205Zoonotic disease transmission risk in displaced populations

Background Repeated spillover events of zoonotic diseases from animals to humans, in combination with unprecedented levels of forced migration, present a major challenge to the global health security agenda. Infectious disease risk is affected by a range of ecological, political and socio-economic drivers. Methods This study uses a qualitative case study methodology to determine how displacement affects the risks of zoonotic disease transmission. Based on key informant interviews and observational studies in Jordan and Pakistan, the study analyses social-structural factors impacting zoonotic disease transmission. Results The study shows that displacement may influence zoonotic disease transmission through its impact on environmental, socio-economic and behavioural factors, influenced by historical, political and socio-economic processes. Sporadic outbreaks of zoonoses including cutaneous leishmaniasis, rabies and Tuberculosis are reported among displaced populations. Risk factors include a decline in health services, increased population density, changes in environment, and reduced quality and availability of shelter, water and nutrition, in turn determining vulnerability to vectors and pathogens. Conclusions Risk factors affecting zoonoses in displacement are complex and interlinked. While the presence of animals may increase the risk in densely populated areas lacking hygiene, livestock may be beneficial to the health status of displaced by improving nutrition. Responses need to be interdisciplinary, multilevel and contextualized. Key messages To mitigate the risk of zoonotic disease transmission during displacement, responses need to include pathogen and vector control, as well as reducing vulnerability to disease, including through access to health and veterinary services and humanitarian assistance.