Final Report (in Spanish, 55 pp, PDF, 638 Kb, with internal links to the chapters and to the corresponding presentations in Spanish, Portuguese, and English; below are links to the individual presentations available, in the language shown in the title, with other headings translated into English for user orientation)
Part I: Introduction
- Executive Summary (translated to right)
- Work Dynamic and Participants
Part II: Working Sessions
- Sesión de Apertura de OTCA (Opening Presentation by ATCO)
- Inaugural Presentation: A raiva no século XXI (Rabies in the 21st Century)
1. Epidemiological Situation of Human Rabies Transmitted by Vampire Bats
- Situación de la rabia humana transmitida por vampiros en América Latina (Situation of Human Rabies Transmitted by Vampire Bats in Latin America)
- Situação epidemiológica da raiva no Brasil: Ciclo silvestre (Epidemiological Situation of Rabies in Brazil: Wildlife Cycle)
- Situación de los brotes recientes en el Ecuador (Situation of Recent Outbreaks in Ecuador)
2. Risk Characterization of Rabies Transmitted by Vampire Bats
- Experiencias anteriores en la caracterización del riesgo de rabia humana transmitida por vampiros (Previous Experiences in the Risk Characterization of Human Rabies Transmitted by Vampire Bats)
- Modelo de risgo para circulação do virus da raiva em populações de herbívoros no Estado de São Paulo (Risk Model for the Circulation of the Rabies Virus in Herbivorous Populations in the State of São Paulo, Brazil)
- Caracterização de risco e controle da raiva dos herbívoros em São Paulo, Amazônia, Brasil (Risk Characterization and Rabies Control in Herbivores in São Paulo, Amazon Region, Brazil)
3. Pre- and Post-Exposure Rabies Prophylaxis Schemes in Jungle Areas
- Profilaxia da raiva humana: Recomendações da OMS para tratamento anti-rábico pré- y pós-exposição e esquemas para a Amazônia (Human Rabies Prophylaxis: WHO Recommendations for Pre- and Post-Exposure Anti-Rabies Treatment and Schemes for the Amazon)
- Raiva transmitida por morcegos: Recomendações, 2004 (Bat-Transmitted Rabies: Recommendations, 2004)
- Esquemas de tratamiento con vacunas y sueros para la región amazónica (Treatment Schemes with Vaccines and Sera for the Amazon Region)
- Profilaxis rábica en áreas de difícil acceso (Rabies Prophylaxis in Remote Areas Difficult to Access)
- Esquemas reducidos de profilaxis humana (Reduced Schemes for Human Prophylaxis)
4. Laboratory References
- Bats, Rabies, and Characterization
- Diagnóstico laboratorial como herramienta para la vigilancia y el control de la rabia: Aislados del virus rábico prevalentes en la Amazonía y el nordeste del Brasil (Laboratory Diagnostics as a Tool for Rabies Surveillance and Control: Isolates of the Rabies Virus Prevalent in the Amazon and in Northeastern Brazil)
- Antigenic and Genetic Studies of the Rabies Virus Isolated in Brazil
5. Local-Level Intersectoral and Interprogrammatic Activities
- Coordenação da Raiva dos Herbívoros e das EETs (Coordination of Rabies in Herbivores and EETs)
- Ações conjuntas do MAPA, AGED-MA, MS e SES/MA nos focos de raiva no Maranhão em 2005 (Joint MAPA-AGED-MA, MS, and SES/MA Activities in Rabies Foci in Maranhão, Brazil, in 2005)
- Surto de raiva humana transmitida por morcegos hematófagos no noroeste maranhense (Outbreak of Human Rabies Transmitted by Vampire Bats in Northwestern Maranhão, Brazil)
- Situação posterior ao surto de raiva por morcegos hematófagos no Estado de Pará, Brasil (Post-Outbreak Situation of Rabies Transmitted by Vampire Bats in Pará State, Brazil)
- Intersectoral Activities in Localities in Ecuador Affected by Rabies Transmitted by Vampire Bats
6. International Cooperation and the Amazon Challenge of Preventing Rabies Transmitted by Vampire Bats
- El desafío amazónico: organizaciones nacionales y multilaterales de cooperación en la Amazonía (The Amazon Challenge: National and Multilateral Cooperation Organizations in the Amazon)
- Globalização e desenvolvimento: Ferramentas para construção de uma agenda estratégica (Globalization and Development: Tools for Constructing a Strategic Agenda)
- Acciones intersectoriales e interagenciales en la región (Intersectoral and Interagency Activities in the Region)
- Las enfermedades de los animales y el comercio internacional: el rol de la Organización Mundial de Sanidad Animal (Animal Diseases and International Commerce: The Role of the World Organization for Animal Health)
- Recommendations, by Topic
a. Surveillance and Risk Characterization
b. Anti-Rabies Prophylaxis in Jungle Areas
c. National and Local Intersectoral Activities
d. Technical Cooperation between Agencies and Countries
e. Recommendations Presented by More than One Group
- Final Comments
Part III: Annexes
Annex 1: Committees
Annex 2: Agenda
Annex 3: List of Participants
Annex 4: Consideration on the Prevention, Control, and Epidemiologic Surveillance of Vampire Bat-Transmitted Rabies in Man in the Americas: Report of the 1991 PAHO Consultation on Bat-Transmitted Rabies
Annex 5: Projeto Morcego: Ações de controle da raiva humana transmitida por morcegos (Bat Project: Control Actions for Human Rabies Transmitted by Bats: Report of the Consultation on Bat-Transmitted Rabies organized by the Ministry of Health of Brazil in 1991; in Portuguese)
Annex 6: Summary of the Technical Meeting to Evaluate the Epidemiological Situation of Rabies in Brazil, with Emphasis on Bat-Transmitted Rabies (Ministry of Health of Brazil, Brasilia, 30 June – 2 July 2004; in Spanish)
- Report (Working Document, in Spanish)
- Zoonoses / Animal Health
- Veterinary Public Health Unit
