Abstract
BackgroundGuangxi is the province most seriously affected by rabies virus (RABV) in China. Those most affected by RABV each year are people in rural areas, where dogs are the main cause of human infection with the virus.MethodsIn this study, we established a rabies vaccination demonstration program that included eradication, core, and peripheral areas. This program was implemented for 9 years and comprised three stages: 12 counties in the first stage (2008–2010), 21 counties in the second stage (2011–2013), and then extending to all counties of Guangxi Province in the third stage (2014–2016). The program included a dog vaccination campaign, surveillance of clinically healthy dogs who may be potential RABV carriers, monitoring anti-RABV antibody titers in vaccinated dogs, and compiling and reporting statistics of human rabies cases.ResultsThe target effectiveness was achieved in the eradication, core, and peripheral areas in all three stages. The vaccination demonstration program successfully promoted RABV vaccination of domestic dogs throughout Guangxi Province by drawing upon the experience gained at key points. Compared with a vaccination coverage rate of 39.42–46.85% in Guangxi Province overall during 2003–2007, this rate gradually increased to 48.98–52.67% in 2008–2010, 60.24–69.67% in 2011–2013, and 70.09–71.53% in 2014–2016, thereby meeting World Health Organization requirements. The total cases of human rabies in the province decreased from 602 in 2004 to 41 cases in 2017.ConclusionsThe present pilot vaccination program obviously increased the rabies vaccination and seroconversion rates, and effectively reduced the spread of rabies from dogs to humans as well as the number of human rabies cases, thus successfully controlling rabies in Guangxi.
Highlights
Guangxi is the province most seriously affected by rabies virus (RABV) in China
Epidemiological surveys and phylogenetic analyses have indicated that elimination of rabies among domestic dogs in rural areas is critical for the control of human rabies in China [2]
Information sources Epidemiological data of human rabies in Guangxi Province from January 1982 to December 2017 were retrieved from the surveillance database of the National Disease Reporting Information System (NDRIS) of the Chinese Center for Disease Control and Prevention (CDC)
Summary
Guangxi is the province most seriously affected by rabies virus (RABV) in China. Those most affected by RABV each year are people in rural areas, where dogs are the main cause of human infection with the virus. A PEP-based approach to prevention can impede progress toward instituting large-scale dog vaccination campaigns [7]. This is true even in upper middle-income countries, which have clear capability to implement mass dog vaccination but have failed to effectively carry out such programs. These countries still have a high burden of human deaths and experience continued escalation of the demand for PEP, with costs amounting to hundreds of millions dollars each year [8]. Preventing human rabies deaths by eliminating the disease in dogs incurs far lower cost than relying indefinitely on PEP to treat exposed individuals [9, 10]
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