A brief history of rabies in Haiti until the adoption of the One Health approach for its epidemiological surveillance and control

Abstract

Rabies was first identified in dogs and humans by a French veterinarian, Jean Lompagieu Lapole, in 1788 in the colony of Saint-Domingue, which later became Haiti. Rabies has continued to persist in the country despite some intermittent successes in combating this disease over the past 20 years. We are trying to understand why rabies, which has officially existed in the country for around 250 years, is still classified as a neglected disease and continues to result in cases of human mortality. For a significant period, until the implementation of the Haiti Animal Rabies Surveillance Program (HARSP) in 2011, there was no robust initiative to fight against rabies based on regular vaccination campaigns and an effective epidemiological surveillance system despite certain efforts made by the Ministry of Agriculture and Pan American Health Organization Project of Strengthening Public Agricultural Services (RESEPAG): Projet de Renforcement des Services publics Agricoles (PAHO) to increase dog vaccinations. The HARSP program was established with technical assistance from the Center for Disease Prevention and Control of Infectious Diseases (CDC) to control and eliminate rabies in the short term, according to the One Health approach. It was a passive surveillance system based on strengthening the rabies diagnostic capacity of the Veterinary Laboratory, training veterinary and public health technicians, and supporting rabies vaccination campaigns. This approach has resulted in effective cooperation between the Ministry of Agriculture and the Ministry of Public Health based on the “One Health” enabling the Ministry of Public Health to report daily on bite to the Ministry of Agriculture for further investigations. HARSP marked a pivotal moment in the Rabies Control and Elimination Program. Between January 2013 and December 2017, there were 9,342 reported human exposures to animals suspected of carrying rabies in Haiti. The number of Human exposures to rabies suspected animals in Haiti from January 2013 to December 2017 was 9,342 heads. Among these cases, 2.4% were confirmed, 4.9% probable, 17.8% suspected, and 74.6% discarded. The One Health rabies program has demonstrated the potential for achieving control of both animal and human rabies in Haiti if the ministries of Agriculture and Health commit unequivocally to continue their collaborative development efforts and adhere to HARSP methodology, including vaccinating over 70% of the dog population.