One Health: The global challenge of epidemicand endemic leishmaniasis
Uma Saúde: O Desafio Global da Leishmaniose Epidêmica e Endêmica
Clarisa B Palatnik-de-Sousa, Michael J Day
’One Health’proposes the unification of medical and veterinary sciences with the establishment of collaborativeventures in clinical care, surveillance and control of cross-species disease, education, and research into diseasepathogenesis, diagnosis, therapy and vaccination. The concept encompasses the human population, domesticanimals and wildlife, and the impact that environmental changes (’environmental health’) such as global warmingwill have on these populations. Visceral leishmaniasis is a perfect example of a small companion animal disease forwhich prevention and control might abolish or decrease the suffering of canine and human patients, and whichaligns well with the One Health approach. In this review we discuss how surveillance for leishmaniases isundertaken globally through the control of anthroponootic visceral leishmaniasis (AVL) and zoonotic visceralleishmaniasis (ZVL). The ZVL epidemic has been managed to date by the culling of infected dogs, treatment ofhuman cases and control of the sandfly vector by insecticidal treatment of human homes and the canine reservoir.Recently, preventive vaccination of dogs in Brazil has led to reduction in the incidence of the canine and humandisease. Vaccination permits greater dog owner compliance with control measures than a culling programme.Another advance in disease control in Africa is provided by a surveillance programme that combines remotesatellite sensing, ecological modelling, vector surveillance and geo-spatial mapping of the distribution of vectorsand of the animal-to-animal or animal-to-human pathogen transmission. This coordinated programme generatesadvisory notices and alerts on emerging infectious disease outbreaks that may impede or avoid the spreading ofvisceral leishmaniasis to new areas of the planet as a consequence of global warming.