Elimination of human rabies in Goa, India through an integrated One Health approach

Dog-mediated rabies kills tens of thousands of people each year in India, representing one third of the estimated global rabies burden. Whilst the World Health Organization (WHO), World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) have set a target for global dog-mediated human rabies elimination by 2030, examples of large-scale dog vaccination programs demonstrating elimination remain limited in Africa and Asia. We describe the development of a data-driven rabies elimination program from 2013 to 2019 in Goa State, India, culminating in human rabies elimination and a 92% reduction in monthly canine rabies cases. Smartphone technology enabled systematic spatial direction of remote teams to vaccinate over 95,000 dogs at 70% vaccination coverage, and rabies education teams to reach 150,000 children annually. An estimated 2249 disability-adjusted life years (DALYs) were averted over the program period at 526 USD per DALY, making the intervention ‘very cost-effective’ by WHO definitions. This One Health program demonstrates that human rabies elimination is achievable at the state level in India

Leptospirosis in the Asia Pacific region

<p>Abstract</p> <p>Background</p> <p>Leptospirosis is a worldwide zoonotic infection that has been recognized for decades, but the problem of the disease has not been fully addressed, particularly in resource-poor, developing countries, where the major burden of the disease occurs. This paper presents an overview of the current situation of leptospirosis in the region. It describes the current trends in the epidemiology of leptospirosis, the existing surveillance systems, and presents the existing prevention and control programs in the Asia Pacific region.</p> <p>Methods</p> <p>Data on leptospirosis in each member country were sought from official national organizations, international public health organizations, online articles and the scientific literature. Papers were reviewed and relevant data were extracted.</p> <p>Results</p> <p>Leptospirosis is highly prevalent in the Asia Pacific region. Infections in developed countries arise mainly from occupational exposure, travel to endemic areas, recreational activities, or importation of domestic and wild animals, whereas outbreaks in developing countries are most frequently related to normal daily activities, over-crowding, poor sanitation and climatic conditions.</p> <p>Conclusion</p> <p>In the Asia Pacific region, predominantly in developing countries, leptospirosis is largely a water-borne disease. Unless interventions to minimize exposure are aggressively implemented, the current global climate change will further aggravate the extent of the disease problem. Although trends indicate successful control of leptospirosis in some areas, there is no clear evidence that the disease has decreased in the last decade. The efficiency of surveillance systems and data collection varies significantly among the countries and areas within the region, leading to incomplete information in some instances. Thus, an accurate reflection of the true burden of the disease remains unknown.</p

Incidence of Wound Infection after cholecystectomy with or without appendicectomy

From the 1st of September 1978 to the end of August 1979 one hundred and one patients undrewent laprotomy for gall-stones and gall-bladder diseases in the Department of Surgery, Bir Hospital, All operations were performed by one team. Among-them seventeen were males (16.8%) and eighty four females (83.2%). Cholecystectomy and appendicectomy were performed in fortyseven patients, among them nine patients underwent choledochotomy as well. Postoperative wound infection after cholecystectomy. cholecystectomy with choledochotomy and removal of the gall bladder with appendicectomy was 5.9, 10 and 10.6 percent respectively. Despite high incidence of wound sepsis after biliary surgery with appendicectomy the later procedure is advocated during routine cholecystectomy, because there are very few hospitals in Nepal where facilities for laparotomy exist, and review of English literature has revealed a number of references to concomitant cholecystic - appendiceal disease. These reports refer to the high incidence of unsuspected pathological process within the appendex as a indication for its removal at the time of elective cholecystectomy

The Epidemiology of Human Rabies Post-Exposure Prophylaxis in Kathmandu Valley, 1992-1996

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An overview of transboundary animal diseases of viral origin in South Asia: What needs to be done?

SIMPLE SUMMARY: The Transboundary Animal Diseases (TADs) are highly transmissible epidemic diseases of livestock which have the capability for rapid spread to new areas and regions regardless of national borders. The TADs are a major threat to livestock of any nation as they have the potential to cause large-scale damage, staking the food security of the country, and can cripple the nation’s economy significantly by direct loss in the form of disease conditions and deaths in affected population or indirectly due to required counter epizootic measures, loss in trade and probable zoonotic transmission. South Asian countries are more vulnerable to the introduction of Transboundary Animal Diseases (TADs) because people continue to move commodities and animals across borders. In addition to South Asian countries, TADs like Peste des Petits Ruminants, Avian Influenza, Foot-and-Mouth Disease, Lumpy Skin Disease and African Swine Fever are generating significant economic losses worldwide. Livestock diseases can result in significant losses for farmers’ subsistence and have a negative impact on the nation’s economy. The existing policies need a review in the light of recent understanding of drivers of emergence and re-emergence of transboundary animal diseases. Hence, there is a need for a critical review of the existing policies that regulate the preparedness for the prevention of TADs. Rapid diagnosis, surveillance, immunisation, and coordination among all the South Asian countries. The present study focuses on the state of several TADs in South Asia and provides plans of action and suggestions that the scientific community and authorities on animal health might implement. ABSTRACT: Transboundary animal diseases (TADs) pose a serious threat to the sustainability and economic viability of the existing animal agriculture ecosystem in south Asia. The rapid spread of African swine fever and lumpy skin diseases in south Asia must be considered a wake-up call to prevent the entry, spread, and establishment of new exotic TADs, as south Asia has the highest density of livestock populations, and it will have a huge socioeconomic impact. Regional cooperation for the prevention and control of TADs is necessary, but rational decisions should be made to initiate even sub-regional cooperation in the present geopolitical situation. Cross-border collaboration for surveillance, early warnings, and animal movement control should be encouraged on a bilateral or multilateral basis as many countries share a porous border. Foot-and-mouth disease (FMD), peste des petits ruminants (PPR), and avian influenza (AI) have been identified as regional priority TADs, and many regional and country initiatives have been undertaken in the last two decades that need to be translated into action. The incursion of exotic TADs into south Asia has compelled us to rethink overall policies and strategies for prevention and control of TADs. This paper took into consideration six emerging and endemic TADs of viral origin to suggest a future course of action

The Middle East and Eastern Europe rabies Expert Bureau (MEEREB) third meeting: Lyon-France (7–8 April, 2015)

MEEREB is an inter-regional network of countries from North Africa, Europe, the Middle East and Central Asia that work together with the aim of improving rabies control and prevention at local, regional and global level. MEEREB members met for the third time in 2015 in France (Lyon) to review the current rabies situation within the network and to discuss the way forward the prospect of a One Health approach against rabies. Dogs were the main vector of transmission in all MEEREB countries except for Croatia and Serbia where foxes represented the primary source. The number of rabies animal cases reported in 2014 varied substantially between countries with Ukraine reporting the highest number of animal cases. Human cases still occur in North Africa and all Middle East and Eurasian countries while no cases of human rabies were reported in Croatia, Serbia and Romania, although cases of rabies were identified in both dogs and foxes in 2014. Participants concluded that MEEREB can act as a think-tank where countries can share data, information, experiences and best practices to jointly address challenges in rabies control and prevention. They called for elimination of dog-transmitted rabies through vaccine and rabies immunoglobulin stockpiles and implementation of a One Health approach to achieve rabies’s eradication. Keywords: MEEREB, Rabies, Epidemiology, Repor