- Email: [email protected]
“One Health” – Linking human, animal and environmental health
International Journal of Medical Microbiology 304 (2014) 775–776
Contents lists available at ScienceDirect
International Journal of Medical Microbiology journal homepage: www.elsevier.com/locate/ijmm
Editorial
“One Health” – Linking human, animal and environmental health
In early 2000, the German infectious disease researchers, envisioning the need for fostering research on zoonotic diseases, were able to express their needs to the German Ministry of Education and Research (BMBF). Globalization, new-emerging pathogens and the ever looming influenza pandemic proved substantial enough for a fact-based initiative. Indeed, the BMBF in 2006 launched a research initiative which was completely unthinkable a few years before. What was so special about this funding initiative? The topic of zoonotic diseases was and is as timely and important as it has always been. However, what made this initiative unique were the rules of applied interdisciplinary and transdisciplinary consortia. A prerequisite for any funding possibility was the mandatory involvement of partners from at least both the veterinary and the medical field. This condition sine qua non proved to foster research in zoonotic diseases in Germany tremendously. Today, after eight years, new bonds have been linked and new infrastructures equipped with technology to meet the challenges in the world of infectious diseases have been set in Germany. Medics, vets, hygienists, epidemiologist, ecologists, etc. generated sound networks for the sake of human and veterinary health. The German Research Platform for Zoonoses was established (www.zoonosen.net). Critically evaluating the merits of this launch makes it an even more outstanding success story. One can argue that environmental health was not embedded enough, but the established networks unravelling needs, strengths and pitfalls of each discipline have set the stage to now move forward to a “One Health” concept. It clearly is time to revitalize the “One Health” initiative, which actually originated from scientists like the German Rudolph Virchow, Robert Koch or Robert von Ostertag in the late 19th century, but was rather neglected due to traditional boundaries between disciplines. The “One Health” concept expands interdisciplinary collaborations and communications in all aspects of health care including humans, animals and the environment, thereby enhancing public health efficacy and improving medical education and clinical care. What other goal would you approach in times of the current Ebola outbreak that dramatically points towards the crucial importance of the “One Health” concept? This special issue of the “International Journal of Medical Microbiology” (IJMM) gives an insight into various aspects of research, new developments and scientific improvement that have been achieved during a six year period of funding. A total of 16 articles summarize some of the most thrilling data gained by many of the involved researchers. The consortia analyzed mechanisms of
http://dx.doi.org/10.1016/j.ijmm.2014.08.014 1438-4221/© 2014 Elsevier GmbH. All rights reserved.
transmission, microevolutionary events of pathogens and established molecular epidemiological tools, evaluated the risk of infections and based on these data, unravelled molecular mechanisms of the infection biology of a total of 23 bacterial, two viral and one parasitic pathogen. The initial four papers cover an area, which only ten years before would not have had the chance to be funded under the umbrella of zoonotic diseases: infections with the mostly multi-resistant methicillin-resistant Staphylococcus aureus (MRSA) and extended--lactamase (ESBL)-producing Enterobacteriaceae. When screening through the literature some years ago, both these opportunistic pathogens have been judged as nosocomial pathogens, spreading in and from hospitals. It is now clear with a steady increasing amount of infections that these bugs have a zoonotic potential, both causing harm to animals as well as humans. The articles by Ballhausen et al. (2014), Vincze et al. (2014), and Becker et al. (2014) cover various aspects of MRSA epidemiology, virulence and resistance mechanisms. It is amazing to see that some particular genetic lineages, mostly defined by sequence types (STs), evolve and make their way into various habitats, envisioning steady microevolutionary adaptive