>>>GOOD AFTERNOON, EVERYBODY,
IT’S 1:00 AND LET’S BEGIN. THIS IS A MEETING ABOUT THE DOG
AND ABOUT THE DOGS. AND THE OTHER THING THAT IED
LIKE TO POINT OUT, WE’D LIKE TO TAKE DOWN ALL OF YOUR NAMES SO
THAT EVERYBODY CAN GET A SPECIAL AWARD. GIVEN THE NUMBER OF MEETINGS CDC
HAS HELD TODAY, THIS IS AN ABSOLUTE RECORD, 917. YOU ALL DESERVE SPECIAL CREDIT
FOR COMING TODAY. THANK YOU. IN ADDITION TO TALKING ABOUT
DOGS, THIS IS AN EVENT THAT WILL FOCUS ON DIRECTION OF PEOPLE,
ANIMALS, AND THEIR ENVIRONMENT. AND YOU WILL HEAR FROM OUR
SPEAKERS A LOT MORE ABOUT THIS. I’D LIKE TO WELCOME THOSE WHO
ARE ON INTERNAL AND EXTERNAL VIEWERS AND WELCOME THEM TO OUR
PUBLIC HEALTH GRAND ROUNDS. I WOULD LIKE TO REMIND YOU THAT
WE ARE TRACKING THE NUMBER OF VIEWERS, AND EVEN THOUGH IT
SEEMS LIKE WE’RE PATTING OURSELVES ON THE BACK, IT SEEMS
LIKE ROUGHLY GOOD NUMBER. WE ARE GETTING SEVERAL THOUSAND
PEOPLE EVERY TIME VIEWING US OUTSIDE OF THE AUDITORIUM AND
OUR COLLEAGUES IN VISION LAND. WE’RE NOT NECESSARILY DOING AS
SPECTACULAR WELL ON YOUTUBE, BUT THEN THE TOPICS ARE NOT EXACTLY
GEARED TOWARD YOUTUBE AUDIENCE. I THINK WE’RE STILL DOING QUITE
WELL. I WOULD LIKE TO REMIND YOU AND
MENTION ONE NEW PIECE OF INFORMATION THAT I MAY NOT HAVE
MENTIONED BEFORE. ALL OF YOU WHO WANT TO GET
CONTINUING EDUCATION CREDITS FOR THESE EVENTS, YOU NEED TO USE
THE CODE PHGR. PUBLIC HEALTH GRAND ROUNDS 10. AND IT’S ALWAYS GOING TO BE THE
SAME CODE. JUST TO MAKE SURE THAT YOU CAN
GET THE CREDIT FOR ATTENDING. I WOULD LIKE TO THANK TWO OF OUR
COLLEAGUES WHO HAVE PROVIDED SELECTIONS FOR OUR SCIENCE CLIPS
THIS MONTH, AND AS YOU WILL SEE, THERE’S A WHOLE BUNCH OF TOMMICS
COVERED UNDER THE RAIN — TOPICS COVERED UNDER THE RABIES SECTION
FOR VACCINE, RABIES IN LATIN AMERICA, SO ON, THE VERY SAME
TOPICS WE’RE GOING TO BE DISCUSSING TODAY. I’D LIKE TO POINT OUT THAT WE
HAVE PUBLISHED FOUR MMWR PIECES ON SOME OF OUR TOPICS, AND WE
WILL CONTINUE TO DO SO. SOME OF THE UPCOMING TOPICS, I’M
SURE YOU WILL FIND AS INTERESTING AS ONES BEFORE, AND
TO KEEP YOU INTERESTED IN COMING AND ATTENDING, THIS IS A LIST OF
SOME THAT WE ARE WORKING ON FOR THE NEXT SEVERAL MONTHS. SO AS I MENTIONED, THIS IS — OF
ALL THESE EVENTS ARE REALLY A TRUE TEAM EFFORT AND REQUIRE A
LOT OF PREPARATION, COORDINATION, AND REHEARSALS. AND I REALLY WANT TO SAY THAT
THIS WAS AN UNBELIEVABLE WONDERFUL GROUP OF COLLEAGUES TO
WORK WITH. I’M ALWAYS HUMBLED WITH THESE
WORLD KNOWN EXPERTS COME HERE AND REALLY WORK WITH US IN SUCH
A WONDERFUL COOPERATIVE SPIRIT. I REALLY WANT TO POINT OUT HOW
WONDERFUL IT WAS TO WORK WITH THEM — AND CHARLES. SO THE SPEAKERS TODAY ARE
CHARLES RUBRICK, OUR OWN CHARLES, DENVER IS LAY FROM
USDA, EVENT NELSON MANDELA OH LAMAS, AND DEBBIE RESTRICTIONS
FROM GLOBAL LINES RABIES CONTROL. TO SAY A COUPLE OF WORDS ABOUT
THEM. THIS IS A VERY PASSIONATE GROUP
OF PEOPLE, NOT TO MENTION THAT WE HAVE SOMEBODY FROM LATIN
AMERICA. I WAS HOPING THIS WAS GOING TO
BE THE MOST PASSIONATE EVENT THAT WE’VE HAD EVER. I GOOGLED HIM A LITTLE BIT, AND
YOU WILL SEE THAT HE HAS HIS OWN ACADEMY OF NATIONAL TANGO, AND
HE LET US KNOW YESTERDAY THAT HE’S A REAL TANGO FAN AND
DANCER. SO I HAVE SEEN THAT HE AND
DEBBIE HAVE ACTUALLY BEEN PRACTICING FOR THIS EVENT. NOT TO SAY THAT CHARLES AND
DENNIS ARE ANY LESS SPECIAL. I’VE BEEN CHEERING THEM AND
BEING ON THEIR SIDE. SO YOU’RE IN FOR A REALLY
SPECIAL TREAT, AND THAT INCLUDES A COUPLE OF COMMENTS FROM OUR
DIRECTOR.>>THANK YOU ALL VERY MUCH FOR
BEING HERE, AND THANKS FOR OUR SPEAKERS FOR THEIR WORK PUTTING
THIS TOGETHER. RAIN CZYZ A
— RAIN CZYZ A NEGLECTED DISEASE — RABIES IS A NEGLECTED
DISEASE. 55,000 A YEAR DIE FROM A
TERRIBLE DISEASE, ONE WITH IMPLICATIONS FOR HUMAN HEALTH,
ANIMAL HEALTH, AND SOCIETAL WELL-BEING AND ECONOMIC
STABILITY. AS A FORMER HEALTH COMMISSIONER,
I CAN TELL YOU THAT RABIES IS ONE OF THOSE THINGS THAT YOU
TAKE REALLY SERIOUSLY. IT’S COMPLICATED AND DIFFICULT
AND CHALLENGING. I REMEMBER WELL ONE OF OUR
EXPOSURES WHERE WE HAD A BOX OF KITTENS HAD BEEN LEFT OUT FOR
PEOPLE TO TAKE. AND HAD BEEN BROUGHT BACK BY A
COUPLE OF INDIVIDUALS WHO WERE INVOLVED IN THE ILLICIT DRUG USE
INDUSTRY BUT ALSO HAD HAPPENED TO BRING KITTENS BACK, AND THEY
WERE RABID. AND FINDING PEOPLE WHO HAD HAD
INTERACTION WITH PEOPLE WHO WERE SELLING DRUGS AND MAY HAVE PET
RABID KITTENS PROVIDED A PARTICULARLY CHALLENGING
SITUATION FOR THE LOCAL HEALTH DEPARTMENT. I THINK MANY OF US DEAL WITH THE
CHALLENGES OF THE REAL WORLD, AND RABIES IS AS REAL WORLD AS
IT GETS. IT’S ALSO AS ONE WORLD AS IT
GETS BECAUSE IT DOES HIGHLIGHT THE INTERACTIONS BETWEEN HUMAN
AND ANIMAL HEALTH THAT CHANGES IN OUR ENVIRONMENT, THAT IS
REINTRODUCING SPECIES INTO SOME AREAS, INCREASING SPECIES IN
SOME AREAS. SO THERE’S A LOT OF BOTH
CONSISTENCY AND EVOLUTION IN THE WORK OF RABIES PREVENTION AND
CONTROL GOING BACK TO THE FIRST RABIES VACCINE, WHICH WOULD
NEVER HAVE GOTTEN THROUGH AN IRB TODAY, BUT SAVED A CHILD’S LIFE. THERE IS REAL PROGRESS POSSIBLE
IN RABIES THROUGH EDUCATION, THROUGH QUARANTINE, THROUGH
INJECTABLE VACCINATION PROGRAMS AND ORAL VACCINATION PROGRAMS
AND ANIMAL CONTRACEPTION AND ANIMAL POPULATION CONTROL. ALL OF THESE ARE POSSIBLE. THERE HAS BEEN SUCCESS, THERE’S
SOME AREAS WHERE THERE’S BEEN SOME FALLING BACK, BUT I THINK
IT’S AN AREA WHERE WE CAN BOTH CELEBRATE THE SUCCESS NOW AND
RECOGNIZE HOW MUCH MORE PROGRESS IS BOTH NECESSARY AND POSSIBLE. THANK YOU VERY MUCH.>>GOOD AFTERNOON, I’M CHARLES
RUPRECK. WE THANK YOU FOR THE OPPORTUNITY
TO SHARE SOME OF OUR THOUGHTS ABOUT THIS HIGH CONSEQUENCE
PATHOGEN. MANY MISCONCEPTIONS PROBABLY
BASED UPON NAIVETE IS THAT THIS DISEASE OF NATURE IS RARE AND
THAT THERE’S LITTLE TO NOTHING WE CAN DO ABOUT IT. BOTH OF WHICH COULD NOT BE
FURTHER FROM THE TRUTH. BY AND LARGE WITH RARE KPEPGDSS,
IF YOU DEVELOP — EXCEPTIONS, IF YOU DEVELOP CLINICAL SIGNS, YOU
DIE. ONE OF THE HIGHEST CASE FATALITY
