Nepal Elephant Healthcare and TB Surveillance Program Update 2013

Transcription

1 Nepal Elephant Healthcare and TB Surveillance Program Update 2013 Susan Mikota, Suraj Subedi, Kamal Gairhe, Sarad Paudel, Jeewan Thapa, Barbara Vincent, Naresh Subedi, Gretchen Kaufman I s like to acknowledge my co authors I will be sharing this presentation with Dr. Suraj Subedi who is one of the winners of the international scholarship. I ll present the history and evolution of the Nepal program and Dr. Subedi will talk about challenges and the future. 1

2 AAZV Presentations 2006: TB: Implications for Elephant Management 2007: Comparison of 4 Serological Assays and Culture 2009: TB in Nepal: Elephants, Humans, Livestock, and Wildlife 2011: Vitamin D and This presentation is an update on our work in Nepal. We reported details of earlier work at AAZV meetings in 2006,2007, and In 2011 we presented work done in collaboration with Dr. Agnew at MSU looking at Vit D in samples from Nepal. 2

3 Evolution of Nepal Program Need identified by Nepal Serendipity Networking; collaboration; partnerships Funding Perseverance Ask permission not forgiveness The Nepal Elephant Healthcare and TB Surveillance Program had its official beginning in The items listed on this slide are the main factors that combined to facilitate its implementation and sustainability. Of key importance is that Dr. Gairhe, Nepal s wildlife veterinarian and the Wildlife Department requested support to address TB. Beyond this first point, serendipity, networking, collaboration, funding, and perseverance were all important as we will illustrate in the slides that follow. I think that too often we westerners barnstorm into other countries with our ideas of what needs to be done and how to do it. This can be very different from the perspective of the country s wildlife officials and other stakeholders. 3

4 Timeline Dr. Gairhe diagnosed the first case of TB in The elephant that died was a patrol bull in his prime. When a second case occurred in 2004, he became concerned that TB could impact Nepal s conservations programs. This led to plans for a trunk wash project by a Nepali veterinary masters candidate under a program Dr. Kaufman developed between Tufts Center for Conservation Medicine and the Institute of Agriculture and Animal Science (IAAS). American vet student Karin Hamilton and Nepali veterinarian Kamal Giri were the principles. When Gretchen contacted me about the project it seemed like a great opportunity to explore other diagnostic tests. I began networking with other colleagues and applied for funding and permits. 4

5 2006: Nepal TB Project Trunk wash culture / Nepal and NVSL ELISA Larsen, CSU MAPIA / RT - Chembio Immunoblot Waters, NADC Immune profile Terio, Uof I CBC Nepal lab Chem panel M. Miller, Disney 1 st comprehensive elephant TB surveillance in Asia Collaborators, funders and CITES permits in place, in January 2006 our U.S. team headed to Nepal. In less than a month we evaluated 120 captive elephants using this battery of tests. To our knowledge this was the first comprehensive TB surveillance of elephants in Asia. Interpreting the data was challenging but we were dealing with areal time practical situation that required practical answers. Elephants were assigned to a high or low risk group. Due to the limitations of cultures and the goal to mitigate TB transmission to the wild, serological data took precedence in our decision making. We issued a report to the Government explaining the basis for the risk groups and making recommendations for segregation or re testing. 5

6 Timeline 2007 In 2007 Elephant Care International signed an MoU with IAAS and initiated a fellowship for a Nepali veterinarian to continue the TB work. Office and lab space were offered by the National Trust for Nature Conservation, a Nepali NGO, and WWF Nepal organized a workshop during which we reviewed the results from 2006, made plans to seek additional funding, and began discussing a national elephant TB plan for Nepal. 6

7 Timeline 2008 ECI and WWF Nepal received grants from the USFWS Asian Elephant Conservation Fund in ECI continued to focus on testing and treatment; WWF Nepal constructed a segregation stable and tested mahouts. 7

8 Accomplishments 1 st Elephant TB Plan in Asia Prevent TB transmission to wild Control TB at the captive-wild interface Before Dr. Subedi reports on the current testing and treatment, I want to mention some of the program s accomplishments. Most significant is the Nepal Elephant TB Control and Management Action Plan which is endorsed by the government as part of Nepal s Elephant Action Plan. One of the main goals is to prevent TB transmission to the wild by controlling TB at the captive wild interface. We hope this document will serve as guideline for other Asian elephant range countries with TB issues. 8

9 Publications Mikota et.al. TB surveillance in captive elephantsin Nepal in prep Lyashchenko et.al Field application of serodiagnostics to identify elephants with TB Mikota and Maslow TB at the human animal interface Landolfi, et.al Comparison of systemic cytokine levels Landolfi, et.al Development and validation of cytokine quantitative, real time RT-PCR assays. Plus student papers In addition to presentations, there have been 4 peer reviewed publications, another in preparation and numerous student papers. 9

10 Capacity Building Kamal Giri: Masters Sarad Paudel: Masters / PhD Jeewan Thapa: Masters / PhD Suraj Subedi Masters pending Nepali and U.S. Vet student projects Partnerships and collaborations Three Nepali veterinarians have completed their masters projects on TB topics and two are now studying for their PhDs in Japan. Dr. Subedi is contemplating a masters program. Nepali vets who pursue higher training return to Nepal as the next generation of conservation leaders. U.S. and Nepali vet students have worked together thanks to Dr. Kaufman s program. Many ongoing collaborations between the U.S. and Nepal have been formed. 10

11 Student Projects TB Risk Factor Survey Infrasound Operant conditioning Blood pressure Herpesvirus Chem reference values Diet analysis TB PCR This slide lists the elephant related TB projects completed by students. 11

