Successful rabies elimination Examining options for mitigating rabies in cattle in Bhutan: Policy perspective Authors: Sangay Rinchen1, Tenzin2 , David Hall1, Susan Cork1 Introduction Pictorial depiction of rabies in Bhutan Rabies is a fatal viral zoonosis responsible for ~ 59000 human deaths and massive economic losses globally a 95% of human fatalities are reported from Asia and Africa and 99% are dog mediated b Rabies, once endemic across Bhutan, is now restricted only to the southern parts of the country Bhutan is a small Himalayan country located in Asia, where 70% of the population (est.750,000) depend primarily on Agriculture. Livestock diseases thus remains potential threat to livelihood of poor farmers In the south, about 16 outbreaks in dogs annually with spill over to cattle and other livestock c Control of rabies along the border with India (south and North East) remains difficult due to the free movement of animals Rabies control measures in dogs have been successful but currently no measures are advocated for cattle and other livestock Fig.1 Bhutan map showing the rabies endemic areas with number of outbreaks from 2012-2015 Fig. 2 Typical rabies transmission cycle between dogs and livestock in Southern Bhutan. The picture also depicts the impact of rabies on livestock farmers and the public health. Sylvatic cycle is not reported till date in Bhutan. Recommendations Enhance vaccination coverage in dogs Foster cross border collaboration program on rabies control Advocate, adopt and enhance cross-sectorial collaboration Community empowerment and engagement in rabies control program Stringent implementation of responsible pet ownership, animal transportation and import regulations and enhance identification and traceability Enhance surveillance system (communication at all level) Assess sustainable control measures through economic and policy assessments Enhance awareness on rabies (general public and specific population of interest) Community engagement Problem statements Awareness/education Effective policy Successful rabies elimination Regional cooperation Enhanced control at source surveillance Awareness/education Rabies in cattle has remained a potential public health concern due to peoples close association and dependence on them for their livelihoods The loss of cattle to rabies has significant impacts on the livelihoods of cattle farmers Rabies in animals poses potential threat of disease translocation to rabies free areas The cost on Government for providing free Post exposure prophylaxis has been escalating annually Materials and method Preliminary Qualitative risk assessment was carried out supported by available literature, un-published articles and government data Likelihood of cattle and dogs (main reservoir) contracting rabies in endemic areas was assessed Likelihood of rabies translocation into areas considered free of rabies was assessed Planned course of actions Economic feasibility cattle vaccination Risk assessment Assessment of knowledge attitude and Practice Economic analysis of vaccinating cattle against rabies in rabies high risk areas of Bhutan Assessing the Knowledge attitude and practice of dairy farmers Qualitative risk assessment of risk to the animals in the southern region and the risk of incursion in to the northern territories. Findings of the preliminary risk assessment There is significant likelihood of cattle in endemic area contracting rabies Translocation of rabies through human associated movement of cattle is high threatening public health The likelihood of rabies incursion to rabies free areas of Bhutan remains of concern through movement of animals, particularly dogs. These likelihoods are contingent to effectiveness of rabies control at the source, surveillance system, movement control regulation and awareness level among public Success of rabies control in cattle would depend on effective control at source and applying measures to break the chain of disease transmission (eg. Vaccination, good farm practices, imparting awareness to dairy farmers and dog owners) References and Acknowledgements References: a Hampson et al., 2015 b Bourhy, Dautry-Varsat, Hotez, & Salomon, 2010 c National Centre for Animal Health-Notifiable disease report, 2014 Acknowledgements: 1. Department of Ecosystem and Public Health, University of Calgary 2. Department of Livestock, Ministry of Agriculture and Forests, Bhutan Footnotes 1 Department of Ecosystem and Public Health, University of Calgary, Canada 2 National Centre for Animal Health, Thimphu Bhutan sangay.rinchen@ucalgary.ca sccork@ucalgary.ca (Supervisor)