The ‘One Health’ Paradigm: Time for Infectious Diseases Clinicians to Take Note?

W hat do severe acute respiratory syndrome (SARS), monkeypox, highly pathogenic influenza A, new variant Creutzfeld-Jacob disease, cryptosporidiosis and verotoxigenic Escherichia coli have in common?All represent infectious diseases that have emerged, been recognized or changed their distribution markedly over the past three decades, and all may be considered to be 'zoonotic' threats; ie, they are diseases (or commensal microbes) found in animals that can be transmitted to humans, causing disease in the latter.The preponderance of zoonoses among emerging infectious diseases is striking: a pre-SARS Institute of Medicine (USA) report (1) suggested that approximately three-quarters of emerging infections originated in animals.Zoonotic threats become an even greater menace when combined with the rapidity of air travel, and the high volumes of animal trafficking and smuggling that currently occur.SARS was an infectious threat that moved from a natural reservoir (likely bats) to civet cats in animal markets in Guangdong province, China, and were then carried by infected humans to the hospitals of Toronto, Ontario, in a few short months (2).Similarly, an Old World virus causing West Nile virus fever and encephalitis emerged as a novel infectious entity in the western hemisphere in 1999, possibly following illicit animal importation into New York (USA) (3,4).The list goes on.Although these recent events show animal health and human health to be integrally connected, few clear lines of communication exist between veterinary and medical professionals with respect to preventive medicine and public health, clinical practice or research.The potential advantages of greater integration 'across species' have been identified and documented by individuals involved in the 'One Health Initiative' (www.onehealthinitiative.com) (5).The One Health Initiative was founded by Dr Laura Kahn (a physician at Princeton University [New Jersey, USA]), Dr Bruce Kaplan (a retired veterinarian formerly with the United States Centers for Disease Control and Prevention, and the United States Department of Agriculture's Food Safety Inspection Service) and Dr Tom Monath (a physician and former Division Director at the Centers for Disease Control and Prevention, and the United States Army Medical Research Institute for Infectious Diseases).More recently, the group has been joined by Jack Woodall, a cofounder and Associate Editor of ProMED-mail.The One Health concept has won endorsement from many professional societies, including the American Medical Association (6) and the American Veterinary Medical Association (7), and has had its principles endorsed by the

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