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Table 1 Zoonotic diseases of concern in humanitarian emergencies and displacement (identified in the literature reviewed), disease data from: WHO communicable disease control in emergencies, A field manual [28]

From: Identifying the research gap of zoonotic disease in displacement: a systematic review

Zoonoses

Symptoms in humans

Transmission

Main risk factors

Geographical locations

Contamination and direct transmission

 Salmonellosis (caused by non-typhoidal Salmonella)

acute abdominal pain, diarrhoea, nausea, fever, and sometimes vomiting

contaminated water and food, livestock products, contact with infected animals

living conditions: lack of hygiene, especially of food

Asia [16], Bangladesh [27], Indonesia [17, 18], Syria [28], EU [5, 29], Italy [29], US [18, 30], Haiti [15].

 Foodborne infections (caused by E. coli), respiratory illness, pneumonia

diarrhea, vomiting, fever, respiratory disease symptoms

contaminated water and food, livestock products, contact with infected animals

living conditions: lack of hygiene, especially of food

Bangladesh [18, 27, 31, 32], Thailand [16], Syria [28], EU [29], Denmark [29], US [30], Haiti [15].

 Hepatitis E

yellow skin, secretions, tiredness, fever, vomiting, nausea, abdominal pain, loss of appetite; liver failure, death during pregnancy

human sewage contaminated food and water; eating undercooked pig meat

living conditions: lack of hygiene

Sub-Saharan Africa [16], Ethiopia [14], Kenya [14], Somalia [14], Sudan [27, 32,33,34,35,36], South Sudan [34], Asia [16], Bangladesh [31], India [32], Nepal [37], Pakistan [17, 18, 22, 37], Indonesia [17, 18], Thailand [38], Turkey [29]

 Leptospirosis

fever, headache, nausea, loss of appetite, jaundice, swollen limbs, chest pain, shortness of breath, coughing blood

contaminated soil and water, animal urine

injuries, skin lesions; occupational exposure

Southeast Asia [38], Philippines [27], Thailand [17, 38], China [17], India [17, 18, 32], Nepal [37], Pakistan [22], Taiwan [17, 18], Puerto Rico [16], Central and South America [39] Argentina [18], Brazil [18], Nicaragua [39], Caribbean [24], Haiti [15, 39], Austria [29], Bulgaria [29], Germany [29], France [29], Russia [29].

 Bovine tuberculosis

weakness, loss of appetite, weight loss, fluctuating fever, intermittent cough, diarrhoea, large prominent lymph nodes

eating or drinking contaminated, unpasteurized dairy products

direct contact with infected animals or contaminated tissues during slaughter

animal husbandry; living conditions; occupational exposure; wildlife reservoirs

Africa [40], Nigeria [12].

 Brucellosis

fluctuating fever, body ache, weight loss, weakness, abdonimal pain

contact with aborted foetuses, vaginal fluids, placentae, placental fluids, urine, semen, feces and hygroma fluids

fomites, milk

occupational exposure; ingesting unpasteurised dairy products

Africa [40], Algeria [41], Nigeria [12], Tanzania [2], Somalia [42], Mongolia [2], Nepal [37], Syria [28].

 Rabies

rapidly progessive fatal encephalitis, preceded by generalised arousal or hyperexcitability and hydrophobia; progressive lower motor neuron weakness, paralysis

animal bites (especially dogs)

free roaming dogs; wildlife, rarely pets

Africa [3, 40], Algeria [41], Chad [6], Malawi [2], Niger [6], Indonesia [24], Myanmar [6], Nepal [37], Thailand [38], Syria [28], Cuba [24], Haiti [15, 39].

 Middle East Respiratory Syndrome (MERS

fever, cough, shortness of breath, pneumonia, gastrointestinal symptoms, diarrhoea; respiratory failure

transmission in unprotected healthcare settings; dromedary contact, undercooked meat

lack of quality healthcare

Eastern Meditteranean Region [43, 44], Middle East [45].

