The Significance of Education in the Preparedness for Zoonotic Diseases

Abstract

Zoonotic diseases can potentially cause different illnesses in humans and animals, ranging from mild to severe manifestations and resulting in fatalities. Regrettably, the public and governmental bodies often lack awareness regarding the significance of many zoonoses. Neglected zoonotic diseases, including Leptospirosis, Chagas disease, Leishmaniasis, and various parasitic and virus infections, are particularly concerning. In different contexts, diverse educational strategies address the intricate interplay between human health, animal health, and the environment. By fostering recognition of zoonotic diseases, communities can better understand the underlying dynamics and develop effective prevention, control, and mitigation strategies for improving their health.

1. Introduction

Zoonoses, which encompass infectious diseases transmitted between animals and humans, pose significant challenges to public health. These diseases can range from illnesses in humans and animals, varying from mild to severe manifestations and even fatalities [1]. Notably, zoonoses constitute a substantial portion of Emerging Infectious Diseases (EIDs), accounting for 60.3% of reported cases according to recent studies [1, 2, 3].

Regrettably, many zoonoses remain unfamiliar to both the public and the public and governmental bodies, cognition of their significance. Consequently, numerous zoonotic diseases, such as Leptospirosis, Chagas disease, Leishmaniasis, and various parasitic infections, are often neglected [4]. These diseases predominantly affect low and middle-income countries (LMICs), particularly regions where communities reside near livestock populations.

To address the complex interplay between human health, animal health, and the environment, the concept of “One Health” has emerged as a pivotal theoretical framework. The One Health approach acknowledges the interconnectedness of public health in humans, animal health, and the environment, emphasizing the necessity for a multidisciplinary and collaborative practice [5, 6]. By recognizing the intricate relationships between these domains, the One Health approach seeks to elucidate the underlying dynamics of zoonotic diseases and develop effective prevention, control, and mitigation strategies.

By conducting a comprehensive exploration of noteworthy zoonotic diseases, their epidemiological characteristics, and the potential impact of education, this chapter aims to shed light on how knowledge dissemination can contribute to enhancing awareness and implementing effective biosecurity measures among the population. Furthermore, it seeks to underscore the significance of informed policy making, emphasizing the imperative for interdisciplinary collaboration in safeguarding public health within our increasingly interconnected world (Figure 1).

Figure 1.

Dissemination process of zoonotic diseases.

2. Some important zoonotic diseases

Zoonotic diseases are a significant concern due to their potential to spread from animals to humans.

2.1 Bacteria

2.1.1 Brucellosis

Brucellosis, a bacterial zoonotic disease, is the most prevalent and noteworthy zoonosis. It is acknowledged as both a re-emerging and neglected ailment [7, 8]. In endemic regions, the incidence rate of brucellosis stands at 10%, with a low fatality rate. However, the World Health Organization (WHO) estimates that a considerable proportion of cases go unreported, resulting in only half a million cases being officially registered annually. Moreover, the number of unreported instances exhibiting unspecified clinical symptoms is 10 times higher. Consequently, brucellosis represents a paramount concern in the realm of public health [9]. Notably, individuals across all age and gender groups are susceptible to brucellosis, necessitating the implementation of control measures in humans focused on curtailing animal infections through vaccination and comprehensive care initiatives [7, 8, 9].

The causative agent of brucellosis is a bacterium known as Brucella, encompassing distinct species that affect a broad range of susceptible hosts. Noteworthy among these species are Brucella abortus, Brucella melitensis, Brucella suis, Brucella ovis, Brucella canis, Brucella neotomae, and Brucella microti [10].

Brucellosis can be transmitted through horizontal and vertical routes; this organism exhibits higher concentrations in the uterine region of pregnant animals, with aborted fetuses, placental membranes, and uterine discharges serving as the primary sources of infection. Moreover, the transmission of the disease from infected animals to newborns can transpire through milk contaminated with Brucella organisms. These microorganisms can persist for extended periods, particularly in cold and moist environments. Animals contract the infection by ingesting feed and water that has been contaminated or by meeting aborted fetuses, fetal membranes, and uterine discharges. Additionally, infected bulls can spread disease between herds through natural mating or artificial insemination [11].

