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Advanced Sciences and Technologies for Security Applications

Anthony J. Masys
Ricardo Izurieta
Miguel Reina Ortiz Editors

Global
Health
Security
Recognizing Vulnerabilities, Creating
Opportunities
Advanced Sciences and Technologies
for Security Applications

Series Editor
Anthony J. Masys, Associate Professor, Director of Global Disaster Management,
Humanitarian Assistance and Homeland Security, University of South Florida,
Tampa, USA

Advisory Editors
Gisela Bichler, California State University, San Bernardino, CA, USA
Thirimachos Bourlai, West Virginia University, Statler College of Engineering and
Mineral Resources, Morgantown, WV, USA
Chris Johnson, University of Glasgow, Glasgow, UK
Panagiotis Karampelas, Hellenic Air Force Academy, Attica, Greece
Christian Leuprecht, Royal Military College of Canada, Kingston, ON, Canada
Edward C. Morse, University of California, Berkeley, CA, USA
David Skillicorn, Queen’s University, Kingston, ON, Canada
Yoshiki Yamagata, National Institute for Environmental Studies, Tsukuba, Ibaraki,
Japan
The series Advanced Sciences and Technologies for Security Applications comprises
interdisciplinary research covering the theory, foundations and domain-specific topics
pertaining to security. Publications within the series are peer-reviewed monographs
and edited works in the areas of:
– biological and chemical threat recognition and detection (e.g., biosensors, aero-
sols, forensics)
– crisis and disaster management
– terrorism
– cyber security and secure information systems (e.g., encryption, optical and
photonic systems)
– traditional and non-traditional security
– energy, food and resource security
– economic security and securitization (including associated infrastructures)
– transnational crime
– human security and health security
– social, political and psychological aspects of security
– recognition and identification (e.g., optical imaging, biometrics, authentication
and verification)
– smart surveillance systems
– applications of theoretical frameworks and methodologies (e.g., grounded theory,
complexity, network sciences, modelling and simulation)
Together, the high-quality contributions to this series provide a cross-disciplinary
overview of forefront research endeavours aiming to make the world a safer place.

The editors encourage prospective authors to correspond with them in advance of

submitting a manuscript. Submission of manuscripts should be made to the Editor-
in-Chief or one of the Editors.

More information about this series at http://www.springer.com/series/5540

Anthony J. Masys • Ricardo Izurieta
Miguel Reina Ortiz
Editors

Global Health Security

Recognizing Vulnerabilities, Creating
Opportunities
Editors
Anthony J. Masys Ricardo Izurieta
College of Public Health College of Public Health
University of South Florida University of South Florida
Tampa, FL, USA Tampa, FL, USA

Miguel Reina Ortiz

College of Public Health
University of South Florida
Tampa, FL, USA

ISSN 1613-5113 ISSN 2363-9466 (electronic)

Advanced Sciences and Technologies for Security Applications
ISBN 978-3-030-23490-4 ISBN 978-3-030-23491-1 (eBook)
https://doi.org/10.1007/978-3-030-23491-1

© Springer Nature Switzerland AG 2020

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The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
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Foreword

Our small planet is effectively growing smaller every day. In the nineteenth century,
it was possible to believe that geographic distances could protect a country from
disruptions, natural disasters, and plagues raging far away on the other side of the
world. But this is no longer the case. Thanks to our international air travel network, it
is now possible to get from any city on the planet to any other city on the planet in
less than one day. And the number of people traveling internationally by air has
grown by over 5% a year for the past 10 years. Paralleling this growth in air travel is
a growth in shipping. Few of the goods we now consume are produced locally. Most
come from across the world. The increase in the movement of both people and goods
means that we are no longer sheltered from events that happen on the other side of
the world. The world has turned into a village.
And we are seeing more disasters and threats to the security in our planetary
village. Political instability and environmental changes caused by global warming
are displacing more and more people. In 2017, it was estimated that over 65 million
people were refugees. Displaced people often are forced to live in crowded, less than
ideal conditions which can breed disease, food insufficiency, and radicalism. Envi-
ronmental degradation and the incursion of people into previously wild habitats
spurs the development of zoonoses which can become devastating epidemics and
pandemics. Climate change can result in slow moving (e.g., the inundation of the
Pacific atoll island nations) and rapid (e.g., hurricanes) weather-related disasters that
leave people homeless and traumatized. Any many of these factors can often afflict a
population at the same time, leading to complex humanitarian disasters that are very
difficult to address. A good example of this is the Ebola epidemic in North Kivu
Province of the Democratic Republic of the Congo in 2018. Despite deploying an
effective vaccine, the international community has struggled to contain this epi-
demic, as a result of political unrest, population movement, and distrust of outsiders
by the local population.
The authors of this volume highlight many of the challenges that confront our
global security environment today. These range from politically induced disasters to
food insecurity, to zoonoses, and to terrorism. More optimistically, the authors also

v
vi Foreword

present some advances in technology that can help us combat these threats. Under-
standing the challenges that confront us and the tools we have to overcome them will
allow us to face our future with confidence.

Professor, Global and Planetary Health, Thomas Unnasch

College of Public Health, University of
South Florida, Tampa, FL, USA
Contents

Part I Emerging Threats

Plagues, Epidemics and Pandemics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Ricardo Izurieta
Agricultural Emergencies: Factors and Impacts in the Spread
of Transboundary Diseases in, and Adjacent to, Agriculture . . . . . . . . . 13
Ashley Hydrick
The Threat Within: Mitigating the Risk of Medical Error . . . . . . . . . . . 33
Simon Bennett
Climate Change, Extreme Weather Events and Global Health
Security a Lens into Vulnerabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Carson Bell and Anthony J. Masys
Global Health Biosecurity in a Vulnerable World – An Evaluation
of Emerging Threats and Current Disaster Preparedness Strategies
for the Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Kristi Miley
The Emerging Threat of Ebola . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Michelle LaBrunda and Naushad Amin

