Dog Vaccination Research Articles

Challenging a paradigm: Staggered versus single-pulse mass dog vaccination strategy for rabies elimination.

From smallpox to poliomyelitis, halting contagion transmission through simultaneous mass vaccination is ubiquitous and often perceived as the only possible solution. But implementing mass vaccination campaigns in large populations within a short period poses many challenges. For example, in Arequipa, Peru, sweeping mass vaccination campaigns conducted yearly over a single weekend have failed to achieve the required 'herd immunity' to halt canine rabies transmission. Contrary to the global paradigm of a simultaneous campaign, the 2022 Arequipa rabies campaign was implemented at the sub-district level (patches), with dates of the campaign staggered across 6 months. We constructed a stochastic, metapopulation model to examine how the timing of pulsed vaccination campaigns across patches can affect metapopulation dynamics. We explore general metapopulation dynamics for pulsed vaccinations as well as parameterizing the model for canine rabies in Arequipa, Peru. We simulated how the timing of the planned vaccination campaign, staggered over 6 months versus a single yearly pulse, affected the prospects for regional rabies elimination. Metapopulation dynamics can affect the efficacy of pulsed vaccination campaigns. In the case of Arequipa, Peru, the planned staggered mass dog vaccination campaign has the potential for local elimination with the tradeoffs of increased time to elimination and increased outbreak size due to metapopulation dynamics. Heterogeneities caused by control strategies enactment at sub-population scales should be accounted for when modeling transmission dynamics. In Arequipa, Peru, although metapopulation dynamics may allow for re-introduction of canine rabies in previously vaccinated patches when mass dog vaccination campaigns are staggered temporally over 6 months, continuous mass vaccination reaching recommended vaccination coverage levels is sufficient to eliminate canine rabies.

The use of vaccines for the prevention and treatment of dermatomycosis in small domestic animals (retrospective analysis)

The authors present information about the effective of the use of local national vaccines against microsporia and trichophytia of dogs and cats for therapeutic and preventive purposes. The research work was carried out on base of the veterinary clinic «Vettal» in Moscow from 2013 to 2023. During the analyzed period veterinarians carried out 2,065 animal vaccinations against microsporia and trichophytia. Of these 1,263 dogs and cats were vaccinated for preventive purposes and 802 animals were vaccinated for therapeutic purposes, which are overwhelmingly represented by cats. The diagnosis of dermatomycosis was established on the basis of examination, laboratory and instrumental diagnostics. The phase contrast method microscopy was used for pathological material for the convenience of identifying pathogens of fungal diseases. For therapeutic purposes vaccination was carried out 2 or 3 times. The intervals between administration of the drugs were 10- 14 days. The evaluation criteria recovered animals were: absence of clinical manifestations on the body, negative luminescent diagnosis, repeated mycological sowing on nutrient media without growth of the pathogen. According to the results of the analysis, the authors found that after 2-fold vaccination of animals diagnosed with microsporia/trichophytia, recovery occurred in 66.32% of sick cats and 87.27% of sick dogs; after 3-fold vaccination, recovery occurred in 84.71% of cats and 95.45% of dogs. According to the results of a survey of doctors with more than ten years of experience and accounting documents, 100% effectiveness of preventive vaccination of cats and dogs with domestic antifungal vaccines has been established, subject to compliance with the vaccination regime. Thus carrying out preventive and curative vaccinations in dogs and cats with local national specialized vaccines against microsporia and trichophytia is a highly effective and safe method of combating eooanthroponous dermatomycosis.

Cellular immune response against rabies vaccination in laboratory-bred dogs: A systematised review.

