One Health approach for emergent and resurgent infectious diseases LancetMicrobe TheLancet infectiousdisease disease infection health onehealth
Background Eighty-one cases of highly pathogenic avian influenza A subtype H5N6 in humans have been detected to date since the first human case in 2014. Most of these cases occurred during 2021-22, mainly in China. In contrast, millions of birds died this year due to avian influenza; for instance, more than 40 million birds have been killed in the United States since January 2022.
The resurgence of H5N6, amid an ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 , is opportune as the political appetite and funding for disease surveillance were never so significant. A sentinel surveillance program for influenza has prevailed for decades, even before the coronavirus disease 2019 pandemic, as shown by the World Health Organization Global Influenza Surveillance and Response System .
Role of genomic surveillance Related StoriesSince October 2021, all HPAI H5 viruses detected in Europe were of the 2.3.4.4b clade associated with outbreaks in Asia over the past few years. This clade is widespread and appears to be evolving; a recent study from China revealed novel reassortment of H5N6 viruses with other H5 viruses, resulting in newer strains. Antigenically, these strains were distinct from the vaccine used in the poultry industry.
One Health approach The need for a ‘One Health’ approach for the surveillance of emergent infectious diseases has been well established. The Wildlife Conservation Society released the Manhattan principles in 2004, urging world leaders to recognize the link between public and environmental health. The SARS-CoV-2 spillover has rekindled the interest in One Health, but it is complex to integrate various disciplines into surveillance.
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