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One Health and Zoonoses: The 

Evolution of One Health and 

Incorporation of Zoonoses  

 

Govindaraj V. Asokan 
 
Public Health Program, College of Health Sciences, University 

of Bahrain, Manama, Bahrain 

 

 

 

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Abstract 

Introduction: Zoonotic disease outbreaks have surged in the last two decades. These include severe acute respiratory syndrome 

(SARS), Hendra virus, Nipah virus, influenza viruses, Middle East Respiratory Syndrome (MERS) coronavirus, and ebola. One 

Health is the initiative of an inclusive collaboration linking human, animal, and environmental health. One Health is advocated 

through an intersectoral coordination to combat zoonoses, and the term has evolved over centuries. The primary aim of this literature 

review was to examine the change in the definition of the term One Health over time, particuarly following the the introduction of 

the latest definition in 2007 by the American Medical Association and the American Veterinary Medical Association. 

Methods: This review was conducted in four phases. The first phase consisted of a general PubMed search for the phrase “One 

Health” for every literature published up to December 2014. Then an advanced search was carried out using “One Health” in 

conjunction with the terms “zoonosis” and “zoonoses” in PubMed for the time period between January 2007 and December 2014.  

The articles found were then categorized based on the type of journals in which the articles were published. For the second phase, 

“One Health” was searched as a Medical subject heading (MeSH) term, which is the National Library of Medicine controlled 

vocabulary thesaurus used for indexing articles. In the third phase, One Health advocate organizations were found using Google 

search engine. During the final phase, One Health was searched in Google scholar, examined by Google trends, and analyzed by 

Google ngram.  

Results: Before 2007, One Health had many connotations to health in the medical literature with an incomplete adherence to the 

usage of One Health linking zoonoses. The Google trends analysis shows an overal steady increase of the search of One Health 

from 2007 to 2014, which is consistent with the findings of articles from Pubmed. 

Discussion: Our results indicate that the linkage between the terms One Health and zoonoses started in 2007, which correlates with 

the joint declaration made by the American Medical Association and the American Veterinary Medical Association in 2007. We 

suggest creating a MeSH term for One Health in the PubMed database to support more specific research on zoonoses, and exploring 

the possibility of a patent of the term One Health to support global health and evidence based public health.  

Keywords: One Health, zoonoses, global health, public health, MeSH 

 

One Health and Zoonoses: The 

Evolution of One Health and 

Incorporation of Zoonoses  

Govindaraj V. Asokan 
 

Public Health Program, College of Health Sciences, University of 

Bahrain, Manama, Bahrain 

Research 

An estimated two-thirds of all known infectious 

diseases and 75% of emerging diseases are zoonoses.1 

Zoonotic disease outbreaks, often viral, have surged in 

the last two decades,2 highlighting the necessity for a One 

Health approach. Most emerging viruses were often from 

the South East Asian Region, such as the severe acute 

respiratory syndrome (SARS),3 Nipah virus,4 and the 

highly pathogenic influenza viruses,5 with the exceptions 

being the Middle East Respiratory Syndrome (MERS)6 

coronavirus in the Gulf, and the ebola virus in West 

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Africa.7 Outbreaks of these diseases have augmented 

public awareness of the links between wild animals, 

livestock production, and global public health.8 

The One Health concept, which originates from 

ancient civilizations, gained substantial acceptance in the 

19th century through infectious disease research9 and  

comparative medicine.10 Evolution of the terms related to 

One Health is summarized in Table 1. In the 19th century, 

Robert Virchow coined the term “zoonosis” to describe 

pathogens that are naturally transmitted between 

vertebrate animals and humans.11 Virchow’s 

contemporary, Sir William Osler, was the first to use the 

term “one medicine.”9 Later, during the 20th century, 

Calvin Schwabe revived the concept of “one medicine.”10 

A few years ago, the term “One Health” emerged from 

the joint efforts of American Veterinary Medical 

Association (AVMA) and American Medical 

Association (AMA). By definition, One Health is based 

on a systems approach, which includes disciplines of 

human medicine, veterinary medicine, and other related 

scientific health disciplines, working locally, nationally, 

and globally, to attain optimal health for people, animals, 

and our environment.12 Currently, One Health aims to 

develop the capacity and infrastructure to prevent and 

respond to the rapidly expanding zoonoses through 

research that is not only focused on the disease but also 

on the promotion of health at the individual, population, 

and ecosystem levels.13 

 

Table 1: Evolution of the term One Health 

 

