2014|Student Guide FUNDAMENTALS OF INFECTIOUS DISEASES This publication was made possible in part through the support provided by the United States Agency for International Development (USAID). The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of USAID or the US Government. USAID reserves a royalty-free nonexclusive and irrevocable right to reproduce, publish, or otherwise use, and to authorize others to use the work for Government purposes. SEAOHUN One Health Course - Student Guide Module: Fundamentals of Infectious Disease Module Overview This module fosters an understanding of the basic principles of infectious disease in the context of One Health. The module will use a One Health approach to examine various important zoonotic infectious diseases of humans and animals and will help students understand the fundamentals of infectious disease ecology and their impacts on humans, animals and the environment. Key outcomes of the module are the ability to: Describe and interpret fundamental concepts of selected infectious diseases and how they affect the life of humans, animals and environmental health. Understand how culture and tradition influence infectious diseases. Use systems thinking in the context of infectious diseases. Communicate effectively on infectious disease topics. There are nine sessions in this module: 440 Minutes 120 Minutes 60 Minutes 75 Minutes 90 Minutes 150–210 Minutes 120–180 Minutes 180 Minutes 60 Minutes Module Agenda Fundamental Concepts of Infectious Diseases One Health Team Role-Playing Activity Issues in Daily Life Related to Infectious Diseases Human Impacts on Infectious Disease Transmission Natural Disasters and Infectious Disease Role-Playing Activity Culture and Traditions in the Local Community (Field Trip) Developing a Systems Map for an Infectious Disease Creating messages to Convey Infectious Disease Information Learning Reflections and Evaluation 1|Page Module: Fundamentals of Infectious Disease Module Competencies Competency #1 Describe the fundamental concepts of infectious diseases. Competency #2 Interpret the fundamentals of infectious diseases and their impacts on daily life. Learning Objectives to Develop Competency Understand basic concepts related to infectious diseases and be able to: Describe the etiology and epidemiology of important infectious diseases. Compare the pathology, pathogenesis, clinical manifestations, and treatments of various infectious diseases. Apply fundamental concepts to develop a One Health approach to the control and prevention of an infectious disease. Design a One Health approach for health promotion related to infectious diseases at a community level. Learning Objectives to Develop Competency Use fundamental concepts of infectious diseases to be able to: Identify and classify the types of infectious diseases endemic in a given area in humans and animals. Give examples of infectious diseases in humans and animals and explain their effects on the daily lives of affected populations. Analyze an infectious disease scenario influenced by a natural disaster. Competency #3 Learning Objectives to Develop Competency Identify infectious disease issues relating to culture and traditional practices (e.g., livestock, sanitation). Understand problems associated with culture and beliefs, and values and ethics that are related to infectious disease by being able to: Describe traditional livestock production practices and livestocktransmitted infectious diseases in a local area Understand how local cultural practices can influence the emergence and transmission of an infectious disease Analyze an infectious disease problem and identify potential solutions to conflicts with culture and traditional practices Competency #4 Learning Objectives to Develop Competency Integrate the respective elements of fundamental concepts of infectious disease. Understand systems thinking in relation to infectious diseases and use it to: Describe the fundamental concepts for an infectious disease and how they are related. Develop a transmission diagram that incorporates all components of the “system” for an infectious disease, including downstream effects. 2|Page Describe how various stakeholders are involved in an infectious disease and how they may be impacted by the disease. SEAOHUN One Health Course - Student Guide Module Competency #5 Apply various communication strategies in writing, oral presentation and role plays. Learning Objectives to Develop Competency Understand how to use available communication methods to appropriately convey information about an infectious disease issue by being able to: Effectively convey information about an infectious disease to professionals and laypersons in a written communication. Describe the history, current epidemiology, pathology, treatment, control and prevention of an infectious disease in an oral presentation. Understand how to communicate with various stakeholders in a role-play scenario of a newly emerged infectious disease to effectively use and relay information. 