A passive ‘One Health’ surveillance system to track canine rabies in urban India

Abstract

Abstract Robust and widely implementable ‘One Health’ surveillance systems are required to detect and control the spread of zoonotic infectious diseases. Using technological tools coupled with a rapid field response and rapid diagnostics can help in the surveillance of deadly diseases such as rabies, even in densely populated urban areas. Here, we describe the use of an animal rescue system (Hawk Data Pro) that was adapted as a passive surveillance tool for rabies in a large metropolis in India. We used a Webline and helpline that reported injured or sick animals to an animal rescue facility to determine possible rabies cases in street animals in Pune city in western India. Suspected rabid animals were tested using lateral flow assays and this information was used to direct awareness materials on rabies as well as in conducting mass dog vaccinations in areas that reported multiple cases. Over a ~4-year period, we received over 90,700 calls or reports, of which 1162 calls were for suspected rabies cases in dogs, and 6 for other animals (cats, goats and cattle). Of these, 749 dogs and 4 other animals tested positive for rabies. Most of the cases were reported from the densely human-populated central Pune region. In response, ~21,000 people were provided with educational materials on post-bite management, and ~23,000 dogs were vaccinated. We show that the adoption of the Hawk Data Pro system as a passive surveillance tool allowed us to document an ongoing outbreak of rabies in a large metropolis in India. Such systems can be modified or adapted to other areas as well to meet the surveillance and reporting requirements of the WHO’s Zeroby30 strategy to eliminate rabies globally. One Health impact statement India is a priority country for the action plan for rabies elimination by 2030. Yet, systematic surveillance for rabies in the primary reservoir remains weak. Here, we showcase a collaboration with an animal welfare organization and adaptation of their bespoke animal rescue system for passive surveillance of rabies in dogs and other animals in Pune city in western India. This method allowed us to improve the detection of potentially rabid animals, rapidly ensure post-exposure prophylaxis and provide awareness materials for exposed human victims. To the best of our knowledge, this collaboration between scientists and civil society organizations resulted in the detection of the largest number of rabies cases reported in an urban area anywhere in the world. The use of this system highlights the scope of the problem in urban India and also provides practical guidance on how to improve surveillance using basic technological tools.