Diapositiva 1

1
SAPUVETNET
Case StudyVenezuelan Equine Encephalitis Outbreak

• Animal and public health

Adittional material Encefalitis equinas en
salud pública book
2
SAPUVETNET
In memoriam To the valuable contribution of Dr.
Jaime Cardenas (R.I.P.) PAHO/WHO Colombian
veterinary Public health adviser
3
SAPUVETNET
Antecedents

• 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

4
SAPUVETNET
Outbreak evolution

• 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).

5
SAPUVETNET
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
6
SAPUVETNET
Outbreak investigation
About what diseases would you think? Make a
list of them and indicate the most probable
ones.
7
SAPUVETNET
Outbreak investigation

• About what diseases would you think?
• 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.

8
SAPUVETNET
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?
9
SAPUVETNET
Diagnosis

• 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

• 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 pre-established
  plans of contingency.

10
SAPUVETNET
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..
11
SAPUVETNET
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

12
SAPUVETNET
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
lcvillamilj_at_unal.edu.co, redspvet_at_yahoo.com.ar)