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Validation of Occupational Zoonotic Disease Questionnaire Using Fuzzy Delphi Method

Sulaiman HF, Ismail R, Mohd Yusoff H, Anuar N, Mohd Jamil MR, Daud F

J Agromedicine, 2020 04;25(2):166-172.
PMID: 31533524 DOI: 10.1080/1059924X.2019.1666763

Objective: The Fuzzy Delphi Method (FDM) is one of the phases in Design and Development Research (DDR). It is a systematic method for tool development and validation. This article aims to validate an occupational zoonotic disease questionnaire using this technique. DDR is applied going through phase 1 (needs analysis), phase 2 (development and design), and phase 3 (usability).Method: In phase 1, information about safe work practices and occupational zoonotic exposure was obtained from discussions to verify predetermined domains as stated in The National Park Service survey on zoonotic disease exposure and risk. In phase 2, agreement from 14 experts about the domains was obtained using the FDM. In phase 3, a cognitive debriefing was performed to determine its usability for future studies. A total of five superior domains were verified, and their items were adapted. All domains and their items were submitted to experts to obtain consensus agreement.Results: A total of 31 (96.9%) passed the Triangle of Fuzzy Numbers and Defuzzification process with acceptable consensus agreement (78.8-91.9%) and threshold d value (0.07-0.14). Only four veterinarians were needed for cognitive debriefing to achieve the point of saturation.Conclusion: FDM in DDR is suitable to be applied by various professions for tool validation, as it is doable and cost and time effective. The Occupational Zoonotic Disease Questionnaire is now ready to be used for future studies in Malaysia.

Matched MeSH terms: Zoonoses/epidemiology*
Fulltext Human and animal invasive muscular sarcocystosis in Malaysia--recent cases, review and hypotheses

Tappe D, Abdullah S, Heo CC, Kannan Kutty M, Latif B

Trop Biomed, 2013 Sep;30(3):355-66.
PMID: 24189667

Sarcocystosis, an unusual parasitic zoonotic disease, is caused by coccidian/ apicomplexan protozoa in humans and animals. The parasites usually develop in a heteroxenous predator-prey life-cycle involving final (carnivore) and intermediate (omnivore/herbivore) hosts. Besides the intestinal, non-invasive form of the disease in which humans and animals are the definitive hosts for certain Sarcocystis spp., the invasive form has come to recent attention. In the latter, humans and animals serve as intermediate host harbouring sarcocysts in their muscle tissue. Already in 1991 sarcocystosis was seen as a potential emerging food borne zoonosis in Malaysia, and in 2011 and 2012 the largest cluster of symptomatic human muscular sarcocystosis world-wide was reported from Tioman Island, Pahang state. In this review, we focus on invasive sarcocystosis in humans and animals in Malaysia, review the recorded cases and epidemiology, and present hypotheses.

Matched MeSH terms: Zoonoses/epidemiology*
Prevalence of Onchocerca japonica and O. takaokai infections in the Japanese wild boar, Sus scrofa leucomystax, and the Ryukyu wild boar, S. s. riukiuanus, in Japan

Uni S, Fukuda M, Uga S, Agatsuma T, Nakatani J, Suzuki K, et al.

Parasitol Int, 2021 Aug;83:102313.
PMID: 33662527 DOI: 10.1016/j.parint.2021.102313

Reports of zoonotic infections with Onchocerca japonica (Nematoda: Filarioidea), which parasitizes the Japanese wild boar, Sus scrofa leucomystax, have recently increased in Japan. To predict the occurrence of infection in humans, it is necessary to determine the prevalence of O. japonica infection in the natural host animals. We investigated the presence of adult worms in the footpads, and of microfilariae in skin snips, taken from the host animals, between 2000 and 2018. Onchocerca japonica was found in 165 of 223 (74%) Japanese wild boars in Honshu and Kyushu. Among the nine regions studied, the highest prevalence of O. japonica infection was found in Oita, Kyushu, where 47 of 52 (90.4%) animals were infected. The ears were the predilection sites for O. japonica microfilariae. Adult worms of O. japonica were found more frequently in the hindlimbs than in the forelimbs of the host animals. Onchocerca takaokai was found in 14 of 52 (26.9%) Japanese wild boars in Oita. In Kakeroma Island among the Nansei Islands, both O. japonica and O. takaokai were isolated from the Ryukyu wild boar, S. s. riukiuanus. These observations could help predict future occurrences of human zoonotic onchocercosis in Japan.

