Every year, nearly 2 million young Americans experience homelessness. which can be both a crucial source of emotional support and a barrier to receiving services such as housing or medical care. Studies have shown that Some may choose veterinary care for their animals over obtaining health care for themselves. Ěý

The Seattle One Health Clinic was designed to address those barriers. Led by the operated in collaboration with the Washington State University College of Veterinary Medicine, and supported by two nonprofit organizations, the clinic offers free veterinary care alongside its medical services. A paper Ěýin the Journal of Primary Care & Community Health found that the integrated approach increased access to preventative medical care for both people and their pets.Ěý

“It’s truly integrated — human and animal providers working together is a unique approach,” said , lead author of the paper and a postdoctoral researcher in the Center for One Health Research.Ěý

At the One Health Clinic, a nurse practitioner and veterinarian, often accompanied by veterinary students, provide primary care services while UW students volunteer as patient navigators, helping to coordinate care and address shared health needs such as extreme weather, environmental contaminants and zoonotic disease. The clinic also helps clients document their pets as emotional support animals, which enables them to access a wider range of housing and other services. Ěý

“The data clearly shows that this model of care is building trust,” Rejto said. “It’s special to see holistic care that takes into account the environment, the animal, the person and their relationships in society, to provide care to these young people. It’s incredibly important for people to have preventative care, and that in turn has a great impact on public health.” Ěý

The study analyzed medical and veterinary records of clinic visits between 2019 and 2022. The majority of human participants were 23 years old or younger. Of the 88 human clients who visited the clinic during that period, 75 saw a health care provider at least once, and 40 patients established care for the first time in at least the past two years. Most of those patients returned for at least one follow-up appointment within two years of their first visit.Ěý

Most significantly, nearly 80% of all visits to the One Health Clinic resulted in clients receiving human health care. That includes 69% of visits where clients initially intended to seek care only for their pets.Ěý

“Adding veterinary care to a primary care clinic creates a supportive environment that is vastly different from a typical medical care facility”, said co-author , one of the founders of the One Health Clinic and director of the UW Center for One Health Research, who is also a UW professor of environmental and occupational health sciences and an associate professor of medicine in the UW School of Medicine. “This unique atmosphere encourages clients to seek care for themselves as well as their animals.”ĚýĚýĚý

A fully integrated model may be a new concept to many, requiring novel partnerships between human health and veterinary professionals, Rejto acknowledged. But the results suggest that health care providers should give greater consideration to the health impact of the human animal bond between people and their pets.ĚýĚý

“Potentially a good start would be to increase collaboration and communication between animal and human health care, to have human health facilities that are in communication with veterinary facilities. That could help identify diseases and shared environmental risks,” Rejto said. “It’s about expanding providers’ and human health care workers’ framework for addressing health.”Ěý

Other authors include , senior research coordinator and center manager at the Center for One Health Research; , a UW assistant professor of global health and of epidemiology and deputy director of the Center for One Health Research; Hannah Fenelon, Michael Xie, Alice Tin and Erin Tabor of the UW Center for One Health Research; of the Washington State University College of Veterinary Medicine; Kate Schneier and Andrew Nee of Neighborcare Health; and Amanda Richer of Uplift Consulting.Ěý

This research was funded by the National Institutes of Health, National Institute of Nursing Research Training Program in Global Health Nursing at the UW, the New Tudor Foundation, and by a gift from the now-shuttered Y/YA Shelter “Peace for the Streets by Kids from the Streets.” Funding for the publication of this study was provided by the American Society for the Prevention of Cruelty to Animals’ (ASPCA) Open-Access Publishing Fund.

Four years ago, as attention locked onto COVID-19, another virus began circling the globe. A major outbreak of a new strain of bird flu — formally named — has since killed millions of wild birds and infected poultry, dairy cattle, and a small number of humans.ĚýĚý

In the United States, four people have contracted the virus. The most recently confirmed , a dairy worker in Michigan, was the first to experience flu-like respiratory symptoms. For now, federal health officials have deemed the virus a low risk to public health, while and monitoring the virus’s spread.Ěý

But what exactly are public health officials looking for? How is this virus different from previous H5N1 outbreaks? And how can a bird flu become humanity’s problem, anyway?ĚýĚý

UW News brought these questions and more to ĚěĂŔÓ°ĘÓ´«Ă˝ experts Peter Rabinowitz, a professor of environmental and occupational health sciences and of family medicine, and , an assistant professor of epidemiology and of global health. They are director and deputy director, respectively, of UW’s , which studies the connections between the health of people, animals and our shared environment.

