Agricultural diseases on the move early in the third millennium

Special Focus Agricultural Diseases on the Move Early in the Third Millennium Veterinary Pathology 47(1) 15-27 ª The American College of Veterinary Pathologists 2010 Reprints and permission: http://www. sagepub.com/journalsPermissions.nav DOI: 10.1177/0300985809354350 http://vet.sagepub.com J. Arzt,1 W. R. White,2 B. V. Thomsen,3 and C. C. Brown4 Abstract With few exceptions, the diseases that present the greatest risk to food animal production have been largely similar throughout the modern era of veterinary medicine. The current trend regarding the ever-increasing globalization of the trade of animals and animal products ensures that agricultural diseases will continue to follow legal and illegal trade patterns with increasing rapidity. Global climate changes have already had profound effects on the distribution of animal diseases, and it is an inevitable reality that continually evolving climatic parameters will further transform the ecology of numerous pathogens. In recent years, many agricultural diseases have given cause for concern regarding changes in distribution or severity. Foot-and-mouth disease, avian influenza, and African swine fever continue to cause serious problems. The expected announcement of the global eradication of rinderpest is one of the greatest successes of veterinary preventative medicine, yet the closely related disease peste des petits ruminants still spreads throughout the Middle East and Asia. The spread of novel strains of bluetongue virus across Europe is an ominous indicator that climate change is sure to influence trends in movement of agricultural diseases. Overall, veterinary practitioners and investigators are advised to not only maintain vigilance against the staple disease threats but to always be sufficiently broad-minded to expect the unexpected. Keywords agriculture, climate change, disease, epidemiology, globalization, trends, transboundary, foot-and-mouth disease International animal health is a public good. —Dr. Bernard Vallat, Director General of the OIE Infectious diseases of animals have constrained agricultural endeavors for as long as humans have maintained animals for food, fiber, and draft. Sheep are believed to have been first domesticated in the 10th century BCE in Iraq, and in the 4th century BCE, Aristotle wrote extensively on the subject of veterinary diseases.49 In the Old Testament, the fifth plague brought upon the pharaoh of Egypt was pestilence of cattle (most similar to rinderpest), as sandwiched between beasts and boils and contextually in the league of severity of death of firstborn sons, thus clearly indicating familiarity with agricultural diseases as part of the early human experience. Changes in the distribution and severity of the effect of such diseases have surely occurred throughout the human agricultural experience and may be broadly separated as occurring owing to four main influences: environmental or ecological change, changes in movements of humans and their domesticated animals, evolution of hosts and/or pathogens, and changes in wildlife or vector distribution. These four influences upon agriculture were as relevant in prehistory as today. However, in the present era, profound environmental changes in the form of climate change and pan-societal globalization are occurring with such rapidity that the impact upon abilities to feed the world may be affected with similar severity. The discussion that follows is not an all-inclusive list of relevant agricultural diseases, nor is it a thorough treatment of any disease. Rather, it is a brief guide to the agricultural diseases that at present have indicated distributional changes that are noteworthy for potential impact on animal health, global food production, and commerce. In the interest of presenting the most current status of changes in disease distributions, we cite selected, frequently updating public databases, as indicated. These include ProMED-mail* (from the International Society for Infectious Diseases), the WAHIDy interface (from the World Organization for Animal 1 Foreign Animal Disease Research Unit, Agricultural Research Service, Plum Island Animal Disease Center, USDA, Greenport, NY 2 Foreign Animal Disease Diagnostic Laboratory, APHIS, Plum Island Animal Disease Center, USDA, Greenport, NY 3 National Veterinary Services Laboratories, APHIS, USDA, Ames, IA 4 Department of Veterinary Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA Corresponding Author: Dr Jonathan Arzt, PO Box 848, Plum Island Animal Disease Center, Foreign Animal Disease Research Unit, Agricultural Research Service, USDA, Greenport, NY 11944 Email: jonathan.arzt@ars.usda.gov Downloaded from vet.sagepub.com by guest on August 17, 2016 15 16 Veterinary Pathology 47(1) Health, or OIE), Global Alert and Responsez (from the World Health Organization), and EMPRES§ (from the Food and Agriculture Organization; FAO). Although such sources are not refereed in the manner of scientific literature, they do offer the advantage of more expedient availability of data on rapidly changing disease situations. Foot-and-Mouth Disease Foot-and-mouth disease (FMD) has for decades been, and continues to be, the exclusively agriculture-associated disease|| that poses the greatest economic threat to developed FMD-free nations. The cost of the 2001 epizootic in the United Kingdom has been estimated at $11 billion,87 and estimated costs of an incursion in the United States have been projected at $20 billion to $60 billion.58,63 Intense vigilance against FMD incursion is justified by this extreme expense, the ease with which the disease could be introduced (accidentally or intentionally), and the substantial difficulties associated with successful eradication. Current challenges in control of FMD are multifactorial and include the extreme contagiousness of the virus, the ability to spread over vast distances on wind-borne aerosols, the ability of the virus to infect numerous domestic and wild species, and the multiple serotypes of the virus that (at present) require distinct vaccine products. The significance of the last point is that when an outbreak is suspected, FMD virus must not just be confirmed but also serotyped and subtyped before an appropriate, type-specific vaccine can be disseminated in the field. The complexities surrounding the global control of FMD are reflected in the fact that even the most ambitious mitigation plans project programs of at least 30 years’ duration.73 The disease itself is generally a syndrome of high morbidity and low mortality, although, rarely, some viral strains cause high mortality among certain hosts.39 All domestic clovenhoofed livestock are susceptible, and several studies have characterized susceptibility of American68 and African94 wildlife to infection.88 FMD gets its name from the hallmark vesicular lesions most frequently occurring on the oral and pedal epithelium. Upon observation of such lesions, confirmatory diagnosis is necessary because several other conditions may manifest with indistinguishable clinical characteristics. Although many FMD viruses have retained their established geographic ranges, there are noteworthy exceptions over recent years that serve as reminders that this disease