The immunogenicity of rabies vaccines is commonly measured by serological testing, which includes measuring rabies virus-neutralising antibody titre levels in the serum. Apart from humoral immunity, cellular immunity measurements are also helpful in assessing the immunogenicity and efficacy of rabies vaccinations. Recently, there has been an increased emphasis on cellular immunity measurements against rabies in humans and animals. This review aimed to systematically analyse the literature on the composition of cellular immune responses against rabies vaccination in laboratory dogs. A literature survey was conducted to collect suitable articles by searching the research databases PubMed, Web of Science and Scopus. Subsequently, a two-person screening was conducted to identify suitable articles based on predetermined inclusion and exclusion criteria. Data extraction was performed by two authors independently. A total of 1396 studies were identified from the initial search. Following the screening, six studies were selected for final review. Different methods of detecting immune parameters from peripheral blood mononuclear cells were identified from the studies. Reports have demonstrated positive outcomes of the use of adjuvants for cellular immunity development. Even though the lack of specific immunological techniques and the specific reagents have negatively affected these types of cellular immunity measurements, it was evident that combining both humoral and cellular immune parameters against the rabies antigen would provide a clearer picture of the level of responsiveness in animals towards vaccinations and the protection against the disease. The protocol for this review was published in the International Prospective Register of Systematic Review (CRD42022380023).

Rabies vaccinations at the rural-urban divide: successes and barriers to dog rabies vaccination programs from a rural and urban campaign in Zambia.

Dog vaccination against rabies is considered one of the most effective strategies at preventing human deaths from rabies and is a key strategy for eliminating dog-mediated human rabies deaths. Traditional vaccination approaches in Zambia rarely collect operational data to assess coverage and inform subsequent campaigns. Following mass vaccination campaigns in rural (Itezhi tezhi) and urban (Lusaka) communities, we evaluated vaccination coverage achieved during the campaigns and characterized and estimated the dog population in these communities. Herd immunity (i.e., 70% vaccination coverage) was not achieved in the Lusaka campaign, likely due to challenges in pre-campaign community sensitization and distance to vaccination sites in the central point campaign approach. Dog population density showed a strong exponential association with human density (R2 = 0.89). Extrapolating this relationship nationally, there are an estimated 3.2 million dogs in Zambia (human-to-dog ratio 5.8:1) with 86% residing in rural communities at a very low density of less than 6 dogs per square kilometer. As most dogs were found to reside at very low densities, unique challenges to large-scale dog vaccination approaches may impact Zambia, due to high logistical costs associated with these settings. Prioritizing vaccinations in higher-density free-roaming dog populations could maximize effectiveness in resource-limited settings. Private veterinary services were commonly utilized among surveyed dog owners in urbanized communities in Lusaka, suggesting that they are an important collaborator for achieving rabies herd immunity. With improved knowledge of dog population and ownership characteristics, Zambia is well-prepared to design more effective vaccination campaigns as the rabies elimination program expands.

Correction to ‘Reservoir dynamics of rabies in south‐east Tanzania and the roles of cross‐species transmission and domestic dog vaccination’

Correction to ‘Reservoir dynamics of rabies in south‐east Tanzania and the roles of cross‐species transmission and domestic dog vaccination’

Dog demography and ecology with reference to rabies in the Amhara region, Ethiopia.

ology: The study employed dog census and questionnaire surveys of 907 households selected using a multistage sampling technique from six rural and six urban districts of the Amhara region, Ethiopia. The ecology and demography of owned dogs in the selected areas were recorded and described using descriptive statistics. Mixed-effect logistic regression models were used to identify factors associated with dog ownership and rabies occurrence. A total of 6609 dogs were estimated from 42 kebeles in the 12 study districts. The male-to-female ratio of dogs was 1.7:1.0, and the mean age of dogs was 3.2 years. The proportion of households who owned at least one dog was 5.9%. The average number of dogs per dog-owned household was 1.3. Dog to household ratio was 1.0:13.0, and dog to human ratio was 1.0:48.5. The majority of the dog owners (97%) keep dogs for home guard and livestock herding. Only 57% of the dogs were confined, and 16% of them were vaccinated. Ninety-one percent of the dog owners did not practice neutering and spaying for dog population control. Religion, livestock ownership pattern, and occupation were associated with dog ownership (p<0.05). Community residence and age of respondents were associated with rabies occurrence (p<0.05), while zone was associated with both dog ownership and rabies occurrence at p-value <0.05. The study indicated a low dog population relative to humans, which might make dog-based rabies control manageable. But at the same time, most dogs were not properly managed (confined and vaccinated), which calls for more awareness about responsible dog ownership to reduce zoonotic disease risk, including rabies. Generally, the study provides useful information about the demography and ecology of owned dogs in relation to rabies for making proper and effective rabies control strategies and is important to design the spatial distribution of rabies vaccination in dogs. However, as the study did not include stray dogs, which have great contributions to the spread of rabies, the information should be used with this caveat into consideration.

