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Vaccinating increases family wealth, girls’ education

A Maasai man herds grazing cattle.

Vaccinating increases family wealth, girls’ education

by Marcia Hill Gossard ’99, ‘04

A Washington State University-led research team found households in rural Africa that vaccinate their cattle for East Coast fever increased their income and spent the additional money on food and education. Researchers also found that when fewer cattle died from the fever, girls were more likely to attend secondary school.

“When households vaccinate, it increases their wealth and income and sets them on a trajectory to provide education for their children,” said lead author Tom Marsh, professor in WSU’s School of Economic Sciences and the PaulG. Allen School for Global Animal Health.“Vaccinating is a way for households to pull themselves out of poverty.”

“And it has an intergenerational effect ifa family can spend more of their resources on education, especially for girls,” he said.

More milk, fewer antibiotics

Published this week in the journal Science Advances (http://advances.sciencemag.org/content/2/12/e1601410), the study foundthat vaccinating increased a household’sincome because fewer cattle died anddisease free cattle produced more milkto feed the family or could be sold in themarketplace.

Households also saved money because vaccinated cattle did not need as many antibiotic treatments or to be sprayed as often for ticks, which spread the disease. “We are interested in understanding how the health of livestock translates into household decisions and meets sustainable development goals,” said Marsh. “For example, concern about loss of milk production drives the adoption of vaccines because it is so important to households and children.”

Leading cause of calf death

Caused by the parasite Theileria parva,East Coast fever is spread from diseased cattle to healthy cattle through tick bites.The disease can spread quickly and infect cattle throughout the community.“East Coast fever is one of the most devastating cattle diseases,” said Marsh.“It is the leading cause of calf death in East Africa.”For pastoral families, cattle are a main source of income. Losing even one to disease can negatively affect an entire family

Broader implications for antibiotic resistance

Households that vaccinated used fewer antibiotics to treat animals, so the widespread adoption of vaccinations could have larger global health benefits. “We need to think long term about the use of antibiotics and antibiotic resistance, as well as vaccines,” said Marsh. “If organizations are going to invest more money on vaccines, then besides the known effects—such as fewer cattle deaths—we need to understand the indirect effects.“Developing better vaccines and easier ways to distribute them could have broad societal effects,” he said.

Partnering with Veterinarians and Clients to End Rabies

by Marcia Hill Gossard ’99, ‘04

Boy with puppies and line
The WSU rabies vaccination team sees firsthand how important vaccination is to dog owners. Although many in rural Africa may not be able to pay for the vaccine, they walk many miles to have their dog vaccinated.

 

Beginning in the summer of 2015, the Allen School is partnering with veterinary clinics and their clients to eliminate rabies as a public health problem worldwide. The goal is zero human deaths by 2030.

“We are partnering with veterinary clinics around the country because together we can do more than we could ever do alone,” says Guy Palmer, WSU Senior Director of Global Health.

Each year more than 59,000 people die from rabies worldwide and about half of those deaths are children under the age of 16. In developed countries, such as the United States, rabies is quite rare because of access to vaccinations. But in many developing countries, rabies is not under control. Globally, more than 99% of human rabies deaths are caused by dog bites—almost all of these in Africa and Asia. Vaccinating 70 percent of the dog population will protect humans and wildlife, such as lions, from the disease.

“Rabies is easily preventable with regular dog vaccinations,” says Palmer.

One of the main reasons rabies continues to be so prevalent in many parts of the world is challenges in getting the vaccinations to the most vulnerable people in resource-poor countries, says Palmer. “In many parts of sub-Saharan Africa and Asia where the death rates are the highest, there is no reliable system to get vaccinations to where they are needed most.”

Many areas in rural Africa also do not have electricity; currently the vaccine needs to be stored at cold temperatures. And governments in many countries have historically put their resources into treating the disease with postexposure prophylaxis, a series of post-bite inoculations that must be started within the first 24 hours after a person is bitten by a rabid dog. If it is not administered in time and symptoms appear, the disease is always fatal. Because of the narrow window for treatment and the treatment’s high cost, post-exposure prophylaxis has not been effective in reducing deaths in resource-poor countries.