RATES OF ANY CONVENTIONAL AGENT AND OBVIOUSLY BECAUSE OF ITS
IMPACT ON HUMAN AND VETERINARY PUBLIC HEALTH, A GLOBAL PROBLEM. DISTRIBUTED EVERYWHERE WITH THE
EXCEPTION OF ANTARCTICA AND ONE OF THE OLDEST DESCRIBED
DISEASES, IN FACT EVERY MAJOR CIVILIZATION FROM THE
BABYLONIANS TO THE PRESENT TIME DESCRIBE SOMETHING AKIN AT LEAST
BASED ON THEIR SYNDROMIC SUGGESTIONS, THE BITE FROM AN
ANIMAL SUGGESTIVE OF RABIES. THESE ARE HIGHLY VARIABLE AGENTS
IN THE FAMILY RABDOVERITY, BULLET-SHAPED VIRUSES. AT LEAST A DOZEN SPECIES THAT
CAUSE THIS DISEASE AND ANAGENIC VARIATION IN SOME OF THEM GIVE
US PAUSE TO CONCERN BECAUSE OF THE LACK OF CROSS REACTIONTIVITY
OF ANY VETERINARY OR HUMAN BIOLOGIICS IN THE WORLD. ADDITIONAL PATHOGEN DISCOVERY IS
EXPECTED OVER THE REST OF THIS CENTURY. ALL MAMMALS ARE SUSCEPTIBLE, BUT
VARIANCE ARE ADAPTED PARTICULARLY TO CARNIVORES AND
TO BATS. THE QUINTESSENTIAL NEURORESPECT
TOIC — NEUROTROPIC AGENT THROUGH BITE OR INHALATION OR
WHEN THE DONOR’S NOT SUSPECTED THROUGH TRANSPLANTATION, THE
VIRUS ENTERS FROM THE PERIPHERY, REPLICATES INTO THE CENTRAL
NERVOUS SYSTEM, AND IS FOUND IN JUST ABOUT EVERY INTERVATED
ORGAN AS WELL AS THE EXIT PORTALS, THE SALIVA. HENCE, INTERVENTION NEEDS TO BE
PROMPT AND PRACTICAL AND PROPER. TIMELY BASED UPON LOCAL EVENTS. WHILE THE VIRUS IS STILL IN THE
PERIPHERY AND, HENCE, RAIDIES IMMUNE GLOB — RABIES IMMUNE
GLOB LYNN AND WOUND CARE, WASHING WITH SOAP AND WATER
PRIOR TO ACTIVE IMMUNITY TO MULTIPLE DOSES OF VACCINE OVER
THE FIRST TWO-WEEK TIME. OTHERWISE, ONCE THE VIRUS
AGAINST ACCESS TO CNS, DEATH IS ALL BUT INEVITABLE. INCUBATION PERIOD IS QUITE
VARIABLE FROM DAYS TO YEARS, ON AVERAGE FOUR TO SIX WEEKS. VERY NONSPECIFIC PRODROMAL
STAGE. THE ACUTE NEUROLOGIC HAS HYDRO
PHOBIA AND AROPHOBIA. SHOESHTLY THEREAFTER THE PATIENT
LANCES INTO A COMA. WITH THE EXCEPTION OF ONE
HISTORICAL SURVIVOR WITHOUT ANY PRIOR VACCINATION, DEATH RESULT
A S A FEW DAYS LATER. A RELATIVELY EASY DISEASE TO
DIAGNOSE IF YOU HAVE A HISTORY OF EXPOSURE TO A RABID ANIMAL
AND THESE CLASSIC CLINICAL SIGNS. IT CAN BE A CHALLENGE. LABORATORY DIAGNOSIS, THE GOLD
STANDARD, IS THE DIRECT FLORES FLUORESCENT ANTIBODY TEST. STANDARDIZED IS THE NATIONAL
PROTOCOL HERE AT CDC IN THE YEAR 2000. WITH REGULAR TRAINING PROVIDED
THROUGH THE NATIONAL LABORATORY TRAINING NETWORK. IN HUMANS, WHEN AN EXPOSURE IS
NOT THOUGHT, ANTI-MORTEM DIAGNOSIS CAN BE CHALLENGING
BASED UPON THE DETECTION OF RABIES VIRUS ANTS EN — ANTIGENS
AND ANTIBODIES PRIOR TO DEATH. TENS OF MILLIONS OF EXPOSURES
AND TENS OF THOUSANDS OF HUMAN CASES — IN FACT, SINCE WE’VE
BEGUN, AT LEAST ONE CHILD HAS SUCCUMBED TO THE DISEASE. MOST OF THESE OCCURRING,
UNFORTUNATELY, IN DEVELOPING COUNTRIES OF AFRICA AND ASIA. WITH A DOMESTIC DOG STILL AS THE
MAJOR RESERVOIR THROUGHOUT THE WORLD, AND WHERE IT HAS BEEN
CONTROLLED WILDLIFE SERVING AS IMPORTANT. FOR EXAMPLE, IN THE UNITED
STATES. EXPOSURES ARE NOT UNCOMMON. IT’S IN OUR BACK YARD, IT’S IN
OUR HOUSES, SOMETIMES IN TERMS OF RESERVOIRS. 20,000 TO 40,000 PEOPLE EXPOSED
HER PER YEAR, RESULTING IN ONE TO EIGHT CASES OF RABIES
ANNUALLY. THERE’S JUST AS MUCH NOW AS WHEN
I WAS A CHILD, IT’S JUST DIFFERENT. NOW IT’S IN WILDLIFE. WHEN I WAS A CHILD, WE STILL HAD
DOGS AS OUR MAJOR RESERVOIR. TODAY WE ARE TALKING ABOUT
RACCOONS AND SKUNKS AND FOXES AND MONGOOSE DISTRIBUTED IN
EVERY STATE BUT HAWAII. WE KNOW THIS BECAUSE OF
DECENTRALIZED SURVEILLANCE, MORE THAN 100 LABORATORIES, AND MORE
THAN 100,000 SUSPECT ANIMALS EXAMINED LOCALLY. WHY FOCUS ON DOGS? BECAUSE MOST OF OUR EXPOSURES
ARE DUE TO DOGS, MOST OF OUR CASES ARE DUE TO DOGS. BECAUSE OF THE IMPORTANT PUBLIC
HEALTH ROLE OF ANIMALS SUCH AS DOGS INVITED INTO OUR HOMES OVER
THE LAST FEW MILLENNIA. AS MANY AS 1% ESTIMATES OF
EMERGENCY ROOM VISITS BEING DUE TO ANIMAL BITES OR PEDIATRIC
HOSPITALIZATIONS. THERE ARE OBSTACLES TO SUCCESS. IN COUNTRIES LIKE THE UNITED
STATES, DOG RABIES TRANSMISSION HAS BEEN INTERRUPTED AND THAT
PARTICULAR VIRUS HAS BEEN EXTRIPATED. ORAL VACCINATION MAY OFFER ONE
POTENTIAL SOURCE OF MANAGEMENT OVER TIME. REGARDLESS, THE FOCUS IS UPON
HEARD IMMUNITY — EVACUATION NIGHT DOGS WHETHER IN A
DEVELOPED OR DEVELOPING COUNTRY, AND HUMAN CASES FALL. FOCUS UPON ANIMALS FOR DIAGNOSIS
AND ANIMALS FOR CONTROL AND THE HUMAN HEALTH BENEFITS ARE
OBVIOUS. HENCE, IMMUNITY AND VACCINATION
EN MASSE,MINTMIZATION THROUGH HEGZ EDUCATION OF HUMAN
EXPOSURES WHEN EXPOSURES DO OCCUR. PROMPT WOUND CARE, INFILTRATION
OF IMMUNE GLOBULIN AND CELL CULTURE ARE ALL BUT ASSURED
SURVIVORSHIP AFTER SUCH EXPOSURES. AND OBVIOUSLY AFTER MAINTAINING
CONTROL AND FOR SOME PLACES RABIES-FREE STATUS, VIGILANCE TO
MAINTAIN YOUR RABIES-FREE STATUS AS WELL AS TO EFFECT PROMPT
CONTROL WHEN IT DOES ENTER. OUR PANEL TODAY WILL EMPHASIZE
TOPICS SUCH AS DR. SLATE, HOW DO WE COUNTER THE EMERGENCE OF
VIRUSES FROM WILDLIFE TO DOMESTIC SPECIES AND INTO
HUMANS? HOW DO WE DEVELOP MORE HUMANE
METHODS OF ANIMAL POPULATION CONTROL? DR. LEANIS FROM PAHO WILL BE
TALKING ABOUT THE TRANSLATION OF SUCH WORK FROM DEVELOPED TO
DEVELOPING COUNTRIES ON A REGIONAL BASIS. AND DR. BRIGGS WILL BE
ADDRESSING THE ISSUE OF HOW DO WE MAINTAIN ADVOCACY AND DYNAMIC
PARTNERSHIPS FOR A DISEASE THAT’S BEEN WITH US FOR
MILLENNIA. AND WITHOUT FURTHER ADIEU, WE’LL
TURN TO DR. SLATE FROM USDA WILDLIFE SERVICES.>>THANK YOU, DOCTOR. AND GOOD AFTERNOON. MY PRESENTATION WILL FOCUS ON
RABIES ALONG THE HUMAN-ANIMAL INTERFACE. SOME OF THE KEY CHALLENGES WE
FACE IN PROMISING NOVEL APPROACHES TO ENHANCED RABIES
CONTROL IN DOGS AS WELL AS CARNIVORES. DR. RUPRICK COVERED POINTS TO
STRESS THE IMPACT OF DOG RABIES ON HUMANS. I’D LIKE TO ADD THAT HERE IN THE
U.S., EVEN THOUGH RABIES WAS DECLARED — EVEN THOUGH U.S. WAS
DECLARED RABIES FREE, HERE IN THE U.S. WE HAVE DOG RABIES
STILL IN THE SOURCE OF THIS RABIES IS IN WILDLIFE. THESE ARE NOT CANINE TRUE CASES,
BUT WERE THE RESULT OF RACCOONS, STUNKS, FOXES — SKUNKS, FOXES,
