Risk Of Rabies Research Articles

Epidemiological and Clinical Characteristics of Patients Admitted to the Pediatric Emergency Department After Exposure to the Risk of Rabies

Epidemiological and Clinical Characteristics of Patients Admitted to the Pediatric Emergency Department After Exposure to the Risk of Rabies

Çocuk Acil Servisine Kuduz Riskli Temas Sonrası Başvuran Hastaların Epidemiyolojik ve Klinik Özellikleri

Çocuk Acil Servisine Kuduz Riskli Temas Sonrası Başvuran Hastaların Epidemiyolojik ve Klinik Özellikleri

Large-scale phylogenetic analysis reveals genetic diversity and geographic distribution of rabies virus in South-East and South Asia.

South-East Asia (SEA) and South Asia (SA) are two important geographic regions with the most severe enzootic rabies in the world. In these regions, phylogenetic analysis of rabies virus (RABV) has been conducted only at a country level; the results obtained from different countries are scattered and unequal, with a non-uniform system to name RABV genotypes. Therefore, it is difficult to undertake origin-tracking and compare inter-country RABV evolution and transmission. To avoid the confusion in understanding and to generate a panoramic picture of RABV genetic diversity, distribution, and transmission in SEA and SA, the present study conducted a systematic phylogenetic analysis by combining all sequences representing 2368 RABV strains submitted to GenBank by 14 rabies endemic SEA and SA countries. The results showed that RABVs circulating in two regions were classified into four major clades and many subclades: the Asia clade is circulating only in SEA, the Indian subcontinent, and Arctic-like clades only in SA, while the Cosmopolitan clade has been detected in both regions. The results also showed a wide range of hosts were infected by divergent RABV subclades, with dogs being the major transmission source. However, wildlife rabies was also found to be an important issue with 6 wild carnivore species identified as potential sources of spillover risk for sylvatic rabies to humans, domestic animals, and other wild animals. Current findings indicate that the two regions have separate virus clades circulating thus indicating the absence of cross-transmission between the regions. The study emphasizes the importance of phylogenetic analysis in the regions using uniform genotyping and naming systems for rabies surveillance, to coordinate actions of member countries to eliminate dog-mediated human rabies by 2030.

Evaluation of potential rabies exposure among Japanese international travelers: A retrospective descriptive study.

Although Japan has been a rabies-free country for >50 years, a few cases have been reported among people traveling abroad. This study aimed to investigate animal exposure among Japanese travelers using the Japanese Registry for Infectious Diseases from Abroad (J-RIDA). In this retrospective analysis, we examined Japanese overseas travelers with animal exposure, as included the J-RIDA database, reported from October 1, 2017, to October 31, 2019, with a focus on pre-exposure prophylaxis (PrEP) administration and the animals to which the patients were exposed. Among the 322 cases included in the analysis, 19 (5.9%) patients received PrEP and 303 did not. The most common purpose of travel was a non-package tour (n = 175, 54.3%). Most trips (n = 213, 66.1%) were to a single country for <2 weeks. Most patients (n = 286, 87.9%) traveled to countries with a rabies risk. The majority of patients with and without PrEP were injured in rabies-risk countries [n = 270 (89.1%) for non-PrEP and n = 16 (84.2%) for PrEP]. Animals associated with injuries included dogs (55.0%), cats (25.5%), and monkeys (15.5%). Most patients were classified as World Health Organization Category II/III for contact with suspected rabid animals (39.5% and 44.1% for categories II and III, respectively) and had exposure within 5 days of travel. Southeast Asia (n = 180, 55.9%) was the most common region in which travelers were exposed to animals. Japanese overseas travelers had contact with animals that could possibly transmit the rabies virus, even on short trips. Promoting pre-travel consultation and increasing awareness of the potential for rabies exposure are important for prevention of rabies among Japanese international travelers.

Cat rabies in Brazil: a growing One Health concern.