Part II Mitigation, Preparedness and Response and Recovery

Natural and Manmade Disasters: Vulnerable Populations . . . . . . . . . . . 143
Jennifer Marshall, Jacqueline Wiltshire, Jennifer Delva, Temitope Bello,
and Anthony J. Masys
Global Sexual Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Sara Spowart

vii
viii Contents

Global Health Security and Weapons of Mass Destruction Chapter . . . . 187

Chris Reynolds
Antimicrobial Resistance in One Health . . . . . . . . . . . . . . . . . . . . . . . . . 209
Marie-jo Medina, Helena Legido-Quigley, and Li Yang Hsu
Food Security: Microbiological and Chemical Risks . . . . . . . . . . . . . . . . 231
Joergen Schlundt, Moon Y. F. Tay, Hu Chengcheng, and Chen Liwei

Part III Exploring the Technology Landscape for Solutions

Gaussianization of Variational Bayesian Approximations with
Correlated Non-nested Non-negligible Posterior Mean Random
Effects Employing Non-negativity Constraint Analogs and Analytical
Depossinization for Iteratively Fitting Capture Point, Aedes aegypti
Habitat Non-zero Autocorrelated Prognosticators: A Case Study
in Evidential Probabilities for Non-frequentistic Forecast
Epi-entomological Time Series Modeling of Arboviral Infections . . . . . . 277
Angelica Huertas, Nathanael Stanley, Samuel Alao, Toni Panaou,
Benjamin G. Jacob, and Thomas Unnasch
Simulation and Modeling Applications in Global Health Security . . . . . . 307
Arthur J. French
The Growing Role of Social Media in International Health Security:
The Good, the Bad, and the Ugly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
Stanislaw P. Stawicki, Michael S. Firstenberg, and Thomas J. Papadimos

Part IV Leadership and Partnerships

Effecting Collective Impact Through Collective Leadership
on a Foundation of Generative Relationships . . . . . . . . . . . . . . . . . . . . . 361
Marissa J. Levine
Global Health Security Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 387
James Stikeleather and Anthony J. Masys

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427
 Part I
Emerging Threats
Plagues, Epidemics and Pandemics

Ricardo Izurieta

1 Introduction

Plagues have been on earth before mankind and in fact they emerge along with life
on earth and they have experience three and a half billions of years of evolution and
adaptation. The encounter of civilizations has facilitated the exchange of microor-
ganisms determining the emergence of plagues and pandemics that have decimated
populations. The presence of the Spaniards in the Americas during the end of the
fifteenth and beginning of the sixteenth centuries resulted in the global expansions of
plagues like yellow fever, variola, measles, rubella, syphilis, tuberculosis among
others. Also, a few centuries before, the thirteenth century expansion of the Mongol
empire facilitated the dissemination of the black plague.
Plagues should not only be analyzed from its biological determination but also
from its social, economic, cultural and even moral determinants. The plague of the
ends of century twentieth -Human Immunodeficiency Virus/Acquired Immunodefi-
ciency Syndrome (HIV/AIDS)- cannot be seen as a mere genetic evolution and
adaptation of the Simian Immunodeficiency Virus (SIV) but also as a social con-
struction in which elements like access to health care services and therapeutics,
knowledge about the disease and even cultural and moral elements should be
incorporated into the analysis.

R. Izurieta (*)
College of Public Health, University of South Florida, Tampa, FL, USA
e-mail: rizuriet@health.usf.edu

© Springer Nature Switzerland AG 2020 3

A. J. Masys et al. (eds.), Global Health Security, Advanced Sciences
and Technologies for Security Applications,
https://doi.org/10.1007/978-3-030-23491-1_1
4 R. Izurieta

2 Discussion

As described in historical chronologies of the times of the Plague (years

1347–1350), people reacted to the pandemic with penitence acts to assuage God’s
anger. One of the most striking demonstrations of auto-infliction of pain and
suffering were the Processions of the Flagellants that took place in the Netherlands
and Germany [1]. Similar reactions were seen in the times of cholera -1991 Cholera
pandemic of the Americas- when the parishioners of the port of Guayaquil, Ecuador
decided to participate in the Eastern Christ of Consolation Procession. Actually,
these religious ceremonies became the epicenters of the transmission of the patho-
gens instead of ameliorating the epidemics and pandemics. A synergy of socioeco-
nomic, cultural, ecological and biological were observed during the Eastern Christ of
Consolation Procession, where parishioners of all catholic churches of the main port
of Guayaquil, Ecuador and its surroundings participated in the procession to ask for
God’s mercy since the cholera epidemic had already taken thousands of lives in the
country.
During the times of cholera in the Americas, a rampant expansion of the seventh
cholera pandemic originated in the Celebs Islands, Indonesia arrived into Peru in
December 1990 to later be expanded to Ecuadorian territories. Just a few weeks after
Peru had declared a cholera epidemic, the first case of the disease was reported in
Ecuador on February 28, 1991. A fisherman who had traveled by a small vessel to
Peru contracted cholera and initially infected the town of Bajoalto in El Oro
province. The epidemic spread rapidly. During the first epidemiological week,
cases were reported in widespread regions of the country such as Esmeraldas in
the north, Guayas in the center of the coastal zone, and throughout parts of the
Andean highlands. In a matter of months, the epidemic had reached beyond the
Andean mountains to the waters of the Amazon River spreading throughout the
rainforest. At the peak of the epidemic—the 17th epidemiological week (April 27-
May 4, 1991)—more than 3000 new cases were reported in the country [2]. The
causative agent was found to be Vibrio cholera O1 of biotype El Tor serotype Inaba
[3] (Fig. 1).
Since John Snow’s classic work in 1885 on cholera in London, water is known to
be one of the most important vehicles of transmission for cholera [4]. As in the case
of Snow’s work, our findings on the positive relationship between potable water
supply and increased cholera attack rates suggested the contamination of municipal
water supplies. Prior to the 1991 cholera epidemic in Ecuador, Guayaquil’s munic-
ipal water system had already reported low water pressure and other deficiencies in
their system. Although the central tap water reservoir in the city had 0.1 p.p.m. of
free chlorine, no chlorine was detected from jury-rigged connections at the periphery
of the water system [5]. In short, deficiencies of the municipal water system within
the country were the explanation for the correlations found between high potable
water coverage and increased cholera attack rates. These inadequacies may have
caused massive widespread contamination with hundreds of patients overcrowding
emergency health care services.
Plagues, Epidemics and Pandemics 5

Fig. 1 Cholera patient with severe dehydration (sunken eyes) under rapid intravenous water and
electrolytes infusion

