Spillover infection

Spillover infections occur when a pathogen is transmitted from their natural reservoir or another host species into a new host species. In zoonotic spillover, the pathogen is transmitted from an animal to a human. Spillover may occur through direct contact with infected animals, exposure to contaminated surroundings or vectors. Whether a pathogen establishes an infection in the new host depends on factors like exposure, host susceptibility and compatibility between the pathogen and the host's biological systems.Spillover does not necessarily result in sustained transmission among the new host population; some introductions end in isolated infections, while others may lead to further transmission and in certain circumstances outbreaks and epidemics. Due to climate change and land use expansion, the risk of viral spillover is predicted to significantly increase.

Mechanisms of spillover

Spillover is a complex process in which a pathogen is transmitted from one host species to another and establishes an infection in the new recipient host. It occurs through a series of ecological, epidemiological and biological processes. These processes can be divided into stages: pathogen pressure, exposure and host susceptibility.

Pathogen pressure

It refers to the amount of infectious pathogen available to a potential recipient host at a given place and time. It is influenced by the distribution and abundance of reservoir hosts, infection prevalence, pathogen shedding and the pathogen's survival and dissemination outside the host.

Exposure

Occurs when a susceptible host encounters the pathogen through direct contact, contaminated environments or materials, or transmission by an intermediate host or vector. Host behaviour and ecological conditions influence the likelihood, route and dose of exposure. Contact between different host species may be affected by ecosystem changes, including habitat fragmentation and human encroachment into wildlife habitats, although the effects of these changes on spillover risk vary across ecological systems.

Host susceptibility

Determines whether infection becomes established. This depends on the pathogen dose, pathogen's ability to enter host cells, route of entry, replicate and evade or withstand host immune defences as well as the recipient host's genetic and physiological characteristics.

The result of spillover ranges from infections that do not lead to further transmission to sustained transmission that may result in outbreaks or epidemics, depending on pathogen characteristics, host susceptibility and epidemiological conditions.

Examples of spillover infections

The fruit bat is believed to be the zoonotic agent responsible for the spillover of the Ebola virus.

Spillover is a common event; in fact, more than two-thirds of human viruses are zoonotic. Documented spillover infections affect humans through transmission of viruses, bacteria, parasites and fungi from animals or animal-associated environments.

Most spillover events result in self-limited cases with no further human-to-human transmission, as occurs, for example, with rabies, anthrax, histoplasmosis or hydatidosis. Other zoonotic pathogens are able to be transmitted by humans to produce secondary cases and even to establish limited chains of transmission. Some examples are the Ebola and Marburg filoviruses, the MERS and SARS coronaviruses and some avian flu viruses. Some spillover events can result in the final adaptation of the microbe from animals to humans, who become a new stable reservoir, as occurred with the HIV virus resulting in the AIDS epidemic and with SARS-CoV-2 resulting in the COVID-19 pandemic.

Among bacterial diseases, plague is caused by Yersinia pestis, which circulates among rodents and their fleas can infect humans through flea bites or contact with infected animal tissues. Leptospirosis, caused by bacteria of genus Leptospira, can be acquired through contact with urine of infected animals or urine contaminated water and soil.

Parasitic spillover by zoonotic malaria caused by Plasmodium knowlesi, a parasite in macaques and transmitted to humans by mosquitoes bites and toxoplasmosis, caused by Toxoplasma gondii, which transmits through exposure to environment contaminated with infected cat faeces which contain toxoplasma eggs or through consumption of contaminated food.

Evolutionary factors influencing spillover

When host-microbe interactions last over long periods of time, they can lead to stable associations and co-evolution, and in some cases, permanent integration of microbial genetic material into human genome, as in case of endogenous viruses. The closer the two host species (reservoir and recipient) are in phylogenetic terms, the easier it is for microbes to overcome the biological barrier to produce spillovers. Other mammals are the main source of zoonotic agents for humans. For example, in the case of the Ebola virus, fruit bats are the suspected zoonotic agent.

Genetic variation and evolutionary changes in pathogens' genetic material can influence their capacity to infect new host species, though cross-species infection (spillover) does not necessarily result in infection or sustained transmission in recipient host population.

Environmental and anthropogenic drivers for spillover

During the late 20th century, zoonotic spillover increased as the environmental impact of agriculture promoted increased land use and deforestation, changing wildlife habitat. As species shift their geographic range in response to climate change, the risk of zoonotic spillover is predicted to substantially increase, particularly in tropical regions that are experiencing rapid global warming. As forested areas of land are cleared for human use, there is increased proximity and interaction between wild animals and humans thereby increasing the potential for exposure.

Intraspecies spillover

The bumblebee is a potential reservoir for several pollinator parasites.

Commercially bred bumblebees used to pollinate greenhouses can be reservoirs for several pollinator parasites including the protozoans Crithidia bombi and Apicystis bombi, the microsporidians Nosema bombi and Nosema ceranae, plus viruses such as Deformed wing virus and the tracheal mites Locustacarus buchneri. Commercial bees that escape the greenhouse environment may then infect wild bee populations. Infection may be via direct interactions between managed and wild bees or via shared flower use and contamination. One study found that half of all wild bees found near greenhouses were infected with C. bombi. Rates and incidence of infection decline dramatically the further away from the greenhouses where the wild bees are located. Instances of spillover between bumblebees are well documented across the world, particularly in Japan, North America and the United Kingdom.

Examples of Spillover Zoonosis
Disease Reservoir
Hepatitis E Wild Boar
Ebola Fruit Bats
HIV/AIDS Chimpanzee
COVID-19 Bats

Surveillance and prevention of spillover infections

Surveillance

Surveillance and prevention of spillover infections involve identifying pathogens in animal reservoirs, monitoring transmission at animal-human-environment interfaces and reducing factors that help in cross-species transmssion. The One Health approach involves human, animal and environmental health surveillance, recognising that disease emergence is influenced by interactions among these systems.Surveillance can combine clinical case reporting, pathogen testing in wildlife and domestic animals, environmental sampling, genomic analysis and monitoring of ecological or human activities related with increased exposure. Surveillance of potential reservoir hosts and drivers of disease emergence help identify emerging spillover threats before they lead to large outbreaks.

Prevention

Preventive measures include improving biosecurity on farms, reducing occupational exposure to infected animals, implementing appropriate animal vaccination and disease-control programmes, regulating wildlife trade, improving food safety and reducing contact with contaminated materials or surroundings.Environment management and land-use strategies may also help in reducing spillover risk. When spillover occurs, rapid diagnosis, laboratory confirmation, case reporting, contact tracing where relevant, infection prevention and control and vaccination or treatment can help limit further transmission. As spillover pathways vary among pathogens and settings, prevention strategies should be adapted to local ecological conditions, host species and routes of transmission.

See also

References

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