This review of human and cat rabies from 1986 to 2022 has shown mostly AgV3 variant in human cases with 29/45 (64.4%) reports including 23 from bats, four from cats, and two from unknown species, followed by 8/45 (17.8%) of AgV2 variant (all from dogs), 4/45 from marmoset variant (all from Callithrix jacchus), 2/45 samples compatible with wild canid variant (both from Cerdocyon thous), and one/45 of AgV1 variant from a domestic dog. Only one sample of human rabies was not typified, related to bat aggression. In addition, surveillance conducted in the state of São Paulo confirmed the presence of rabies in 7/23,839 cats (0.031%) and 3/106,637 dogs (0.003%) between 2003 and 2013, with a 10:1 overall cat-to-dog positivity ratio. This 10-fold higher infection rate for cat rabies may be explained by cats' hunting habits and predation. In addition, after 28 years of rabies-free status, a new cat rabies case was reported in the city of São Paulo in 2011. The rabid cat lived, along with other pets, in a household located near the largest downtown city park, whose owners presented animal hoarding behavior. Thus, animal hoarders and rescuers, public health agents, animal health professionals, and the general population with contact need to be aware of the risk of bat-borne rabies followed by spillover from cats to humans. In conclusion, cat rabies cases are becoming increasingly important in Brazil. This poses a One Health concern, given the overlapping of human, bat and cat populations within the same predisposed environment.

Risk factors and molecular epidemiology of canine rabies in Beijing

Rabies is a serious public health problem in Asia and Africa. Approximately 99% of cases result from a bite by an infected dog. The high rabies risk countries are generally characterized by rapid urbanization; however, the prevalence and risk factors for rabies in urban dogs in developing countries remain unclear. Beijing, the capital of China, has been undergoing rapid urbanization, and implemented compulsory rabies immunization for dogs on October 1, 2014. We evaluated the effects of this immunization policy and investigated the dynamics and determinants of the spread of dog rabies virus (RABV) in Beijing. Between 2013 and 2018, the positive rate of rabies in biting dogs declined significantly; 79.6% of these were stray dogs. Reconstructed spatiotemporal diffusion for RABV presents a more central distribution within Beijing and a surrounding dissemination of virus lineage toward suburban areas, indicating that rabies is self-sustaining in Beijing. Continuous RABV phylogeographic reconstructions and logistic regression analysis of rabies cases revealed that rabies tended to remain in commercial areas, high-rise residences, demolition areas, and high-GDP, high-population and high-accessibility areas. Demolition areas, where many residents have abandoned their pets, are recognized as high-risk areas for rabies. Our findings reveal that the implementation of the immunization policy in Beijing has been effective in prevention and control of canine rabies, and because the prevalence of canine rabies results from multiple factors, emphasize the important role of multi-sectoral cooperation in rabies prevention and control.

Assessment of Perception of Rabies Infection Risk among Dog Handlers and ‎Dog Meat Consumers in Plateau State, Nigeria

The risk of rabies exposure via atypical means such as handling dogs that have uncertain vaccination status, handling/processing and eating dog meat make public enlightenment inevitable. A cross-sectional study was conducted among dog handlers, dog meat handlers, and consumers at dog sales/slaughter locations and sales points of dog meat in the three major dog markets in Plateau State, Nigeria. Structured questionnaires were randomly administered to 150 respondents via face-to-face interviews or self-administered. Data collected were analyzed using IBM® SPSS® statistics version 23.0. Chi-squared test of association was conducted to determine the relationship between socio-demographic characteristics and perceived risk of rabies exposure among respondents. Binary logistic regression models were used to determine the strength of the association. Logistic regression models were statistically significant for the combination of sex and tertiary educational background to predict likelihood that respondents would eat all parts of dog meat, χ2 (2) = 7.023, P-value = 0.03. The effect size was between 6.2% (Cox and Snell R2) and 8.4% (Nagelkerke R2) of the variance in likelihood to eat all parts of dog meat and correctly classified as 60.9% of cases. Educational background was the only statistically significant predictor variable (p-value=0.016; 95% CI: 0.16– 0.83), as respondents in the higher educational cadre (tertiary) have a better perception of risk of rabies and are not likely to eat all parts of the dog meat nor a rabid dog. The study reveals the significance of taking appropriate actions to ensure rabies control and prevention, rather than having mere head knowledge of the disease. Strict policies against indiscriminate dog trade, uninspected slaughter, and improper processing of dog meat, are necessary steps to prevent disease incursions via atypical means.