OR SPECIES THAT ARE RESPONSIBLE FOR OVER 0% OF THE CASES
REPORTED IN THE U.S. THE EVENTS DRAW ATTENTION TO THE
RABIES TRANSMISSION ALONG THE DOG-WILDLIFE INTERFACE WHICH
CANNOT BE COMPLETELY DISCOUNTED WHEN WE’RE ESTABLISHING
EFFECTIVE DOG RABIES CONTROL PROGRAMS. IN 2007, IT WAS ESTIMATED THAT
37.2% OF U.S. HOUSEHOLDS OWNED AN AVERAGE OF 1.7 DOGS, PUTTING
THE U.S. POPULATION AT 72 MILLION DOGS. AND A 2001 ESTIMATE OF THE
GLOBAL DOG POPULATION WAS PUT AT 400 MILLION DOGS. THAT’S A LOT OF DOGS. ONLY RECENTLY A FREE ROAMING
DOG’S BEEN STUDIED FROM AN ECOLOGICAL PERSPECTIVE. THE STRUCTURE AND DYNAMICS THIS
COMPONENT OF THE OVERALL DOG POPULATION IS NOT WELL
UNDERSTOOD. NOR ARE ESTIMATES WIDELY
AVAILABLE FOR THESE RELATIVE POPULATION SIZE OF THESE
FREE-ROAMING DOGS. RELATIVE ABUNDANCE OF ROAMING
DOGS IN THE UNITED STATES IS ALSO UNKNOWN. BUT THEY ARE COMMON ON NATIVE
AMERICAN LANDS WHERE EXTREMELY LOW RABIES VACCINATION RATES ARE
ALSO SUSPECTED. THE MAJOR DOG RABIES
TRANSMISSION PATHWAYS ARE SHOWN HERE AND ILLUSTRATE THAT
PERPETUATION OF CANINE RABIES IS POSSIBLE IN SPECIFIC WILD
CARNIVORES. THE EPISODE THAT OCCURRED IN
COYOTES AS WELL AS DOGS AND WILDLIFE IN SOUTH TEXAS
BEGINNING IN THE 1980s AS A RESULT OF SPILLOVER OF CANINE
VIRUS VARIANT IN DOGS IN MEXICO REPRESENTS A WELL-DOCUMENTED
EXAMPLE OF VIRUS TRANSMISSION ALONG THIS — ALONG THE
DOG-WILDLIFE INTERFACE. SOME OF THE KEY CHALLENGES WE
FACE ARE ACHIEVING THE 50% TO 70% POPULATION IMMUNITY REQUIRED
TO PREVENT DOG-TO-DOG TRANSMISSION OF RABIES. THE FREE-ROAMING DOG SEGMENT OF
THE POPULATION IS DIFFICULT TO VACCINATE AND MAY REQUIRE NOVEL
APPROACHES SUCH AS ORAL RABIES VACCINATION TO ACHIEVE
MEANINGFUL HERD IMMUNITY LEVELS. I’M GOING TO TALK A BIT MORE
ABOUT THIS LATER ON, BUN STUDY NOT YET PUBLISHED — ONE STUDY
NOT YET PUBLISHED SUGGESTS THAT HERD IMMUNITY AMONG DOGS CAN BE
INCREASED WITH VACCINATION, WITH ADDITIONAL EVALUATION OF THE
EFFECTIVE ORV STRATEGIES IS WARRANTED. RABIES SPILLOVER FROM DOGS INTO
WILD CARNIVORES HAS HAD IMPACTS TO RARE SPECIES. IT’S LED TO PERPETUATION OF
CANINE VARIANCE IN CLOSELY RELATED SPECIES SUCH AS THE
COYOTE AS I MENTIONED. EXAMPLES OF THE TWO MAJOR
CONSEQUENCES OF RABIES TRANSMISSION ALONG THE
DOG-WILDLIFE INTERFACE ARE THAT IT MAIM PACT OUR ABILITY TO
ACHIEVE BOTH RABIES CONTROL IN DOGS AND WILD CARNIVORES. SUCH AS THE VIRUS SPILLOVER
EVENT THAT I JUST MENTIONED IN TEXAS. IT ALSO MAY HAVE PROFOUND
IMPACTS ON THREATENED — RARE AND THREATENED SPECIES. TWO OF THE WORLD’S MOST
ENDANGERED WILD CARNIVORES, THE ETHIOPIAN WOLF AND AFRICAN WILD
DOG, ARE THREATENED WITH EITHER LOCAL EXTRIPATION OR EXTINCTION
AS A RESULT OF RABIES SPILLOVER IN DOGS. IN THE U.S., THE COMPENDIUM OF
RABIES CONTROL SERVES AS A BASIS FOR ANIMAL PREVENTION AND
CONTROL PROGRAMS THROUGHOUT THE UNITED STATES, AND TO FACILITATE
STANDARDIZATION OF PROCEDURES AMONG JURISDICTIONS. GUIDANCE IN THE COMPENDIUM
EXTENDS TO NOVEL APPROACHES, SUCH AS ORAL VACCINATION OR
CONTRA STHAEPGZ MAY BE INCORPORATED IN FUTURE
DOG-RABIES CONTROL PROGRAMS WHERE INJECTABLE VACCINATION IS
THE CENTRAL TACTIC. AND FOR THE REMAINDER OF MY
PRESENTATION, I’M GOING TO FOCUS ON THESE NOVEL APPROACHES, ORAL
RABIES VACCINATION AND CONTRACEPTION. A FUNDAMENTAL TENET OF ORAL
RABIES VACCINATION IS THAT IT SUPPLIED TO ESTABLISH HERD OR
POPULATION IMMUNITIES IS NOT A MEANS OF VACCINATING INDIVIDUAL
ANIMALS. ORAL VACCINATION WORKS TO
ESTABLISH HERD IMMUNITY TO PREVENT RABIES TRANSMISSION. BAITING OCCURS AT THE LANDSCAPE
SCALE BY AIR BUT MAY INCLUDE DISTRIBUTING BAITS FROM GROUND
VEHICLES OR BY WALKING. IN EUROPE, CANADA, AND THE U.S.,
THE PRIMARY AREAS INVOLVED IN THE RABIES VACCINATION TARGETING
WILD CARNIVORES, OVER 42 MILLION DOSES WERE DISTRIBUTED IN 2009
ALONE. WITHIN THE U.S., ORAL RABIES
VACCINATION PROGRAMS ARE DIRECTED AT RABIES CONTROL IN
THE RACCOON, GRAY FOX, AND COYOTE. THE U.S. WAS DECLARED CANINE
RABIES FREE IN 1997. BUT THIS DOESN’T ADDRESS
SPILLOVER OF CANINE VIRUS INTO WILD COYOTE POPULATIONS WHICH
ARE ABUNDANT IN SOUTH TEXAS AND ARE DISTRIBUTED THROUGHOUT THE
UNITED STATES. OIV WAS INTEGRATED INTO
CONVENTIONAL RABIES CONTROL PROGRAMS THAT TARGETED DOGS. AND THROUGH STRATEGIC CREATION
OF ORB ZONES, FIRST TO PREVENT THE NORTHWARD SPREAD, RABIES WAS
ELIMINATED FROM THE U.S. IN 2007, WITH THE LAST DOCUMENTED
CASE OCCURRING IN 2004 ALONG THE BORDER NEAR LAREDO, TEXAS. THAT WAS IN A DOG. SURVEILLANCE IS AN ENHANCED —
SURVEILLANCE IS AN ESSENTIAL COMPONENT OF ORAL RABIES
VACCINATION PROGRAMS, AND ANY EFFECTIVE RABIES CONTROL PROGRAM
FOR THAT MATTER. THE CDC DEVELOPED DIRECT RAPID
IMMUNOHISTA MI NE TEST THROUGHOUT AN ACCURATE DIAGNOSIS
CAN BE RECEIVED IN ONE HOUR, HAS LED TO A SHIFT OF WHICH HIGHER
LEVELS OF SURVEILLANCE ARE ACHIEVED TO SUPPORT HIGHER
RABIES PROGRAMS IN THE U.S. SINCE FIELD IMPLEMENTATION OF
DRIT OR DRIT AS IT’S CALLED IN 2005, MORE THAN 40,000 SAMPLES
HAVE BEEN TAKEN — TESTED NEAR ORB ZONES IN THE U.S. TO ASSESS
PROGRAM PROGRESS AND TO MAKE ADJUSTMENTS IN MANAGEMENT. AN EVALUATION OF HANDOUT MODEL
ON THE NAVAJO NATION IN ARIZONA RESULTED IN GOOD BATIX AMONG
FREE-ROAMING DOGS, WITH 1/3 OF THE DOGS SHOWING POST ORV VIRUS,
RABIES VIRUS ANTIBODIES WITH THE USE OF THE ORG AS A VACCINE. WHILE ADDITIONAL RESEARCH IS
WARRANTED, THE HANDOUT MODEL AS DREM STRAIGHTDEMONSTRATED A
MODEL TO EXHIBIT A GREATER PORTION OF THE
DOG POPULATION WITHIN A COMMUNITY. LIMITING DOG REPRODUCTION TO
ENHANCED RABIES CONTROL IS A HUGE CHALLENGE. SURGERIES ARE HIGHLY EFFECTIVE,
BUT IT’S TIME CONSUMING AND DIFFICULT TO APPLY ON A LARGE
SCALE. THE INJECTABLE CONTRACEPTIVE MAY
BE AVAILABLE AS AN OPTION IN SOME AREAS, BUT ITS USE IS
LIMITED TO MALES. IMMUNOCONTRACEPTIVE VACCINE
GONACON HAS EXPERIMENTALLY BEEN SHOWN TO BE EFFECTIVE IN SEVERAL
SPECIES BUT IS CURRENTLY ONLY REGISTERED FOR USE IN DEER IN
THE U.S. GIVEN THAT THIS VACCINE HAS
CONTRACEPTIVE EFFECTS IN MALES AND FEMALES, IT HOLDS PROMISE
