oie- global conference on rabies control: elimination of ......venezuela v3, v5 colombia v3 brazil 1...

of 19 /19
Pan American Health Organization World Health Organization Veterinary Public Health OIE- Global Conference on Rabies Control: ELIMINATION OF HUMAN RABIES TRANSMITED BY DOG IN THE AMERICAS: ACHIEVMENTS Hugo Tamayo Silva PANAFTOSA-OPS/OMS Incheon - Seoul - Republic of Korea 7 - 9 September 2011

Author: others

Post on 08-May-2020

1 views

Category:

Documents


0 download

Embed Size (px)

TRANSCRIPT

  • Pan American Health OrganizationWorld Health Organization

    Veterinary Public Health

    OIE- Global Conference on Rabies Control:

    ELIMINATION OF HUMAN RABIES TRANSMITED BY DOG IN

    THE AMERICAS: ACHIEVMENTS

    Hugo Tamayo SilvaPANAFTOSA-OPS/OMS

    Incheon - Seoul - Republic of Korea

    7 - 9 September 2011

  • EPIDEMIOLOGICAL CONTEXT...

    COUNTRY

    /SUBREGIÓ N

    ANIMAL SPECIES

    CANADA - SKUNKS (34%) – FOXES (9%)

    - NON HEMATOPHAGUS BATS (38%)TOTAL 2009 = 145 CASOS CON DL

    USA - RACCONS (35%) - SKUNKS (24%)

    - FOXES (7%)

    - NON HEMATOPHAGUS BATS (24%)TOTAL 2009 = 6.694 CASOS CON DL

    MEXICO - DOGS (V1 - V2)

    - HEMATOPHAGUS BATS (V3)

    - NOT HEMATOPHAGUS BATS (V4)

    CENTRAL A. and

    CARIBE L.

    CUBA - HAITI

    R.DOMINCANA

    P. RICO

    - DOGS (V1 - V2)

    - HEMATOPHAGUS BATS (V3)

    - NOT HEMATOPHAGUS BATS (V4)

    - MANGOOSES (V1)

    ANDEAN A.:

    COLOMBIA

    - DOGS (V1 - V2)

    - HEMATOPHAGUS BATS (V3)

    - NON HEMATOPHAGUS BATS (V4)

    - UROCYON CINEREOARGENTUS (VNC)

    SUL CONE

    BRAZIL

    - DOG (V1 - V2)

    - HEMTOPHAGUS BATS (V3)

    - NON HEMATOPHAGUS B. (V4) (VNC)

    - MARMOSET (VNC)

    - CRAB EATING FOXES (VNC)

  • Venezuela V3, V5

    Colombia V3

    Brazil 1 V3

    Peru-Brazil V3

    Brazil 2 V3

    Argentina V3

    Bolivia V3

    Brazil 3 V3

    Mexico 1 V3

    Mexico-Colombia V3

    Mexico V11

    Colombia V8/V3 – Peru V3

    Mexico V8 atypical

    Tadarida brasiliensis V9 North America

    Tadarida brasiliensis V4 South America

    Colonial bats North America

    Other bats South America

    Solitary bats North America

    Terrestrial carnivores North America

    Sagui monkey Brazil

    Out group 3

    PHYLOGENETIC

    TREE OF RABIES

    VIRUSES

  • 0

    1000

    2000

    3000

    4000

    5000

    6000

    1959 1964 1969 1974 1979 1984 1989 1994 1999 2004 2009

    Cases

    Year

    Rabies in Wild Animals, 1959-2009

    Raccoons Skunks Skunk Variant Bats Foxes

    Source: Centers for Disease Control and Prevention, November 2010

    USA: RABIES IN WILD ANIMALS, 1959-2009

  • 257 millions (46%) without health care, public or private

    685,000 children without vaccination

    17% parturition done by personel not qualified

    LAC: CONTEXT, 2007.....

    - Population: 572 millions

    - In poverty 35.1%

    - In extreme poverty: 15.9%

  • POLITICAL

    FRAMEWORK…

    MANDATES

    1983:

    1a REDIPRA - III RIMSA – OPS/CD 31

    2008 - 2009

    XV RIMSA - OPS/CD 48/R13 CD 49/R19

    2010:

    13ª REDIPRA

  • COMMITMENTS....

    • REDIPRA, Guayaquil 1983: Strategy and action plan for the

    elimination of urban rabies from the major urban centers in Latin

    America by the end of 1980’s

    • PAHO, 1991: extension policies and strategies to isolated areas

    and small rural populations

    • PAHO, 1992: emphasize the surveillance of wildlife rabies,

    particularly transmitted by bats

    • PAHO, 2008: to eliminate dog- trasmittd human rabies from hemisphere

    by 20102 (XV RIMSA – CD 48/R13)

  • REGIONAL PLAN: COMPONENTS ...

    • Timely post-exposure

    prophylaxis for people bitten.