Matched MeSH terms: Zoonoses/epidemiology*
Nipah virus: transmission of a zoonotic paramyxovirus

Clayton BA

Curr Opin Virol, 2017 Feb;22:97-104.
PMID: 28088124 DOI: 10.1016/j.coviro.2016.12.003

Nipah virus is a recently-recognised, zoonotic paramyxovirus that causes severe disease and high fatality rates in people. Outbreaks have occurred in Malaysia, Singapore, India and Bangladesh, and a putative Nipah virus was also recently associated with human disease in the Philippines. Worryingly, human-to-human transmission is common in Bangladesh, where outbreaks occur with near-annual frequency. Onward human transmission of Nipah virus in Bangladesh is associated with close contact with clinically-unwell patients or their infectious secretions. While Nipah virus isolates associated with outbreaks of human infection have not resulted in sustained transmission to date, specific exposures carry a high risk of person-to-person transmission, an observation which is supported by recent findings in animal models. Novel paramyxoviruses continue to emerge from wildlife hosts, and represent an ongoing threat to human health globally.

Matched MeSH terms: Zoonoses/epidemiology
Fulltext The Main Risk Factors of Nipah Disease and Its Risk Analysis in China

Yu J, Lv X, Yang Z, Gao S, Li C, Cai Y, et al.

Viruses, 2018 10 19;10(10).
PMID: 30347642 DOI: 10.3390/v10100572

Nipah disease is a highly fatal zoonosis which is caused by the Nipah virus. The Nipah virus is a BSL-4 virus with fruit bats being its natural host. It is mainly prevalent in Southeast Asia. The virus was first discovered in 1997 in Negeri Sembilan, Malaysia. Currently, it is mainly harmful to pigs and humans with a high mortality rate. This study describes the route of transmission of the Nipah virus in different countries and analyzes the possibility of the primary disease being in China and the method of its transmission to China. The risk factors are analyzed for different susceptible populations to Nipah disease. The aim is to improve people's risk awareness and prevention and control of the disease and reduce its risk of occurring and spreading in China.

Matched MeSH terms: Zoonoses/epidemiology
Fulltext Association of rodent-borne Leptospira spp. with urban environments in Malaysian Borneo

Blasdell KR, Morand S, Perera D, Firth C

PLoS Negl Trop Dis, 2019 02;13(2):e0007141.
PMID: 30811387 DOI: 10.1371/journal.pntd.0007141

Although leptospirosis is traditionally considered a disease of rural, agricultural and flooded environments, Leptospira spp. are found in a range of habitats and infect numerous host species, with rodents among the most significant reservoirs and vectors. To explore the local ecology of Leptospira spp. in a city experiencing rapid urbanization, we assessed Leptospira prevalence in rodents from three locations in Malaysian Borneo with differing levels of anthropogenic influence: 1) high but stable influence (urban); 2) moderate yet increasing (developing); and 3) low (rural). A total of 116 urban, 122 developing and 78 rural rodents were sampled, with the majority of individuals assigned to either the Rattus rattus lineage R3 (n = 165) or Sundamys muelleri (n = 100). Leptospira spp. DNA was detected in 31.6% of all rodents, with more urban rodents positive (44.8%), than developing (32.0%) or rural rodents (28.1%), and these differences were statistically significant. The majority of positive samples were identified by sequence comparison to belong to known human pathogens L. interrogans (n = 57) and L. borgpetersenii (n = 38). Statistical analyses revealed that both Leptospira species occurred more commonly at sites with higher anthropogenic influence, particularly those with a combination of commercial and residential activity, while L. interrogans infection was also associated with low forest cover, and L. borgpetersenii was more likely to be identified at sites without natural bodies of water. This study suggests that some features associated with urbanization may promote the circulation of Leptospira spp., resulting in a potential public health risk in cities that may be substantially underestimated.

Matched MeSH terms: Zoonoses/epidemiology*
Fulltext Long-Tailed Macaque Response to Deforestation in a Plasmodium knowlesi-Endemic Area

Stark DJ, Fornace KM, Brock PM, Abidin TR, Gilhooly L, Jalius C, et al.