FOR REDUCING DOG FUCUNDITY. LONG RANGE ORAL CONSUMPTION
WOULD CONSTITUTE FREE-ROAMING. RECOGNIZING THAT RABIES HAS NO
POLITICAL BOUNDARIES, A NORTH AMERICAN RABIES MANAGEMENT PLAN
WAS SIGNED IN 2008, ACTUALLY SIGNED ON THIS STAGE DURING THE
RABIES AND AMERICAS CONFERENCE IN 2008. THIS PLAN PROVIDES A CONTINENTAL
FRAMEWORK FOR COLLABORATION AMONG THE U.S., CANADA, MEXICO,
AND THE NAVAJO NATION TO ADVANCE THE STATE OF SCIENCE FOR RABIES
SURVEILLANCE AND CONTROL PROGRAMS. IT HAS BEEN A SPRINGBOARD FOR
THE COLLABORATION, COOPERATIVE RESEARCH ON GONACON ON CAPTIVE
DOGS IN MEXICO THAT I MENTIONED. AND IT — AS DOG RABIES, AS WELL
AS DOG RABIES INITIATIVES REFERENCED EARLIER ON THE NAVAJO
NATION. AND IN SURVEILLANCE CONTROL AND
RESEARCH INITIATIVES BETWEEN CANADA AND THE U.S. ON RACCOON
RABIES. THIS PLAN REPRESENTS A
FUNCTIONAL MODEL OF ONE TO BE ADAPTED TO OTHER REGIONS WHERE
INTERJURISDICTIONAL COLLABORATION IS ESSENTIAL TO
ACHIEVE RABIES-CONTROL OBJECTIVES. TO CONCLUDE, PREVENTING RABIES
TRANSMISSION TO HUMANS THROUGH THEIR LONG-STANDING BOND WITH
DOGS REPRESENTS A CHALLENGE WE MUST OVERCOME TO REDUCE THE
IMPACT THIS ANCIENT DISEASE STILL HAS ON HUMANS IN THE 21st
CENTURY. ADVANCES AND NOVEL APPROACHES
SUCH AS ORAL VACCINATION WOULD ALLOW US TO MORE COMPREHENSIVELY
ADDRESS RABIES CONTROL ELIMINATION WHERE FREE-ROAMING
DOGS AND CARNIVORES PLAY A KEY ROLE IN VIRUS DYNAMICS. ADVANCES IN CONTRACEPTIVE
METHODS WILL BE CRITICAL SO THAT DOG POPULATION CONTROL MAY BE
MORE FULLY INTEGRATED INTO — INTO RABIES, DOG RABIES CONTROL
PROGRAMS. AND CLEARLY, AN OVERARCHING GOAL
IS TO WORK TO ENHANCE COST EFFECTIVENESS SO IT WOULD BE
PRACTICAL FOR APPLICATION THROUGH PROGRAMS DESIGNED TO
REACH THE DEVELOPING WORLD WHERE RABIES STILL TAKES ITS GREATEST
TOLL. THANK YOU VERY MUCH, AND I’LL
TURN IT OVER TO OUR NEXT SPEAKER, DR. LEANIS.>>TO EVERYBODY HERE ON THE
INTERNET AND TO THE DOG, I AM — I’M NOT A TANGO DANCER. AS SHE WANTS ME TO BE. AND I WILL TALK ABOUT THE
APPROACH TO RABIES ELIMINATION IN LATIN AMERICA. BAJO IS ORIGINAL OFFICE IN THE
AMERICAS AND SEE HAS 36 MEMBER STATES FIGHTING GAIBS AGAINST
RABIES AND — FOR HEALTH IN WASHINGTON, D.C. AND THE REGIONS AS SHOWN ON THE
MAP. I WILL ADDRESS POLITICAL
DECISIONS AND MANDATES FOR RABIES IMMUNIZATION, TRENDS, AND
THE STRATEGY STATES ARE FOLLOWING FOR ELIMINATION OF
RABIES IN LATIN AMERICA. MAIN POLITICAL MANDATES AND
INTERNATIONAL AGREEMENTS FOR THE ELIMINATION OF RABIES IN LATIN
AMERICA ARE THE PROGRAM FOR RABIES ELIMINATION LAUNCHED IN
1983, FOSTERING NATIONAL PLANS IN MEMBER COUNTRIES. THEN WE HAVE 2008, URGING THE
ELIMINATION OF HUMAN RABIES TRANSMITTED BY DOGS BY 2012,
NEXT YEAR. THEN WE HAVE COUNTRY BY COUNTRY
FOLLOWUP GIVEN BY THE NETWORK OF RABIES NATIONAL DIRECTOR FOR
MEMBER STATES, PARTNERS, AND SCIENCE BACKED BY CDC. NATIONAL PLANS ARE VERY SIMPLE
AND ARE BASED ON SURVEILLANCE OF RABIES AND RABIES EXPOSURES,
TIMELY PRO- LYLY LYLY PROPHYLAXIS. MEMBER COUNTRIES CONSIDER THE
PREVENTION OF ELIMINATION OF HUMAN RABIES AN ETHICAL
COMMITMENT. FOR EXAMPLE, HEALTH CARE TO
PERSONS EXPOSED TO RABIES IS A BASIC HUMAN RIGHT WHICH IS
GUARANTEED WITHOUT CAUSE BY ALL MEMBER STATES TO ALL INHABITANTS
OF THE AMERICAS. AS YOU CAN SEE IN THE CHART, THE
TREND IN OUR HEMISPHERE IS ONE OF THE MOST SUCCESSFUL IN THE
REGIONS. TOWARD RABIES ELIMINATION. FROM 1970 TO 2009, THERE WERE
MORE THAN 7,000 HUMAN CASES WITH AN ESTIMATED 60% TRANSMITTED BY
DOGS. AS YOU CAN SEE, THE ORIGINAL
PROGRAM HAS BEEN EFFECTIVE IN REDUCING THE INCIDENCE OF HUMAN
AND DOG RABIES. THERE WERE MORE THAN 300 HUMAN
CASES PER YEAR WHEN THE REGIONAL PROGRAM WAS LAUNCHED IN 1983. IN 2009, THE NUMBER OF HUMAN
CASES OF RABIES AND RABIES DOGS DIMINISHES SIGNIFICANTLY, BUT
THERE STILL WERE 19 CASES IN 2009. 11 WERE TRANSMITTED BY DOGS. REGARDING SPECIFICALLY THE HUMAN
RABIES TRANSMITTED BY DOGS FROM 2000 TO 2009, THERE WERE 239
HUMAN CASES. THE NUMBER OF CASES PICKED, AS
YOU SEE IN 2001, AND IS DECLINING IN ALL THE REGIONS
REACHING 11 CASES IN 2009. THIS MAP WAS PRODUCED AND
IDENTIFIES IN YELLOW COUNTRIES CERTIFIED INTERRUPTION OF
CIRCULATION OF RABIES AMONG DOGS, AREAS OF LOW RISK. IN LIGHT BLUE, NO CASES OF DOG
RABIES BUT WITH PENDING CERTIFICATION. AND AREAS WITH SUSTAINED AND
CIRCULATION OF RABIES AMONG DOGS AND A HIGH RISK OF HUMAN RABIES. DOG-TRANSMITTED RAIN CZYZ A
CONSEQUENCE OF — RABIES IS A CONSEQUENCE OF POOR DEVELOPMENT,
BUT MEMBER COUNTRIES CAN PROVE TO THE WORLD THAT INTERVENTIONS
FOR DOG RABIES ELIMINATION ARE ACHIEVABLE EVEN IN DEVELOPING
COUNTRIES WITH CURRENT ECONOMIC RESOURCES. AS YOU CAN SEE, FOR EXAMPLE,
CASE IN NICARAGUA, PERU, MANY COUNTRIES HAVE SUCCEEDED IN THE
ELIMINATION OF DOG RABIES. THE NETWORK OF NATIONAL
DIRECTORS, I MENTION TODAY BEFORE, RECOMMENDED VERY SIMPLE
CORRECTIVE ACTIONS TO EACH COUNTRY TO ACHIEVE ZERO CASES OF
RABIES TRANSMITTED BY DOGS BY THE YEAR 2012. VIS-A-VIS FOUR MAIN REMAINING
CHALLENGES. IN SIX COUNTRIES, DOG
VACCINATION PROGRAMS WAS NOT ACHIEVED DUE TO INSUFFICIENT
PROVISION OF VACCINES CAUSING HUMAN DEATHS. PATIENTS BITTEN BY RABID DOGS
RECEIVED NO PROPER PROPHYLAXIS IN CENTERS IN GUATEMALA AND
DOMINICAN REPUBLIC. DUE TO LACK OF LOCAL
COORDINATION FOR MASS DOG VACCINATION CAMPAIGNS, DOG
RABIES PERSISTED IN AREAS OF MEXICO, VENEZUELA, AND BRAZIL. AND ALSO DOG RABIES WAS A
TRANSBOUNDARY HEALTH HAZARD IN SEVERAL COUNTRY BORDERS AS SEEN
ON THE MAP, REQUIRING BETTER COMBINATION BETWEEN COUNTRIES. WELL, TO MANY NUMBERS HERE —
BUT RABIES TRANSMITTED IS A PARTICULAR CONDITION OF THE
AMERICAS. AND ALSO A MAJOR REMAINING
CHALLENGE. 462 CASES OF HUMAN RABIES WERE
CLASSIFIED BY RESCISSION VOYEUR SPECIES THROUGH CLINIC OR CDC
ANTIBODIES FROM 2000 THROUGH 2009. I SAID BEFORE 439 WERE CAUSED BY
DOGS. BUT YOU CAN SEE THAT 149 WERE
CAUSED BY VAMPIRE BATS, MAINLY IN THE RAIN FORESTS OF THE
NORTHERN SOUTH AMERICA. OTHER TRANSMITTERS WERE BATS,
CATS, LIVESTOCK, AND [ INAUDIBLE ]
