VN October 2023

Vetnuus | October 2023 18 susceptibility, and therefore probability, of elephants acquiring and harboring infections, either from each other or from humans, but also to the likelihood of them asymptomatically or symptomatically shedding pathogens. There is no specific safe distance over which infection can be assuredly avoided, because airborne droplets may travel widely according to, for example, expulsion forces, quantity of droplets, air density, and local ventilation conditions. Pathogens such as Mycobacterium spp. (TB), in particular, involve a potential risk of elephant-to-human and human-to-elephant infection. Current guidance on disease prevention and control and elephant welfare Tourism industry guidance Industry guidance encourages direct contact experiences between humans and elephants, recognizes that elephants are carriers of TB, and advises that clientele should be informed of risks [73]. Although guidance from the tourism advocacy sector to clientele regarding both public health and safety and animal welfare should be welcomed, such information may not be impartial or evidence- based and instead may harbor vested interest messaging that in effect increases relevant risks. For example, industry advice for avoiding elephant-associatedhumanTB recommends handwashing to prevent infection [73]. However, given that TB pathogens are typically transmitted by air and inhalation and not by touch, such advice on handwashing constitutes grossly oversimplified and misleading guidance. In addition, industry public health guidance [73] presents only voluntary controls; thus, even if such information was scientifically sound (which it is not) then that information remains lacking in authority and enforcement. The importance of adherence to impartial, evidence-based, guidance independent of industrial influence is thus essential and emphasized. Scientific and independent guidance Relevant guidance within the scientific literature regarding zoonotic infections and risk prevention, as well as animal welfare, essentially consists of broad recommendations concerning increased knowledge pertaining to diseases, handwashing and other practical measures, occupational health education, screening of animals for infection, and training for mahouts [5, 6, 46, 103, 111, 162]. Detailed recommendations were proposed providing a six-step “Animal-Visitor Interaction Protocol” for the assessment and alleviation of animal welfare and elephant-human problems, and which focused on behavioral observations and analyses, physiological measures, risk assessment, visitor experience assessment, ethical analysis, and final assessment, along with training,withanoverviewofimprovingconditionsforbothelephants and their human interactors [9]. The same authors also proposed a five-stage “General control measures of zoonotic risk” protocol, which focused on biosecurity, veterinary control, environmental hygiene, design of exhibition areas, and control measures for risks of infection. While all of these measures offer potentially valuable improvements, they all may also hold limited potential for disease prevention and control. Uptake of and adherence to information by the public is notoriously poor. Face masks to protect people from possible elephant-associated contaminants are probably valuable ad hoc barriers to infection, but their use and effectiveness is less than comprehensive, as demonstrated during the pandemic spread of SARS-CoV-2/COVID-19 [163–166]. Elephants in tourism are also exposed to substantial numbers of people of uncertain health status, and there are no rational grounds to presume that simple adoption of face masks by mahouts, other handlers, or public clientele would, in any event, be consistently complied with. Accordingly, air that is relevantly free of pathogens cannot be assured in either direction across the elephant-human interface, leaving both parties exposed. In addition, many gaps exist regarding current knowledge of relevant diseases, their incidence, prevalence, transmission modes, infectivity, and other issues; consequently providing clear information of sufficient breadth for public health protection is challenging. Infections frequently involve an inactive or latent phase during which the re-emergence of the disease may be triggered by, for example, environmental factors, stressors, or concomitant disease. Screening for infection against the background of latency and disease lag phases may not merely erode confident assessment but also invite complacency. Furthermore, screening for the diversity of pathogens harbored by elephants is not feasible. Guidance regarding monitoring and improvement of elephant welfare in tourism is varied. For example, a behavioral assessment tool for elephant welfare has been developed using established indicators trialed at zoos [167], as well as a generalized dedicated welfare index trialed at zoos and sanctuaries [132]. Stakeholder education methods have been proposed to incentivize commerce, including against negative criticism [168, 169]. Much of the current guidance on elephant welfare is aimed at factors such as balancing commercialism, community economics, and sustainability through “practical” measures [7, 170–172], promoting environmental, psychological, and social enrichment [136], education, standard setting, and accreditation [154], and positive incentives for mahouts and related actors [170]. Thus, recommendations frequently presume the continuation of the elephant tourism industry with some prospective degrees of reduction rather than prioritizing animal welfare (or public health and safety) as overarching primary issues. However, captive elephants, whether in zoos or in tourism, share numerous commonalities of poor welfare related to their biological demands, nature of captivity, and associated husbandry challenges [136]. These issues raise the question that if elephant welfare cannot be assured even in the major regulated institutions (zoos), then the prospects for good welfare in lesser regulated conditions – that is, tourism – are worrying, and this conforms to the concept of controlled deprivation [173]. Some authors look beyond the theoretical reduction of welfare with elephant tourism and commerce, toward promoting observational tourism involving only free-ranging animals [131]. Conclusion While much is known regarding public health issues between elephants and humans, much information, particularly epidemiological data, is lacking. These deficits should not be used to justify latency to act to curtail potential disease spread. Despite these data deficits, we believe that sufficient information is known regarding pathogens and their modes of transmission to warrant a precautionary approach to safeguarding animal and human health. Accordingly, this study has embraced the precautionary principle throughout. Increasing pressures on natural habitats and wildlife are key drivers of zoonotic problems, and even subtle ecological alterations may act as rapid trigger events to transform historically stable host-pathogen relationships into epidemics or pandemics. It was likely that SARS-CoV-2/COVID-19 emerged from just such a scenario, with globally devastating results. Relatedly, potential pathogens can be difficult to detect and disease spread can manifest from highly insidious processes during which time affected individuals are asymptomatic yet destined to become sick perhaps months later. Such infection latency and disease lag phases may cause tourists and medical health professionals to fail to associate sick animals or people with their causative situations, Elephant tourism: An analysis and recommendations for public health, safety ...... <<< 17