- Pan American Center for Foot-and-Mouth Disease (PANAFTOSA)
Epidemiological Surveillance System for Rabies (SIRVERA)
Virtual Library in Veterinary Public Health (VHL)
WHO: Human and Animal Rabies
Although the efforts of the countries of the Americas have produced excellent results in controlling human rabies transmitted by dogs—bringing about a reduction in approximately 95% of all human cases thus originated—cases due to vampire bats have increased considerably. In 2004, for the first time in the history of the Regional Program for Rabies Elimination coordinated the Pan American Health Organization (PAHO), the number of human rabies cases transmitted by wildlife was greater than the number transmitted by dogs (Schneider, 2005). In 2005, this trend became clearly manifest when 51 cases of bat-transmitted human rabies were reported, in contrast to 11 dog-transmitted human rabies cases (Regional Information System for the Epidemiological Surveillance of Rabies in the Americas [SIRVERA/PAHO], 2006). Most of the cases transmitted by vampire bats occurred in the Amazon region, which includes territories from the eight countries participating in the Amazon Cooperation Treaty Organization (ACTO).
With the goal of discussing the topic of rabies transmitted by vampire bats in the Amazon Region, PAHO, ACTO, the Inter-American Institute for Cooperation on Agriculture (IICA), the Ministry of Health (MS) of Brazil and the Ministry of Agriculture, Livestock and Supply (MAPA) of Brazil held the Expert Consultation on Rabies Transmitted by Vampire Bats in the Amazon Region, on 10–11 October 2006, at the PAHO Country Office in Brasilia, Brazil.
The objectives of the Consultation were as follows:
- Review the experiences to date in this territory and generate recommendations to support the countries in the Amazon region that are at risk of outbreaks or cases of human rabies transmitted by vampire bats.
- Stimulate interinstitutional collaboration for the prevention and control of outbreaks of this disease.
- Establish partnerships for technical cooperation among the Amazon countries.
A total of 76 participants attended the meeting, including professionals from the health sector who represented seven of the countries and technical personnel from the agricultural sector of agriculture from four the countries. Others were national and international experts in matters related to the topic of the meeting—for example, the Centers for Disease Control and Prevention (CDC) of the United States—and representatives of state and municipal governmentes where cases of human rabies transmitted by vampire bats have been reported. In addition to staff members from the international organizations in charge of the meeting, delegates were present from the World Organization for Animal Health (OIE), the Oswaldo Cruz Foundation (FIOCRUZ / Ministry of Health, Brazil), and such nongovernmental organizations (NGOs) as the World Society for the Protection of Animals (WSPA) and the Latin American Association for Wildlife Conservation and Management, as well as members of the National Council of Municipal Health Secretariats (CONASEMS) of Brazil.
The program was planned so that it allowed for expeditious interaction among international researchers and experts and authorities responsible for controlling local outbreaks, as well as the full involvement of representatives of national and international, governmental and nongovernmental organizations. The agenda included expert presentations and panels followed by discussion and working groups who reviewed the selected subjects and prepared recommendations subject to general discussion.
As a result, the following recommendations were approved and submitted in the plenary sessions:
- Strategies should be adopted so that people attacked by bats receive post-exposure treatment in accordance with WHO technical standards. In remote areas with difficult access to health services, where many of the assaults on people are registered, pre-exposure treatment is recommended.
- Research should be promoted on regimens to facilitate the logisitics of applying the rabies prophylaxis.
- Local activities should be promoted in the areas of health education and control of bat populations, in an attempt to have both the projects and the activities respect local cultures and involve local communities and their leaders.
- Commissions should be created at the central and local levels that are part of the health, agricultural, educational, and environmental sectors, so that they might formulate broad and coordinated local strategies in which the functions and responsibilities of each participant are clearly indicated.
- The countries of the Amazon region should prepare agreements and projects on this subject, given the importance both for public health and for the economy of human rabies transmitted by vampire bats.
- Rabies programs and rabies control measures should be strengthened at all levels. PAHO/WHO is asked to act as advocate for this issue with the ministries of health and agriculture, in an effort to point out the urgency of taking action against human rabies transmitted by vampire bats.
During the sessions, participants viewed a video (DVD) on rabies transmitted by vampire bats, entitled Rabies and Vampire Bats, which was produced by PAHO and the Government of Mexico, with support from the Governments of Brazil and Peru. In addition, technical personnel involved in the prevention and control of bat-transmitted rabies were given a CD-ROM with a bibliography on the subject of the consultation.
Photos courtesy of Dr. Cristina Schneider, PAHO/WHO Veterinary Public Health Unit