Risk of Rabies and Implications for Postexposure Prophylaxis Administration in the US

In the US, rabies postexposure prophylaxis (PEP) is often administered without a comprehensive and regionally appropriate rabies risk assessment. For low-risk exposures, this can result in patients incurring out-of-pocket expenses or experiencing adverse effects of PEP unnecessarily. To use a model to estimate (1) the probability that an animal would test positive for rabies virus (RABV) given that a person was exposed, and (2) the probability that a person would die from rabies given that they were exposed to a suspect rabid animal and did not receive PEP, and to propose a risk threshold for recommending PEP according to model estimates and a survey. In this decision analytical modeling study, positivity rates were calculated using more than 900 000 animal samples tested for RABV between 2011 and 2020. Other parameters were estimated from a subset of the surveillance data and the literature. Probabilities were estimated using Bayes' rule. A survey was administered among a convenience sample of state public health officials in all US states (excluding Hawaii) plus Washington, DC and Puerto Rico to determine a risk threshold for PEP recommendation. Respondents were asked whether they would recommend PEP given 24 standardized exposure scenarios while accounting for local rabies epidemiology. A quantitative and regionally appropriate approach for helping health care practitioners and public health professionals determine whether to recommend and/or administer rabies PEP. A total of 1728 unique observations were obtained from the model for the probability that an animal would test positive for RABV given that a person was exposed, and 41 472 for ) the probability that a person would die from rabies given that they were exposed to a suspect rabid animal and did not receive PEP. The median probability that an animal would test positive for RABV given that a person was exposed ranged from 3 × 10-7 to 0.97, while the probability that a person would die from rabies given that they were exposed to a suspect rabid animal and did not receive PEP ranged from 1 × 10-10 to 0.55. Fifty public health officials out of a target sample size of 102 responded to the survey. Using logistic regression, a risk threshold was estimated for PEP recommendation of 0.0004; PEP may not be recommended for exposures with probabilities below this threshold. In this modeling study of rabies in the US, the risk of death|exposure was quantified and a risk threshold was estimated. These results could be used to inform the decision-making process as to the appropriateness of recommending rabies PEP.

An Overview of Prophylaxis and Compliance with Vaccination in Contacts with Rabies Risk

An Overview of Prophylaxis and Compliance with Vaccination in Contacts with Rabies Risk

Rabies post-exposure prophylaxis of international travellers - Results from two major German travel clinics

BackgroundTravel to regions with rabies risk has increased. However, data on adequate rabies post exposure prophylaxis (PEP) abroad is scarce. The aim of this study was to assess the appropriateness of medical management following suspected rabies exposure (SRE) in international travellers. MethodA cross-sectional questionnaire-based study in returning travellers with reported SRE who sought post-exposure medical care was conducted in two large German travel clinics. ResultsThe 75 included SRE cases had a median age of 34 years (range 26–43) and showed a female predominance (59%, 44/75). Most participants returned from Asia (47%, 34/72). About 28% had received pre-exposure prophylaxis (PrEP, ≥2 vaccine doses) (20/71). In 51% the animal was actively approached (34/67).All patients had category II/III exposure according to the World Health Organization (65% category III, 49/75). With 78% (52/67), most patients cleaned the wound after SRE; 36% (24/67) used water and soap. Only 57% (41/72) of participants sought medical care during their trip. Overall, 45% (33/74) received rabies vaccination abroad which corresponds to 80% out of those who sought healthcare (33/41). ConclusionsAwareness for appropriate first aid and the urgency of seeking timely professional treatment including PEP after an SRE seems to be insufficient in German travellers. Travel practitioners need to educate travellers about rabies risk, prevention measures and the correct behaviour after SRE including adequate wound treatment and seeking immediate medical help for PEP. PrEP should be offered generously especially to travellers with high rabies-exposure risk and those visiting areas with limited healthcare access.

Mapping rabies distribution in China: a geospatial analysis of national surveillance data

ObjectivesDog-mediated human rabies remains an important public health problem in China. In this study, we aimed to understand the spatiotemporal variation of rabies and examine its nonmedical ecological factors. MethodsIn this study, we used the annual incidence data for rabies at the province level in China to describe the incidence trends for the period 2004-2019 and used a Bayesian hierarchical spatiotemporal model to determine the impacts of environmental, economic, and demographic factors. ResultsFrom 2004 to 2019, there were 26,593 cases reported in 31 provinces in Mainland China, and the annual incidence increased from 0.02 per 100,000 in 2004 to 0.14 in 2007, substantially decreased in 2008, and was gradually declining thereafter. Guizhou, Guangxi, Hunan, and Hainan were four high-risk provinces, and Yunnan and Anhui provinces showed an increased risk in 2018 and 2019. Temperature and per capita gross domestic product were significantly positively correlated with the disease risk. The standardized morbidity ratio of rabies is likely to increase by 28% (relative risk: 1.28, 95% credible interval: 1.13-1.36) for every 1°C rise in temperature, and 17% (relative risk: 1.17, 95% credible interval: 1.01-1.34) for every 10,000 yuan increase in per capita gross domestic product. ConclusionIn most provinces in China, the risk of rabies has been reduced to a persistently low level. However, the progress of rabies control in six provinces have been less than satisfactory. The study highlights interventions, such as enhancing animal vaccination need to be implemented in these priority areas.

