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VOLUME ONE HUNDRED AND SEVENTEEN
ADVANCES IN
PARASITOLOGY
SERIES EDITOR
D. ROLLINSON J. R. STOTHARD
Life Sciences Department Department of Tropical
The Natural History Museum, Disease Biology
London, United Kingdom Liverpool School of Tropical
d.rollinson@nhm.ac.uk Medicine, Liverpool, United Kingdom
russell.stothard@lstmed.ac.uk
EDITORIAL BOARD
T. J. C. ANDERSON K. KING
Department of Genetics, Texas Department of Zoology,
Biomedical Research Institute, University of Oxford,
San Antonio, TX, United States Oxford, United Kingdom
M. G. BASÁÑEZ M. G. ORTEGA-PIERRES
Professor of Neglected Tropical Professor of the Department of Genetics
Diseases, Department of Infectious and Molecular Biology,
Disease Epidemiology, Faculty of Centro de Investigación y de
Medicine (St Mary’s Campus), Estudios Avanzados IPN,
Imperial College London, Mexico City, Mexico
London, United Kingdom
D. L. SMITH
D. D. BOWMAN Johns Hopkins Malaria Research
Director Cornell CVM MPS—Veterinary Institute & Department of Epidemiology,
Parasitology, Professor of Parasitology, Johns Hopkins Bloomberg School
C4-119 VMC, Dept Micro & Immunol, of Public Health, Baltimore,
CVM Cornell University, Ithaca, MD, United States
NY, United States
R. B. GASSER R. C. A. THOMPSON
Head, WHO Collaborating Centre
Faculty of Veterinary and Agricultural
for the Molecular Epidemiology
Sciences, The University of Melbourne,
of Parasitic Infections, Principal
Parkville, VIC, Australia
Investigator, Environmental
A. L. GRAHAM Biotechnology CRC (EBCRC),
Professor of Ecology & Evolutionary Biology, School of Veterinary and Biomedical
Co-Director of the Global Health Program, Sciences, Murdoch University,
Princeton University, Princeton, Murdoch, WA, Australia
NJ, United States
X.-N. ZHOU
J. KEISER Professor, Director, National Institute of
Head, Helminth Drug Development Unit, Parasitic Diseases,
Department of Medical Parasitology and Chinese Center for Disease Control
Infection Biology, Swiss Tropical and Public and Prevention, Shanghai,
Health Institute, Basel, Switzerland People’s Republic of China
VOLUME ONE HUNDRED AND SEVENTEEN
ADVANCES IN
PARASITOLOGY
Edited by
DAVID ROLLINSON
Life Sciences Department
The Natural History Museum,
London, United Kingdom
RUSSELL STOTHARD
Department of Tropical
Disease Biology
Liverpool School of Tropical
Medicine, Liverpool, United Kingdom
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ISBN: 978-0-323-98949-7
ISSN: 0065-308X
Contributors vii
v
vi Contents
Vahab Ali
Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry,
ICMR-Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna,
Bihar, India
Sachidananda Behera
Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry,
ICMR-Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna,
Bihar, India
Stefan Biendl
Swiss Tropical and Public Health Institute, Department of Medical Parasitology and
Infection Biology; University of Basel, Basel, Switzerland
Jo Cable
School of Biosciences, Cardiff University, Cardiff, Wales, United Kingdom
Asif Equbal
Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry,
ICMR-Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna;
Department of Botany, Araria College, Purnea University, Purnia, Bihar, India
Danny Govender
SANParks, Scientific Services, Savanna and Grassland Research Unit, Pretoria; Department
of Paraclinical Sciences, University of Pretoria, Onderstepoort, South Africa
Jennifer Keiser
Swiss Tropical and Public Health Institute, Department of Medical Parasitology and
Infection Biology; University of Basel, Basel, Switzerland
Afreen Nawaz
Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry,
ICMR-Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna,
Bihar, India
Krishna Pandey
Department of Clinical Medicine, ICMR-Rajendra Memorial Research Institute of Medical
Sciences (RMRIMS), Patna, Bihar, India
Alexandra Probst
Swiss Tropical and Public Health Institute, Department of Medical Parasitology and
Infection Biology; University of Basel, Basel, Switzerland
Isa-Rita M. Russo