Peter, you recently . What makes this outbreak different, and why is it drawing so much attention from health officials?ĚýĚý

Peter Rabinowitz: Thirty years ago, outbreaks of highly pathogenic avian influenza were rare in birds. Beginning around 2003, a deadly strain of H5N1 avian influenza started spreading widely, but mostly impacted domestic poultry. Now this recent strain of H5N1 that has been circulating worldwide for the past two years is unprecedented in its ability to affect mammals.Ěý

The H5N1 virus started with birds before “jumping” to dairy cattle and now a handful of humans. How does a virus “jump” between species like that, and what makes certain species vulnerable while others seem to resist the virus?Ěý

PR: As they circulate, influenza viruses are continually changing some of their genetic material, acquiring new mutations in a process known as “” Sometimes when two different strains of a virus are present in the same host human (or animal), they can “recombine” to create a quite different strain.ĚýĚý

Health officials have said the chances of H5N1 becoming a major threat to humans are minimal, but that they’re monitoring the situation for any changes. What are they looking for?ĚýĚý

PR: Health officials are looking for evidence of mammal-to-mammal transmission in non-human mammals, and any evidence of person-to-person transmission, which could be a definite warning about H5N1’s potential to become an epidemic.ĚýĚý

The earliest cases of H5N1 in humans were mild — two dairy workers with eye infections — but the most recent case appears to be . That’s triggered alarm, of course, but what does that say about how the virus is evolving?ĚýĚý

Julianne Meisner: The location of symptoms can sometimes — though not always — tell us something about transmission. When symptoms are restricted to just the eye, it’s likely that transmission would require contact with the tissues around or fluids from the eye, similar to how pink eye (conjunctivitis) is transmitted.Ěý

When health professionals see respiratory symptoms, we get concerned about transmission through droplets or aerosols. Because breathing is something every one of us needs to do, all of the time, respiratory transmission is incredibly efficient, and difficult to avoid. Also, some respiratory symptoms, such as coughing, can propel virus particles further, increasing the efficiency of transmission.ĚýĚý

Much has been made of H5N1 as the next possible pandemic. Should that happen, are there lessons we’ve learned from the COVID-19 pandemic that could help us navigate this one?ĚýĚý

PR: Yes, the lessons learned from COVID-19 in terms of rapid development of vaccines and the effectiveness of control measures such as masks would allow us to respond quickly. Unfortunately, everyone is quite tired of hearing about pandemics, so a challenge would be to capitalize on the helpful lessons learned and find a way to avoid misinformation and public backlash to a public health response.ĚýĚý

JM: While COVID has been very divisive in many ways, it has also familiarized many people with public health: People now know how to navigate dashboards on the health department’s website, and we have muscle memory regarding social distancing, mask wearing, handwashing, etc. Basic epidemiology principles such as quarantine, isolation, transmission rate, etc. are familiar to the general public now. But there is also a lot of fatigue, as Peter mentions, which may make it harder to implement public health countermeasures if they become necessary.ĚýĚý

You both study the connection between human and animal health. It’s easy for people to understand that animal diseases can spread to humans, but how else should we consider that relationship?Ěý

PR: We should raise awareness about the terrible impact of the current avian influenza outbreak on wild and domestic animal populations: millions of poultry dying because of spreading infections, also hundreds of thousands of wild birds and mammals, including sea mammals such as sea lions and seals. An event like this represents a threat to biodiversity and the health of ecosystems, which we have learned is extremely important for human health. The concept of “One Health” stresses these vital connections between the health of humans, other species, and our shared ecosystems.ĚýĚý

To reach Rabinowitz or Meisner, contact Alden Woods of UW News at acwoods@uw.edu.ĚýĚý