Variation of Rabies Incidence with Rainfall Pattern in Uganda: Neglected Implication of Climate Change on Rabies Risk

Variation of Rabies Incidence with Rainfall Pattern in Uganda: Neglected Implication of Climate Change on Rabies Risk

Knowledge, attitudes, and practices regarding dogs and dog bites in Indigenous northern communities: A mixed methods study.

The singular relationship developed over the years between northern Indigenous peoples and dogs has been profoundly changed through historical trauma, settlements and increased use of snowmobiles. Issues related to dogs have become increasingly complex and worrisome with the endemic presence of the rabies virus among Arctic fox populations, and given the fact that northern Indigenous peoples may have a higher risk of dog bites than the general population. This study aimed to investigate factors related to the risk of dog bites in Naskapi and Innu communities located in northern Quebec (Canada) by (1) describing the knowledge, attitudes and practices (KAP) regarding dogs and dog bites in these communities, and (2) analyzing experiences of inhabitants and health professionals with regard to dog bites and their management. A mixed methods study design that combined an observational cross-sectional survey and individual interviews was used. The survey collected data on KAP regarding dogs and dog bites among 122 respondents. Individual interviews (n = 37) were then conducted with victims of dog bites, owners of dogs that have bitten a person before, and health professionals. Descriptive and inferential analysis (quantitative data) and thematic analysis (qualitative data) were performed. Results highlighted that 21% of respondents have had a dog bite in their lifetime. Most respondents were not aware of the risk of contracting rabies following a dog bite, although rabies risk perception was associated with risk perception of dogs (linear regression: coefficient = 0.69, 95% CI = 0.36-1.02). The odds of being more knowledgeable on rabies were higher (logistic regression: OR = 2.92, 95% CI = 1.07-7.98) among young adults. Dogs were perceived as both threats and protectors by community members. When the fear of dogs was present, it affected the quality of life of some inhabitants. There was confusion about responsibilities in the management of biting dogs, although protocols to follow after a bite were clear for health care professionals. This study revealed a lack of awareness and knowledge about dog bites and rabies risks in both communities. Results provide important knowledge for the development of interventions adapted to northern Indigenous communities.

Connaissances de la rage, perception du risque et observance réglementaire : propositions issues de deux enquêtes a l’école nationale vétérinaire d’Alfort (ENVA)

Although France is considered rabies-free according to WHO, the RABV and EBLV-1 viruses have recently caused human and animal victims in France. Through two surveys at the EnvA, we sought to assess the knowledge of do-mestic carnivore owners, clinicians and students about rabies and travel regulations, their perception of rabies risk and their degree of compliance with the regulations. The knowledge of owners appears to be extremely de-ficient, while that of clinicians and students present limitations. Risky behaviors are highlighted as well as a non-optimal consideration of rabies risk by professionals. Faced with this worrying finding, avenues for improvement are proposed, centered on better communication targeting all actors, both qualitatively and quantitatively, and on possible regulatory changes based on risk analysis.

The potential for the double risk of rabies and antimicrobial resistance in a high rabies endemic setting: detection of antibiotic resistance in bacterial isolates from infected dog bite wounds in Uganda

