Dog-transmitted Rabies Research Articles

New approaches must be taken to control rabies in low- and middle-income countries.

Krishna Prasad Acharya and Sarita Phuyal argue that while low- to middle-income countries may have some rabies control initiatives in place, these are not fully effective and strategies must be improved to reach the global goal of eliminating human deaths from dog-transmitted rabies by 2030.

Rabies surveillance and prevention in Guinea: Epidemiological data and postexposure prophylaxis challenges.

Canine rabies is an endemic form of zoonosis and represents a major public health threat in Guinea, similar to other African countries. However, few investigations on the epidemiology of rabies in animals and humans have been conducted, and evidence-based data required to inform health policies remain inadequate. This study was conducted to update our knowledge of human dog-mediated rabies epidemiology and post-exposure prophylaxis (PEP) accessibility-related factors in Guinea. This retrospective study, conducted from January 2018 to December 2020, collected data on animal bite cases, veterinary observations, rabies diagnoses through fluorescent antibody test, and PEP delivery from three veterinary and medical entities. Statistical analysis utilized Chi-square test and Fisher's exact test to evaluate relationships between variables. An average of 775 bites was recorded annually, and dogs were responsible for 98% of bites. However, only 64% of the biting dogs were under veterinary observation as required for integrated bite case management. Regarding the geographical distribution of bite cases, the entire country was affected, with the highest number of bites recorded in the prefectures of Nzérékoré and the special zone of Conakry. In addition, the laboratory diagnosis of brain samples from biting dogs indicated that 72% of the samples were rabies-positive. However, regarding prevention, only 58% of the bitten individuals received full PEP. Improving disease surveillance and PEP provision for dog-transmitted rabies is crucial to preventing human cases and deaths. Increasing community awareness is essential for enhancing dog vaccination and PEP utilization. A national action plan integrating stakeholders for controlling canine rabies should be developed for effective One Health collaboration.

Human dog-mediated rabies in the Circle of Kati, Mali: An epidemiological situation analysis and the stakeholder’s knowledge regarding rabies and the One Health approach

Background and Aim: Human dog-transmitted rabies remains a serious public health issue in Mali despite efforts to mitigate it. Indeed, several stakeholders have implemented multiple initiatives for years. However, there is still a lack of cooperation among stakeholders. This study was conducted to capture situational data on rabies and One Health practices among key actors involved in the fight against rabies in Mali. Materials and Methods: Data from veterinary and medical services were collected for analysis. Data collection was based on a review of technical documents (epidemiology of rabies in animals and humans and activities conducted to tackle the disease) and stakeholder interviews (awareness of rabies and the One Health approach). Results: With regard to the epidemiological situation, the findings revealed unsatisfactory vaccination coverage in dogs and low suspected sample collection for laboratory diagnosis. In addition, only half of the exposed individuals received complete post-exposure prophylaxis. A survey carried out by experts in the fields of animal health, human health, and the environment indicated that only 22.47% were well aware of rabies and had never heard of the One Health approach. Overall, there was no significant association between knowledge and participant sector of origin (p > 0.05), highlighting the need for operationalization of the One Health approach in Mali. Conclusion: Therefore, an integrated national action plan for rabies control should be developed with a particular focus on capacity building, particularly in the area of the One Health core competencies. Keywords: epidemiology, multisectoral engagement, One Health, Public Health priority zoonoses, Stakeholders.

Knowledge, attitudes and prevention practices related to dog-mediated rabies in Ethiopia: a systematic review and meta-analysis of observational epidemiological studies from inception to 2023.