    Access immunobiological

    • Elimination of human rabies

    transmitted by dogs. Dog mass

    vaccination

    • Active surveillance and

    prevention of wildlife rabies

    • Social organization, education

    end information diffusion

  • ALC: ACHIEVEMENTS, 1970 – 2011*

    Source: SIRVERASource: SIREVERA/SIEPI - PANAFTOSA/OPS August/2011

    0

    20

    40

    60

    80

    100

    120

    140

    160

    180

    200

    220

    240

    260

    280

    300

    320

    340

    360

    1970

    1971

    1972

    1973

    1974

    1975

    1976

    1977

    1978

    1979

    1980

    1981

    1982

    1983

    1984

    1985

    1986

    1987

    1988

    1989

    1990

    1991

    1992

    1993

    1994

    1995

    1996

    1997

    1998

    1999

    2000

    2001

    2002

    2003

    2004

    2005

    2006

    2007

    2008

    2009

    2010

    2011

    Year

    Hu

    man

    Rab

    ies

    0

    2500

    5000

    7500

    10000

    12500

    15000

    17500

    20000

    22500

    25000

    Rab

    ies in

    Do

    gs

    Human Cases transmitted by dog Human cases transmitted by bats Rabies in Dogs

    15

    19

    196

    25,000 351

    60

  • LAC: SPATIAL DISTRIBUTION: 1999 - 2006

    Rabia Humana Origen Perro

    Año 2006

    3 a 7 (2)

    2 (3)

    1 (8)

    0 (404)

    AmericaAdm1Rabia by Rc1999

    8 to 8 (1)

    3 to 8 (2)

    2 to 3 (6)

    1 to 2 (19)

    0 to 1 (389)

    AmericaAdm1Rabia by Rh2007

    8 to 8 (1)

    3 to 8 (1)

    1 to 3 (1)

    0 to 1 (414)

    AmericaAdm1Rabia by Rh2006

    2 to 2 (1)

    1 to 2 (2)

    0 to 1 (414)

    AmericaAdm1Rabia by Rh2005

    4 to 17 (2)

    3 to 4 (2)

    2 to 3 (1)

    1 to 2 (2)

    0 to 1 (410)

    Rabia origen pe rros 1999

    8 (1)

    3 a 7 (2)

    2 (6)

    1 (19)

    0 (389)

    Rabia Humana Origen Perros

    Año 1999

    8 y + (1)

    3 a 7 (2)

    2 (6)

    1 (19)

    0 (389)

    AmericaAdm1Rabia by Rh2007

    8 to 8 (1)

    3 to 8 (1)

    1 to 3 (1)

    0 to 1 (414)

    AmericaAdm1Rabia by Rh2006

    2 to 2 (1)

    1 to 2 (2)

    0 to 1 (414)

    AmericaAdm1Rabia by Rh2005

    4 to 17 (2)

    3 to 4 (2)

    2 to 3 (1)

    1 to 2 (2)

    0 to 1 (410)

    Rabia origen pe rros 1999

    8 (1)

    3 a 7 (2)

    2 (6)

    1 (19)

    0 (389)

  • 111111

    PAHO RESOLUTION (DC 49

    2009): ELIMINATION OF HUMAN

    RABIES TRANSMMMITED

    BY DOG….

    LAC: RABIES HOTSPOTS - 2009

  • 2010

    2011-2012

    To here

    High

    Moderate

    Low

    RABIES IN LAC: GOAL

  • LAC: CAPACITY FOR RABIES ELIMINATION ….

    Brasil - México

    Argentina - Colombia Venezuela - Perú

    Ecuador - Nicaragua

  • DECLARATION OF RABIES FREE

    COUNTRY/TERRITORIES, VARIANTS 1 AND 2

    DECLARED IN PROCESS PROGRAMMED

    Chile

    Mexico

    Peru

    Costa Rica

    Nicaragua

    Uruguay

    Argentina

    Brazil -south

    Colombia

    Equador

    Venezuela

  • • Epidemiological Surveillance: A Network for

    rabies diagnosis laboratories

    • > more than 100 laboratories

    • Medical care to people exposed (PEP)

    > 1,000,000 people bitten annually

    > 500,000 patients prophilaxis post exposition

    > 2,000,000 vaccine doses applied (> C.C.)

    • Canine Vaccination

    > 45,000,000 dogs vaccineted annually

    • Education, community participation

    KEY TO SUCCESS....

  • 0

    15

    19

    1

    37

    5

    0

    10

    20

    30

    40

    50

    60

    2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

    Years

    Hu

    ma

    n C

    as

    es

    of

    Ra

    bie

    s

    Cat Dog Bat

    CHALLENGE: WILD RABIES RE-EMERGENCE...

    Source: SIREVERA/SIEPI - PANAFTOSA/OPS August/2011

  • D.rotundus

    Artibeus spp

    Brasil

    CatDog

    D.rotundus

    Artibeus spp

    2° Costa Rica

    3° Colômbia

    4° Equador

    Secondary transmission of rabies in the Americas

    (Wild Cicle Urbanization?)

  • WILD RABIES SURVEILLANCE:

    SIMPLIFICATION OF ECOSYSTEMS

  • Challenges Opportunities

    Country/Areas with rabies : less

    developed:

    - Inmunobiological deficiency

    - Low dog vaccination coverage

    - Lack integration, coordination

    Strengthening National Progr. bi or

    multinational border:

    - Policies to combat poverty

    - Unfinished agenda in health

    - Local Development

    - Weakening national

    - programs

    - Low epidemiological

    surveillance

    - Declaration countries / territories

    free (WHO-OIE)

    - Strengthening Field-laboratory

    surveillance

    •Re-emergence wild rabies cicle - Strengthening regional laboratory

    network

    - Strengthening active survillance

    field-laboratory