Presentation at 3rd GRF One Health Summit 2015 Session Surveillance And Early Warning

1. Institut Pasteur: An International Partner to
Implement One Health
Maria D. Van Kerkhove, Kathleen Victoir, Isabelle Pitrou, Rebecca Grant, Jason Rizzo,
Marc Juoan, Arnaud Fontanet and Christian Brechot on behalf of the Pasteur Center for
Global Health, the International Direction and the Ebola Task Force
Davos, Switzerland
5 October 2015

2. Emerging and re-emerging infectious of zoonotic origin
Human health, animal health and the state of ecosystems are
inextricably linked with 75% of emerging and re-emerging infectious
diseases known to be of zoonotic origin
Jones et al (2008) Nature
MERS-COV Avian influenza Ebola

3. Timeline of emerging infectious diseases
Source: adapted from HPA, mult sources
1980 1985 1990 1995 2000 2005 2010 2015
Monkeypox virus
Ebola virus
Human T-
lymphotropic virus
Human immuno-
deficiency virus
Bovine spongiform
encephalopathy
Hepatitis C virus
Hepatitis E virus
Hantavirus pulmonary
syndrome
Kaposi Sarcoma
Avian influenza A
virus in humans
West Nile virus
SARS coronavirus
Pandemic H1N1
influenza A virus
H7N9 avian influenza
MERS coronavirus
24 hours…

4. Apparent increase in emerging pathogens
• Human encroachment on natural habitat of animals
- changes in land use
- changes in food and agricultural systems
- changes in human behavior
- changes in environmental systems
• Genetic Reassortant
- accelerated subtype emergence
• Changes in trade patterns/animal movement
– Creating new mixing patterns of susceptible animals
• Improved surveillance, Improved diagnostic capacities
Heymann & Dai (2014) BMJ
Morens & Fauci (2013) PLoS Pathogens

5. One Health in Action
Vision: “A world capable of preventing, detecting, containing,
eliminating and responding to animal and public health risks
attributable to zoonoses and animal diseases through multi-
sectoral cooperation and strong partnerships.”
• Strong global commitment
• Evidence of adoption at national policy level
• Limited local implementation
WHO-FAO-OIE (2010)

6. Evaluation of the “One Health” approach in infectious
disease outbreaks
Aspect of One Health principle included in investigation*
Virus Human
Animal +
Human
Environment
+ Human
Animal +
Environment
+ Human
H7N9 7 0 0 2
H5N1 19 1 0 0
SARS 37 2 1 0
MERS-CoV 14 1 0 0
Ebola 42 4 1 0
Total 119 8 2 2
*151 recent outbreak investigation studies conducted at the time of emergence

7. Some Examples of Institut Pasteur’s experiences in One Health
implementation

8. Rabies
• The Institut Pasteur has played a leading role in the prevention and
control of rabies worldwide
• Research
– Epidemiological and genetic studies (IP Paris, Dakar, Bangui and Côte
d’Ivoire)
– Improving diagnostic techniques (Paris, Madagascar, Dakar and
Cambodia)
– Development of new vaccines and treatments (IP Paris, Tunis, Algeria,
Vietnam)
• In 2008, the institutes of the Institut Pasteur International Network
administered 500,000 doses of rabies vaccine on five continents
– Knowledge transfer through training, courses and workshops
(Cambodia, Madagascar, Vietnam, Shanghai)
Source: IP http://www.web.pasteur.fr/ip/resource/filecenter/document/01s-000041-0bu/plaquette-rage-en.pdf

9. H5N1
First human cases in 1997 in Hong Kong
As of 4 Sept, 844 human cases from 16 countries
16 HA, and 9 NA subtypes have been detected in wild birds and poultry

10. MERS-CoV
• Support to National Ministries of Health in the Middle East and South Korea
• Joint animal/human investigations with MoH and MoA in affected countries
• Coordination and implementation of camel/human serologic studies in
Algeria, Iran and Morocco
• Rapid diagnosis (CIBU) and laboratory training in multiple countries
Between 2012 and 1,593 human cases; 26 countries

11. Outbreak Investigation Task Force
OITF One Health implementation:
• Expands collaboration to include veterinarians, environmental experts and
animal/environment sectors of local governments
• Assists with the translation of knowledge from joint investigations into
public health policy recommendations and future One Health protocols
Carrying this tradition forward
Epidemio-
logists
Bacteriolo
gists
Virologist
s
Supportin
g
outbreak
response
Social
Scientists
Vetrinarians
Lab
technician
s
Clinicians

12. Some recent field actions by Pasteur
Jan
2015
Aug
GOARN Mission to
Sierra Leone for EVD
Jan
2016
Ebola
Field Support : Operational Lab in Macenta, Guinea
IP Dakar was the first lab deployed in Guinea ( 23 March 2014)
MERS-CoV
Supporting local authorities in the management of and response to an infectious
disease outbreak

13. Strategies for improving implementation of One Health
• Some hurdles for zoonoses
– Relatively small human case numbers
– Overcoming reluctance of animal/veterinary sector to engage in
“human health issues”
– Need for better communication of uncertainty and building public
trust
– Need for joint missions/trainings with MoH and MoA
– Lack of tools available for joint investigations

14. Pasteur’s unique capacity to respond to global threats
Source: HealthMap
Solid foundation in the field  Established relationships with local
governments  Recognized partner for outbreak response
MERS-CoV
MERS-CoV
Chikungunya
Avian
Influenza
Ebola
Dengue
Dengue
Dengue
Chikungunya
Location of Institut Pasteur
Recent Outbreaks
Solid foundation in the field  Established relationships with local
governments  Recognized partner for outbreak response

15. Thank you
Maria D. Van Kerkhove, Kathleen Victoir, Isabelle Pitrou, Rebecca Grant, Jason Rizzo,
Marc Juoan, Arnaud Fontanet and Christian Brechot on behalf of the Pasteur Center for
Global Health, the International Direction and the Ebola Task Force