Embrace ‘One Health’

Medical experts are calling for stronger adherence to the global One Health mandate by Jamaican authorities, citing the outbreak of leptospirosis following Hurricane Melissa a month ago as a clear indication of why such a move is pivotal.

One Health, as outlined by the World Health Organisation (WHO), speaks to an integrated, unifying approach that aims to balance and optimise the sustainable health of people, animals, and ecosystems.

“It recognises that the health of humans, domestic and wild animals, and plants is closely linked and interdependent,” states the WHO.

The One Health approach gained traction, particularly after the deadly SARS outbreak in 2003.

However, while Jamaica has adopted the approach to some extent, senior veterinarian Dr Paul Cadogan believes the recent passage of the hurricane exposed areas requiring much-needed improvement. This is especially as it relates to considerations made for the nation’s animals, he explained, outlining the limited availability of resources to test for certain diseases in them.

Just last September, a cash-strapped Jamaica Society for the Prevention of Cruelty to Animals, widely regarded as Jamaica’s main hospital for pets and livestock, was in a rut and in need of finding $200 million for a hasty relocation, following the sale of its long-time Winchester Road, St Andrew, home. Many in the veterinary community - some of whom have been making donations in cash and kind to the cause - regarded this as a “national disgrace”.

“What I want to call for, when it comes to leptospirosis control and other diseases, is that we need to utilise the One Health approach. Health is not just about humans. It includes: plants, animals, and the environment. They are all interrelated,” stressed Cadogan, noting that leptospirosis viruses are transferred from animals to humans through urine or contaminated water and have an affinity for flooded areas such as those after storms.

“We can’t control leptospirosis only from the human standpoint. You have to deal with it from the animal and environmental standpoints as well as the sources of infection,” he explained, noting that while there is awareness and interaction, “we don’t yet have a formal One Health platform, an overarching body that includes persons from the various sectors.”

“They do exchange information, but it needs to be formalised,” he continued, noting that the outbreak of the leptospirosis disease can bring the various sectors together. The One Health approach is best practice in other parts of the world, he said, citing outbreaks of the deadly rabies disease that fuelled the formulation of structured platforms.

It is law in some countries that animals be vaccinated, but unfortunately, that is not so in Jamaica, he lamented.

Following a webinar for pet owners put on by the Ministry of Health and Wellness, the Caribbean College of Family Physicians, and the Jamaica Veterinary Medical Association (JVMA), Cadogan urged the public to practise proper sanitation and rodent control, seek help earliest after symptoms, and ensure that pets and animals are properly vaccinated though this may not ward off cases of the disease. Pet owners, farmers, and other individuals in direct contact with animals are among the most vulnerable.

On November 21, the Ministry of Health and Wellness declared a leptospirosis outbreak following an increase in suspected and confirmed cases. As of December 2, a total of 50 cases were reported, including dozens of confirmed cases and 12 related deaths. The cases have been spread over St Elizabeth, St Catherine, Hanover, Westmoreland, Trelawny, St Ann, St James, and St Mary. Portland Medical Officer Dr Sharon Lewis has also urged residents to take precautionary measures against the disease.

In the meantime, Dr Kathy-Ann Pate-Robinson, infectious disease specialist at the University Hospital of the West Indies, charged that if Jamaicans do not pay attention to the health of animals and the environment, the island will inevitably fail at protecting its people’s health.

“Long story short, we will just fail. That is it,” she said.

“It (leptospirosis) is not contagious from regular contact. How you get it is whether through your mouth, eyes, broken skin, or any sort of more vulnerable part of your body that the organism comes into contact with,” she explained. “Not everybody will get ill, and not everybody will die. But that means we have to work to prevent it. In the context of Hurricane Melissa, we have a lot more water around and a greater risk of contamination.”

People wading through flood waters or trying to retrieve items such as clothing and furniture from flooded areas are among the possible contact points for the disease, she said.

corey.robinson@gleanerjm.com