September 2018 Rabies Elimination in Tunisia  
     
 
 
 
 
   
 

Tunis, 28 September 2018. Rabies is a major zoonosis that affects the central nervous system of warm-blooded mammals. Africa and Asia record over 95% of fatal cases of rabies worldwide. Dogs are the main source of rabies infections and children the main victims of the disease. Mass vaccination of dogs is the most appropriate way to control and eliminate the disease at the animal source, in order to interrupt the infectious cycle of the disease from animals to humans.

FOCUS ON TUNISIA
Tunisia is the smallest country in the North African Region. It shares borders with Algeria to the west and Libya to the southeast, and abuts the Mediterranean Sea. The country covers an area of about 160,000 km˛ and has a Mediterranean coastline of 1,300 km. It comprises 24 Governorates and the population is estimated at around 11 million, with more than 65% living in urban areas. Rabies is endemic in Tunisia and cases are reported all over the country with an average per year of about 200 animal and 3-4 human cases.

A recent paper entitled “Review of rabies situation and control in the North African region with a focus on Tunisia” was published in December 2017.

Table recording animal and human cases from 1992 to 2017:

ECONOMIC IMPACT
The overall annual costs for Post-Exposure Prophylaxis (PEP) are on average about USD 1.7 million. The cost of purchasing the animal vaccine is about USD 150.000 annually. It should be added economic losses such as livestock victims, elimination infected carcasses, diagnostic and human resources. PREVENTIVE AND POST-EXPOSURE HUMAN VACCINATION Between 1.000 and 1.500 people are treated with preventive vaccination (veterinarians, vaccinators, technicians in the laboratory). About 40.000 persons are treated each year for PEP. NATIONAL STRATEGY The National Strategy to fight rabies has been developed since 1982 through a specific regulation. Three ministries are involved through specific activities. Below the image that shows their tasks:

The annual mass dog vaccination was launched in 1993 and continued as of today. About 200 permanent vaccination centers were established in the country. On average, around 400.000 dogs are vaccinated annually.

MAJOR CHALLENGES ENCOUNTERED OVER THE PAST YEARS

  • Lack of coordination between Ministries;
  • Lack of security;
  • Mismanagement of waste;
  • Increase of the number of stray dogs over the years;
  • Low degree of awareness of the population.
  • An increase of animal cases was registered from 2011 onward and, therefore, the Veterinary Authority has undertaken specific activities on the following fields:

  • Communication;
  • Vaccination;
  • Management of stray dogs.
  • In addition, the Veterinary Services applied a complete review of the national strategy in order to better address the activities and the target of the dog population.

    Communication

  • Activities in the schools, hypermarkets, shopping centers and also in rural areas;
  • Celebration of the World Rabies Day with dedicated actions in the country;
  • Launching of a website about rabies developed by the National Commission for fighting rabies:
  • Posters, TV and radio spots.
  • Some pictures referring the communication activities conducted by the Tunisian Veterinary Services are reported below.

    Vaccination
    The General Directorate of the Tunisian Veterinary Services has applied to the OIE for obtaining a vaccine donation from OIE vaccine bank - The OIE responded positively and Tunisia received 3 donations. These donations were made through the OIE vaccine bank with European Union funding:
    o 80.000 doses in 2016
    o 200.000 doses in 2017
    o 300.000 doses in 2018
    - Creation of 2 centers for vaccination (veterinary school and municipality of Tunis);
    - Reinforced vaccination of animals in tourist centers.

    However, the major challenge for doing vaccination is to catch aggressive dogs.

    Management of stray dogs
    To address this issue, the Tunisian Veterinary Services requested the OIE support. Two learning workshops (May and September 2017) dedicated to the management of the stray dog population (mainly focused on capture techniques) were organised by the Veterinary Authority and the Municipality of Tunis in collaboration with the OIE Sub-Regional Representation for North Africa.

    As a result, it was created the first permanent municipal center for sterilisation and vaccination of stray dogs.

    CONCLUSIONS
    A new dynamic in fighting rabies in Tunisia has started in the recent past years by involving key partners including also the OIE Reference Laboratory for rabies based in France (Nancy). A reinforced strategy against rabies is being developed through the increase of political willingness, citizen awareness and better intersectoral actions and collaboration between Ministries, which lead to consider that “Zero Human Cases” by 2030 is feasible in the country

    Article submitted by Alessandro Ripani: Programme Officer - OIE Sub Regional Representation for North Africa, Tunis, Tunisia
    Kaouther Oukaili: Directorate General of Veterinary Services in Tunisia: Animal Health coordinator of the national rabies elimination programme

     
     

    All pictures © Directorate General of Veterinary Services of Tunisia 2018, except where mentioned otherwise.

     
     

     
     
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