Rabies free zone in Thailand Dr. Pornpitak Panlar Bureau of General Communicable Disease Department of Disease Control
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
Distribution of the risk levels of humans contracting rabies, worldwide, 2011
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Rabies situation in Thailand 100 90 80 70 60 50 40 30 20 10 0 91 78 74 77 44.5 47.1 49.9 41.5 58 57 68 50 37 30 32.7 29.1 22 27.6 28.9 28.7 18.8 21.6 24.1 24.5 18.2 20.2 18 19 20 22 24 14 9 % animal rabies positive no. human death 29.2 17.8 13.7 13.2 15 7 7 4 3 7 2.9 5.7 3.6 Year Source: R.36 and TRN Update: 15 Jul 2015
Rabies risk areas 2015 Divide by 1. No. of human rabies cases 2. No. of positive rabies in animals Source: R.36 and TRN
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.
What s next? SAARC and the ASEAN Plus 3 ( SEA + China, Japan and Rep. of Korea) 2020 2015 2030
Road map to Rabies free area 2020 2013 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
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 2020. 6 Missions 5 core strategic Visions Missions Strategies
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
Rabies control programs and results 1. Foster multi-sectorial efforts and collaboration to prevent and control rabies in local communities nationwide. project. - 91.43% of local community in Thailand join in Rabies free zone
Areas of Rabies free zone in Thailand during 2013-2014 30% 12% 58% 201 3 A B C ปลอดโรค 30% 9% 1% 60% 201 4
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)
Surveillance System
http://r36.ddc.moph.go.th/r36/home
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.
RB campaign
RB campaign Credit: District livestock office, Chiang Kong and Terng, Chiang Rai province
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
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