Contemporary Approach Towards Rabies Elimination from Bangladesh

Rabies is a devastating zoonotic disease that has the utmost equal public and animal health significance due to its lethality. The canine mediated rabies is the main threat globally dominated in Bangladesh. To eliminate rabies that requires to break down the transmission cycle within animals and humans. Bangladesh's government acted on the mass dog vaccination and post-exposure prophylaxis for humans that were not sufficient to eliminate rabies. This multifaceted zoonotic disease is complicated to eliminate; thus, a multi-sectoral one-health approach could be the best strategy to eliminate rabies. However, the successful elimination of rabies from society requires strengthening our surveillance, proper rubbish management, stray dogs/cats birth control, mass dog vaccination, wildlife conservation, post-exposure prophylaxis (PEP) for humans and animals, regular (pre-exposure prophylaxis) PrEP for pets, and mass awareness programs. Therefore, the objective of the essay is to figure out contemporary risk factors of rabies spreading and the most effective way to eliminate it.

Combining genomics and epidemiology to investigate a zoonotic outbreak of rabies in Romblon Province, Philippines

AbstractRabies is a viral zoonosis that kills thousands of people annually in low- and middle-income countries across Africa and Asia where domestic dogs are the reservoir. ‘Zero by 30’, the global strategy to end dog-mediated human rabies, promotes a One Health approach underpinned by mass dog vaccination, post-exposure vaccination of bite victims, robust surveillance and community engagement. Using Integrated Bite Case Management (IBCM) and whole genome sequencing (WGS), we enhanced rabies surveillance to detect an outbreak in a formerly rabies-free island province in the Philippines. We inferred that the outbreak was seeded by at least three independent human-mediated introductions that were identified as coming from neighbouring rabies-endemic provinces. Considerable local transmission went undetected, and two human deaths occurred within 6 months of outbreak detection. Suspension of routine dog vaccination due to COVID-19 restrictions likely facilitated rabies spread from these introductions. Emergency response, consisting of awareness measures, and ring vaccination, were performed, but swifter and more widespread implementation is needed to contain and eliminate the outbreak and to secure rabies freedom. We conclude that strengthened surveillance making use of new tools such as IBCM, WGS, and rapid diagnostic tests can support One Health in action and progress towards the ‘Zero by 30’ goal.

First Recording of Isospora spp. in dogs and cats in Basra Governorate

Isospora spp are protozoa coccidian parasites from the phylum Apicomplexa found in the small intestine in hosts (dogs and cats). The aim of this study was to diagnose the Isospora spp infection microscopically in both dogs and cats (stray and housing), using flotation methods by Sheither solution. In the current study, a total of 130 fecal samples of dogs and cats (different in sex and ages) were collected. These animal’s samples divided into (109) cats, and (21) dogs, which were obtained from different areas of Basrah city during the period from September 2023 to April 2024. A total of infections with Isospora spp were that 9.5% for dogs and 10% for cats. The results depended on the shape, structure, and diameters of isolated oocysts under light microscopy which found oocysts of Isospora spp in dogs were distinguished by their large size and measurement. A high infection rate with Isospora spp. was observed in the Al-Fayhaa area (13.3). Monthly study analysis showed that the high infection rate occurred in February (23.8%), while September and October showed no recorded infection. In addition, the infection of Isospora spp. was high in the rural area of Basra province (13.3%). The current study demonstrated the presence of the different clinical symptoms in infected cats and dogs (dehydration, diarrhoea, fever, abdominal pain, weight loss, and vomiting). There are no significant differences in the statistical study. Through studying this research, I concluded that the parasite spreads due to differences in temperature and lack of care for the animal. Therefore, we advise the breeder to take vaccines for cats and dogs periodically and to conduct veterinary examinations.