School of Biosciences, Cardiff University, Cardiff, Wales, United Kingdom
Anya V. Tober
School of Biosciences, Cardiff University, Cardiff, Wales, United Kingdom
vii
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CHAPTER ONE
Contents
1. Introduction 2
2. The ‘Microscopic Five’ 4
2.1 Bovine tuberculosis 7
2.2 Rift Valley fever 7
2.3 Brucellosis 8
2.4 Cryptosporidiosis 8
2.5 Schistosomiasis 9
3. Challenges of BTb control at the wildlife-livestock interface: The South African
case study 10
3.1 Control in livestock 10
3.2 Control in wildlife 10
4. Drivers of disease: The Kruger National Park case study 13
4.1 Past and present disease management 13
4.2 Kruger National Park’s current adaptive management approach 14
4.3 Environmental drivers of disease transmission 15
4.4 Anthropogenic drivers of disease transmission: Wildlife-livestock-human
interface 23
5. Disease knowledge gaps and lessons learnt from African protected areas 28
6. Communities and conservation 33
7. Conclusions 35
Acknowledgements 37
References 37
†
Authors contributed equally to this work.
Abstract
African protected areas strive to conserve the continent’s great biodiversity with a
targeted focus on the flagship ‘Big Five’ megafauna. Though often not considered,
this biodiversity protection also extends to the lesser-known microbes and parasites
that are maintained in these diverse ecosystems, often in a silent and endemically sta-
ble state. Climate and anthropogenic change, and associated diversity loss, however,
are altering these dynamics leading to shifts in ecological interactions and pathogen
spill over into new niches and hosts. As many African protected areas are bordered by
game and livestock farms, as well as villages, they provide an ideal study system to
assess infection dynamics at the human-livestock-wildlife interface. Here we review
five zoonotic, multi-host diseases (bovine tuberculosis, brucellosis, Rift Valley fever,
schistosomiasis and cryptosporidiosis)—the ‘Microscopic Five’—and discuss the
biotic and abiotic drivers of parasite transmission using the iconic Kruger National
Park, South Africa, as a case study. We identify knowledge gaps regarding the impact
of the ‘Microscopic Five’ on wildlife within parks and highlight the need for more
empirical data, particularly for neglected (schistosomiasis) and newly emerging (cryp-
tosporidiosis) diseases, as well as zoonotic disease risk from the rising bush meat
trade and game farm industry. As protected areas strive to become further embedded
in the socio-economic systems that surround them, providing benefits to local com-
munities, One Health approaches can help maintain the ecological integrity of eco-
systems, while protecting local communities and economies from the negative
impacts of disease.
1. Introduction
As we enter the sixth mass extinction, protecting the world’s bio-
diversity has never been more critical. Protected areas, including national
parks, cover over 18.8 million km2 and are at the forefront of a global effort
to safeguard biodiversity (Chape et al., 2003). Managers of these protected
areas must strike a balance between protecting the ecological integrity of
ecosystems and preventing exploitation of local resources while promoting
their use in education and recreation (Chape et al., 2003). If managed
correctly, protected areas can be beneficial to wildlife conservation and
the country’s economy through promoting ecotourism and creating local
employment opportunities (Cheung, 2012; Spies et al., 2018). However,
the management of protected areas is challenging, particularly in the
Anthropocene era of human mediated global change, and increased
emergence and re-emergence of infectious diseases (reviewed by Cable
et al., 2017). These diseases can reduce fitness, alter wildlife population
Managing zoonoses in African protected areas 3
structure/size and even alter ecosystem function (Holdo et al., 2009; Prins
and Weyerhaeuser, 1987; Scott, 1988). Therefore, to effectively manage
wildlife populations and ecosystems, it is essential to understand the threats
posed by pathogens and the diseases they cause.