changes. Of particular interest is the question raised by an ever increasing amount of stakeholders: how much do veterinary and medical isolates overlap and in which direction do they transfer? Valentin et al. (2014) address this topic by providing a first estimation of the amount of ESBL-producing Enterobacteriaceae originating from livestock putatively involved in human infections. Infections with these Gram-negative multiresistant bugs are of particular concern and are seen as the most important challenge among the medical and the veterinary fields. Being aware that risk assessment is only possible if sound molecular epidemiological data are provided, Thomas Alter and colleagues describe the current situation regarding Campylobacterinfections, the most important reservoir for which are chickens (Gölz et al., 2014). The group of Petra Dersch gives an intriguing insight into host specificity of Yersinia enterocolitica, new findings that have only been possible by combining expertise on infection biology of Yersinia with the veterinary expertise of the ValentinWeigand group on infection models in pigs (Valentin-Weigand et al., 2014). It is increasingly reported that avian pathogenic E. coli (APEC) pose a zoonotic risk. However, the existence of various genetic lineages blurs the epidemiological signal. That is why Nishant Nandanwar and colleagues target one particular chromosomal background of E. coli strains, those belonging to sequence type complex 95 (STC95). These authors compare infection biological
776
Editorial / International Journal of Medical Microbiology 304 (2014) 775–776
features of human and avian strains (Nandanwar et al., 2014). Two other food-borne pathogens, Vibrio spp. and M. avium subsp. paratuberculosis (MAP) are the topic of papers by Hühn et al. (2014), Schirmeister et al. (2014) and Atreya et al. (2014). While Hühn and colleagues summarize their current data on the importance of the mostly neglected vibrio pathogens in Germany, Schirmeister and colleagues describe molecular diagnostics, which are of utmost importance for sound risk assessment of marine food. The review “Facts, myths and hypotheses on the zoonotic nature of MAP” gives an in-depth state-of-the-art insight into the putative role of MAP in chronic enteritis of humans. Moving from these extracellular bacterial pathogens to obligate intracellular ones, the article by Frangoulidis et al. (2014) summarizes recent molecular epidemiological data on the Q-fever agent Coxiella burnetii. Knittler et al. (2014) provide an excellent overview on current knowledge of the pathogenesis caused by infections with Chlamydia species. Staying on intracellular pathogens, Ludwig et al. (2014) focus on viruses, in particular influenza, and Yakobson et al. (2014) on rabies. These articles cover aspects of prophylactic and therapeutic interventions against these zoonotic pathogens. While Yakobson et al. describe the successful eradication of rabies in Kosovo – knowing that carnivore bites are the utmost important transmission route, a per se “One Health” topic – Ludwig and colleagues provide detailed insights into current and future possibilities regarding the development of drugs to treat influenza infections. The final two articles highlight infections caused by Toxoplasma gondii. Herrmann et al. (2014) and Schlüter et al. (2014) critically discuss recent research findings. Again, molecular epidemiological typing sets the platform for a more sound understanding of infection biology mechanisms, and it is obvious that different genetic lineages have distinctive biological features. I hope that the wide spectrum of research performed on highly relevant zoonotic pathogens fosters the concept of “One Health”. Clearly, all research data presented here were only possible through the existence of inter- and transdisciplinary networks. Needless to say that I am rather privileged and happy for Jörg Hacker having given me the opportunity to act as guest editor for such a timely and important IJMM special issue like “One Health”. References Atreya, R., Bülte, M., Gerlach, G.-F., Goethe, R., Hornef, M., Koehler, H., Meens, J., Moebius, P., Roeb, E., Weiss, S., on behalf of the ZooMAP consortium, 2014. Facts, myths and hypotheses on the zoonotic nature of Mycobacterium avium subspecies paratuberculosis. Int. J. Med. Microbiol. 304, 858–867. Ballhausen, B., Jung, P., Kriegeskorte, A., Makgotlho, P.E., Ruffing, U., von Müller, L., Köck, R., Peters, G., Herrmann, M., Ziebuhr, W., Becker, K., Bischoff, M., 2014. LA-MRSA CC398 differ from classical community acquired-MRSA and hospital acquired-MRSA lineages: functional analysis of infection and colonization processes. Int. J. Med. Microbiol. 304, 777–786. Becker, K., Ballhausen, B., Köck, R., Kriegeskorte, A., 2014. Methicillin resistance in Staphylococcus isolates: the “mec alphabet” with specific consideration of mecC,
