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Towards the elimination of Towards the elimination of Rabies in EurasiaRabies in Eurasia

Jean Blancou, WOAH, May 27 Jean Blancou, WOAH, May 27 07 07

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IntroductionIntroduction

The burden of rabiesThe burden of rabies Historical background Historical background

and current situation and current situation Epidemiological features Epidemiological features

in various speciesin various speciesRabies control in dogsRabies control in dogsRabies control in wildlifeRabies control in wildlifeRabies control in other Rabies control in other

speciesspeciesConclusion and Conclusion and

perspectivesperspectives

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The burden of rabiesThe burden of rabies

Human rabiesHuman rabies ranks 7th ranks 7th among other infectious among other infectious diseases, but these diseases, but these human deaths could be human deaths could be avoided.avoided.

Animal rabiesAnimal rabies does not does not threaten rural economy: threaten rural economy: its elimination will its elimination will essentially benefit to essentially benefit to human health services, human health services, which should share the which should share the cost of this elimination.cost of this elimination.

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Current situation andCurrent situation and historical backgroundhistorical background

Endemic and most Endemic and most feared since feared since thousands of yearsthousands of years

End of the 19th End of the 19th century: century: 4 to 8 human deaths/ 4 to 8 human deaths/ 101066 inhabitants inhabitants

Today: 4 to 8 human Today: 4 to 8 human deaths/10deaths/1066 inhabitantsinhabitants

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Species barrier : the factsSpecies barrier : the facts

Susceptiblity:

IM. LD 50 of a fox strain for IM. LD 50 of a fox strain for dogs = 10dogs = 105,65,6 IC.LD/miceIC.LD/mice

IM. LD 50 of a fox strain for IM. LD 50 of a fox strain for foxes = 10foxes = 10-0,5 IC.LD/mice-0,5 IC.LD/mice

IM. LD 50 of a dog strain for IM. LD 50 of a dog strain for foxes = 10foxes = 105 IC.LD/mice5 IC.LD/mice

IM. LD 50 of a dog strain for IM. LD 50 of a dog strain for dogs = 10dogs = 10-- 0,9 IC.LD/mice0,9 IC.LD/mice

Virus sheding: The fox The fox virus is shed by 95% of virus is shed by 95% of infected foxes versus 25% infected foxes versus 25% of infected dogs.of infected dogs.

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Species barrier: practical Species barrier: practical consequencesconsequences

1. Target the vector, not the victim2. More than 95% of human deaths in 2. More than 95% of human deaths in EurasiaEurasia are following dog bites.dog bites.3. 3. Dogs should be the main targetDogs should be the main target

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Epidemiological situation of Epidemiological situation of Dog rabies in EurasiaDog rabies in Eurasia

Epizootic:from time Epizootic:from time to timeto time

Enzootic: 175,000 to Enzootic: 175,000 to 250,000 rabid dogs 250,000 rabid dogs each year based on each year based on a ratio 1/5 to a ratio 1/5 to human cases human cases

Epidemiological situationEpidemiological situation of of Dog rabies in EurasiaDog rabies in Eurasia

175,000 to 250,000 rabid dogs each year based on a ratio 1/5 to 175,000 to 250,000 rabid dogs each year based on a ratio 1/5 to human caseshuman cases

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Non medical measures of Non medical measures of dog rabies control in dog rabies control in

EurasiaEurasia

Efficient when Efficient when properly properly implemented, implemented, butbut

Have still to face Have still to face many technical, many technical, financial, or financial, or human human obstaclesobstacles

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Parenteral vaccination of Parenteral vaccination of dogs in Eurasiadogs in Eurasia

EfficientEfficient when properly when properly implemented but have implemented but have also to face many also to face many technical, or financial technical, or financial obstacles.obstacles.

Main difficultyMain difficulty: : reaching a sustainable reaching a sustainable and efficient vaccination and efficient vaccination coverage where and coverage where and when human health when human health services do not services do not contribute at national or contribute at national or local levels. local levels.

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Oral vaccination of dogs in Oral vaccination of dogs in EurasiaEurasia

Considered to day as a Considered to day as a supplement to the supplement to the parenteral vaccinationparenteral vaccination

In the future could be In the future could be applied on a larger applied on a larger scale and become the scale and become the main tool of rabies main tool of rabies control.control.