Infected animals exhibit various clinical signs, particularly related to reproductive failures, such as abortion and the birth of weak offspring that serve as carriers within the herd. The clinical manifestations and numerous complications of brucellosis in different animal species primarily manifest in the reproductive tract. The disease’s incubation period can vary from 2 weeks to several months. Calves can become infected early, but clinical symptoms may only become apparent as they mature. Late abortions in pregnant animals lead to weak calves, reduced fertility, retention of fetal membranes, endometritis, and diminished milk production. The abortion rate in susceptible herds can range from 30 to 80% [7, 9, 12, 13].

The zoonotic significance of brucellosis is experiencing a notable escalation due to various factors, including the substantial growth in the global trade of animal products, rapid deforestation, unregulated and unsustainable development practices, urbanization, intensive farming methods, migratory or nomadic animal husbandry, and increased international travel and tourism [9].

2.1.2 Leptospirosis

This disease poses an epidemic threat, particularly in the aftermath of heavy rainfall [14]. Leptospirosis is caused by the bacterium Leptospira interrogans, which has more than 200 serologic variants and is pathogenic to humans and animals [15]. The primary transmission mode for humans is direct contact with the urine of infected animals or a urine-contaminated environment [14].

Leptospirosis can manifest in diverse clinical presentations, ranging from mild illness to severe and occasionally fatal disease. The symptoms of Leptospirosis often overlap with those of other infectious diseases, such as influenza, dengue, and viral hemorrhagic fevers. Common signs and symptoms include fever, headache, myalgia, jaundice, renal failure, hemorrhage, myocarditis with arrhythmias, meningitis/meningoencephalitis, and pulmonary hemorrhage with respiratory loss [16].

Diagnosing Leptospirosis involves a combination of serology, clinical presentation, and epidemiological data. Serologic tests are commonly utilized to detect specific antibodies in the patient’s blood, aiding in confirming the infection. However, it is essential to consider the patient’s symptoms, travel history, occupational exposure, and potential contact with animals or contaminated environments when diagnosing [17].

In recent years, an increasing number of cases of Leptospirosis have been documented in various countries within the Middle East. Both human and animal cases have been reported [18], highlighting the widespread nature of this zoonotic disease [19]. Human Leptospirosis often involves individuals working in occupations such as farming and rice field labor, as well as travelers and plumbers. Additionally, Leptospirosis in children and adults who have met infected livestock or contaminated water has been recorded [16].

While animal cases encompass a variety of species, livestock are commonly affected by Leptospirosis. Furthermore, there have been reports of direct detection of Leptospirosis in water resources, underscoring the potential for waterborne transmission of the disease [17, 19].

Preventive measures are crucial to mitigate the health and economic consequences of Leptospira infection in the community. These measures include a comprehensive understanding of the disease’s epidemiology, raising public awareness about the risks and prevention methods, and implementing vaccination programs for domestic animals and high-risk populations.

2.2 Viruses

2.2.1 Influenza

The avian influenza virus (AIV) is classified within the family Orthomyxoviridae and the genus Influenza virus A [20]. Wild aquatic birds, specifically ducks, gulls, and shorebirds, serve as this virus’s primary hosts and natural reservoirs. Consequently, the wide geographic distribution and circulation of AIV can be attributed to these bird species [21].

Various factors have contributed to the increased spread and occurrence of AIV outbreaks globally. These factors include the expansion of international trade, intensified poultry production practices, climate alteration, bird migration patterns, human mobility, and the rapid growth of the global population [22]. Many countries engage in commercial farming practices involving high-density poultry populations and bird rearing in free-range environments, such as backyards and rooftops [23]. Consequently, backyard birds have emerged as an intermediary host for AIV transmission, affecting commercial poultry and human populations, primarily because backyard farms often lack adequate biosecurity measures, given their outdoor enclosures [20, 23].

Bird-to-human transmission of avian influenza has predominantly resulted from direct contact with infected backyard birds and through slaughtering and de-feathering. In terms of specific sources of exposure, the reported cases of human infections have been attributed to interactions with backyard poultry (70%), domestically bred birds (26%), slaughtered poultry (14%), or deceased birds (4%) [24].