. SO LATIN AMERICA IS UNIQUE
REGARDING RABIES DUE TO THE PRESENCE OF VAMPIRE BATS AND THE
RISK OF INCIDENTAL TRANSMISSIONS OF RABIES BY ANY SPECIES OF
BATS. FOR EXAMPLE THROUGH DOMESTIC
CATS AND LIVESTOCK. ALSO, LATIN AMERICA AND THE
CARIBBEAN SHARE WITH OTHER REGIONS OF THE WORLD THE THREAT
OF RABIES SPILLOVER FROM — TO HUMANS OR DOGS FROM
[ INAUDIBLE ] SO THE MAIN ELEMENTS OF THE
STRATEGY FOR TRACKING THE REMAINING CHALLENGES INCLUDE A
FOCUS TO AVOID RELAXATION OF CONTROLS WHEN NO HUMAN CASES ARE
REPORTED. MANAGE ENVIRONMENTS IN RELATION
TO STRAY DOGS. PREVENT CIRCULATION OF RABIES
AMONG DOGS AND WHITE CARNIVORE AND TACKLING THE CHALLENGE OF
PROPHYLAXIS IN REMOTE AREAS WITH NO ACCESS TO HEALTH SERVICES. TO ACHIEVE THE DREAM OF AN AREA
WITHOUT HUMAN RABIES, STATES ARE REINFORCING THE LEADERSHIP OF
THE HEALTH SECTOR WITH STRONGER PARTNERSHIPS, TAKING ADVANTAGE
OF THE ENVIRONMENT SET BY THE ALLIANCE FOR RABIES CONTROL. NEW APPROACHES ARE NEEDED TO
TACKLE THE REMAINING CHALLENGES AND THE CONCEPT. ORAL VACCINATIONS FOR ALL
FREE-ROAMING CARNIVORE IN ADDITION TO TRADITIONAL DOG
VACCINATION WHEN APPLICABLE, CAPACITY TO DETECT NEW VARIANCE
OF THE VIRUS VIA SURVEILLANCE BASED ON CDC MONITORING BODIES,
TO MONITOR DOG RABIES VARIANCE CAUSED BY OTHER SPECIES, IN
EVERY COUNTRY AS A MATTER OF INTERNATIONAL PUBLIC HEALTH
INTEREST. PROMOTION OF ANIMAL WELFARE AND
PROTECTION OF PEOPLE IN REMOTE AREAS WITH BETTER PROPHYLAXIS
SCHEMES. ALL THIS SHOULD AND CAN BE
APPLIED IN ALL THE COUNTRIES WITH ALL LEVELS OF DEVELOPMENT
AS WELL AS DEMONSTRATED BY MEMBER STATES WITH THE TECHNICAL
TOOLS DEVELOPED BY CDC AND OTHER SCIENTIFIC PARTNERS TO REACH
SUSTAINABLE ACHIEVEMENTS IN PUBLIC HEALTH. AND NOW, OUR NEXT SPEAKER,
DEBBIE BRIGGS.>>GOOD AFTERNOON. I’M DEBRA BRIGGS, THE DIRECTOR
OF THE GLOBAL LINES FOR RABIES CONTROL, AND I’M GOING TO TALK
ABOUT THE ROLE OF ADVOCACY AND PARTNERSHIPS AND HOW THAT CAN BE
VERY EFFECTIVE AT A COMMUNITY LEVEL. SO YOU’VE HEARD FROM MY
COLLEAGUES ABOUT THE TOOLS THAT WE HAVE AND THE FACT THAT WE CAN
ACTUALLY PREVENT HUMAN RABIES. SO THEREFORE, ONE BEGINS TO
WONDER, WHY DO PEOPLE STILL DIE OF RABIES. AND I CAN TELL YOU FROM MY TRIPS
THAT WHAT I SEE IS ONE OF THE MAIN REASONS IS BECAUSE OF LACK
OF AWARENESS ON ALL LEVELS, INCLUDING RESPONSIBLE PET
OWNERSHIP AND THE NEED TO VACCINATE PETS, TO WHERE TO GET
POST EXPOSURE PRO-FLAGS IS — PHOPHYLAXIS AND WOUND CARE. RABIES IMMUNEOIMMUNOGLOBULIN IS
OFTEN NOT AVAILABLE TO POOR COUNTRIES. THIS IS A PICTURES OF A FAMILY
WHO HAD TO TRAVEL A VERY LONG WAY IN TANZANIA TO FIND VACCINE. WHEN THEY GOT THERE, THEY ONLY
HAD ENOUGH MONEY TO VACCINATE ONE OF THE FIVE CHILDREN THAT
WAS EXPOSED TO A DOG. SO THEY HAVE TO MAKE A DECISION. AND THIS IS REALTY. SO I WANT TO TALK ABOUT HOW
GLOBAL PARTNERSHIPS AND EFFORTS CAN ACTUALLY HELP TO CHANGE THE
SITUATION. ABOUT FIVE YEARS AGO, RABIES
EXPERTS FROM AROUND THE WORLD GOT TOGETHER TO SEE WHAT WE
COULD ACTUALLY DO. AND IN 2007, WE LAUNCHED THE
FIRST WORLD RABIES DAY, WHICH IS A FOCAL POINT FOR INCREASING
AWARENESS. THE SAME YEAR, THE GLOBAL
GLOBALALLIANCE FOR RABIES CONTROL, 501-3C WAS LAUNCHED. THEN AN INFORMAL GROUP OF PUBLIC
AND PRIVATE PARTNERSHIPS, PEOPLE, THAT COME TOGETHER IN
ORDER TO SOLVE PROBLEMS AND FIND SOLUTIONS. AND THROUGH THESE ORGANIZATIONS,
WE HAVE CREATED A GLOBAL E-COMMUNICATIONS NETWORK AND A
BANK OF FREE EDUCATIONAL MATERIAL. AND WE HAVE ACTUALLY IN THE LAST
THREE YEARS LAUNCHED AND SUCCESSFULLY ELIMINATED CANINE
RABIES IN THE PHILIPPINES. I’M GOING TO TALK ABOUT THAT. SO WHAT HAVE WE DONE SINCE THE
FIRST WORLD RABIES DAY WHICH, INCIDENTALLY, IS ON SEPTEMBER
28. WHAT WE’VE SEEN IS 135 COUNTRIES
THAT HAVE ACTUALLY REPORTED HOLDING EVENTS. WE’VE HAD MORE THAN 150 SCHOOLS
OF VETERINARY MEDICINE AND COLLEGES OF MEDICAL EDUCATION
THAT HAVE BEEN INVOLVED AND HOSTED EVENTS. WE HAVE HAD MORE THAN 300,000
PEOPLE COMING TO OUR WEB SITE TO DOWNLOAD EDUCATIONAL MATERIAL. AND WE HAVE HEARD FROM OVER 200
COUNTRIES ABOUT WHAT THEY’RE DOING THROUGH EFFORTS THAT WE’VE
PUT ON THE WEB TO HELP CONTROL RABIES. AND HERE IS A PICTURE OF
ACTUALLY THE GRAPH OF WHAT YOU CAN SEE HOW THE AWARENESS HAS
INCREASED OVER THE YEARS. AND THE PEAKS ARE IN SEPTEMBER,
THE MONTH OF WORLD RABIES DAY, AND YOU CAN SEE PEOPLE COMING TO
OUR SITE TO DOWNLOAD INFORMATION. WHAT WE’VE SEEN REGARDING AN
IMPACT IS MORE THAN 1,200 REPORTED EVENTS, AND WE KNOW
THERE ARE MORE THAN THAT WHEN WE TRAVEL AROUND AND SPEAK TO
COLLEAGUES. WE KNOW THAT ALMOST FIVE MILLION
ANIMALS HAVE BEEN VACCINATED ON WORLD RABIES DAY. AND WE KNOW THAT WE’VE SENT
EDUCATIONAL MESSAGES TO OVER 150 MILLION PEOPLE ACROSS THE WORLD. WE ALSO KNOW THAT THROUGH WORLD
RABIES DAY, NEW ANIMAL VACCINATION PROGRAMS HAVE BEEN
ESTABLISHED IN ENDEMIC COUNTRIES. WE’VE SEEN REINVIGORATED
EDUCATIONAL PROGRAMS. WE’VE ESTABLISHED GLOBAL
NETWORKS, AND WE’RE ALSO — WORLD RABIES DAY IS LISTED ON
THE U.N. GLOBALLY OBSERVED DAY. PRIOR TO WORLD RABIES DAY, FOR
EXAMPLE, IN A COUNTRY LIKE MOZAMBIQUE, DOGS WERE NOT
VACCINATED BECAUSE THE PEOPLE THOUGHT THAT BY VACCINATING DOGS
THEY WERE NO LONGER GOOD WATCHDOGS. IT WAS A LACK OF SUPPORT FROM
THE GOVERNMENT, AND THE BASIC EDUCATIONAL MATERIALS WERE NOT
AVAILABLE. AFTER WORLD RABIES DAY, IN
MOZAMBIQUE WE SAW PARTNERSHIP BETWEEN THE VETERINARY CLINICS
AND THE VETERINARY UNIVERSITY. WE’VE SEEN MULTIPLE DOG
VACCINATION CLINICS BEING HELD THROUGHOUT THE COUNTRY AND THE
NATIONAL GOVERNMENT IS NOW FUNDING VACCINATION PROGRAMS ON
WORLD RABIES DAY. WE’VE SEEN INCREASED EDUCATIONAL
AWARENESS OF OF THE LOCALS, AND EVEN A CONSTRUCTION OF AN ANIMAL
RECORD DATA BASE. OUR COMMUNICATIONS OUTREACH
BEGINS BY PEOPLE GETTING ON THE WEB, LOGGING ON TO OUR SITE,
PUTTING IN THE INFORMATION THAT THEY NEED AND THEN PETER COSTA,
OUR GLOBAL COMMUNICATION SS EXPERT
WILL SEND THEM, TAKE WHAT THEY NEED, SEND THE MATERIAL, AND
THEY ARE THE ONES THAT USE IT TO EDUCATE THE PEOPLE IN THEIR
