Loida Valenzuela, DVMProvincial Veterinarian

Ilocos Norte, Philippines

Location/Description of Ilocos NorteIlocos 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

3 2 2 2 2

50

28

44

188

0

20

40

60

2008 2009 2010 2011 2012Human 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 vaccinationPeople knowledge about rabies limited Local practicesRIG for Cat.3 bite patients limited

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?

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 rabies1. Partners’ support2. Executive and legislative support3. Inter-agency collaboration4. Provision of appropriate and timely Post-Exposure

Prophylaxis (PEP)5. Diagnostic surveillance and monitoring6. Education and communication7. Rabies control at municipal and barangay level

1. Support from international partnersAcknowledge 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 projectNetwork 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 collaborationPVO, 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, poster-

making contests, slogan contests, among others

DA-BAI and DOHCapability building for laboratory staff and field

personnel Proficiency evaluation of trained staff Logistic support for vaccines and vaccination

paraphernalia

3. Inter-agency collaboration

4. Provision of prophylaxisFlowchart of Handling Animal Bite Cases

BiteVictimCat. II or

IIIVaccination

MHO/PHO/ ABTC

Dog’s Welfare

Full Vaccination

Continue or discontinue vaccination

Lab ResultBite victim, PHO and

ABTC/MHO/MAO concerned.

Lab Analysis (PVO) Dead

5. Diagnostic surveillance and monitoring

Appropriately equipped laboratory Proficiency testsActive 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 SurveyMajority 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

Bantay Rabies sa Barangay Volunteers (BRBVs) Focal person in every barangay Conduct dog registrationAssist during mass vaccinationAssist dog bite victims for medical attention and

submission of dog head sample in case the biting animal dies

7. Rabies Control at Municipal and Barangay Level

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.