may cause events with great surprise as well as mundane predictability. The most significant FMD occurrence over the last decade has been the spread of the serotype O, PanAsia lineages of FMD virus across Asia and Europe.34,48,92 The PanAsia strains have replaced previously enzootic viruses in numerous nations but have also caused incursions into several FMD-free nations, including Taiwan, the United Kingdom, Ireland, South Korea, Russia, Japan, France, and the Netherlands. The economic impact from these events has tallied well into the billions of dollars (US) from the depopulation of millions of infected and susceptible animals, trade losses, vaccine deployment, and lost tourism revenues.47,48 Collectively, these outbreaks serve as a 16 stark reminder of the true transboundary nature of FMD and the transcontinental impact that may occur subsequent to minimal (and initially regional) viral genomic changes. The spread of FMD virus serotype O (PanAsia) reinforces the general trend indicating that changes in distribution of FMD in enzootic regions typically follows legal and illegal movement of infected animals, whereas incursions into FMD-free regions is more commonly associated with illegal movement of animal products.74,92 In August–September 2007, the United Kingdom suffered another outbreak of FMD that was determined to have originated at the Pirbright laboratories for FMD research and vaccine development.20,75 Rapid diagnosis and implementation of mitigation plans made the management of this event a great success, requiring the culling of only 1,578 animals75 and the total cost of just £100 million.20 Compared to the costs of other FMD outbreaks, this really was quite inexpensive. Overall, the event must serve as a reminder to FMD-free nations that regardless of the quality of biocontainment facilities, the risk of working on exotic agents within domestic terrain is never completely eliminated. In the first 6 months of 2009, there were 122 FMD outbreaks reported to OIE.100 These incidents span Asia, Africa, and the Middle East and include reintroduction to Taiwan, which had been FMD-free since at least 2001 (ProMED, archive 20090219.0689). FMD is also known to be enzootic or sporadically occurring in at least 9 South American nations,82 and it is enzootic in the Republic of Turkey. These statistics clearly indicate that FMD is an agricultural disease of substantial importance that requires continued vigilant surveillance and preparedness. Novel countermeasures to protect livestock against FMD are currently under development and over the next decade will likely improve the control and potential eradication of FMD virus.38 Most notably, recombinant vaccine products offer several advantages over the conventional, inactivated virus preparations that are currently available. The holy grail of FMD vaccinology is a rapid-protecting, multivalent, long-duration, single-administration vaccine that allows differentiation of vaccinated and infected animals. This panacea is still many years away, however; but with the new approaches already in motion, at least such a product can be envisioned. Avian Influenza The attention and concern of the general public regarding the Asian-based highly pathogenic avian influenza (HPAI) H5N1 virus, causing human fatalities, transcontinental disease, and the potential emergence as a human pandemic virus, has put avian influenza at the forefront of transboundary diseases. This concern is understandable because avian influenza viruses are believed to have played a significant role in the emergence of the last three human influenza pandemics.16,90 As Asian HPAI H5N1 virus continues to circulate within domestic poultry, there is continued human exposure and continued risk that the virus may become more readily transmissible from human Downloaded from vet.sagepub.com by guest on August 17, 2016 17 Arzt et al to human.90 Between 2003 and July 2009 Asian HPAI H5N1 has resulted in 262 laboratory-confirmed human deaths, with 65% of the fatalities occurring in Indonesia and Vietnam.37 During the first 6 months of 2009, Egypt reported 30 human cases of disease with 4 fatalities, and there have been 8 human deaths in Vietnam and China (4 each).37 A silver lining of this awareness is that (1) the philosophy of one medicine has moved forward and (2) veterinary and public health infrastructure across the world has been strengthened, all of which has made the international community more prepared for the next disease threat—the 2009 pandemic influenza virus (H1N1), for instance.41 However, the human health risks associated with H5N1 should not diminish the fact that HPAI is foremost a disease of poultry; as such, controlling the disease in poultry is key to preventing human disease.16,90 Avian influenza viruses are segmented, single-stranded, negative-sense RNA, enveloped type A influenza viruses that are further subtyped by their major surface glycoproteins, which may be any combination of the 16 hemagglutinin antigens and 9 neuraminidase antigens.81 Aquatic birds worldwide are the reservoir hosts for influenza A viruses, and subclinical infections are especially common in the orders of Anseriformes (ducks, geese, and swans) and Charadriiformes (shore birds and gulls).81 In poultry, the viruses are classified by the OIE as high or low pathogenicity based on intravenous inoculations of chickens; for H5 and H7 viruses, the amino acid sequence at the hemagglutinin cleavage site is a second method to evaluate the potential virulence of these viruses.59 The majority of AI viruses from any of the H1 through H16 subtypes cause subclinical or mild disease, with a limited few H5 and H7 viruses being highly pathogenic.85 When identified in poultry, all HPAI viruses are reportable to OIE and so termed highly pathogenic notifiable avian influenza.59 All low-pathogenicity H5 and H7 subtypes, termed low-pathogenicity notifiable avian influenza, are also reportable, because these viruses may evolve into highly pathogenic strains if allowed to circulate in poultry.59,85 The number of HPAI outbreaks appears to be increasing. Thirteen of the 24 HPAI outbreaks since 1959 have occurred in the last 15 years.15 In addition to the ongoing Asian HPAI H5N1 outbreak, there have been numerous other developments around the world. For example there was an H7N7 outbreak in England during 2008, two unrelated H7N3 outbreaks in Canada in 2004 and 2007, a H7N7 outbreak in North Korea during 2005, two unrelated H5N2 outbreaks primarily involving ostriches in South Africa during 2004 and 2006, and an H5N2 outbreak in the United States during 2004.2,35,85,91 A notable large H7N7 outbreak during 2003 started in the Netherlands and spread to Germany and Belgium, and it resulted in the destruction of over 25 million birds.5 The ongoing Asian HPAI H5N1 outbreak in which hundred of millions of birds have died or been euthanized has spread across Asia, Europe, and Africa, illustrating how HPAI moves around the world regardless of political borders.5 The virus was first identified in mainland China in 1996, then later in 1997 after causing mortality in poultry and humans in the Hong Kong Special Autonomous Region.78,79 Between 1998 and 2002, new reassortant HPAI H5N1 viruses were identified in the region that caused clinical