COMMUNITY. WE CONTINUALLY EVALUATE OUR
PROGRAMS AND WHAT WE’VE SEEN AS A RESULT OF WORLD RABIES DAY, WE
CONDUCTED A SURVEY THIS YEAR. AND OF THE 213 SURVEYS THAT WERE
RETURNED IN FOUR LANGUAGES, WE SAW ABOUT 96% OF THE PEOPLE THAT
SAID RABIES EDUCATION IS ACTUALLY SAVING LIVES. WE SAW 90% OF THE PEOPLE THAT
SAID WORLD RABIES DAY IS MAKING A DIFFERENCE, AND 95% OF THE
PEOPLE SAID THAT THEY WOULD HOST ANOTHER WORLD RABIES DAY EVENT. WHAT MORE CAN WE DO? WHEN WE PUT TOGETHER THE
PARTNERS FOR RABIES PREVENTION, WE WANTED TO REALLY SIT TOGETHER
AND WORK AS A GROUP, AND THE PARTNERS FEBRUARYOR RABIES
PREVENTION INCLUDES ALL THE INTERNATIONAL
HEALTH ORGANIZATIONS. WE COME TOGETHER TO DISCUSS
COMMON STRATEGIES, LOOK AT NEEDS, DEVELOP TIMETABLES AND
DELIVERABLES, AND ACTUALLY MAKE A DIFFERENCE. THE GLOBAL LINES SITS AS
SECRETARIAT. WE DEVELOPED A ROAD
THAT EVERYBODY AGREED UPON IN 2008. IN 2009 AND 2010, WE DEVELOPED
THE FIRST-EVER BLUEPRINTS FOR CANINE RABIES ELIMINATION AND
PREVENTION. THE NEXT STEP, WHAT WE’RE DOING
NOW, IS TO RE-EVALUATE THE GLOBAL BURDEN OF RABIES. IF WE TAKE JUST A MINUTE TO LOOK
AT THE BLUEPRINT WHICH YOU CAN SEE A PICTURE OF THE WEB SITE
HERE, IT IS THE FIRST TIME THAT ALL THE INFORMATION HAS BEEN PUT
TOGETHER IN ONE PLACE. IT’S FREELY ACCESSIBLE, LINKS TO
IMPORTANT DOCUMENTS, IT HAS INFORMATION ON COSTS, PLANNING,
FUNDING, ET CETERA. IT’S ACTUALLY A NEW CONCEPT. BY PUTTING EVERYTHING TOGETHER
THAT’S ACCESSIBLE, PEOPLE HAVE LESS TIME TO HAVE TO FIND WHAT
THEY NEED AND DON’T HAVE TO PAY FOR IT. IT’S AIMED AT COUNTRIES WHERE
ITS PRESENT AND COUNTRIES WHERE RABIES IS REINTRODUCED. NOW, LOOKING FROM THE —
ACTUALLY WRITING THE BLUEPRINT TO IMPLEMENTATION, WHAT HAS IT
DONE? WELL, IT WAS LAUNCHED ABOUT SIX
MONTHS AGO, AND WE’VE ALREADY SEEN WORKSHOPS IN ISTANBUL AND
IN INDIA, AND I CAN TELL YOU THAT INDIA’S USING THE BLUEPRINT
TO ACTUALLY, AS A REFERENCE FOR HUMAN RABIES PREVENTION, AND
WEST AFRICA THE BLUEPRINT IS BEING USED TO IMPROVE
COMMUNICATIONS AND INSTITUTE DOG VACCINATION PROGRAMS. AND WE ARE NOW WORKING WITH THE
E.U. ON FOUR NEW LANGUAGES FOR THE BLUEPRINT, AND WE HOPE TO
HAVE THAT ON LINE IN THE FUTURE. OUR PROGRAM IN THE PHILIPPINES
BEGAN ACTUALLY WITH A PUBLICATION THAT WAS AUTHORED BY
DR. DAN FISHBEIN FROM THE CDC AND DR. BETSY MIRANDA FROM THE
PHILIPPINES. AND THEY LOOKED AT WHAT WOULD
HAPPEN IF YOU ACTUALLY ELIMINATE ED IN THE PHILIPPINES. THEY REPORTED THAT IF DOG RABIES
WAS ELIMINATED IN THE PHILIPPINES, IT WOULD SAVE $2.5
MILLION A YEAR, AND THAT MONEY WOULD BE THE — THE COST OF THE
PROGRAM WOULD ACTUALLY BE RECUPERATED IN FOUR TO 11 YEARS. THEREFORE, WE THOUGHT THAT WE
COULD DO A PILOT PROJECT IN THE PHILIPPINES, AND WE BEGAN WITH
BOHOL. AND WHAT HAS HAPPENED — I CAN
TELL YOU THAT THIS PROBLEM HAS BEEN AMAZING. WE’VE GONE FROM 140 PEOPLE IN
THAT PARTICULAR PROVINCE OF WHICH 1.4 MILLION PEOPLE LIVE TO
15,000 PEOPLE THAT ARE INVOLVED IN RABIES CONTROL. WE VACCINATED 70% OF THE DOGS,
WE’VE INCREASED THE CLINICS AND TRAINING, AND OF ALL OF THE
SCHOOLCHILDREN THAT ARE ENROLLED IN THE EDUCATION IN THE
PHILIPPINES, WE’VE EDUCATED ALL OF THEM. AND THAT IS 182,000 PEOPLE. AND LAST YEAR, CDC ACTUALLY
CONDUCTED A TRAINING ON THE DRIT. THE RESULT IS IN THE LAST TWO
YEARS, THERE HAVE BEEN NO RABIES DEATHS IN BOHOL, PHILIPPINES,
AND PRIOR TO THAT THERE WERE AT LEAST TEN CASES A YEAR. AND BOHOL IS BEING EVALUATED BY
THE MINISTRY OF HEALTH TO SEE IF IT CAN BE DECLARED RABIES FREE. WHAT HAVE WE LEARNED FROM ALL OF
THIS? WELL, WE’VE LEARNED THAT WE CAN
ACTUALLY PREVENT RABIES, BUT WE NEED SUPPORT FROM MULTIPLE
SECTORS. WE NEED PUBLIC/PRIVATE
PARTNERSHIPS, WE KNOW NOW THAT COMMUNICATION NETWORKS ARE VERY
POWERFUL, LOOK AT WORLD RABIES DAY. AND LAST YEAR WE HAD OUR FIRST
GLOBAL WEBINAR AND HAD 34 COUNTRIES PARTICIPATING, OVER
2,000 PARTICIPANTS WERE ABLE TO ASK EACH OTHER QUESTIONS. WE KNOW THAT WE HAVE MANY TOOLS
IN PLACE, INCLUDING VACCINES, REDUCED REGIMENTS, THE DRIT WEB
SITES, ET CETERA BUT WE STILL HAVE LOTS OF CHALLENGES. ONE OF THE MOST IMPORTANT THINGS
WE NEED TO DO IS TO INVEST IN TOOLS FOR DOG POPULATION
MANAGEMENT, AND YOU HEARD THAT ALREADY FROM MY COLLEAGUES. WE NEED SHORTER PREEXPOSURE
VACCINATION REGIMENS AS THE DOCTOR SAID, IN PLACES LIKE THE
AMAZON, THE INDIGENOUS PEOPLE CANNOT COME AND SIT FOR A MONTH
TO HAVE THE VACCINATION REGIMEN GIVEN TO THEM. WE NEED IMPROVED GLOBAL AND
NATIONAL SURVEILLANCE, WE NEED TO REASSESS THE GLOBAL BURDEN SO
THAT WE CAN ACTUALLY LOOK AT TOOLS AND MODELS AND HOW THAT
CAN SAVE MONEY IN THE LONG RUN. WE NEED NOVEL STRATEGIES AND
METHODS, MOST IMPORTANTLY, TO ENSURE SUSTAINABILITY WHERE
PROGRAMS HAVE ACTUALLY BEEN SUCCESSFUL. WITH THAT, I THANK YOU ON BEHALF
OF ALL OF THE SPEAKERS. [ APPLAUSE ]
>>WE’D LIKE TO OPEN IT TO QUESTIONS. IF THERE’S ANYONE ON N-VISION. NOT SEEING ANYBODY. ANY QUESTIONS FROM THE AUDIENCE? IF YOU HAVE A MICROPHONE, PLEASE
RAISE YOUR HAND. OTHERWISE PLEASE APPROACH THE
MICROPHONE.>>HI, I’M FROM NATIONAL
STANDARDS OF INFECTIOUS EMERGING DISEASES. IT’S LARGE. THIS QUESTION IS FOR THE DOCTOR,
YOU MENTIONED IN YOUR TALK THAT RABIES WAS HISTORICALLY
INTRODUCED INTO WILDLIFE, PARTICULARLY IN SOUTHERN U.S. FROM DOGS INTO CATEGORIES AND
SOME OTHER SPECIES. LATER YOU MENTIONED THAT
PRINCIPALLY THERE’S A CURRENT PROGRAM IN TEXAS WHERE THE —
IT’S SEEN IN THE DOG POPULATION. MY QUESTION IS, WHAT IS THE REAL
RISK OF THE NOW ADOPT ED ADOPTED ROLE OF
DOG POPULATION AND WHAT ABOUT THE DOG POPULATION MANAGEMENT TO
ACHIEVE THE ELIMINATION?>>THANK YOU. YES, THERE HAVE BEEN CASES OF
GRAY FOX SPILLOVER INTO DOGS. FORTUNATELY THROUGH THE ORB
EFFORT THAT HAVE OCCURRED THERE IN WEST TEXAS, THERE’S NOT BEEN
ANY CONTINUATION OF THAT TREND. THERE’S BEEN NO CASES SINCE MAY
OF — I BELIEVE IT’S 2009. SO, YOU KNOW, THEY’RE BOTH —
OBVIOUSLY THE CION GENIUS IS MORE DISTANT THAN CAUS AS A
COYOTE. INTERNATIONALLY, I’D HATE TO
