| 感染症トピックス | 研究会目次 | ||
| 狂犬病国際シンポジウム講演要旨英文 Abstracts of Presentations | ||
| １ |
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| Dr. David Mitsuo SASAKI (D.V.M., M.P.H) State Public Health Veterinarian Hawaii Department of Health |
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| Hawaii has always been free of rabies, and is the only state in the United States to be rabies-free. However, Hawaii has two species of wild animals that are known rabies reservoirs in other areas: Small Indian Mongoose and the Hoary bat. Since 1912, Hawaii has had a 120 day quarantine of all pets entering the State. In addition, mammals other than pets and livestock are not permitted entry into the State. | ||
| However, there have been two incidents in the past 40 years that have drawn attention to the importance of a strong surveillance and prevention program. In 1967, shortly after laboratory workers received training in the then new Direct Fluorescent Antibody test for rabies, rabies was reported in a rat. In two months, 27 animals were diagnosed with rabies. Further investigation revealed false positive diagnoses. The "outbreak" was expensive and traumatic to residents of the State. In 1991, a bat that stowed away in a shipping container that arrived from California, was diagnosed with rabies. A public announcement was withheld pending subsequent Centers for Disease Control confirmation. Investigation determined no one who had direct contact with the bat had been "exposed" to rabies. Also, 8 mongooses trapped around the shipping dock tested negative for rabies. | ||
| As a result of the 1967 rabies scare, while David Sasaki was working on his Masters of Public Health degree, Professor Robert Worth suggested developing a rabies contingency plan to prevent the chaos that accompanied the 1967 incident. A detailed document was developed to identify agencies that would respond to a rabies outbreak, the role of each, and a communications network that would allow rapid, objective response to an outbreak of rabies. | ||
| Even though the contingency plan has never had to be used, elements of the plan were implemented with the discovery of the rabid bat. This enabled the smooth implementation of the investigation and follow-up of the incident. | ||
| ←狂犬病国際シンポジウムの概要へ戻る | ||
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| Dr. Channarong MITMOONPITAK (D.V.M.) Queen Saovabha Memorial Institute,The Thai Red Cross Society ( WHO Collaborating Center for Research in Rabies) |
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| Rabies is a viral disease that produces fatal encephalitis in human and other mammalian species. In developing countries where canine rabies is still endemic, almost all of human rabies deaths are due to dog bites. No specific treatment exists for rabies virus infections in human. Therefore, death is inevitable in an individual who develops clinical rabitoms of rabies. | ||
| Canine rabies remains a serious public health problem in Thailand. The prevalence of canine and human rabies in Thailand has decreased significantly during the last decade. In Thailand ,the purified rabies vaccines i.e. human diploid cell ( HDCV ), purified chick embryo cell ( PCEC ), purified vero cell ( PVRV ), and purified duck embryo (PDEV ) are available and completely replaced the nervous tissue vaccine since 1993. The impact of these safe and highly immunogenic vaccines has been demonstrated by declining in the number of human rabies death. The economical multisite intradermal rabies vaccination regimens are approved as the alternative to the conventional intramuscular schedule. So, this has been associated with an increasing number of human post - exposure treatments more than 200000 cases annually. But it is very difficult to achieve the goal of no human rabies death as wish. Many factors concerned e.g. the poverty and ignorance of the rabies exposed victims lead to delay and inappropriate treatment. Human or Equine rabies immune globulin ( HRIG or ERIG ) should be given together with the first dose of vaccine to all patients who have been severely exposed to rabies. Now, rabies immune globulin is expensive and under supply for giving to all cases of WHO category III rabies exposure. So pre - exposure immunization is recommended for resident and travelers who travel to the rabies endemic areas and should be considered for children resided in the rabies endemic countries. | ||
| Control of animal rabies such as vaccination in dogs should be focused. Rabies vaccination by injection is difficult in some areas and the oral vaccination might be alternative. Achievement in rabies control need the government policy and supply of the efficacious vaccines in man and animals as well as an extensive educational campaign and the community participation. | ||
| ←狂犬病国際シンポジウムの概要へ戻る | ||
| ３ |
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| Dr. Ian David Balfour MCBRYDE (D.V.M.) Proprietor-Small animal veterinary practice Chairman of the Urban Animal Management Advisory Group |
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| Australia 's emergency veterinary plan (Ausvetplan) has two sections regarding Lyssa viruses. | ||
| The first is Rabies - and like Japan Australia is an island nation and free of the disease. The likelihood of Rabies entering Australia can be divided into legal or illegal entry. Legal entry is controlled by strict quarantine regulations in Australia. | ||
| Illegal entry is the most likely way for rabies to get in and in particular through yachts or other boats and dogs on board those vessels. The Northern Australian Quarantine Strategy is a programme that is designed to detect exotic diseases in neighbouring countries and islands as well as early detection of the disease if it does enter Australia from the North. The control of rabies if it enters Australia is aimed at eradication of the disease. It must be recognized that this may not be possible and it could become endemic in Australia. In any rabies outbreak there are strict controls on the movement of animals and their product. Responsible ownership of animals is vital and any stray animals are likely to be destroyed. Vaccination in an outbreak would be the inactivated form of vaccine unless baiting of wildlife was required. Education is a vital part of any eradication and detection campaign as public assistance is vital to the success of any efforts. There must be compulsory recording of ALL animal bites or scratches during an outbreak. The cooperation between veterinary, medical and local government authorities must be very high and involve the media and the public. | ||