Understanding and overcoming geographical barriers for scaling up dog vaccinations against rabies

Rabies causes 59,000 human deaths annually in over 150 countries. Mass dog vaccination (MDV) is key to controlling dog rabies, requiring 70% coverage in the susceptible dog population to eliminate rabies deaths. MDV campaigns must achieve geographical homogeneity of coverage. Although rabies elimination is feasible, operation challenges exist, especially in hard-to-reach areas. We conducted geospatial modelling to identify geographical factors affecting MDV success in terms of campaign completeness and vaccination coverage across 25 districts in south-eastern Tanzania. From October 2016 to January 2017, about 81,000 dogs were vaccinated in 1,379 (68%) villages within these districts. Multivariable regression analysis revealed that land cover, residence, poverty, and elevation were associated with campaign completeness. The odds of achieving completeness in croplands were 1.75 times higher compared to forests. Vaccination coverage was influenced by residence, area, poverty index, and elevation, with urban areas having lower odds of achieving coverage compared to rural areas. Coverage probabilities exceeding 70% were lower on islands, highlands, urban areas, and areas bordering protected areas. As the 2030 deadline for "zero dog-mediated human rabies deaths" approaches, operational and logistical challenges in MDV campaigns persist. Our data provide insights into MDV success and failure, guiding future control efforts to improve their effectiveness.

Evaluation of the immune status of dogs vaccinated against rabies by an enzyme-linked immunosorbent assay using crude preparations of insect cells infected with a recombinant baculovirus encoding the rabies virus glycoprotein gene.

Evaluation of the effectiveness of vaccination of animals against rabies is not routinely implemented. In cases where it is carried out, the rapid fluorescent focus inhibition test (RFFIT) or the fluorescent antibody virus neutralization (FAVN) test are the recommended tests. However, both of these tests require handling of live rabies virus (RABV), and are cumbersome to perform. In view of this, the enzyme-linked immunosorbent assay (ELISA) has been proposed as a surrogate test; however, availability of appropriate antigen is a major impediment for the development of ELISAs to detect anti-rabies antibodies. The most widely used antigen is the RABV glycoprotein (G) purified from cell culture-propagated virus, which requires a biosafety level 3 containment. The alternative is to use recombinantly expressed G, which needs to be to be properly glycosylated and folded to serve as the best antigen. The most suitable system for its production is the baculovirus expression system (BVES). However, purification of RABV G is challenging. We therefore tested partially purified preparations in the form of extracts of insect cells infected with baculovirus expressing RABV G, against sera from vaccinated dogs in an indirect ELISA. The results showed good concordance against RFFIT, with sensitivity and specificity of 90.48% and 80.00%, respectively. The system may be used for quick screening to determine the presence and an approximate level of antibodies, and can be modified to enable monitoring of mass dog vaccination programs, as well as to facilitate certification of dogs intended for international travel and transportation.

Elimination of dog-mediated human rabies: scientific tools, One Health and partnerships.

A world free of dog-mediated human rabies by 2030 would be an outstanding achievement. This ambitious goal for a neglected tropical disease, set by the World Organisation for Animal Health (WOAH), the World Health Organization, the Food and Agriculture Organization of the United Nations and the Global Alliance for Rabies Control together with partners and countries, has a clear and achievable pathway to success. In the 100 years since the inception of WOAH, many scientific tools have been developed to support the elimination of dog-mediated rabies. In addition to these tools, engaging communities and health workers to build awareness to prevent bite exposures, managing dog populations and ensuring herd immunity through dog vaccination are key to achieving the elimination goals. The provision of post-exposure prophylaxis and care for exposed victims are important interventions on the human side. Success in eradicating rabies will require applying a One Health approach, an integrative and systemic approach to health grounded in the understanding that human health is closely linked to animal and environmental health. Political commitment and availability of adequate resources are key to achieving the Zero by 2030 goal.