Research in Tanzania and other countries has now convinced the World Health Organization and national governing bodies that canine vaccination can be effectively used for global elimination, says Palmer. Vaccinations are also a much more cost effective option.

“The direct costs of post-exposure prophylaxis are 20 times higher than the amount spent on dog vaccination in affected countries,” says Palmer. “Even the cost of the vaccine is too much for many families.”

Together with global partners* the Allen School is already making a difference. Each year the vaccination team visits 180 villages in seven districts adjacent to the Serengeti National Park. Each day they vaccinate an average of 300 dogs. The result is that the vaccination zone—a cordon sanitaire—is now rabies free. The Allen School is confident that this rabies-free vaccination zone is an illustrative model for other parts of subSaharan Africa and south Asia.

“We have all the tools needed to eliminate rabies, we only need to deploy them,” says Palmer. “One major challenge is creating a reliable vaccine bank that would provide a consistent and affordable vaccine supply for countries to draw on and then replenish.”

Palmer has set a goal to raise $10 million to develop a reliable vaccine bank and improved distribution in high-risk area of Africa and Asia. Through partnerships with veterinary clinics and others committed to eliminating rabies, Palmer knows they can make an even bigger difference for communities and for the people who live with rabies as a reality every day.

“We have all the tools needed to eliminate rabies, we only need to deploy them.” —Guy Palmer WSU Senior Director of Global Health

“When I am in Africa working with our vaccination team, I see firsthand how important vaccination is to dog owners,” says Palmer. “Although they may not be able to pay in cash for the vaccine, they will walk many miles just to be able have their dog vaccinated.”

The Allen School has partners around the world including the Global Alliance for Rabies Control as an umbrella organization, the World Health Organization, the World Organisation for Animal Health, and the Food and Agriculture Organization. Our research in Tanzania is in cooperation with the Serengeti Health Initiative and the University of Glasgow.

 

Learn how you can help support the WSU Rabies Vaccination Program at EliminateRabies.wsu.edu

 

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Freedom from the Cold Chain by Allowing Villagers to Help Themselves

Notes From the Field

by Dr. Felix Lankester, clinical assistant professor in the Allen School and director of the Serengeti Health Initiative

The WSU Rabies Vaccination Program team vaccinates an average of 500 dogs each day in east Africa.  Each year, 59,000 people die from rabies worldwide; about half are children.
The WSU Rabies Vaccination Program team vaccinates an average of 500 dogs each day in east Africa. Each year, 59,000 people die from rabies worldwide; about half are children.

The sun is not long up. Sitting on the step of my guesthouse, I can already see children walking down the dusty street with their dogs. Most of the dogs are trotting along freely by their owners’ sides, whilst a few are leashed with a piece of twine. One girl strolls past carrying a litter of puppies nestled into a bucket on her head. All are making their way to the center of the village where, in an hour’s time, the Serengeti Health Initiative team will begin vaccinating dogs against canine rabies. But this day will be different. Unlike the normal vaccination campaign the team has carried out around the Serengeti National Park since 2003, this will be a lot more work. Today the team are carrying out a WSU-funded vaccine trial* that will determine whether our hypothesis—that the rabies vaccine is still effective even when it is not stored at cold temperatures—is true.

The significance of confirming the hypothesis cannot be overstated. For most rural areas in Tanzania, and many other parts of Africa where electricity is yet to arrive, it will mean that batches of vaccines can be delivered to villages and safely stored at ambient temperatures. As a result, rather than waiting for a campaign to come through their village, communities will be able to manage and administer vaccines to their dogs themselves. Because puppies are born frequently, being able to routinely vaccinate any new litter will greatly increase vaccinations rates and, as a result, herd immunity. Unlike in America where the reservoir host for rabies is wildlife species such as raccoons and skunks, in Africa and Asia, where 99% of human rabies cases occur, the reservoir host is the domestic dog. So when dogs are vaccinated, it protects people and other animals including domestic and wildlife species that are not vaccinated.

