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Salazar R, Brunker K, Díaz EW, Zegarra E, Monroy Y, Baldarrago GN, Borrini-Mayorí K, De la Puente-León M, Kasaragod S, Levy MZ, Hampson K, Castillo-Neyra R. Genomic Characterization of a Dog-Mediated Rabies Outbreak in El Pedregal, Arequipa, Peru. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.21.608982. [PMID: 39229209 PMCID: PMC11370554 DOI: 10.1101/2024.08.21.608982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Background Rabies, a re-emerging zoonosis with the highest known human case fatality rate, has been largely absent from Peru, except for endemic circulation in the Puno region on the Bolivian border and re-emergence in Arequipa City in 2015, where it has persisted. In 2021, an outbreak occurred in the rapidly expanding city of El Pedregal near Arequipa, followed by more cases in 2022 after nearly a year of epidemiological silence. While currently under control, questions persist regarding the origin of the El Pedregal outbreak and implications for maintaining rabies control in Peru. Methods We sequenced 25 dog rabies virus (RABV) genomes from the El Pedregal outbreak (n=11) and Arequipa City (n=14) from 2021-2023 using Nanopore sequencing in Peru. Historical genomes from Puno (n=4, 2010-2012) and Arequipa (n=5, 2015-2019), were sequenced using an Illumina approach in the UK. In total, 34 RABV genomes were analyzed, including archived and newly obtained samples. The genomes were analyzed phylogenetically to understand the outbreak's context and origins. Results Phylogenomic analysis identified two genetic clusters in El Pedregal: 2021 cases stemmed from a single introduction unrelated to Arequipa cases, while the 2022 sequence suggested a new introduction from Arequipa rather than persistence. In relation to canine RABV diversity in Latin America, all new sequences belonged to a new minor clade, Cosmopolitan Am5, sharing relatives from Bolivia, Argentina, and Brazil. Conclusion Genomic insights into the El Pedregal outbreak revealed multiple introductions over a 2-year window. Eco-epidemiological conditions, including migratory worker patterns, suggest human-mediated movement drove introductions. Despite outbreak containment, El Pedregal remains at risk of dog-mediated rabies due to ongoing circulation in Arequipa, Puno, and Bolivia. Human-mediated movement of dogs presents a major risk for rabies re-emergence in Peru, jeopardizing regional dog-mediated rabies control. Additional sequence data is needed for comprehensive phylogenetic analyses.
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Affiliation(s)
- Renzo Salazar
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Kirstyn Brunker
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- The Boyd Orr Centre for Population and Ecosystem Health, University of Glasgow, Glasgow, United Kingdom
- MRC-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Elvis W Díaz
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Edith Zegarra
- Laboratorio de Referencia Regional de la Gerencia Regional de Salud de Arequipa, Arequipa, Perú
| | - Ynes Monroy
- Laboratorio de Referencia Regional de la Gerencia Regional de Salud de Arequipa, Arequipa, Perú
| | | | - Katty Borrini-Mayorí
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Micaela De la Puente-León
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Sandeep Kasaragod
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- MRC-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Michael Z Levy
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Perú
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Katie Hampson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- The Boyd Orr Centre for Population and Ecosystem Health, University of Glasgow, Glasgow, United Kingdom
| | - Ricardo Castillo-Neyra
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Perú
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Touré A, Savadogo M, Doumbouya MI, Kourouma F, Gbamou P, Tarnagda Z, Bada-Alambedji R. Rabies surveillance and prevention in Guinea: Epidemiological data and postexposure prophylaxis challenges. Vet World 2024; 17:1828-1835. [PMID: 39328452 PMCID: PMC11422633 DOI: 10.14202/vetworld.2024.1828-1835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 07/16/2024] [Indexed: 09/28/2024] Open
Abstract
Background and Aim 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. Materials and Methods 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. Results 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. Conclusion 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.