and subclinical disease in domestic ducks, which significantly changed the dynamics of disease transmission.79 The rapid expansion of disease in nine countries in Southeast Asia during 2003–2004 was likely due to movement of asymptomatic domestic ducks shedding high levels of virus, in conjunction with ongoing legal and illegal movements of domestic poultry and poultry products.79 After their initial introduction into a geographical area, these viruses were readily dispersed by live bird markets and by movement of contaminated poultry equipment, vehicles, and clothing.85 The following year, Asian HPAI H5N1 moved westward across Asia possibly by a different, less common route of transmission—namely, wild waterfowl. The role of wild waterfowl in the spread of Asian HPAI H5N1 is incompletely understood and controversial, but evidence suggests that wild waterfowl were involved in the spread of the virus along migratory flyways to countries in Eurasia in 2005 and in western Europe in 2006.36 Also in 2006, Asian HPAI H5N1 was first identified in eight countries in Africa. Epidemiology and phylogenetic analysis of the African isolates suggests that there were three distinct introductions of the virus into Africa and that the viruses may have initially been introduced by wild migratory birds and then spread further by domestic poultry.19 Meat products may have also played a role in dissemination. Recently, disease transmission via commercially processed duck purchased from grocery stores was the suspected cause of three outbreaks of Asian HPAI H5N1 in backyard chicken flocks in Germany.40 Asian HPAI H5N1 virus has been isolated from duck meat imported into Japan and South Korea (from China); experimentally, disease transmission occurs when chickens are fed breast meat from previously inoculated chickens.53,84,89 Through these different mechanisms, the virus has been spread to and reported by a total of 62 countries between 2003 and 2009.99 So far, in the first half of 2009, 10 countries in Asia and Africa had identified the disease in poultry, with Egypt and Indonesia disease status listed as endemic.101 During this period, isolated cases limited to wild birds have been identified in Russia, Mongolia, and Germany.101 Avian influenza viruses pose a major challenge because of their ability to cause disease in poultry, their inherent genetic instability and worldwide distribution, and their ability to infect many avian and mammalian species. These challenges and solutions are examined in detail in several publications, including The Global Strategy for Prevention and Control of H5N1 Highly Pathogenic Avian Influenza, by the Food and Agriculture Organization of the United Nations and the World Organization of Animal Health, in collaboration with the World Health Organization.18,32,83 In well developed countries, robust biosecurity based on scientific advances and control methods has assisted in excluding the virus from commercial poultry production, and these countries also have the resources to rapidly identify and depopulate facilities should HPAI occur.85 Current control methods have been less successful in poorly developed production systems such as those in villages and Downloaded from vet.sagepub.com by guest on August 17, 2016 17 18 Veterinary Pathology 47(1) backyards around the world.21 Antigenic drift via point mutations and antigenic shift via genetic reassortment produce an ever-changing array of viruses, each with its own unique characteristics.95 This genetic instability magnifies the difficulties of understanding the pathogenesis and epidemiology in each of the many susceptible species.26 Rift Valley Fever Rift Valley fever (RVF) may be the most neglected of the important agricultural diseases. As a disease historically limited to Africa, it has been insufficiently addressed by the scientific communities of the developed world for decades. However, the expansion of the range of RVF beyond historical limits, into the Middle East and North and West Africa, indicates that this disease is a substantial international concern in the current era of globalization and climate change. The RVF virus (RVFV) is a segmented, enveloped, singlestranded RNA virus in the genus Phlebovirus, Bunyaviridae family. Disease in ruminants appears most frequently as abortion storms or deaths of neonates. The classic primary lesion is massive hepatic necrosis owing to infection of hepatocytes; hemorrhagic syndromes and lesions of other organs are uncommon sequelae. RVF is zoonotic, and although many humans are infected asymptomatically, there are cases of severe liver disease as well as other complications, mostly vascular. Human case fatality rate with RVF is usually low, on the order of 1 to 5%, but it can be higher. Cases of the disease in humans occur when there is a high level of RVFV in the vector population, which would occur only if there are infected ruminants in the vicinity. Serologic evidence of infection exists for a range of animal species. It is likely that the virus is maintained in the vector and possibly subclinically in various hosts, only to emerge in epizootic (and/or epidemic) form after a heavy rainfall, which allows for an increase of the mosquito vector. Subsequently, infection of ruminants, which develop high viremias, would amplify within the vector populations and spill over to humans. For those unfamiliar with the disease ecology of RVF, West Nile fever provides a suitable parallel. Substitute crows for sheep and goats and the situation becomes similar. At least 30 species of mosquitoes in eight genera can effectively carry RVFV from one mammalian species to another. Transovarial transmission occurs and the virus can remain dormant for years in eggs oviposited in dry areas. With rainfall, eggs hatch and mosquitoes can transmit the disease. Endemicity becomes thoroughly established, but episodic outbreaks of disease are decidedly sporadic, infrequent, and dependent on the increases in rainfall. RVF was first recognized in 1930 in an outbreak among sheep on a farm near Lake Naivasha in Kenya’s Rift Valley.23 For more than 40 years thereafter, there were recurring reports of isolated outbreaks in Africa but all restricted to the geographic zone for which it is named, the Great Rift Valley, a 6,000-mile fissure in the earth’s crust stretching along the eastern border of Africa. 