control of rabies in turkey - fve · etlik central veterinary control and research institute ......
TRANSCRIPT
Control of Rabies inControl of Rabies in TurkeyTurkey
The feasibility of oral vaccination The feasibility of oral vaccination ofof dogsdogs
Dr. Orhan Aylan<[email protected]>
Etlik Central Veterinary Control and Research InstituteAnkara / Turkiye
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Rabies Situation in TurkeyRabies Situation in Turkey
• Dog-mediated rabies– 70 % of all cases reported in dogs
• Primary source of infection for humans is dogs
IncidenIncidencece between 1991 between 1991 –– 20020077(According to Animal Species)(According to Animal Species)
%4.12150Wild Life Total
%95.873488Domestic Total
0.5219Other Wild Life
0.104Bear
0.135Badger
3.07112Fox
0.2710Wolf
0.218Other Domestic
0.9033Horse
0.4115Donkey & Mule
4.01146Sheep & Goat
3.29120Cat
19.81721Cattle
67.202445Dog
%nSpecies
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
IncidenIncidencece between 199between 19966 –– 20020077(According to Animal Species)(According to Animal Species)
20
102
190
06
11
100
182
05
17
59
139
03
8
51
103
04
20321591-4-Wild Life
16575127208181104117103Dogs
287217173245208128138125Domestic Animals
0702010099989796
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Incidence 2000 Incidence 2000 -- 20072007
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Fox -- 19991999
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Fox –– 20002000--20012001
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Fox -- 20022002
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Fox –– 20032003--20072007
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
IncidenIncidencece between 1991 between 1991 –– 20032003(According to Regions)(According to Regions)
189
34
22
4
0
1
61
67
2001
246
22
12
6
4
3
178
21
2002
160
25
7
4
4
1
85
34
2003
254209128142125168170287320428TOTAL
601323202014416045South EastAnatolia
113200046418East Anatolia
10108112021672134Black sea
5444106212046CentralAnatolia
6
41
121
2000
0291313304459Mediterranean
4937432628437170Aegean
13052551171598479100156Marmara
199919981997199619951994199319921991
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Rabies Control and Eradication Rabies Control and Eradication ProgramsPrograms
• GDPC– The General Directorate of Protection and
Control
• The Provincial and Local Veterinary Authorities
• Veterinary Control and Research Institutes
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Control MethodsControl Methods
• Control of stray dogs• Vaccination• Quarantine measures• Public information and training programs
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Employed VaccinesEmployed Vaccines
279.000310.6222000
159.000247.5322001
391.000227.6772002
211.000219.9502003
588.750172.2382007
668.227167.3432006
440.850215.4902005
547.300182.5602004
114.000176.0101999
317.000168.0051998
412.000158.4301997
128.000171.3991996
94.000166.5291995
Inactivated Rabies Vaccines (Dose)Kelev Kuduz Aşısı (Dose)
ImportDomestic
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
DiagnosisDiagnosis
• In nation-wide, diagnosis are performed in eight (8) Veterinary Control and Research Institutes (VCRI)– Etlik Central VCRI (National Reference Lab)– Others
• Istanbul Pendik, Izmir Bornova• Samsun, Konya, Elazig, Erzurum, Adana
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
DiagnosisDiagnosis
• Fluorescent Antibody Test• Mouse Inoculation Test• RT-PCR• RFFIT (FAVN)
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
PhylogeneticPhylogenetic RRelationshipelationship BBetweenetween198 European RABV 198 European RABV IIsolatessolates
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Distribution of Genetic Variants of Distribution of Genetic Variants of RABV in EuropeRABV in Europe
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
The ProjectThe Project
• Project Basic Information– Title: “Control of rabies disease in Turkey”– Sector: Agriculture– Location: Turkey– Duration: 3 years
• Objectives– Eradicate rabies disease in Turkey– Ensure human and animal health status– Conform to EU standards
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
PurposePurpose
• Control of rabies among animals– Wild life– Domestic
• Reduce the risk factors for humans to get infected– with rabies– other zoonoses caused by domestic animals
• Adopt EU control measures
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
AimsAims
• Eradication of rabies while complying with EU Legislation 90/638/EEC– Parenteral vaccination of domestic animals– Oral vaccination of wild animals
• Secondary objectives– Identify the number of domestic cats and
dogs– Control stray animals (esp. dogs)
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
ActivitiesActivities
• Animal Rabies Disease Control Strategy– Legislation– Epidemiological Analysis– 3 Pilot Schemes (OV of Foxes, Dogs, Wildlife
Surveillance)
• Human Risk Reduction– Improve PET usage– Improve info and know-how exchange
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
ActivitiesActivities
• Training– Diagnosis Tech, OV in Wildlife, Epidemiology,
Mass Dog Vaccination, Dog Census, Surveillance in Bats
• Communication & Public Awareness– OV in Foxes– Mass Dog Vaccination
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Expected ResultsExpected Results
• Control and monitoring system for rabies• Raising the immunity level against rabies• Control of stray cats and dogs
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Care UnitsCare Units
• 3 care units will be constructed in major cities; Ankara, Istanbul, Izmir.