Similar occurrences were described in Rioacha of Colombia and Trujillo and

Piura of Peru [6, 7]. In the Piura study, researchers concluded that “Piura’s water
system [had] distributed the infection throughout the city” thereby demonstrating as
Snow and others did in the mid-1900s, that untreated water in centralized distribu-
tion systems still pose as hazards to public health [6]. Such common sources of
contamination were associated with one or more of the following deficiencies:
insufficiently maintained pipes, low or intermittent water pressure, illegal
(unmetered) water connections, water taps located below ground level, and substan-
dard levels of chlorine in the system. In the Rioacha case study, epidemiological
research linked the municipal drinking water supply as a risk factor for both acute
diarrheal diseases and cholera. Their findings showed that the municipal water
system was contaminated and was thus serving as a key vehicle for cholera
transmission [8].
But water was not the only vehicle of transmission of V. cholerae, as demon-
strated years later by Rita Colwell. V. cholerae actual reservoir is in the brackish
waters of the estuaries all around the world. V. cholerae The Tor has been isolated
from aquatic estuaries where the temperature is higher than 10  C and the salinity is
between 2‰ and 2.5‰, these are optimal conditions for vibrio growth [9]. This
correlation between cholera O1, temperature and salinity, was described by
Hood et al. in two studies conducted in Florida [6]. Miller et al. found that
the optimum concentration of salt for the survival of cholera was 2.0‰, the
salt concentration of the rivers of Ecuador and the water of the Pacific Ocean
were optimal for the development of the bacteria, phenomenon attributed to
the increase of rain water during the rainy season of March-May 1991 in Ecuador.
6 R. Izurieta

The correlation between high rainfall during the rainy season and the epidemic peaks
of. V. cholerae actually was later demonstrated in Ecuador [6, 8]. In addition,
zooplankton plays an important role in the survival of cholera and the association
with copepods is a characteristic of V. cholerae as other vibrios like Vibrio
parahaemoliticus. Hug et al. have stated that salinity and the presence of zooplank-
ton are the main factors that determine the growth of vibrios, in this environment
V. cholerae is apt to contaminate organisms developed by their ability to adhere to
surfaces [6].
Consequently, seafood became the second most common vehicle of transmission
of V. cholerae. The historical and ancient practice of eating raw seafood or dry fish
among the Ecuadorian and Peruvian population factored into the V. cholera trans-
mission in the coastal regions. Substantial evidence points to the consumption of raw
fishery products as one of the greatest risks [10–13]. We found that the popular
national dish “ceviche,” (containing marinated seafood) was a vehicle of V. cholera
transmission [14]. The presence of V. cholera in “conchas” (or shellfish) in Ecuador
were described in the studies of Weber et al. [5]. Thus, it was concluded that
contaminated seafood, handling and preparation, including the time the seafood is
exposed to citric acid in the lemon juice marinade, affect the outcome of cholera
cases. People consuming raw or dry seafood unleashed a cholera epidemic that took
thousands of lives.
On the Good Friday of March 29, 1991, hundreds of thousands of parishioners
from of catholic churches of Guayaquil and its satellite cities and counties congre-
gated in the streets to participate in the Eastern Christ of Consolation Procession. As
usual, that day the route of procession began early in the morning in the church of
Cristo del Consuelo located at the intersection of Lizardo García and A streets,
southwest of Guayaquil. People were agglomerated on the streets while the residents
of houses and buildings located on the sides of the route were throwing water to
ameliorate the heat people were experiencing during those high temperature days
which are typical of the rainy season.
Early in the afternoon, the National Epidemiological Surveillance System
mounted by the Ministry of Public Health got an emergency call indicating the
presence of dozens of cholera cases in an apartment located in one of the poor
neighborhoods of the Febres Cordero parish, close to the El Salado estuary. When
the epidemiology brigade arrived, about a dozen men and women were sitting or in
bed with the classical profuse watery diarrhea proper of cholera. Immediately, oral
rehydration with Oral Rehydration Salts (ORS) or intravenous rehydration with
Ringer’s Lactate was stablished. While being rehydrated, a case control study
interview was administered in order to identify the foods consumed in the last
3 days by the patients and their family controls. The Odds Ratios clearly pointed
at the consume of dry shrimp 2 days ago as the main factor associated with the
profuse diarrhea. In a qualitative interview, the patients, all of them members of an
extended family, mentioned that relatives from the Puna island have brought dry
shrimp to consume during the Eastern week in Guayaquil and to participate in the
Christ of Consolation Procession. Paradoxically, they have arrived to ask God to
protect Guayaquil and its surroundings from the cholera epidemic that was being
extended like fire since its beginning 4 weeks ago in the Ecuadorian territory. During
Plagues, Epidemics and Pandemics 7

Fig. 2 Hundreds of thousands of parishioners of the port of Guayaquil, Ecuador participating in the
Eastern Christ of Consolation Procession

the dinner of Good Wednesday they consumed fish and seafood and no meat at all as
it is banned by the Catholic church. That weekend we went to visit Puna island to see
if there were more patients who needed immediate rehydration in a low population
zone where there is no health care services. Few more cholera cases where found
also associated with the consumption of dry shrimp. During the inspection of the
water and sanitation systems, it was found that the water was obtained from wells
[15] and that the sanitation system was composed of pit latrines. Consequently,
contamination of the sea by sewage discharges was not possible and the contami-
nation of shrimp and fish in their natural environment was plausible. The results of
the case-control study were immediately faxed to the Minister of Public Health who
forwarded the fax to the Ministry of Fishery. The order of the Ministry of Fishery
was to declare the document as classified due to the possible impacts on shrimp
exportations. This was the first epidemiological evidence of the contamination of
fish and seafood in their natural marine environment. But also, it brings to discussion
the following questions: Since in the London of century twenty-first there were not
refrigerators, did London used to consume dry fish which could have been contam-
inated? Besides the transmission by water was there a transmission through seafood
during the 1854 London epidemic? Was the cholera epidemic controlled not only by
John Snow’s clever interventions but also because of the development of protective
natural immunity in the population? (Fig. 2)
Although the highest morbidity rates of cholera were observed in the coastal
provinces, the highest Case Fatality rates (CFR) were reported in the Andean
provinces where there is a predominance of indigenous Kichwa population, descen-
dants of the Incas. The presence of the cholera pandemic in Ecuador and the Andean
region showed us that after 500 years of the conquest of the Inca Empire by the
Spaniards, our indigenous populations were still ignored by the government health
system. The Kichwa and other indigenous ethnic groups were mistreated and
marginalized in health services managed by the “mestizos”. Emergencies were not
8 R. Izurieta

