key: cord-0974934-1zsogfmc authors: Bonilla-Aldana, D. Katterine; Holguin-Rivera, Yeimer; Perez-Vargas, Soffia; Trejos-Mendoza, Adrian E.; Balbin-Ramon, Graciela J.; Dhama, Kuldeep; Barato, Paola; Lujan-Vega, Charlene; Rodriguez-Morales, Alfonso J. title: Importance of the One Health approach to study the SARS-CoV-2 in Latin America date: 2020-06-25 journal: One Health DOI: 10.1016/j.onehlt.2020.100147 sha: 84424a2facffa0195164a03f361befa4c6fce9f6 doc_id: 974934 cord_uid: 1zsogfmc nan . In this region (including the Caribbean), up to June 14, 2020, 1,581,301 cases have been reported, more than 1,360,000 of them in South America, and 828,810 just in Brazil [5, 6] . This, the largest country in the region, have reported 41,828 deaths (5.05%). Mexico, the second largest country, has a higher proportion of deaths, 16,488 out of 139,196 (11.85%). On the other side, Chile, although have reported 167,355 cases, only 3,101 deaths have registered (1.85%) [5, 6] . In the case of Venezuela, this a country where doubts about the numbers have been raised. Up to June 14, 2020, 2,879 cases have been reported, but, this number could be underestimated because of under-testing and under-reporting [7] . In the region, there have been clear differences in the responses to the disease, with countries such as Colombia, Peru, Bolivia, Chile, Argentina, among others following wide recommendations of quarantine, physical distance and biosecurity education in an early stage of the pandemic, whilst in others such as Brazil or Mexico, this has been delayed, with very well-known consequences. In Brazil, the poorly-urbanized neighborhoods on the margins of city centers, the so called favelas, are focal points for the disease, with precarious living conditions and high population density making social distancing a near-impossibility [8] . The coronaviruses (CoVs) are pathogens that can be transmitted between and infecting in both humans and animals. These have a worldwide distribution [9] [10] [11] [12] [13] . Due to the importance of the SARS-CoV-2 outbreak that started in Wuhan, province of Hubei, China, the World Health Organization (WHO) declared this viral infection as a health emergency of international concern and later as a pandemic [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] . For One Health, viruses among the Coronaviridae family are archetypal [24] . The virus shares a high level of identity with some bat coronaviruses and is recognized as a zoonotic virus [24, 25] . The virological and epidemiological scenario of this pandemic is complex, and still, many questions remain unanswered. Animal infection due to zoonotic coronaviruses has been previously reported on a farm and domestic animals such as cattle, pigs, dogs, among others [26] . This probably have been occurring for years, and not only in animals but in asymptomatic humans. Nevertheless, the first significant and apparent report in humans was described in 2002 in Guangzhou, province of Guangdong, China, where more than eight thousand cases were confirmed due to a new virus, causing 774 deaths in 32 countries around the world [27] . That virus was the SARS-CoV [27] [28] [29] [30] [31] . Later in 2012, another outbreak of a zoonotic coronavirus was reported. The Middle East Respiratory Syndrome coronavirus (MERS-CoV), originated in Saudi Arabia, also spread to other Asian, African, European, and American countries, also causing deaths [11, [32] [33] [34] . In the case of the SARS-CoV, it was shown that the outbreak originated due to the transmission of the Himalayan civet (Paguma larvata) [30] . However, it was also reported that animal species such as raccoons and bats could carry the virus [30] . In the case of MERS-CoV, after identifying the virus, the epidemiological relationship between human and camel cases was confirmed [34] [35] [36] . Both SARS-CoV and MERS-CoV have caused more than 10,000 cumulative cases in the past two decades, with case fatality rates of 10% and 37%, respectively [34] [35] [36] . The identified coronaviruses were the tip of the iceberg. More of them would emerge and become apparent as already occurred with the current pandemic SARS-CoV-2/COVID-19 [11, 12, 23] . In this scenario of interaction between animal and human health, also the environmental health, then, the concept of One Health, is again of utmost importance. One Health is an approach that recognizes that the health of people is closely connected to the health of animals and our shared