• The motivation of constructing care units is to provide example institutions for stray animal care
• We expect municipalities and NGOs to form and construct similar institutions whose operations will be controlled by GDPC but operational costs born by establishing bodies
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
New Lab. FacilitiesNew Lab. Facilities
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
New Lab FacilitiesNew Lab Facilities
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Dog Dog RabiesRabies: A : A WorldwideWorldwide PProblemroblem
55,000+ human rabies cases
annually
98% of all human cases are caused
by bites fromrabies infected
dogs
Removal
Control Methods
Mass Parenteral Vaccination Campaigns
Control Methods
Neuter-and-release campaigns
Control Methods
2007
Oral vaccination of foxes against rabies
Oral Vaccination
• Safe, Efficacious
• Attractive bait
• Targeted bait delivery
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Immunogenicity
Study Animal route dose seroconversion rate . (FFU/ml) (%)
1 foxes bait 2.0E+06 25/27 93%
2 lab dogs p.o. 1.4E+06 0/5 -
3 lab dogs p.o. 7.5E+07 4/5 80%
4 stray dogs p.o. 3.2E+07 5/34 14%
5 stray dogs p.o. 2.0E+08 14/14 100%
Vaccine virus used: SAD B19Source: Müller W et. al (1998) J Etlik Vet Microbiol, 9:61-71
Neubert A et. al (2001) J Vet Med B, 48:179-183
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Baits ≠ Dog Baits
• Dogs have different food preferences and aversions than foxes
• Dogs handle food different than foxes (swallowing)
• Dogs often search for food together, in contrast to the solitaryhunter; the red fox
Boiled intestine bait
Fox Bait
Bait Types
Köfte Bait
Bait Delivery System
a) At selected sites
b) At central vaccination points
c) House-to-house
A
C
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Bait Delivery Systems: At Selected Sites
Disadvantages:- Already vaccinated dogs can also locate and consume baits distributed.
- Bait depletion by non-target species.
- Increased risk of unintentional human contact with vaccine virus.
Köfte bait uptake (%) n=400
53%13%
26%8%
dogscatsbirdsunknown
Bait Delivery Systems: At Selected SitesCapture - Mark - Recapture
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Sarıgazi Ferhatpaşa
Number of dogs tagged 22 31
Bait density (baits/km²) 43 150
Baits disappearance (%) 64,7 92,7
Seroconversion (%) 4,3 23,3
Bait Delivery Systems: At Selected Sites
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Bait Delivery Systems: Vaccination At Central Point
Sarigazi, IstanbulOnly 21.8% of owned dogs
were vaccinated free of chargeat central veterinary clinic
Aydin Province>70% of owned dogs in villages
were vaccinated at mobile vaccination points
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Bait Delivery Systems: House-to-house Campaign
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Bait Delivery Systems:
Summary
Vaccination coverage (%) owned dog population
AREA Sarıgazi Ferhatpaşaprior to campaign 18.0 15.5campaign at vaccination centre 21.8 ---house-to-house campaign
parenteral 22.8 40.5oral 21.2 18.1
Total 83.8 74.1
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Conclusions:
- Oral vaccination of dogs against rabies is a feasible option, especially in urban areas
- House-to-house campaigns are the most effective; combining parenteral and oral vaccination
- The baiting strategy developed by recollection of (discarded) vaccine containers eliminates almost completely the risk of unintentional human contacts with the vaccine viruses
However …
Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Conclusions:
-There are still some doubts concerning safety-related issues with present available oral rabies vaccines
-Proven high efficiency of mass dog vaccination campaigns by the parenteral route, also in urban areas
- Oral vaccination reduces responsibility of dog owners even further, and could therefore interfere with attempts to increase responsible dog ownership
Thank you!
Photographs: Perihan Agnelli, Sarah Cleaveland, Ad Vos, BFAV-Tübingen, IDT-Biologika GmbH