Fig. 3 During burial ceremonies and celebration of the Day of the Death countless cholera
outbreaks were reported among indigenous Kichwa communities. In these celebrations relatives
of the deceased used to share food and drinks spreading the disease among the invitees

managed based on the severity of the case but on the racial background of the patient.
Many Kichwas preferred to die at home with their relatives instead of dying in a
hospital alone and mistreated by strangers that talked to them in another
language [16].
For the Kichwa population, diseases are classified as environmental and proper of
the community and those diseases of outside or God are those caused by the presence
or contact with whites and mestizos on indigenous lands. These diseases can also be
brought by the Indians who go to work in the cities of whites and mestizos, on the
coast, or in another place different from that of the community. Outside the com-
munities, in the cities, kichwas can be contaminated by their uncontrolled life, by the
excess of work, but mainly by the continuous contact with white-mestizo carriers of
these diseases. Therefore, there is no cure within the community and these diseases
must be treated in white-mestizo hospitals. These diseases are considered as a
punishment sent by God and are diagnosed and cured by white doctors in hospitals.
The healers and Yachacs (shamans) try not to mediate in this group of diseases. But
they are also attributed to a punishment for breaking community values or norms
(carelessness, filth, alcoholism) or for the social degradation existing in the commu-
nities [17, 18] (Fig. 3).
The paradoxical existence -from the merely bio-ecological point of view- of the
epidemic in the frosty Andean provinces can lead us to propose a new pattern of
alternative transmission. The Andean region, characterized as a zone of cold climate
Plagues, Epidemics and Pandemics 9

Fig. 4 Lake San Pablo which waters were invaded by V. cholera stablishing a new enclave of the
plague in the Andean mountains

in which temperatures are almost always below 10  C, theoretically does not

constitute an ecological environment conducive to the maintenance of V. cholerae.
The fact that Vibrio cholerae can develop with an incredible adaptability even in
cold freshwater of the Andes as described in rivers in eastern Australia and saltwater
as described in the North American bays in the Gulf of Mexico poses a menace to
human populations who do not have natural immunity. In conclusion we could
accept the fact that the microorganism was able to invade new ecological niches in
the Andean mountains as well as to find an immunological virgin Kichwa population
whose socioeconomic status and characteristic culture harbored the conditions for an
explosive and lethal epidemic (Fig. 4).
In the historical analysis carried out by Glass and Black, cholera disease shows a
cyclical behavior. According to these analyzes, epidemic outbreaks should be
expected every 5–7 years [4]. The behavior of cholera worldwide seems to be
closely related to the climatic changes caused by El Niño current in Latin America
and the Monsoons in Southeast Asia. In the same way, the seasonal behavior of
cholera has been reported in several investigations [19], for sure the epi-
demic adopted this seasonal and cyclical behavior Andean zone. Therefore, the
statement that cholera is also linked to ecological and cultural conditions has a
logical basis. The verification of a seasonal and periodic cholera behavior in the
Andean region would be evidence of the connection of outbreaks of the disease
with climate changes, which in turn would be related to the cultural practices of
the affected populations. The ethnocultural and environmental factors would be
10 R. Izurieta

integrated into socioeconomic determinants and health infrastructure to constitute

what would be called a syndemic pattern of transmission of cholera in the Andean
zone. As a matter of fact, there are strong epidemiological and biological bases for
the construction of this syndemic pattern of Andean transmission integrating the
socioeconomic, religious, environmental and ethnocultural factors of the region.

3 Conclusion

Although the persistence of cholera in certain provinces is mainly attributed to

socioeconomic conditions and the availability of sanitary infrastructure, these factors
do not completely explain the behavior of cholera in the Andean zone. Therefore, a
reasonable complementary explanation of the epidemic behavior and endemization
of cholera is the influence of ecological and cultural factors associated with ancestral
practices among the descendants of the pre-Hispanic ethnic groups that inhabit the
Andean highlands. After the epidemic of 1991, which attacked an immunologically
virgin population, the disease had a tendency to disappear with no evidences of its
endemization.
In the global context, the recent epidemics have weakened the reputation of
international organizations during the Ebola epidemic. Dr. Joanne Liu, Medicins
Sans Frontieres (MSF) International President, denounced United Nations has not
deployed the minimum necessary resources to tackle the exceptionally large out-
break of Ebola virus. Despite repeated calls by non-government international orga-
nizations like MSF for a massive mobilization on the ground, the international
response was lethally inadequate [20].

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Panorama Epidemilogico del Ecuador. Ministry of Public Health of Ecuador, Quito
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America and the Caribbean, University of South Florida
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Cholera. Plenum Publishing Corporation, New York
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Puhr ND, Cameron DN, Tenover FC, Barret TJ, Bean NH, Ivey C, Tauxe RV, Blaske PA
(1994) Epidemic cholera in Ecuador: multidrug-resistance and transmission by water and
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Agricultural Emergencies: Factors
and Impacts in the Spread
of Transboundary Diseases in,
and Adjacent to, Agriculture

Ashley Hydrick

1 Introduction: The Importance of Agriculture

In 2015, 40 years after the first call to end global hunger, the United Nations
(UN) made food security through sustainable agriculture the second Sustainable
Development Goal (SDG-2) [1]. In addition to providing for the basic human right of
food security, a robust agricultural industry is vitally essential to ensure the social,
economic, and political stability of a nation [2–4]. Food security is the state of
having access to a sufficient supply of food that is safe, nutritious, and meets a
group’s dietary needs and preferences to maintain a healthy lifestyle [5]. The state
where these criteria are not met is called food insecurity. Depending on the resource,
it is estimated that between 820 million and 940 million people worldwide live in
some form of chronic or recurring food insecurity, and about 108 million people live
in a state of food emergency [6–8]. The UN describes a two-fold intervention
approach for food insecurity, which are reducing the degree of exposure to the
hazards that contribute to food insecurity or increase the ability of communities to
cope with those hazards [5]. Hazards that contribute to food insecurity may include:
Human-made disasters – war or chemical/radiologic contamination, Climatic events
– droughts, storms, or flooding, and Disease or pest outbreaks that impact agriculture
[9, 10]. Any one or a combination of these events may constitute an agricultural
emergency, which will be defined in this chapter. Food aid has been a cornerstone of

The views and information presented are those of the author and do not represent the official
position of the U.S. Army Medical Department Center and School Health Readiness Center of
Excellence, the U.S. Army Training and Doctrine Command, or the Departments of Army/Navy/
Air Force, Department of Defense, or U.S. Government.

