Control of Rabies in Turkey - FVE · Etlik Central Veterinary Control and Research Institute ......
Transcript of Control of Rabies in Turkey - FVE · Etlik Central Veterinary Control and Research Institute ......
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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
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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
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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
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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
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Incidence 2000 Incidence 2000 -- 20072007
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Fox -- 19991999
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Fox –– 20002000--20012001
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Fox -- 20022002
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Fox Fox –– 20032003--20072007
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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
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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
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Control MethodsControl Methods
• Control of stray dogs• Vaccination• Quarantine measures• Public information and training programs
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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
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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
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
DiagnosisDiagnosis
• Fluorescent Antibody Test• Mouse Inoculation Test• RT-PCR• RFFIT (FAVN)
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
PhylogeneticPhylogenetic RRelationshipelationship BBetweenetween198 European RABV 198 European RABV IIsolatessolates
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Distribution of Genetic Variants of Distribution of Genetic Variants of RABV in EuropeRABV in Europe
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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
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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
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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)
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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
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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
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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
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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
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
New Lab. FacilitiesNew Lab. Facilities
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
New Lab FacilitiesNew Lab Facilities
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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
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Removal
Control Methods
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Mass Parenteral Vaccination Campaigns
Control Methods
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Neuter-and-release campaigns
Control Methods
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2007
Oral vaccination of foxes against rabies
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Oral Vaccination
• Safe, Efficacious
• Attractive bait
• Targeted bait delivery
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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
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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
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Boiled intestine bait
Fox Bait
Bait Types
Köfte Bait
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Bait Delivery System
a) At selected sites
b) At central vaccination points
c) House-to-house
A
C
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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
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Bait Delivery Systems: At Selected SitesCapture - Mark - Recapture
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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
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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
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Dr. Orhan AylanEtlik CVCRI
Antalya, TRDecember 2008
Bait Delivery Systems: House-to-house Campaign
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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
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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 …
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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
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Thank you!
Photographs: Perihan Agnelli, Sarah Cleaveland, Ad Vos, BFAV-Tübingen, IDT-Biologika GmbH