a mec homolog associated with zoonotic S. aureus lineages. Int. J. Med. Microbiol. 304, 794–804. Frangoulidis, D., Walter, M.C., Antwerpen, M., Zimmermann, P., Janowetz, B., Alex, M., Böttcher, J., Henning, K., Hilbert, A., Ganter, M., Runge, M., Münsterkötter, M., Splettstoesser, W.D., Hanczaruk, M., 2014. Molecular analysis of Coxiella burnetii in Germany reveals evolution of unique clonal clusters. Int. J. Med. Microbiol. 304, 868–876. Gölz, G., Rosner, B., Hofreuter, D., Josenhans, C., Kreienbrock, L., Löwenstein, A., Schielke, A., Stark, K., Suerbaum, S., Wieler, L.H., Alter, T., 2014. Relevance of Campylobacter to public health – the need for a One Health approach. Int. J. Med. Microbiol. 304, 817–823. Herrmann, D.C., Maksimov, P., Hotop, A., Groß, U., Däubener, W., Liesenfeld, O., Pleyer, U., Conraths, F.J., Schares, G., 2014. Genotyping of samples from German patients with ocular, cerebral and systemic toxoplasmosis reveals a predominance of Toxoplasma gondii type II. Int. J. Med. Microbiol. 304, 911–916. Hühn, S., Eichhorn, C., Urmersbach, S., Breidenbach, J., Bechlars, S., Bier, N., Alter, T., Bartelt, E., Frank, C., Oberheitmann, B., Gunzer, F., Brennholt, N., Böer, S., Appel, B., Dieckmann, R., Strauch, E., 2014. Pathogenic vibrios in environmental, seafood and clinical sources in Germany. Int. J. Med. Microbiol. 304, 843–850. Knittler, M.R., Berndt, A., Böcker, S., Dutow, P., Hänel, F., Heuer, D., Kägebein, D., Klos, A., Koch, S., Liebler-Tenorio, E., Ostermann, C., Reinhold, P., Saluz, H.P., Schöfl, G., Sehnert, P., Sachse, K., 2014. Chlamydia psittaci: new insights into genomic diversity, clinical pathology, host–pathogen interaction and anti-bacterial immunity. Int. J. Med. Microbiol. 304, 877–893. Ludwig, S., Zell, R., Schwemmle, M., Herold, S., 2014. Influenza, a One Health paradigm – novel therapeutic strategies to fight a zoonotic pathogen with pandemic potential. Int. J. Med. Microbiol. 304, 894–901. Nandanwar, N., Janssen, T., Kühl, M., Ahmed, N., Ewers, C., Wieler, L.H., 2014. Extraintestinal pathogenic Escherichia coli (ExPEC) of human and avian origin belonging to sequence type complex 95 (STC95) portray indistinguishable virulence features. Int. J. Med. Microbiol. 304, 835–842. Schirmeister, F., Wieczorek, A., Dieckmann, R., Taureck, K., Strauch, E., 2014. Evaluation of molecular methods to discriminate the closely related species Vibrio fluvialis and Vibrio furnissii. Int. J. Med. Microbiol. 304, 851–857. Schlüter, D., Däubener, W., Schares, G., Groß, U., Pleyer, U., Lüder, C., 2014. Animals are key to human toxoplasmosis. Int. J. Med. Microbiol. 304, 917–929. Valentin, L., Sharp, H., Hille, K., Seibt, U., Fischer, J., Pfeifer, Y., Brenner Michael, G., Nickel, S., Schmiedel, J., Falgenhauer, L., Friese, A., Bauerfeind, R., Roesler, U., Imirzalioglu, C., Chakraborty, T., Helmuth, R., Valenza, G., Werner, G., Schwarz, S., Guerra, B., Appel, B., Kreienbrock, L., Käsbohrer, A., 2014. Subgrouping of ESBL-producing Escherichia coli from animal and human sources: an approach to quantify the distribution of ESBL types between different reservoirs. Int. J. Med. Microbiol. 304, 805–816. Valentin-Weigand, P., Heesemann, J., Dersch, P., 2014. Unique virulence properties of Yersinia enterocolitica O:3 – an emerging zoonotic pathogen using pigs as preferred reservoir host. Int. J. Med. Microbiol. 304, 824–834. Vincze, S., Brandenburg, A.G., Espelage, W., Stamm, I., Wieler, L.H., Kopp, P.A., LübkeBecker, A., Walther, B., 2014. Risk factors for MRSA infection in companion animals: results from a case–control study within Germany. Int. J. Med. Microbiol. 304, 787–793. Yakobson, B., Goga, I., Freuling, C.M., Fooks, A.R., Gjinovci, V., Hulaj, B., Horton, D., Johnson, N., Muhaxhiri, J., Recica, I., David, D., O’Flaherty, R., Taylor, N., Wilsmore, T., Müller, T., 2014. Implementation and monitoring of oral rabies vaccination of foxes in Kosovo between 2010 and 2013 – an international and intersectorial effort. Int. J. Med. Microbiol. 304, 902–910.
