Zoonoses in the Mediterranean Area
Professor National School Of Public Health
The Mediterranean area is an interesting part of the earth from every point of view. It is the birth land of cultures and human activities going back to the depth of history. The climate conditions are representative of almost the whole earth. The flora and the fauna are also so variable that except from penguins all other animals are present. Such a blessed area is natural to be the crossroad and the main pass of many nations as well as animal species and the wider area of the Mediterranean to be the cradle of civilization. However, the last centuries of the previous millennium a new and unfortunately unfavorable historical cycle began for the nations of the area. The center of letters, arts and philosophy became the battlefield of every kind (political, religious and military) with dramatic consequences on the quality of life, the health and the welfare of people. The situation was deteriorated even more after the two World Wars and the regional conflicts, which unfortunately still continue.
As a result of this situation the area is also interesting nowadays from the epidemiological aspect of view. More specific and regarding the zoonoses, the world community (WHO-World Health Organization) taking into consideration on the health problems of the area, established in 1978 the Mediterranean Zoonoses Control Center, which has its seat in Greece.
More than 200 different zoonoses have been reported from the area. These were previously classified as native and exotic. Nowadays, because of the means of transportation and the easy, quick and frequent movements of the human populations, the animals and the products the spread and the epidemiology of these diseases has been modified and such a classification is not applicable.
Migration of persons and animals
Density of: human populations, domestic animals, synanthropic animals, wild animals
Types of farming
Presence and type of sheep and goat farming
Pig rearing of the family type
Presence of stray dogs
COMPANION ANIMALS AND ZOONOSES
The most important of the zoonoses that are related directly (contact, bites) or indirectly (arthropods, pollution of the environment, infected objects) to the dogs and cats and are transmitted by these animals are presented in the following table. It is worth mentioning that this list instead of being shortened, it has unfortunately been elongated in nowadays.
Diseases acquired from Dogs and Cats
ZOONOSES ACQUIRED FROM DOGS AND CATS IN THE MEDITERRANEAN AREA
Echinococcosis-Hydatidosis (E. granulosus), Rabies (urban type), Leishmaniosis (Leishmania infantum), Toxoplasmosis (Toxoplasma gondii) and certain Rickettsial related diseases such as Q Fever (Coxiella burnetti), Bounoneses Fever (Rickettsia conorii) and Cats Scratch Disease (Bartonella/Rochalimaea henselae) are considered to be zoonoses of great importance in the Mediterranean Area.
Lyme Disease, Granulocytic Ehrlichiosis, Dirofilariosis (Dirofilaria immitis, Dirofilaria repens), Visceral and Cutaneous Larva Migrans (Toxocara canis, Toxocara cati), Leptospirosis (Leptospira canicola), Brucellosis (Brucella canis, Brucella melitensis and Brucella suis) and Cryptosporosis (Cryptospora neoformans) and Pasteurellosis from bites (Pasteurella multocida) are of minor importance.
Finally, dermatophytiasis, (Microsporum canis) and scabies (Sarcoptes scabiei) are even less important zoonoses.
The evaluation of zoonoses as presented above is more or less arbitrary because cases are not constantly reported and the epidemiological data for human diseases are not reliable. This holds true even for the most important zoonoses like Rabies, Brucellosis, Hydatidosis and Leishmaniosis. More conclusions could be drawn from the epidemiological surveys on animals, which are more frequent due to the improvements in veterinary care in companion animals or their implications in farm animals (Hydatidosis, Q Fever, Toxoplasmosis).
CONTROL OF ZOONOSES
Zoonoses are considered to be an important problem for Public Health. Unfortunately, the true Public Health significance is unknown or rather unclear in many countries because of lack of appropriated programs of surveillance and in particular of diagnostic laboratories and wherever they exist there is no proper coordination and evaluation of their results. Furthermore, although in 1978 in Alma Ata decision the intrasectoral cooperation was considered to be the more essential element for effective control of zoonoses, in most of the countries Human and Veterinary Public Health Departments do not act simultaneously. Many programs have failed because it was felt that either a Human or Veterinary Public Health organization alone, at the national level would solve the problem as reported by the Mediterranean Center of Zoonoses to WHO.
It is therefore necessary, on the occasion of the present Congress to reconsider the role of the veterinarians in the protection of Public Health, to promote the intrasector cooperation and taking advantage of the technological means to decrease the implications of zoonoses in our area.