Loida Valenzuela, DVM Provincial Veterinarian Ilocos Norte, Philippines
Location/Description of Ilocos Norte Ilocos Norte is found north of the Philippines, on the northwestern tip of mainland Luzon.
Location/Description of Ilocos Norte Congressional Districts: 2 Cities: 2 Municipalities: 21 Villages/Barangays: 557 Proximity from Manila (488 kms. to Laoag) by air approximately 45 minutes by land 8 hours
Location/Description of Ilocos Norte Area: 3,622.91 sq. kms. Limited plains with the southeastern, eastern and northern parts hilly and mountainous 150 kms. coastal areas traversing 9 towns Primarily agricultural Human Population: 568, 017 (PSA, 2010)
Rabies situation before intervention 60 40 20 0 50 44 28 18 3 2 2 2 8 2 2008 2009 2010 2011 2012 Human Rabies Case Canine Rabies Case
Rabies situation before intervention LGU policy not all LGUs have policies (ordinances) for rabies control LGU priorities - more inclined on infrastructure and agricultural production projects Limited resources risk-based vaccination People knowledge about rabies limited Local practices RIG for Cat.3 bite patients limited
Why rabies control is a priority in Ilocos Norte? Ilocos Norte is the tourist hub of the north. It has an international airport with direct flight from Guangzhou, China and daily flights from Manila. Influx of tourists and risk of rabies exposure may cause possible negative travel advisories. About 95% of the households have close relatives as OFWs or immigrants to other countries. Exposure to bite incidents and rabies during their vacation may cause delays/changes in their itinerary.
Why rabies control is a priority in Ilocos Norte? Almost all households have dogs as pets. Approximately 20% of the population are poor, and majority of bite cases in humans are from this sector; hence, completing PEP is too costly for them to shoulder. Majority of bites are children.
Why rabies control is a priority in Ilocos Norte? All LGUs already have passed their respective Ordinances on rabies control. Efforts need to be holistic to decrease human and canine rabies to zero.
Rabies situation now The last case for canine rabies from laboratory results was in July, 2013. Laboratory samples yielded negative results since then. The last human rabies case was reported in May, 2013. Category 2 and 3 animal bite cases are being followed through for PEP, as needed, and health status of the biting animal.
Key factors in eliminating rabies 1. Partners support 2. Executive and legislative support 3. Inter-agency collaboration 4. Provision of appropriate and timely Post-Exposure Prophylaxis (PEP) 5. Diagnostic surveillance and monitoring 6. Education and communication 7. Rabies control at municipal and barangay level
1. Support from international partners Acknowledge support from technical partners: OIE, FAO, GARC, HSI and WAP for the trainings that honed understanding, skills and approaches in controlling zoonoses and other emergencies. With the MOU entered into by the PGIN and GARC through the Communities Against Rabies Exposure project on April 27, 2012, the goal of zeroing in on rabies intensified. Ilocos Norte also became a recipient of the OIE support for rabies vaccines from its vaccine bank.
2. Executive and legislative support Passage of local Ordinances Issuance of Executive Orders and memoranda by the LCEs at different levels (provincial, city, municipal, village/barangay) Provision of funds for vaccine purchase (humans), vaccination paraphernalia, and counterpart funds for various activities.
3. Inter-agency collaboration The project also acknowledges other collaborators in the implementation of various activities the Universities, DA and BAI, DILG, PNP, DOH, Department of Education, private organizations, student organizations.
3. Inter-agency collaboration Multi-sectoral collaboration Launching of the PGIN-GARC CARE project Network with the LMP, ABC, PCMVLP Provincial Rabies Control Council Periodic provincial rabies situation assessment Region 1 Rabies Summit on March 26, 2015 Technical Working Committee for incentives and awards
3. Inter-agency collaboration PVO, PHO, LGUs Referral and submission of dog heads to PRDL Protocol for releasing laboratory results Established Quick Response Team (QRT) Capability building for frontliners Vaccination protocol Rabies Educators Bureau Managing bite cases Conduct of pet-related events
3. Inter-agency collaboration Local University, Media Production of localized information materials Information awareness TV and radio advocacy on rabies awareness and related topics
3. Inter-agency collaboration University collaboration Volunteer vaccinators Information advocacies
3. Inter-agency collaboration Department of Education Preparation of teachers manual on rabies using local data Animal bite management integrated in rabies awareness seminars Advocacies thru different events like quiz bee, postermaking contests, slogan contests, among others
3. Inter-agency collaboration DA-BAI and DOH Capability building for laboratory staff and field personnel Proficiency evaluation of trained staff Logistic support for vaccines and vaccination paraphernalia
4. Provision of prophylaxis Flowchart of Handling Animal Bite Cases BiteVictim Cat. II or III Vaccination MHO/PHO/ ABTC Lab Analysis (PVO) Dead Dog s Welfare Lab Result Bite victim, PHO and ABTC/MHO/MAO concerned. Continue or discontinue vaccination Full Vaccination
5. Diagnostic surveillance and monitoring Appropriately equipped laboratory Proficiency tests Active surveillance for highly suspect bite cases Follow thru on the biting animal and PET or PEP Rabies Death Review (RDR)
6. Education and communication Integration of rabies education in the elementary curricula Rabies Prevention Program Manual for teachers Village/barangay seminars/iecs School information campaigns (quiz bees, art competitions, folk media) Early Child Intervention (ECI)
6. Education and communication TV, radio and print interviews Kapihan, press briefings Border control advocacy in coordination/collaboration with bus management companies Billboards, bus stickers, infoboards Leaflets and information materials using the local language
6. Education and Communication
7. Rabies control at city, municipal and barangay levels Knowledge, Attitudes and Practices Survey Majority of bite victims are male with age range from 5-15 yrs. old. Many are aware about rabies but have insufficient application of knowledge. 89% heard of rabies but only 12% have adequate knowledge on rabies.
7. Rabies control at city, municipal and barangay levels Rabies Educators Bureau Training of C/MHO and C/MVO/MAO staff Conduct rabies awareness seminars in barangays and schools
7. Rabies Control at Municipal and Barangay Level Bantay Rabies sa Barangay Volunteers (BRBVs) Focal person in every barangay Conduct dog registration Assist during mass vaccination Assist dog bite victims for medical attention and submission of dog head sample in case the biting animal dies
Future activities Collaborating with a private company (supplier of rabies vaccine) on the training of BRBVs and other volunteers on the proper handling of vaccines while on field work, and tapping them as volunteer vaccinators Collaborating with HSI on the training of extension workers and dog pound staff on the humane handling of stray (owned but unconfined/unleashed) animals for vaccination Coordinating with the PSWDO in extending the ECI component to other LGU day care schools Collaborating with adjacent provinces on border control, and helping them establish their surveillance system for rabies control
Lessons learned Collaboration: it opens new windows for exploration. it is easier to work with other agencies. it creates a venue for continuous education. alternative plans can easily be implemented. People attitude can be varied, but working for a common goal crosses barriers. Prioritization and focus can be achieved if aiming for a common objective.
Constraints/Challenges and how we resolve/plan to resolve them: Different people, different strokes. Listen, hear, then talk. Consistency is important, but flexibility can be done. Prioritization by LCEs Communication and IEC lines open from the start of each political period, and continuously thereafter. Tapping the national agencies (DA-BAI, DOH, NDRRMC, OCD, DOT) and private groups and organizations for support.
Constraints/Challenges and how we resolve/plan to resolve them: Should anything bad happens, contingency plans are ready. After more than two years of zero rabies, we pray that no more case of canine nor human rabies occur.
Working towards rabies-free Ilocos Norte Thank you for listening.