Notably, avian influenza viruses have sporadically crossed over to infect other mammalian species. Among these, pigs play a significant epidemiological role in the evolutionary dynamics of novel influenza viruses due to their susceptibility to avian and human influenza viruses, facilitating viral reassortment and the emergence of new strains [20].

2.2.2 Rabies

Rabies is an acute viral infection caused by lyssaviruses, capable of infecting all terrestrial mammals. The primary transmission mode is through infected animals’ saliva, typically from bites, although scratches and organ transplants can facilitate transmission in rare cases [25]. This disease has a profound global impact, with an estimated annual death toll of 59,000 individuals attributed to dog-mediated rabies. Alarmingly, approximately 40% of these fatalities occur in children under the age of 15 years [26], disproportionately affecting impoverished and underserved communities. Developing countries in Africa and Asia bear the heaviest burden of this disease [10]. Consequently, rabies presents significant global social and public health challenges and a substantial economic burden estimated at $8.6 billion annually [27].

The World Health Organization (WHO), in collaboration with the Food and Agriculture Organization (FAO) and the World Organization for Animal Health (WOAH), has set a vision to eliminate dog-mediated rabies by the year 2030 [25]. This ambitious goal aligns with broader global objectives, such as poverty alleviation and the reduction of childhood mortality, as outlined in the Millennium Development Goals. While achieving this target by 2030 poses a significant challenge for specific regions, it is noteworthy that many of these areas consistently try to enhance their capacity to combat rabies [26, 28].

Rabies presents itself in two distinct forms: encephalitic (furious or classical) and paralytic (dumb) rabies. The encephalitic form, which is more prevalent, is observed in approximately 80% of patients. Among these cases, a significant proportion, ranging from 50 to 80%, exhibit classic symptoms such as hydrophobia and aerophobia, which are unique to rabies [3, 29]. This presentation typically progresses to severe flaccid paralysis, coma, and death due to multiple organ failures. In contrast, paralytic rabies manifests with pronounced muscle weakness early in the disease course [30].

The incubation periods for both encephalitic and paralytic rabies are comparable, from 2 weeks to several months. The typical incubation period in humans ranges from 2 to 3 months [31]. Regrettably, there is no recognized or approved treatment for rabies once clinical symptoms have manifested. Nevertheless, palliative care is advised for individuals afflicted with rabies to alleviate suffering and potentially extend survival time temporarily (references [32] and [33]). However, it is essential to note that effective pre-and post-exposure prophylaxis measures are available [30, 31].

2.3 Protozoa

2.3.1 Chagas disease

This disease is caused by the parasite Trypanosoma cruzi (T. cruzi) is a zoonotic infection primarily prevalent in Latin American countries [32]. This disease is estimated to affect 8 to 11 million people worldwide. Chagas disease carries significant health implications, with approximately 20 to 30% of infected individuals developing a chronic form of the infection that can lead to fatal heart or gastrointestinal diseases [34, 35].

Transmission of Chagas disease occurs through various means. The most common transmission mode is through contact with the feces or urine of the reduviid bug, also known as the triatomine bug or kissing bug, which serves as the intermediate host for the parasite. Vertical transmission from mother to fetus is another route of infection. Additionally, the disease can be transmitted through blood transfusions, organ transplants from infected individuals, or consumption of contaminated food or drinks [36, 37].

The clinical symptoms of Chagas disease can be diverse, but significant complications often include cardiomegaly (enlargement of the heart), gastrointestinal disorders, and, in some cases, peripheral neuropathy. The chronic form of the disease can have severe consequences, potentially leading to life-threatening conditions [32, 37].

Despite the significant impact of Chagas disease on public health, no vaccination is currently available for its prevention. Consequently, controlling the disease relies on vector control, which involves reducing the population of triatomine bugs and improving housing conditions to minimize contact with the bugs [34].

