In efforts to prevent another pandemic, The Lancet has launched a major scientific push to better understand how dangerous pathogens jump from animals to people – the announcement coming hard on the heels of a Cambodian toddler’s death from bird flu, the second such death within a week.
The journal said its members have been asked to go “beyond biology” and delve into the behaviours, environments and policies that cause viruses found in the wild to jump to humans, reports The Telegraph.
Many of the risk factors for zoonotic spillover events, such as deforestation, fur farms and wet markets, are already known, but rolling out strategies to effectively tackle them has so far proved difficult.
The Lancet commission – which includes 28 experts from every continent – aims to identify and develop risk spillover mitigation policies that are both doable and effective.
“We know, more or less, the biological mechanisms that drive disease transmission,” said Professor Dirk Pfeiffer, a veterinary epidemiologist at the City University of Hong Kong and member of the new commission.
“What we struggle with is the human behaviour aspect – it’s hard to control because it depends on economic drivers, cultural drivers, that vary so much across the planet… but we need to come up with sophisticated responses that actually deal with the underlying causes to reduce the frequencies of these outbreaks, and detect them early.”
Dead child ‘played in chicken yard’
The two deaths in Cambodia have reinforced the constant threat posed by zoonotic diseases.
On Monday, a two-year-old in the province of Prey Veng died after contracting H5N1 avian influenza. The previous day, the Ministry of Health had announced that a 50-year-old man in neighbouring Svay Rieng province had died from the virus.
It is not yet clear if the cases are linked, but reports suggest dead chickens had been found in the villages where both victims lived.
“I presume that she may have become infected with the virus when she played in the yard, as she normally did, where the chickens had been,” the little girl’s mother said, adding that she started vomiting, with a cough and high temperature, in early October. She later died at a children’s hospital.
Pfeiffer said incidents like this demonstrate the very real risks posed by animal diseases, and the need to do more to limit the threat posed by spillovers.
“Disease transmission events will continue to happen, but we need to try to reduce their frequencies, detect them early,” he said. But he added that strategies should not be specific to individual pathogens.
“In the 2000s, we all thought avian flu from chickens would be the next pandemic, and we enhanced our surveillance systems and vaccines were developed, but different diseases have taken us in completely unexpected directions.
“So we need to go beyond focusing on a single pathogen. This is about understanding ecosystems and behaviour and developing realistic, deployable strategies that will reduce the frequency and severity of these transmission events.”
The Lancet Commission panellists said they would start by assessing strategies already proposed, from curbing deforestation to ramping up biosecurity at wet markets, and improving access to healthcare for rural communities in close proximity to wildlife.
Within the next three years, the group aims to develop a more comprehensive picture of these and other possible approaches to curb spillover events, from both a disease perspective and a cost-benefit analysis.
“Spillover prevention is a topic that is poorly understood and largely unaddressed by major institutions working in public health,” said Dr Raina Plowright, co-chair of the commission. “Our commission will improve our understanding of disease threats. We need to shine a spotlight on this problem and then provide a strategy to solve it.”
See more from MedicalBrief archives:
Avian flu shots prepped for humans ‘just in case’
Why most bird flu viruses don’t move to people – Scottish study
Zoonotic transfer study fuels call for ban of wildlife trade, markets and medicinal use
Will bird flu spark the next pandemic?