Transcript Diapositiva 1

Case Study
Venezuelan Equine Encephalitis Outbreak
• Animal and public health
Adittional material:
“Encefalitis equinas en salud pública”
book
In memoriam
To the valuable contribution of Dr. Jaime
Cardenas (R.I.P.)
PAHO/WHO Colombian veterinary Public
health adviser
Antecedents
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The events happen in Northern South
American countries with coasts on the
Caribbean Sea and a wide border zone.
In the border region of the neighboring
country (A), the animal health services
notified, during May an equids febrile disease
event (equines, asnals and mules), with fast
diffusion towards other localities. An
indigenous group that inhabits that border
zone, notified cases in its asses.
By those time this ethnic group makes an
annual trip to the neighboring country (B), to
make marine salt harvesting activities
Outbreak evolution
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Towards the end of July, on the other side of the border (country B),
the animal health authorities, notified the presence of an outbreak of
febrile disease with nervous signs in equids. During that month a
transition between the rains season and the dry station happened, flood
zones persisted and strong vectorial activity: Ochlerotatus (Aedes)
taeniorhynchus; entomological research were carried out, to evaluate
the population density of several species of mosquitoes, revealing a high
density of Ochlerotatus taeniorhynchus, Psorophora confinnis; Culex
quinquefasciatus, Anopheles spp, Culex spp and Deinocerites pseude1
adults and larvae.
Between the 8 and the 16 of September, the health services notified an
increase in the number of clinical consultations for febrile disease
compatible with classic dengue. An attack rate greater than 60 % was
found (febrile picture).
¿Do you think there is any relation between the
cases of humans and animals?
According to your criteria what would be the basis to
justify that relation.
Consider the period of time, the subjects involved
and the areas where the facts happened
Outbreak investigation
About what diseases would you think?
Make a list of them and indicate the most probable
ones.
Outbreak investigation
About what diseases would you think?
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Rabies, arbovirus encephalitis (Japanese encephalitis,
EEE, WEE, West Nile encephalitis, Saint Luis
encephalitis y Murray Valley encephalitis , among
others), viral equine rhinoneumonitis, infectious
equine anemia, pseudo rabies, African equine plague,
maindrain virus, borna disease;
Tetanus, botulism, intoxication with heavy metals,
hepatogenic encephalopathy because of toxic plants;
Equine Mielopathy;
Parasitary diseases because of nematodes, babesiosis,
tripanosomiasis and toxoplasmosis.
With this information,
How would you make the diagnosis?
What samples would you take?
¿ How
would you send the samples?
How would you interpret the results?
Diagnosis
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While you are waiting the
results, what actions World
you take?
In humans, the report of the
sanitary authorities was:
22.900 cases
1.200 hospitalizations
Dissemination rate 5 km/Day
Increase in the number of
abortions/Month
3000 neurologically affected
cases
300 associated deaths
Isolation of EEV virus subtype
1C
Most affected ethnic group:
Wayuú
Source: Reyes, M., Villamil, L., De la
Hoz, F., 2006
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The report in animals was:
137 affected farms
38 with diagnose of Venezuelan
equine encephalitis (by laboratory)
12 with diagnose of east equine
encephalitis (by laboratory)
87 with clinical diagnose
Given the rapidity with which the
epidemics and epizootics of VEE
are scattered in the different
geographic areas, an intervention
of effective emergency is
required; once a center of EEV is
characterized in the zone, the
actions of center control are
made, by means of preestablished plans of contingency.
Which is your role as veterinarian in public health?
What actions must be taken? Think on the
intersectorial cooperation. Discuss it
Give attention to the intersectorial cooperation,
the comunicattion, the animal movement control,
the vaccinations program, the epidemiologic
surveillance systems, the vector control and the
community participation..
BIBLIOGRAPHY
•Brito, E. Encefalitis Equina - Relatoría. Simposio Internacional "Salud Pública Veterinaria, Protección
Sanitaria y Desarrollo Agropecuario". Bogotá, Colombia. 2002.
•Brito, E. Situación de la Encefalitis Equina Venezolana en Colombia. Simposio Internacional "Salud Pública
Veterinaria, Protección Sanitaria y Desarrollo Agropecuario". Bogotá, Colombia. 2002.
•Cárdenas, J. Las Encefalitis Equinas causadas por virus transmitidos por artrópodos, esfuerzos para su
prevención y control. Simposio Internacional "Salud Pública Veterinaria, Protección Sanitaria y Desarrollo
Agropecuario". Bogotá, Colombia. 2002.
•Centres for disease Control and Prevention, Departamento de salud y servicios humanos, bioseguridad en
laboratorios de microbiología y biomedicina, 4th Edition, Ver:
http://www.cdc.gov/od/ohs/pdffiles/bmbl4_spanish.pdf
•Dora, F. Encefalitis Equina en Venezuela. Simposio Internacional "Salud Pública Veterinaria, Protección
Sanitaria y Desarrollo Agropecuario". Bogotá, Colombia 2002.
•Ferro, C.; Boshell, J.; Weaver, S.; et al. Natural Enzootic Vectors of Venezuelan Equine Encephalitis Virus,
Magdalena Valley, Colombia. Emerging Infectious Diseases, Vol 9, N° 1, Enero 2003.
•López, E. Encefalitis Equinas en Centro América. Simposio Internacional "Salud Pública Veterinaria,
Protección Sanitaria y Desarrollo Agropecuario". Bogotá, Colombia. 2002.
•Mejía, F. Epidemiología de la Encefalitis Equina Venezolana en Colombia. Universidad Nacional de
Colombia. Bogotá D.C. 2002.
•Mesa FA., Cárdenas J., Villamil L.C. Las encefalitis equinas en la salud pública. Universidad nacional de
Colombia. ISBN 958 701 598 3. 123pp. 2005
•OPS / OMS. Brote de Encefalitis Equina Venezolana 1995. Epidemiological Bulletin. Vol. 16, No. 4 .
Diciembre 1995.
•Rivas, F; De la Hoz, O.; Boshell, J.; Olano, V; Roselli, D; et al. Epidemic Venezuelan Equine Encephalitis in
La Guajira, Colombia, 1995. The Journal of Infectious Diseases, 175: 828-32, 1997.
•Ruiz, A.; Zúñiga, I.; Álvarez, E. Bases Para la Instrumentación de un Sistema de Información y Vigilancia
Epidemiológica de la Encefalitis Equina Venezolana en la Región de las Américas. Organización
Panamericana de la Salud. OPS/HCP/HCV/96.24
•SANINET. Encefalomielitis Equina Venezolana. www.iica.saninet.net
Acknowledgement
To the valuable contribution of Dr. Jaime Cardenas (R.I.P.),
PAHO/WHO Colombian veterinary Public health adviser and Dr.
Fabio Mesa D from the ICA Colombian Risks Office.
Case study developed by the members of RED SPVET, Universidad Nacional de
Colombia y SAPUVETNET II – (contact: Luis Carlos Villamil J, E-mail:
[email protected], [email protected])