SPECULATE. I WOULD TURN IT TO DR. RUPRICK
TO SPECULATE.>>IT’S A VERY INTERESTING
QUESTION. I THINK THE BIGGER TAKE-HOME
PICTURE IS THAT NOT ONLY HAS RED FOX RABIES THROUGH ORV BEEN
CONTROLLED AND ELIMINATED SOME PLACES, AND WE’VE BROKEN
TRANSMISSION OF THAT PARTICULAR VARIANT MOST IMPORTANTLY HERE IN
THE UNITED STATES, WE’VE PREVENTED THE PROGRESSION OF
RACCOON RABIES FROM EAST TO WEST. THIS ORV DEMONSTRATION,
PARTICULARLY IN TEXAS, DEMONSTRATES, AGAIN, THAT WE’RE
DRIVING THESE VARIANCE TO EXTRIPATION. AS YOU’RE AWARE, SOME OF THESE
VIRUSES NO LONGER EXIST EXCEPT IN OUR FREEZERS. ANOTHER DEMONSTRATION OF
INTERSECTORIAL COOPERATION, BASED UPON THE ECOLOGY OF THE
DISEASE AND USING USEFUL, HUMANE, AND INNOVATEIVE
TECHNIQUES TO DRIVE THESE VIRUSES TO EXTINCTION. THE ABILITY TO BRING IT BACK
WILL BE DRIVEN TO ZERO. THAT VARIANT NO LONGER EXISTS IN
NATURE. YES, IT IS MICROPHONE.>>OADS. THANK YOU ALL FOR THE
PRESENTATIONS. ONE OF THE SPEAKERS ALLUDED TO
THE NEED FOR SIMPLIFIED PREOR POST EXPOSURE REGIMENS FOR
HUMANS. ARE THERE ANY SORT OF
TECHNOLOGICAL BREAKTHROUGHS LIKE THAT ON THE HORIZON? I KNOW RECENTLY WE’VE GONE TO A
REDUCED DOSAGE, REDUCED NUMBER OF DOSAGES. BUT ARE THERE — ARE THERE ANY
MUCH LARGER BREAKTHROUGHS TO GET IT DOWN TO WHERE WE ARE WITH
MOST VACCINES WHERE IT’S A — A SINGLE DOSE OR A SMALLER —
SMALLER NUMBER?>>THANKS, THAT’S AN EXCELLENT
QUESTION. QUICK ANSWER — YES, FROM SOME
OF THE FBRR-FUNDED RESEARCH INITIATIVES. FOR EXAMPLE AT CDC. WE’RE LOOKING TOWARD NEEDLIST
DELIVERY OF BIOLOGICS WHICH IN THEORY COULD BE AS IF NOT MORE
EFFECTIVE THAN INTRADERMAL DELIVERY, WHICH IS A VERY
COST-EFFECTIVE MEASURE. AND IN ADDITION, MANY
RESEARCHERS ARE LOOKING AT THE POSSIBILITY OF REPLICATION
DEFICIENT RABIES VIRUS VACCINES. FOR EXAMPLE, IN AREAS THAT THE
DR. MENTIONED SUCH AS IN AMAZONIA, THIS WOULD PROVIDE THE
OPPORTUNITY TO GIVE IN THEORY PERHAPS EVEN A SINGLE DOSE OF A
FUTURE BIOLOGIC IF IN FACT THIS IS PROVEN OUT THROUGH LIMITED
CLINICAL TRIALS. PERHAPS DR. BRIGGS AND LEANIS
HAVE OTHER COMMENTS ABOUT BREAKTHROUGHS?>>I THINK IT’S A REALLY GOOD
QUESTION. ONE OF THE PROBLEMS IS THE COST
OF DOING CLINICAL TRIALS. BUT WHAT WE HAVE SEEN IN
COUNTRIES WHERE IT’S VERY EXPENSIVE, THE VACCINE IS VERY
EXPENSIVE, FOR EXAMPLE IN ONE COUNTRY I KNOW OF IN ASIA, THE
AVERAGE NUMBER OF DOSES THAT A PATIENT WOULD RECEIVE IS THREE. AND WE DON’T SEE DEATHS. SO WE KNOW THAT WE CAN ACTUALLY
REDUCE THE NUMBERS. IT’S JUST DOING THE CLINICAL
TRIALS.>>YES, MA’AM?>>HI, DR. TAX, EIS OFFICER AT
THE RABIES BRANCH. I HAVE A QUESTION ABOUT THE ROLE
OF CATS AND RABIES. VIRAL CATS POPULATIONS IN
GENERAL TEND TO BE A BIG PROBLEM IN MOST STATES. I DON’T BELIEVE EVEN REQUIRE
VACCINATION NECESSARILY OF CATS IN GENERAL OR NECESSARILY ALL
CATS. SO WHAT’S THE RISK IN MAYBE SOME
OTHER ALTERNATIVE CONTROLS? BECAUSE JUST LIKE WITH GETTING
SOME OF THE ROAMING DOG POPULATIONS, TRYING TO CATCH A
FERILE CAT AND VACCINATE IT IS QUITE A SAFETY HAZARD.>>THANK YOU. THAT’S AN EXCELLENT POINT. AND IN FACT, CATS HAVE REPLACED
DOGS AS THE MAJOR DOMESTIC SPECIES OF CONCERN IN THE UNITED
STATES. THERE’S BEEN A LOT OF ACTIVITY
AS YOU’RE PROBABLY AWARE ABOUT THE MANAGEMENT OF FERILE CAT
POPULATIONS THROUGH ABC, SUCH AS VACCINATION, RELEASE,STERILITY
CONTROL, ET CETERA SIMILARLY, CATS ARE ONE OF THOSE ANIMALS
THAT FOR WHATEVER REASON WE IGNORE. WE THINK THAT A HAPPY CAT
NECESSARILY HAS TO BE AN OUTDOOR CAT. WHICH BRINGS UP ISSUES OF
RESPONSIBLE PET OWNERSHIP. OBVIOUSLY THERE’S SIMILARITIES
BETWEEN RESPONSIBLE PARENTING AND RESPONSIBLE PET OWNERSHIP,
AS WELL. WE DON’T LET OUR — WELL, WE’RE
NOT SUPPOSED TO LET OUR CHILDREN GO UNSUPERVISED. A SIMILAR SITUATION IN REGARDS
TO OUR PETS. I THINK ONE OF THE MAJOR THINGS
THAT WE CAN DO AND HOPEFULLY AGREE ON IS IMPROVE EDUCATION
THROUGH RESPONSIBLE PET OWNERSHIP, AND I KNOW DR. SLATE
MIGHT HAVE SOMETHING TO SAY IN TERMS OF THE CONTRACEPTIVE
POSSIBILITIES FOR GNRH-LIKE VACCINES FOR CATS.>>I HEARD YOU MENTION BOBCATS. LET ME SPOKE TO THAT FIRST. THERE WAS IN SOUTH TEXAS WHERE
WE WERE CONDUCTING ON, RABB VACCINATION IN CLAB — RABIES
EVACUATIONATION IN COLLABORATION WITH THE STEPS OF HEALTH
SERVICES. THERE’S SUSPICION GIVEN THE
NUMBER OF BOBCATS IN THE AREA THAT BOBCATS MIGHT SERVE AS A
RESERVOIR. THEY ARE THE NEXT SPECIES MOST
FREQUENTLY REPORTED, IF I’M NOT CORRECT — RIGHT? WELL, POSSIBILITIES — I MEAN,
THERE MAY BE POSSIBILITIES AS IT WORKS IN BOTH MALES AND FEMALES. I WOULD PUT YOU IN TOUCH WITH
DR. LOWELL MILLER AT OUR NATIONAL RESEARCH CENTER TO LOOK
SFWROR INTO THE POSSIBILITY. THIS WORKED IN SEVERAL SPECIES
IT’S BEEN TESTED IN SO FAR WITH ONE-SHOT MULTIPLE-YEAR EFFICACY. SO I WOULD PUT YOU IN TOUCH WITH
DR. MILLER. WE’LL BE HAPPY TO DO THAT. BUT THE BOBCAT QUESTION WAS ONE
OF COULD IT BE A RESERVOIR. PERHAPS. I MEAN, IT’S CERTAINLY — AN
INTERESTING QUESTION. IT MIGHT BE A RESERVOIR UNDER
CERTAIN HIGH DENSITY SITUATIONS AND CERTAIN GEOGRAPHY WITH —
WITH, SAY, GRAY FOX VARIANT PRESENT. NOBODY KNOWS THE ANSWER TO THAT,
BUT WE HAVE DONE SOME ECOLOGICAL STUDIES ON HABITAT PARTITIONING
AND CONTACT RADIO TELEMETRY THAT WILL BE INTERESTING TO SEE THE
FINAL RESULTS ON THERE.>>SO THERE COULD BE BENEFITS
FROM FOCUS OF RESEARCH ON BOBCATS, AS WELL AS DOMESTIC
CATS FOR THE ISSUE OF THE FELADAY AS A WHOLE. LUCKILY, BARRING THIS LAST
POTENTIAL EXAMPLE, LUCKILY NO CATS DOMESTIC OR WILD ANYWHERE
IN THE WORLD ARE RECOGNIZED AS RESERVOIRS. AND SO ONE OF THE PRIMARY WAYS
AT LEAST FROM THE RABIES STANDPOINT IS TO FOCUS ON THE
RESERVOIRS AND RABIES CASES IN CATS WOULD THEN BE DRIVEN TO
STICHKZ. OF COURSE, VACCINATION BECAUSE
THE ISSUES RELATED TO BATS AND BAT CATCHING CATS.>>FROM THE ORAL VACCINATION
STANDPOINT, IT WOULD BE DIFFICULT TO BEAT CATS BECAUSE
THEY ARE TRULY CHASE PREDATORS. WOULD BE HARD TO BAIT THEM WITH
THE TYPE OF BAIT THAT’S WE’RE USING NOW AT LEAST.>>DR. MONROE?>>THANKS. STEPHEN MONROE, DIVISION OF HIGH