Ecohealth, 2019 12;16(4):638-646.
PMID: 30927165 DOI: 10.1007/s10393-019-01403-9

Land-use changes can impact infectious disease transmission by increasing spatial overlap between people and wildlife disease reservoirs. In Malaysian Borneo, increases in human infections by the zoonotic malaria Plasmodium knowlesi are hypothesised to be due to increasing contact between people and macaques due to deforestation. To explore how macaque responses to environmental change impact disease risks, we analysed movement of a GPS-collared long-tailed macaque in a knowlesi-endemic area in Sabah, Malaysia, during a deforestation event. Land-cover maps were derived from satellite-based and aerial remote sensing data and models of macaque occurrence were developed to evaluate how macaque habitat use was influenced by land-use change. During deforestation, changes were observed in macaque troop home range size, movement speeds and use of different habitat types. Results of models were consistent with the hypothesis that macaque ranging behaviour is disturbed by deforestation events but begins to equilibrate after seeking and occupying a new habitat, potentially impacting human disease risks. Further research is required to explore how these changes in macaque movement affect knowlesi epidemiology on a wider spatial scale.

Matched MeSH terms: Zoonoses/epidemiology*
Fulltext Nipah@20: Lessons Learned from Another Virus with Pandemic Potential

Gómez Román R, Wang LF, Lee B, Halpin K, de Wit E, Broder CC, et al.

mSphere, 2020 07 08;5(4).
PMID: 32641430 DOI: 10.1128/mSphere.00602-20

Nipah disease is listed as one of the WHO priority diseases that pose the greatest public health risk due to their epidemic potential. More than 200 experts from around the world convened in Singapore last year to mark the 20th anniversary of the first Nipah virus outbreaks in Malaysia and Singapore. Most of these experts are now involved in responding to the coronavirus disease 2019 (COVID-19) pandemic. Here, members of the Organizing Committee of the 2019 Nipah Virus International Conference review highlights from the Nipah@20 Conference and reflect on key lessons learned from Nipah that could be applied to the understanding of the COVID-19 pandemic and to preparedness against future emerging infectious diseases (EIDs) of pandemic potential.

Matched MeSH terms: Zoonoses/epidemiology
Nine cases of human dipylidiasis in Moscow region during 1987 to 2017

Bronstein AM, Fedyanina LV, Maximova MS, Lukashev AN, Sergeev AR

Trop Biomed, 2020 Mar 01;37(1):194-200.
PMID: 33612730

Dipylidium caninum is a parasite that commonly infects dogs and cats worldwide. The large population of wild and stray dogs and cats may potentially transmit D. caninum to humans via their flea and lice. Humans are an accidental host, and dipylidiasis is more commonly seen in infants and children. There is scant information about human dipylidiasis in Russia. We report nine cases of dipylidiasis - eight in children and one in an adult. The patients were asymptomatic, except for excreting active proglottids in their faeces, which was the most common complaint. The clinical significance of asymptomatic dipylidiasis is not understood, except mothers were anxious because of the continuous appearance of active worms in the faeces of their children. The patients were successfully treated with praziquantel (15 mg/kg). Preventing dipylidiasis in pets and humans requires the control of fleas and lice, avoiding the outdoor defecation of definitive hosts, deworming pets, preventing children from playing with stray animals and spread of information about dipylidiasis among pet owners. Dogs and cats in many places in Russia breed freely, defecate outdoors in any area, and are not subjected to deworming and insect control. These circumstances favour the fact that, although this zoonosis is rare, it is a re-emerging disease and might reach important levels in Russia.

Matched MeSH terms: Zoonoses/epidemiology*
Fulltext Predictive analysis across spatial scales links zoonotic malaria to deforestation

Brock PM, Fornace KM, Grigg MJ, Anstey NM, William T, Cox J, et al.