environment ( Figure 1 ). Currently at homes, zoological parks and farms, there have been reports of infections from humans to animals. At the integrative disease ecology study of SARS-CoV-2/COVID-19, its relevance seems to be more than evident. Notably, at the beginning of the pandemic, during the first identified spillover between animals and humans, at the Huanan Seafood Wholesale Market in Wuhan or in the suburban-wild interphases or ecotones that probably allow the interaction between SARS-CoV-2 infected animals and humans, this should be a relevant factor (Figure 1 ). Current evidence is showing that the SARS-CoV-2 would be transmitted from humans to domestic cats at home, as well as to wild felids in zoological parks (Figure 1 ), without evidence of transmission from these animals to humans [26, 37, [41] [42] [43] [44] . Nevertheless, at this moment we do not know the real susceptibility of animals to SARS-CoV-2 exposure, including the role of the inoculum, the route of transmission, among other related factors. In the current scenario of significant human-to-human transmission appear as the main focus to be attended, and the role of animals would be seen as marginal, but this deserves a comprehensive approach and assessment to understand the epidemiology and future advance of disease. If individual animals became reservoirs or vehicles of SARS-CoV-2, this infection might become endemic. In the case of South America, yet not reports of transmission from human to animals have been made, nevertheless, in addition to dogs, cats, tigers and lions, maybe there is concern about infection in Mustelidae from South America [45] , but this is yet to be seen and reported. In the context of COVID-19 pandemic, the presence of SARS-CoV-2 in wastewater has been consider as a potential health risk, but also as an effective approach to predict the potential spread of the infection by testing for infectious agents in wastewater [46] [47] [48] [49] . Given that plumbed wastewater In the environmental context, the impact of climate change and land use, including deforestation and intensive farming practices, should also be analyzed [62] . Disruptions in environmental conditions and habitats can provide new opportunities for SARS-CoV-2 and maybe other CoVs to spillover. Given the abundance of non-human primates in forested areas of South America, and recent evidence indicating that also rhesus macaques are susceptible to SARS-CoV-2 [63] , human cases in these niches are a matter of concern. In Brazil, especially in Rio de Janeiro, as well as also in Argentina, in some park is common the close contact between monkeys and human tourists [64] . In the case of Latin America such disruptions have been seen especially in the Amazon jungle, and area shared not only with Brazil, but with many other countries in South America, observing the impact on zoonotic and vector-borne diseases and pathogens, such as malaria, dengue, chikungunya, Zika, hantavirus, hemorrhagic viral fevers [62, [65] [66] [67] . Health programs targeting an integrative approach for COVID-19 should consider the role of One Health initiatives [9, 68] . Operative research on animals in close contact with positive SARS-CoV-2 humans, beginning with those at home or in zoological parks, such as dogs, pets, ferrets among others, should be studied, as recent evidence suggests the possible human-to-felines and human-todogs transmission (Figure 1 ) [69] [70] [71] [72] . Many unanswered questions need to be carefully studied with ONE HEALTH approach [73] . This would be helpful for a better understanding of SARS-CoV- there is a lack of responses directly targeting these approaches. Furthermore, multiple teams composed by engineers, biologists, physicists, veterinarians, public health professionals are making efforts to develop Colombian and Peruvian products such as mechanical ventilators, N95 masks, and ozone cabinets to aid to contain the effects of this disease. However, not in all cases there is an integration of combining the knowledge from a multidisciplinary and multi-institutional team. Health is one. Now is time to make this critical message to deliver to health authorities and society. The study and control of all emerging and zoonotic diseases require this approach. It will benefit the understanding and the opportunities to deploy early interventions and mitigate the profound impacts, a pandemic of zoonotic origin has. 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