Efforts to combat Chagas disease also involve blood and organ screening to prevent transmission through transfusions and transplants. Public health initiatives focus on raising awareness about the disease, promoting early detection and treatment, and implementing preventive measures to reduce exposure to the vector and contaminated sources. Likewise, developing an effective vaccine would be a significant breakthrough in the fight against Chagas disease, offering long-term protection and contributing to its eventual eradication [34, 35, 37].

2.3.2 Leishmaniasis

Leishmaniasis, a vector-borne disease, represents the most marginalized condition of its kind and can be attributed to various obligate intracellular protozoan species belonging to the Leishmania genus. These parasites are transmitted between mammalian hosts primarily through phlebotomine sandflies. Regarding disease epidemiology, dogs play a pivotal role among domestic animals [38].

The diseases can be classified into two distinct types based on the primary reservoir hosts responsible for human infection: zoonosis and anthroponosis. Zoonosis is an infectious disease that primarily affects animals but can be transmitted to humans, whereas anthroponosis denotes a naturally occurring condition primarily affecting humans [38, 39]. The majority of Leishmania species are implicated in zoonotic transmission. Infected animal reservoir hosts are often introduced into humans, leading to spillover events and subsequent zoonotic diseases. Within humans, twenty-two Leishmania species belonging to the subgenera L. (Leishmania), L. (Mundinia), and L. (Viannia) have been identified.

Leishmaniases encompass a wide range of clinical presentations, encompassing self-healing localized or multiple cutaneous lesions, mucosal lesions, and potentially life-threatening visceral forms. Although specific species or subgenera are often associated with conditions, these manifestations are not exclusive to a single species [10]. Cutaneous Leishmaniasis (CL) often results in self-resolving skin lesions that leave permanent scars. However, certain species can lead to more severe pathologies, including mucocutaneous (MCL), diffuse (DCL), or disseminated (DL) cutaneous leishmaniases. Visceral Leishmaniasis (VL), known as kala-azar, represents the most severe form of Leishmaniasis and can be fatal if left untreated. Prominent clinical indicators include non-tender splenomegaly, with or without hepatomegaly, and individuals with pre-existing health conditions may develop post-kala-azar dermal Leishmaniasis (PKDL) because of treatment [25].

Additionally, environmental changes and socioeconomic factors, such as inadequate housing and sanitation, malnutrition, and population mobility, significantly influence the dynamics of vector-borne diseases. These anthropogenic factors often lead to alterations in the composition and behavior of sand fly vectors.

2.3.3 Toxoplasmosis

Toxoplasma gondii is an apicomplexan parasite widely recognized as one of the most significant zoonotic protozoan infections due to its pathogenicity during gestation in various animal species, including humans. Its definitive host is domestic cats and other felids [40, 41].

In the feline population, the life cycle of T. gondii is typically sustained through their predation of rodents, such as mice. For instance, a study conducted on a cat population in southern Poland revealed that 68.8% of the animals tested seropositive for T. gondii, with a notably higher prevalence observed in older cats (> 1 year) (83.5%) compared to younger cats (48.3%), as well as in cats dwelling outdoors as opposed to indoors (69.7% vs. 16.7%) [42]. The presence of T. gondii infection in marine mammals has raised concerns regarding the potential role of reptiles (e.g., turtles, crocodiles, snakes), amphibians (e.g., frogs, toads), and fish as sources of infection [43].

Dogs and cats, particularly those exhibiting feral behavior, significantly threaten biodiversity. However, it should be noted that predation can also transmit parasites, some of which may possess zoonotic potential, posing risks not only to our companion animals but also to human health [44]. Nonetheless, despite the potential for zoonotic transmission, most research and efforts have primarily focused on the impact of predation on conservation [41].

Regarding Toxoplasmosis, the parasite Toxoplasma gondii can be vertically transmitted to various intermediate host species, including humans. Given that farm animals serve as sources of infection for humans and reservoirs of T. gondii for wildlife, it has been suggested that efforts be directed toward minimizing T. gondii infections in livestock, particularly in the case of pigs [40, 41, 42].