Risk of canine distemper virus vaccination of domestic dogs in giant panda habitat to giant pandas

The giant panda (Ailuropioda melanoleuca), a unique relic species in China and a global biodiversity conservation symbol, faces the threat of canine distemper virus (CDV). Vaccinating domestic dogs in panda habitats against CDV is crucial, yet the associated risks remain understudied. We investigated the safety of CDV vaccination in 69 domestic dogs within panda habitats, employing enzyme-linked immunosorbent assay for CDV antibodies and quantitative reverse transcription polymerase chain reaction for viral RNA, a marker of viral shedding. Results revealed that vaccinated dogs posed a risk through viral shedding, mainly starting from the ninth day post-vaccination. Unvaccinated dogs exhibited increased CDV antibodies and subsequent shedding, with phylogenetic analysis confirming infection from vaccinated dogs in shared kennels. Dogs with higher initial antibodies displayed reduced shedding and a markedly abbreviated shedding duration (6.7 days) than those with lower initial antibodies (9.8 days). Habitat area analysis revealed substantial overlaps between domestic dogs and wild giant pandas in two nature reserves in China. To safeguard wildlife, particularly giant pandas, we recommend restricting vaccinated dogs’ activity for at least three weeks post-vaccination, complementing existing management practices. We advocate collaborative efforts among local authorities, reserve management and villagers for effective vaccination and post-vaccination management of domestic dogs.

Human-Centered Design to Respond to Public Health Crises: Maintaining Canine Rabies Vaccination during the COVID-19 Pandemic in Peru.

In the early coronavirus disease 2019 pandemic, limited understanding of severe acute respiratory syndrome coronavirus 2 transmission and fears of infection hindered mass dog vaccination efforts in dog rabies-affected areas. Interruption of dog rabies vaccination campaigns could lead to a rapid increase in the risk of human rabies. To address these challenges, we applied human-centered design (HCD) principles to develop a vaccination strategy that prioritizes safety while ensuring dog rabies vaccination continuity in Arequipa, Peru, a rabies-affected area. We describe the process of rapid prototyping and testing undertaken by our research team to adapt the vaccination process in response to a health crisis. A multidisciplinary team met twice a week to prototype a fixed-point vaccination campaign that ensured distancing and reduction of fomite transmission while allowing for the continuation of dog vaccination. Field notes and videos informed successive meetings. The final prototype was used in rabies hotspots. In 4 weeks, six prototypes of safe booths and supporting safety protocols were designed, and two copies of each prototype were field tested. During testing, additional innovations were identified and implemented, including virtual vaccine certificates and online data collection forms. The final prototype was implemented across 251 sites, and 17,876 dogs were vaccinated. Using HCD principles, we swiftly developed a mass vaccination strategy that provided safety and enabled the maintenance of rabies vaccination programs. This work highlights the importance of innovative and adaptive approaches to address public health challenges in times of crisis.

Animal rabies in Mozambique: a retrospective study with focus on dog rabies and vaccination coverage

Animal rabies in Mozambique: a retrospective study with focus on dog rabies and vaccination coverage

2022 AAHA Canine Vaccination Guidelines (2024 Update).

Vaccination is a cornerstone of canine preventive healthcare and one of the most cost-effective ways of maintaining a dog's health, longevity, and quality of life. Canine vaccination also serves a public health function by forming a barrier against several zoonotic diseases affecting dogs and humans. Canine vaccines are broadly categorized as containing core and noncore immunizing antigens, with administration recommendations based on assessment of individual patient risk factors. The guidelines include a comprehensive table listing canine core and noncore vaccines and a recommended vaccination and revaccination schedule for each vaccine. The guidelines explain the relevance of different vaccine formulations, including those containing modified-live virus, inactivated, and recombinant immunizing agents. Factors that potentially affect vaccine efficacy are addressed, including the patient's prevaccination immune status and vaccine duration of immunity. Because animal shelters are one of the most challenging environments for prevention and control of infectious diseases, the guidelines also provide recommendations for vaccination of dogs presented at or housed in animal shelters, including the appropriate response to an infectious disease outbreak in the shelter setting. The guidelines explain how practitioners can interpret a patient's serological status, including maternally derived antibody titers, as indicators of immune status and suitability for vaccination. Other topics covered include factors associated with postvaccination adverse events, vaccine storage and handling to preserve product efficacy, interpreting product labeling to ensure proper vaccine use, and using client education and healthcare team training to raise awareness of the importance of vaccinations.