18 In 1977, RVF was documented for the first time in a location outside of the Rift Valley, when the disease was diagnosed in Egypt in an extensive outbreak involving thousands of human and animal cases.54 How it traveled across the Sahara to become established in the Nile Delta is uncertain, but most likely it was due to animal movement from Sudan.1 However, the Aswan Dam was built in the years before this outbreak to allow for controlled flooding of agricultural lands, and this resulted in an increase in the mosquito population, which proved to be an important facilitating factor in the disease outbreak. Ten years later, an outbreak of RVF occurred again outside the Rift Valley, this time in Mauritania, in West Africa. Here, factors pointed to construction of the Diama Dam on the Senegal River.25 These two human endeavors of dam building, creating increased water availability for vector expansion, were followed decades later by climatic events with the same result. Excessive rainfall, largely brought about by El Niño–Southern Oscillation effect, engendered moist, mosquito-enhancing conditions that contributed to outbreaks in East Africa in 1997–1998 and again in 2006–2007.8 RVF was recognized for the first time outside of Africa in 2000, when reports surfaced almost simultaneously from the Kingdom of Saudi Arabia and from Yemen.51,57 In this Arabian Peninsula outbreak, the human case fatality rate was an alarming 14%. The source of the virus, as determined from genetic analysis of causative strains, was most likely animals transported across the Red Sea from the Horn of Africa.77 Annually, the religious festivals in the Arabian Peninsula utilize 7 to 10 million live animals for sacrifice, a number supplied primarily by East Africa, creating concerns for recurring transmission of RVFV24 as well as other agricultural diseases.{ The greatest threat from RVF is that animal movements and changes in virus–vector–host dynamics will facilitate extension of the disease’s range into Europe and beyond, with calamitous veterinary and human public health consequences. As has already occurred with bluetongue virus (BTV) vectors, evolving climatic conditions may allow expansion of the ranges of historical RVFV vectors and so promote the development of competence of new vectors in new regions.52 RVF could serve as the poster child to represent (1) disease threats associated with climate change and globalization and (2) benefits achievable through the one-medicine philosophy. Long neglected by the human and veterinary medical communities, the disease is now on the move through animal trade and in facilitated transmission mode owing to climatic changes. In many of the documented outbreaks, humans have been the sentinels of infection; that is, activity of the virus is first noted as a result of clinically ill humans presenting at medical facilities, even though the disease in animals always precedes that in humans.10,25 This scenario is a clear indication of the potential advantages from the enhancement of veterinary infrastructure and disease surveillance in developing regions. Without amplification in agricultural animals, the disease in humans does not occur, because only ruminants have a sufficiently high viremia to infect enough mosquito vectors for extensive transmission. The limited capacity for diagnosis in the animal sector in many Downloaded from vet.sagepub.com by guest on August 17, 2016 19 Arzt et al of the regions in which RVF occurs contributes to lack of an early warning system for public health. However, even when the disease has been documented in animal populations and in humans, invariably the literature that follows the outbreak is unequivocally stovepiped, with rare articles addressing the outbreak in true ecologic and one-health fashion. Countermeasures for RVF exist, but none are adequate. Once a herd or flock of ruminants experiences disease, the virus is readily amplified and spreads extensively through mosquito vectors. Controlling an outbreak in animals requires rapid depopulation and stringent insect control. Various vaccine formulations are available for livestock, but each has benefits and deficits, and none are approved for use in North America or Europe. For humans, a formalin-inactivated vaccine, TSIGSD-200, has been used extensively to protect laboratory workers and has excellent safety and efficacy.66 The RVFV is classified between the Centers for Disease Control and Prevention and the US Department of Agriculture as a category A overlap select agent.14 This means that any work with the agent has to be closely regulated and monitored, thereby making investigative work challenging. However, the designation may be warranted, given that intentional introduction into a geographic area that has ruminants and a competent mosquito vector could lead to establishment of the disease with immediate and long-term agricultural and public health concerns. Overall, RVF is a disease for which sustained global investment in improved surveillance, diagnostics, and countermeasures is well justified. Although RVF is still largely a disease of developing regions, developed nations should recognize the importance of investing in preparedness against this potentially catastrophic zoonotic disease. African Swine Fever African swine fever (ASF) and classical swine fever (CSF) have historically been the two most important transboundary diseases of pigs. Although CSF is a more important disease globally, ASF is treated in greater detail in this review owing to the first-ever incursion into the Caucasus region# of Central Asia in May 2007 and subsequent westward progression. ASF was first documented in Kenya in 1921 as a cause of a high-mortality disease syndrome among populations of domestic pigs that had been exposed to wild suids;56 the disease was subsequently recognized as enzootic in wild and domestic pigs in most countries of sub-Saharan Africa. ASF virus (ASFV) is the only known DNA arbovirus, and it is the sole member of the genus Asfivirus, Asfarviridae family. Domestic pigs and wild suids are the only species naturally infected with ASFV. ASF is a serious threat to domestic pig populations worldwide because of its high morbidity and mortality, high viral loads shed into all secretions (therefore contagious and infectious), extreme environmental resistance of the virus, and lack of any commercial or experimental vaccine. In addition, ASF is an important transboundary animal disease given the presence of globally distributed argasid tick vectors of the Ornithodoros genus and sizable naı̈ve domestic and wild pig populations in most countries. There are three distinct ASFV transmission cycles: an ancient and recurring sylvatic cycle involving Ornithodoros ticks and wild suids, including warthogs (Phacochoerus spp) and bushpigs (Potamochoerus spp); an Ornithodoros tick and domestic pig cycle; and a highly contagious domestic pig cycle with direct horizontal transmission. Warthogs have low blood and tissue titers and are rarely contagious to domestic pigs, but they are important in maintaining the sylvatic cycle. However, Ornithodoros ticks amplify and transmit the virus to wild or domestic pigs and remain infectious for years through transstadial, transovarial, and sexual transmission. The most common route of incursion of ASFV into previously free countries or regions is through feeding uncooked or partially cooked contaminated pork products. ASFV remains infectious for 3 to 6 months in uncooked products, such as sausage, chorizo, and dry hams.45 Once introduced, the virus is usually maintained horizontally by direct or indirect contact through infectious excretions and secretions. However, the virus may also enter the tick–domestic pig or sylvatic cycles if competent vectors are present. For example, in the 1960s during the Spanish epizootic, 50 to 55% of the ASF outbreaks were allegedly caused by O erraticus ticks.30 ASF attracted international attention when it left Africa for the first time in 1957, appearing in Lisbon, Portugal, causing nearly 100% mortality.69 The disease persisted in Portugal and Spain until 1995, when it was finally eradicated at great effort and expense. This arrival of