3. Educational strategies

3.1 Description of the condition

To address the prevention of human diseases is necessary to first focus on addressing what is happening in the animal kingdom. In the years past, most of the numerous main human epidemics infectious diseases that caused morbidity and mortality worldwide are transmitted from animal to human either directly or indirectly through products of animal origin [45], so a better and more precise knowledge and understanding with a solid awareness of the implications of zoonotic diseases to public health may result to improvement in surveillance and intervention systems for prevention and control [46, 47].

3.2 The influence of educational initiatives on the prevention and management of zoonotic diseases

The efficacy of preventive and control measures against zoonotic diseases is contingent upon disseminating accurate and timely information through awareness, education, and knowledge-sharing mechanisms. The promotion of awareness concerning these diseases relies on the effective utilization of information, communication, education, and technology transfer, in conjunction with the recognition, investigation, collaboration, advancement of diagnostic techniques, the deployment of surveillance tools, the application of epidemiological practices, and the utilization of molecular biology methodologies [48].

It is imperative to foster awareness and educate the public about zoonotic diseases’ risk factors and potential reservoirs. This approach facilitates a comprehensive comprehension of pathogen diversity, reservoir specificity, and the development of preventive and control strategies for such conditions. Notable instances showcasing the effectiveness of awareness campaigns include the general awareness among European populations regarding the risk of human infection associated with prion-contaminated beef meat (linked to bovine spongiform encephalopathy), as well as similar awareness initiatives observed in North America [25].

3.3 Some health education initiatives around the world

Health education initiatives play a significant role in disease control, although they are often overshadowed by more prominent intervention programs [2]. These initiatives can adopt various formats and have been implemented worldwide.

In the past, community education efforts primarily relied on pamphlets, community health workers who would disseminate information to village communities, and radio and television advertisements. Posters have traditionally been employed to convey health-related information to school-aged children. However, in today’s increasingly digital era that fosters interactive experiences, signs often need to be revised to engage children effectively. Consequently, over the past two decades, numerous endeavors have been made to deliver health education through media such as cartoons, films, radio programs, comic books, and cultural performances [34, 46, 49].

The Meena Communication Initiative (MCI) is an exemplary health education program which emerged as a pioneering Education Entertainment (EE) project in Southeast Asia in 1991 [50]. This project created at least seven episodes, focusing on public health topics such as handwashing, worm prevention, and pediatric diarrheal disease [33].

A study in Nepal in 2002 revealed that 96% of children who engaged with the Meena media reported implementing at least one behavioral change, with handwashing being the most frequently mentioned change [49]. Meena was regarded as the most efficacious strategy ever devised by UNICEF, as even young adults in their late twenties continued to recollect the lessons imparted by Meena regarding handwashing and hygiene [2, 33, 50].

Another educational program is “The Magic Glasses,” a 12-minute cartoon explicitly developed for implementation in Hunan province, China. This animated production revolves around a child bestowed with special glasses enabling him to perceive the larvae and eggs of soil-transmitted helminths within his village. As he explores the community and witnesses the impact of worm infestation on places and individuals, he resolves to educate his fellow villagers about these parasites and methods to prevent infection [51].

The positive reception from children underscores the effectiveness of this tool in imparting knowledge to schoolchildren on averting soil-transmitted helminth infections. In the group of students exposed to the video intervention, there was a 50% reduction in disease prevalence compared to the control group, which received a poster containing essential information on soil-transmitted helminths. Furthermore, there was a noticeable increase in handwashing behavior among children in the intervention group after using the bathroom and before meals [52].

Snakes and Ladders have been utilized in various studies conducted in Asia and Africa to assess the effectiveness of health education interventions targeting schistosomiasis, Taenia solium, and Taenia saginata. To gauge the efficacy of this game as an intervention tool, students who had yet to receive any prior educational interventions were requested to complete a pre- and post-game questionnaire. Before laying the competition, students were presented with a questionnaire consisting of 10 fill-in-the-blank questions. Subsequently, after engaging in the game, they were provided with a post-game questionnaire containing the same set of questions as the pre-game questionnaire. The analysis revealed an 18.5% increase in correct answers between the pre- and post-game questionnaires, indicating that even a brief period of interaction with the game could enhance knowledge acquisition [53, 54].