Rabies is a horrific and neglected zoonotic disease that kills thousands of people worldwide each year and continues to pose threats to public health. Prevention and control of dog-transmitted rabies require mapping the level of understanding, perception, and existing practices to minimize its impacts on health. Therefore, we undertook this systematic review and meta-analysis to pool evidence from available data on knowledge, attitudes, and prevention practices regarding the disease from studies conducted in various areas of Ethiopia. Articles were searched in electronic bibliographic medical databases such as the Excerpta Medica database, PubMed, Web of Science, African Journals Online, Google Scholar, and Scopus. We used Microsoft Excel spreadsheets and STATA software version 16 for the data excerption and analysis, respectively. The variability among studies was evaluated via Higgins and Thompson's I2 statistics and the x2 test (significant at p ≤ 0.1). The Dersimonian and Laird random-effect meta-analysis model was used to estimate the pooled effect at a 95% uncertainty interval (UI). Visual inspection and Egger's test (significant at p ≤ 0.05) were used to identify the presence of small-study effects. The search identified 1,249 electronic records. Of them, 27 studies involving 11,150 participants met the inclusion criteria. The pooled prevalence of a good level of knowledge was 62.24% (95% UI: 48.56, 75.92). Furthermore, the pooled prevalence of a favorable level of attitudes towards rabies and a good level of rabies prevention practices was only 56.73% (95% UI: 47.16, 66.29) and 52.73% (95% UI: 43.32, 62.15), respectively. The study revealed credible gaps in attitudes and prevention practices, though some level of knowledge about dog-mediated rabies was demonstrated. Therefore, we call for country-wide cross-sectoral collaboration to allow for the realization of a global elimination strategy for dog-mediated human rabies.

Of love and other demons: depicting human rabies in Colombia

Human rabies has been described by various cultures in many countries around the world. Gabriel García Márquez's novel Of love and other demons recounts the story of a girl who, in colonial Colombia in the 18th century, was bitten by a rabid dog. This paper aims to review the general status of the disease in Colombia and interweave it with García Márquez's book. Developed countries have successfully controlled dog-mediated rabies virus transmission, whereas in some countries in Latin America wildlife and canine rabies are still an issue. Our approach suggests that although the measures that have been taken to mitigate dog-transmitted rabies have worked well in most parts of the world, greater efforts are required to control sylvatic rabies transmitted by bats or other mammals, as occurs in Colombia. Since developing countries are the most affected by the disease at present, transdisciplinary commitment between human and veterinary sectors is necessary to fight against rabies virus transmission.

Review of Oral Rabies Vaccination of Dogs and Its Application in India.

Oral rabies vaccines (ORVs) have been in use to successfully control rabies in wildlife since 1978 across Europe and the USA. This review focuses on the potential and need for the use of ORVs in free-roaming dogs to control dog-transmitted rabies in India. Iterative work to improve ORVs over the past four decades has resulted in vaccines that have high safety profiles whilst generating a consistent protective immune response to the rabies virus. The available evidence for safety and efficacy of modern ORVs in dogs and the broad and outspoken support from prominent global public health institutions for their use provides confidence to national authorities considering their use in rabies-endemic regions. India is estimated to have the largest rabies burden of any country and, whilst considerable progress has been made to increase access to human rabies prophylaxis, examples of high-output mass dog vaccination campaigns to eliminate the virus at the source remain limited. Efficiently accessing a large proportion of the dog population through parenteral methods is a considerable challenge due to the large, evasive stray dog population in many settings. Existing parenteral approaches require large skilled dog-catching teams to reach these dogs, which present financial, operational and logistical limitations to achieve 70% dog vaccination coverage in urban settings in a short duration. ORV presents the potential to accelerate the development of approaches to eliminate rabies across large areas of the South Asia region. Here we review the use of ORVs in wildlife and dogs, with specific consideration of the India setting. We also present the results of a risk analysis for a hypothetical campaign using ORV for the vaccination of dogs in an Indian state.

Rabies mortality and morbidity associated with animal bites in Africa: a case for integrated rabies disease surveillance, prevention and control: a scoping review

ObjectiveThe objective of this scoping review was to map the current situation and available evidence and gaps on rabies morbidity, mortality, integrated rabies surveillance programmes, and existing prevention and control...

Long-range movements coupled with heterogeneous incubation period sustain dog rabies at the national scale in Africa.