Lothar H. Wieler Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany E-mail address: [email protected]
Contents lists available at ScienceDirect
International Journal of Medical Microbiology journal homepage: www.elsevier.com/locate/ijmm
Editorial
“One Health” – Linking human, animal and environmental health
In early 2000, the German infectious disease researchers, envisioning the need for fostering research on zoonotic diseases, were able to express their needs to the German Ministry of Education and Research (BMBF). Globalization, new-emerging pathogens and the ever looming influenza pandemic proved substantial enough for a fact-based initiative. Indeed, the BMBF in 2006 launched a research initiative which was completely unthinkable a few years before. What was so special about this funding initiative? The topic of zoonotic diseases was and is as timely and important as it has always been. However, what made this initiative unique were the rules of applied interdisciplinary and transdisciplinary consortia. A prerequisite for any funding possibility was the mandatory involvement of partners from at least both the veterinary and the medical field. This condition sine qua non proved to foster research in zoonotic diseases in Germany tremendously. Today, after eight years, new bonds have been linked and new infrastructures equipped with technology to meet the challenges in the world of infectious diseases have been set in Germany. Medics, vets, hygienists, epidemiologist, ecologists, etc. generated sound networks for the sake of human and veterinary health. The German Research Platform for Zoonoses was established (www.zoonosen.net). Critically evaluating the merits of this launch makes it an even more outstanding success story. One can argue that environmental health was not embedded enough, but the established networks unravelling needs, strengths and pitfalls of each discipline have set the stage to now move forward to a “One Health” concept. It clearly is time to revitalize the “One Health” initiative, which actually originated from scientists like the German Rudolph Virchow, Robert Koch or Robert von Ostertag in the late 19th century, but was rather neglected due to traditional boundaries between disciplines. The “One Health” concept expands interdisciplinary collaborations and communications in all aspects of health care including humans, animals and the environment, thereby enhancing public health efficacy and improving medical education and clinical care. What other goal would you approach in times of the current Ebola outbreak that dramatically points towards the crucial importance of the “One Health” concept? This special issue of the “International Journal of Medical Microbiology” (IJMM) gives an insight into various aspects of research, new developments and scientific improvement that have been achieved during a six year period of funding. A total of 16 articles summarize some of the most thrilling data gained by many of the involved researchers. The consortia analyzed mechanisms of
http://dx.doi.org/10.1016/j.ijmm.2014.08.014 1438-4221/© 2014 Elsevier GmbH. All rights reserved.
transmission, microevolutionary events of pathogens and established molecular epidemiological tools, evaluated the risk of infections and based on these data, unravelled molecular mechanisms of the infection biology of a total of 23 bacterial, two viral and one parasitic pathogen. The initial four papers cover an area, which only ten years before would not have had the chance to be funded under the umbrella of zoonotic diseases: infections with the mostly multi-resistant methicillin-resistant Staphylococcus aureus (MRSA) and extended--lactamase (ESBL)-producing Enterobacteriaceae. When screening through the literature some years ago, both these opportunistic pathogens have been judged as nosocomial pathogens, spreading in and from hospitals. It is now clear with a steady increasing amount of infections that these bugs have a zoonotic potential, both causing harm to animals as well as humans. The articles by Ballhausen et al. (2014), Vincze et al. (2014), and Becker et al. (2014) cover various aspects of MRSA epidemiology, virulence and resistance mechanisms. It is amazing to see that some particular genetic lineages, mostly defined by sequence types (STs), evolve and make their way into various habitats, envisioning steady microevolutionary adaptive changes. Of particular interest is the question raised by an ever increasing amount of