Letter of Invitation

Eaton, Danice (CDC/OPHSS/CSELS)
From:
Sent:
To:

Cc:
Subject:

Tran, Cuc Hong (CDC/OID/NCEZID)
Friday, October 30, 2015 10:12 PM
Wallace, Ryan (CDC/OID/NCEZID); Blanton, Jesse (CDC/OID/NCEZID); Reynolds, Mary
(CDC/OID/NCEZID); Carroll, Darin (CDC/OID/NCEZID); Gronostaj, Michael
(CDC/OPHSS/CSELS); Bosch, Stacey A. (CDC/OPHSS/CSELS); CDC Epi Aid Response
Team
'[email protected]'
FW: Request of technical assistance for Rabies from CDC

Hi,
I am forwarding this email to you from Dr. Max Millien for the Epi-Aid.
Thanks!
Cuc
From: Millien Max [mailto:[email protected]]
Sent: Friday, October 30, 2015 9:55 PM
To: Tran, Cuc Hong (CDC/OID/NCEZID) ; Wallace, Ryan (CDC/OID/NCEZID)
Subject: Request of technical assistance for Rabies from CDC

Dear CDC members,

Early September 2015, a four year old girl died from a rabies like illness in Gonaives, Haiti. According to a
preliminary investigation conducted late September, the child was bitten on the stomach by an aggressive dog,
owned by the household (dog died about a week after the bite incident). Prior to her death, she exhibited clinical
symptoms of rabies: agitation, paralysis on the right side, and hydrophobia. She was not taken to the hospital
and the case was not officially reported through Haiti’s National Surveillance System (NSS). Furthermore, a
preliminary investigation by the Ministry of Agriculture identified at least six dogs in this rural community with
rabies-like illness and a Ministry of Health investigation has since identified an additional 5 bite victims that
had not sought treatment nor reported the rabies exposure to a healthcare professional. This is extremely
concerning, given the case fatality of rabies is almost 100% if bite victims do not seek care for post-exposure
prophylaxis (PEP) treatment as soon as possible. Furthermore, the breakdown of reporting to the NSS may
adversely impact PEP and canine rabies vaccination procurement, leading to a potential shortage when another
outbreak occurs.

We request technical assistance from CDC for an investigation to:

1) Identify additional bite victims and refer for immediate treatment at a medical center
2) Assess knowledge of rabies and barriers to care if bitten

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3) Estimate the rabies vaccination rates among pet owners
4) Assess public health officials knowledge of treatment for rabies, availability of PEP at their
treatment center, and if and how they are reporting these cases to the National Surveillance System.
We'd appreciate that the Haitian Rabies Program continues receiving technical assistance from CDC.
Best regards
Dr MILLIEN
CVO of Haiti.

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