Proc Biol Sci, 2019 Jan 16;286(1894):20182351.
PMID: 30963872 DOI: 10.1098/rspb.2018.2351

The complex transmission ecologies of vector-borne and zoonotic diseases pose challenges to their control, especially in changing landscapes. Human incidence of zoonotic malaria ( Plasmodium knowlesi) is associated with deforestation although mechanisms are unknown. Here, a novel application of a method for predicting disease occurrence that combines machine learning and statistics is used to identify the key spatial scales that define the relationship between zoonotic malaria cases and environmental change. Using data from satellite imagery, a case-control study, and a cross-sectional survey, predictive models of household-level occurrence of P. knowlesi were fitted with 16 variables summarized at 11 spatial scales simultaneously. The method identified a strong and well-defined peak of predictive influence of the proportion of cleared land within 1 km of households on P. knowlesi occurrence. Aspect (1 and 2 km), slope (0.5 km) and canopy regrowth (0.5 km) were important at small scales. By contrast, fragmentation of deforested areas influenced P. knowlesi occurrence probability most strongly at large scales (4 and 5 km). The identification of these spatial scales narrows the field of plausible mechanisms that connect land use change and P. knowlesi, allowing for the refinement of disease occurrence predictions and the design of spatially-targeted interventions.

Matched MeSH terms: Zoonoses/epidemiology*
Fulltext Risk Factors and Prediction of Leptospiral Seropositivity Among Dogs and Dog Handlers in Malaysia

Goh SH, Ismail R, Lau SF, Megat Abdul Rani PA, Mohd Mohidin TB, Daud F, et al.

Int J Environ Res Public Health, 2019 04 28;16(9).
PMID: 31035316 DOI: 10.3390/ijerph16091499

This study determined the potential risk factors that may contribute to seropositivity among dogs and dog handlers from working dog and dog shelter institutions. Data was collected from dogs (n = 266) and dog handlers (n = 161) using a standardised guided questionnaire. Serum obtained from the dogs and dog handlers was tested using the microscopic agglutination test (MAT). A logistic regression analysis was used to predict leptospiral seropositivity of dogs and dog handlers based on potential risk factors. A total of 22.2% of dogs and 21.7% of dog handlers were seropositive. The significant predictors for the dogs' seropositivity were presence of rats (OR = 4.61 (95% CI: 1.05, 20.33), p = 0.043) and shared common area (OR = 5.12 (95% CI: 1.94, 13.46), p = 0.001) within the organisation. Significant predictor for dog handler seropositivity was contact time with the dogs of more than six hours/day (OR = 3.28 (95% CI: 1.28, 8.40), p = 0.013) after controlling for the effect of other risk factors such as small mammal contact, rat infestation at home, flooding at housing area (within three months) and urban locality. The exposure to various disease sources identified poses risk to dogs and dog handlers. Risk could be reduced with adequate application of protection at work while handling dogs and thus limiting contact with these sources and reducing exposure to infection.

Matched MeSH terms: Zoonoses/epidemiology*
Fulltext Justice Is the Missing Link in One Health: Results of a Mixed Methods Study in an Urban City State

Lysaght T, Capps B, Bailey M, Bickford D, Coker R, Lederman Z, et al.

PLoS One, 2017;12(1):e0170967.
PMID: 28129409 DOI: 10.1371/journal.pone.0170967

BACKGROUND: One Health (OH) is an interdisciplinary collaborative approach to human and animal health that aims to break down conventional research and policy 'silos'. OH has been used to develop strategies for zoonotic Emerging Infectious Diseases (EID). However, the ethical case for OH as an alternative to more traditional public health approaches is largely absent from the discourse. To study the ethics of OH, we examined perceptions of the human health and ecological priorities for the management of zoonotic EID in the Southeast Asia country of Singapore.
METHODS: We conducted a mixed methods study using a modified Delphi technique with a panel of 32 opinion leaders and 11 semi-structured interviews with a sub-set of those experts in Singapore. Panellists rated concepts of OH and priorities for zoonotic EID preparedness planning using a series of scenarios developed through the study. Interview data were examined qualitatively using thematic analysis.
FINDINGS: We found that panellists agreed that OH is a cross-disciplinary collaboration among the veterinary, medical, and ecological sciences, as well as relevant government agencies encompassing animal, human, and environmental health. Although human health was often framed as the most important priority in zoonotic EID planning, our qualitative analysis suggested that consideration of non-human animal health and welfare was also important for an effective and ethical response. The panellists also suggested that effective pandemic planning demands regional leadership and investment from wealthier countries to better enable international cooperation.
CONCLUSION: We argue that EID planning under an OH approach would benefit greatly from an ethical ecological framework that accounts for justice in human, animal, and environmental health.

