What have vector-borne diseases to do with Covid-19 and urban planning?

For this week’s blog post we conducted an interview with the Swedish researcher Dr Johanna Lindahl. Johanna is an Assistant Professor in veterinary epidemiology at both Uppsala University, Swedish University of Agricultural Sciences and...

For this week’s blog post we conducted an interview with the Swedish researcher Dr Johanna Lindahl. Johanna is an Assistant Professor in veterinary epidemiology at both Uppsala University, Swedish University of Agricultural Sciences and International Livestock Research Institute in Hanoi. In 2018, Johanna was awarded the SIGHT Award by the Swedish Institute for Global Health Transformation, a branch under the Royal Swedish Academy of Science, for her research on the interaction between antibiotic resistance, humans and animals.

In broad terms, Johanna’s research is focusing on food safety, and vector-borne, zoonotic and emerging infectious diseases in developing countries. Over the last seven years, Johanna has conducted research in India. We were curious to learn more about her research and her experiences of working in India.

Dr Johanna Lindahl, field research, Guwahati, India. Photo: Johanna Lindahl

Could you tell us a bit about your research in Guwahati, India?

Johanna: I am heading a research project called the ‘Metropolitan Mosquito project’ we are studying mainly mosquito-borne infectious diseases (with a focus on Japanese encephalitis and West Nile fever) in the urban and peri-urban parts of the Guwahati. We are trying to create better understanding for how the prevalence of mosquito-borne infectious diseases is linked to livestock keeping. One aim is to understand which risk factors are important for the spread of infections, including the awareness of disease risks among farmers. In addition, we are trying to map the livestock keeping practices and other zoonotic* infections, such as leptospirosis.

In addition to this project, I am also working in different projects in Guwahati together with International Livestock Research Institute and Assam Agricultural University, looking at improving livestock farming, reducing disease transmission of zoonotic diseases, improving food safety and reinforcing the regional government’s laboratory capacity.

*Zoonotic diseases (also known as zoonoses) are caused by germs that spread between animals and people. Zoonotic diseases are caused by harmful germs like viruses, bacterial, parasites, and fungi. These germs can cause many different types of illnesses in people and animals, ranging from mild to serious illness and even death.

Can you share an important insight from your research?

Johanna: We presently know very little about the spread of most infectious diseases in India. We do know that many diseases could be mitigated by relatively simple measures, such as hygiene and sanitation, but lack of resources, education and infrastructure prevents implementation of effective mitigation efforts.

What does your research teach us about how we can prevent and fight pandemics like Covid-19?

Johanna: For an increased preparedness, it is vital to have an open communication between veterinary and medical surveillance programs. We need to avoid situations where the agricultural sector does not want to study diseases because the impact is too minor on the productivity, but may be large for humans, and where the medical sector does not want to study livestock. Similarly, the livestock sector may be afraid of screening for diseases due to economic impacts of finding new or zoonotic diseases. Therefore, zoonotic diseases sometimes fall between the chairs. We need to start with the knowledge we already have at hand and mitigate the diseases we already know about. This is highly relevant also for preventing new pandemics as most of the mitigation methods would be the same for fighting emerging infectious diseases like Covid-19.

If we can improve food markets and food safety so that endemic* diseases, such as salmonella, cannot be transferred, we at the same time reduce the risk for the transmission of new diseases like Covid-19 (Covid-19 is likely to have originated in a food market in Wuhan). If we improve sanitation and reduce mosquito breeding grounds for dengue and Japanese encephalitis vectors, we also make it more difficult for emerging vector-borne diseases such as Zika and Chikungunya to spread.

*An endemic disease is a disease that is always present in a population.

The number of people infected with malaria and dengue fever increased during the Covid-19 lock-down in New Delhi, why do you think that is?

Johanna: This is a very interesting question and may have many reasons. One explanation can be that people with fever, which is common symptom for all these diseases, are now being tested, and therefore the reporting goes up, even though the actual number of cases has not increased. Another explanation can be that the number of cases are  really increasing. Both dengue and malaria have socioeconomic determinants and factors associated with reduced incomes, potentially caused by the lock-down when many poor people can no longer own their living, which could trigger an increase in cases.

What pre-emptive measures would you like to see to curb the prevalence and devasting impact of vector-borne diseases?

Johanna: The vector-borne diseases are today occurring much under the radar, causing disease mainly among poorer people. Pre-emptive measures mainly belong to what I mentioned before: We need to stop mosquitoes from breeding, by removing garbage and having proper drainage. One of the key factors for preventing vector-borne diseases is the planning of proper drainage, good water supply systems, good systems for managing garbage, as well as making sure that surrounding irrigated fields use modern methods, such as intermittent irrigation. All of these will stop mosquitoes from breeding, and thereby reduce the spread of diseases.

Sampling cows during field research, Guwahati, India. Photo: Johanna Lindahl

What new research questions would you like to explore in the context of India?

Johanna: There is a multitude of interesting research questions. First, I would like to know more about the presence of different zoonotic diseases, including Q-fever and Nipah virus in India. Then what we really need is action research to reduce the devasting impact of vector-borne diseases. How can we empower cities to reduce transmission? How can such efforts be owned and championed by the cities themselves for creating sustainable effects?

How would you describe the importance of developing more and stronger Sweden-India research partnerships? Do you have any advice to Swedish researchers who would like to conduct research in India?

Johanna: I have really appreciated working in India and learned lots from the collaborations. We live in a global world and it is important to build transnational links and admit that we can all learn from each other. Sweden and India have potential to form strong collaborations with public health impact.

In terms of research partnerships, the most important thing is to make sure that the partnerships are beneficial for all participants and that the research needs of India are met. Before starting new collaborations, it is good to make sure that all partners are clear on the agenda and agree on the sampling plans etc, and it is good to make sure to obtain all permits that may be needed. India is a very big and very diverse country and it may be easier to implement partnerships and working relations at state level.

Moreover, I think it is important to enable Indian students to enroll in Sweden as PhD students. That way Sweden can contribute to stronger research institutes and capacity building.

We would like to thank Dr Johanna Lindahl for her kind support to write this blog and for sharing knowledge about her research. Do you want to know more about Johanna’s research?  Take a look at her publications here.

Johanna’s research is one of many examples of how Swedish and Indian researchers can pursue common scientific endeavors of benefit not only to our two countries, but also the international community’s mission to fulfil the UN Sustainable Development Goals. This is objective is very much in line with the Joint Declaration on Sweden-India Innovation Partnership for a Sustainable Future, signed in April 2018. The innovation partnership between Sweden and India aims to drive prosperity and address global challenges, such as climate change and sustainable development, through joint innovation and research.

Both Sweden and India have agreed to continuously explore ways to increase the impact of our bilateral cooperation in innovation, science and technology by engaging stakeholders from government, industry and academia. If you are working at a Swedish university or research institute and would like to establish an institutional partnership with India (or vice versa), please contact us if you need support or guidance. We would be happy to assist you in your mission to find a partner!

To all our Swedish partners and followers, we hope you have had a wonderful summer vacation!

Greetings from the OSI Team

Fanny von Heland, Leena Kukreja, Mini Nair