Control of Rabies in Turkey



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Control of Rabies in Turkey The feasibility of oral vaccination of dogs <orhan@aylan.name.tr> Etlik Central Veterinary Control and Research Institute Ankara / Turkiye

Rabies Situation in Turkey Dog-mediated rabies 70 % of all cases reported in dogs Primary source of infection for humans is dogs

Incidence ce between 1991 2007 (According to Animal Species) Species Dog Cattle Cat Sheep & Goat Donkey & Mule Horse Other Domestic Wolf Fox Badger Bear Other Wild Life n 2445 721 120 146 15 33 8 10 112 5 4 19 % 67.20 19.81 3.29 4.01 0.41 0.90 0.21 0.27 3.07 0.13 0.10 0.52 Domestic Total Wild Life Total 3488 150 %95.87 %4.12

Incidence ce between 1996 2007 (According to Animal Species) 96 97 98 99 00 01 02 03 04 05 06 07 Domestic Animals 125 138 128 208 245 173 217 139 103 182 190 287 Dogs 103 117 104 181 208 127 75 59 51 100 102 165 Wild Life - 4-1 9 15 32 17 8 11 20 20

Incidence 2000-2007

Fox - 1999

Fox 2000-2001 2001

Fox - 2002

Fox 2003-2007 2007

Incidence ce between 1991 2003 (According to Regions) 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Marmara 156 100 79 84 159 117 55 52 130 121 67 21 34 Aegean 70 71 43 28 6 2 43 37 49 41 61 178 85 Mediterranean 59 44 30 13 3 1 9 2 0 6 1 3 1 Central Anatolia 46 20 21 6 0 1 4 4 4 5 0 4 4 Black sea 34 21 67 21 0 2 11 8 10 10 4 6 4 East Anatolia 18 4 6 4 0 0 0 2 3 11 22 12 7 South East Anatolia 45 60 41 14 0 2 20 23 13 60 34 22 25 TOTAL 428 320 287 170 168 125 142 128 209 254 189 246 160

Rabies Control and Eradication GDPC Programs The General Directorate of Protection and Control The Provincial and Local Veterinary Authorities Veterinary Control and Research Institutes

Control Methods Control of stray dogs Vaccination Quarantine measures Public information and training programs

Employed Vaccines Domestic Import 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Kelev Kuduz Aşısı (Dose) 166.529 171.399 158.430 168.005 176.010 310.622 247.532 227.677 219.950 182.560 215.490 167.343 172.238 Inactivated Rabies Vaccines (Dose) 94.000 128.000 412.000 317.000 114.000 279.000 159.000 391.000 211.000 547.300 440.850 668.227 588.750

Diagnosis In nation-wide, diagnosis are performed in eight (8) Veterinary Control and Research Institutes (VCRI) Etlik Central VCRI (National Reference Lab) Others Istanbul Pendik, Izmir Bornova Samsun, Konya, Elazig, Erzurum, Adana

Diagnosis Fluorescent Antibody Test Mouse Inoculation Test RT-PCR RFFIT(FAVN)

Phylogenetic Relationship Between 198 European RABV Isolates

Distribution of Genetic Variants of RABV in Europe

The Project Project Basic Information Title: Control of rabies disease in Turkey Sector: Agriculture Location: Turkey Duration: 3 years Objectives Eradicate rabies disease in Turkey Ensure human and animal health status Conform to EU standards

Purpose Control of rabies among animals Wild life Domestic Reduce the risk factors for humans to get infected with rabies other zoonoses caused by domestic animals Adopt EU control measures

Aims Eradication of rabies while complying with EU Legislation 90/638/EEC Parenteral vaccination of domestic animals Oral vaccination of wild animals Secondary objectives Identify the number of domestic cats and dogs Control stray animals (esp. dogs)

Activities Animal Rabies Disease Control Strategy Legislation Epidemiological Analysis 3 Pilot Schemes (OV of Foxes, Dogs, Wildlife Surveillance) Human Risk Reduction Improve PET usage Improve info and know-how exchange