ASFV into Europe stimulated considerable research, including unsuccessful attempts to develop a vaccine and the discovery that Ornithodoros ticks maintained the virus for long periods and were capable vectors of the disease.65 Attempts to vaccinate with an attenuated vaccine probably led to emergence of low-virulence strains and corresponding subacute and chronic forms of the disease that have higher survival rates. ASF again left Africa to infect pigs in Malta, Sardinia (Italy), Brazil, and the Dominican Republic in 1978; in Haiti in 1979; and in Cuba in 1980. ASF has since been eradicated from these countries and has remained enzootic only in subSaharan Africa and Sardinia. In Malta, the entire population of 80,000 pigs died or were slaughtered within 12 months of diagnosis; this was the first time that any country had slaughtered all members of a species of domestic animal to eliminate a disease.96 In 1998, ASF was reported in Madagascar for the first time and is now considered to be enzootic in domestic pigs; at the end of 2007, ASF was introduced onto a second Indian Ocean island, Mauritius.72 The unforeseen incursion and subsequent spread of ASF into the Caucasus in 2007 was a major event in the disease’s epizootology. This was the first appearance of ASF north of Spain, and various factors led to the failure to contain the disease. ASFV likely entered the Caucasus at the Port of Poti, Republic of Georgia, through ship waste containing contaminated pork products that were disposed in local municipal dumps. Molecular analysis has shown that the Georgia strain Downloaded from vet.sagepub.com by guest on August 17, 2016 19 20 Veterinary Pathology 47(1) is most similar to isolates from Madagascar, which further reinforces the transboundary nature of this virus.72 Nearly all pigs in the Republic of Georgia are familyowned, free-range backyard animals that scavenge for food. Once ASFV entered the Georgian pig population, this husbandry system facilitated the rapid spread of the virus eastward: Approximately 60 days after the first cases were documented, 52 of 65 districts had been affected; more than 30,000 pigs had died; and 3,900 pigs had been euthanized.28 This incursion led to cross-border spread to all of Georgia’s neighbors—Armenia, Azerbaijian, and Russia. ASF entered Russia in November 2007 (ProMED, archive 20070607.1845) and has now been reported to affect Chechnya, North Ossetia-Alania, Ingushetia, Orenburg, the Stavropolskiy Kray (Stavropol), and the Krasnodarskiy Kray (Krasnodar). Most recently, ASFV has spread further westward into the Rostovskaya Oblast, which has common borders with Ukraine (ProMED, archive 20090410.1376) and puts ASFV in an excellent staging field for further westward expansion into eastern Europe. ASF is moving rapidly within Russia in areas bordering the Caucasus, and it will require more than a modified stamping-out approach for eradication, given that wild boar may be affected. Socioeconomic aspects of ASF are disparate across nations and largely defined by the regional presence of ASFV and the economic role of swine production. Africa accounts for less than 1% of the world’s pork supply. Nevertheless, in this part of the world, pigs are invaluable at the village level, especially in forested regions where cattle production is difficult. In these areas, swine provide large supplies of high-quality protein from low-grade nutritional sources.65 In addition, in Africa, pigs often serve as a ‘‘piggy bank,’’ with the sale of an animal providing for school fees, medical expenses, and clothing for special occasions. Traditional pig farming and ASF have coexisted for centuries in Africa, and the establishment of ASF-resistant pig populations has occurred in areas where introduction of naı̈ve pigs would result in 100% mortality.64 ASF still remains the most important constraint to pig production in much of Africa. By contrast, exporting countries are concerned with maintaining or expanding market share and with protecting their domestic livestock population from disastrous introduction of a transboundary animal disease. When first introduced, ASF-associated mortality can be nearly 100% in naı̈ve herds, and near-permanent loss of export markets can be expected. ASFV entered Spain in 1960 when the Spanish economy was relatively undeveloped and its swine industry was predominated by family holdings and outdoor pig raising (similar to the current era of swine rearing in the Caucasus). When introduced to Spain in 1960, clinical disease was acute and mortality approached 100%. However, by 1985, when Spain’s eradication program began, the economy had changed markedly, and swine production had become industrial and intensive.9 Through the years, ASF had become endemic, and the disease had changed to mild and subclinical forms, with less than 5% mortality. In addition, Spain’s pig population continued to increase from 6.0 million to 16.7 million animals in 1960 and 1989, respectively. Although eradication took 20 10 years (1985–1995) and occurred at great economic cost, it was successfully completed without a vaccine, in the presence of infected soft tick vectors (O erraticus), and with relatively simple diagnostic serological tools. This disease eradication model might be applicable to the Caucasus and certain regions of sub-Saharan Africa with substantial technical and financial support from the international community. Eradication from such regions is unlikely to be successful without restructuring of swine industries, as proved to be an essential component of eradication in Spain. Classical Swine Fever CSF is more important globally than ASF because of its much wider geographic distribution and greater cumulative economic impact, causing disease outbreaks on all the major continents. CSF virus (CSFV) is a member of the Pestivirus genus of Flaviviridae family and thus belongs to a genus of important viruses that cross-react on diagnostic tests, including bovine viral diarrhea virus and border disease virus. CSF has some similarities to ASF, including high- and low-virulence forms and high degree of contagion. Both CSFV and ASFV are environmentally stable and are found in all secretions, excretions, and tissues, including meat. There are also important differences: The highly virulent viruses of CSF seldom circulate; effective vaccines are available for CSF but not for ASF; and there is no tick transmission of CSF.22 Moderate- to lowvirulence strains of CSF predominate globally, with most epizootics today caused by moderately virulent strains of virus.46 Because of the prevalence of low-virulence strains, in which animals may not appear clinically ill but still carry and transmit the virus, it is easy for CSFV to enter a free country or region and spread before the establishment of a diagnosis. Such a scenario resulted in the severe consequences of the epizootic in the Netherlands in 1997–1998, which resulted in losses of $2 billion.55 In such instances, clinical surveillance is unreliable because the mild or subclinical disease course (when it does occur) can resemble many other common diseases of swine. When CSF returned to the United Kingdom in 2000 after a 14-year absence, diagnosis was complicated by lack of ‘‘typical’’ clinical signs and by clinical similarities