3|Page 4|Page SEAOHUN One Health Course - Student Guide FUNDAMENTAL CONCEPTS OF INFECTIOUS DISEASE Learning Objectives: Pre-Class Assignment: Describe the etiology and epidemiology of important infectious diseases. Compare the pathology, pathogenesis, clinical manifestations and treatment of various infectious diseases. Apply fundamental concepts useful to develop a One Health approach to the control and prevention of an infectious disease. Read Article – Daszak, P., Zambrana-Torrelio, C., Bogich, T.L., et al. Proc Natl Acad Sci U S A. 2013 Feb 26; 110 Suppl 1:3681–8. doi: 10.1073/pnas.1201243109. Interdisciplinary approaches to understanding disease emergence: The past, present, and future drivers of Nipah virus emergence. Article available free online at PubMed Central: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586606/ Pre-Work Read: “Interdisciplinary approaches to understanding disease emergence: the past, present, and future drivers of Nipah virus emergence.” Article available free online at PubMed Central: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586606/ Reading Assignment Overview of Key Terms and Concepts Lecture Key terms and concepts to know: Infectious diseases of medical and veterinary importance Concept of zoonotic diseases Biological classification of the causative agents Common nomenclatures Concepts of host–pathogen relationships Specific and non-specific clinical manifestations Cross reactivity between the agents 5|Page Module: Fundamentals of Infectious Disease Term Definition Pathogen Infection Carrier Virulence Latent Reservoir Host Prophylaxis Classification of Organisms that Cause Infectious Disease 6|Page SEAOHUN One Health Course - Student Guide Notes: Bacteria Virus Fungi 7|Page Module: Fundamentals of Infectious Disease Protozoa Helminths Prions 8|Page SEAOHUN One Health Course - Student Guide Disease Triangle Notes: 9|Page Module: Fundamentals of Infectious Disease 10 | P a g e SEAOHUN One Health Course - Student Guide Infectious Disease: Interdisciplinary Approaches to Nipah Virus Small Group Activity “Nipah Virus Infection (NiV) is an emerging infectious disease of public health importance in the South-East Asia Region. The virus is named after the Malaysian village where it was first discovered. This virus along with Hendra virus comprises a new genus designated Henipavirus in the subfamily Paramyxovirinae. Fruit bats of the genus Pteropus have been identified as natural reservoirs of NiV. A sero-epidemiologic study in Malaysia implicated four fruit bat species, Pteropus hypomelanus, P. vampyrus, Cynopterus brachyotis, Eonycteris spelaea, and an insectivorous bat, Scotophilus kuhlii. Nipah virus has been isolated from the brain and spinal fluid of victims in Malaysia. Infective virus has also been isolated from environmental samples of bat urine and partially-eaten fruit in Malaysia.” What do you think? What is a reservoir of disease? What is Nipah virus and where did it first emerge? What are the pathological manifestations of Nipah virus in humans? What are the pathological manifestations of Nipah virus in other animals? What is meant by drivers of emerging infectious diseases? How did Nipah virus emerge from animal populations and infect humans? How does climate change relate to disease emergence? What strategies can help us predict future disease emergence? Describe how a One Health approach is important for understanding disease emergence. Notes: 11 | P a g e Module: Fundamentals of Infectious Disease Identifying Infectious Organisms Practical laboratory session: Direct fecal examinations Thin and thick blood smears Bacterial culture and staining Notes: 12 | P a g e SEAOHUN One Health Course - Student Guide Movie – Quarantine Watch the movie thinking about: What type of infectious disease is described in the movie? What are the effects of the disease? How does the disease spread? What control measures are introduced? Are they effective? Notes: 13 | P a g e Module: Fundamentals of Infectious Disease Notes: 14 | P a g e SEAOHUN One Health Course - Student Guide ONE HEALTH TEAM ROLE-PLAYING ACTIVITY Learning Objectives: Describe how various stakeholders are involved in an infectious disease outbreak and how they may be impacted by the disease. Use a role-play scenario to demonstrate how to communicate with various stakeholders following an outbreak of a newly emerging infectious disease. Design a One Health approach for health promotion related to infectious diseases at the community level. Components of Disease Management and Stakeholders Lecture Notes: 15 | P a g e Module: Fundamentals of Infectious Disease Notes: 16 | P a g e SEAOHUN One Health Course - Student Guide Outbreak of an Unknown Infectious Disease Role Play Imagine an outbreak of a novel (“emerging”) zoonotic infectious disease. You know that this disease is causing high fever, headache, and muscle aches in human patients, and