Rabies control

I have a PhD student named Ewaldus Wera. He is working at Kupang State Agriculture Polytechnic Univesity in Kupang, West Timor, Indonesia and has a grant from the Indonesian government to get his PhD at Wageningen University. After an initial time in Wageningen to do some courses and to set up his research plans, he went back for data collection. I had the pleasure to visit him in Indonesia. During my visit I had the honour to give a presentation on animal health economics to the veterinary students of Kupang State Agriculture Polytechnic and to visit the Animal Science facilities over there. It was great to find out that there were people there that were following my activities on the social media. Wow.

The most important part of my visit, however, was to make a site visit to the Island of Flores, where Ewaldus is doing is field work, in co-operation with the local animal health authoroties there.

The topic of his research: economics of rabies control. Indeed, a little different topic than most topics I discussin this blog, Nevertheless it is quite interesting. When I had to fly over, I had to make a stopover on Bali and on the airport there was a banner warning for rabies on the island. 

Warning banner as a welcome on the airport of Bali (after 15 hours of flying I was not able to keep my phone steady, so it is a bit fuzzy). 

Basically, rabies is a zoonotic disease that, in humans is always fata once clinical signs appear. The main transmission routes is through dog bites. There is a lot of information to be found on the internet, for instance here and here.

In Flores island alone, rabies is the cause of 19 human deaths per year. After the introduction of rabies, the local government has been taking quite a lot of efforts to eradicate rabies again from the island, without succes until now. Ewaldus has carried out an economic study to evaluate the costs that were associated with the control measures carried out since the year 2000 on Flores island. Currently, rabies control measures on Flores Island include mass vaccination and culling of dogs, laboratory diagnostics of suspected rabid dogs, putting imported dogs in quarantine, and pre- and post-exposure treatment (PET) of humans. 

Using a deterministic economic calculation model, Ewaldus estimated that the control measures were estimated to be US$1.08 million (range: US$0.57–1.42 million) per year. He presented his work at the last ISVEE meeting and the proceedings are available. Interestingly, Ewaldus not only looked at the costs of vaccination, but also at the costs of culling, especially at the value of the culled dogs. In Flores Island, dogs are a source of protein for the population (in other words, dogs are eaten) and dogs play an important role in chasing away monkeys, so that they do not damage the harvest. The consequence of taking those costs into account are that the costs of culling (semi) roaming dogs were the highest portion (about 39 % of the total costs). Post exposure treatment was the second highest portion of the costs (35 %). 

Ewaldus (orange shirt) and his data collection team in one of the villages in the field research

In Flores Island, there is a tendency towards less preventive measures and more PET. However, in the long run that may be more expensive then prevention. Next steps in the research are going to be aimed at the willingness of dog owners to co-operate with preventive measures and the costs-benefit of preventive measures. So you will be hearing more about his research in the future. 

One of the benefits of travel: Ewaldus took me to Kelimutu lakes, a beautiful spot, where volcanic lakes have totally different colours that even change over time.