to porcine dermatitis and nephropathy syndrome, which had become a serious problem in Great Britain one year earlier.62 In addition, because CSFV is immunosuppressive, antibodies form late (2 to 3 weeks postinfection); thus, serological surveillance has drawbacks in detecting early infection. Tissue surveillance by swabbing tonsils and testing with real-time reverse-transcription polymerase chain reaction is the most sensitive system for detecting early infection; however, implementation of this surveillance strategy on a sufficiently large scale is an expensive and time-consuming process that would require implementation of robotic high-throughput techniques. Overall, owing to the widespread distribution of CSF and abundance of low-virulence strains, this disease can readily cause unexpected incursions into disease-free regions. Downloaded from vet.sagepub.com by guest on August 17, 2016 21 Arzt et al Peste Des Petits Ruminants and Rinderpest Peste des petits ruminants (PPR) is a severe viral disease of goats and sheep with variable but usually high morbidity and mortality. It is considered the most economically important viral disease of these species in enzootic regions.71 Given that sheep and goats are more economically important than cattle in many regions of the world that rely on pastoralism, PPR has a major impact on the food supply in these regions.12 Since the disease was first described in 1942, the distribution has steadily expanded to include large regions of Africa, the Middle East, and Asia. PPR is a high-priority disease for the FAO Emergency Preventive System, and mitigation of the disease’s impact is considered an important step to help alleviate poverty in enzootic regions.33 The disease readily crosses national boundaries, and it is now considered the most constraining disease of small ruminant production in sub-Saharan Africa and the Indian subcontinent.86 Additionally, the eradication of rinderpest (RP) in Africa and Asia has elevated the relative economic importance of PPR. PPR occurs in acute and subacute forms characterized by variable extents of fever, conjunctivitis, erosive stomatitis, enterocolitis, and pneumonia. It closely resembles RP clinically and pathologically except for the frequent occurrence of pneumonia with PPR. PPR virus (PPRV) is a distinct member of the Paramyxoviridae family, Morbillivirus genus, which includes RP virus (RPV), canine distemper virus, measles virus, phocine distemper virus, and cetacean morbillivirus of dolphins and porpoises. Each of these viruses has only one serotype, and they are all closely related phylogenetically, which generally facilitates vaccination strategies. Transmission of PPR is mainly by oronasal contact with secretions from infected animals, with nearly all outbreaks traced to movement of livestock. There are four known phylogenetic lineages of PPRV. Lineage IV is a more recently emerged group of viruses occurring in Asia and the Middle East, in contrast to the other three PPRV lineages, which are of African origin. Lineage I and II viruses have been found exclusively in West Africa, whereas lineage III viruses occur in East Africa, Arabia, and southern India. The source of the ‘‘new’’ lineage IV virus is unknown, although it is most closely related to African lineage I.86 PPR was first discovered in the Ivory Coast in 1942; further investigations led to knowledge of its widespread occurrence in sub-Saharan and Sahelian Africa, including Egypt, Sudan, and Ethiopia. For over three decades, there was no clinical evidence that PPR had extended south of the line from Cameroon to Ethiopia, although such a transgression had been widely predicted. In Asia, PPR was first discovered in southern India in 1987. Subsequently, epizootic PPR spread across the Arabian Peninsula, the Middle East, and the remaining parts of the Indian subcontinent in 1993–1995, where it has since remained endemic. The last three decades have seen a considerable extension in worldwide distribution of PPR. This trend is likely multifactorial, with indeterminate contributions from increased transportation of live animals, better diagnostic tests, increased vigilance of surveillance systems, and greater awareness of PPR after eradication of RP. The recent spread of PPR can be correlated with the increase of animal movement for commercial and trade purposes (eg, the massive imports of small ruminants to the Middle East), transhumance and nomadic customs, and the extensive farming practices in the Saharan regions.29 In recent years, PPR has expanded across international borders and has been repeatedly diagnosed in known enzootic regions. More recently in Asia—specifically, 2007—Tibet (China), Nepal, and Tajikistan reported their first cases of PPR. In Africa, PPR has now spread south of the equator to Gabon (1996), the Congo (2006), Kenya (2006), and Uganda (2007) and has now spread north of the Sahara to Morocco (2007) (ProMED, archive 20090314.1056). The chronological spread of PPRV, as recorded by detection in previously unaffected countries, gives the impression that the geographical spread of PPR occurred eastward, from West Africa to Bangladesh. However, this does not necessarily mean that PPR originated in West Africa. Sequence analyses and lineage typing of historical and new PPRV isolates have provided interesting perspectives on the origin of the virus. For example, PPRV probably originated in Eurasia (as did RPV) and spread to Africa on multiple occasions via trade of livestock (ProMED, archive 20081016.3282). In addition, there is reasonable molecular evidence that PPR existed in India before being ‘‘discovered’’ in West Africa. In Asia, diagnosis may have been delayed owing to misdiagnoses of RP (oral erosions and diarrhea), contagious caprine pleuropneumonia, or pasteurellosis (bronchopneumonia), which is a common superinfection associated with primary PPR-induced pneumonia. Thus, PPR might have been transported to West Africa by sailing ship from India long ago. This would mean that lineage IV or a precursor was the parental lineage of PPR and that each time PPRV was transported to a new continent, a new lineage arose. The Moroccan outbreak may illustrate the same fundamental pathway—that is, the movement of lineage IV out of Asia Minor to Africa. Preliminary results of sequencing the nucleocapsid N gene of viruses from this outbreak indicate that the PPR isolate is a lineage IV virus that is closely related to the Saudi Arabian and Iranian strains. This suggests that the virus entered Morocco from the Middle East by trade in live infected animals and not by nomadic movement across its open borders, as originally speculated. Considering the evidence that the emergence of new lineages of PPRV has historically been correlated with intercontinental movements of the virus, it has been proposed that the birth of a new African lineage may presently be occurring in Morocco (ProMED, archive 20081016.3282). The continuing outbreaks of PPR in Morocco (as of this writing) should be of great concern for neighboring countries, especially Algeria, in which there are approximately 19 million sheep and 3 million goats. The risk is also high for southern European countries that historically have had substantial trade with Morocco. Of these countries, Spain