leads to neurologic disease causing death in 10% of human patients with this illness (i.e., “cases”) reported by local hospitals and clinics. You also have reports of undiagnosed illness in cattle in the area, which have not yet been fully investigated. There have been reports of some farmers sending sick animals to the slaughterhouse before death. People in the village have also noticed an apparent increase in mortality of birds around town, but it is not known if this is related to the human cases. The area has recently begun clearing existing forest areas to make room for farmland. The following stakeholders are involved: Control agencies members: Veterinarian from World Organization for Animal Health (OIE) Public health expert from Centers for Disease Control (CDC) International health agency staff from World Health Organization (WHO) Government officials – national and local (e.g., district) levels Community members: Farmers Local doctor and nurse at health clinic Local veterinarian Community member: shop owner Community member: raw food sales at market Community member: customer of the market Slaughterhouse workers As a group of stakeholders you need to decide how to best work as a One Health team, what each person’s role on the team will be, and then to develop a plan involving all members to investigate, identify and respond to the emergency of the outbreak. Your role during the role play will be: You have 15 minutes to think about: What activities would be implemented in the community by the stakeholders to respond to the disease? How do you think you are involved in transmission of this disease? How do you solve issues related to your role? What is each stakeholder’s responsibility? How should members of national or international health agencies work with local (e.g., district level) health officials, and university experts, and how should they communicate to the local community? How can local community members best work with members from outside agencies? What are the challenges and obstacles to working with all stakeholders to address the emergence of the new disease? How can all members feel important and necessary as part of a One Health team trying to improve the health of the local community? 17 | P a g e Module: Fundamentals of Infectious Disease Notes: What do you think? How did the team do? What did you learn about how to design a One Health approach? What did you learn about implementing stakeholder activities during an infectious disease outbreak? Notes: 18 | P a g e SEAOHUN One Health Course - Student Guide ISSUES IN DAILY LIFE RELATED TO INFECTIOUS DISEASES Learning Objective: Give examples of infectious diseases in humans and animals and explain their effect on the daily lives of the affected populations. Pre-Class Assignment: Personal Log of Daily Activities Pre-Work Complete a personal activity log for two or more days to record your daily activities and how those activities may relate to the risk of transmission of an infectious disease. Pre-work SAMPLE ACTIVITY LOG Hour Activity Infectious Disease Risk 7:00 Wake up, shower Water Contamination Drink glass of water 7:30 Prepare breakfast (eggs, toast, Foodborne disease, inadequate milk) cooking practices, eggs–particular risk of Salmonella (if eggs undercooked) 8:00 Travel to work/school Contact with infected people (e.g., influenza) using public transport Hour PERSONAL ACTIVITY LOG Activity Infectious Disease Risk 0:00 1:00 2:00 3:00 4:00 5:00 19 | P a g e Module: Fundamentals of Infectious Disease 6:00 7:00 8:00 9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 18:00 19:00 20:00 21:00 22:00 23:00 Additional Observations: 20 | P a g e SEAOHUN One Health Course - Student Guide Infectious Disease and Daily Life Daily activities for: Lecture Individual: Food preparation Eating and serving food Care of pets Interaction with other animals Personal hygiene Interaction with other people Family: Sharing meals and food preparation Care of children and elders Cleaning Celebrations School Funerals Community: Food markets Restaurants and catered events Gatherings – religious, celebrations, school, lectures Theater Notes: 21 | P a g e Module: Fundamentals of Infectious Disease Interview About Issues in Daily Life Related to Infectious Disease Choose a family member or friend from your local community and interview them about their daily life activities and knowledge of how those activities might relate to transmission of infectious disease. Record their answers to the questions below and add any other questions appropriate to your family or local community. Start by explaining to the person you will interview that you are taking a class on One Health and you are studying ways that normal activities in daily life can relate to the spread of infectious diseases. Tell them that you have already made a log of your own daily activities and would like to ask them questions about their activities and knowledge of infectious