By Rose Hoban
SARS, bird flu, West Nile Virus, HIV and many other emerging diseases all have one thing in common – they had their origins in interactions between humans, people and the environments where both live.

The study of the intersection of human health, veterinary health and environment has given rise to a health care approach that’s been dubbed “One Health,” defined as the “collaborative effort of multiple disciplines… to attain optimal health for people, animals and the environment.”
“It’s simple, but so hard to do,” veterinary expert Marguerite Pappaioanou told students from all three Triangle universities at a seminar Tuesday evening held at the NC Biotechnology Center in Research Triangle Park.
The students – undergrads, and graduate medical, public health and veterinary students – were sitting in on the first session of a semester-long seminar focusing on One Health sponsored by the NC One Health Collaborative, a group of professionals interested in the topic. A number of career professionals are also sitting in on the sessions – veterinarians from state and federal agencies, academics, physicians and environmental specialists.
The lectures are also open to the public.
Pappaioanou, who has had a 30-year career at the Centers for Disease Control and Prevention, the US Public Health Service, the US Agency for International Development and private agencies, said researchers have found that between 75-80 percent of infectious diseases have zoonotic – i.e. coming from animal – origins.

“We started having all these outbreaks that were zoonotic diseases, and the world started to catch on about ‘isn’t this a brand new phenomenon?’” Pappaioanou said. “And I thought, ‘this isn’t new information… we’ve known this.’ But not so, a lot of the world didn’t necessarily understand that or know it,”
She said animals and humans have co-existed for most of human history, it’s just that modern people have lost sight of that relationship.
“In many agrarian societies in the world, you don’t have specialists in different places. Animals are part of your life, in your house, in your environment. And when there’s unclean water and all the animals are there, it’s just life.”
Pappaioanou said healthcare disciplines have diverged and become isolated from one another, she said. Knowledge of how all the disciplines fit together has been lost. She said funding structures, culture and the way different professionals in different disciplines are trained keep them from learning about what other healthcare professionals do.
“So, why take a One Health approach?” asked Pappaioanou. “Health problems are complex, they’re caused by multiple drivers and factors. the policies made to solve one problem often will lead to… will impact another problem or cause other problems. There are numerous opportunities for prevention and mitigation across a broad variety of disciplines. No discipline can do it alone. It’s too complex.”
Pappaioanou, who worked in a veterinary clinic for three years, told a story about a woman who brought in her dog to be vaccinated against rabies. She asked the woman if she had vaccinated her children, the woman said, “no.”
“So, why are you vaccinating your dog?” Pappaioanou asked.
“Because the law requires it,” the woman responded.

The exchange was key in getting Pappaioanou to start thinking about veterinarians’ role in promoting human health along with that of animals.
“I can get a vaccination by a pharmacists at CVS… I don’t see why veterinarians can’t offer flu vaccines to their clients,” she said. “I think they have more clinical training than pharmacists do.”
And she said the health promotion message should go in the other direction too: doctors should talk to their patients about how having relationships with animals can improve health. One example is in obesity management.
“There’ s good data that shows people will take their dog for a walk. If they plan to go for a walk with another human and the other human drops out, they don’t go. If they have a dog, they go,” Pappaioanou said.
Cover photo courtesy benjgibbs, Flickr Creative Commons