Conceptual frame Alternative Ring Alternative Dough Conclusion Scenarioanalysis

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Scenario-analysis evaluating emergency strategies after rabies re-introduction Hans-Hermann Thulke & Dirk Eisinger Helmholtz Centre for Environmental Research UFZ : : Dept. of Ecological Modelling Leipzig/Germany Thomas Selhorst & Thomas Müller FLI Friedrich-Löffler-Institut : : Institute for Epidemiology Wusterhausen/Germany Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Scope: Scope Rabies-free region + naïve population X Large scale countrywide vaccination successful in past here economically useless Strategy: Strategy Limited control area Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Strategy: Strategy Limited control area Compact circle with 20 baits per km 2 Unvaccinated area Vaccinated area X XX X X X Rabies detection Increase control area… Target: Target Eradication + Avoiding breakout from control area Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Alternative: Ring (Vaccinated area constant + number of baits equal + distance differs) CIRCLE X XX X X X COMBAT Eco. Epi – Dept. Ecological Modelling RING X XX X X X CONTAIN Institute for Epidemiology 3

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion ? Simulation results: results Circle vs. Ring (10. 000 repetitions) Risk of Breakout RING CIRCLE Time [campaigns] Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Ring design: design Strategy Risk of breakout higher Economy Public Health Prolongation of measure More cases of rabies (inner part vaccinated later) (inner part epidemic starts) Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Compact control area around detection is mandatory! Eisinger et al. (2005) BMC Inf Dis 5: 10 Emergency vaccination of rabies under limited resources – combating or containing? Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Alternative: Bait density (Immediate combat + Number of baits equal + vaccinated area differs) DOUGH CIRCLE 20 baits per km 2 X XX X X X XX X COMBAT Eco. Epi – Dept. Ecological Modelling 10 baits per km 2 X XX X X X COVER 40 baits per km 2 X XX X X X XX X Focused COMBAT Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Simulation results: results Area vs. density ? Risk of Breakout [%] (10. 000 repetitions) _ Dough thinner Eco. Epi – Dept. Ecological Modelling _ + … Dough thicker Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Dough design by: Strategy slightly thinner advantageous Economy The thicker the quicker is eradication Eco. Epi – Dept. Ecological Modelling Public Health The thicker the fewer rabies cases Institute for Epidemiology

Conceptual frame – Alternative Ring – Alternative Dough – Conclusion Model-based pre-testing helpful • Development and evaluation of alternatives Ring not applicable • Immediate combat of the outbreak is mandatory Lower bait density and larger area beneficial • Trading-off between success and control costs or rabies occurrence ? X x Need for further research! • Mixed application according to situation Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Thank you Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Scenario deduction – Model description – Scenario evaluation – Conclusion & outlook Evaluation of relative performance of alternative scenarios Simulation experiment Model Description Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology 5

Scenario deduction – Model description – Scenario evaluation – Conclusion & outlook Simulation model – Rule based Model realisation Population • Individual foxes (Position & age, sex & disease state) Seasonality • Reproduction in spring • Dispersal in autumn Spatial organization suscept. infected infectious empty • Fox families in grid cells i. e. Sayers et al. 1985 Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Scenario deduction – Model description – Scenario evaluation – Conclusion & outlook Model rules : : Biology Individuals: Subadults: Mortality Dispersal Reproduction Bait uptake Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Scenario deduction – Model description – Scenario evaluation – Conclusion & outlook Model rules : : Rabies transmission Neighborhood contacts Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Scenario deduction – Model description – Scenario evaluation – Conclusion & outlook Model rules : : Rabies transmission Neighborhood contacts Dispersal Mating activity Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology

Scenario deduction – Model description – Scenario evaluation – Conclusion & outlook Model rules : : Bait distribution • 1 - 40 baits/km 2 (Spring & Atumn campaigns) • Spatial assignment to fox families • Bait competition • Individual bait uptake Eco. Epi – Dept. Ecological Modelling Institute for Epidemiology