Rabies free zone in Thailand. Dr. Pornpitak Panlar Bureau of General Communicable Disease Department of Disease Control

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1 Rabies free zone in Thailand Dr. Pornpitak Panlar Bureau of General Communicable Disease Department of Disease Control

2 Burden of Rabies Rabies remains a public health concern in Thailand. There are some people death from rabies every year. The mean age of the patients was 40 years old. Over 1 million people are potentially at risk of rabies infection. More than 5 hundred thousand patients receive rabies vaccination annually at an estimated cost of 1 billion Bath. More than 99% of all human deaths from rabies did not have postexposure prophylaxis. Domestic dogs the major source of human cases. Source: R.36 and TRN

3 Distribution of the risk levels of humans contracting rabies, worldwide, 2011

4 Rabies situation in Thailand % animal rabies positive no. human death Year Source: R.36 and TRN Update: 15 Jul 2015

5 Rabies risk areas 2015 Divide by 1. No. of human rabies cases 2. No. of positive rabies in animals Source: R.36 and TRN

6 Why human rabies still remain? Public health Most of rabies case did not receive post exposure prophylaxis. Lack of public participation from people Inadequate of risk communication. Provider error. Health services accessibility. Livestock Vaccine coverage in dogs is less than 80% Inadequate of laboratory diagnosis. Stray dogs especially in border line.

7 What s next? SAARC and the ASEAN Plus 3 ( SEA + China, Japan and Rep. of Korea)

8 Road map to Rabies free area A = 27 provinces 2014 A =18 provinces RFZ= 44 provinces 2015 A =15 provinces RFZ= 47 provinces 2017 RFZ= 77 provinces 2020 RFZ= 77 provinces Control area level C Control area level B Control area level A Rabies Free Area

9 Goal To achieve a long-term goal of zero rabies fatality both in human and animal populations Thailand will become the Rabies Free Country by Missions 5 core strategic Visions Missions Strategies

10 Efficient management and integrated approach to prevention and control of rabies Increased role and active engagement from local administration organizations in rabies prevention and control Surveillance, prevention and control of rabies in human and animal populations Multi-sectoral engagement and public participation Efforts to raise awareness, increase knowledge and skills, and influence behavior changes among the public for rabies prevention and control

11 Rabies control programs and results 1. Foster multi-sectorial efforts and collaboration to prevent and control rabies in local communities nationwide. project % of local community in Thailand join in Rabies free zone

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13 Areas of Rabies free zone in Thailand during % 12% 58% A B C ปลอดโรค 30% 9% 1% 60% 201 4

14 Rabies control programs and results 2. Promote dog registration and rabies vaccination. - The estimated vaccine coverage in dog is 78.97% - Unable to consolidate updated and accurate dog populations. 3. Control and minimize the number of stray dogs. 4. Continued rabies surveillance prevention and control in both humans (Rabies) and animal (Thai Rabies Net)

15 Surveillance System

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18 Rabies control programs and results 5. Raise public knowledge, understanding and awareness on rabies prevention. Animal health: - Thailand s dog vaccination program: 2 rounds of vaccination annually Public health: 1 st round: April May 2 nd round: September October - The patients have to see a doctor, if they are bitten by animals. 6. Enforce applicable laws related to rabies prevention and control.

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20 RB campaign

21 RB campaign Credit: District livestock office, Chiang Kong and Terng, Chiang Rai province

22 Challenge Prevention and control : Introduce cost-effective public health intervention techniques to improve accessibility, affordability and availability of post-exposure prophylaxis including mass dog vaccination and dog population control. Promotion : Improve understanding of rabies through awareness, education and operational research. Partnership : Collaboration between involvement of community, civil society, government and non-government sectors and international partners i.e. CDC, DLD, OIE, FAO, WHO

23 Thank you