diseases. Before starting, you can answer any questions the interviewee may have about what you mean by infectious diseases or how they spread. Name of Interviewee: __________________________________________ Date of Interview: __________________________________________ What meals are usually prepared in the home on a daily basis? Who is involved in the cooking? How do you usually serve food prepared at home? 22 | P a g e SEAOHUN One Health Course - Student Guide How do you store food in your home? Ask more specifically about raw meats, vegetables, milk and eggs. What meals do you and your family eat in a restaurant? How do you think food preparation and serving may relate to spread of infectious diseases? Explain what you mean by infectious disease to the interviewee, if needed. Are you aware of any specific diseases that may be transmitted by food? 23 | P a g e Module: Fundamentals of Infectious Disease What household cleaning or hygiene activities do you usually perform on a regular basis? Who is responsible for most of the cleaning in your home? Do you know of any ways that cleaning activities or food storage practices could relate to spread (or the prevention) of infectious diseases? Do you have children in your home? Who usually cares for the children? Do you have pets in your home or livestock on your property? Who usually cares for pets or livestock? 24 | P a g e SEAOHUN One Health Course - Student Guide Are you aware of any infectious diseases that may spread from animals to people during routine interactions? What activities do you usually do in the community on a regular basis? Think of buying food at a market or grocery store, attending school, going to work, religious activities, group gatherings, etc. Can you think of any ways that you could personally be at risk for an infectious disease during one of these activities? What animals, including pets, livestock or wildlife are present in your community? Where are these animals located? 25 | P a g e Module: Fundamentals of Infectious Disease How can animals present in the community be involved in the spread of infectious disease? Can you think of any specific diseases that are spread from animals to people? Additional Questions/Observations: 26 | P a g e SEAOHUN One Health Course - Student Guide HUMAN IMPACTS ON INFECTIOUS DISEASE TRANSMISSION Learning Objectives: Give examples of infectious diseases in humans and animals and explain their effects on the daily livees of affected populations. Understand how local cultural practices influence the emergence and transmission of an infectious disease. Analyze an infectious disease problem and identify potential solutions to conflicts with culture and traditional practices. Human Impact Lecture Notes: 27 | P a g e Module: Fundamentals of Infectious Disease Human Ecology and Human-Related Change to the Environment Please read the paper below and plan to discuss in a small group. Murray, K.A., and P. Daszak. Human ecology in pathogenic landscapes: two hypotheses Small Group on how land use change drives viral emergence. Curr Opin Virol. Feb 2013; 3(1): 79–83. Activity Complete article available online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713401/ Notes: 28 | P a g e What is meant by human ecology? How can human-related (anthropogenic) changes to the landscape result in disease emergence? What are some local cultural, traditional or livestock husbandry practices that may result in infectious disease? How do human activities resulting in a local change in land use impact the global system? What are some human impacts that can result in disease emergence? How can we advocate for a One Health approach to deal with human-influenced impacts on disease transmission, including land use change, culture, traditions and livestock practices? SEAOHUN One Health Course - Student Guide NATURAL DISASTERS AND INFECTIOUS DISEASE ROLE-PLAYING ACTIVITY Learning Objectives: Analyze an infectious disease scenario influenced by a natural disaster. Describe how various stakeholders are involved in the infectious disease and how the disease may have impacts on them. Pre-Class Assignment: Read Article – Chaturongkasumrit Y., et. al. Microbiological evaluation of water during the 2011 flood crisis in Thailand. Sci Total Environ. 