility of Poultry to Influenza A (H7N9) Virus
A13-2 Transmission of Influenza A (H7N9) Virus in Quail, Pigeons, and Ducks