12 Accomplishments: IT S NOT JUST ABOUT TB! Inevitably a program like this has spin offs so its not just about TB. 12

13 Other Benefits Equipment used for other projects rhino, tiger, vulture Other healthcare issues addressed Health camps Footcare workshop Equipment purchased for the elephant program has benefitted other projects for example our elephant serum bank also holds rhino, tiger, and vulture samples. We ve held two health camps for privately owned elephants and a footcare workshop. 13

14 Sauraha Mobile Rabies Camp Free Vaccinations May a.m. and 4-6 p.m. And we organized a rabies campaign in the village and vaccinated 210 dogs and cats in 2 days after several buffalo and a dog died of rabies. 14

15 TB Program Challenges and Future Dr. Suraj Subedi Now Dr. Subedi will discuss the TB program challenges and future. 15

16 Risk to Wild Populations Species at risk Elephants, rhinos Sambar and swamp deer Risk factors Intermingling No livestock TB program Since the 1 st case of TB was diagnosed, there has been a serious concern about the potential for TB to be transmitted to the wild. Nepal s protected areas are home to wild elephants and an important population of rhinos. Native deer species are also susceptible to TB. Humans, domestic livestock, and elephants all intermingle in Nepal. There is no formal TB control program for domestic livestock. There is now a published case of TB in an ex-captive African elephant. We are also aware of cases in India. So while we don t know how great the risk is, it is clearly there. 16

17 Captive Elephant Uses Patrol / anti-poaching Rhino censuses Conservation projects Captive breeding Tourism Captive elephants are used for patrol, rhino censuses, research, and tourism. All captive elephants government and privately owned work in protected areas and have the potential for interaction with wild species. During elephant back safaris captive elephants come very close to rhinos and given how far elephant can spray the possibility of TB transmission clearly exists. Our captive breeding program is successful and no elephants are removed from the wild however wild bulls breed with captive females. 17

18 Surveillance TB Program Status 233 (91%) tested DPP VetTB test Culture Treatment > 25 treated 21 under treatment Over 91% of the elephant population in Nepal has been TB tested most several times. We are using the Chembio DPP Vet TB test and in select cases culture and experimentally PCR. Over 25 elephants have completed treatment and 21 are currently under treatment. 18

19 TB Program Challenges Education Changing management practices Increased sero-prevalence Shifting elephant ownership No vet Enforcement TB is a complicated disease to explain and educating officials and private owners has been one of our challenges. Elephants used in tourism typically gather at central booking locations so clear explanations of risk and TB transmission have been necessary to change this practice. We tested 147 elephants in January 2013 and found an increased sero prevalence. We attributed this and 3 elephant TB deaths to a lapse in surveillance when the program was without a vet. Also as a result of the government revoking the licenses of all the hotels in Chitwan National Park, many elephants were sold so there was a lot of elephant movement and inter mixing. Enforcement of the TB Program is the responsibility of the wildlife department but the department is under staffed and under funded. It is not always possible to police the private owners and elephants still move into Nepal from India without being TB tested. 19

20 TB Program Challenges Drugs taste bad Mahouts prefer rectal Side effects No drug level lab available Distance between elephants Work overload in high tourist season Treatment is difficult. Many elephants will not accept the drugs orally and the mahouts lack the patience to try different things. The mahouts prefer rectal treatment but it is more expensive. Mahouts often change jobs and elephants so there is not always a strong bond. We do see side effects from the drugs mainly anorexia but also peripheral neuropathy and ocular issues. There is no lab in Nepal where we can check drug levels so we are dosing based on the recommendations in the U.S. guidelines. The elephants under treatment are in various locations so my job to monitor them daily is another challenge. Private owners depend on their elephants for their income and continue to work elephants under treatment during the high season. 20

21 Funding: the Ultimate Challenge Intl funding + local in-kind support Sustainability essential Private owners pay for TB treatment Government elephants need $ support Other program expenses To date the TB program has been largely supported by international funding. If the program is to succeed longer term, however, we have to find ways to make it sustainable. Private elephant owners are responsible for paying for treatment for their elephants but there may not be adequate funds for government owned elephants. Besides treatment, there are other expenses such as salaries and supplies. 21

22 Timeline In 2010 ECI received a 3 rd USFWS grant. One of the specific aims was to determine how the program would become sustainable. Meetings were held in Nepal in 2011 and earlier this year to discuss this issue. A 5 year budget was developed with commitments from various stakeholders to contribute support. With the precedent of a Gharial breeding program in Nepal that had depended on external support but became self sustaining there was confidence that the TB program would be sustainable. 22

23 Nepal Program Collaborators Government of Nepal / DNPWC CITES / FADDL Institute of Agriculture and Animal Science (IAAS) Tufts Center for Conservation Medicine Graduate School of Veterinary Medicine, Hokkaido University, Japan Elephant Care International National Veterinary Services Laboratories Center for Molecular Dynamics Nepal Many researchers in Nepal and U.S. Elephants and mahouts! We would like to acknowledge all of our collaborators. 23

24 Funding Acknowledgments USFWS Asian Elephant Csv Fund Mazuri / AAZV Dodge Foundation Alexander Abraham Foundation AVMA Foundation Dr. Walter J. Ernst, Jr. Vet. Mem l. Foundation Ocean Park Foundation Humane Society of the United States We would like to acknowledge these foundations and granting agencies for their support 24

25 Funding Acknowledgments Busch Gardens Tampa Disney s Animal Kingdom Dallas Zoo Columbus Zoo Oklahoma City Zoo Phoenix Zoo Tulsa Zoo Buttonwood Park AAZK Chapter As well as these zoos that have contributed to Elephant Care International s TB efforts. 25

26 Thank-you! / Dhanyabad! 26