Of the 3881 terrestrial and marine national parks in the world, almost half
are in sub-Saharan Africa, with terrestrial parks here covering 1 million
km2 (4% of the total land area; Chape et al., 2003; Muhumuza and
Balkwill, 2013). These parks aim to conserve Africa’s unique and iconic eco-
systems ranging from open savannas and grasslands to dense forest. This vari-
ety of habitats supports high levels of biodiversity, drawing numerous
tourists who aspire to spot the ‘Big Five’ megafauna: African buffalo (here-
after referred to as buffalo), lion, African elephant (hereafter referred to as
elephant), rhinoceros and leopard (Dube and Nhamo, 2019). However,
hidden and often forgotten biodiversity within protected areas includes
pathogens, which modulate animal abundance, fitness and behaviour
(Gómez and Nichols, 2013). It is crucial to better understand drivers for past
and current wildlife disease outbreaks within protected areas, to find new
approaches to predict and prevent future outbreaks. A review of all infec-
tious wildlife diseases within protected areas would be too large a task.
Instead, we focus on five diseases referred to here as the ‘Microscopic
Five’, which are important at the human-livestock-wildlife interface due
to their broad host range and zoonotic potential. These interface diseases
would all benefit from a ‘One Health’ approach to management (Fawzy
and Helmy, 2019; Innes et al., 2020; Webster et al., 2016). We therefore
purposefully included high profile diseases (bovine tuberculosis (BTb),
Rift Valley fever and brucellosis) as well as neglected diseases (cryptosporid-
iosis and schistosomiasis) for study. Using Kruger National Park, one of the
most researched parks in Africa (van Wilgen et al., 2016), we will review the
key factors that can influence outbreaks and transmission of the ‘Microscopic
Five’ within and around protected areas (Fig. 1). By focusing on a select
group of pathogens within a specific park our intention is to highlight drivers
of disease common among many protected areas and the importance of
considering all infectious diseases in wildlife management plans. We will first
give a brief introduction to the ‘Microscopic Five’ and then give examples of
the environmental and anthropogenic factors driving the dynamics of these
diseases within and around Kruger National Park. We will then discuss the
key knowledge gaps and future challenges for managing the ‘Microscopic
Five’ and other important diseases and touch on different management
approaches followed in various parks.
4 Anya V. Tober et al.
Extreme
weather events
Co-infections
Reservoir hosts
Landscape
heterogeneity
Mixing at
waterholes
Translocation
Illegal wildlife trade Permeable fences
Fig. 1 The ‘Big Five’ and ‘Microscopic Five’, and the drivers of disease at the wildlife-
livestock-human interface. Arrows represent anthropogenic drivers from beyond
Kruger National Park. Created with Microsoft PowerPoint (version 2109) and Adobe
Photoshop (2021).
in the last 20 years, predominantly in Africa and Saudi Arabia (Petrova et al.,
2020). Little is known about how the pathogen is maintained during
inter-epidemic periods. One suggestion is vertical transmission from mos-
quitoes to their ova, which has been demonstrated with Aedes mosquitoes
under laboratory-controlled conditions (Romoser et al., 2011). Another
possibility is that it is maintained in wild animal populations (Beechler
et al., 2015a; see Section 4.3.4). Commercial vaccines are available for live-
stock but there is currently no licensed human vaccine (Petrova et al., 2020).
2.3 Brucellosis
Brucellosis, caused by bacteria of the Brucella genus, is ranked among the
most economically important zoonotic diseases globally. Although it is an
OIE notifiable disease, outbreaks are thought to be greatly under-reported
in Africa (McDermott et al., 2013). The species of medical and veterinary
importance are Brucella abortus, Brucella melitensis and B. suis (see Ducrotoy
et al., 2017). Infection in humans can lead to a debilitating illness known
as ‘Mediterranean’ or ‘undulant’ fever and is commonly misdiagnosed as
malaria (Ducrotoy et al., 2017; Godfroid et al., 2011). Human infection
occurs through direct contact with or consumption of an infected animal.