Matched MeSH terms: Zoonoses/epidemiology*
Fulltext Prevalence of simian malaria parasites in macaques of Singapore

Li MI, Mailepessov D, Vythilingam I, Lee V, Lam P, Ng LC, et al.

PLoS Negl Trop Dis, 2021 Jan;15(1):e0009110.
PMID: 33493205 DOI: 10.1371/journal.pntd.0009110

Plasmodium knowlesi is a simian malaria parasite currently recognized as the fifth causative agent of human malaria. Recently, naturally acquired P. cynomolgi infection in humans was also detected in Southeast Asia. The main reservoir of both parasites is the long-tailed and pig-tailed macaques, which are indigenous in this region. Due to increased urbanization and changes in land use, there has been greater proximity and interaction between the long-tailed macaques and the general population in Singapore. As such, this study aims to determine the prevalence of simian malaria parasites in local macaques to assess the risk of zoonosis to the general human population. Screening for the presence of malaria parasites was conducted on blood samples from 660 peridomestic macaques collected between Jan 2008 and Mar 2017, and 379 wild macaques collected between Mar 2009 and Mar 2017, using a Pan-Plasmodium-genus specific PCR. Positive samples were then screened using a simian Plasmodium species-specific nested PCR assay to identify the species of parasites (P. knowlesi, P. coatneyi, P. fieldi, P. cynomolgi, and P. inui) present. All the peridomestic macaques sampled were tested negative for malaria, while 80.5% of the 379 wild macaques were infected. All five simian Plasmodium species were detected; P. cynomolgi being the most prevalent (71.5%), followed by P. knowlesi (47.5%), P. inui (42.0%), P. fieldi (32.5%), and P. coatneyi (28.5%). Co-infection with multiple species of Plasmodium parasites was also observed. The study revealed that Singapore's wild long-tailed macaques are natural hosts of the five simian malaria parasite species, while no malaria was detected in all peridomestic macaques tested. Therefore, the risk of simian malaria transmission to the general human population is concluded to be low. However, this can be better demonstrated with the incrimination of the vectors of simian malaria parasites in Singapore.

Matched MeSH terms: Zoonoses/epidemiology*
Simian malarias in man: facts, implications, and predictions

Coatney GR

Am J Trop Med Hyg, 1968 Mar;17(2):147-55.
PMID: 4869108
Matched MeSH terms: Zoonoses/epidemiology*
Fulltext Plasmodium cynomolgi Infections Not Found in Microscopy-Diagnosed Malaria Cases across Sabah, Malaysia

Murdiyarso LS, Rajahram GS, Tan AF, Piera KA, William T, Oyong DA, et al.

Am J Trop Med Hyg, 2025 Jan 08;112(1):85-88.
PMID: 39531730 DOI: 10.4269/ajtmh.24-0264

Zoonotic malaria presents a major public health challenge in Southeast Asia. Plasmodium cynomolgi coinfects the same macaque hosts and mosquito vectors as the most common cause of zoonotic malaria, Plasmodium knowlesi. Plasmodium cynomolgi appears morphologically similar to Plasmodium vivax on microscopy and can amplify P. vivax polymerase chain reaction (PCR) assays, confounding transmission estimates. We screened 2,103 samples for P. cynomolgi across all 26 districts in Sabah, Malaysia, from 2010 to 2021. Samples comprised 1,425 P. knowlesi, 256 P. vivax, 293 P. falciparum, and 31 Plasmodium malariae PCR-confirmed malaria cases and 100 malaria microscopy-positive and species-specific PCR-negative samples. A nested PCR assay targeting P. cynomolgi-specific 18S small subunit ribosomal ribonucleic acid with a detection limit of ∼2 parasites/µL was conducted on whole blood samples. No P. cynomolgi infections were detected. Symptomatic P. cynomolgi co-infections appear rare in Malaysia, although prevalence may be underestimated owing to the absence of routine molecular screening and the sensitivity of available assays.