2013 Oct 1;463-464:959-67. Abstract available at: http://www.ncbi.nlm.nih.gov/pubmed/?term=23872186 Homework Read, Chaturongkasumrit et al. “Microbiological evaluation of water during the 2011 flood crisis in Thailand” and think about how various stakeholders are impacted by infectious diseases during natural disasters. Reading Assignment Review the WHO Fact Sheet on Leptospirosis. The Flood! Role Play It is October of 2011 and severe flooding has affected your community in Thailand. Many people have been impacted by flooding in their homes, schools, places of work, and farmland. Increasing cases of undiagnosed febrile illness have occurred in humans in the community, and leptospirosis is suspected as a possible diagnosis. Disease is also being reported in livestock and pets in the community, but has not yet been investigated as the immediate focus has been on human safety during the crisis. As the flood waters recede, the community needs to work together to determine the cause of the illness in humans and animals. Roles: Community Members Farmer Patient You are a member of the community who lives and works there. You interact with other community members on a daily basis and have heard of people who have experienced a febrile illness but don’t know the cause. You own a cattle farm in the rural area outside of the community affected by the flooding. Your pregnant cattle have recently experienced some abortions. You have noticed numerous rats seeking refuge on your farm and in your animal enclosures to get away from flooded areas. You developed a high fever and muscle aches several days ago after wading through water in a flooded area. The illness progressively worsened and you are seeking medical attention at the local hospital. 29 | P a g e Module: Fundamentals of Infectious Disease Doctor You work at the local hospital and have recently seen more patients with severe febrile illness, which you have not yet diagnosed. Veterinarian You work at a clinic that provides medical care to pets and livestock in the community. You have received calls regarding disease in livestock and have also seen dogs with hepatic disease and jaundice. Public Health Specialist You work on disease investigations and are called to the community to investigate multiple cases of an unknown febrile illness and are tasked with developing a plan for management. Environmental Health Officers As a result of the flooding, you are called to the community to assess flood damage to the local environment. Prepare for the role play by thinking about: How you would feel and what you would do in this situation? How would you interact with members of the community to try to solve this health problem? 30 | P a g e SEAOHUN One Health Course - Student Guide Debriefing / Discussion How did you feel as the person in your assigned role? How well did your group of stakeholders interact in this situation? What problems or obstacles did you face? Give an example of how the opinions or values of different roles conflicted with each other. How did a natural disaster make investigation of the problem more difficult? What factors make leptospirosis a complicated disease to address during an outbreak? Why could leptospirosis have occurred as a result of the flooding? Do you think your group was able to find a way to address the problem of a leptospirosis outbreak in the community? Are there ways different stakeholders could interact in a more effective way to address the problem of an outbreak of infectious disease during a natural disaster? Notes: 31 | P a g e Module: Fundamentals of Infectious Disease Notes: 32 | P a g e SEAOHUN One Health Course - Student Guide CULTURE AND TRADITIONS IN THE LOCAL COMMUNITY (FIELD TRIP) Learning Objectives: Pre-Class Assignment: Identify and classify the types of infectious diseases influencing human and animal health in a given area. Describe traditional livestock production practices and livestocktransmitted infectious diseases in the local area. Understand how local cultural practices influence the emergence and transmission of an infectious disease. Effectively convey information about an infectious disease to professionals and laypersons in a written communication. Read Article on Website – Traditional Asian Health Beliefs and Healing Practices Homework Pre-work Prepare for your field trip by going to the website Dimensions of Culture and reading about “Traditional Asian Health Beliefs & Healing Practices” at www.dimensionsofculture.com/2010/10/traditional-asian-health-beliefs-healingpractices/ Culture and Tradition in the Local Community - Field Trip Notes Location: ___________________________________ Date: _________________ During the field trip take notes on any cultural or traditional practices you observe and answer the following questions: What are the cultural practices that you observe? 33 | P a g e Module: Fundamentals of Infectious Disease What population are you observing? What animals are present? Pets? Livestock? What livestock husbandry practices are used? How are pets treated and cared for in the community? 34 | P a g e SEAOHUN One Health Course - Student Guide What is the ecosystem in and around the community? What factors related to the humans, animals, and their environment could impact infectious disease transmission? How have infectious diseases influenced local culture or practices? 35 | P a g e Module: Fundamentals of Infectious Disease What is the direct impact of infectious diseases on the families and the community (economic impact, loss of time, etc.)? What is the indirect impact of infectious diseases to the family and community (economic impact, loss of time, etc.)