Economic loss occurring due to zoonotic disease in Humans and Dairy animals: A status review in India
Authors: Dr. H. R. Meena and A. P. Verma
Dairy Extension Division ICAR-NDRI, Karnal-132001

Zoonotic diseases and human health are matter of particular concern in India because near about 68% of India’s workforces are in direct close contact with domestic animals, and often not far from wild ones. Their activities, such as working with animals, in their sheds, improper disposal of waste material from animal sheds, skinning of infected animals, slaughtering of diseased animals, disposal of infective diseased animals, and poor personal hygiene practices, have been one of the important risk factors. Besides apart from the mortality and morbidity they cause, zoonoses are responsible for huge economic losses, particularly in dairy animals, meat, milk, and other foods and products of animal origin. The developing countries suffer much more than do the industrialized developed countries, partly because they have less well-developed infrastructure on public health care and veterinary services and also because of their unfavorable climatic and environmental conditions. Lack of awareness about the occurrence of zoonotic dis-eases, lack of knowledge on disease incidence factor, lack of preventive health behaviour and their impact on public health have also acted as a major hurdle in commencing adequate and effective control measures (Asokan, et al. 2011).


What is Zoonotic Disease?

Zoonotic diseases are those diseases and infections that are naturally transmitted between vertebrate animals and men with or without an arthropod intermediates. It is Infections that are naturally transmitted from vertebrates’ animals to humans and human to animal and also from human to human are classified as zoonoses (WHO 2007; Plamer et al. 1998). These zoonotic diseases represent one of the major leading causes of illness and death from infectious diseases (PAHO, 2001).

CLASSIFICATION
A. Bacterial zoonoses e.g. anthrax, brucellosis, plague, leptospirosis, salmonellosis, lyme disease.
B. Viral zoonoses e.g. rabies, arbovirus infections, KFD, yellow fever, influenza.
C. Rickettsial zoonoses e.g. murine typhus, tick typhus, scrub typhus, q-fever.
D. Protozoal zoonoses e.g. toxoplasmosis, trypanosomiasis, leishmaniasis .
E. Helminthic zoonoses e.g. Echinococcosis (hydatid disease), Taeniasis, Schistosomiasis, Dracunculiasis.
F. Fungal zoonoses e.g. Deep mycosis - Histoplasmosis, Cryptococcosis, Superficial dermatophytes.
G. Ectoparasites e.g. Scabies, Myiasis.

Burden of Zoonotic disease

Infectious diseases account for 29 out of the 90 major causes of human morbidity and mortality listed by the World Health Organization and the World Bank (Murray and Lopez, 1996) and 25% of global deaths (over 14 million death annually). According to World Health Organization more than 1.4 billion people are at potential risk of rabies infection in the South-East Asia Region. Each year, 23,000-25,000 people die in the SEA Region due to rabies. This accounts for approximately 45% human deaths due to rabies worldwide. However, the actual numbers are not known since all cases of rabies are not notified or reported. It is estimated that 3.8 million patients receive post-exposure rabies prophylaxis (PEP) after being exposed to animals that are suspected of rabies annually in these countries.

Incidence of Rabies in India

• Bites by rabid domestic dogs cause 99% of human rabies deaths (WHO Rabies Fact Sheet, September 2011).
• Roughly 36% of the world’s rabies deaths occur in India each year, most of those when children come into contact with infected dogs (Bulletin of the World Health Organization, 2009).
• Rabies continues to be a serious health problem in the country. Approximately 30,000 deaths due to rabies are estimated to occur every year while more than 1.8 million persons bitten by suspected rabid animals seek antirabic vaccination at rabies treatment centre’s (NICD, 2005). The actual number of bites may be three times of this.
• WHO reports also revealed that around 50 000 rabies deaths every year, out of which 20 000 are estimated to occur in India alone. Human deaths from rabies are likely to be grossly underreported, particularly in the youngest age groups. In India, early estimates of rabies mortality have been based on regional hospital data projected to the total population of the country. Rabies is a disease of low public health priority and there is no national program for its control and elimination.
• The National Multicentric Rabies Survey, conducted in 2004 by the Association for Prevention and Control of Rabies (APCR) in India in collaboration with the World Health Organization, estimated annual human rabies deaths incidence to be 20 565 deaths from rabies per year. Most animal bites in India (91.5%) are by dogs, of which about 60% are stray and 40% pet. The incidence of animal bites is 17.4 per 1000 population. A person is bitten every 2 seconds, and someone dies from rabies every 30 minutes.