Activities Training Diagnosis Tech, OV in Wildlife, Epidemiology, Mass Dog Vaccination, Dog Census, Surveillance in Bats Communication & Public Awareness OV in Foxes Mass Dog Vaccination

Expected Results Control and monitoring system for rabies Raising the immunity level against rabies Control of stray cats and dogs

Care Units 3 care units will be constructed in major cities; Ankara, Istanbul, Izmir. The motivation of constructing care units is to provide example institutions for stray animal care We expect municipalities and NGOs to form and construct similar institutions whose operations will be controlled by GDPC but operational costs born by establishing bodies

New Lab. Facilities

New Lab Facilities

Dog Rabies: : A Worldwide Problem 55,000+ human rabies cases annually 98% of all human cases are caused by bites from rabies infected dogs

Control Methods Removal

Control Methods Mass Parenteral Vaccination Campaigns

Control Methods Neuter-and-release campaigns

Oral vaccination of foxes against rabies 2007

Oral Vaccination Safe, Efficacious Attractive bait Targeted bait delivery

Immunogenicity Study Animal route dose seroconversion rate. (FFU/ml) (%) 1 foxes bait 2.0E+06 25/27 93% 2 lab dogs p.o. 1.4E+06 0/5-3 lab dogs p.o. 7.5E+07 4/5 80% 4 stray dogs p.o. 3.2E+07 5/34 14% 5 stray dogs p.o. 2.0E+08 14/14 100% Vaccine virus used: SAD B19 Source: Müller W et. al (1998) J Etlik Vet Microbiol, 9:61-71 Neubert A et. al (2001) J Vet Med B, 48:179-183

Fox Baits Dog Baits Dogs have different food preferences and aversions than foxes Dogs handle food different than foxes (swallowing) Dogs often search for food together, in contrast to the solitary hunter; the red fox

Bait Types Köfte Bait Fox Bait Boiled intestine bait

Bait Delivery System a) At selected sites b) At central vaccination points c) House-to-house A C

Bait Delivery Systems: At Selected Sites Disadvantages: - Already vaccinated dogs can also locate and consume baits distributed. - Bait depletion by non-target species. - Increased risk of unintentional human contact with vaccine virus. Köfte bait uptake (%) n=400 26% 13% 8% 53% dogs cats birds unknown

Bait Delivery Systems: At Selected Sites Capture - Mark - Recapture

Bait Delivery Systems: At Selected Sites Sarıgazi Ferhatpaşa Number of dogs tagged 22 31 Bait density (baits/km²) 43 150 Baits disappearance (%) 64,7 92,7 Seroconversion (%) 4,3 23,3

Bait Delivery Systems: Vaccination At Central Point Aydin Province >70% of owned dogs in villages were vaccinated at mobile vaccination points Sarigazi, Istanbul Only 21.8% of owned dogs were vaccinated free of charge at central veterinary clinic

Bait Delivery Systems: House-to-house Campaign

Bait Delivery Systems: Summary Vaccination coverage (%) owned dog population AREA Sarıgazi Ferhatpaşa prior to campaign 18.0 15.5 campaign at vaccination centre 21.8 --- house-to-house campaign parenteral 22.8 40.5 oral 21.2 18.1 Total 83.8 74.1

Conclusions: - Oral vaccination of dogs against rabies is a feasible option, especially in urban areas - House-to-house campaigns are the most effective; combining parenteral and oral vaccination - The baiting strategy developed by recollection of (discarded) vaccine containers eliminates almost completely the risk of unintentional human contacts with the vaccine viruses However

Conclusions: -There are still some doubts concerning safety-related issues with present available oral rabies vaccines -Proven high efficiency of mass dog vaccination campaigns by the parenteral route, also in urban areas - Oral vaccination reduces responsibility of dog owners even further, and could therefore interfere with attempts to increase responsible dog ownership

Thank you! Photographs: Perihan Agnelli, Sarah Cleaveland, Ad Vos, BFAV-Tübingen, IDT-Biologika GmbH