Control small diseases to be ready for big ones

Our Expert Voices conversation on emerging diseases.

The source of the next big zoonotic disease will hardly be a surprise. It will likely be from already known hotspots where people and animals live in close contact – many of which are in Asia and Africa.

Like preparing for a big soccer game, a team must practice with whichever home teams are available before the big-game team arrives. In many emerging disease hotspot areas, rabies — an exemplar viral zoonotic disease transmitted directly from infected dogs to humans — is endemic. To control rabies, health care workers must collaborate with their veterinary colleagues, share disease intelligence and execute coordinated responses against the arguably most lethal infectious disease. Health care systems that can detect and report rabies human cases, can detect and are better prepared for the next Ebola epidemic.

Bottom line: I work as an epidemiologist in East Africa at the forefront of rabies elimination. Investments in surveillance, response and prevention of rabies, and other endemic zoonotic diseases are our best bet preparing for the next big zoonotic disease. It is the practice that makes us better and effective during the big match.

Other voices in the conversation:

• Anne Rimoin, epidemiologist, UCLA: Watch where people and animals interact
• Justin Lessler, epidemiologist, Johns Hopkins University: It's not where a virus comes from but how it becomes contagious
• Kevin Olival, ecologist, EcoHealth Alliance: There are 5,000 places to look