Dog-transmitted rabies is responsible for more than 98% of human cases worldwide, remaining a persistent problem in developing countries. Mass vaccination targets predominantly major cities, often compromising disease control due to re-introductions. Previous work suggested that areas neighboring cities may behave as the source of these re-introductions. To evaluate this hypothesis, we introduce a spatially explicit metapopulation model for rabies diffusion in Central African Republic. Calibrated on epidemiological data for the capital city, Bangui, the model predicts that long-range movements are essential for continuous re-introductions of rabies-exposed dogs across settlements, eased by the large fluctuations of the incubation period. Bangui’s neighborhood, instead, would not be enough to self-sustain the epidemic, contrary to previous expectations. Our findings suggest that restricting long-range travels may be very efficient in limiting rabies persistence in a large and fragmented dog population. Our framework can be applied to other geographical contexts where dog rabies is endemic.

Elimination of dog-mediated human rabies: the burden of human rabies in Africa.

Hope exists for the elimination of dog-mediated human rabies in Africa. Momentum is gathering towards this goal, with an increasing number of successful demonstration projects showing that elimination is feasible. The Pan African Rabies Control Network is bringing Africa together against rabies, supported by the World Health Organization, the World Organisation for Animal Health and the Food and Agriculture Organization of the United Nations, which have a combined resolution to eliminate human deaths from dog-transmitted rabies by 2030. Furthermore, the inspiring examples of both rinderpest and smallpox eradication hold all the elements necessary to have confidence that this momentum can lead to success. Smallpox and rinderpest, whose last battles were fought on the African continent, highlight the simple fact that once the primary tools are available (such as vaccines), by far the greatest challenges lie within the realm of implementation. Science can effectively argue the subtleties of virology, immunology, vaccinology, etc. but it often fails to describe the science of implementation. In the face of other major diseases and socio-economic difficulties, rabies is not perceived as a threat by many African countries, despite the fact that the burden of the disease has been shown to be extensive. The challenge of mobilising mass interventions requires leadership and fortitude within resource-poor, infrastructurally challenged, politically uninterested and often bureaucratically restricted environments. Continent-wide elimination remains a daunting prospect for investors, who often lack insight into environmental disease dynamics, which is essential for enabling the implementation of strategic, community-based interventions. Implementation in Africa needs to be seen through African eyes. It needs local community support, and it needs effective transport and procurement systems and systems of self-development with a view to sustainability. The Aidto- Africa model needs to be replaced by a model that empowers communities to act, demonstrates that success is possible and stimulates the expansion of control efforts.

The Road to Dog Rabies Control and Elimination-What Keeps Us from Moving Faster?

Rabies, a vaccine preventable neglected tropical disease, still claims an estimated 35,000–60,000 human lives annually. The international community, with more than 100 endemic countries, has set a global target of 0 human deaths from dog-transmitted rabies by 2030. While it has been proven in several countries and regions that elimination of rabies as a public health problem is feasible and tools are available, rabies deaths globally have not yet been prevented effectively. While there has been extensive rabies research, specific areas of implementation for control and elimination have not been sufficiently addressed. This article highlights some of the commonest perceived barriers for countries to implementing rabies control and elimination programs and discusses possible solutions for sociopolitical, organizational, technical, and resource-linked requirements, following the pillars of the global framework for the elimination of dog-mediated human rabies adopted at the global rabies meeting in December 2015.

The Middle East and Eastern Europe rabies Expert Bureau (MEEREB) third meeting: Lyon-France (7-8 April, 2015).