Juma Na Kichocho is a comic book designed to educate children in Zanzibar, Africa, about schistosomiasis and malaria. While malaria had been a topic covered in routine health education at local schools, no such educational efforts had been directed toward schistosomiasis. The comic book is a child-friendly medium through which information on symptoms, transmission, life cycles, and control measures of both diseases is presented. Before distributing the comic books, students were administered a pre-exposure knowledge, attitudes, and practices (KAP) questionnaire. Subsequently, the comic books were distributed alongside a 30-minute presentation delivered by a health educator from the Helminth Control Laboratory Unguja. Over the following year, teachers were encouraged to incorporate comic booklets into their school health education curriculum. The initiative culminated in administering a post-exposure questionnaire to assess the participants’ KAP. The results obtained from the post-questionnaire indicated a no significant increase or decrease was observed in schistosomiasis-related knowledge [2, 55].

“The Vicious Worm” is a computer program specifically developed to facilitate the educational process surrounding the topic of Taenia solium, a parasitic infection. The program’s primary objective is to disseminate comprehensive information about the transmission, diagnosis, risk factors, prevention, and control measures associated with the disease. Each of these aspects is further subdivided into relevant subsections, encompassing hand hygiene practices, safe procurement and preparation of uninfected pork, pig husbandry techniques, the life cycle of Taenia solium, appropriate slaughtering methods, and meat inspection protocols. Upon accessing all the informational sections, users are given a quiz within a virtual schoolhouse designed to assess their comprehension of the acquired knowledge. The initial evaluation of this program took place in Tanzania, East Africa, involving 79 participants from the agriculture and health sectors. Notably, all subjects scored 70% or higher on the pretest before engaging with the program. After a session lasting approximately one and a half hours, all participants displayed a significant improvement in knowledge, as demonstrated by their post-program assessment results [56].

A subsequent follow-up assessment was conducted 2 weeks after the utilization of the program, revealing that all participants achieved higher scores than their initial baseline scores. Furthermore, a secondary follow-up evaluation involving the same participants was conducted 1 year later. Although the results demonstrated a decline from the 2-week post-test scores, they remained superior to the original baseline scores. Moreover, it was observed that 82% of the participants (50 individuals) had engaged with the Vicious Worm program on multiple occasions, either for personal learning or to facilitate knowledge sharing with others [55, 56].

Mobile health applications and programs, designed to monitor health, manage doctors’ appointments, and facilitate virtual consultations with healthcare professionals, are anticipated to benefit individuals in low- and middle-income countries (LMICs). This is attributed to the fact that mobile internet usage is the primary means of accessing the Internet for a significant portion of the population in LMICs [57].

Numerous Mobile Health applications allow users to access disease-specific information and track symptoms. An advantage of these applications is that they facilitate the dissemination of essential training materials and medical information to community health workers. To illustrate, during the 2014 Ebola outbreak in Nigeria, the Adandach Group developed a mobile tutorial for healthcare professionals. This tutorial provided comprehensive insights into the causes, diagnostic methods, transmission pathways, and field treatment of Ebola. Equipped with this knowledge, previously uninformed healthcare workers were able to enhance their self-protection measures and safeguard the well-being of patients visiting their clinics [2, 8].

Amidst the Covid-19 pandemic, numerous applications were created to monitor potential virus symptoms, perform contact tracing, and issue notifications. Utilizing such apps could prove valuable in managing future outbreaks of Ebola or other pandemics. While these applications may possess limited practicality for most zoonotic diseases, they have the potential to serve as a reporting mechanism for identifying cases. Furthermore, in conjunction with this program, numerous similar initiatives have been implemented in various countries, leveraging similar technology to furnish healthcare workers with current resources and facilitate communication with patients residing in remote areas [58].

3.4 Significant impact of modest outcomes

The efficacy of theoretical and practical instruction within the educational setting has been demonstrated in fostering comprehension of the phenomenon of disease transmission in a circular manner, wherein diseases are transmitted between animals and humans and back to animals. Noteworthy investigations have revealed that theoretical lectures can enhance knowledge of zoonoses and equip the populace with preventive measures, as evidenced by Tables 1 and 2 findings. These findings substantiate an overall increase in general awareness, suggesting that adolescents possess the necessary resources to address such diseases when adequately informed effectively [6, 59].