Incidence of Brucellosis in India

Brucellosis is one of the world’s major zoonoses that still are of veterinarian, public health and economic concern in many parts of the world. In India brucellosis disease ranging from 6.5% to 16.4% in different species of livestock (Lone et al., 2013). Brucellosis is being considered as an important economic concern (ILRI, 2012) with losses occurring in the human, livestock and wildlife populations. However, most data and evidence on the economic burden of brucellosis and benefits of its control are from the developed world even though the losses are believed to be higher in the developing countries (McDermott et al., 2013). In livestock, brucellosis results in reduced productivity, abortions and weak offspring and is a major impediment for trade and export. Almost all domestic species can be affected. Human brucellosis is a severely debilitating disease that requires prolonged treatment with a combination of antibiotics often leaving permanent and disabling sequelae, and results in considerable medical expenses in addition to loss of income due to loss of working hours.

Brucellosis is one of the highly contagious reproductive diseases of dairy animals and highly prevalent among bovine population of the country (Patel et al., 2014) thus leading to an annual economic loses to the tune of US$ 58.8 million (Kollannur et al., 2007). The economic losses are because of abortions, stillbirths, reduced milk production, infertility (McDermott and Arimi, 2002) and revenue losses due to international trade impediment for animals and their products. Brucellosis is also the second most important zoonotic disease of the world after rabies (FAO, 2005). In India brucellosis alone is estimated to cause annual loss of approximately 30 million man days. Approximately 80% of India’s population lives-in rural areas in close contact with large domestic animal population (512.05 million approximately) abundance of vectors because of suitable climate, low socio-economic conditions and lack of proper medical care, zoonotic diseases assume great public health significance. However, because of inadequate diagnostic facilities, unfamiliarity of physicians with these diseases and lack of co-ordination between physicians, veterinarians, and epidemiologist, the extent of their existence is obscured (NICD 2005).

Incidence of human brucellosis in India

Brucellosis is one of the most common laboratory acquired infections mostly because aerosolization is a mechanism of transmission in this setting (Robichaud et al, 2004). It is found that more than 60% of the patients with brucellosis had a history of both consumption of fresh goat’s milk and close animal contact. The habit of consuming fresh goat milk to obtain relief from chronic ailments was also noted (Mantur et al., 2004). Human brucellosis was recognized in India in 1942 (Renukaradhya et al., 2002) and high clinical suspicion must be made in patients especially when there is history of animal contact or consumption of unpasteurized milk (Gokhale et al., 2003). The disease is acute in about half the cases, with an incubation period of 2-3 weeks. In the other half, the onset is insidious, with symptoms developing over a period of weeks to months from the infection. This zoonosis is a significant public health problem in India, the magnitude of which is not known. Due to lack of clinico-epidemiologic data hampers control strategies. Persistence of animal reservoir, low physician awareness, poor availability of diagnostic facilities, and the non-existence of regional data bases contribute towards the perpetuation of zoonosis in India. (Handa et al. 1998). It is reported that fewer than 10% of the human cases of brucellosis may be clinically recognized and treated or reported in India (Mantur et al., 2007).

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About Author / Additional Info:
I am currently working as Senior Scientist in Dairy Extension Division, ICAR-National Dairy Research Institute, Karnal-132001 Haryana (India). I have also worked with ICAR-Indian Veterinary Research Institute, Izatnagar-243122 Bareilly, Uttar Pradesh (India) as Scientist for 10 year. Also a recipient of the ICAR’s prestigious "The Swami Sahajanand Saraswati Outstanding Extension Scientist Award" in social science.