stakeholders: how much do veterinary and medical isolates overlap and in which direction do they transfer? Valentin et al. (2014) address this topic by providing a first estimation of the amount of ESBL-producing Enterobacteriaceae originating from livestock putatively involved in human infections. Infections with these Gram-negative multiresistant bugs are of particular concern and are seen as the most important challenge among the medical and the veterinary fields. Being aware that risk assessment is only possible if sound molecular epidemiological data are provided, Thomas Alter and colleagues describe the current situation regarding Campylobacterinfections, the most important reservoir for which are chickens (Gölz et al., 2014). The group of Petra Dersch gives an intriguing insight into host specificity of Yersinia enterocolitica, new findings that have only been possible by combining expertise on infection biology of Yersinia with the veterinary expertise of the ValentinWeigand group on infection models in pigs (Valentin-Weigand et al., 2014). It is increasingly reported that avian pathogenic E. coli (APEC) pose a zoonotic risk. However, the existence of various genetic lineages blurs the epidemiological signal. That is why Nishant Nandanwar and colleagues target one particular chromosomal background of E. coli strains, those belonging to sequence type complex 95 (STC95). These authors compare infection biological
776
Editorial / International Journal of Medical Microbiology 304 (2014) 775–776
features of human and avian strains (Nandanwar et al., 2014). Two other food-borne pathogens, Vibrio spp. and M. avium subsp. paratuberculosis (MAP) are the topic of papers by Hühn et al. (2014), Schirmeister et al. (2014) and Atreya et al. (2014). While Hühn and colleagues summarize their current data on the importance of the mostly neglected vibrio pathogens in Germany, Schirmeister and colleagues describe molecular diagnostics, which are of utmost importance for sound risk assessment of marine food. The review “Facts, myths and hypotheses on the zoonotic nature of MAP” gives an in-depth state-of-the-art insight into the putative role of MAP in chronic enteritis of humans. Moving from these extracellular bacterial pathogens to obligate intracellular ones, the article by Frangoulidis et al. (2014) summarizes recent molecular epidemiological data on the Q-fever agent Coxiella burnetii. Knittler et al. (2014) provide an excellent overview on current knowledge of the pathogenesis caused by infections with Chlamydia species. Staying on intracellular pathogens, Ludwig et al. (2014) focus on viruses, in particular influenza, and Yakobson et al. (2014) on rabies. These articles cover aspects of prophylactic and therapeutic interventions against these zoonotic pathogens. While Yakobson et al. describe the successful eradication of rabies in Kosovo – knowing that carnivore bites are the utmost important transmission route, a per se “One Health” topic – Ludwig and colleagues provide detailed insights into current and future possibilities regarding the development of drugs to treat influenza infections. The final two articles highlight infections caused by Toxoplasma gondii. Herrmann et al. (2014) and Schlüter et al. (2014) critically discuss recent research findings. Again, molecular epidemiological typing sets the platform for a more sound understanding of infection biology mechanisms, and it is obvious that different genetic lineages have distinctive biological features. I hope that the wide spectrum of research performed on highly relevant zoonotic pathogens fosters the concept of “One Health”. Clearly, all research data presented here were only possible through the existence of inter- and transdisciplinary networks. Needless to say that I am rather privileged and happy for Jörg Hacker having given me the opportunity to act as guest editor for such a timely and important IJMM special issue like “One Health”. References Atreya, R., Bülte, M., Gerlach, G.-F., Goethe, R., Hornef, M., Koehler, H., Meens, J., Moebius, P., Roeb, E., Weiss, S., on behalf of the ZooMAP consortium, 2014. Facts, myths and hypotheses on the zoonotic nature of Mycobacterium avium subspecies paratuberculosis. Int. J. Med. Microbiol. 304, 858–867. Ballhausen, B., Jung, P., Kriegeskorte, A., Makgotlho, P.E., Ruffing, U., von Müller, L., Köck, R., Peters, G., Herrmann, M., Ziebuhr, W., Becker, K., Bischoff, M., 2014. LA-MRSA CC398 differ from classical community acquired-MRSA and hospital acquired-MRSA lineages: functional analysis of infection and colonization processes. Int. J. Med. Microbiol. 304, 777–786. Becker, K., Ballhausen, B., Köck, R., Kriegeskorte, A., 2014. Methicillin resistance in Staphylococcus isolates: the “mec alphabet” with specific consideration of mecC,