BackgroundPost-exposure treatment for dog bites in humans aims at alleviating the risk of rabies and promoting wound healing. Wound healing may be complicated by bacteria. This study identified the different bacteria and their antibiotic susceptibilities in infected dog bite wounds (DBWs) in Uganda.MethodsA cross-sectional study was conducted among 376 dog bite patients. Wound swabs from patients with infected DBWs were collected and inoculated into recommended media. They were cultured for both aerobic and anaerobic bacteria. All isolated bacteria were identified based on colony characteristics, gram stain, and standard biochemical tests. Molecular identification was performed for strains that were resistant to three or more antibiotics. Antibiotic susceptibility testing was conducted using the disc diffusion method following the modified Kirby-Bauer method. The data were analysed using Stata version 15 software.ResultsApproximately half of the patients (52.9%, 199/376) presented with infected wounds. Majority of the swabs (84.4%, 168/199) were culture positive, and yielded a total of 768 isolates where about half (52.9%, 406/768) were gram positive bacteria, and about two-thirds (64.6%, 496/768) were recovered from category II wounds. Among the gram positive bacteria, 339 (83.5%) were aerobes where Staphylococcus aureus (103, 30.4%), Coagulase-negative staphylococci (68, 20.1%), and Corynebacterium spp (33, 9.7%) had the highest prevalence. For the 362 Gram negative isolates, 217 (59.9%) were aerobes and the commonest isolates were P. maltocida (64, 29.5%), Capnocytophaga canimorsus (36, 16.6%) and P. canis (26, 12.0%). Gram-positive isolates were resistant to metronidazole (93.6%), oxacillin (68.5%), ceftriaxone (14.6%) and amoxicillin/clavulanic acid (14.0%). Gram negative isolates were resistant to metronidazole (100%), ampicillin (30.7%), oxacillin (29.3%), and doxycycline (22.9%). Multidrug resistance was in 105 (29.0%) and 121/406 (29.8%) of the gram-negative and gram-positive isolates, respectively. All gram-positive isolates were susceptible to vancomycin and ciprofloxacin.ConclusionsInfection rates of DBWs in Uganda are high and the dominant bacterial isolates are Staphylococcus aureus, Pasteurella spps, and Capnocytophaga canimorsus. Multidrug resistance to commonly used antibiotics is high. The recommendation in the Uganda Clinical Guidelines to use metronidazole in the management of DBWs should be reviewed. DBWs should be enlisted for routine antimicrobial resistance surveillance and rational use of antimicrobial agents should be promoted.

Rabies risk from imported dogs.

Rabies risk from imported dogs.

A CROSS SECTIONAL STUDY ON AWARENESS OF ANIMAL BITE MANAGEMENT AND RABIES IMMUNIZATION AMONG GENERAL PRACTITIONERS IN A METROPOLITAN CITY OF INDIA

Background: Rabies is a viral disease that has 100% case fatality following the onset of the clinical symptom. It can be prevented by vaccination before and/or after suspected or proven exposure to the virus. An observational cross-secti Methods: onal study was conducted among the general practitioners of an urban area/a metropolitan city. The study investigators visited the clinics of the participants &amp; data collection was done using a semi-structured questionnaire. The participants who gave consent were enrolled in the study. SPSS Version 27 was used to analyze the data. Results: Out of the 60 general practitioners, 18 M.B.B.S. and 42 non-M.B.B.S. (BAMS/BHMS/BUMS) doctors were interviewed. Among all the general practitioners, 60% (36) were able to state the categories of animal bite as per WHO classication whereas 12 (66.7%) M.B.B.S. and 25 (59.5%) non M.B.B.S. general practitioners could answer correctly about the rst aid treatment. The awareness regarding rabies vaccine (p=0.05); precaution for passive immunization (p=0.01); awareness of pre-exposure prophylaxis (p=0.04); people at high risk for rabies (p=0.01) were found to be statistically signicant among M.B.B.S. and non M.B.B.S. general practitioners. The knowledge was comparatively better among M.B.B.S. doctors. Regular training for general practitioners is recommended for updating the knowledge Conclusions: regarding wound care, treatment and administration of available vaccines for rabies.

Evaluation of Our Rabies Prevention Practices: Is Our Approach Correct?

Rabies disease is zoonotic disease-causing encephalitis and resulting in death. It is possible to prevent the disease with suitable prophylaxis approaches. This study examined the compliance of post-exposure prophylaxis approaches with the guidelines and the reasons for non-compliance in contact cases at risk of rabies. This retrospective cross-sectional study includes patients who continued the vaccination program from 2014-2018 at the Ordu University Medical Faculty Hospital Rabies Vaccination Center in Ordu, Turkey. Cases were assessed in terms of sociodemographic features, previous rabies vaccination history, features of the contact with rabies risk, attendance duration after contact, and whether all stages of prophylaxis were completed after contact. Of the 748 cases attending the vaccination center, the age range was 1- 91 yr, with a mean age of 28.12 ± 21.60 yr. Of cases, 62.3% were male (n =466) and 37.7% were female (n =282). Of risky contact, 60% comprised stray animals. Of recorded cases, 55.2% displayed approaches compatible with guidelines. Among incompliant approaches, the most frequent was administering vaccines even though observation was sufficient. (n = 174, 52%). Contact with risk of rabies may result in insufficient administration of the stages in prophylaxis after contact, or contrarily, mistaken administration based on acting with a sense of excessive safety. Stray dogs or domestic animals without sufficient vaccinations comprise a significant risk despite all efforts. In order to prevent risky contact, there is a need for the development of correct strategies and to ensure continuity of in-service training for health professionals.