Consumption of un-pasteurised milk causes most human infections, while
human to human transmission is rare (Godfroid, 2018). Several wildlife spe-
cies have been reported as seropositive for this disease and African buffalo are
thought to be a reservoir for B. abortus (see Godfroid et al., 2013). Infection
can cause abortions in livestock reducing farm productivity, however the
effects of the disease on wildlife are largely unknown and may differ between
species (Gorsich et al., 2015). Vaccines are available for livestock and small
ruminants but not yet for humans (Ducrotoy et al., 2017).
2.4 Cryptosporidiosis
Cryptosporidiosis, caused by several species of the protozoan
Cryptosporidium genus, can lead to severe diarrhoea in humans and animals
globally. Infectious diarrhoea is a major cause of death in children under five
in Africa and Cryptosporidium is second only to rotavirus as a contributor to
this disease (Kotloff et al., 2013; Squire and Ryan, 2017). Transmission
occurs through the faecal oral route via close contact with infected humans,
animals or contaminated food and water (Innes et al., 2020). Currently there
are at least 40 recognised species with varying host specificities but the most
important two species infecting humans and livestock are C. hominus and
Managing zoonoses in African protected areas 9
2.5 Schistosomiasis
Schistosomiasis is a waterborne, zoonotic disease of veterinary and medical
importance, caused by digenean parasites of the genus Schistosoma.
Schistosomiasis is a major public health threat with an estimated 207 million
people infected and 779 million people at risk globally, with 90% of these
infections in Africa (Steinmann et al., 2006). Like all digeneans, schistosomes
have an indirect lifecycle. They require an intermediate freshwater snail host
within which they reproduce asexually ultimately producing cercariae,
which are free-swimming larval stages that subsequently infect a definitive
mammalian host (Cribb et al., 2003). Definitive animal or human hosts can
become infected with schistosomiasis by entering infested waters—the
water-borne larvae burrow through the skin of the new host (Cribb
et al., 2003). There are at least 12 known schistosome species in Africa of
which 5 are known to infect humans (S. haematobium, Schistosoma
mansoni, S. intercalatum, S. guineensis and S. mattheei). Schistosoma mattheei
is of note as although predominantly a parasite of cattle, it has also been
found in wildlife and humans where it is known to hybridise with
S. haematobium (see Pitchford, 1961). The other species infect a wide range
of domestic and wild animals including cattle, horses, buffalo, baboons,
zebra, hippopotamus and rodents (Standley et al., 2012). Traditionally, mal-
acological monitoring programmes have only targeted snail species known
to harbour human infecting schistosomes, but a wider approach is clearly
needed as we become aware of wider host ranges (Pennance et al., 2021)
10 Anya V. Tober et al.
Surveillance herd One off survey used by state officials to determine the
programme prevalence of BTb within an area or by a stock owner
conducting a self-assessment
Maintenance herd To join this programme, herds are required to
programme undergo two consecutive tests with 100% negative
results at least 3 months apart. These BTb free herds
are then tested every 2 years. If an individual tests
positive, then the entire herd is moved to the infected
herd programme
Infected herd programme Compulsory programme for herds that have tested
positive with the CIT test, as well as those detected
from meat and milk inspection, post-mortems or
clinical cases. These herds are placed under
quarantine and kept under supervision of a state
veterinarian, who will order the slaughter of infected
animals. The rest of the herd is tested every 3 months
and is only let out of quarantine once the herd has
undergone two consecutive negative tests
Diagnostic testing Individual cattle destined to be imported or exported.