A. Hydrick (*)
Long Term Health Education and Training Program, U.S. Army, University of South Florida
College of Public Health, Tampa, FL, USA
e-mail: marie105@health.usf.edu

© Springer Nature Switzerland AG 2020 13

A. J. Masys et al. (eds.), Global Health Security, Advanced Sciences
and Technologies for Security Applications,
https://doi.org/10.1007/978-3-030-23491-1_2
14 A. Hydrick

humanitarian assistance for nearly half a century, but has been found to be costly and
unsustainable if the hazard cannot be immediately eliminated [4, 10–12]. Therefore,
development of agriculture toward food self-sufficiency has become the new focus
of world leaders in addressing the food insecurity challenges of today [4, 13]. The
purpose of this chapter is to introduce agricultural emergencies and provide some
case examples, specifically transboundary disease (TBD) events, that have threat-
ened sustainable agriculture worldwide. This discussion is not meant to provide a
detailed description of every threat to sustainable agriculture but will provide a basic
working knowledge of the area from which the reader can develop his or her own
knowledge base.

2 Food Self-Sufficiency: The New Goal of Food Security

According to the UN, investment in small farming operations and improving

agricultural technology can assist transition of small subsistence farmers to high-
impact commercial productions that increase food security and improve social
capital by adding “marketable surpluses” [13]. In other words, the new goal of
many international organizations is the development of high-impact sustainable
agriculture to create a state of food self-sufficiency, which is the ability of a country
or community to meet or exceed its own food needs through domestic agricultural
production [4, 13, 14]. This section will introduce the importance of domestic
agriculture and food self-sufficiency in the world today.
The ability of a country to domestically produce even half of its own food
requirements means improved food security for communities, less vulnerability to
price fluctuations in the international market, increased participation in the global
food trade, and increased social stability and trust of the people [2, 6, 14]. Establish-
ment, or re-establishment, of local agricultural markets in war-torn areas has been
shown to improve the sense of social security and welfare, which increases regional
stability [12, 15]. Vulnerable populations, especially women, greatly benefit from
development of commercial agriculture and return of these markets through improv-
ing social capital [15]. It is estimated that 950 million people (16% of the world
population) cover their demand for agricultural products using international trade,
and there are about 2.5 billion small-scale farmers worldwide that subsist primarily
on their own agricultural production. Most of these individuals are in North Africa
and South Asia, which are also the most food insecure areas of the world [6, 16]. Con-
versely, many of the most food secure countries in the world are neither major
importers or exporters of food, indicating that they are likely producing and con-
suming most of their food domestically (Table 1). These examples indicate that food
self-sufficiency can be associated with improving food security and social stability.
Agricultural Emergencies: Factors and Impacts in the Spread of. . . 15

Table 1 Comparison of top food secure countries to top countries in agricultural trade
Rank Food security index Top food importing countries Top food exporting countries
1 Singapore China U.S.
2 Ireland U.S. Brazil
3 U.S. and U.K.a Germany Netherlands
4 Netherlands Japan Germany
5 Australia U.K. France
These rankings were obtained from the FAOSTAT (2017) and the Global Food Security Index
(2018) [17, 18]
a
The United States of America (U.S.) and the United Kingdom (U.K.) were tied for third rank

Table 2 Top producers of staple commodities eorldwide

Rank Maize Rice Wheat Roots and tubers Potato Cottonseed
1 U.S.a China China Ethiopia China China
2 Chinaa India India D.R.a India India
3 Brazil Indonesia Russiaa Pakistan Russia Pakistan
4 Argentina Bangladesh U.S. Indonesia Ukraine U.S.
5 Mexico Vietnam Canada Namibia U.S. Brazil
These rankings were obtained from the FAOSTAT Countries by commodity page for the year 2016
[19]
a
China China (mainland), D.R. Dominican Republic, Russia Russian Federation, U.S. United States
of America

There are a number of societal benefits to obtaining a state of food self-

sufficiency, but the social and economic benefits of this autonomous state is com-
plicated [14, 18]. The assumption is that food security should be intrinsically linked
to robust domestic agricultural production. However, Mainland China, which is a top
producer of nearly all staple commodities (Table 2), is also the number one global
food importer, and is still ranked 46 in the world on the Global Food Security Index
(GFSI) [17]. Conversely, the U.S. is a top staple food producer, food importer and
exporter, and is a top ranked food secure nation (Tables 1 and 2). Many countries,
like Saudi Arabia and United Arab Emirates, are able to meet their food requirements
almost purely through trade due to economic wealth stemming from other industry
[14]. The amount of global food trade is increasing with over one-sixth of agricul-
tural products entering international market [14]. This allows for many countries
with no agricultural production capability to attain food security, while countries
with robust domestic agricultural systems supplement and improve stability of their
food resources through international trade [14, 16]. However, the concern is that, as
populations grow and resources become increasingly scarce, the lack of food self-
sufficiency in some countries will cause food insecurity and destabilized those
nations [16]. Therefore, food self-sufficiency would not only provide social, polit-
ical, and economic benefit at the local national level today, but is expected to also
improve sustainability and stability of agricultural systems into the future.
16 A. Hydrick

