Abstract
Almost half of all countries in the world are effectively free of human deaths from dog-mediated rabies. But the disease still affects people in low- and middle-income countries, especially the rural poor, and children. Successful regional elimination of human rabies is attributable to advances in significant and sustained investment in dog vaccination, post-exposure vaccination and surveillance, illustrated by productive efforts to reduce human rabies in Latin America over the last 35 years. Nonetheless, countries still facing endemic rabies face significant barriers to elimination. Using the 2017 Global Strategic Plan to end human rabies deaths from dog-mediated rabies by 2030 as a reference point and an organizing framework, we assess progress toward global rabies elimination by examining the characteristics of successful regional control efforts and barriers to elimination. Although substantive barriers exist for countries where rabies remains endemic, advances in knowledge, technology, institutions, and economics provide a basis for optimism.
Highlights
Rabies, one of the oldest known zoonotic diseases, is caused by a negative-stranded RNA virus from the Lyssavirus genus [1]
Sixteen studies were conducted in India, 12 in Tanzania, 8 in the Philippines, 6 in China, and 5 each in Kenya and Iran, while the remaining countries had fewer than 4 studies each (Fig. 2)
The number of articles identified by the search are provided in appendix Table A1, and individual paper characteristics of interest are summarized in Table A2 (Fig. 3)
Summary
One of the oldest known zoonotic diseases, is caused by a negative-stranded RNA virus from the Lyssavirus genus [1]. The disease is a considerable public health problem, every year killing an estimated 59,000 people worldwide, and causing over 3.7 million disability-adjusted life years and 8.6 billion USD economic losses [2, 3]. The virus can be eliminated from source populations through mass dog vaccination (MDV) [5]. Rabies has been eliminated in high-income countries and has been controlled in many middle-income countries, dog-mediated rabies remains endemic in much of Africa and Asia, with people in poor, rural communities and children most likely to die of the disease [3]. Human rabies can be described as a disease of poverty
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