No 4 - 2020

Statens Serum Institut is now a One-Health institute

In 2017, acting together as Danish Veterinary Consortium (DK-VET) , the University of Copenhagen (UCPH) and Statens Serum Institut (SSI) won a competitive tender to provide veterinary public sector consultancy services for the Ministry of Environment and Food of Denmark; a task that was previously provided by the Technical University of Denmark (DTU).

In 2018, DK-VET, DTU and the Danish Veterinary and Food Administration agreed on a gradual handover of the tasks. Thus, the handover was accomplished stepwise in the course of 2019, as DK-VET took over evermore consultancy and diagnostics tasks and also employed various DTU staff members. On 1 January 2020, the Consortium concluded its takeover of all preparedness tasks, thereby assuming full responsibility for veterinary preparedness services in Denmark.

The public sector consultancy services include research, consultancy, monitoring and preparedness tasks within the following fields: serious infectious diseases affecting livestock animals, avian influenza, and other zoonotic and enzootic (commonly occurring in domesticated animals) virus infections, antibiotic resistance, infestations and diseases in wild animals, fish, crustaceans and double-shelled molluscs. The latter is achieved in close collaboration with DTU Aqua through the newly established Danish Centre for Aquatic Animal Health (DACAH).

The Department of Veterinary Sciences (IVH) handles the UCPH end of the collaboration. At the SSI, the collaboration embraces all infection preparedness services and various service functions. The veterinary field has been integrated into the existing departments and laboratories where new veterinary staff members have been employed. A new laboratory building for highly classified veterinary pathogens is being built and is expected to be ready for use by the end of 2020.

As part of the agreement to provide veterinary public sector consultancy services, the SSI was appointed national veterinary reference laboratory. Concurrently, the Institute remains responsible for national monitoring, diagnostics and preparedness-associated research in the human field. This means that Denmark now has in place a joint human and veterinary preparedness programme allowing us to reap the benefits of synergies relating to laboratory facilities and knowledge about the prevalence and spreading of diseases. It also means that the SSI is now officially a One-Health institute

Joining forces with the UCPH is an advantage in this context as DK-VET overall brings expertise from the veterinary as well as the human field. This combination creates a unique opportunity to meet preparedness requirements by applying a One-Health approach, i.e., a comprehensive view encompassing humans, animals and the environment, while keeping in mind the needs of authorities, industry and society. In the current vision for veterinary preparedness services, the SSI holds an obligation to provide guidance for the Danish Veterinary and Food Administration based on a One-Health mindset that takes into account humans, animals and the environment when providing research-based guidance.

What is One Health?

One Health is the idea that health should be understood based on knowledge about the surrounding world and not exclusively based on knowledge about animals or humans. The starting point in One Health is the understanding that human health, animal health and conservation of the environment are interconnected, and the approach is based on collaboration between various professions. 

One Health was initially developed as strengthened cooperation between the human medicine world and the veterinary medicine world. Today, One Health increasingly comprises other disciplines including, among others, environmental science, food science, climate research and the social and behavioural sciences.

Why is One Health relevant?

One Health is relevant because 75% of all newly emerging infections are zoonotic - caused by virus, bacteria and parasites that can be transmitted between animals and humans. This occurs in interaction with other factors, e.g., changes in production systems, climate changes, demographic changes and rising human exploitation of natural resources. A very recent example of this interaction is the detection of the new corona virus in Wuhan, China, where the infectious reservoir is presumably a - currently unidentified - animal, EPI-NEWS 3/20.

Transmission of resistance genes and spreading of resistant bacteria between animals and humans and in the environment are also a very important part of the overall antibiotics resistance problem.

Therefore, One Health is necessary to prevent and fight resistance.

Furthermore, to ensure careful monitoring of diseases and risk assessment, multidisciplinary co-operation is important. However, One Health is also an important approach because disease processes in animals and humans are similar in many respects. Over time, researchers have learned much from each other by studying the similarities and differences between diseases in humans and in various animal species.

Ongoing One-Health activities at the SSI

The One-Health approach is not new to the SSI. For a number of years, the SSI has dealt with topics that are not limited to the human field. Examples hereof include that:

• the SSI participates in the DANMAP co-operation, which integrates monitoring of antimicrobial consumption and resistance among animals and humans.
• the SSI conducts research into how resistant bacteria spread, including the role of antibiotics consumption in the development of resistance.
• the SSI forms part of the Central Outbreak Group. This group coordinates efforts related to food-borne outbreaks; and in addition to the SSI, the group counts the participation of the Danish Veterinary and Food Administration and DTU Food.
• the SSI monitors a considerable number of zoonotic infections and collaborate with other disciplines in this context. The majority of new infections affecting humans are zoonotic.
• the SSI operates the Livestock MRSA Consultancy Service at the joint request of the Danish Ministry of Health and the Ministry of Environment and Food of Denmark.
• the SSI focuses on climate-caused changes in the prevalence of diseases transmitted by insects and ticks, and on changes in the epidemiology of water and food-related conditions.

