To Vanessa A. Makarewicz, the health of people, animals and the earth are inherently connected.
As the infection control operations manager at Harborview Medical Center, Makarewicz says there should not only be a worldwide partnership for medicine, but a local focus on what measures can be taken to help eliminate disease.
She said that nearly 75 percent of emerging diseases and 60 percent of all known human diseases originate from animals.
“It’s very important for us to be monitoring what’s happening in our animal population,” she said.
“Even your domestic cat, your dog, because that might be actually a marker of what is coming on the horizon for humans.”
In collaboration with SPU’s Nursing School, the Interprofessional Grand Rounds (IPGR) hosted Makarewicz’s lecture on Thursday, May 11 in Otto Miller for their Spring 2017 IPGR event.
The event, entitled “Pathogens Know No Borders: All Health is Global Health,” centered around preparing students for a world that isn’t yet completely able to fight disease effectively.
Makarewicz offered advice on practices of asking patients questions and encouraging awareness of hygiene and the importance of communication when it comes to risk factors that can have far-reaching consequences.
“I believe the more we know, the better we can treat our patients in the entire globe safe,” Makarewicz said. “New diseases emerge very frequently, and that could be due to a bunch of different pressures: deforestation, population growth, climate change. Whether you believe it or not, climate change does impact it — and really interaction between animals in our environment and humans [is impacted] as well.”
She addressed illnesses from Ebola to influenzas, emphasizing the importance of a “one health approach.”
Without the sharing of resources and information, or a working health system for every part of the world, she said, many are endangered.
“How robust is your infectious disease surveillance program?” she asked. “In the United States we … have our Centers for Disease Control [and] a lot of other countries have a version of that. But how well are we actually sharing the information between countries and worldwide?”
What’s needed is a global partnership and tracking system to effectively fight them, something she said was lacking in 2014 during the Ebola scare in West Africa.
“It was the first time they ever saw Ebola in West Africa,” she said.
“Their public health system’s pretty non-existent; they don’t have a ready supply of gloves, masks, gowns, right? So really a lot of things play into how these pathogens can move about … How fast can we rapidly share this information, analyze it, try to figure out what’s happening?”
Although there are the global problems of health, Makarewicz spoke directly to the science and nursing students, saying that through local work, they can begin to address these problems as well.
Here in Washington State, where medical care is available and accessible, there were 273 influenza deaths in the year last year, according to Makarewicz.
This, she said, can be attributed to a lack of hygiene and a less than desirable rate of vaccinations among patients and medical professionals alike, even though most hospitals require a 90 percent and above vaccination rate among their employees.
Starting the process here at home with strategies of containment and responsible medical practices is important in a medical environment where people are vulnerable.
Her number one advice? Get vaccinated.
“The interesting thing about influenza is that you can have no symptoms at all or mild symptoms and you could be transmitting this virus to your friends, your family, your coworkers, particularly your patients,” Makarewicz said.
Makarewicz also touched on the 2013 H7N9 epidemic — a different strain of influenza from the H1N1 here in the U.S. — in Asia to emphasize how important human connections with animals are when spreading pathogens.
“H7N9 actually was a recombination of flu viruses from ducks, wild birds and domestic culture,” she said. “They all combined and then we interacted with these animals and we got this virus … All of a sudden there was a rise in this new influenza. All at once some provinces in Southeastern China were more affected than others. We are currently going through an H7N9 epidemic right now.”
Makarewicz pointed out that we don’t see this on the news since it isn’t directly affecting the West.
Senior Stephanie Butcher commented afterward on the most important thing she’d learned from Makarewicz’s insight.
“Infectious disease is a local problem and also a global problem, so it impacts the whole world, but we can start in our own community,” she said.