The authors, key functionaries in the Kerala state Public Health system, reviews the communicable disease scenario of the state for the past four years, and in the background of the One Health concept, opines that the re emerged discipline is perfectly in tune with the current challenges of the state.
The unique model of Kerala state is witnessing newer challenges in in its Public Health arena: the rapidly increasing migrant workforce from relatively poorer states of India, rapid urbanization and its consequent stress on public health, unsolved issues of urban waste disposal, re emergence of many communicable diseases like malaria, more so, the falciparum type, emergence of many zoonotic diseases like Lyme disease, Scrub typhus, and Kyasanur forest disease etc. Conventional zoonotic infections like Anthrax and Brucellosis remains potential threat for human health as well. Rabies continued to cause major concern from mortality point of view as well as major drainer of states budget every year.
Leptospirosis has remained major burden among the communicable disease for the past 10 years, and the annual incidence ranged from 2 to 7 per 100,000 population. Having a large section of its people working in various agriculture and animal rearing occupations, the state has all risk factors for propogation of Leptospirosis, but lacks inter disciplinary collaboration in its control and prevention area, the authors highlights major avenues for collaboration.
Japanese Encephalitis appeared as an epidemic in 2011 in two of the southern districts in Kerala, one of the district being a famous tourist spot for both humans as well as migrant birds. There is ample scope for collaborative research on the source of the virus, and in the subsequent years, the disease had been detected in more districts.
Lyme disease, was reported for the first time in India, from one of the districts in Kerala, promptly investigated by a joint team from human public health and veterinary public health institutions in 2013, reiterating the effectiveness of interdisciplinary collaboration in outbreak investigations.
Food borne infections had been frequent in the state, but despite having many tertiary care centers, there is deficiency of laboratories capable of conducting comprehensive diagnostic tests to identify the infective organisms, which can be easily supplemented by the better equipped microbiological laboratories under the Veterinary sectors, if mutually agreed pathway is identified.
Influenza had been evolving rapidly in the state from the seasonal type earlier, to H1N1 since past few years, now poised for an emergence of MERS Corona and still expected are the more fatal and highly pathogenic types. The migratory bird-pig-domestic birds-human interface being a well knit network in the state, is most suitable for all new variants of influenza virus evolution. Outbreaks of these infectious diseases having great impacts on both human and animal life, necessitates investigations by combined teas from Human Health, Animal Heath and Wild life departments.The One Health concept thus becomes appropriate to address such public health situations. The authors have concluded by identifying probable avenues for such collaborative works in addressing the public health challenges of Kerala state, India.
Key words: One Health, platform for intervention, Kerala state, epidemiological transition, re emerging diseases, emerging zoonotic infections, Leptospirosis, serovar identification, Japanese Encephalitis, migratory birds, Rabies, Anthrax, Brucellosis, Influenza, Food borne infections, Kyasanur forest disease, collaboration in laboratory confirmation, man animal and environment philosophy.
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