Adolescents’ population	Percentage of adolescents who do not know about zoonoses before educational intervention. Germany, Slovenia, Friuli Venezia Giulia, Carinthia (n = 656)	Percentage of adolescents who do not know about zoonoses after educational intervention. Germany, Slovenia, Friuli Venezia Giulia, Carinthia (n = 338)
Can pets like dogs and cats become sick like humans?	11.89%	9,97%
Must dogs be given medication against intestinal worms at least once a year?	23,78%	8,54%
Is it worthwhile to vaccinate dogs against rabies and other diseases?	8,69%	3,32%
Many diseases that affect humans come from animals.	28,96%	20,47%
Zoonoses are diseases transmitted from animals to humans.	32,16%	15,18%
Can pet animals transmit diseases to humans	31,40%	9,48%
Can humans transmit diseases to animals?	59,91%	34,52%

Table 1.

Knowledge about general zoonoses in adolescents.

Modified from “What Do Adolescents Know About One-Health and Zoonotic Risks? A School-Based Survey in Italy, Austria, Germany, Slovenia, Mauritius, and Japan” [59].

Adolescents’ population	Percentage of adolescents who do not know about these zoonoses before educational intervention. (n = 315)	Percentage of adolescents who do not know about these zoonoses after educational intervention. (n = 315)
Rabies	87,30%	19,36%
Brucellosis	85,07%	31,74%
Leptospirosis	86,98%	57,14%
Bartonella’s	86,66%	51,42%
Leishmaniasis	74,60%	39,68%
Giardiasis	70,79%	41,58%
Toxoplasmosis	79,68%	38,09%
Toxocariasis	89,52%	49,52%
Ancylostomiasis	78,41%	44,12%
Scabies	66,98%	25,39%
Dermatophytosis	71,11%	24,44%

Table 2.

Knowledge about zoonotic diseases in high school students.

Modified from “Improving the knowledge of high school students about zoonotic diseases from pets in Medellín-Colombia” [6].

The acquisition of proficiencies and aptitudes in health prevention and zoonotic diseases holds paramount significance in equipping future generations to safeguard themselves against present and forthcoming infectious diseases [60]. Implementing corrective measures should commence with health prevention initiatives within educational institutions and integrating early education principles. Furthermore, specific investigations reveal that health education and hygiene instruction should be more valued, particularly among children and adolescents. Nevertheless, several authors have demonstrated that health education alone can serve as an effective preventive measure against zoonoses such as toxocariasis and others [61].

Within this framework, recognizing the risk associated with zoonotic diseases is essential for implementing effective prevention strategies. However, the public’s inadequate comprehension of zoonotic illnesses presents a significant concern. The limited understanding observed in this study regarding zoonotic diseases is not unexpected, as regrettably, these subjects are absent from the curricula of numerous educational institutions worldwide [25, 62].

4. Conclusions

Zoonotic diseases prevail in various contexts, highlighting the need to develop diverse strategies to enhance knowledge about these diseases. Many zoonoses continue to pose significant challenges for low- and middle-income countries, resulting in illnesses and even fatalities. However, considerable potential exists to leverage advancements in children’s programming by integrating health education messages into widely popular cartoons and media, addressing this pressing issue.

Various health education interventions exhibit varying levels of effectiveness, with a select few demonstrating enduring impacts on their recipients. This presents numerous opportunities to enhance and broaden educational programs, increasing their effectiveness across different countries.

Given the perpetual struggle between our species and the potentially fatal zoonotic diseases, it is imperative to incorporate the One Health concept into school curricula. As Isaac Asimov astutely remarked, “Education is something you cannot finish,” emphasizing the ongoing battle against pathogens that never ceases.

Acknowledgments

The author declares no funding to write this book’s chapter.

Conflict of interest

The author declares no conflict of interest.

Notes/thanks/other declarations

Thanks to the Unilasallista University Corporation for allowing me to take the time to write this chapter.