MEEREB is an inter-regional network of countries from North Africa, Europe, the Middle East and Central Asia that work together with the aim of improving rabies control and prevention at local, regional and global level. MEEREB members met for the third time in 2015 in France (Lyon) to review the current rabies situation within the network and to discuss the way forward the prospect of a One Health approach against rabies. Dogs were the main vector of transmission in all MEEREB countries except for Croatia and Serbia where foxes represented the primary source. The number of rabies animal cases reported in 2014 varied substantially between countries with Ukraine reporting the highest number of animal cases. Human cases still occur in North Africa and all Middle East and Eurasian countries while no cases of human rabies were reported in Croatia, Serbia and Romania, although cases of rabies were identified in both dogs and foxes in 2014. Participants concluded that MEEREB can act as a think-tank where countries can share data, information, experiences and best practices to jointly address challenges in rabies control and prevention. They called for elimination of dog-transmitted rabies through vaccine and rabies immunoglobulin stockpiles and implementation of a One Health approach to achieve rabies's eradication.

Rabies in South Africa: Where Do We Stand in 2015?

Rabies. The word invokes divergent thoughts. Firstly, it is one of the oldest infectious diseases known to mankind with ancient scripts referring to the scourge of the rabid dog. Also the knowledge of how to control and prevent the disease has been understood for more than a century. Louis Pasteur showed how to prevent rabies virus infection by applying his crude nervous tissue vaccines in dogs and humans before the turn of the 20th century. Nevertheless, the question of why and how this highly fatal, but preventable, disease can then still be considered one of the most formidable zoonotic diseases in the world today is a burning one. A recent study estimated the burden of rabies globally and the figures are staggering. 1 It is estimated that approximately 59 000 human deaths can be attributed to dog-transmitted rabies, with the brunt borne in the developing countries of Africa and Asia. 1 This statistic relates roughly to a human rabies death every 10 minutes. The estimated global economic loss exceed US $ 8.6 billion with a substantial contribution due to the cost of rabies vaccines and immunoglobulin for prevention of rabies in exposed humans. 1

Gains and Future Road Map for the Elimination of Dog-Transmitted Rabies in the Americas

In 1983 the countries of the Americas, with the technical cooperation of the Pan American Health Organization (PAHO), pledged to eliminate human rabies transmitted by dogs.1 Since then, countries have made great efforts to eliminate this disease, with notable success, within the framework of the Regional Program of Elimination of Human Rabies. The success achieved during the last 30 years and the historical solidarity between countries in the region support the goal of elimination of dog-transmitted rabies in the American continent by 2015. As this date approaches, there is a need to reflect and reassess the current plan of rabies elimination. This work briefly describes the achievements of the Regional Program and the proposed new Regional Action Plan for the elimination of dog-transmitted rabies.

Progress towards eliminating canine rabies: policies and perspectives from Latin America and the Caribbean.

Human rabies transmitted by dogs is considered a neglected disease that can be eliminated in Latin America and the Caribbean (LAC) by 2015. The aim of this paper is to discuss canine rabies policies and projections for LAC regarding current strategies for achieving this target and to critically review the political, economic and geographical factors related to the successful elimination of this deadly disease in the context of the difficulties and challenges of the region. The strong political and technical commitment to control rabies in LAC in the 1980s, started with the regional programme coordinated by the Pan American Health Organization. National and subnational programmes involve a range of strategies including mass canine vaccination with more than 51 million doses of canine vaccine produced annually, pre- and post-exposure prophylaxis, improvements in disease diagnosis and intensive surveillance. Rabies incidence in LAC has dramatically declined over the last few decades, with laboratory confirmed dog rabies cases decreasing from approximately 25 000 in 1980 to less than 300 in 2010. Dog-transmitted human rabies cases also decreased from 350 to less than 10 during the same period. Several countries have been declared free of human cases of dog-transmitted rabies, and from the 35 countries in the Americas, there is now only notification of human rabies transmitted by dogs in seven countries (Bolivia, Peru, Honduras, Haiti, Dominican Republic, Guatemala and some states in north and northeast Brazil). Here, we emphasize the importance of the political commitment in the final progression towards disease elimination. The availability of strategies for rabies control, the experience of most countries in the region and the historical ties of solidarity between countries with the support of the scientific community are evidence to affirm that the elimination of dog-transmitted rabies can be achieved in the short term. The final efforts to confront the remaining obstacles, like achieving and sustaining high vaccination coverage in communities that are most impoverished or in remote locations, are faced by countries that struggle to allocate sufficient financial and human resources for rabies control. Continent-wide cooperation is therefore required in the final efforts to secure the free status of remaining countries in the Americas, which is key to the regional elimination of human rabies transmitted by dogs.

