Controlling dog rabies in Africa: successes, failures and prospects for the future.

Abstract

Rabies is an acute and progressive encephalitis caused by lyssaviruses (family Rhabdoviridae, order Mononegavirales). Approximately 99% of the estimated 59,000 annual human rabies deaths in Africa and Asia are attributed to dog bites and are preventable through parenteral dog vaccination. In addition to dog rabies, the rabies virus also circulates in wildlife carnivores in southern Africa and virus exchange occurs readily across species barriers. In the early 1900s, rabies outbreaks were brought under control by the restriction of animal movements and by killing stray dogs. Subsequently, the disease was effectively controlled through vaccination. One prerequisite for rabies control is a thorough knowledge of dog populations. In Africa, only a few mass dog vaccination campaigns have reached the 70% coverage believed to minimise the spread of the disease. Live attenuated vaccines, such as SAG-2, used to control fox rabies in Europe, are safe for nontarget species, making oral vaccination an appealing complementary approach for dog rabies control in Africa. The success of rabies control in KwaZulu/Natal (South Africa) and Serengeti (Tanzania) is an excellent example of how public- private partnerships (PPPs) can contribute to the elimination of dog-mediated human rabies in Africa by 2030. Such PPPs are pivotal and will enhance public health awareness, promote mass dog vaccinations and improve accessibility to post-exposure prophylaxis.