WHO CC for Rabies Surveillance and Research, OIE Reference Laboratory for Rabies, Germany Principles of rabies eradication Thomas MüllerM
Rabies control Basic considerations Problem identification Goal Plan development Tools Principles Canine & wildlife rabies
Basic considerations Problem identification Canine rabies? both? Wildlife rabies? Rabies surveillance Notifiable disease Basis for any rabies control programme Collection, analysis & dissemination of data Submission & testing of indicator animals Emphasis on laboratory confirmation Reporting of human & animal rabies cases Reporting of number of PEPs
Basic considerations Goal Containment of disease Avoiding of further spread Elimination of disease Freedom from disease Paradigm shift one health approach
Basic considerations Plan development Destruction of target (reservoir) species ineffective unacceptable Mass vaccination of target species dogs - mass parenteral vaccination wildlife - oral vaccination
Definition A long term plan of action designed to achieve a particular goal. Criteria State Basic considerations Tool Vaccination strategy State-of-the-art of science and technology Efficiency under any condition Minimal expense maximal success Cost-effective Simple principles to follow
Efficiency Vaccination strategy Relation of benefits to costs Rabies cases Inefficient Efficient Money spent
Principles A basic generalization that is accepted as true or a basic rule that guides or influences action or decision making rules used by veterinarians to organize the elements of rabies eradication programs to create a unified vaccination strategy
Principles of rabies elimination in dogs mass parenteral vaccination campaigns
Principles Dog density estimation Classification of dogs Vaccination campaigns Dog population management Surveillance and Monitoring
overall dog population Methods Capture / mark / re-observe Transect counting (free roaming dogs) Priciples Dog density estimation Random house-to to-house survey (owned dogs) Dog - human ratio
What is a stray dog? Owned vs. unowned Principles Classification of dogs Abandoned or true ownerless Community dogs Restricted vs. free-roaming roaming Changes during day and night Feral dogs Live independent from humans
Organization Priciples Vaccination campaigns (1) Intersectorial collaboration Community participation Strong media support Subregional & local committees to deal with technical & logistic aspects Vaccination of all dogs (70% coverage) Regardless of age, weight or state of health, Regardless of ownership-status status Adequate coverage of puppies Identification of vaccinated dogs
Responsible dog ownership Annual vaccination weeks Once a y / more frequent Fixed time points Basic approaches House-to to-house visits Fixed vacc.. posts Temporary vacc.. posts (mobile teams) Supplementary measure Oral vaccination Principles Vaccination campaigns (2)
Removal of dogs No significant impact Worsens situation (disruption of social system) Unacceptable In certain situations the only solution (humane) Practical methods Movement restriction Habitat control Reproduction control ABC programmes neuter- and-release release Principles Dog population management
Principles of rabies elimination in wildlife Oral vaccination campaigns
Principles Vaccinated areas Timing of vaccination Bait density Mode of bait distribution Duration of vaccination Surveillance and Monitoring
Principles Vaccination areas large scale 350 300 250 200 150 100 50 0 55 10 15 20 1200 1000 patchy 800 600 400 200 0 55 10 15 20
Principles Timing of vaccination (Foxes) 1 0.9 0.8 0.7 0.6 0.5 rabies incidence 0.4 mating birth 0.3 0.2 0.1? 20 30 40 50 60 70 80 0 dispersal population turnover J F M A M J J A S O N D spring den summer autumn
Principles Mode of bait distribution organizational expense man power large-scale vaccination accessibility to areas cost-effectiveness control hand + + - - - - aerial - - + + + + hand and aerial distribution complement each other
Principles Mode of bait distribution
Principles Bait density 800000 700000 Hunting bag baits per campaign 600000 500000 400000 fox wild boar 300000 200000 100000 12-15/km 15/km 2 18-25/km 2 25-30/km 2 0 1985/86 1990/91 1995/96 2000/01
Principles Bait density varying bait density varying flight line distance 0 1-5 6-10 11-15 16-20 >20 baits Bait densities >20/km² do not increase bait uptake Very small flight line distances cannot improve the ground pattern further
Principles Duration of vaccination Average 6 y budget planning! cessation 2 y after last rabies case
Large scale > 5,000 km² Aerial & complementary hand distribution 25 baits / km²,, cross border coordination Long-term 6 y + 2 y Average 6 y ORV of wildlife Take home message Twice a y (spring /autumn) vs. once a y Stop of vaccination 2 y after last rabies case Targeted surveillance and monitoring Rabies incidence, bait-uptake, seroconversion Epidemiological analysis
Can rabies be eradicated? Charles Rupprecht,, Paris, 2007 Yes (a question of balance in perspective) No (if we are honest and live in the now ) Maybe (because hope springs eternal) I do not know (as ignorance is bliss, things change, and life on earth is unpredictable)
Thank you for your attention!