Rabies Update for Latin America and the Caribbean

Rabies Update for Latin America and the Caribbean

Molecular epidemiology of rabies from Maranhão and surrounding states in the northeastern region of Brazil

Although many outbreaks of rabies have been reported in northern Brazil, few epidemiological studies of these outbreaks have been undertaken. In this study, molecular epidemiological analyses were performed using 41 rabies virus samples isolated in the Maranhão (MA), Pará (PA), and Tocantins (TO) states of northeastern Brazil. A 599-bp region of the glycoprotein (G) gene was first amplified from each sample by RT-PCR, then sequenced and subjected to phylogenetic analysis. A phylogenetic tree divided the 41 isolates into two clades: Clade I was associated with terrestrial carnivores and Clade II was associated with vampire bats. The Clade I isolates were further sub-divided into two groups. The first group was closer to carnivore isolates that predominate in central Brazil, whereas the second group more closely resembled wild fox isolates from the northeastern coastal state of Paraíba (PB). MA isolates of Clade II formed an entirely separate group. These results demonstrate that bat- and dog-transmitted rabies occur in northwestern Brazil.

A review of the economics of the prevention and control of rabies. Part 2: Rabies in dogs, livestock and wildlife.

Although rabies in domestic and wild animals represents a significant threat to public health and can cause economic losses among livestock, there are very few studies that examine the economics of rabies in animals. The literature that does exist can be characterised as poorly documented estimates of costs, with insufficient information to allow replication of the analyses. Most papers have numerous 'violations' of the standard recommended procedures for assessing burden of disease and the cost and benefits of interventions. For example, most studies do not distinguish between financial charges and true economic costs. Further, despite the fact that controlling rabies in animal populations is often a multi-year task, only a few papers contain a multi-year framework, complete with discounting of future costs and benefits. Globally, dog-transmitted rabies represents the largest threat to human health. In order to prevent the transmission of rabies in a dog population, it is theoretically necessary to vaccinate a minimum of 60 to 70% of the dogs. Even countries with potentially sufficient resources, however, do not often meet and sustain these rates. One reason for such failure might be that individual dog owners might feel that it is too expensive to vaccinate their pets. Recent estimates in the US of the cost of vaccinating dogs range from $US16 to $US24 per dog. In developing countries, estimates range from $US0.52 in Thailand, to $US1.19 in the Philippines, to $US2.70 in Malawi. None of these estimates include indirect costs accured by the pet owners. Lethal methods of dog population control are even more expensive, and attempting to control rabies by reducing dog populations has not worked for any extended period. Rabies in livestock is often reported, but the impact in the US and most developed countries appears relatively small. Vampire bat-transmitted rabies in Latin America appears to be the most serious rabies problem in livestock. The largest cost due to wildlife rabies is the cost of vaccinating domestic animals, both large and small. In the US, domestic animals face multiple sources of wildlife rabies. Attributing the entire cost of vaccinating domestic animals to 1 species can result in the over estimation of the benefits of immunising a given wildlife population via vaccine-laden baits. For example, despite a definite decline in the number of rabid foxes, it has been difficult to obtain the promised benefits of using oral vaccines in Europe to control fox rabies. Other authors maintain that the use of oral vaccines to control fox rabies is cost beneficial, but there are no convincing data supporting that claim. Additionally, vaccinating raccoons with an oral vaccine requires approximately 4 times more vaccine-laden baits vaccinating foxes, which makes it highly questionable if it would be cost beneficial to use oral vaccine to attempt raccoon rabies elimination in areas where it is already enzootic. The economics of using oral vaccines to prevent raccoon rabies invading uninfected areas has yet to be examined.