The concept of One Health strongly emerged in 

2007, and has gained acceptance worldwide. To combat 

the threats of zoonoses, One Health is advocated through 

intersectoral coordination.14-16 In 2008, the United 

Nations established a framework for approaching 

emerging diseases by establishing intersectoral 

coordination and communication strategies, which, in 

turn, enhances surveillance and emergency response of 

systems at the national, regional, and international 

levels.14 This new approach minimizes the risk and global 

impact of epidemics and pandemics due to emerging 

infectious diseases. The Office International des 

Epizooties (OIE) – World Organization for Animal 

Health endorsed the One Health approach in 2008, as a 

collaborative and all-encompassing way to address 

animal and public health globally.15 The Centers for 

Disease Control and Prevention (CDC) established a One 

Health office in 2009, and in 2010, the European Union 

reaffirmed its commitment to operate under One Health 

umbrella.16 One Health also gained international 

prominence through the coordinated efforts of 

multidisciplinary professionals, such as physicians, 

veterinarians, ecologists, etc. 

The purposes of this literature review are:  

 to identify how One Health has been used 

recently in the medical literature; 

 to identify One Health advocates, such as 

national and international organizations, and 

academia, as promoters of One Health research; 

 to explore the usage of the term One Health 

though Google Trends and nGram. 

 

Methods 

This literature review was conducted in four 

phases.  The first phase consisted of a general search in 

PubMed for the term “One Health” for any literature 

published up to December 2014. This search returned 

1,682 articles, with the oldest article from January 1953. 

The articles found by the general search term “One 

Health” were not necessarily linked to zoonoses but had 

a multitude of meanings, such as One Health district, 

region authority, system, care, resource, sciences, etc. 

Literature published beginning in November 2006 was 

more associated to zoonoses. In order to examine the 

effect of the 2007 definition of One Health, we excluded 

articles prior to 2007 with no link to zoonosis. After 

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exclusion of such articles, an advanced search using the 

term “zoonosis” AND “One Health” returned 193 articles 

published from January 2007 to December 2014. 

Similarly, an advanced search for the term “zoonoses” 

AND “One Health” identified 188 articles from January 

2007 to December 2014.  Through an advanced search, 

“zoonosis AND one health” and “zoonoses AND one 

health” terms were searched for the period between 

January 2007 and December 2014. The articles found 

were then categorized based on the type of journals in 

which the articles were published. For the second phase, 

“One Health” was searched as a Medical subject heading 

(MeSH)17 term, which is the National Library of 

Medicine controlled vocabulary thesaurus used for 

indexing articles. In the third phase, One Health advocate 

organizations were found using Google search engine. 

During the final phase, “One Health” was searched in 

Google scholar and examined by Google trends, which 

analyzes the number of searches for terms in Google.18 

Google ngram was then used to to analyze the use of the 

terms in Google books.19 

 

Results 

The search results indicate that, in general, there 

was a gradual increase in the usage of One Health from 

the year 2007 onwards, with an accelerated usage of the 

term in 2013 and 2014. The only exceptions were 2010 

and 2012, in which there were slight decreases in the 

usage of One Health (Table 2).  

 

Table 2: Frequency of articles from January 2007 to 

December 2014 for advanced search terms in PubMed 

 

A discipline based journal categorization was 

almost the same between the two advanced search terms 

(Table 3). For the search term “zoonosis” AND “One 

Health,” 71 articles were from veterinary medical 

journals, out of which 30 articles were listed from 

Scientific and Technical Review of the OIE alone; 53 

articles were listed by public health journals, 34 articles 

from medical journals, and 33 articles in the others 

category, which included basic science journals such as 

ecology, environmental, and wildlife journals.  

 

Table 3: Stratification of articles by discipline for 

advanced search terms in PubMed from January 2007 to 

December 2014 

The most common keywords associated with 

“One Health” were “Zoonosis” and “Zoonoses,” and our 

search strategy was confirmed by the returned results. 

Our search in the MeSH browser for indexing of the term 

“One Health” found no results. 

One Health Advocates 

Google searches identified many prominent 

organizations that support One Health, including: WHO, 

FAO, OIE, CDC, AVMA, AMA, One Health Initiative 

movement, One Health Sweden, World Veterinary 

Association, One Health Global Network, One Health 

Commission, One Health Alliance of South Asia, One 

World–One Health effort, Ecological Society of 

America, and the World Bank. The OIE, as a One Health 

advocate, is the largetst contributor, with 30 articles in 

Scientific and Technical Review of the Journal OIE. 

