Health risks in the IOC area
Here is a non-exhaustive list of health crises that have taken place in the IOC region since the chikungunya epidemic in 2006:
Regional surveillance
Regional surveillance consists mainly of sharing health information between countries.
The latter is coupled with an international health watch conducted by the IOC.
In practice, every month, country surveillance managers take part in a teleconference hosted by the IOC and CIRAD.
Each person presents the health situation in his or her country.
These teleconferences are also an opportunity to ask questions and share experiences.
The IOC’s CDC-OH-IO carries out daily checks on health events that could represent a risk for the region.
In the event of an emergency, the veterinary services are notified immediately by e-mail or telephone.
The results of this health monitoring activity are summarized and shared monthly via teleconference.
Indeed, the common denominator of the countries’ problems was data feedback.
As part of this e-surveillance, while respecting the specificities of each country’s surveillance systems in terms of field devices and priority diseases, data are entered on smartphones at each farm visit.
They are then sent to an online database.
Each country has its own database, administered by the veterinary services’ surveillance unit. E-surveillance is currently operational in the Seychelles, Madagascar, Mauritius and the Comoros.
These country databases have the same structure, with the same variables.
At regional level, this enables data to be pooled and a common analysis carried out to identify disease trends common to all countries.
Intersectoral surveillance and response to zoonoses
60% of human infectious diseases (and 75% of emerging diseases) are of animal origin.
Similarly, five new human diseases appear every year, three of which are of animal origin.
Effective surveillance therefore requires coordination between public health authorities, veterinary services and environmental authorities.
This is in line with the ” One Health ” initiative promoted by the World Health Organization (WHO) and the World Organization for Animal Health (WOAH).
It is defined as a global priority by WHO, WHOA and the United Nations.
Antibiotic resistance is a unifying theme that concerns all sectors: public health, animal health and the environment. It is the subject of One Health surveillance at regional level in the IOC Member States.
This regional surveillance particularly targets Enterobacteriaceae producing Extended Spectrum Betalactamases (EBLSE), which can induce resistance to several antibiotic families at the same time.
However, in addition to these EBLSEs, each country adds specific germs of national importance.
In terms of human health, this surveillance is laboratory-based.
Particular emphasis is placed on community samples.
In animal health, it involves repeated cross-sectional surveys of livestock.
This surveillance network is managed by CIRAD, as part of its partnership with the IOC.
The network also benefits from the participation of centers of excellence such as Madagascar’s Institut Pasteur and the laboratory of the Centre Hospitalier de Saint Denis (La Réunion).
In addition to providing leadership, support to countries has also involved equipping laboratories where necessary, and building skills through training courses run by SEGA One Health Network experts.
A quality control procedure is planned.
The same applies to interaction with research to identify the molecular basis of these resistances.
Human deaths due to rabies are recorded every year in Madagascar.
Similarly, several outbreaks of animal rabies, either in dogs or ruminants, are reported each year.
The IOC’s support for rabies surveillance and control began with the IDSR.
The aim now is to help Madagascar eliminate rabies.
On the animal side, rabies surveillance is integrated into the MADSUR network, which also includes data needed for human health.
For human health, surveillance of rabies cases and bites is included in the IDSRInvestigations in the event of an outbreak fall within the scope of investigative support.
Support involves the implementation of appropriate control measures. These controls are based on the level of rabies circulation in the various districts.
This includes, but is not limited to, dog vaccination campaigns, dog population management and all related expenses.
In view of the country’s efforts to combat rabies, and following discussions with the CDC-OH-IO and the DSV of Madagascar, the WOAH decided to allocate 100,000 doses of rabies vaccine to Madagascar.
This vaccination campaign is being implemented with the technical and financial support of the IOC as part of the SEGA – One Health Network, through the RSIE3 and 4 projects.
Rift Valley fever (RVF) and Q fever are two abortifacient diseases of small ruminants. Both are transmissible to humans, and both are endemic to the Comoros and present on all three islands.
Animal health surveillance regularly detects episodes of abortion in ruminants, without any laboratory confirmation.
On the human health side, we also note outbreaks of dengue-like and/or flu-like syndromes, for which these diseases may be the cause. Since January 2016, One Health surveillance has been operational, with the support of the IOC.
RVF and Q fever have been included in sentinel surveillance of fevers at the human health level.
They are also included as abortifacient diseases in the national network for the epidemiosurveillance of animal diseases in the Comoros (RENESMAC).
Intersectoral communication procedures are in place.
Alerts have been detected and investigated collectively (animal health/human health).
Biological samples are taken and analyzed at the IPM or CIRAD in La Réunion.
This activity, which began in 2019, involves sampling bats in Mauritius and monitoring the circulation of pathogens, all of which are zoonotic (Ebola, Marburg Fever, leptospirosis, rabies…).
Analyses are carried out by the Institut Pasteur de Madagascar.
Considering the role of bats in the transmission of diseases to humans (Ebola, coronavirus…), this surveillance will be an ongoing activity, with a sampling campaign every year.
Animal disease surveillance in the Indian Ocean
In addition to diseases that are transmissible to humans, the main concern of veterinary services is diseases with a high economic impact.
These diseases can decimate large proportions of the herd.
The 60% reduction in the pig population in Madagascar when African swine fever was introduced in 1998 is a case in point.
In addition to direct losses due to mortality and the fact that domestic animals are a source of protein for the population, livestock farming is also a source of cash, capitalization of earnings, energy and fertilizer for agricultural work. This type of disease has a direct impact on people’s well-being and quality of life.
These priority animal diseases include those of regional importance.
These are classified as transboundary diseases, with a capacity for rapid spread and/or considerable economic impact in the event of outbreaks.
Some are still absent from the islands of the south-west Indian Ocean, but are being kept under surveillance because of the dangers they represent.
These regionally important diseases are :
- avian flu
- Newcastle disease
- foot-and-mouth disease
- contagious bovine pleuropneumonia
- peste des petits ruminants
- African/classical swine fever
- Rift Valley fever
- contagious lumpy skin disease in cattle
The specificities of each country’s context imply different priority diseases. Examples include anthrax in Madagascar, theileriosis in the Comoros and contagious caprine pleuropneumonia in Mauritius.
Tick-borne diseases such as babesiosis, anaplasmosis and cowdriosis are also monitored in all countries.
The objectives of strengthening national surveillance in countries are to :
- strengthen national surveillance to detect alerts, investigate them and respond appropriately,
- track disease trends to better target interventions and verify the effectiveness of control measures.
In addition, effective national surveillance is needed to generate health information that can be exchanged at regional level.
Support tailored to the context of each country
IOC support is provided at different levels, depending on the context of each country:
- setting up new monitoring networks and/or reinforcing existing ones
- skill building
- diagnostic support
- regular training/hosting
- investigative support
- support for the production of national epidemiological bulletins
The SEGA – One Health Network has been able to promote and consolidate monitoring systems in Member States:
- National network for the epidemiosurveillance of animal diseases in the Comoros (RENESMAC)
- Madagascar Diseases Animal Surveillance (MADSUR)
- animal disease surveillance in Mauritius, including Rodrigues
- animal disease surveillance in Seychelles
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