Rabies Epidemiology and Control in Ecuador.

Esteban Ortiz-Prado,Anna M Stewart-Ibarra,Washington Bolivar Cardenas,Jorge Ponce-Zea,Jaime Yockteng,Dario Ramirez,Luciana Armijos

doi:10.5539/gjhs.v8n3p113

Abstract

Objective:Describe the epidemiology and the control effort for rabies in Ecuador.Methods:This observational study included data from the Ecuadorian National Institute of Census and Statistics (INEC), and mortality and morbidity data reported by the Ministry of Public Health and the National Institute for Social Security. We conducted a phylogeny analyses to compare the N gene from the Challenge Virus Standard (CVS) vaccine strain used in Ecuador with published Cosmopolitan, Asian and Sylvatic strains. Descriptive and inferential statistics were used to determine the significance of the data.Results:In 1996 Ecuador suffered the highest rate of rabies per capita in the Americas, with an incidence rate of 0.56 cases per 100 000 people per year. Human and canine rabies showed a sharp decline until 2012. Between 1994 and 2014, we found a correlation of 0.925 (p<0.01) between annual cases of dog and human rabies. In 2011, there was an epidemic of sylvatic rabies transmitted to people by vampire bats (Desmodus rotundus) in the Amazon region, specifically in Morona Santiago, leading to 11 fatalities. Phylogenetic analyses of the CVS vaccine N gene showed an association with urban canine rabies strains (the Cosmopolitan lineage and Asian strains), whereas sylvatic rabies, like those reported in the Amazon region, were found to be grouped in a different clade represented mainly by bat-derived strains.Conclusions:This study presents the first compilation of epidemiological data on rabies in Ecuador. The incidence of human and canine rabies, also known as urban rabies, has clearly decreased due to massive canine vaccination campaigns. Phylogenetic analysis of the prevailing vaccine used in the country showed a clear separation from bat-derived rabies, the source of recent rabies outbreaks. Efforts are ongoing to develop rabies vaccines that are highly specific to the rabies virus genotype circulating in the region, including sylvatic rabies. These efforts include the implementation of reverse genetics to generate recombinant virus coding for the prevailing glycoprotein gene.

Highlights

Rabies is a preventable viral disease, typically transmitted through the bite of a rabid animal
In 2011, there was an epidemic of sylvatic rabies transmitted to people by vampire bats (Desmodus rotundus) in the Amazon region, in Morona Santiago, leading to 11 fatalities
Phylogenetic analyses of the Challenge Virus Standard (CVS) vaccine N gene showed an association with urban canine rabies strains, whereas sylvatic rabies, like those reported in the Amazon region, were found to be grouped in a different clade represented mainly by bat-derived strains

Summary

Introduction

Rabies is a preventable viral disease, typically transmitted through the bite of a rabid animal. The first detailed description of the rabies syndrome, including the long incubation period, is found in Fracastoro’s writings during the Dark Ages. Louis Pasteur and Émile Roux, developed the first rabies vaccine in 1885 (Baer, 1991). The causative agent is a ~12 Kb, single-stranded, non-segmented negative sense RNA genome virus that belongs to the Mononegavirales order, Rhabdoviridae family and Lyssavirus genus. Vol 8, No 3; 2016 proteins: nucleoprotein (N), phosphoprotein (P), matrix protein (M), glycoprotein (G) and polymerase (L). Lyssavirus show a broad antigenic cross reactivity at the nucleocapsid level due to a high sequence conservation of the N gene

Methods

Results

Conclusion