Zoonotic hepatitis E has been a growing public health concern in Europe, but the transmission of its causative agent, hepatitis E virus (HEV), remains incompletely understood. Environmental surveillance, particularly through wastewater monitoring, has proven valuable for tracking viral circulation and variant shift during the COVID-19 pandemic, yet its application to HEV is still limited. In this review, we systematically analyzed HEV sequences across Europe, focusing on environmental sources from a genetic perspective. Of more than 13,100 HEV sequences deposited in the NCBI database, only 2.4 % (316/13,118) originated from environmental samples, including wastewater, surface water, and biosolids. Additional typing data from the literature revealed highly uneven geographic distribution, with 97 % of environmental sequences reported from Italy, France, the United Kingdom (UK), Spain, Sweden, and Germany. HEV-3 was the dominant genotype, while HEV-1 and HEV-4 were occasionally detected. Subtypes 3c and 3f were most common, but their prevalence varied across countries and sample types. Some countries, such as France, Sweden, and the UK, exhibited divergent subtype patterns between humans, animals, and environmental sources, whereas others, such as Spain and Germany, showed more consistent distributions. These findings highlight the importance of integrating clinical, veterinary, and environmental surveillance to better understand HEV transmission in Europe under a One Health framework. However, the scarcity of environmental data, technical challenges in sequencing, and lack of standardized protocols limit comprehensive assessment of HEV circulation. Expanding sequencing efforts, improving detection methods, and coordinating international surveillance frameworks will be critical to strengthen HEV monitoring and preparedness against emerging HEV threats.

A widespread and underreported zoonosis, anthrax is a severe infectious disease of significant public health concern for humans, livestock, and wildlife. In this study, we used historical data from 1991 to 2020 from northern Vietnam and a simulation model to investigate the effects of different vaccination strategies on livestock outbreaks. We developed a novel approach combining semi-synthetic data generation and a sliding windows model fitting routine to estimate disease transmission parameters from surveillance data and address the temporal mismatch between pathogen transmission dynamics and disease reporting. Results showed that vaccination leads to a significant reduction in buffalo mortality, with reactive and increasing vaccination campaigns having the largest impact in reducing outbreak size. Reactive and decreasing vaccination campaigns initially controlled outbreaks, but mortality increased as soon as vaccination ceased, highlighting the need for sustained, long-term vaccination. In scenarios where populations had high natural immunity, the impact of vaccination was less pronounced, though still evident, suggesting that prioritizing vaccination efforts for more susceptible populations may provide a greater return on investment in outbreak prevention and control. Simulation models can offer valuable insights into vaccination and control strategies, providing tools to compare and evaluate potential outbreak scenarios. Our findings underscore the value of mathematical and simulation approaches to overcome data challenges and underreporting in global disease management for anthrax and other neglected diseases. We highlight the importance of continued investment in surveillance and modeling efforts, while providing a practical approach to optimize the use of existing data in Vietnam and similar settings.

Misuse of antimicrobial in both animal and human health remains a key driver of antimicrobial resistance (AMR). Strengthening policy and regulation framework is essential to promote responsible antimicrobial use (AMU). This study aimed to 1) identify policies and regulations governing AMU in Kenya's veterinary sector and 2) undertake a comparative analysis with Denmark's AMU governance system, widely recognised for its comprehensive approach, to identify potential areas for policy improvement. A desk-based review was conducted to identify relevant AMU policies and legislation in Kenya and Denmark. Data sources included the Food and Agriculture Organisation of the United Nations (FAO) databases (FAOLEX and AMR-LEX), government websites, and publications. Semi-structured interviews with key stakeholders from both countries were used to validate the findings. FAO's framework for analysing AMR-relevant legislation in the food and agriculture sector was used to analyse policies across key areas: veterinary medicinal products, animal health and production, feed legislation, pesticides, water quality, plant health, food safety, environmental health, soil and waste, and institutional coordination. We identified 547 legislative documents in Kenya and 206 in Denmark. The comparative analysis identified several areas where Kenya's policy framework could be further strengthened including enhanced regulation of the use of critically important antimicrobials for humans in animals, creation of sub-national AMU monitoring programs, definition of veterinary prescription benchmarks, and enforcement of restrictions on non-therapeutic use. Further, gaps were identified in policies addressing antimicrobial monitoring in the environment, particularly in soil and waste management, alongside the absence of a dedicated funding mechanism for the country's AMR coordination body and the lack of defined targets for reducing antimicrobial use in animals. The study highlights the importance of continued legislative development in Kenya to enhance AMU governance, particularly in the areas of veterinary oversight, monitoring, and environmental protection. Demark's experience illustrates the value of integrated legislative approach, which has contributed to measurable reductions in veterinary AMU. Tailoring and strengthening Kenya's regulatory framework, while ensuring coordinated institutional support and sustainable funding, can help align its AMR governance with international standards and contribute to more effective AMR mitigation efforts.