A randomized controlled trial of the effectiveness of a community-based rabies vaccination strategy.

Approximately 60,000 people die from dog-mediated rabies annually. Low and heterogeneous coverage reduces the effectiveness of dog vaccination campaigns that can eliminate rabies. Campaigns typically involve teams travelling annually to villages to deliver cold chain stored vaccines from centralized headquarters. Thermotolerant vaccines enable novel decentralized delivery of locally-stored vaccines by communities throughout the year. We compared the effectiveness of annual team-based versus continuous community-based dog vaccination strategies. We conducted a cluster randomized controlled trial across Mara region, Tanzania. Trial clusters were administrative wards (112, on average four villages each). For the team-based arm vaccinators hosted annual static-point clinics, whilst for the community-based arm, a ward-based animal health officer with a village community leader managed vaccinations using vaccines stored within the ward. We measured vaccination coverage, the primary outcome, twice annually per cluster (month 1 and 11) through household surveys over three years (November 2020 to October 2023) and examined spatial and temporal coverage variations as secondary outcomes. Community-based delivery achieved significantly higher coverage (49-62%) than team-based delivery (22-46%), and consistently exceeded the critical threshold for herd immunity (40%), Odds ratio (OR): 1.48-3.49. The lower less uniform coverage achieved through team-based delivery had a higher monthly probability of falling below the critical threshold (0.6, 95% CI: 0.38-0.81) vs 0.18 (95% CI: 0.04-0.40). Greater declines in coverage over the year were recorded in the team-based arm compared to the community-based. Community-based mass dog vaccination achieves higher more consistent coverage than team-based delivery across settings typical of many sub-Saharan African countries. This approach could play an important role in national rabies elimination programmes aiming to end human rabies deaths by 2030 as part of the global 'zero by 30' strategy. Department of Health and Human Services of the National Institutes of Health (R01AI141712), Wellcome Trust (207569/Z/17/Z, 224520/Z/21/Z) and MSD Animal Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Density estimation using spatial capture‐recapture analyses: application to vaccination of prairie dogs against sylvatic plague

AbstractPrairie dogs are notoriously difficult to enumerate, with previously methods including visual counts, mark‐resight, burrow counts, and catch per unit effort. Unlike those methods, spatial capture‐recapture (SCR) analyses allow for formal estimation of density along with associated estimates of uncertainty, detection probability, and the size of the average area over which an individual was detected during the study period (referred to as an activity center). Using SCR analyses, we compared density estimates as part of a field trial evaluating the effectiveness of an oral sylvatic plague vaccine in black‐tailed prairie dogs (Cynomys ludovicianus), Gunnison's prairie dogs (C. gunnisoni), white‐tailed prairie dogs (C. leucurus), and Utah prairie dogs (C. parvidens) at 11 study areas in the western United States. The study was designed as a matched pairs analysis that included 27 individual paired plots (54 plots), each consisting of a plot treated with vaccine baits and a plot treated with placebo baits. Overall, we captured &gt;3,000 individuals each year on these plots, and recapture rates ranged from 5–87%. For black‐tailed prairie dogs, density estimates ranged from 2.7 individuals/ha (95% CI = 2.2–3.3/ha) to 77.3/ha (63.2–94.4/ha), and for Gunnison's prairie dogs, estimates ranged from 11.7/ha (10.6–12.8/ha) to 15.4/ha (14.4–16.7/ha). White‐tailed prairie dogs were at their lowest density (3.3/ha, 95% CI = 2.9–3.8/ha) during the first year of the study and their highest density (14.5/ha; 13.5–15.6/ha) during the last year of the study. Utah prairie dog density estimates ranged from a low of 4.0/ha (95% CI = 3.55–4.6/ha) to a high of 20.8/ha (16.8–25.8/ha). Best‐fitting models of prairie dog density indicated increasing patterns of density over time on most study plots, negative effects of plague, and positive effects of vaccination. Finally, we found low correlations between catch per unit effort estimates from previous published literature at these sites and our densities estimates. Spatial capture‐recapture estimates allowed us to consistently compare treatment effects across space and time, although some exceptions are noted where we observed significant movement between plots within a pair (3 pairs) and when trapping effort between plots or years was not consistent.

