Rabies in the Americas: 1998-2014.

Mary Freire De Carvalho,Ottorino Cosivi,Alexandra Vokaty,Baldomero Molina-Flores,Victor J Del Rio Vilas,Marco A N Vigilato,Felipe Rocha,Julio A Pompei,Charles E Rupprecht

doi:10.1371/journal.pntd.0006271

Abstract

Through national efforts and regional cooperation under the umbrella of the Regional Program for the Elimination of Rabies, dog and human rabies have decreased significantly in Latin America and Caribbean (LAC) countries over the last three decades. To achieve this decline, LAC countries had to develop national plans, and consolidate capabilities such as regular mass dog vaccination, opportune post-exposure prophylaxis and sensitive surveillance. This paper presents longitudinal data for 21 LAC countries on dog vaccination, PEP and rabies surveillance collected from the biannual regional meeting for rabies directors from 1998–2014 and from the Regional Epidemiologic Surveillance System for Rabies (SIRVERA). Differences in human and dog rabies incidence rates and dog vaccination rates were shown between low, middle and high-income countries. At the peak, over 50 million dogs were vaccinated annually in national campaigns in the countries represented. The reported number of animal exposures remained fairly stable during the study period with an incidence rate ranging from 123 to 191 reported exposures per 100,000 people. On average, over 2 million doses of human vaccine were applied annually. In the most recent survey, only 37% of countries reported that they had sufficient financial resources to meet the program objectives. The data show a sufficient and sustained effort of the LAC countries in the area of dog vaccination and provide understanding of the baseline effort required to reduce dog-mediated rabies incidence.

Highlights

Dog-mediated rabies still poses a heavy burden on the most disadvantaged populations in the world [1]
Since 1998, prior to the regular REDIPRA meetings coordinated by PAHO and attended by health and agricultural officials from most of the countries in the Americas, PAHO distributes a survey to all rabies program managers to collect data on the status of their rabies programs capacities and supporting functions
The sustained effort in Latin America and Caribbean (LAC) at the national and regional level over the last 4 decades produced a significant reduction in dog rabies incidence

Summary

Introduction

Dog-mediated rabies still poses a heavy burden on the most disadvantaged populations in the world [1]. In Latin America and Caribbean (LAC) countries, dog and human rabies have decreased significantly over the last three decades due to interruption of rabies virus circulation between dogs and dog-mediated transmission to humans [2,3]. This success has come from national efforts and regional cooperation under the umbrella of the Regional. The commitment from PAHO member states to eliminate rabies was first discussed in 1983 during the Meeting of the Directors of National Programs for Rabies in the Americas (REDIPRA), and was endorsed by the American. Since the beginning of the regional elimination effort in 1983, the burden of dog-mediated rabies in LAC countries has decreased by 95% with only six countries reporting dog-mediated human cases in 2015, and three in 2016 [5]

Methods

Results

Discussion

Conclusion