Embed Size (px)
DESCRIPTION
RABIES in the MIDDLE EAST. A. Seimenis, D.V.M. Director, WHO/Mediterranean Zoonoses Control Centre ATHENS, GREECE [email protected] , www.mzcp-zoonoses.gr. RABIES in the MIDDLE EAST (ME). Endemic in most countries of the ME; - PowerPoint PPT Presentation
Citation preview
WHO/MZCP
RABIES in the MIDDLE EASTRABIES in the MIDDLE EAST
A. Seimenis, D.V.M.Director, WHO/Mediterranean Zoonoses Control Centre
ATHENS, [email protected], www.mzcp-zoonoses.gr
WHO/MZCP
Endemic in mostmost countries of the ME;
Mediterranean (southern and eastern) littoral countries with with commoncommon climatic, geographical, socio-cultural, epidemiological characteristics
SeriousSerious public health problems.
RABIES in the MIDDLE EAST (ME)
1
WHO/MZCP
DOG: main source of human infection;
CATS: second most important source followed by other domestic animals and wild life;
WILDLIFE: red fox, jackals, wolves, etc.
2
RABIES in the MIDDLE EAST
WHO/MZCP
Rabies in HumansRabies in Humans: : approximately approximately 300 reported cases annually300 reported cases annually
Post-exposure treatmentPost-exposure treatment: : several several hundreds of thousandshundreds of thousands
Most cases inMost cases in: : EGYPT, IRAQ, EGYPT, IRAQ, IRAN, PAKISTAN, SUDAN, YEMENIRAN, PAKISTAN, SUDAN, YEMEN
3
RABIES in the MIDDLE EAST
WHO/MZCP
Rabies in AnimalsRabies in Animals: : part only of cases are reported
Laboratory confirmation upon restricted Laboratory confirmation upon restricted number of cases onlynumber of cases only
Growing problem for certain countries, Growing problem for certain countries, e.g. YEMENe.g. YEMEN
Rabies in wildlifeRabies in wildlife: growing public health : growing public health problemproblem
Wild animals population (red fox, Wild animals population (red fox, jackals) on increasejackals) on increase
4
RABIES in the MIDDLE EAST
WHO/MZCP
Epidemiological surveillance NOT well established
Data NOT always reliable No regular laboratory
confirmation Correlation between DOG and
WILDLIFE rabies difficult
5
RABIES in the MIDDLE EAST
WHO/MZCP
Difficulties for efficient control programmes
Control activities based on stray dog elimination and voluntary individual vaccination
Cell-culture vaccines and immunoglobulins for human post-exposure treatment
Dog mass vaccination campaigns never performed
Lack of dog population estimates Dog vaccination rate not estimable
6
RABIES in the MIDDLE EAST
WHO/MZCP
Rabies control failure due to: Weak infrastructures; Inappropriate control strategies; Lack of sustainable resources and
workforce; Weak laboratory diagnosis support; Lack of intersectoral collaboration; Population socio-cultural factors; Weak community awareness.
7
RABIES in the MIDDLE EAST
WHO/MZCP
Wildlife rabies control-no activities
Need forNeed for: Ecological studies for target animals; Vaccination strategy to be
developed; Live vaccine strain/high temperatures relation to
be evaluated; Trained personnel; Adequate funding; Intercountry agreements.
8
RABIES in the MIDDLE EAST
WHO/MZCP
Weaknesses of various kind: infrastructures, no co-operation, funds, personnel, etc.), should NOT BE ACCEPTABLE as they maintain DESPERATE HUMAN SUFFERING from preventable zoonoses,
9
RABIES in the MIDDLE EAST
WHO/MZCP
CODE: DI SEASE CONTROL Cr Control of wildlife
reservoir P Prohibition of import
from infected countries Pa Control programme for
only some areas of the country or certain
types of breeding Pn Control programme for
the whole country Q Quarantine movement
control and other precautions at frontier
and inside the country Qf Quarantine and other
precautions at frontier Qi Quarantine measures
and movement control inside the country S Stamping-out Sp Modified stamping-out Su Surveillance te Testing V Vaccination * Notifiable disease DI SEASE OCCURRENCE 0000 Never reported --- Not reported (+) Exceptional occurrence + Low sporadic
occurrence ++ Enzootic +++ High Occurrence +.. Disease exists;
distribution unknown .... No information
available
TABLE 1. REPORTED OCCURRENCE OF RABIES & CONTROL MEASURES IN HUMANS & ANIMALS IN SELECTED COUNTRIES OF THE MIDDLE EAST (Source: Official Reports, WHO/Rabnet, OIE-Questionnaires)
Domestic Animals
Country Cases in Humans Period (Year)
Post-exposure Treatments Bovine Ovine Caprine Dogs/Cats
Wild Life
Bahrain --- 1988-97 30 --- --- --- --- 1988-98: 61 cases rep. in dom animals
Egypt 521 114 278
1987-95 1996-98 1999-04
377 10,080 QiSp* QiSp* +QiSV* 0000
Iran (Islamic Republic)
15 2005-06 250,212 ++V* - 2005-06
859 ++V*
16++*
Iraq 39 2005-06 17,038 .... .... V* .... 2005-06: 11 cases rep. in
domestic animals Israel .... 2005-06 (2005) 1,500
(2006) .... .... QiSu*
27V* 5*
1988-00: 65 cases rep. in dom animals 2005-06: 8 cases rep. in dom animals Jordan
6 0 0
1992-96 1997-02 2003-06
4,376 3,304 7,801 +S* +S* 1996: 4/1
+V*
1996: 4
Kuwait (State of)
0 1 0
1992-94 1995
1996-02 2002-04
1,500 910
1,720 2,434
---* ---* ---* ---*
---* ---* ---* ---*
---* ---* ---* ---*
---* ---* ---* ---*
1989-00: 17 cases rep. in dom animals +.. Lebanon
4 14 1
1992-93 1995-02 2003-04
125 340
1,011 +S* +S* +V*
1988-00: 4,080 cases rep. in dom animals +..* Oman
(Sultanate of)
3 0 3 1
1990-93 1994-96 1997-99 2001-04
1,800 3,150 1,700
....
++S* ....
++S* ....
++V* ....
---* ---* ---*
Qatar --- 1988-99 1,470 --- --- --- ---
Saudi Arabia (Kingdom of)
43 6 7
1985-95 1996-00 2005-06
(1990-94) 3,974 (1997-00) 7,111
....
---
....
+..QV*
....
+QV*
....
+..*
.... 1999-00: 2,015 cases rep. in dom animals .... Sudan 265
91 1990-93 1995-00
52,000 .... ++* ++* ++*
1989-00: 165 cases rep. in dom animals Syrian Arab Republic
31 20 5
1987-96 1997-02 2003-04
26,381 47,980 21,228
+QSVSu*
+QSVSu*
*+QSV Su
.... 17
Turkey 48 24 ....
1987-94 1995-02 2003-06
754,040 647,893 477,934
(2001-04) 254
QiSuV*
(2001-04) 47
QiSSu*
(2001-04) 263
(2005-06) 173
QiSSuV*
(2001-04) 61
(2005-06) 27
1999-00: 35 cases rep. in dom animals United Arab Emirates
--- --- --- (+)PaSteV*
(+)PaSteV* +PnQSteV*
++*
Yemen
72 20 0
....
1990-95 1997
1998-00 2005-06
(1988-92) 4,830 4,900
.... 10,742
++*
....
++*
.... +++* 724
+.. 5
10
WHO/MZCP
Thank you.
Source: www. pbase.com
