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Rabies situation in Far East Asia

Rabies situation in Far East Asia. Zhen F. Fu Department of Pathology University of Georgia. North America/Europe <50 Cases < 100 000 PET. Asia 35 - 55 000 >8 000 000 PET. Rabies Incidence. Africa 5000 – 15000 Cases < 500 000 PET. Latin America <60 Cases

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Rabies situation in Far East Asia

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  1. Rabies situation in Far East Asia Zhen F. Fu Department of Pathology University of Georgia

  2. North America/Europe <50 Cases < 100 000 PET Asia 35 - 55 000 >8 000 000 PET Rabies Incidence Africa 5000 – 15000 Cases < 500 000 PET Latin America <60 Cases < 500 000 PET

  3. 44 2490 3209 19000 248 2000 76 1100 40 24 30 Human rabies cases (>28,000) in Far East Asia in 2006

  4. Human Rabies and Treatments, Far East Asia,2006 Post-exposure Country Deaths Rate/million Treatment Rate/mil India 19,000 16.7 1,800,000 1,768 Pakistan 2,490 17 69,000 469 Bangladesh 2,000 12 60,000 455 Myanmar 1,100 23 5,000 102 China 3209 2.5 8,000,000 3,959 Philippines 248 3.3 102,148 1,338 Indonesia 40 0.2 8,800 43 Sri Lanka 76 4 80,000 4,200 Thailand 24 0.41 200,000 3,178 Vietnam 30 0. 38 635,000 8,105 Nepal 44 2.17 25,000 1,085 Cambodia 2 0.80 12,000 1,071 Lao People s Democratic Republic 2 1.26 3,000 540 TOTAL 28,275 6.5 1,881 10,692,010

  5. Rabies in the Far East Asian • Not much has changed: • Rabies free countries or regions: Japan, Singapore, HK, Taiwan. • Endemic with slow increase: most of other countries • Continued and sustained improvement: Thailand • Dramatic changes: China • South Korea: No human cases, but wildlife rabies spreads.

  6. Reported Human Rabies Deaths in Thailand 171 National rabies centre, 1995 68 24 Veera Tepsumethanon

  7. Rabies in China in the past 60 years

  8. Characteristics of rabies in Far East Asia • A neglected disease of the poor – rural areas • For example: India • Urban: 1,058 5% • Rural: 18,201 95%

  9. Rabies: a disease of childhood •Children aged less than 15 years are involved in 40% of the cases 70 70 60 60 50 50 C P T A 40 40 A H M K A 30 30 B I I C O S L 20 20 H D INDIA T A I I 10 10 A N N A N D A 0 0

  10. Most of the human vaccines are locally produced and brain vaccines are still used in some countries •HDCV: India •PVRV: India, Columbia, China •PCEC: India, Japan, Thailand, Philippines •PDEV: India •PHKC: China •SMB: Vietnam, Cambodia •Semple: India, Bangladesh, Nepal, Pakistan Blue are WHO recognized products Black are recognized locally only Red are WHO condemned products

  11. The major reservoir is the domestic dog • >90% human cases from dogs • There is no dog registration • There is no dog leash • There is little dog vaccination

  12. Anti-ABLV and the newly discovered lyssavirus antibodies have been found in bats in Thailand. Detection of RV antibodies in bats in China? Raccoon dogs spread RV in the Korean peninsula.

  13. Dog vaccination coverage

  14. Rabies Control in Far East Asia • Dog vaccination is the key!!!!! • Establish infrastructure. • Adapt methods of diagnosis and surveillance. • Produce cheap dog rabies vaccines. • National or regional campaigns. • WHO/OIE/EC encouragement and assistance. • As the economy improves in Asia, resources will become available. Many countries are initiating dog immunization programs.

  15. ACKLOWLEDGEMENTS • Dr. Yongzhen Zhang, China • Dr. T. Hemachudha, Thailand • Dr. S Takahashi, Japan • Dr. Hyaw Sunn, Myanmar • Dr. Dhan Raj Ratala, Nepal • Dr. Davinio P. Catbagan, Philippines • Dr. S. K. R. Amarasekara, Sri Lanka • Dr. Huang-lin Kao, Taiwan • Dr. Van Dang Ky, Vietnam

  16. Thank you Questions?

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