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World Rabies Day marked at WSAVA World Congress 2018 with Expert Discussion on Managing the Disease in Asia

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  • World Rabies Day marked at WSAVA World Congress 2018 with Expert Discussion on Managing the Disease in Asia

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    (left to right): Dr Sarah Jayme, Dr Ronello Abila, Jean-Christophe Thibault (Boehringer Ingelheim), Emeritus Professor Michael Day, Dr Joy Santos, Dr Nalinika Obeysekere and Professor Sanipa Suradhat

    The role of the ‘vaccinated dog as a soldier in the fight against rabies’ in Asia was a key theme of two keynote lectures organized by Boehringer Ingelheim and a roundtable discussion hosted by the World Small Animal Veterinary Associationto mark World Rabies Day, Friday 28 September, during WSAVA World Congress in Singapore.

    Lectures were given by rabies experts, Dr Ronello Abila, Sub-Regional Representative for South-East Asia of the World Organisation for Animal Health (OIE); Dr Sarah Jayme, Asia Representative from the Global Alliance for Rabies Control (GARC) and Professor Sanipa Suradhat from the Department of Veterinary Microbiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok. They were later joined by Dr Nalinika Obeysekere, founder of the Blue Paw Trust in Sri Lanka, and Dr Joy Santos from the Philippine Animal Hospital Association to take questions from delegates. The session was chaired by Emeritus Professor and WSAVA Executive Board member Michael Day.

    59,000 people are killed annually by canine rabies, primarily in Asia and Africa, but also in some parts of Latin America. 99% of deaths are caused by bites from infected dogs, with 40% of those killed being children under 15 years old. 80% of deaths take pace in rural areas where levels of deprivation are highest and education is poor.

    Dr Jayme highlighted that while rabies kills, it is 100% preventable and a perfect example of the importance of taking a One Health approach to prevention. If 70% of dogs can be vaccinated it creates a level of herd immunity which breaks the transmission cycle of the disease. It is also much more cost-effective to vaccinate dogs ($4 per dog) than people ($100 per person). GARC is working towards bringing about an end to dog-mediated human deaths from rabies by 2030 and Dr Jayme outlined a global plan created by the United Against Rabies collaboration (WHO, OIE, FAO and GARC). The focus of the plan includes maximizing the use of existing tools and mechanisms for increasing awareness and enhancing education, increasing the effectiveness of dog vaccination and ensuring timely access to healthcare and human vaccines. Dr Jayme also highlighted the recommendations of the WHO Expert Consultation meeting in 2017 on the requirements for strategic planning of dog vaccination campaigns, which included:
    • Studies into the ecology of the dog population in affected countries
    • Studies and monitoring of vaccination campaigns
    • Discussions as to the most effective vaccines and the optimum age for vaccination. Vaccinating pups younger than three months old is now common in some countries to prevent rabies. The use of oral vaccines is also under discussion for ‘hard to reach’ (free-roaming) dogs in Asia.

    Dr Jayme then explained work being undertaken by GARC to unify rabies control networks around the world (Pan-African Rabies Control Network, Asian Rabies Control Network) to showcase success and to promote the development of education and strategic tools to help rabies control programmes. These include the GARC Education Platform with the Rabies Educator Certificate and Animal Handling and Vaccination Certificate of particular use to veterinary professionals working in the community.

    The importance of education to help people in affected areas to learn how to behave around animals was also highlighted by Dr Jayme. Education helps them to become responsible pet owners and, if bitten, to ensure that appropriate steps were taken, she explained. Untreated, rabies is fatal but she reminded delegates that it is still possible to prevent the disease through post-exposure prophylaxis.

    By taking a multi-pronged approach, Dr Jayme concluded that the Philippines is making progress in tackling rabies and gave the example of a regional educational project which is being scaled up to include all public schools in the country by 2019. Veterinarians were also being awarded CPD points for supporting mass vaccination and spey/neuter campaigns in recognition of their role as ‘rabies champions.’

    Dr Suradhat updated delegates on the latest science and management factors affecting vaccination. She also explained that significant progress is being made in Latin America thanks to a focus on dog vaccination and that a downward trend in human cases could be seen as a result. In Africa and Asia though, while Bali has eliminated rabies for a period of time, overall problems with the level of vaccine coverage remain. She reported that since 1995, Thailand had made great strides in tackling rabies through focusing on dog vaccination but, in 2015, an issue related to vaccine distribution policy and a lack of public awareness had led to significant reduction in vaccine coverage. As a result, rabies cases are once again on the increase in the country.

    Building on this theme, Dr Abila from the OIE said that while it was clear that vaccinating dogs was the most cost-effective strategy to combat rabies, it was still challenging to convince politicians to invest in vaccines for dogs. It was also difficult to put the manpower in place to resource mass vaccination campaigns. Work in these areas must continue. He explained that the OIE had created a ‘vaccine bank’ to help make the supply of quality vaccines more accessible in developing countries. It was also focusing on rabies surveillance and on the development of tools to support this. It has, for instance, recently conducted a ‘compliance check’ of OIE standards in South East Asia and has supported the development of an ASEAN Rabies Elimination Strategy. ‘Share the message, save a life’ was his closing message to delegates.

    In summing up the discussions, Emeritus Professor Day reminded delegates that WSAVA supports rabies control through its One Health Committee, its Vaccination Guidelines Group and the WSAVA charitable Foundation’s African Small Companion Animal Network (AFSCAN)project. The WSAVA is affiliated to the OIE and an ultimate goal of achieving the global elimination of canine rabies by 2030 was proposed during the joint WSAVA – OIE meeting on canine rabies in 2013. The WSAVA Foundationactively supports the work of Mission Rabies in Asia and Africa with some of the proceeds from its annual Congress Fun(d) Run being used to underpin its vaccination and education campaigns.

    The WSAVA works to enhance the clinical care of companion animals globally, representing more than 200,000 veterinarians around the world through 110 member associations. Its core activities include the creation of Global Guidelines which set standards for veterinary care and providing continuing education (CE) and other educational resources for its members, particularly those in whose countries companion animal veterinary care is still emerging.

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