Spatio-temporal epidemiology of animal and human rabies in northern South Africa between 1998 and 2017

BackgroundRabies is a fatal zoonotic disease that is maintained in domestic dogs and wildlife populations in the Republic of South Africa. A retrospective study was conducted to improve understanding of the dynamics of rabies in humans, domestic dogs, and wildlife species, in relation to the ecology for three northern provinces of South Africa (Limpopo, Mpumalanga, and North-West) between 1998 and 2017.MethodsA descriptive epidemiology study was conducted for human and animal rabies. Dog rabies cases were analyzed using spatio-temporal scan statistics. The reproductive number (Rt) was estimated for the identified disease clusters. A phylogenetic tree was constructed based on the genome sequences of rabies viruses isolated from dogs, jackals, and an African civet, and Bayesian evolutionary analysis using a strict time clock model. Several ecological and socio-economic variables associated with dog rabies were modeled using univariate analyses with zero-inflated negative binomial regression and multivariable spatial analyses using the integrated nested Laplace approximation for two time periods: 1998–2002 and 2008–2012.ResultsHuman rabies cases increased in 2006 following an increase in dog rabies cases; however, the human cases declined in the next year while dog rabies cases fluctuated. Ten disease clusters of dog rabies were identified, and utilizing the phylogenetic tree, the dynamics of animal rabies over 20 years was elucidated. In 2006, a virus strain that re-emerged in eastern Limpopo Province caused the large and persistent dog rabies outbreaks in Limpopo and Mpumalanga Provinces. Several clusters included a rabies virus variant maintained in jackals in Limpopo Province, and the other variant in dogs widely distributed. The widely distributed variant maintained in jackal populations in North-West Province caused an outbreak in dogs in 2014. The Rt was high when the disease clusters were associated with either multiple virus strains or multiple animal species. High-risk areas included Limpopo and Mpumalanga Provinces characterized by woodlands and high temperatures and precipitation.ConclusionCanine rabies was maintained mainly in dog populations but was also associated with jackal species. Rural communities in Limpopo and Mpumalanga Provinces were at high risk of canine rabies originating from dogs.

Identifying high-risk areas for dog-mediated rabies using Bayesian spatial regression

Despite ongoing control efforts, rabies remains an endemic zoonotic disease in many countries. Determining high-risk areas and the space-time patterns of rabies spread, as it relates to epidemiologically important factors, can support policymakers and program managers alike to develop evidence-based targeted surveillance and control programs. In this One Health approach which selected Thailand as the example site, the location-based risk of contracting dog-mediated rabies by both human and animal populations was quantified using a Bayesian spatial regression model. Specifically, a conditional autoregressive (CAR) Bayesian zero-inflated Poisson (ZIP) regression was fitted to the reported human and animal rabies case counts of each district, from the 2012–2017 period. The human population was used as an offset. The epidemiologically important factors hypothesized as risk modifiers and therefore tested as predictors included: number of dog bites/attacks, the population of dogs and cats, number of Buddhist temples, garbage dumps, animal vaccination, post-exposure prophylaxis, poverty, and shared administrative borders. Disparate sources of data were used to improve the estimated associations and predictions. Model performance was assessed using cross-validation. Results suggested that accounting for the association between human and animal rabies with number of dog bites/attacks, number of owned and un-owned dogs; shared country borders, number of Buddhist temples, poverty levels, and accounting for spatial dependence between districts, may help to predict the risk districts for dog-mediated rabies in Thailand. The fitted values of the spatial regression were mapped to illustrate the risk of dog-mediated rabies. The cross-validation indicated an adequate performance of the spatial regression model (AUC = 0.81), suggesting that had this spatial regression approach been used to identify districts at risk in 2015, the cases reported in 2016/17 would have been predicted with model sensitivity and specificity of 0.71 and 0.80, respectively. While active surveillance is ideal, this approach of using multiple data sources to improve risk estimation may inform current rabies surveillance and control efforts including determining rabies-free zones, and the roll-out of human post-exposure prophylaxis and anti-rabies vaccines for animals in determining high-risk areas.