Matched MeSH terms: Zoonoses/epidemiology
The pandemic potential of Nipah virus

Luby SP

Antiviral Res, 2013 Oct;100(1):38-43.
PMID: 23911335 DOI: 10.1016/j.antiviral.2013.07.011

Nipah virus, a paramyxovirus whose wildlife reservoir is Pteropus bats, was first discovered in a large outbreak of acute encephalitis in Malaysia in 1998 among persons who had contact with sick pigs. Apparently, one or more pigs was infected from bats, and the virus then spread efficiently from pig to pig, then from pigs to people. Nipah virus outbreaks have been recognized nearly every year in Bangladesh since 2001 and occasionally in neighboring India. Outbreaks in Bangladesh and India have been characterized by frequent person-to-person transmission and the death of over 70% of infected people. Characteristics of Nipah virus that increase its risk of becoming a global pandemic include: humans are already susceptible; many strains are capable of limited person-to-person transmission; as an RNA virus, it has an exceptionally high rate of mutation: and that if a human-adapted strain were to infect communities in South Asia, high population densities and global interconnectedness would rapidly spread the infection. Appropriate steps to estimate and manage this risk include studies to explore the molecular and genetic basis of respiratory transmission of henipaviruses, improved surveillance for human infections, support from high-income countries to reduce the risk of person-to-person transmission of infectious agents in low-income health care settings, and consideration of vaccination in communities at ongoing risk of exposure to the secretions and excretions of Pteropus bats.

Matched MeSH terms: Zoonoses/epidemiology
Nipah virus fact sheet (revised in July 2009)

Wkly. Epidemiol. Rec., 2010 Feb 19;85(8):64-7.
PMID: 20210044
Matched MeSH terms: Zoonoses/epidemiology*
Outbreaks of trypanosomiasis and the seroprevalence of T. evansi in a deer breeding centre in Perak, Malaysia

Adrian MS, Sani RA, Hassan L, Wong MT

Trop Anim Health Prod, 2010 Feb;42(2):145-50.
PMID: 19642008 DOI: 10.1007/s11250-009-9406-8
Matched MeSH terms: Zoonoses/epidemiology
Fulltext Epizootology and experimental infection of Yokose virus in bats

Watanabe S, Omatsu T, Miranda ME, Masangkay JS, Ueda N, Endo M, et al.

Comp Immunol Microbiol Infect Dis, 2010 Jan;33(1):25-36.
PMID: 18789527 DOI: 10.1016/j.cimid.2008.07.008

To reveal whether bats serve as an amplifying host for Yokose virus (YOKV), we conducted a serological survey and experimentally infected fruit bats with YOKV isolated from microbats in Japan. YOKV belongs to the Entebbe bat virus group of vector unknown group within the genus Flavivirus and family Flaviviridae. To detect antibodies against YOKV, we developed an enzyme-linked immunosorbent assay (ELISA) using biotinylated anti-bat IgG rabbit sera. Serological surveillance was conducted with samples collected in the Philippines and the sera supplied from Malaysia. One of the 36 samples from the Philippines (2.7%) and 5 of the 26 samples from Malaysia (19%) had detectable ELISA antibodies. In the experimental infections, no clinical signs of disease were observed. Moreover, no significant viral genome amplification was detected. These findings revealed that YOKV replicates poorly in the fruit bat, suggesting that fruit bats do not seem to serve as an amplifying host for YOKV.

Matched MeSH terms: Zoonoses/epidemiology*
[Nipah virus infection]

Kaku Y

Uirusu, 2004 Dec;54(2):237-42.
PMID: 15745162

Nipah virus (NiV), emerged in Peninsular Malaysia, caused an outbreak of severe febrile encephalitis in humans and respiratory diseases in pigs between 1998 and 1999. By May of 1999, the death of 105 humans and the culling of about 1.1 million pigs were reported. Fruitbats of Pteropid species were identified as the natural reservoir hosts. The epidemiological studies suggested that NiV was introduced into pig farms by fruitbats, and was than transmitted to humans (mainly pig farmers) and other animals such as dogs, cats and horses. In 2004, NiV reappeared in Bangladesh with greater lethality. In contrast to the Malaysia case, epidemiologic characteristics of this outbreak suggested the possibility of fruitbats-to-person, or person-to-person transmission. In this article, the epidemiological comparison between two outbreaks in Malaysia and Bangladesh, and the new-trends of virological studies of NiV will be discussed.

Matched MeSH terms: Zoonoses/epidemiology*

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