 Lassa Hemorrhagic Fever

fever, malaise, headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhea, cough, abdominal pain; bleeding, low blood pressure and death

contaminated food or other items by infected rats; transmission in unprotected healthcare settings

living conditions, lack of hygiene; lack of quality healthcare

Africa [25], West Africa [5, 36, 46], Guinea [3], Liberia, Sierra Leone [3, 36].

 Ebola Virus Disease

fever, fatigue, muscle pain, headache, sore throat, vomiting, diarrhoea, rash, impaired kidney and liver function; internal and external bleeding, low white blood cell and platelet counts, elevated liver enzymes

human to human bodily fluids contact; close contact with the blood, secretions, organs or other bodily fluids of infected animals

living conditions and poor hygiene, lack of quality healthcare, pregnancy, lactation, burial practices

Africa [6, 7, 25], West Africa [5, 29, 43, 45, 47, 48], Gabon [30], Guinea [43], Ivory Coast [25], Liberia [25, 43], Sierra Leone [43], DRC [25, 36, 49], Sudan [25].

Parasites

 Endo-parasites, including Opistorchis, Echinostoma, Strongyloides, Taenia, Sarcocystis, hookworm [42], Giardia, Ascaris, Trichuris, Echinococcus [44].

failure to thrive, skin bumps, rashes, weight loss, increased appetite, abdominal pain, diarrhea, and vomiting, sleeping problems, anaemia, aches and pains, allergies, weakness, malaise, fever

contaminated food and water, bites, contaminated soil

high population density, poor sanitation

Angola, Burkina Faso, Central African Republic, DRC, Equaltorial Guinea, Gabon, Liberia, South Sudan [6], Eastern Africa [40], Ethiopia [50], Eritrea, Swaziland, Zambia, Zimbabwe, Afghanistan, China, Laos, Malaysia, Mongolia, Tajikistan, Papua New Guinea, Thailand [6, 38], Kiribati, Marschall Islands, Guatemala, Peru, Jamaica [6].

Vector-borne

 Leishmaniasis

cutaneous leishmaniasis: skin lesions, nodules, or papules; visceral leishmaniasis: fever, weight loss, enlargement of the spleen and liver - untreated typically fatal

Leishmania parasite through bite of female phlebotomine sand fly which feed on blood; 70 animal species are natural reservoir hosts, including humans

lack of vector control; environmental changes, and urbanization; malnutrition, population displacement, poor housing/ sanitation, health status, poverty

Ethiopia [50], South Sudan [51, 52], Sudan [53,54,55], Northern Africa Middle East, Iraq, Jordan, Lebanon, Libya, Saudi Arabia [56], Syria [28, 43, 56, 57], Tunisia, Turkey, Yemen [6], Afghanistan [54, 56], Pakistan [22, 56, 58], Nepal [37], Brazil [52], Colombia, Venezuela [54, 59].

 Crimean-Congo haemorrhagic fever (CCHF)

fever, myalgia, dizziness, neck pain, stiffness, backache, headache, sore eyes and photophobia, nausea, vomiting, diarrhoea, abdominal pain, sore throat; mood swings, confusion; sleepiness, depression lassitude, liver enlargement, tachycardia, lymphadenopathy, petechial rash; hepatitis, liver failure

tick bites, contact with infected livestock

occupational exposure; population movement

Africa, Asia, Europe, Middle East [60], Eastern Mediterranean Region [43], Turkey [28, 60], Afghanistan, Iran [44], Pakistan [61, 62].

 Rift Valley Fever (RVF)

range from mild flu-like illness to severe lethal haemorrhagic fever

contact with blood or organs of infected livestock; mosquito bites; unpasteurized milk

occupational exposure; lack of vector control

Africa [40, 60, 63], Egypt [63], Kenya [24, 45, 63], Somalia [59, 63], Sudan [63], Tanzania [59], Eastern Mediterranean Region [43], Asia [60].