Photo Afssa NancyPhoto Afssa Nancy

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Oral vaccination of dogs in Oral vaccination of dogs in EurasiaEurasia

Conditions for a mass Conditions for a mass vaccination campaign vaccination campaign to succeed :to succeed :ConsensusConsensusShared costsShared costsFree vaccination Free vaccination Well planedWell planedWell coordinatedWell coordinatedWell evaluatedWell evaluated

Photo Afssa NancyPhoto Afssa Nancy

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Epidemiological situation of Epidemiological situation of Wildlife rabies in EurasiaWildlife rabies in Eurasia

Western Europe: Western Europe: starting wave in starting wave in 19381938

Wildlife rabies Wildlife rabies inin

Eurasia : Eurasia : historyhistory

Epizootic wave Epizootic wave from 1938 to from 1938 to

19891989

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Wildlife rabies in Eurasia in 2006Wildlife rabies in Eurasia in 2006

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Non medical measures of Non medical measures of Wildlife rabies control in Wildlife rabies control in

EurasiaEurasia

AbandoneAbandonedd

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Oral vaccination of Wildlife Oral vaccination of Wildlife against rabies in Eurasiaagainst rabies in Eurasia

The « magic » tool for The « magic » tool for rabies control : have rabies control : have not only succeeded to not only succeeded to eradicate the disease eradicate the disease in less tha 10 years in in less tha 10 years in many countries but many countries but remains available at remains available at any time in case or any time in case or its re-emergenceits re-emergence

Photo EIDLR NancyPhoto EIDLR Nancy

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Epidemiological situation of Epidemiological situation of rabies in other animals in rabies in other animals in

EurasiaEurasia

vectors/reservoirsvectors/reservoirs

Raccoon dogsRaccoon dogs

Polar foxesPolar foxes

WolwesWolwes

[Raccoon,jackal[Raccoon,jackal

mongoose..]mongoose..]

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Epidemiological situation of Epidemiological situation of bat rabies in Eurasiabat rabies in Eurasia

Less than 1000 cases since 1954Less than 1000 cases since 1954

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Bat rabies control in Bat rabies control in EurasiaEurasia

Possible Possible vectors/reservoirs in vectors/reservoirs in tropical areas tropical areas Frugivorous species Frugivorous species Permanent vectors Permanent vectors reservoirs in Europe reservoirs in Europe Insectivorous Insectivorous endangeredendangered species speciesControl : information Control : information and vaccination of those and vaccination of those at risk.at risk.

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control of rabies in other control of rabies in other species in Eurasiaspecies in Eurasia

CatsCatsVictims of the Victims of the main vector, main vector, no no independent independent cycle cycle established established so far.so far.VaccinationVaccination

2020

Control of rabies in other Control of rabies in other species in Eurasia (2)species in Eurasia (2)

HerbivorousHerbivorous

Victims of the Victims of the main vector, no main vector, no independent independent rabies cycle rabies cycle observed so observed so far.far.Vaccination?Vaccination?

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ConclusionConclusion

In Eurasia:In Eurasia:• Animal losses are negligible Animal losses are negligible

compared to more than compared to more than 30,000 human deaths 30,000 human deaths

• The main vector/reservoir The main vector/reservoir of human rabies is the dog, of human rabies is the dog, and canine rabies can be and canine rabies can be eliminated by oral eliminated by oral vaccinationvaccination

• The ministries of health The ministries of health should mobilize should mobilize all the all the other national bodies other national bodies involved in dog rabies involved in dog rabies control, and contribute all control, and contribute all necessary resources to necessary resources to control this reservoircontrol this reservoir

•Animal losses are Animal losses are negligible compared to negligible compared to more than 30,000 human more than 30,000 human deaths in Eurasiadeaths in Eurasia•More than 97% of human More than 97% of human rabies following dog bitesrabies following dog bites• Canine rabies can be Canine rabies can be eliminated by eliminated by oral/parenteral vaccinationoral/parenteral vaccination•The ministries of health The ministries of health should use the competences should use the competences of Veterinary services and of Veterinary services and mobilize mobilize all the other all the other national bodies and all national bodies and all necessary resources to necessary resources to control this reservoircontrol this reservoirPhoto Alex WandelerPhoto Alex Wandeler

ConclusionConclusion