Abstract
Dog-transmitted rabies is responsible for more than 98% of human cases worldwide, remaining a persistent problem in developing countries. Mass vaccination targets predominantly major cities, often compromising disease control due to re-introductions. Previous work suggested that areas neighboring cities may behave as the source of these re-introductions. To evaluate this hypothesis, we introduce a spatially explicit metapopulation model for rabies diffusion in Central African Republic. Calibrated on epidemiological data for the capital city, Bangui, the model predicts that long-range movements are essential for continuous re-introductions of rabies-exposed dogs across settlements, eased by the large fluctuations of the incubation period. Bangui’s neighborhood, instead, would not be enough to self-sustain the epidemic, contrary to previous expectations. Our findings suggest that restricting long-range travels may be very efficient in limiting rabies persistence in a large and fragmented dog population. Our framework can be applied to other geographical contexts where dog rabies is endemic.
Highlights
Rabid dogs constitute the main source of rabies transmission to humans, understanding disease dynamics in dogs is essential to reduce human risk
Applied to Central African Republic, our model indicates that continuous re-introductions of rabid dogs via human-mediated movements are critical in sustaining the disease in the country
As rabid dogs constitute the main source of transmission to humans, understanding the dynamics of rabies in domestic dog populations is essential to identify the key drivers for pathogen maintenance and develop improved control measures to reduce spillover opportunities and, the number of human fatalities
Summary
Canine rabies is a viral zoonosis responsible for approximately 21,500 (95% C.I. 9,100–58,100) annual human deaths in Africa [1]. Despite the low-level endemic stability that would require relatively low degrees of vaccination coverage to eliminate rabies [20], empirical and theoretical evidence suggests that sustained pulsed vaccination campaigns with 70% coverage of the domestic dog population are needed to achieve long-term elimination [17,21,22]. This high coverage is required to prevent the rapid decline of population herd immunity below its critical value between two consecutive campaigns, induced by the large renewal of the naive domestic dog population due to dogs’ short life-span and high fecundity rate [19,23]
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