The New Face of Human Rabies in Mexico, What's Next After Eradicating Rabies in Dogs.

Abstract

In pre-Hispanic Mexico, dogs were not identified as an important source of rabies. We know from codexes and chronicles of the conquerors that at that time, rabies cases in humans and domestic animals were caused by local wildlife species such as bats. Canine-rabies virus variant seems to have arrived with Europeans. The first documented case of canine rabies in the Americas is found in Mexico in the Annals of the Holy Inquisition (16th century). During Mexico's independence, cases were frequently reported. In the 19th century the first attempts to control human rabies were made through sanitary measures such as elimination of rabid dogs and applying postexposure vaccination. During the first half of the 20th century, the efficacy of canine vaccination to prevent human rabies was established. However, in Mexico, despite reports of numerous human cases (>70/year), canine vaccination did not have enough coverage. It was only during the 1990s that Mexico made a serious commitment to eliminate dog-transmitted human rabies. Since the beginning, vaccination campaigns have been free and massive. Coverage increased from 7,100,000 doses in 1990 to more than 18,000,000 since 2017. This culminated in the elimination of dog-mediated human rabies cases since 2006. Subsequently, the epidemiology of rabies had changed. Nowadays, it is wildlife species (mainly bats and skunks) that are the source of human rabies. As a mega-biodiverse country Mexico has numerous wildlife species with potential to transmit rabies virus. Thus it is paramount to remain vigilant with respect to canine vaccination campaigns and to promote rabies research in wildlife.