To test the hypothesis that the rabies vaccines are effective even when stored outside of the “cold chain,” dogs will be immunized with vaccines randomly selected from one of seven batches, with each batch having been stored, for up to six months, at a different temperature. Batch number seven, for example, has had vaccines stored at 37°C (98.6°F) for six months! After receiving a vaccine, each dog will be micro chipped and will have a blood sample collected. One month later the team will return to the same village and will identify all the dogs that have taken part in the trial so that a follow up blood sample can be collected and a cold chain vaccine can be given. In this way the team can be sure that, following the trial, every dog is protected. All the blood samples will be analyzed for rabies antibodies. This will allow us to determine whether the hypothesis is correct: that vaccines stored outside of the cold chain are effective at eliciting a protective immune response.

The first round of immunizations is complete. We now must wait one month before returning to collect samples that will be sent for testing. The results of the test will be known sometime this summer. The battle against this most terrifying disease will continue, yet these children and their dogs may play a crucial role that will determine whether this ancient disease can finally be defeated.

*The trial is conducted in association with MSD Animal Health (Merck Animal Health) using the Nobivac® rabies vaccine.

Learn more about the WSU Rabies Vaccination Program at go.vetmed.wsu.edu/Rabies.

Tracking Animal Disease to Improve Human Health

by Marcia Hill Gossard ’99, ‘04

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Victoria Olsen-Mikitowicz (’15 DVM) spent one month in Kenya working on several research projects including the population-based animal syndromic surveillance project, or PBASS. She plans to pursue a career in veterinary public health, education, and research in global animal health.

In rural Kenyan villages where few families have electricity or indoor plumbing, a surprising technology helps researchers study the health of animals and people: the cell phone.

Families who are part of the population-based animal syndromic surveillance project, or PBASS, use their cell phones to call a veterinarian toll free when an animal is sick. More than 70 percent of families participating in the survey have cell phones; only three percent are connected to the electricity grid.

“Mobile telephony is actually very well developed in most of Africa, especially in Kenya,” says Thumbi Mwangi, clinical assistant professor in the Paul G. Allen School for Global Animal Health, who has been collecting data since the survey began in February 2013.

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Visiting Risper Oyogo: Just One of 1,500 Families Allen School Scientists are Following in Western Kenya to Help Improve Health and Wellbeing

Notes From the Field

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Risper and her herdsman watch as Dr. Elkanah Otiang examines one of her calves.

by Dr. Thumbi Mwangi, assistant research professor in the Allen School

It’s the last Thursday in August and today I am having the Kisumu County medical epidemiologist, Dr. Dickens Onyango, accompany me for a field visit to the Allen School research projects in the Lwak area, by the shores of Lake Victoria. At about 8 a.m., Dickens and I meet up at the West mall, the newest mall in Kisumu, where we quickly grab coffee and set off in one of the Kenya Medical Research Institute (KEMRI) field trucks. Our first stop is 14 kilometers north at the KEMRI Kisian Campus, a beautiful campus with neatly-manicured lawns and rows of well-aligned and mature umbrella trees providing a welcoming cool calm of shade.

Here we only get to exchange a few morning greetings with colleagues, before being joined by Dr. Elkanah Otiang, a young energetic field veterinarian who will often be heard belting a hearty often loud, but pleasant laugh. Elkanah doesn’t like to spend time at his desk, and will find every reason to be in the field talking with farmers and treating their animals. He has a team of 15 animal health assistants and community interviewers that work directly under him in the field, and who are involved in the collection of invaluable surveillance data for the Allen School and its partners.

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Zoobiquity Conference

The Allen School and the WSU College of Veterinary Medicine are two of the sponsors for this year’s Zoobiquity Conference to be held Saturday, November 1, in Seattle. The theme is “Environment and Health,” with a focus on health issues that people and animals share.  WSU faculty will be some of the featured speakers at this event. The afternoon includes walking rounds at the Woodland Park Zoo with presentations at various exhibits including seasonal affective disorder and geriatrics (gorillas), obesity (bears), BRCA gene breast cancer (jaguars), and zoonotic TB and uterine leiomyoma (elephants).  Zoobiquity stems from the idea that although animals and people get many of the same diseases, physicians and veterinarians don’t often consult with one another.  It calls for an interdisciplinary approach to health issues shared across species.