3 Agricultural Emergencies Definition

Agricultural emergencies are a threat to the stability and development of food self-
sufficiency worldwide. Many governmental and non-governmental organizations
refer to “agricultural emergencies” in several contexts, but there are limited, often
inconsistent, definitions or descriptions in literature and practice [20–23]. Some
organizations refer to agricultural emergencies exclusively in terms of disease
outbreak events [21], while others refer to emergencies in agriculture in broader
context to include the impacts of climatic disasters [20, 22–24]. In 1998, the UN
defined emergencies in the agricultural sector as those that threaten agricultural
production and livelihoods to constitute a general or food emergency [25]. Similarly,
Gilpen, Carabin, Regens, & Burden define agricultural emergencies as “any type of
event, regardless of intent, that jeopardizes the economic stability of any sector of
agriculture” [24]. These were the only two direct definitions of agricultural emer-
gencies that could be found by this author. Commonalities between these definitions
involve threats to production and economic stability on the large or small scale. This
aligns with the widely accepted general definitions of emergencies and disasters,
which are present or imminent hazardous conditions that threaten the lives and well-
being of persons and property, disrupt normal systems, and require immediate
coordinated response to prevent further damage or injury [20, 26]. Disasters are
differentiated from emergencies by exceeding local coping capacities that requires
outside aid or assistance [26].
The agricultural emergency definitions lean heavily on easily quantifiable impacts,
such as monetary losses and production volume, making them most applicable to the
commercialized agricultural systems that are characteristic of developed nations.
There is some applicability to the small subsistence operations of the lesser developed
nations, but the coping capacity of those systems are often more quickly overcome
than in large-scale commercial agriculture [13, 27]. These definitions only partially
capture the variety of social considerations involved in agricultural emergencies,
which are generally poorly characterized in literature, either over or under sensation-
alizing the issue [2, 28]. Lubroth et al. reference the social impacts of agricultural
emergencies, including psychosocial isolation, increases in suicides, and, in some
cases, breakdown of rule of law as a result of disease outbreak in the agricultural
systems [2]. Discussion of the economic impacts of agricultural emergencies is
important to meet the intent of the formal definitions, but this discussion will also
attempt to capture the social implications of the events presented.

4 Transboundary Agricultural Diseases

Transboundary diseases (TBDs) are highly communicable agents responsible for

high rates of morbidity and/or mortality in the affected populations, thus are usually
socially, economically, and politically significant [29, 30]. Animal TBDs are capable
Agricultural Emergencies: Factors and Impacts in the Spread of. . . 17

of moving undetected over large geographic areas facilitated by airborne particles

and mechanical or biologic vectors, which can rapidly escalate outbreaks and makes
elimination of these diseases difficult [29–31]. There are several organizations
dedicated to the monitoring and containment of these diseases worldwide [29, 30,
32]. The World Organization for Animal Health (OIE) is one such agency that
provides surveillance and subject matter expertise for the World Trade Organization
(WTO) in all matters involving animals and TBDs. The OIE lists 117 internationally
reportable animal TBDs that affect species ranging from cattle and swine to bees and
amphibians [29, 32]. While agricultural TBDs have largely declined in developed
countries due to improved veterinary treatment, primary prevention, and biosecurity
measures, they have remained a major source of economic and political instability in
less affluent Asian, African, and South American nations [2, 9, 29, 33]. Outbreaks of
these diseases in non-endemic countries are diverse and complex large population
disasters that affect multiple species, and are increasing in frequency and scope of
impact worldwide [32–35]. This section will discuss important TBDs and several
important outbreaks that have occurred since the start of the twenty-first century.

4.1 Foot and Mouth Disease

One of the TBDs of greatest significance is foot and mouth disease (FMD), primarily
because of the severe economic and political repercussions of the disease
[36, 33]. FMD is a highly transmissible viral disease that causes fever and vesicular
lesions progressing to erosions on feet, mouth, and udders of cloven-hooved ani-
mals, especially swine and bovine species [29, 32]. This disease is associated with
medium to low mortality rates, especially in endemic zones, but is responsible for
significant morbidity and obvious production loss [29, 37]. It is estimated that
endemic zones, where the disease normally circulates, suffer losses of up to $21
billion annually due to the direct and indirect impacts of FMD [36]. Direct losses
from FMD encompass production losses, like decreased weight gain, reproductive
challenges, juvenile mortality, decreased milk production, and increased disease
burden from secondary infections [29, 37]. Additionally, FMD endemic countries
are subject to restrictions from affluent trade markets, which limits economic growth
and stability [2, 33, 37]. Epizootic outbreaks of FMD can rapidly escalate in cost in
non-endemic areas due, in part, to the direct and indirect impacts of the disease, but
also to the cost of disease elimination efforts to regain FMD-free status [9, 38]. These
risks are made more severe by the high mobility of the FMD virus, which can travel
on aerosolized particles for up to 30 miles across land and further on dust and
contaminated persons or equipment [29, 39–41]. Concerns over the challenges of
being declared FMD endemic has led countries to sometimes extreme responses to
outbreaks.
Between 2000 and 2001, multiple isolated FMD outbreaks became one of the first
seminal TBD events of the twenty-first century [33, 35, 38]. Table 3 summarizes
several of the larger 2000–2001 FMD outbreaks. Many countries, like Japan or
18 A. Hydrick

Table 3 Summary of 2000–2001 FMD outbreaks

Uruguay (2000– S. Korea Japan
UK (2001) 2001)a (2000) (2000)
Duration 7.5 months 4 months 1 months 1 month
Case No. 2057 2033 15 3
Animals Slaughtered 6.24 mil. 20,406 2216 740
Financial cost (USD) 9.2 bil. 730 mil. 433 mil. 15 mil.
Financial cost (% 0.6 3.4 <0.1 <0.1
GDP)b
These numbers were obtained from the UN Food and Agriculture Organization FMD reports
[38, 44]
a
Uruguay experienced two isolated outbreaks of FMD in October 2000 (FMD Type O) and from
April to August 2001 (FMD Type A)
b
Estimated % of the country’s 2001 gross domestic product (GDP)

