VN October 2023

Oktober 2023 9 The frequent and brutal illegal killing of African elephants for the ivory market has been blamed for negatively affecting ecotourism by dramatically reducing or eliminating wild populations, and thus the viability of the sector [2, 10]. More recently, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/Coronavirus disease 2019 (COVID-19) pandemic also reduced human-elephant tourism and consequently impacted the sector [6]. While both Asian and African contexts involve observational, low-level interactive, and high-level interactive events, there are different emphases between the two regions. In Asia, elephant tourism is substantively associatedwith direct and indirect elephant-centered interactive entertainment – attracting primarily animal welfare and public health and safety concerns, but also species conservation concerns [6, 10, 11]. In Africa, elephant tourism is substantively associated with free-range elephant ecotours, killing of elephants for related bioproducts and linked to substantial economic losses from population declines affecting tourism, and increasing species conservation threats [2, 10]; and to perhaps a lesser extent, at least within the literature, animal welfare and public health and safety concerns. Threats to species conservation arising from killing and habitat Copyright: Warwick, et al. This article is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/ by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. International Journal of One Health, EISSN: 2455-8931 50 Available at www. onehealthjournal.org/Vol.9/No.2/2.pdf loss affecting both Asian and African elephants are increasingly noted [2, 10, 11]. This article is broadly relevant to situations affecting both Asian and African elephants in the captive animal tourism sector. Public health issues and concerns are endemic to elephant tourism. Numerous elephant-to-human zoonoses (notably tuberculosis [TB]) and other transmissible infectious agents are documented as confirmed or potential threats to public health [12–41]. Elephants are also susceptible to reverse human zoonoses – infections transmissible from humans to elephants, notably TB [42–44], with varying degrees from low to high morbidities and mortalities affecting both elephants and humans. The term “zoonoses” is commonly used to describe diseases that are transmissible between animals and people. There are over 200 zoonoses that range widely across pathogen classes, including bacteria, viruses, fungi, parasites, and prions [45–47]. Approximately 61% of human diseases are considered to be potentially zoonotic in origin [48]. Of the global emerging human diseases, around 75% generally have links to wild animals [49]. Accordingly, the association between pathogens occurring in wildlife and those in, or merging with, humans is well established. In addition, numerous captive elephant-to-human injuries and fatalities are also increasingly documented [50–54]. These injuries are mostly reported in the general media rather than within scientific documents and require a dedicated study of formalized public records, which was beyond the scope of the present article; thus, this issue is minimally discussed. Although public health issues form the focus of this study, animal welfare is or should be, a powerful driver of any policy where humans have managemental responsibility over other species [55–57]. Both the treatment and well-being of elephants for tourism are increasingly raised as issues of concern [1, 5, 6, 10, 58, 59]. Audiovisual materials have been presented by the animal welfare campaigning sector regarding human-to-elephant physical and mental abuse in tourism, such as injurious handling, forced confinement, and social deprivation [60–62]. These campaigns broadly call for action to prohibit high-level interactive entertainment and limit tourism to the low-level observational engagement of free-living elephants. The scientific community has also provided numerous studies that similarly report and broadly justify the concerns of animal welfare campaigners [1, 4, 7, 63]. Psychobehavioral damage to elephants from abuse or transmission of elephant-associated human pathogens and disease (which may be exacerbated by stress- related immunosuppression in animals) is a relevant consideration potentially affecting public health and safety. As for other captive animals, elephants that are subjected to poor or stress-inducing treatment may present increased risks to public health and safety within somewhat circular causes and effects. Such implications in disease transmission emphasize the importance of the one health paradigm, which considers the environment, animals, and people interconnectedly [64–67]. Elephants are held captive in several world regions, for example, in zoos – which are arguably also confined for tourism reasons. However, within Western nations, greater frameworks exist that offer some foundation for protecting public health and safety and animal welfare compared with Asia and Africa [68–71]. Accordingly, for this study, elephant tourism refers primarily to in situ human-elephant contact or informational experiences as entertainment that occur in captivity or related managed conditions and involve such activities as rides, photo opportunities, petting experiences, and feeding sessions in Asia and Africa [72, 73]. This study aims to review information regarding captive elephants used for tourism, with regard to key public health issues, as well as associated animal welfare considerations relevant to a one health context, and offers recommendations for alleviating key concerns. Materials and Methods Ethical approval . Ethical approval was not needed for this study. Databases search criteria .The literature was systematically searched using Google Scholar and PubMed for studies published from 2000 to 2023 (Box-1 & Figure-1). Inclusion and exclusion criteria Items were included based on search terms and subsequently screened for relevance (Box-1 & Figure-1). Further articles were supplemented from the authors’ libraries. Studies were excluded based on low relevance, for example, where focused on subjects such as pathogen serotyping methodologies, highly specific veterinary treatment protocols, individual animal and small number case studies with no apparently relevant content, general discussions on human-wildlife conflicts, narrow welfare remits, and older reviews for which contents are repeated in more recent papers, and studies regarding zoo elephants. Leading Article >>> 10