LESSONS LEARNT FROM RABIES CONTROL PROGRAMMES IN VIETNAM

How can we work together better and get more? Legislation/Planning Development Implementation LINKING/ COLLABORATION Animal Health Lab Human Health Epi

Legislation/Planning Development

Legislation MARD-MOH Joint Circular for coordinating prevention and control of zoonotic diseases

NATIONAL PROGRAMME ON RABIES CONTROL TOWARD RABIES ELIMINATION, 2017 - 2021 Prime Minister’s Decision No. 193/QĐ-TTg, 13/02/2017 approving the national programme Implementing: MARD & MOH Relevant ministries Multi-sectoral consultative meeting on the development of the National Programme

Implementation

Sharing information, joint investigation at all levels. Collaboration (DAH/NCVD, NIHE and GDPM) Training workshop on the implementation of the Circular 16, outbreak investigation. Scientific seminars to share experiences on Rabies control and prevention; joint organisation of the World Rabies Day. Jointly developed and submitted the National Programme for Rabies control and prevention for 2017 - 2021.

Awareness: Joint development and implementation of materials

Animal – Human Health collaboration DIAGNOSTICS Animal – Human Health collaboration NIHE NCVD US CDC

Vaccination for vet. staff Post-vaccination antibody testing Human health experts (NIHE) to train animal health staff at NCVD

US CDC experts (Dr. Lilia and Dr MA) Laboratory training 10-13/03/2015 US CDC experts (Dr. Lilia and Dr MA) Sample preparation

Integrated Bite Case Management (IBCM) Detect Respond To achieve these goals, an integrated approach is needed. Detection stars at an animal bite/person getting PEP Response is the PEP treatment IBCM encompasses the following components, Detect, Respond, and Prevent Prevent

IBCM Detect Respond Prevent Identify additional bite victims Animal exposure at health care facility Rabies suspect animal in community Respond Post-Exposure Prophylaxis (PEP) Investigation (community and animal) Identify additional bite victims Animal capture and assessment Quarantine or euthanasia and diagnostic testing Reporting of test results Prevent Additional exposures by humanely removing animals Additional human deaths by identifying additional bite victims Unnecessary PEP use IBCM encompasses the following components, Detect, Respond, and Prevent

IBCM: Detect Animal exposure at health care facility Daily reporting from preventative center to sub-DAH Rabies suspect animal in community Reporting from the community to sub-DAH

IBCM: Respond PEP at health care facility Wound treatment PEP series Investigation (community and animal)

IBCM: Respond Investigation (community and animal) Identify additional bite victims Animal capture and assessment Quarantine Euthanasia and diagnostic testing Report outcome from investigation

IBCM: Respond Investigation (community and animal) Identify additional bite victims Animal capture and assessment Quarantine Euthanasia and diagnostic testing Report outcome from investigation

IBCM: Respond Investigation (community and animal) Identify additional bite victims Animal capture and assessment Quarantine Euthanasia and diagnostic testing Report outcome from investigation Signs of rabies = euthanasia Healthy = quarantine for 10 days

IBCM: Respond Investigation (community and animal) Identify additional bite victims Animal capture and assessment Quarantine Euthanasia and diagnostic testing Report outcome from investigation

IBCM: Respond Investigation (community and animal) Identify additional bite victims Animal capture and assessment Quarantine Euthanasia and diagnostic testing Report outcome from investigation

IBCM Cycle Report Outcome ~7 - 14 Days Detection Responses

Wild life surveillance

Continue to implement/extend IBCM Future collaboration Continue to implement/extend IBCM Strengthen collaboration between human and animal laboratories, central and regional labs. Sharing animal samples to NIHE and CDC

Acknowledgements DAH NIHE GDPM Phu Tho CDC-VN CDC-PRB Cat Tien NP