Rabies, The Administration of Vaccines and Public Health Concern, Neglected Challenges and Historical Perspective in China

Abstract

Rabies virus is transmitted via contact of saliva of a rabid animal with a person ,s mucosa or a skin lesion. It is a fatal encephalomyelitis caused by members of expanding Lyssavirus genus, and the genus included 17 species. The aim of this literature review is to survey on rabies and vaccination in China, threats and challenges to eliminate it, especially in China. The information provided is obtained from randomized control experiments, review articles, and analytical observations and studies which were gathered from various literature sources such as Scopus, Google Scholar, PubMed, and Science Direct. The keywords were dogs, glycoprotein, lyssavirus, post-exposure prophylaxis, and rabies virus. Rabies virus is a bullet shaped enveloped virion, and the classical rabies virus and its field strains are discovered worldwide and induces to rabies in animals and humans. In recent years, China has made wonderful and significant achievements in rabies prevention and control, and currently, the mortality and incidence rate of human infection with rabies have decreased to the minimum level historically, which has caused a notable foundation for the ultimate elimination of human rabies. Generally, five proteins are available in mature rabies virus particles, phosphoprotein, nucleoprotein, glycoprotein, matrix protein, and RNA-dependent RNA polymerase. The main carriers of rabies in China are dogs which are accountable for most of the human rabies deaths in China. Most common way of entry of rabies virus into the body is both via infected neural tissue through open cuts in the skin and salvia. The most notable parameters which limit rabies vaccinations are limited laboratory-based surveillance, diminished community outreach and education, underestimation of the population at risk, irregular vaccine applications in space and time, inaccessible naïve free-ranging dogs, exclusion of puppies, cold chain failure, translocation of cases, effect of other species, including cats, wildlife, and livestock, accessibility to remote hotspots, competing priorities, lack of adequate resources, impact of poverty on responsible social ownership and routine animal health care, cultural disparities, Sisyphean fatigue, frustration and staff burn-out. Rabies remain a public health problem and continue to present health risks for both animals and human; It is important to improve access to PEP in endemic countries where human rabies deaths still happen, but the big problem is its costs that should be curtailed and surveillance strengthened for controlling and eliminating it.