New One-Health activities at the SSI

The takeover of the veterinary field has triggered a number of new One-Health initiatives at the SSI. To take an example, following the takeover of the veterinary preparedness services, the reference laboratories for human and animal influenza have been merged. This provides a unique opportunity to implement One Health in an area that demands considerable attention in relation to zoonotic transmission and the risk of new pandemics. The most recent influenza epidemic in 2009 occurred due to swine influenza virus that had mixed genes, and subsequently transmitted to humans. The joint monitoring of veterinary and human influenza viruses produces a joint expertise that will allow us to remain very well prepared professionally for any new situation in the influenza field. This makes good sense, particularly in Denmark; compared with the human population, Denmark thus has one of the largest pig populations in the world.

Additionally, the SSI participates in a range of One-Health research projects. Examples of some of these projects are described below.

FluZooMark

The SSI is a partner in an ambitious influenza research centre. FluZooMark (website under construction at fluzoomark.dk) is an influenza-focused One-Health centre aiming to identify factors that determine whether influenza virus can cross the inter-species host barrier and therefore cause zoonotic transmission and future pandemics. The research projects will study influenza viruses and examine growth factors in pigs and humans that may influence if an influenza virus can transmit from one animal species to another and therefore has pandemic potential. Additionally, research will be conducted to develop DNA vaccines that may stop a pandemic virus from spreading. The project’s results will generate knowledge that may help predict future influenza epidemics and design new enhanced vaccines. The Centre is funded by the Novo Nordisk Foundation and counts the following partners: UCPH (heads the Centre), SSI, DTU and St. Judes Children´s Research Hospital, Memphis, USA.

One-Health EJP

The SSI participates in the One-Health European Joint Programme, an ongoing 5-year (2018-2022) co-financed Horizon2020 programme with a 90 million Euro budget. One-Health EPJ is a cross-sectorial network counting 37 partners from 19 countries that focuses on effective science-to-policy dissemination of results to both the national and the EU level. The SSI’s researchers are participating in 18 research and integration projects under the programme and serve as the coordinator of six projects. Additionally, the SSI is engaged in the Project Management Team and holds key roles in relation to science-to-policy activities, cooperation with the ECDC (the European Centre for Disease Prevention and Control) and the EFSA (The European Food Authority), and coordination of One-Health EJP’s annual scientific congresses.

An example of a One-Health EJP research project is TOXOSOURCES, which is coordinated by the SSI. The consortium is comprehensive, consisting of 20 EJP partners and eight external partners. TOXOSOURCES focuses on the Toxoplasma gondii parasite that causes toxoplasmosis. Toxoplasmosis is a zoonosis and therefore important for veterinary as well as human medicine. The many routes of infection of T. gondii include ingestion of insufficiently heat-treated meat from infected animals, ingestion of oocysts excreted by infected cats and transplacental transmission.

TOXOSOURCES explores which sources of infection cause toxoplasmosis in humans and how large the contribution is from each source of infection. The project will work with models based on existing data, multicentre studies that study ready-to-eat salad as a potential source of infection, and the development of serological methods and typing methods. To take an example, TOXOSOURCES explores the usefulness of serology based on oocyst-specific antigens, e.g., serology capable of distinguishing different sources of infection. Additionally, TOXOSOURCES develops typing methods that will enhance our preparedness capacity for detecting import of atypical and potentially more virulent variants of T. gondii and the tracing of sources of infection during outbreaks. By adopting various multidisciplinary approaches, TOXOSOURCES will generate more knowledge about the infection’s epidemiology and about sources of infection, risk factors - and prevention - in Denmark and Europe.

ORION is another example of a One-Health EJP project in which the SSI participates. ORION is a so-called integrative project, meaning that the project does not conduct research. Rather, its objective is to establish and strengthen collaboration between institutions and to bolster inter-disciplinary knowledge exchange relevant to the integration and interpretation of One-Health monitoring data. The project counts 13 partners from both the veterinary and the human sector in seven European countries. The involved partners are all engaged in establishing “best practice” One-Health monitoring, which, in part, consists in describing and collecting guidelines, methods, resources and knowledge in the field of One-Health monitoring. In Denmark, the SSI has established a co-operation with DTU Food to develop a template describing how we may monitor diseases of importance from a One-Health perspective. The template is based on a practical example: Danish monitoring of the zoonotic bacterium Campylobacter jejuni with components from both the veterinary and human sector. This includes, among others, doctors’ notification of diagnosed human campylobacter cases; various samples taken from chickens, abattoirs and chicken meat; the possible associations and potential of prevention; and a detailed description of the data collected. The template can easily be adjusted to allow for additional monitoring components.

For more information about One Health and the SSI’s One-Health activities, please see the SSI website .

(P. Jokelainen, L.S. Vestergaard, R. Trebbien, U.C. Braae, K.G. Kuhn, H. Rosenquist, K. Mølbak, Infection Preparedness)