Abstract
BackgroundCanine rabies causes many thousands of human deaths every year in Africa, and continues to increase throughout much of the continent.Methodology/Principal FindingsThis paper identifies four common reasons given for the lack of effective canine rabies control in Africa: (a) a low priority given for disease control as a result of lack of awareness of the rabies burden; (b) epidemiological constraints such as uncertainties about the required levels of vaccination coverage and the possibility of sustained cycles of infection in wildlife; (c) operational constraints including accessibility of dogs for vaccination and insufficient knowledge of dog population sizes for planning of vaccination campaigns; and (d) limited resources for implementation of rabies surveillance and control. We address each of these issues in turn, presenting data from field studies and modelling approaches used in Tanzania, including burden of disease evaluations, detailed epidemiological studies, operational data from vaccination campaigns in different demographic and ecological settings, and economic analyses of the cost-effectiveness of dog vaccination for human rabies prevention.Conclusions/SignificanceWe conclude that there are no insurmountable problems to canine rabies control in most of Africa; that elimination of canine rabies is epidemiologically and practically feasible through mass vaccination of domestic dogs; and that domestic dog vaccination provides a cost-effective approach to the prevention and elimination of human rabies deaths.
Highlights
Rabies is a viral zoonosis caused by negative-stranded RNA viruses from the Lyssavirus genus
Recent successes have been demonstrated in many parts of central and South America, where canine rabies has been brought under control through large-scale, synchronized mass dog vaccination campaigns [4]
We identify four major reasons commonly given for the lack of effective domestic dog rabies control including (1) low prioritisation, (2) epidemiological constraints, (3) operational constraints and (4) lack of resources (Table 1), focussing on the situation in Africa
Summary
Rabies is a viral zoonosis caused by negative-stranded RNA viruses from the Lyssavirus genus. Genetic variants of the genotype 1 Lyssavirus (the cause of classical rabies) are maintained in different parts of the world by different reservoir hosts within ‘host-adaptive landscapes’ [1]. From the perspective of human rabies, the vast majority of human cases (.90%) result from the bites of rabid domestic dogs [2] and occur in regions where domestic dogs are the principal maintenance host [3]. Recent successes have been demonstrated in many parts of central and South America, where canine rabies has been brought under control through large-scale, synchronized mass dog vaccination campaigns [4]. We identify four major reasons commonly given for the lack of effective domestic dog rabies control including (1) low prioritisation, (2) epidemiological constraints, (3) operational constraints and (4) lack of resources (Table 1), focussing on the situation in Africa.
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