programme (individuals) Imported cattle are kept in quarantine and must
undergo a compulsory CIT test. Before export, cattle
must also receive a comparative CIT test—a
requirement for many importing countries
Kruger National Park and Hluhluwe-iMfolozi Park are the only two
parks within South Africa that contain buffalo herds maintaining BTb yet
they have adopted different control approaches. Bovine Tb was first
detected in Hluhluwe-iMfolozi Park in 1986 and a test and cull disease pro-
gramme was initiated in 1999. This programme involved a mobile capture
unit to corral buffalo in different areas of the park, test them by means of
the CIT test and culling positive individuals. Between 1991 and 2006,
4733 buffalo were tested, with herd prevalence ranging from 2.3% to
54.7%. Subsequent, data analysis suggested that the programme was effective
at reducing BTb prevalence, particularly in areas with intensive test and cul-
ling operations (Le Roex et al., 2016). Kruger National Park took a different
approach to managing BTb in its buffalo population after the disease was
detected in this host species in 1990. They aimed to breed disease free buffalo
from Foot and Mouth Disease infected parents within the park in order to
conserve the genetic pool of Kruger buffalo in an ex-situ population
(Laubscher and Hoffman, 2012). This approach, which used dairy cows
as foster parents for buffalo calves initially, and later switched to having
the buffalo mothers rear their young, was highly successful and also popular
with farmers, eventually shifting from a few government funded projects to
hundreds of private buffalo breeding farms (Laubscher and Hoffman, 2012).
Additionally, Kruger National Park did extensive BTb monitoring surveys
between 1993 and 2007, to assess the spread and impact of BTb in herds, and
determine if the disease was having population level effects. Since it entered
the park, BTb has been detected in 12 spill-over species (Michel et al., 2006)
and remains a concern in low density species, such as wild dog and black
rhinoceros (Higgitt et al., 2019).
With the disease currently not shown to be affecting population recruit-
ment or growth in buffalo, the real concern becomes spill-over to other
hosts and therefore finding an effective vaccine that limits disease severity
and spill-over is a priority. Currently there is only one registered vaccine
for BTb control. The BCG vaccine is predominantly used in humans but
has yielded promising results for use in domestic cattle (Arnot and
Michel, 2020). However, when trialled in wild buffalo within the Kruger
National Park, the BCG vaccine protection was insufficient and did not
limit bacterial shedding (De Klerk et al., 2010). This was thought to have
resulted from priming with environmental non-TB mycobacteria, which
has been shown to reduce the protective efficacy of the BCG vaccine
(Brandt et al., 2002; De Klerk et al., 2010). Importantly similar studies in
badgers in the UK found the BCG vaccine to be effective in limiting disease
Managing zoonoses in African protected areas 13
(Mabunda et al., 2003). Fencing of the park was ordered by the National
Department of Agriculture in order to prevent the spread of disease to
surrounding livestock, such as foot and mouth (FMD) endemic in buffalo
(Bengis et al., 2003). Fence construction started in the early 1960s with
the western boundary followed by the eastern boundary in the late 1960s,
by 1980 all boundaries of the park were enclosed. The fences (over
360 km in length and 65 km in width) restricted movement of wildlife lead-
ing to increased numbers of large herbivores, such as elephant and buffalo,
which were subsequently controlled by culling operations and in the early
1970s, a certified abattoir was built within the park to optimise use of the
culled meat (Mabunda et al., 2003). From 1990 to 2010 management
shifted again to focus on integration, innovation and internationalisation.
The severe drought of 1992–93 followed by the February floods in 2000
as well as the catastrophic wildfire in September 2001, which killed both
people and animals within the park, were indicative of the need for manage-
ment to become more adaptive to the increasingly unpredictable environ-
ment (Mabunda et al., 2003). Since 1995, Kruger has used a strategic
adaptive management approach, which involves management decisions
and actions guided by research and monitoring while learning from unex-
pected events or outcomes. This approach also aims to maximise heteroge-
neity of the park and led to its expansion across national boundaries creating
the Greater Limpopo transfrontier conservation area (GLTFCA) spanning
the Limpopo (Mozambique), Kruger (South Africa) and Gonarezhou
(Zimbabwe) National Parks. A portion of fences of approximately 45 km
was removed between Limpopo and Kruger in 2002 (Caron et al., 2016;
Venter et al., 2008).
Fig. 2 Megaherbivore (African buffalo and elephant) density across Kruger National
Park and fence breakages (red cross) from damage causing animals (DCAs). Elephant
cause most breakages enabling diseased buffalo to escape. Foot and mouth (FMD) vet-
erinary control zones and nearby villages are also shown. Map produced by the Skukuza
GIS Office.
18 Anya V. Tober et al.