seems to be particularly vulnerable, given its geographic proximity and the Downloaded from vet.sagepub.com by guest on August 17, 2016 21 22 Veterinary Pathology 47(1) importance of its vulnerable livestock of 23 million sheep and 3 million goats.29 Enhanced surveillance for PPR is justified for all African and Asian countries; vigilance is indicated in PPRV-free regions as well. When outbreaks occur, regional PPR eradication is a complex task leading to the need for mass vaccinations. The homologous live-attenuated PPR vaccine is commercially available; it is efficacious; and it creates long-lasting immunity. Perhaps with the imminent global eradication of RP, a renewed interest in PPR control and eradication will follow. A macroeconomic study in Niger found that control of PPR by vaccination was highly beneficial to the national goat industry.80 In addition, the FAO believes that eradication of PPR is achievable with education of local governments and stakeholders, creation of sound global and regional strategies, understanding of PPR epidemiology and ecology, and use of thorough vaccination campaigns.33 However, socioeconomic factors will ultimately dictate if eradication is pursued, and the lesser relative importance of small ruminant production to many developed nations may foster a degree of apathy. International funding and support will surely be necessary to control and possibly eradicate PPR and alleviate the immense economic and social problems it causes. In contrast to PPR, there is convincing surveillance evidence in cattle and wildlife that the last remaining focus of RP, the Somali Pastoral Ecosystem, is free of clinical disease and the etiologic agent.31 Declaration of global eradication in 2010 is expected to occur as planned. As of early 2009, the FAO’s Global Rinderpest Eradication Program indicated that RPV has been eliminated from Europe, Asia, Middle East, Arabian Peninsula, and all of Africa; in effect, it has been eradicated globally.31 This is an exceptional accomplishment for a disease that may have been circulating since the time of Aristotle (384– 322 BCE) and has been described as the most dreaded of all animal diseases, causing terrible destruction of cattle and wildlife and bringing famine to rural human populations.61 The notion that the last focus of RP has been eradicated is supported by the fact that (1) the last definitive detection of RPV occurred in 2001,70 (2) all subsequent investigations of a possible ‘‘mild form’’ of circulating RPV in cattle have not been positive (by either virus detection or serology), and (3) repeated serological testing of wildlife in the region has been negative since 2002. Final declaration of RP freedom will be jointly declared by the FAO and OIE once remaining countries have completed the ‘‘OIE rinderpest pathway’’ (described in the OIE’s Terrestrial Animal Health Code**) and been officially declared diseasefree by the OIE. Bluetongue Bluetongue (BT) is a disease of ruminants caused by BTV and transmitted predominantly through feeding of biting midges of the genus Culicoides.93 BT is enzootic in the United States50,93 and many other nations and it has made occasional incursions into southern Europe97 through much of the 20th century. However, recent changes in BT epizootology indicate that this 22 disease is very much on the move.67,97 The changes in Europe are most noteworthy in that since 1998 at least seven distinct strains of BTV have been detected across 12 nations, causing the deaths of millions of sheep and cattle.67 Most significantly, in 2006 BTV serotype 8 caused the first outbreaks of BT ever detected in northern Europe. The virus was first identified in the Netherlands, and it subsequently spread across most northern European nations. The northernmost detection thus far has been within Vest-Agder county of Norway in February 2009 (ProMED, archive 20090402.1278). Although the deaths of millions of animals are always of great concern, this situation is noteworthy because it is the most convincing example of a substantial change in the distribution of a veterinary disease attributed to the current, ongoing global climate changes. The spread of BTV in Europe is closely linked to the northern expansion of Culicoides imicola, the most important vector of BTV in Africa and Asia, and it is the warming temperatures and changes in humidity across Europe that have allowed this expansion.67 Furthermore, these same climatic alterations have allowed indigenous European Culicoides spp to serve as competent BTV vectors. The situation in the United States has some similarities in that BTV-1 was first detected in Louisiana in 2004 and was suspected to be associated with a novel Culicoides spp vector.43 Overall, this scenario provides a practical indication that climate change is already substantially affecting the host–vector–pathogen dynamics of veterinary diseases. It would be profoundly shortsighted to view this as an isolated set of circumstances rather than as a preview of additional climate-driven changes in agricultural disease distributions, some of which likely have already occurred but have not yet been detected. Newcastle Disease Newcastle disease, caused by avian paramyxovirus type 1, is one of the most significant diseases for poultry producers around the world.6 Most birds are susceptible to infection, with the outcome varying from subclinical to severe, depending on the strain of the virus, the species of the bird, and other factors.4 For international trading purposes, strains of virulent Newcastle disease virus (vNDV) are reportable to the OIE.60 The definition of vNDV is based on intracerebral pathogenicity testing of the virus in day-old chicks and/or the presence of multiple basic amino acids at the cleavage site of the fusion protein.60 The disease is widely distributed throughout the world; in 2008, 73 countries reported presence of the disease to the OIE.98 Additionally, numerous nations in Asia, Africa, Central America, and South America have endemic or frequent outbreaks caused by vNDV, and there are sporadic outbreaks of the virus worldwide.63 Disease transmission between countries occurs through a variety of methods, such as the movement of poultry, pet birds, and fomites and, to a much lesser extent, via wild birds such as double-crested cormorants (Phalacrocorax auritus) and Columbiforme birds (pigeons and doves).4,17,42,44 Virulent Newcastle disease virus causes significant losses in highly developed commercial production systems and in Downloaded from vet.sagepub.com by guest on August 17, 2016 23 Arzt et al village poultry, a major reservoir of the virus. During the 2002– 2003 US outbreak in which backyard and commercial poultry were infected, disease eradication efforts cost an estimated $180 million, in addition to loss of export markets.7 The negative effects of disease on income and food security provided by village poultry production are substantial, and vNDV is considered one of the major limiting factors in raising poultry in small flocks within developing countries.3,11 Newcastle disease outbreaks, which cause regular episodes of 50 to 100% mortality in village poultry, confound the identification of HPAI outbreaks because both diseases have similar clinical signs and high mortality.3 