A/Prof Navneet Dhand is leading a consortium of veterinarians to protect our region from the next zoonotic pandemic. By Frank Leggett
The global disaster of the COVID-19 pandemic should be a wake-up call to humanity. Every country has been affected with millions of people infected and hundreds of thousands dead. At the time of writing, there is no end in sight and infection rates are increasing worldwide. It’s almost impossible to believe that this unmitigated crisis started with a virus from a single bat infecting an oblivious human in a wet market in China.
While there is a good reason to believe that we will eventually get COVID-19 under control, it’s just as likely that a similar virus could emerge with even more devastating consequences. Thankfully, a consortium of veterinary professionals are working on a project to train and equip veterinarians with the tools for disease outbreak investigation and surveillance across South-East Asia and the Pacific. The project is funded by the Indo-Pacific Centre for Health Security at the Australian Department of Foreign Affairs and Trade.
Director of the Asia Pacific Consortium of Veterinary Epidemiology (APCOVE) is A/Prof Navneet Dhand from the University of Sydney’s School of Veterinary Science. While he originally trained and worked as a governmental vet in India, he moved to Sydney to complete his PhD in veterinary epidemiology in 2007. At the same time, he joined the Australian College of Veterinary Scientists in the Epidemiology Chapter, picking up the Chris Baldock award for achieving the highest score in the membership examination. At present, he is an Associate Professor in veterinary biostatistics and epidemiology, and consults to the Food and Agriculture Organization of the United Nations.
“The majority of emerging infectious diseases are zoonotic; that is, they spread from animals to humans,” says A/Prof Dhand. “In order to detect them as early as possible, it makes sense to look for these diseases in animals, not in humans. Our goal is to train an animal health workforce that can conduct animal disease surveillance and outbreak investigation. The consortium has drawn on the skills of veterinary scientists from Australia, New Zealand and the USA. We’ve also involved many epidemiologists from South-East Asian countries and specialists from the Food and Agriculture Organization, the World Health Organization, and the Centers for Disease Control and Prevention.”
The consortium plans to train up to 160 vets in eight countries across the region. While there are some existing field epidemiology programs, the objective is to strengthen their capacity for outbreak investigation and surveillance. A/Prof Dhand’s team conducted reviews last year in order to understand the strengths, weaknesses and gaps in the existing training programs. Ideally these newly trained vets will act as ‘disease detectives’, identifying new diseases early and then limiting or stopping their transference to humans.
Watch and react
“These veterinarians will conduct surveillance and collect data during normal times,” says A/Prof Dhand. “They will record the prevalence of the disease, how it is spreading and if it is decreasing or increasing. This information will assist them in containing an outbreak and limiting how far it spreads.”
Another key member of the APCOVE team is Professor Mark Stevenson, an epidemiologist at the University of Melbourne’s Faculty of Veterinary and Agricultural Sciences. “One of the challenges we face is a high level of variability in the veterinary services of each country where we are working,” he says. “Vietnam has a well-functioning and well organised Department of Animal Health. Unfortunately, the same situation doesn’t exist across the board. One of our goals will be to provide more uniformity in veterinary epidemiological practice across each of the countries that take part in the project.”
The ability to surveil, record and react quickly will not just help stop the outbreak of zoonotic diseases but of transboundary diseases too. In 2018, African swine fever spread to several countries in South-East Asia resulting in a loss of 25 per cent of the world’s pig population. Animals, livelihoods and food supply were all dramatically affected.
“China has a huge pig population and since 2011, they have collected tens of thousands of samples from their pigs,” says A/Prof Dhand. “They have identified over 150 influenza viruses and identified one that has been increasing in frequency since 2016.”
Further investigation showed that this strain had the ability to enter human epithelial cells and attach to certain receptors. This was confirmed when they tested pig workers and found that 10 per cent of them had antibodies to that virus. The current influenza vaccines were ineffective which means humans have no immunity against that virus.
“This is a good example of what we’re trying to achieve. If you’re conducting effective surveillance on animals, you pick up on these trends early. That would give us time to develop diagnostic tests and create vaccines or other medicines while the virus is still circulating in the animal population. What we don’t want to see is another COVID-19 situation where we are struggling to develop a vaccine while it is infecting humans, and everything is shut down.”
Not only will APCOVE improve detection abilities where risk factors are present, they will upgrade the skills of those professionals working with surveillance data. “Animal health officials need to be confident to make tough decisions if and when the need arises,” says Dr Stevenson. “If a health official blows the whistle too readily, we’ll have the ‘boy that cried wolf’ syndrome. If they are reluctant to blow the whistle then we’re likely to land in the situation we’re in today.”
It’s almost a given that future zoonotic diseases will emerge in the human population. The question is, why now? What are the reasons that diseases like COVID-19 are emerging?
“The problem is essentially human activity,” says A/Prof Dhand. “We are causing them to emerge. As the human population continues to increase, deforestation spreads as we encroach into wildlife habitat. This brings domestic animals into close contact with wildlife. The viruses usually spill over to domestic animals and then from domestic animals to humans. However, when people use wildlife for traditional medicines or for food, the infection can be direct. The wet markets are a mixture of domestic animals, humans and wildlife in a concentrated environment. It’s a recipe for disaster.”
The best way to limit zoonotic and transboundary diseases is to stop deforestation, restore the environment and cease exploiting wildlife. Of course, the political will needs to be in place for any of that to happen.
“The other issue is intensive farming,” says A/Prof Dhand. “In order to feed eight billion people, we have resorted to intensive farming that’s good for producing food. Unfortunately, with animals living grouped together in close contact, it’s also very easy for viruses to spread quickly.”
APCOVE is presently assessing the current epidemiology capacity of each area they cover. They will then develop e-learning materials and case studies of about 25 to 30 modules. The modules will focus on such subjects as outbreak investigation, surveillance, data analysis, health and leadership. Workshops will be organised in 2021 to train the people who will be mentoring the vets across the region. Each country will have about 20 mentors who will be linked with the appropriate ministries. Some of the training will take place in Australia.
“Many zoonotic diseases have the capacity to spill over,” says A/Prof Dhand. “We need to be ready and prepared for a future pandemic. It’s imperative that there are people who can conduct a surveillance and are able to investigate outbreaks. We need clearly defined systems in place to quickly respond to an outbreak.
“The one thing that has become clear from the COVID-19 pandemic is that the health of humans, animals and the environment is closely interlinked. We need to increase collaboration and coordination between different countries and disciplines to prevent future outbreaks of zoonotic diseases.”