CONSEQUENCE PATHOGENS AND PATHOLOGY. I’M NOT SURE WHO BEST COULD
ANSWER THIS. MY QUESTION HAS TO DO WITH THE
SUSTAINABILITY ISSUE. CERTAINLY WE’VE SEEN WITH THE
POLIO ERADICATION EFFORTS THAT AS THE PROGRAM GOES ON AND
TRYING TO ACHIEVE THE LAST FEW PERCENT THAT IN COUNTRIES WHERE
RESOURCES ARE LIMITED, THERE’S — THE TENDENCY TO
DIVERT RESOURCES FROM A PROGRAM THAT SEEMS TO BE NOT IMPORTANT
ANYMORE TO OTHER THINGS THAT ARE IMPORTANT. SO ARE THERE APPROACHES FROM THE
EDUCATION SIDE, WHATEVER, TO MAINTAIN THE POLITICAL WILL TO
KEEP THE PROGRAM GOING AND SUSTAINED OVER TIME? EVEN WHEN YOU DO ACHIEVE
ELIMINATION OF HUMAN CASES?>>I’D LIKE TO ANSWER THAT. AND JUST LOOKING INGING ULHOL
PHILIPPINES PROJECT, WE LOOKED AT SUSTAINABILITY AND HOW WE
COULD MANY THAT. WHAT THEY DID IN THE PHILIPPINES
WAS ACTUALLY TO CHARGE A SMALL AMOUNT TO REGISTER DOGS, AND
THAT SMALL FEE GOES BACK INTO THE PROGRAM. AND SO IT IS SUSTAINABLE WHEN
THE FUNDING THAT WE HAVE BEEN ABLE TO ACQUIRE WITH A SWISS
FOUNDATION DISAPPEARS. THEN IT’S GOING TO BE
SUSTAINABLE THROUGH THE MONEY THAT THEY RAISE. AND ALSO, EDUCATIONWISE, WHAT
WAS DONE IN THE PHILIPPINES WAS ACTUALLY TO TAKE EDUCATION AND
PUT IT INTO THE CURRICULUM SO RABIES WAS PUT INTO MATH AND
SCIENCE AND READING AND JUST INTEGRATED INTO IT THAT WAY. AND IT APPEARS THAT IT’S
EXTREMELY SUCCESSFUL.>>JAN NICHOLSON, OID. I NOTICED THAT, CHUCK, YOU
TALKED ABOUT THE CONFIRMATORY TEST IS A DFA. I’M WONDERING IF THERE ARE ANY
PLANS TO LOOK AT A MOLECULAR TEST.>>THANK YOU VERY MUCH. YES, THERE ARE A VARIETY OF
MOLECULAR TESTS. THE LIMITATION IS THAT THINGS
LIKE ANTIGEN BASED, BE THEY THE DIRECT FLUORESCENT ANTIBODY TEST
OR THE DRIT, BY AND LARGE WE CAN GET A RAPID ANSWER IN ABOUT AN
HOUR. VERY COST EFFECTIVELY. AND SIMILARLY, UNLESS ONE IS
THINKING ABOUT SOME OF THE ADVANCED DIAGNOSTIC THAT ARE
USED FOR CERTAIN OTHER AGENTS, THE UTILITY OF EVEN LIGHT-BASED
MICROSCOPY IS IT’S AN ANATOMIIC BIOLOGIC DIAGNOSIS AS OPPOSED TO
A LIGHT OR BAND. WHEN WE LOOKED AT SOME OF THE
MORE RECENT POINT OF CARE DEVICES, THEY’VE NOT HAD THE
SENSITIVITY AND SPECFIT THAT WE’D LIKE — SPECFISITY THAT
WE’D LIKE TO SEE. IT COULD BE USEFUL FOR GROSS
SURVEILLANCE, BUT IN TERMS OF THE QUALITY, THE STANDARDS THAT
WE’VE RECENTLY RISEN TO, THERE DOESN’T SEEM TO BE ANYTHING IN
CURRENT DEVELOPMENT THAT’S GOING TO REPLACE EITHER THE
SENSITIVITY OR THE SPECFISITY, THE GOLD STANDARD, BE IT THE
DIRECT TEST OR THE DRIT TEST THAT YOU CAN USE IN THE FIELD
AND DON’T EVEN NEED ELECTRICITY FOR NOW. SO IT’S A MUCH NEEDED GOAL, BUT
ONE THAT WE HAVEN’T BEEN ABLE TO REALIZE AS OF YET. YES, MA’AM?>>ABIGAIL HUMPHRY. QUESTION FOR DR. SLATE. I’VE HEARD YOU PRESENT HALF A
DOZEN TIMES OVER THE LAST SEVERAL YEARS. I’M COMPLETELY FASCINATED THAT
WE DROP VACCINES OUT OF AIRPLANES. I THINK PASTEUR WOULD BE SO
PROUD. MY QUESTION IS IN REGARDS TO —
TO DOING SOME OF THE ORB CAMPAIGNS THAT YOU’VE DONE, WHAT
SORT OF COMMUNICATIONS DO YOU DO IN ADVANCE TO SEMI RESIDENTIAL
AREAS BEFORE VACCINE DROP OCCURS?>>YES, WE WORK WITH THE LOCAL
ENTITY AND USE OUR LEGISLATIVE AND PUBLIC AFFAIRS. AND WE’VE EVEN WORKED WITH CDC
TO GET THE MESSAGE OUT TO LET FOLKS KNOW THAT BATESITS ARE
GOING TO BE FALLING FROM THE AIR AND
TO NOT BE HANDLING THEM. IF THE DOG HAS ONE TRY TON TAKE
IT OUT OF ITS MOUTH. THAT’S THE MOST COMMON WAY THAT
A HUME SAN EXPOSED TO THE VACCINE — HUMAN IS EXPOSED TO
THE VACCINE. WE HAVE A COMMUNICATIONS PLAN TO
GET THE MESSAGE OUT. WE EVEN HAVE MEDIA DAYS WHEN THE
BAIT DROPS BEGIN. BRING THE MEDIA AND GET
TELEVISION COVERAGE AND THINGS OF THAT NATURE. SO IT’S KIND OF A DIVERSE, YOU
KNOW, COMMUNICATIONS PLAN TO GET THE MESSAGE OUT.>>MAYBE A SIGN OF SUCCESS THAT
IN FACT PEOPLE ARE LOSING INTEREST IN THE MEDIA ATTENTION
OF IT BECAUSE IT’S BECOMING ALMOST AS HAPPENSTANCE AS
VACCINATING YOUR DOG OR YOUR CHILD. SO PERHAPS THAT’S A
DEMONSTRATION OF SUCCESS THAT IT’S NO LONGER CONSIDERED
UNUSUAL OR BIZARRE FOR A CONCEPT THAT WAS BORN AT CDC 40 YEARS
AGO.>>HI, JENNIFER McKRISTEN AND
MCEZID. I THINK THE CURRENT NAME. VERY NICE PRESENTATION. AND I WAS REALLY INTERESTED IN
THE INFORMATION YOU PRESENTED ON BOTH INJECTABLE AND POTENTIAL
ORAL CONTRACEPTION FOR DOGS. AND GIVEN THAT DOG POPULATION
CONTROL CAN HAVE NUMEROUS PUBLIC HEALTH IMPACTS AND RIGHTLY
DRIVEN BY RABIES BUT ALSO FIELD DISEASES LOOIG SS BY TICKS AND
THINGS AFFECTED BY POPULATION CONTROL. I’M CURIOUS IF YOU HAVE AN
OPINION ABOUT HOW FAR WE ARE FROM HAVING A LICENSED ORAL OR
INJECTABLE CONTRACEPTIVE FOR DOGS IN THE UNITED STATES.>>WELL, I THINK THAT’S
OBVIOUSLY IDEAL AND VISION AIRARY. I THINK WE’RE A WAYS AWAY FROM
THAT. AS I MENTIONED, THE WORK GOING
ON IN MEXICO I THINK IS A VERY IMPORTANT PIECE OF WORK TO
DETERMINE IF IN FACT THE NEW FORMULATION OF GONACON WOULD BE
ACCEPTABLE TO USE IN MASS INJECTABLE CAMPAIGNS. AND DR. RUE HERE AT CDC HAS DONE
EARLY WORK AT ORAL DEVELOPMENT — DEVELOPMENT OF
ORAL DELIVERY. AND DR. MILLER AT THE NATIONAL
RESEARCH CENTER HAD CONSIDERATIONS. I THINK WE’RE A WAYS DOWNING THE
ROAD BEFORE — DOWN THE ROADS BEFORE ORAL DELIVERY. AND WE’D BE TALKING ABOUT ORAL
DELIVERY IN DOGS. FOR WILDLIFE, USE OF GONACON
WOULD BE INJECTABLE IF AT ALL BECAUSE OF THE — IT’S DIFFICULT
TO INTEGRATE THAT KIND OF THING INTO WILDLIFE POPULATIONS FROM A
POLITICAL PERSPECTIVE.>>THANK YOU ALL VERY MUCH FOR
ATTENDING, PARTICIPATING, AND THANKS TO OUR SPEAKERS. MAY I ASK YOU TO GIVE THEM ONE
MORE ROUND OF APPLAUSE. [ APPLAUSE ]
AND WE’LL SEE YOU SAME TIME, SAME PLACE IN FIVE WEEKS.

Author Since: Mar 11, 2019

  1. They're probably just counting U.S. Cases? Also, this was presented in January the second person who survived the protocol in the U.S. Got sick until May of this year. Although, I'm surprised they didn't mention the Texas girl who survived with no treatment at all in 2009 (that's a miracle).

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