Korea, “stamped out” their FMD outbreaks early due to lack of movement through
domestic markets [35]. Conversely, major outbreaks occurred in the United King-
dom (UK) and Uruguay, due to movement of infected animals through densely
populated live-animal markets [35]. This resulted in over 2000 confirmed cases in
each country with dire economic consequences [35, 38]. The UK opted for a
complete “stamp-out” approach, where all confirmed positive and exposed animals
were destroyed, that resulted in over six million head of livestock destroyed and a
financial cost of over nine billion dollars [29, 35, 42]. This outbreak cost the UK
approximately 100% of their estimated total domestic agricultural value, in addition
to threatening tourism and other industry [42, 43]. The number of culled animal
carcasses resulted in an environmental disaster and required mobilization from
military and foreign veterinary services to manage the infected animals and uphold
stop-movement orders issued by the government [14]. Similarly, from 2000 to 2001,
Uruguay experienced two separate FMD outbreaks that, combined, produced com-
parable case numbers to those seen in the UK, but resulted in lower cost and loss of
property than the UK outbreak [38]. The Uruguay government responded early to
these outbreaks with a “stamp-out” approach, which successfully eliminated the
2000 outbreak [35, 44]. However, when the disease occurred again in 2001 with
widespread transmission, the response became targeted culling with vaccination
[38, 45, 46]. This more conservative approach resulted in approximately 20,406
head of livestock destroyed, and still cost Uruguay $730 million (~50% value)
primarily resulting from the cost of vaccine distribution and prolonged status as an
FMD positive country [35, 36, 38]. However, Uruguay did not experience the
ecologic fallout seen in the UK outbreak, and local government capabilities were
not reported to have been exceeded [14, 46].
These are overviews of impacts at the country level, but possibly more important
were the loss of income for large numbers of families, as well as loss of faith in
government authority [2, 36]. One study found that, in addition to the massive
economic loss produced by the UK FMD outbreak, farmers and response personnel
Agricultural Emergencies: Factors and Impacts in the Spread of. . . 19

involved in the outbreak experienced profound psychological trauma, indicated a

loss of faith in governance, and isolation within their farming communities
[47]. Negative media coverage likely increased these social tensions and impact to
non-agricultural industries [28, 42]. In Uruguay, there was resistance to outbreak
management early, but that resistance declined and positive response was seen due to
the flexibility of the government response to the FMD outbreaks [38, 48]. The
political and economic impacts of FMD are obviously profound, but the social
impacts are more enduring and damaging. The comparison betweeen these two
outbreaks show that inflexibility of management can make the difference between
an agricultural emergency and a disaster.

4.2 Highly Pathogenic Avian Influenza

Avian influenza is another OIE-listed TBD that is politically and economically

significant, but this disease carries a more visceral social fear due to its zoonotic
potential [28, 32, 49]. Sometimes called fowl plague, avian influenza is caused by
the influenza A virus, which is the same one responsible for the annual seasonal flu
in humans [29, 32]. The majority of avian influenza strains are low pathogenic
(LPAI), resulting in variable morbidity and usually low mortality [29]. However,
several strains, especially those with H5 and H7 hemagglutanin markers, are capable
of developing into highly pathogenic avian influenza (HPAI) through a process
called antigenic drift (small changes in the viral genome) and shift (large changes
in the viral genome) [32]. Both LPAI and HPAI strains can cause significant
economic loss and food insecurity due to decreased productivity, depopulation in
controlling the disease, and direct mortality from the virus, up to 100% mortality in
HPAI affected populations [29, 49, 50]. These impacts are profound for large-scale
commercial operations, but losses from HPAI are felt most intensely by small-scale
farming families, because they are absolute losses in assets and income [51]. How-
ever, the even larger concern is that these avian circulating HPAI viruses will
undergo antigenic shift to become highly lethal human circulating influenza viruses,
which could become the next pandemic disaster [32, 52]. The combined economic
and zoonotic implications of HPAI makes this an important TBD for discussion in
this chapter.
Historically, HPAI is a sporadically occurring disease in wild and domestic birds,
capable of severe local impact, but poor extended propagation, due to the extreme
mortality of the agents [29]. However, since the start of the twenty-first century, two
HPAI strains have emerged as a focus of concern for experts due to their recurring
appearance in avian and human hosts [32, 53]. H5N1 is probably the best known and
most concerning HPAI strain that first emerged in Hong Kong (1997), and then on
Mainland China (2003) [29, 53]. Although the H5N1 strain has caused relatively
lower case numbers, it has continued to be a source of concern due to its wider host
range, which has made the virus widespread across multiple continents, higher
human case fatality rate (CFR) up to 60%, and relatively high communicability
20 A. Hydrick

(R0 ¼ 2.26/avian; 1.14/human) (52–54). The H7N9 LPAI/HPAI strain emerged as a

source of concern in China (2013) with higher case numbers than the H5N1 strain
(450 cases/3 years versus 683 cases/18 years) [32, 53]. Although the viral charac-
teristics of this strain are not fully understood, H7N9 appears to cause less severe
illness, with a human CFR of 22%, and has a narrower host range, which has caused
it to remain largely confined to China [30, 53, 54]. The emergence of these HPAI
strains have caused several social and economic impacts [51, 55, 56]. Reports are
highly variable for the economic impacts of the H5N1 emergence, but it is estimated
that those costs likely total in the billions (approx. 2% GDP/East Asia) in outbreak
response, animal production and market losses, not to mention the cost of human
disease and lives lost [51, 55]. Similarly, H7N9 emergence has resulted in over $5
million due to poultry industry losses and higher human case numbers [53, 56]. The
social impacts appear more profound for the H5N1 outbreak with consumer concern
over the disease causing up to 70% reduction in poultry product acquisition in some
countries, and producers indicating fear of returning to poultry production [55]. The
H7N9 outbreak produced less social fear among consumers and producers due to
transparency in public communications and non-urban impacts [56]. However, the
social and financial impacts of both viruses were elevated in severity for producers as
the majority of impacted farms were small-scale operations [51, 55]. Additionally,
continued circulation of both viruses is a point of anxiety among experts for future
pandemics [32, 52, 57].
Non-H5N1/H7N9 outbreaks have also been a source of great public health and
economic concern. Since 2014, there have been two significantly extended HPAI
outbreaks in internationally important poultry operations [9, 49, 50]. Starting in
December 2014, the U.S. experienced the largest agricultural TBD event in North
American history, which resulted in the loss of over 50 million birds, especially
egg-producing chickens, and cost the U.S. $897 million (1.8% industry value) in
response and recovery [9, 49, 58]. The outbreak involved three different HPAI
strains – H5N2, H5N8, and H5N1 – that were geographically dispersed with cases
centering in the Midwest, along the California coast, and Mississippi and Central
avian fly-ways [9]. With the U.S. producing around 18 million metric tons of poultry
products, exporting over three million, this outbreak impacted a major world com-
mercial poultry producer [29, 49, 59, 60]. Following the U.S. 2014–2015 outbreak,
thirty European countries experienced outbreaks of the same H5N8 HPAI with over
2000 positive site cases and over 6 million birds culled from 2016 to 2017 [50]. Like
the U.S. 2014–2015 outbreak, the European Union (EU) outbreak was geographi-
cally widespread to the northern and southern extents of the continent in association
with wild avian flyways [50, 61]. As the EU is another major producer of commer-
cial poultry products, exporting over 1 million metric tons, the economic impacts
were similarly profound [49, 62]. Evidence suggests that the U.S. outbreak did not
cause enough consumer concern or fear to significantly alter domestic product
consumption, but did produce supply shortages and decreased export numbers due
to trade restrictions [9, 59]. Similarly, an EU report indicated low perceived risk of
human disease transmission in affected countries, which lowered the overall social
impacts [61].
Agricultural Emergencies: Factors and Impacts in the Spread of. . . 21