Greater research into methods of disease control are needed not only to decrease worldwide disease prevalence and thus risk of transboundary transmission but also to combat poverty and hunger in developing nations. Ebola Reston in Pigs In October 2008, during an investigation of unexplained increased mortality among pigs in the Philippines, researchers discovered that in addition to being infected with porcine respiratory and reproductive syndrome virus, some pigs were positive for Ebola-Reston virus (ERV).13,27 Subsequently, humans with histories of direct contact with ERV-infected pigs were found to be positive for anti-ERV antibodies (ProMED, archive 20090203.0482).13 Unlike other strains of Ebola virus, ERV may cause fatal infection in monkeys, but it has been known to cause only mild flu-like illness in humans. None of the serologically ERV-positive humans reported any significant illness, and there was no evidence of human-to-human transmission. Although it is unclear if there is any significance to these discoveries for pigs or humans, it is clear that this is a novel pathogen–host combination that merits further observation. Conclusions The continuously increasing population of the earth, combined with the commensurate progressive decrease of land available for agriculture, ensures that the balance of available and necessary food for human consumption will be tenuous in decades to come. This balance will be most precarious in developing nations, whereas richer, developed nations will undoubtedly be involved in the moral decisions regarding how to mitigate regional deficits in the developing world. Although politicians will ultimately be making such decisions, veterinary scientists will surely be tasked to generate some of the data that will form the basis for these decisions. The most important role for veterinary scientists in this scheme will be to monitor, assess, predict, and prevent (when feasible) the movements of diseases of food animals. Numerous subdisciplines of veterinary medicine and investigative science are crucial to the multidisciplinary understanding and control of transboundary diseases. However, in the context of this topic, emphasis must be placed on the importance of the roles of pathologists and regulatory field veterinarians, who often are the first individuals exposed to novel disease incursions. That this ‘‘top 10’’ list of agricultural diseases on the move includes, exclusively, conditions of viral etiology is not coincidental. Viruses have the most rapid mutation rates and, as such, are generally expected to adapt most rapidly to changing environments. Clearly, other classes of diseases with direct or indirect effect on agriculture are on the move. Among bacterial diseases, bovine tuberculosis is on the rise in North America and Europe, and since 2005 there has been a sustained and unprecedented increase in Q fever cases in the Netherlands among goats and humans, which has resulted in regional mandatory vaccination of small ruminants.76 Decimation of amphibians worldwide by chytridiomycosis may presently be serving as the prototype of the spread of fungal diseases associated with global climate change. And the still idiopathic conditions of colony collapse disorder and white nose syndrome are depleting populations of honey bees and bats, respectively. This only scratches the surface of the full complement of diseases on the move. New, previously unknown diseases will surely continue to emerge. And, it is nearly certain that the trends described for the diseases discussed herein will progress, thus ensuring that FMD, ASF, HPAI, BT, RVF, and other catastrophic diseases are all but a stone’s throw away from our doorsteps. It is also true that certain types of key events (or scenarios) that facilitate the movement of pathogens will always be unstoppable. This is a reality for human-initiated events, such as the presumed single action of swill feeding that brought ASF to the Caucasus and beyond. But it is just as relevant in considering the effect of waterfowl migration on HPAI or the effect of climate change on BT spreading through Europe. How the world will respond to these challenges is uncertain. Nations and international organizations that proactively invest in preparedness will be more successful and economical than reactive strategies that simply hope a new disease incursion will not occur. Reactive approaches often seem economical in the short term but in the long run may be far more expensive and may lead to irreparable consequences, such as enzootic establishment of previously exotic diseases. The extreme consequences associated with the 2001 epizootic of FMD in the United Kingdom led to the increased awareness, diagnostic throughput capacity, and availability of first responders, which minimized the impact when the disease appeared again in 2007. Similarly, the profuse media attention given to the pandemic potential of HPAI contributed to a transboundary influenza preparedness that has helped to monitor and mitigate the current, ongoing H1N1 pandemic. Clearly, policy makers will have to pick and choose how to best invest in control of agricultural diseases; but, ultimately, it is the combinatorial breadth of that investment that will determine the global community’s capacity to deal with the inevitable breaches of integrity. Globalization and global climate change make it evermore likely that agricultural diseases will emerge in new locations with greater frequency. Whether the resurgence of a historical disease such as tuberculosis or a novel discovery such as Ebola in swine, the agricultural, veterinary, and political communities are well advised to be prepared. Downloaded from vet.sagepub.com by guest on August 17, 2016 23 24 Veterinary Pathology 47(1) Notes *ProMED-mail is a global electronic reporting system for outbreaks of emerging infectious diseases and toxins (http://www.promedmail.org). yWorld Animal Health Information Database Interface provides access to all data within OIE’s animal health database (http:// www.oie.int/wahis/public.php?page¼country). z Global Alert and Response is an integrated global alert and response system for epidemics of disease in humans and other public health emergencies (http://www.who.int/csr/en/). § Emergency Prevention System for Transboundary Animal and Plant Pests and Diseases livestock program seeks to promote the effective containment and control of the most serious epidemic livestock diseases and transbounday animal diseases (http://empres-i.fao.org/ empres-i/home). || Exclusively agriculture-associated disease is a distinction from disease that affects agriculture but has substantial impact on human public health, such as avian influenza or Rift Valley fever. { Numerous diseases could be spread in this manner, but in the context of the current review, transmission of foot-and-mouth disease virus, bluetongue virus, and peste des petits ruminants virus should be considered. # The region between the Black and Caspian seas, divided by the Caucasus Mountains along the border between the Russian Federation, Georgia, and Azerbaijan. ** See http://www.oie.int/eng/normes/Mcode/en_sommaire.htm (accessed October 26, 2009). 9. 10. 11. 12. 13. 14. 15. 16. 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