Some universities which support or offer 

programs in the area of One Health include:  University 

of Edinburgh, One Health Institute of University of 

California at Davis, Uppsala University, Swedish 

National Veterinary Institute , Swedish University of 

Agricultural Sciences, Linnaeus University, One 

Health/One Medicine initiative at University of Missouri, 

University of Minnesota, University of Pennsylvania, 

Oregon State University, Massey University, University 

of Guelph, Center for One Health at University of 

Illinois, North Carolina One Health Collaborative, and 

University of Florida. A few more nongovernmental 

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organizations, namely Bill and Melinda Gates 

foundation, are allied to One Health. 

Google trends and ngram analysis 

 The Google trends analysis used data from 2004 to 

2014 in order to detect any changes in searches of One 

Health and zoonoses pre- and post-introduction of the 

new One Health definition. The Google trends analysis 

shows a slight decline in searches of One Health from 

2004 to 2007 and then an overall steady increase in 

searches for the term One Health from 2007 to 2014, 

which is consistent with the findings of articles from 

Pubmed and the introduction of the new One Health 

definition (Figure 1). There was no noticeable change in 

the trend of zoonosis or zoonoses.  

A historical ngram analysis of the terms One 

Health and zoonosis/zoonoses shows an overall increase 

in the use of One Health and zoonosis/zoonoses, with the 

greatest increase occurring in the 1940s while tapering 

off slightly in 2010 (Figure 2). 

 

Figure 1: Google trends analysis of advanced search 

terms18 

 

Figure 2: Ngram analysis of advanced search terms19 

 

Discussion 

The prevention of zoonoses that impact public 

health and animal health requires a sustained 

collaboration among the stakeholders to promote the One 

Health approach. Even though One Health has multiple 

definitions accorded to it by its various advocates, the 

common theme that has emerged is collaboration across 

sectors.20 The development of Rift Valley fever vaccine 

by the CDC is one of the noteworthy successes of One 

Health’s collaborative action.21 Such collaboration needs 

to expand to developing countries at all levels of health 

care delivery, risk communication, and research. 

Uninterrupted, accessible, and indispensable information 

from a reliable source is central to achieving the One 

Health goals. The most popular, peer reviewed, reliable, 

and freely available medical and veterinary literature 

database is PubMed. Physicians, veterinarians, basic 

science researchers, and eco-health professionals often 

rely on PubMed for their basic scientific information 

searchers. 

The ngram analysis of the use of One Health 

over time showed a marked increase roughly around 

1945. The 1960s to 1980s mark a particular turn of events 

in infectious disease epidemiology with the eradication 

of smallpox, and the decrease of incidence and 

prevalence of many other diseases, such as measles.22 

With new research on understanding the etiology of the 

most recent emerging diseases (e.g. swine flu, SARS, 

etc.), it has been estimated that roughly 75% of emerging 

diseases are zoonotic in origin,22 which would explain the 

increase in the study of zoonosis/zoonoses and One 

Health in the past few decades. 

The purpose of this literature review was to 

identify how the term One Health is used in the medical 

literature and to identify one health advocates. We were 

able to identify and list the major One Health advocates 

through a Google search, where OIE emerges as the most 

prominent advocate.  However, a PubMed search for One 

Health has shown the zoonoses linkage to the term from 

the year 2007 only, and this correlates with the joint 

declaration made on One Health by AVMA and AMA in 

2007. Prior to 2007, One Health had many connotations 

to health in the medical literature. Our results have shown 

that there is a sustained use of the term One Health from 

2007 onwards, with an accelerated use in 2013 and 2014.  

However, an incomplete adherence to the usage of One 

Health linking zoonoses in the medical literature is 

evident, and this practice of poor adherence will 

potentially impede the implementation of the goals of 

One Health initiatives. The systems approach of One 

Health is practical, cost effective, and involves the 

sustainable, multidisciplinary support of academia and 

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various organizations to undertake more rigorous 

scientific research for countering the accelerated rise of 

zoonoses. Such research inquiry on zoonoses compels the 

correct use of terminologies that are acceptable and 

comprehensible, without any misuse and 

misunderstanding in the medical literature. The term One 

Health suits the current demand of multidisciplinary 

scientists involved in the development of this term, which 

evolved with consensus and feedback from multiple 

disciplines over time.  Therefore, we suggest creating a 

MeSH term for One Health in the PubMed database that 

could be under the MeSH tree structures of Health [N01. 