Molecular characterisation of human rabies in Tanzania and Kenya: a case series report and phylogenetic investigation

BackgroundRabies remains a major public health problem in low- and middle-income countries. However, human rabies deaths are rarely laboratory-confirmed or sequenced, especially in Africa. Five human rabies deaths from Tanzania and Kenya were investigated and the causative rabies viruses sequenced, with the aim of identifying implications for rabies control at individual, healthcare and societal levels.Case presentationThe epidemiological context and care of these cases was contrasting. Four had a clear history of being bitten by dogs, while one had an unclear biting history. Two individuals sought medical attention within a day of being bitten, whereas three sought care only after developing rabies symptoms. Despite seeking medical care, none of the cases received complete post-exposure prophylaxis: one patient received only tetanus vaccination, one did not complete the post-exposure vaccination regimen, one followed an off-label vaccination schedule, and two did not receive any post-exposure vaccinations before the onset of symptoms. These cases highlight serious gaps in health-seeking behaviour, and in health systems providing appropriate care following risky exposures, including in the accessibility and effectiveness of post-exposure prophylaxis as it is administered in the region.ConclusionsThe viral genomic and epidemiological data confirms dog-mediated rabies as the cause of each of these deaths. The phylogenetic investigation highlights the transboundary circulation of rabies within domestic dog populations, revealing distinct rabies virus clades with evidence of regional spread. These findings underscore the importance of coordinated cross-border control efforts between the two countries. Urgent action is needed to improve awareness around the need for emergency post-exposure vaccines that should be accessible in local communities and administered appropriately, as well as investment in coordinated dog vaccination to control dog-mediated rabies, the underlying cause of these deaths.Graphical

Rabies epidemiology in the central of Tunisia: A Call for a One-Health Approach

Abstract Background Advocating for a One-Health approach is crucial for ensuring effective rabies surveillance in Africa, including Tunisia. Collecting information is essential to evaluate the prevalence of dog bites and rabies in Tunisia. To address this, we conducted an analysis of reported incidents in the central region of Tunisia from 2019 to 2022. This analysis aimed to generate valuable insights that can inform strategies for rabies elimination in Tunisia, highlighting the importance of the One-Health approach. Methods We carried out a descriptive study using surveillance data from Monastir governorate in Central Tunisia. All humans exposed to animals, residents in Monastir Governorate and declared to the regional directorate of primary health care from January 1, 2019 to December 31, 2022 were included in our study. Data were entered, cleaned, and analyzed using Excel. Results During the studied period, 7789 cases of human exposures to animals were reported with an annual average of 1969 ± 207 exposures per year. The annual incidence rate of exposure to animal bites was 324 per 100,000 population. The sex-ratio was 2.07 and almost one third of exposed humans were aged less than 15 years-old. The most listed offending animals were dogs (65.2%), followed by cats (24.4%). The number of exposures by unvaccinated dogs increased significantly during our study period. Post-exposure prophylaxis (PEP) was applied among 99% (n = 7772) of declared exposures. Among them, 2.5% (n = 202) did not complete the PEP recommended protocol. During our study period, rabies was confirmed in 39 animals. Two fatal human rabies cases were declared respectively in 2021 and 2022. Conclusions Rabies remains a worrying health problem in Tunisia with a high percentage reported among youth and males. Targeting children and adolescents by education and information campaigns about preventive measures and mass dog vaccination are the key to ending this scourge. Key messages • It is crucial to reinforce preventive strategies, such as mass dog vaccination programs. • Public awareness about rabies prevention should be enforced in order to decrease Human rabies risks.