| The second is Australian Bat Lyssavirus and this is endemic in four species of flying foxes or fruit bats and one species of insectivorous bat. Although the bat lyssa virus appears to be very close to the rabies it is a distinct virus and has only caused two known deaths in Australia. Australian Animal Health Laboratories (AAHL) are run by Commonwealth Serum Laboratories (CSL) a privatised Australian company. They do all exotic disease testing in Australia. The best samples from a suspected infected animal showing rabitoms is fresh brain. This has a 4hour test for fluorescent antibodies. Various other tests taking different times are also used for rabies confirmation, serotyping and genotyping. Other samples (both fresh and fixed should also be taken for differential diagnosis. | ||
| Animal Quarantine time spent is determined by: - the country of origin, the proof of where the animal has been resident for the previous six months and the date and level of rabies neutralising antibody titre (RNAT). Countries not approved by the Australian Government are not permitted to transport dogs or cats into Australia. Animals must be implanted with a microchip prior to any testing taking place. All testing done overseas must be tied to the microchip number AND be done by a government-approved laboratory. No animal that has not completed the requirements can be imported into Australia and many will still have further quarantine on arrival. | ||
| Urban Animal Management in Australia is the responsibility of Local Council Government acting under state legislation. Under the Australian Constitution the federal government controls quarantine but not animal management. Each state in Australia varies widely in the state legislation which the Local Councils must enforce. | ||
| One state has compulsory microchipping at the highest level of control and another has very little legislation relating to dogs at all. | ||
| It is essential that there are controls over the quality of the microchips, the people implanting them and the registries storing the information. | ||
| ←狂犬病国際シンポジウムの概要へ戻る | ||
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| Dr. Satoshi INOUE (D.V.M., Ph.D.) Senior Researcher Department of Veterinary Science National Institute of Infectious Diseases |
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| Although Japan is rare country in the world of having avoided any outbreaks of rabies for the past 45 years, the number of people undergoing rabies measure's in Japan after being bitten by dogs or other animals overseas is on the rise. At the same time, with the importation of large numbers of a wide variety of animals that are not subjected to quarantine, including wild animals, it would not be surprising if some of them have carried the virus here. | ||
| In 2000, the government responded by amending the Rabies Prevention Law to enhance measures to prevent the introduction of rabies through animal importation. Specifically, it extended the import quarantine beyond dogs to include cats, raccoons, foxes, and skunks. However, we may consider additional measures. These include measures to address: 1) returnees and visitors from countries with current rabies outbreaks, as well as their pets, and 2) imported wild animals, such as bats, that are not currently subjected to import quarantine. | ||
| Japanese Rabies Prevention Law requires all dog owners to register their dogs and vaccinate them against rabies and prefectural governments are authorized to impound unregistered and unvaccinated dogs. I believe these domestic measures, combined with the import quarantine, have been key factors in Japan's success in avoiding rabies for the past 45 years. | ||
| Responsibility for implementing Japan's anti-rabies policies is divided among several government entities. The Ministry of Health, Labour and Welfare and municipal public health departments not only manage day-to-day measures such as dog registration and vaccination, but are also responsible for addressing rabies outbreaks. The Ministry of Agriculture, Forestry and Fisheries conducts import quarantines on dogs and, more recently, the other animals I mentioned. In the event of an outbreak, national and local government and the competent ministries must all work together closely to identify the path of the outbreak through epidemiological studies and examine people who may have come into contact with infected animals. | ||
| Because Japan has been free of rabies for so long, not only ordinary citizens, but also the government, municipalities, veterinarians and physicians often lack sufficient knowledge and information on the disease. We must therefore be well prepared for a possible outbreak to assure that our response is quick, appropriate and organized and does not engender panic. | ||
| Given these considerations, we prepared "Rabies Contingency Plan 2001" to help assure that we are ready to quickly identify a domestic rabies outbreak and then proceed with an appropriate, organized response. First, rabies researchers, largely from the government and municipalities, prepared draft plan. In doing so, they drew on a number of overseas sources including documents from the World Health Organization and the World Animal Health Organization(OIE) , the state of Hawaii's 「Rabies Contingency Plan, 2001」, the Centers for Disease Control and Prevention's rabies diagnostic guidelines, documents from a U.S. federal commission on rabies control （「Compendium of Animal Rabies Prevention and Control, 2001」）and an evaluation of rabies damage by Britain's Ministry of Agriculture, Fisheries and Foods（「Memorandum of Rabies, Prevention and Control」）. The final version of our plan incorporated changes by the Ministry of Health, Labour and Welfare to this draft based on suggestions and recommendations from other researchers, persons involved of local government and municipalities. | ||
| These plan form a comprehensive handbook for addressing an outbreak, or suspected outbreak, of rabies in Japan, including organizational systems, policies for dealing with animals, and measures to guide governmental, medical, and other institutions in preventing rabies transmission to humans. To this end, the plan clarify the roles of the government and municipalities, provide for communications channels between institutions, establish measures for dealing with people and animals who may have come into contact with infected animals, provide for the collection of needed materials, and set out specific examination procedures. These plan set out a fundamental approach to addressing suspected rabies outbreaks and are intended to form the basis on which all the institutions involved prepare their own, more detailed, practice handbooks adapted to their own distinct tasks and requirements. | ||
| These plan seek to present ideal, best-practice responses to a domestic rabies outbreak. We think some of the responses described would currently be difficult to implement. We have pretended to included them to help clarify the insufficiencies that remain in our domestic rabies prevention and to encourage continuing discussion of how to overcome them. We hope such discussion leads to a growing level of rabies prevention. | ||
| ←狂犬病国際シンポジウムの概要へ戻る | ||
| 研究会目次 | |