One Health

This course is last course of  the One Health tracking at the Danish veterinary education

'One Health' is a methodological approach which implies interdisciplinary collaboration, joint efforts and communication in all aspects of veterinary and public health aiming to protect humans, animals and the environment. Examples of recent challenges requiring a One Health approach include the Avian Influenza epidemics and spread of antimicrobial resistance which have both highlighted the importance of close collaboration between the medical-, veterinary-, food and agriculture sectors in the prevention and control efforts. Furthermore, experience has shown that collaboration between the research community, authorities, industry and other stakeholders are essential in prioritizing decision making and ensuring timely and effective prevention and control.

The overall objective of this course is that the participants aquire an in-depth knowledge about the One Health approach when solving national, regional as well as global challenges, with special focus on health problems associated with the spread of pathogens between animals and humans ('zoonoses'). This includes laboratory characterization of pathogens, e.g. molecular typing, epidemiological methods used in surveillance, outbreak investigations and mapping of zoonotic pathogens and antibiotic resistance. Through case work the participants will learn how to develop systematic, stepwise approaches into cost-efficient and sustainable disease control programmes based on evidence from literature and new/own investigations of zoonotic diseases. Approaches to handling both foodborne (e.g. salmonella, campylobacter, VTEC 0157), waterborne (e.g. cryptosporidia) and air-, vehicle or vector-borne pathogens (e.g. West Nile Fever, Q-fever) will be addressed during the course.

Didactic principle: Learning will mainly occur through active participation in problem-based group work and practical exercises, and course participants will to a large extend be expected to seek literature and other types of relevant information to solve cases using One Health approaches in practice. The cases and challenges will be chosen according to current challenges faced not just in Denmark, but also by international organisations such as WHO, FAO and ECDC both in Europe and in developing countries. The selected cases will be used to exemplify control and prevention of zoonoses with different levels of knowledge about pathogenesis, occurrence and transmission, and different availability of diagnostic methods and treatment or intervention options. Course participants will not only learn scientific methods, but also be encouraged to practice and develop skills required for taking leadership in groups aiming to solve problems in the often complex One Health settings.

Course structure: The course is organised as follows:

Course week 1 (block week 5 of block 3): Introduction to One Health and zoonoses
Introduction to One Health and exemplification of One Health approaches to zoonoses control, incl. historical perspectives and the added value of One Health.
Introduction to translational medicine and the distinction between One Health and One Medicine.
Introduction to Danish and international stakeholders and their roles in One Health disease approaches, e.g. examples of how Danish veterinarians are involved.
International organisations relevant to veterinary and public health.
Code of conduct, legislation, practices.
Burden assessment methods and burden estimates of major zoonoses.
Risk analysis elements: Risk assessment, risk communication and risk management.

Course week 2-4 (block week 6-8 of block 3): Laboratory typing methods and tracing of zoonotic pathogens
Laboratory methods for typing of pathogens such as MRSA, salmonella, campylobacter.
Detection of transmission routes and tracing methods
Outbreak investigations

Disease burden estimation
Mechanisms and methods for detection of drug resistance
Introduction to group case.

Course week 5-7 (block week 9 in block 3 and 1-2 in block 4): Step-wise strategy for disease control
Elements of importance for successfull disease control programmes
Criteria for eradication of infectious diseases
Leadership, organisation and communication in One Health challenges
Exemplification of the methods learned so far in the course on a specific case run as a multi-day scenario (e.g. Danish experience with control of Salmonella and antibiotic resistance; a Q-fever outbreak)
Strategies for control of neglected zoonotic diseases
Development of algorithms for disease control
Case study on control and elimination of parasitic zoonoses in developing countries (e.g. Taenia solium cysticercosis)
Submission of group report.

Course week 8-12 (block week 3-7 of block 4): Individual case report work and elective activity
Individual report for two weeks on self-selected case (~3 ECTS)
The individual case report must demonstrate a good understanding and ability to apply the elements learned in the course.
The individual case report must be submitted before the end of block week 8 in block 4.

Three weeks are available for 'elective activity' (~ 4 ECTS)

Time spent on individual case report and elective activity(ies) is up to the course participants to organise and agree with their respective groups mates.

The 'elective activity' is a very flexible course element that allows participants to follow relevant course activities offered elsewhere; visits to other countries for relevant work/projects/practical experience (e.g. practical work with One Health projects in developing countries); or internships (external practise training, EPT) at Danish or foreign institutions/industries, international organisations, universities abroad, etc. The activities performed during this period must be recorded (e.g. logbook or small report). Through this elective activity the students will obtain experience in how private and public institutions work with different One Health challenges. The elective activity must be pre-approved by the course responsible or a relevant supervisor appointed by the course responsible.

Oral exam in course week 9 (block week 4 of block 4) based on submitted group report, presentations and opponent performance for other reports and group presentations. The course participants will be assessed on both their own work (written report and oral presentation) and their ability to critically evaluate and provide constructive critiscism to other course participant's written work and oral presentations (see also exam details).