1 Towards the elimination of Rabies in Eurasia Jean Blancou, WOAH, May 27 07

2 Introduction The burden of rabies Historical background and current situation Epidemiological features in various species Rabies control in dogs Rabies control in wildlife Rabies control in other species Conclusion and perspectives

3 The burden of rabies Human rabies ranks 7th among other infectious diseases, but these human deaths could be avoided. Animal rabies does not threaten rural economy: its elimination will essentially benefit to human health services, which should share the cost of this elimination.

4 Current situation and historical background historical background Endemic and most feared since thousands of years End of the 19th century: 4 to 8 human deaths/ 10 6 inhabitants Today: 4 to 8 human deaths/10 6 inhabitants

5 Species barrier : the facts Susceptiblity: IM. LD 50 of a fox strain for dogs = 10 5,6 IC.LD/mice IM. LD 50 of a fox strain for foxes = 10 -0,5 IC.LD/mice IM. LD 50 of a dog strain for foxes = 10 5 IC.LD/mice IM. LD 50 of a dog strain for dogs = ,9 IC.LD/mice The fox virus is shed by 95% of infected foxes versus 25% of infected dogs. Virus sheding: The fox virus is shed by 95% of infected foxes versus 25% of infected dogs.

6 Species barrier: practical consequences 1. Target the vector, not the victim 2. More than 95% of human deaths in Eurasia dog bites. 2. More than 95% of human deaths in Eurasia are following dog bites. 3. Dogs should be the main target

7 Epidemiological situation of Dog rabies in Eurasia Epizootic:from time to time Enzootic: 175,000 to 250,000 rabid dogs each year based on a ratio 1/5 to human cases Epidemiological situation of Dog rabies in Eurasia 175,000 to 250,000 rabid dogs each year based on a ratio 1/5 to human cases

8 Non medical measures of dog rabies control in Eurasia Efficient when properly implemented, but Have still to face many technical, financial, or human obstacles

9 Parenteral vaccination of dogs in Eurasia Efficient when properly implemented but have also to face many technical, or financial obstacles. Efficient when properly implemented but have also to face many technical, or financial obstacles. Main difficulty: reaching a sustainable and efficient vaccination coverage where and when human health services do not contribute at national or local levels. Main difficulty: reaching a sustainable and efficient vaccination coverage where and when human health services do not contribute at national or local levels.

10 Oral vaccination of dogs in Eurasia Considered to day as a supplement to the parenteral vaccination In the future could be applied on a larger scale and become the main tool of rabies control. Photo Afssa Nancy Photo Afssa Nancy

11 Oral vaccination of dogs in Eurasia Conditions for a mass vaccination campaign to succeed : Consensus Shared costs Free vaccination Well planed Well coordinated Well evaluated Photo Afssa Nancy Photo Afssa Nancy

12 Epidemiological situation of Wildlife rabies in Eurasia Western Europe: starting wave in 1938 Wildlife rabies in Eurasia : history Eurasia : history Epizootic wave from 1938 to 1989

13 Wildlife rabies in Eurasia in 2006

14 Non medical measures of Wildlife rabies control in Eurasia Abandoned

15 Oral vaccination of Wildlife against rabies in Eurasia The « magic » tool for rabies control : have not only succeeded to eradicate the disease in less tha 10 years in many countries but remains available at any time in case or its re-emergence Photo EIDLR Nancy Photo EIDLR Nancy

16 Epidemiological situation of rabies in other animals in Eurasia vectors/reservoirs Raccoon dogs Polar foxes Wolwes[Raccoon,jackalmongoose..]

17 Epidemiological situation of bat rabies in Eurasia Less than 1000 cases since 1954

18 Bat rabies control in Eurasia Possible vectors/reservoirs in tropical areas Frugivorous species Permanent vectors reservoirs in Europe Insectivorous endangered species Control : information and vaccination of those at risk.

19 control of rabies in other species in Eurasia Cats Victims of the main vector, no independent cycle established so far. Vaccination

20 Control of rabies in other species in Eurasia (2) Herbivorous Victims of the main vector, no independent rabies cycle observed so far. Vaccination?

21 Conclusion In Eurasia: Animal losses are negligible compared to more than 30,000 human deaths Animal losses are negligible compared to more than 30,000 human deaths The main vector/reservoir of human rabies is the dog, and canine rabies can be eliminated by oral vaccination The main vector/reservoir of human rabies is the dog, and canine rabies can be eliminated by oral vaccination The ministries of health should mobilize all the other national bodies involved in dog rabies control, and contribute all necessary resources to control this reservoir The ministries of health should mobilize all the other national bodies involved in dog rabies control, and contribute all necessary resources to control this reservoir Animal losses are negligible compared to more than 30,000 human deaths in EurasiaAnimal losses are negligible compared to more than 30,000 human deaths in Eurasia More than 97% of human rabies following dog bitesMore than 97% of human rabies following dog bites Canine rabies can be eliminated by oral/parenteral vaccination Canine rabies can be eliminated by oral/parenteral vaccination The ministries of health should use the competences of Veterinary services and mobilize all the other national bodies and all necessary resources to control this reservoirThe ministries of health should use the competences of Veterinary services and mobilize all the other national bodies and all necessary resources to control this reservoir Photo Alex Wandeler Conclusion