Overall, HPAI has been responsible for epidemic disease events in avian species
and thousands of human cases worldwide since the turn of the century [32]. The
impacts of these outbreaks have been experienced in the form of price instability,
food shortages, food insecurity, enduring trade restrictions well past the conclusion
of active disease transmission, and recurrent spillover of the zoonotic disease into
human populations [32, 49, 50, 60]. This discussion highlights the significance of
HPAI as an economic and political TBD, as well as the importance of the viruses as a
potential source of pandemic disease, an intense human health risk.

4.3 Crop Destroying Pests and Pathogens

Crop-destroying pests and pathogens are responsible for mass agricultural and
economic losses worldwide [63–65]. These agents are TBDs in the less obvious
sense, in that they do not emerge and re-emerge in geographically distant regions
like animal TBDs, but rather, remain strongly regionalized in their occurrence
[29, 63]. However, in recent years, the impacted regions are extending well beyond
historic boundaries and are resulting in emerging disease events in large areas
worldwide [63, 66]. On average, crop-destroying agents are responsible for up to
20% of pre-harvest crop loss, and a further 10% rejection of post-harvest product
from the food chain [63, 65]. With the world population rapidly growing, expected
to exceed nine billion by 2050, and the majority of that population obtaining
nutrition primarily through plant staples, like rice and wheat, losses associated
with crop-destroying agents are potentially the most impactful [16, 63, 67, 68].
Crop-destroying insect pests are one of the most important agents that affect crop
yield today [64]. The desert locust is probably the oldest and most sensational
example of a crop destroying insect pests causing profound social and economic
impacts [69]. These insects are always present at low levels throughout North Africa,
as far east as India, and emerge in outbreaks corresponding to prolonged or heavy
rains. Localized outbreaks are common occurrences to this day, emerging in several
locations throughout the locusts’ range annually, but if they are not controlled and
favorable swarm conditions continue, then outbreaks can develop into swarms or full
plagues [68, 70]. A full-sized plague is extremely costly and dangerous. The last full-
scale locust plague occurred from 2003 to 2005 and affected the food security and
livelihoods of over 8 million people across 13 million hectares of land in West
Africa, many of which are small-scale subsistence farmers [6, 71, 72]. This locust
plague caused up to 100% crop and pasture destruction locally and cost the UN Food
and Agricultural Organization (FAO) approximately $570 million in control opera-
tions and over $90 million in 2004 food aid estimates alone [71]. Similarly, other
crop destroying insects, like caterpillars, cornsilk flies, grain beetles, and maize
weevils, are capable of massive production losses (over 77%, 22%, 63%, and 10%
respectively), but those losses are observed throughout the lifecycle of the crops
[64]. Additionally, insect pest control programs are time-consuming and expensive,
which can increase the economic impacts of crop destroying pests, and serve as a
22 A. Hydrick

source of social concern and commentary [65, 69, 73, 74]. The UN Food and
Agriculture Organization Desert Locust program, for example, cost over $18 million
to develop and $3 million to maintain annually [69, 71]. Finally, crop-destroying
insects can present a double threat to agricultural stability by vectoring crop-
destroying pathogens [75, 76].
Fungal pathogens are another significant emerging crop-destroying agent
[63]. There are a variety of important parasitic fungal agents that are destructive to
crop species with or without producing toxins that harm human health, like ergot or
aflatoxin [67, 75]. Recent estimates indicate that rice blast, a rice crop-destroying
fungus, is responsible for a 30% production loss, enough to feed over 60 million
people. The same study found that the development of blast-resistant rice strains
would improve U.S. production by over $69 million [66]. That same improvement
would likely be even more profound in the world’s top rice producers (Table 2).
Similarly, wheat blast is responsible for production losses ranging from 40% to
100% where it is occurring worldwide [34]. Many of the highest impacted areas have
poor economic stability and limited biosecurity capability to prevent and treat for
these fungi, which represents one disastrous consequence of crop-destroying path-
ogens [6, 33, 63, 66]. However, concerns over northward migration of fungal
pathogens and their threats to the agricultural security of affluent trade partners,
causes those trade partners to increase biosecurity measures by restricting trade
access and income for less affluent nations [33, 63]. As seen with FMD, the
two-fold consequence of production and trade loss associated with crop-destroying
pests and pathogens can have profound impacts on affluent commercial production
schemes, but can be devastating for the less affluent small-scale producers.

5 Agriculture Adjacent Transboundary Disease Events

In addition to causing disease in agriculturally significant species, many of the OIE

listed TBDs are maintained and vectored in wildlife species, including comparable
mammalian and arthropod species, which complicates the control of these diseases
[29, 77]. The agriculture-wildlife interface serves as a continuing outbreak source for
many TBDs, like avian influenza and classical swine fever, which have been
eliminated from agricultural production in most developed countries
[29, 32]. Throughout the world, wild avian, rodent, cloven-hooved species and
arthropod pests appear to be the most significant non-human vectors of agricultural
disease [32, 75–77]. Ongoing disease outbreaks in the agricultural sector can be
facilitated by the bi-directional transmission of disease across the agriculture-
wildlife interface, which will be discussed in greater detail in the next section
[50, 78]. Expansion of agricultural practices, and other human centered activities,
to meet growing population demands likely increases the risk of disease outbreaks
from wildlife sources, which is a major threat [16, 77]. Control of TBDs at the
wildlife interface is made additionally complicated by inconsistent, sometimes
conflicting interagency policy within governments [78]. Concerns over these
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