Antibiotic Resistance: What the WSU Paul G. Allen School for Global Animal Health is doing to help solve this global health crisis

by Marcia Hill Gossard ’99, ‘04

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Dr. Douglas Call (left) with Beatus Lyimo, a graduate student at the Nelson Mandela African Institution for Science and Technology. They are working in the lab at the Mandela Institution where Dr. Call and his team process samples to analyze for antibiotic resistance.

Bacteria can do something remarkable. They can share genes. So, if one bacterium is resistant to a particular antibiotic, such as tetracycline, it can pass that resistant gene to another bacterium. That bacterium will become resistant and can pass its resistant gene to another bacterium. And they can keep the resistance for a long time, which allows antibiotic resistance to spread widely.

This highly adaptable behavior, while good for bacterial survival, poses a major risk to human health. Treatments for common infections are becoming ineffective in some parts of the world according to a recent report by the World Health Organization. Globally there are already very high rates of antibiotic resistance for urinary tract infections and pneumonia.

Standard recommendations to reduce antibiotic resistance include using antibiotics only when medically necessary. The FDA recently released guidelines to discontinue the use of antibiotics in food animals who are not showing signs of illness. U.S. prescription guidelines for people are created to help ensure antibiotics are only prescribed when someone has a bacterial infection, not a viral illness. Both will have some impact. But according to researchers at the Paul G. Allen School for Global Animal Health, it is unlikely to do enough.

“Treatment guidelines in the United States alone are not sufficient to solve the problem,” said Guy Palmer, director of the Paul G. Allen School for Global Animal Health.

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Allen School Research Receives Grand Challenge Explorations Grant

thumbi-mwangiDr. Samuel Thumbi Mwangi, assistant professor in the Allen School, was awarded a Gates Foundation Grand Challenges Explorations Grant. He will conduct research at the Kenya Medical Research Institute on malaria and East Coast fever in humans and cattle. Grand Challenge recipients are initially awarded $100,000 and could be funded for up to $1 million if the pilot research is successful.

One World, One Health

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The WSU Allen School has partnered with the University of Washington and Universidade Federal de Viçosa, Brazil, to develop One Health research and training programs. One Health, or One Medicine, is a collaboration between veterinary medicine and human health professions to improve the lives and wellbeing of animals and people.

Universidade Federal de Viçosa has a well-recognized veterinary school and has recently created a new medical school on campus. The partnership between the three universities will enhance One Health efforts through collaborative work on tropical diseases and exchange programs between students in the United States and Brazil.

“This is a great opportunity for us to extend our global health partnership with the University of Washington into longstanding collaborations among WSU and Brazilian colleagues,” said Guy Palmer, Allen School director.

Global Animal Health Pathway Student Returns from Six Weeks in Africa

Healthier Animals, Healthier Children
by Tomasina Lucia ’14 DVM, Global Animal Health Pathway Student

When asked about their “big five,” most travelers to Kenya will regale you with talk of lions, elephants, or Cape buffalo. My big five were a bit different. As part of Washington State University’s Global Animal Health Pathway, I traveled to western Kenya for a six-week clinical rotation in research methods during the winter of my clinical year of veterinary training. After traveling almost 60 hours—with layovers and the time zone shift—to get from wintry Pullman to equatorial Kenya, my days were spent in a remote village called Lwak in the Nyanza Province. I stayed in a two-room cottage, complete with mosquito netting, squat toilet, and (usually!) running water. I was fortunate that Lwak has its own market, where I was able to purchase local fruit and a lot of fish, as the village is only a few kilometers from the shores of Lake Victoria (fun fact, Lake Victoria is the second largest fresh water lake in the world). Along with following community investigators as they surveyed area households, I worked with the project’s animal health team. Instead of snapping pictures of lions and elephants—big game are not historically native to that part of Kenya—my travel photos are mostly of cattle or chickens afflicted with diseases I had previously only seen in textbooks, like foot-and-mouth disease, heartwater, East Coast fever, Newcastle disease, or anaplasmosis.

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