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      Successes and challenges of the One Health approach in Kenya over the last decade

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          Abstract

          More than 75% of emerging infectious diseases are zoonotic in origin and a transdisciplinary, multi-sectoral One Health approach is a key strategy for their effective prevention and control. In 2004, US Centers for Disease Control and Prevention office in Kenya (CDC Kenya) established the Global Disease Detection Division of which one core component was to support, with other partners, the One Health approach to public health science. After catalytic events such as the global expansion of highly pathogenic H5N1 and the 2006 East African multi-country outbreaks of Rift Valley Fever, CDC Kenya supported key Kenya government institutions including the Ministry of Health and the Ministry of Agriculture, Livestock, and Fisheries to establish a framework for multi-sectoral collaboration at national and county level and a coordination office referred to as the Zoonotic Disease Unit (ZDU). The ZDU has provided Kenya with an institutional framework to highlight the public health importance of endemic and epidemic zoonoses including RVF, rabies, brucellosis, Middle East Respiratory Syndrome Coronavirus, anthrax and other emerging issues such as anti-microbial resistance through capacity building programs, surveillance, workforce development, research, coordinated investigation and outbreak response. This has led to improved outbreak response, and generated data (including discovery of new pathogens) that has informed disease control programs to reduce burden of and enhance preparedness for endemic and epidemic zoonotic diseases, thereby enhancing global health security. Since 2014, the Global Health Security Agenda implemented through CDC Kenya and other partners in the country has provided additional impetus to maintain this effort and Kenya’s achievement now serves as a model for other countries in the region.

          Significant gaps remain in implementation of the One Health approach at subnational administrative levels; there are sustainability concerns, competing priorities and funding deficiencies.

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          Most cited references39

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          Global trends in emerging infectious diseases

          The next new disease Emerging infectious diseases are a major threat to health: AIDS, SARS, drug-resistant bacteria and Ebola virus are among the more recent examples. By identifying emerging disease 'hotspots', the thinking goes, it should be possible to spot health risks at an early stage and prepare containment strategies. An analysis of over 300 examples of disease emerging between 1940 and 2004 suggests that these hotspots can be accurately mapped based on socio-economic, environmental and ecological factors. The data show that the surveillance effort, and much current research spending, is concentrated in developed economies, yet the risk maps point to developing countries as the more likely source of new diseases. Supplementary information The online version of this article (doi:10.1038/nature06536) contains supplementary material, which is available to authorized users.
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            MERS Coronavirus Neutralizing Antibodies in Camels, Eastern Africa, 1983–1997

            To analyze the distribution of Middle East respiratory syndrome coronavirus (MERS-CoV)–seropositive dromedary camels in eastern Africa, we tested 189 archived serum samples accumulated during the past 30 years. We identified MERS-CoV neutralizing antibodies in 81.0% of samples from the main camel-exporting countries, Sudan and Somalia, suggesting long-term virus circulation in these animals.
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              An Outbreak of Rift Valley Fever in Northeastern Kenya, 1997-98

              In December 1997, 170 hemorrhagic fever-associated deaths were reported in Carissa District, Kenya. Laboratory testing identified evidence of acute Rift Valley fever virus (RVFV). Of the 171 persons enrolled in a cross-sectional study, 31(18%) were anti-RVFV immunoglobulin (Ig) M positive. An age-adjusted IgM antibody prevalence of 14% was estimated for the district. We estimate approximately 27,500 infections occurred in Garissa District, making this the largest recorded outbreak of RVFV in East Africa. In multivariate analysis, contact with sheep body fluids and sheltering livestock in one’s home were significantly associated with infection. Direct contact with animals, particularly contact with sheep body fluids, was the most important modifiable risk factor for RVFV infection. Public education during epizootics may reduce human illness and deaths associated with future outbreaks.
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                Author and article information

                Contributors
                ikg2@cdc.gov
                Mkariuki.njenga@wsu.edu
                eric.osoro@wsu.edu
                xwl4@cdc.gov
                bitekorinde@yahoo.com
                amwatondo@gmail.com
                muturimathew@gmail.com
                vro4@cdc.gov
                gbigogo@kemricdc.org
                Eotiang@kemricdc.org
                Fade@kemri.org
                sgl6@cdc.gov
                rfbreiman@emory.edu
                jjn6@cdc.gov
                ztq9@cdc.gov
                zux5@cdc.gov
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                10 May 2019
                10 May 2019
                2019
                : 19
                Issue : Suppl 3 Issue sponsor : Publication of this supplement has been funded by the U.S. Centers for Disease Control and Prevention. The articles have undergone the journal's standard peer review process for supplements. The Supplement Editors declare that they have no competing interests.
                : 465
                Affiliations
                [1 ]Division of Global Health Protection, US Centers for Disease Control and Prevention-Kenya, Nairobi, Kenya
                [2 ]Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, USA
                [3 ]GRID grid.415727.2, Zoonotic Disease Unit, Kenya Ministry of health, ; Nairobi, Kenya
                [4 ]GRID grid.463427.0, Zoonotic Disease Unit, Ministry of Agriculture Livestock and Fisheries, ; Nairobi, Kenya
                [5 ]ISNI 0000 0001 0155 5938, GRID grid.33058.3d, Center for Global Health Research, Kenya Medical Research Institute, ; Kisumu, Kenya
                [6 ]ISNI 0000 0001 2163 0069, GRID grid.416738.f, Division of Global Health Protection, US Centers for Disease Control and Prevention, ; Atlanta, GA USA
                [7 ]ISNI 0000 0001 0941 6502, GRID grid.189967.8, Emory Global Health Institute, Emory University, ; Atlanta, GA USA
                [8 ]Division of Global Health Protection, US Centers for Disease Control and Prevention, Dakar, Senegal
                Article
                6772
                10.1186/s12889-019-6772-7
                6696663
                32326940
                e6ea737c-d125-4a07-9640-419845db6ea7
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                Categories
                Correspondence
                Custom metadata
                © The Author(s) 2019

                Public health
                zoonosis,cross-sectoral collaboration global health security
                Public health
                zoonosis, cross-sectoral collaboration global health security

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