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Rickettsiosis in the Americas Final Report

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Rickettsiosis in the Americas Final Report PAHO/WHO EXPERTS CONSULTATION ON RICKETTSIOSIS IN THE AMERICAS FINAL REPORT Ouro Preto, Minas Gerais – Brazil 18-19 September 2004 DISEASES PREVENTION AND CONTROL AREA Veterinary Public Health Unit – PAHO/WHO Pan American Foot-and-Mouth Disease Center PAN-AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 1 PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 2 PAHO/WHO EXPERTS CONSULTATION ON RICKETTSIOSIS IN THE AMERICAS Final Report Ouro Preto, Minas Gerais, Brazil 18-19 September 2004 DISEASES PREVENTION AND CONTROL AREA PAN-AMERICAN FOOT-AND-MOUTHVeterinary Public DISEASE Health CENTER Unit – –Veterinary PAHO/WHO Public Health Unit – PAHO/WHO Pan American Foot-and-Mouth1 Disease Center PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 2 TABLE OF CONTENTS 1. Background ............................................................................................................................................ 7 2. Objectives of the Consultation ............................................................................................................... 7 2.1 General............................................................................................................................................. 7 2.2 Specific............................................................................................................................................. 7 3. Place and Agenda .................................................................................................................................. 7 4. Participants............................................................................................................................................. 8 5. Development of the Consultation .......................................................................................................... 8 5.1 Opening and historical background ................................................................................................. 8 5.2 Presentations on specific themes.....................................................................................................10 6. Recommendations..................................................................................................................................10 6.1 Recommendations for the countries ................................................................................................10 6.2 Recommendations for PAHO/WHO .................................................................................................11 Appendix 1 - Presentations ........................................................................................................................13 Appendix 2 - Participants............................................................................................................................45 PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 3 PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 4 PREFACE Zoonoses represent a serious threat to the health and welfare of the entire world’s population. Several genera and species of the Rickettsiaceae family maintain zoonotic cycles in nature, which represent a great menace to public health because they are agents of malignant fever, typhus fever and scrub typhus in vast areas of the countries in the Americas. Fortunately, these countries have professionals who made significant contributions to the knowledge of such illnesses, and who have provided most effective and efficient alternatives for monitoring, controlling and preventing them. PAHO brought together a group of such experts to analyze the current situation and to implement mechanisms for the improvement and dissemination of knowledge and progress attained in diagnosis, surveillance, prevention and control of Rickettsiosis. The panel produced a set of recommendations and working documents, which are presented here, to serve as an input and a stimulus for actions to protect the people who are exposed to such illnesses. ALBINO BELOTTO Chief of Veterinary Public Health Unit - PAHO/WHO Pan American Health Organization World Health Organization PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 5 PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 6 PAHO/WHO EXPERTS CONSULTATION ON RICKETTSIOSIS IN THE AMERICAS BACKGROUND Several genera and species of the Rickettsiaceae family have zoonotic cycles in nature, representing a great threat to Public Health. Rickettsial type bacteria are most frequently transmitted by ectoparasites. International trade, tourism, and migration are among the factors contributing to the reintroduction of infectious agents, unknown in the areas where the disease did not exist. Microorganisms of the rickettsial type are grouped in spotted fevers, typhus and scrub typhus, being a public health problem in the various countries in the American continent. OBJECTIVES OF THE CONSULTATION General Gather specialists on the theme aiming to increase awareness and generate recommendations to the countries of the Americas. Specific Discuss and update technical and scientific information on Rickettsiosis. Review the situation of Rickettsiosis in the Americas. Analyze the impact of Rickettsiosis on humans and animals, and also its social and economic impact. Establish an epidemiological surveillance network. Prepare recommendations for the countries of the region. PLACE AND AGENDA The meeting was held in the conference hall of the Estalagem Hotel in the city of Ouro Preto, State of Minas Gerais, Brazil, on 18-9 September 2004. PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 7 AGENDA Saturday, 18 September 08:30 - 09:00 Registration of participants 09:00 - 09:30 Inauguration 09:30 - 10:00 Theme 1: Rickettsiosis as a Public Health Problem in South America Speaker: Dr. Márcio Antônio Moreira Galvão - Brazil 10:00 - 10:30 Theme 2: Current Situation and Trends of Rickettsiosis in the Americas Speaker: Dr. David H. Walker – United States 10:30 - 11:00 Recess 11:00 - 11:30 Theme 3: Tick-borne Disease in Humans Speaker: Dr. Luis Jacintho da Silva - Brazil 11:30 - 12:00 Theme 4: Rickettsiosis Research: Diagnosis and Advances Speaker: Dr. Elba Lemos - Brazil and Dr. Donald Bouyer – United States 12:00 - 12:30 Theme 5: Prevention and Control of Rickettsiosis in Peru Speaker: Dr. Elizabeth Irene Anaya Ramírez – Peru 12:30 - 14:00 Lunch 14:00 - 17:00 Working Groups Group 1 (Research and Diagnosis) Group 2 (Control and Prevention) Sunday, 19 September 09:00 - 10:00 Presentation and discussion of activities of Group 1 10:00 - 11:00 Presentation and discussion of activities of Group 2 11:00 - 11:30 Recess 11:30 - 12:30 Conclusions and Recommendations PARTICIPANTS Guest specialists and Pan American Health Organization/World Health Organization (PAHO/WHO) (see Appendix 2) DEVELOPMENT OF THE CONSULTATION Opening and historical background At the opening, Dr. Márcio Antonio Moreira Galvão, Head of the Dean’s Office of the Federal University of Ouro Preto, on behalf of the University’s Dean gave a welcome speech and presented a summary of the exchange of Rickettsiosis scientific information and research among scientists from several countries of the PAN AMERICAN FOOT-AND-MOUTH DISEASE CENTER – Veterinary Public Health Unit – PAHO/WHO 8 Americas, under the leadership of Dr. David H. Walter, of the Center for Biodefense and Emerging Infectious Diseases of the University of Texas. He highlighted the importance of the cooperation of PAHO and noted that this was not the first meeting on the subject because in 1986 PAHO/WHO gave support to the holding of the first national meeting on the topic, since then Brazil began to deal with the problem. The second presentation was made by Professor Dr. Luiz Jacinto da Silva, Superintendent of Endemics Control – SUCEN, Department of Health of the State of São Paulo, Brazil. Dr. Luiz Jacinto emphasized that this technical consultation represents the end of one stage and the beginning of new phase of cooperation, integration, incorporation, formation of human resources and collaboration of health ministries in dealing with these diseases in their working schedules. He recalled that in 1981, Rickettsiosis were included in the list of mandatory reporting diseases in the State of Minas Gerais, thanks to the effort made by Dr. Márcio Galvão. It took place in São Paulo in 1985. He pointed out that, after this consultation, the “XIII Veterinary Parasitology Congress and I Latin American Rickettsiosis Symposium” would start, which means a great advance. He ended his intervention by stressing his hope that at the end of the conference, recommendations for the countries and for the Pan American Health Organization would be available, to contribute to the strengthening of Rickettsiosis control in the region. Dr. Rosely Oliveira, a representative of the Brazilian Ministry of Health, welcomed the participants, and on behalf of Dr. Jarbas Barbosa, Secretary of Epidemiological Surveillance, she congratulated and thanked the organizers for the initiative in having convened this PAHO/WHO Experts Consultation on Rickettsiosis in the Americas. She recalled that for many years in Brazil, zoonosis control was restricted to rabies. Since 2001, advances have been made in Rickettsiosis treatment and it was incorporated to the group of diseases under
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