? What is the impact of culture on the families and the community when a member of a family or community suffers from an infectious disease? 36 | P a g e SEAOHUN One Health Course - Student Guide General Observations and Additional Notes: 37 | P a g e Module: Fundamentals of Infectious Disease Debrief and Concluding Remarks Based on your readings and your new-found knowledge of the community, share your general observations and discuss the following questions: What is meant by culture and traditional practices? Describe culture and beliefs in the local area of the field trip. What are traditional practices observed in this community? What are examples that you observed of how culture can play a role in the transmission of infectious diseases? What are examples of traditional livestock production? Did you observe any of these in the community? How could these practices impact on infectious disease transmission? 38 | P a g e SEAOHUN One Health Course - Student Guide DEVELOPING SYSTEMS MAPS FOR INFECTIOUS DISEASES Learning Objectives: Pre-Class Assignment: Develop a transmission diagram that incorporates all components of the ‘system’ for an infectious disease, including downstream effects. Describe how various stakeholders are involved in an infectious disease and how they may be impacted by the disease. Describe the fundamental concepts for an infectious disease and how they are related. Read Article – Zinsstag, J. and E. Schelling. From “one medicine” to “one health” and systemic approaches to health and well-being. Prev Vet Med. Sep 1, 2011; 101(3-4): 148–156. Article available online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145159/ Read Fact Sheet – WHO Avian Influenza Fact Sheet Preparatory work Pre-work Prior to the session, read the following documents: Zinsstag, J. and E. Schelling. From “one medicine” to “one health” and systemic approaches to health and well-being. Prev Vet Med. Sep 1, 2011; 101(3-4): 148–156. WHO Avian Influenza Fact Sheet 39 | P a g e Module: Fundamentals of Infectious Disease Systems Thinking Nourish Food System Map Source: www.nourishlife.org 40 | P a g e SEAOHUN One Health Course - Student Guide Creating a Systems Map for an Infectious Disease Create a systems map for avian influenza. In creating your map: Put your central idea or concept in the middle. Use connecting lines and arrows to show interrelated part of the system. Organize the map into related areas (could be human, animal, environment for an infectious disease). Use colors to differentiate related areas. Avian Influenza 41 | P a g e Module: Fundamentals of Infectious Disease Notes: 42 | P a g e SEAOHUN One Health Course - Student Guide CREATING MESSAGES TO CONVEY INFECTIOUS DISEASE INFORMATION Learning Objectives: Effectively convey information about an infectious disease to professionals and laypersons in a written communication. Describe the history, current epidemiology, pathology, treatment, control, and prevention of an infectious disease in an oral presentation. Communicating About Infectious Diseases Lecture Source: cdc.gov Notes: 43 | P a g e Module: Fundamentals of Infectious Disease Creating a Message about an Infectious Disease Small Group Activity Select a disease and write a comprehensive message to be delivered orally, aimed at the community to convey information about the disease. Make sure your message covers: General information about the disease outbreak, agent, background, etc. Impact of this disease on human and animal health Remember to use language appropriate for audience Economic impact of the disease Important points about the epidemiology, symptoms, pathology related to disease Effective measures for prevention and control of the disease Measures for proper treatment Appropriate community activities to mitigate the effects of the disease Be prepared to present your message to the class. Message: 44 | P a g e SEAOHUN One Health Course - Student Guide 45 | P a g e Module: Fundamentals of Infectious Disease What feedback did you get about the message after your presentation? How would you improve your message and presentation? Source: www.paho.org 46 | P a g e SEAOHUN One Health Course - Student Guide LEARNING REFLECTIONS AND EVALUATION LECTO Learning Objectives: Reflect on your learning in the Fundamentals of Infectious Disease module. Provide feedback on what you believed to be the strengths of the module and which areas in the module could be improved. Source cdc.gov Evaluate/ Create How would you rate your level -- from understanding to being able to apply to being able to evaluate and create -for the Fundamentals of Infection Disease competencies: Apply Individual Learning Assessment Understand Self-Evaluation Identify problems relating to culture and traditional practices (e.g., livestock, sanitation). Interpret the fundamentals of infectious diseases and the impact of daily life. Identify problems relating to culture and traditional practices (e.g., livestock, sanitation). Integrate the respective elements of fundamental concepts of infectious disease. Apply various communication strategies in writing, oral presentation and role plays. Write down two or three things that you learned from the session. Think about: What was new or surprising to you? What have you changed your mind about? What are you still unsure about? What was interesting to you/what would you like to study in more detail? Are there new behaviors that you will try based on this class? What topics from the class will you share with others outside the class? 