400] similar to family health, public health, rural health, 

occupational health, and veteran’s health to support more 

specific research on zoonoses.  Furthermore, exploring 

the possibility of a comprehensive, definitive definition 

for the term One Health is a necessity to promote One 

Health, global health, and evidence based public health. 

Competing interests 

 The author declares that they have no competing 

interests. 

 

Acknowledgements 

 The author would like to thank the Central Asian 

Journal of Global Health team, particularly Sharon 

Welburn and Faina Linkov, for their assistance with 

utilizing google trends and ngram analysis and for their 

suggestions on improving our original manuscript. 

 

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1. Taylor LH, Latham SM, Woolhouse ME. Risk factors for 

human disease emergence. Philos Trans R Soc Lond B Biol Sci. 

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2. Wang LF, Crameri G. Emerging zoonotic viral diseases. 

Rev Sci Tech Off Int Epiz. 2014;33(2):569-581. 

3. Li W, Wong SK, Fang L, et al. Animal origins of the Severe 

Acute Respiratory Syndrome Coronavirus: Insight from ACE2-S-

protein interactions. J Virol. 2006;80(9):4211-4219. 

4. Epstein JH, Field HE, Luby S, Pulliam JR, Daszak P. Nipah 

virus: Impact, origins, and causes of emergence. Curr Infect Dis 

Rep. 2006;8(1):59-65. 

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/. Accessed June 25, 2015. 

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25, 2015. 

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ml. Accessed June 25, 2015. 

8. Food and Agriculture Organization, United Nations. 

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9. Cardiff RD, Ward JM, Barthold SW. 'One medicine---one 

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medicine: Celebrated then, forgotten now. Vet Pathol. 

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Health94.aspx. Accessed June 9, 2015. 

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Health at at glance. 2015; http://www.oie.int/for-the-

media/onehealth/. Accessed June 9, 2015. 

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Central Asian Journal of Global Health 

Volume 4, No. 1 (2015)  |  ISSN 2166-7403 (online)  |  DOI 10.5195/cajgh.2015.139  |  http://cajgh.pitt.edu 

  

 

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http://www.cdc.gov/onehealth/people-events.html
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Table 1: Evolution of the term One Health 

 Individual/Organization Experimental Basis Evolution of the 

Term 

19th Century Robert Virchow Experimental studies on Trichinella spiralis, 

bovine cysticercosis, and bovine tuberculosis 

Zoonoses9 

19th Century Sir William Osler Comparative pathology between human and 

animal diseases 

One Medicine9 

20th Century Dr. Calvin W. Schwabe Comparative and collaborative medicine to 

combat diseases and to ensure food and 

environment quality 

Reintroduced 

One Medicine10 

2007 American Medical Association 

(AMA) and American Veterinary 

Medical Association (AVMA) 

Integrated research, education, and public 

health prevention, preparedness, and 

response for achieving improved animal and 

human health 

One Health10 

 

  

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Table 2: Frequency of articles from January 2007 to December 2014 for advanced search 

terms in PubMed 

 Search Terms 

Year “zoonosis” and “one health” “zoonoses” and “one health” 

2007 3 3 

2008 5 5 

2009 12 12 

2010 11 11 

2011 21 21 

2012 13 13 

2013 60 56 

2014 68 67 

Total 193 188 

  

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Table 3: Stratification of articles by discipline for advanced search terms in PubMed from 

January 2007 to December 2014 

 Search Terms 

 “zoonosis” and “one health” “zoonoses” and “one health” 

Veterinary medicine 71 71 

Public health 53 52 

Medical 34 32 

Health policy 2 2 

Other 33 31 

Total 193 188 

Note. Other disciplines include: Ecology health, Wildlife diseases, Nursing, Environmental health, etc.  

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Figure 1: Google trends analysis of zoonosis/zoonoses and One Health18  

 

  

One Health 

Zoonosis 

Zoonoses 

One Health 

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ASOKAN 

 

This work is licensed under a Creative Commons Attribution 4.0 United States License. 

 

This journal is published by the University Library System of the University of Pittsburgh as part  

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Central Asian Journal of Global Health 

Volume 4, No. 1 (2015)  |  ISSN 2166-7403 (online)  |  DOI 10.5195/cajgh.2015.139  |  http://cajgh.pitt.edu 

 

 

Figure 2: Ngram analysis of zoonosis/zoonoses and One Health19 

 

 

 

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