a mec homolog associated with zoonotic S. aureus lineages. Int. J. Med. Microbiol. 304, 794–804. Frangoulidis, D., Walter, M.C., Antwerpen, M., Zimmermann, P., Janowetz, B., Alex, M., Böttcher, J., Henning, K., Hilbert, A., Ganter, M., Runge, M., Münsterkötter, M., Splettstoesser, W.D., Hanczaruk, M., 2014. Molecular analysis of Coxiella burnetii in Germany reveals evolution of unique clonal clusters. Int. J. Med. Microbiol. 304, 868–876. Gölz, G., Rosner, B., Hofreuter, D., Josenhans, C., Kreienbrock, L., Löwenstein, A., Schielke, A., Stark, K., Suerbaum, S., Wieler, L.H., Alter, T., 2014. Relevance of Campylobacter to public health – the need for a One Health approach. Int. J. Med. Microbiol. 304, 817–823. Herrmann, D.C., Maksimov, P., Hotop, A., Groß, U., Däubener, W., Liesenfeld, O., Pleyer, U., Conraths, F.J., Schares, G., 2014. Genotyping of samples from German patients with ocular, cerebral and systemic toxoplasmosis reveals a predominance of Toxoplasma gondii type II. Int. J. Med. Microbiol. 304, 911–916. Hühn, S., Eichhorn, C., Urmersbach, S., Breidenbach, J., Bechlars, S., Bier, N., Alter, T., Bartelt, E., Frank, C., Oberheitmann, B., Gunzer, F., Brennholt, N., Böer, S., Appel, B., Dieckmann, R., Strauch, E., 2014. Pathogenic vibrios in environmental, seafood and clinical sources in Germany. Int. J. Med. Microbiol. 304, 843–850. Knittler, M.R., Berndt, A., Böcker, S., Dutow, P., Hänel, F., Heuer, D., Kägebein, D., Klos, A., Koch, S., Liebler-Tenorio, E., Ostermann, C., Reinhold, P., Saluz, H.P., Schöfl, G., Sehnert, P., Sachse, K., 2014. Chlamydia psittaci: new insights into genomic diversity, clinical pathology, host–pathogen interaction and anti-bacterial immunity. Int. J. Med. Microbiol. 304, 877–893. Ludwig, S., Zell, R., Schwemmle, M., Herold, S., 2014. Influenza, a One Health paradigm – novel therapeutic strategies to fight a zoonotic pathogen with pandemic potential. Int. J. Med. Microbiol. 304, 894–901. Nandanwar, N., Janssen, T., Kühl, M., Ahmed, N., Ewers, C., Wieler, L.H., 2014. Extraintestinal pathogenic Escherichia coli (ExPEC) of human and avian origin belonging to sequence type complex 95 (STC95) portray indistinguishable virulence features. Int. J. Med. Microbiol. 304, 835–842. Schirmeister, F., Wieczorek, A., Dieckmann, R., Taureck, K., Strauch, E., 2014. Evaluation of molecular methods to discriminate the closely related species Vibrio fluvialis and Vibrio furnissii. Int. J. Med. Microbiol. 304, 851–857. Schlüter, D., Däubener, W., Schares, G., Groß, U., Pleyer, U., Lüder, C., 2014. Animals are key to human toxoplasmosis. Int. J. Med. Microbiol. 304, 917–929. Valentin, L., Sharp, H., Hille, K., Seibt, U., Fischer, J., Pfeifer, Y., Brenner Michael, G., Nickel, S., Schmiedel, J., Falgenhauer, L., Friese, A., Bauerfeind, R., Roesler, U., Imirzalioglu, C., Chakraborty, T., Helmuth, R., Valenza, G., Werner, G., Schwarz, S., Guerra, B., Appel, B., Kreienbrock, L., Käsbohrer, A., 2014. Subgrouping of ESBL-producing Escherichia coli from animal and human sources: an approach to quantify the distribution of ESBL types between different reservoirs. Int. J. Med. Microbiol. 304, 805–816. Valentin-Weigand, P., Heesemann, J., Dersch, P., 2014. Unique virulence properties of Yersinia enterocolitica O:3 – an emerging zoonotic pathogen using pigs as preferred reservoir host. Int. J. Med. Microbiol. 304, 824–834. Vincze, S., Brandenburg, A.G., Espelage, W., Stamm, I., Wieler, L.H., Kopp, P.A., LübkeBecker, A., Walther, B., 2014. Risk factors for MRSA infection in companion animals: results from a case–control study within Germany. Int. J. Med. Microbiol. 304, 787–793. Yakobson, B., Goga, I., Freuling, C.M., Fooks, A.R., Gjinovci, V., Hulaj, B., Horton, D., Johnson, N., Muhaxhiri, J., Recica, I., David, D., O’Flaherty, R., Taylor, N., Wilsmore, T., Müller, T., 2014. Implementation and monitoring of oral rabies vaccination of foxes in Kosovo between 2010 and 2013 – an international and intersectorial effort. Int. J. Med. Microbiol. 304, 902–910.
Lothar H. Wieler Centre for Infection Medicine, Institute of Microbiology and Epizootics, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany E-mail address: [email protected]