47 | P a g e Module: Fundamentals of Infectious Disease Notes: Sharing the Learning Small Group Discussion Notes: 48 | P a g e In a small group, share: Your key learnings from the module. How you will apply the concepts, knowledge, skills you gained from the module. SEAOHUN One Health Course - Student Guide RESOURCES FOR STUDENTS Included in the Resource Folder Chaturongkasumrit. Y., P.Techaruvichit, et al. (2013). Microbiological evaluation of water during the 2011 flood crisis in Thailand. Science Total Environment. October 1 (463–464). Abstract retrieved on December 1, 2013, from: http://www.ncbi.nlm.nih.gov/pubmed/?term=23872186. Cleveland S., Haydon, D.T., and Taylor, L. (2007). Overviews of Pathogen Emergence: Which Pathogens Emerge, When and Why? Current Top Microbiology Immunology. 315(85–111). Abstract retrieved on December 1, 2013, from: http://link.springer.com/chapter/10.1007%2F978-3-540-70962-6_5#page-1. Daszak, P., Zambrana-Torrelio, C., and Bogich, T. L. (2012). Interdisciplinary approaches to understanding disease emergence: The past, present and future drivers of Nipah virus emergence. Proceedings of the National Academy of the United States of America. Retrieved on December 1, 2013, from http://www.pnas.org/content/110/Supplement_1/3681.full. Dimensions of Culture. (n.d.) Traditional Asian Health Beliefs and Healing Practices. Retrieved on December 1, 2013, from: http://www.dimensionsofculture.com/2010/10/traditional-asian-healthbeliefs-healing-practices/. World Health Organization (WHO). (n.d.) Avian Influenza Fact Sheet. Retrieved on December 1, 2013, from www.who.int/mediacentre/factsheets/avian_influenza/en/. World Health Organization (WHO). (n.d.) Lepstosprisosis Fact Sheet. Retrieved on December 1, 2013, from http://www.searo.who.int/about/administration_structure/cds/CDS_leptospirosisFact_Sheet.pdf. World Health Organization (WHO). (n.d.) Nipah Virus Infection Fact Sheet. Retrieved on December 1, 2013, from: http://www.searo.who.int/entity/emerging_diseases/links/CDS_Nipah_Virus.pdf. Zinsstag, J., Schelling, E. and Waltner-Towes, D. (2011). From “One Medicine” to “One Health” and systemic approaches to health and well-being. Preventive Veterinary Medicine. 101(148–156). Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145159/. Additional Resources Dipiro, J.T., R.L. Talbert, and G.C. Yee. (2011) Pharmacotherapy: A Pathophysiologic Approach, 8th ed. United States: McGraw-Hill Companies, Inc. Barrett, M.A., and S.A. Osofsky. (DATE) One Health: Interdependence of People, Other Species and the Planet. Section 4 Public Health. 364–377. 49 | P a g e Farone, T.S. Incorporating the one-health concept into undergraduate education. J Am Vet Med Assoc. 2011 Dec 1; 239(11):1406–7. Kahn, L.H. (2013).One Health concept for the 21st century. 1st International Symposium Biosafety and Biocontainment 2013, 49p. Kahn, Laura H. et al. (2008). Teaching “One Medicine-One Health.” The American Journal of Medicine. 121(2008) 169–170. Murray, K. and P. Daszak. (2013). Human Ecology in Pathogenic Landscapes: two hypotheses on how land use change drives viral emergence. Current Opinion in Virology 3:1 (79–83). Raizenne, M. (2013). One Health Leadership Experience. Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada. Conrad, P.A. et al. Evolution of a transdisciplinary ‘‘One Medicine–One Health’’ approach to global health education at the University of California, Davis. Preventive Veterinary Medicine 92 (2009) 268– 274. Available online at: http://mwqdesign.com/ionehealth/wpcontent/uploads/2012/08/Dr.Conradspublication.pdf Websites CDC. Photo Quiz. Emerging Infectious Disease Journal. 19(2011) Website at: http://wwwnc.cdc.gov/eid/articles/photo-quiz.htm International Society for Infectious Diseases. Website at http://www.isid.org. National Institute of Health. NIH Curriculum Supplement: Understanding Emerging and Re-Emerging Infectious Diseases. Website at: http://www.ncbi.nlm.nih.gov/books/NBK20370/. ProMED Infectious Disease Reports: http://www.promedmail.org. World Health Organization: Ethics and Infectious Disease. Website at: at www.who.int/bulletin/volumes/86/8/08-056242/en/. World Health Organization: South-East Asia Journal of Public Health. Available free online at http://http://www.searo.who.int/publications/journals/seajph/en/. World Health Organization: Zoonoses. Website at: http://www.who.int/zoonoses/diseases/en/. 50 | P a g e