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Affiliation(s)
- Aissatou Touré
- National Directorate for Veterinary Services, Ministry of Agriculture and Livestock, P.O Box 576, Conakry, Guinea
- Department of Public Health and Environment, Ecole Inter-State School of Veterinary Sciences and Medicine, P.O Box 5077, Dakar, Senegal
| | - Madi Savadogo
- Department of Public Health and Environment, Ecole Inter-State School of Veterinary Sciences and Medicine, P.O Box 5077, Dakar, Senegal
- National Influenza Reference Laboratory, Unit of Epidemic potential Diseases, Emerging Diseases and Zoonoses, Department of Medical Biology and Public Health Research Institute for Health Sciences (IRSS/CNRST), P.O. Box 7047, Ouagadougou, Burkina Faso
- Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine, University of Liege, Quartier Vallée 2 avenue de Cureghem, 6, Liege, Belgium
- Directorate of Animal Health, Directorate General of Veterinary Services, Ministry of Agriculture, Animal et Halieutic Resources, P.O Box 7026, Ouagadougou, Burkina Faso
| | - Mohamed Idriss Doumbouya
- National Directorate for Veterinary Services, Ministry of Agriculture and Livestock, P.O Box 576, Conakry, Guinea
- Department of Public Health and Environment, Ecole Inter-State School of Veterinary Sciences and Medicine, P.O Box 5077, Dakar, Senegal
| | - Fassou Kourouma
- National Directorate for Veterinary Services, Ministry of Agriculture and Livestock, P.O Box 576, Conakry, Guinea
| | - Pépé Gbamou
- National Directorate for Veterinary Services, Ministry of Agriculture and Livestock, P.O Box 576, Conakry, Guinea
| | - Zékiba Tarnagda
- National Influenza Reference Laboratory, Unit of Epidemic potential Diseases, Emerging Diseases and Zoonoses, Department of Medical Biology and Public Health Research Institute for Health Sciences (IRSS/CNRST), P.O. Box 7047, Ouagadougou, Burkina Faso
| | - Rianatou Bada-Alambedji
- Department of Public Health and Environment, Ecole Inter-State School of Veterinary Sciences and Medicine, P.O Box 5077, Dakar, Senegal
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3
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Butala CB, Cave RNR, Fyfe J, Coleman PG, Yang GJ, Welburn SC. Impact of COVID-19 on the neglected tropical diseases: a scoping review. Infect Dis Poverty 2024; 13:55. [PMID: 39075616 DOI: 10.1186/s40249-024-01223-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/28/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND This study investigates the impact of the COVID-19 pandemic on the prevalence, management, and control of the neglected tropical diseases (NTDs) highlighting the current or prospective impact of COVID-19 on research and development funding for, and execution of, NTD programmes. This review was conducted to determine if, and how, NTDs were affected by COVID-19, and whether those effects will delay the elimination goals of the Sustainable Development goals. METHODS Using open-source available data from policy and documentation from official websites of the relevant stakeholders including but not limited to World Health Organization (WHO) documents and policies, government foreign aid documents, and the Policy Cures G-Finder reports, this scoping review explored ongoing challenges to supporting research and development (R&D) for the NTDs and in maintaining NTD control programs; examined the constraints posed for NTD management by the pandemic from disruptions to healthcare services, reduction of finance and explored the potential long-term implications and consequences for those poorer, neglected populations in low and middle income-countries (LMICs). This was done by a scoping review literature search, publications were subject to an initial practical screening step to ensure the most relevant publications were selected for full screening, with the focus on scoping the designated topic of the impact of COVID-19 on NTDs. We further undertook an evaluation of the socio-economic factors exacerbating the impact of COVID-19 on NTD burden. RESULTS Multiple disruptions and setbacks, likely to affect NTD programmes and progress towards their elimination targets were identified in this study. R&D funding for the NTDs and AIDs and TB has declined since the funding high point of 2019, and for malaria since the high point of 2018. Significant changes in allocation of R&D funding within the NTDs are observed post pandemic, likely because of prioritization among donors. Diseases for which the least R&D investment was reported in place, prior to the pandemic (mycetoma, taeniasis/cysticercosis, trachoma and Buruli ulcer) have been particularly impacted post pandemic. We identified specific NTDs including schistosomiasis, leprosy, and rabies that have been affected by the COVID-19 pandemic and disruptions caused to on ongoing NTD control and elimination programs. Pandemic restrictions disrupted essential medical supply manufacturing and distribution impacting immunization programs and hindered efforts to control the spread of infectious diseases. NTD programmes have experienced numerous setbacks including delays in mass drug administration programs (e.g. for schistosomiasis), cancelled or delayed vaccination programs (e.g. for rabies) and closure of testing facilities has resulted in reduced diagnosis, treatment, and disease elimination for all NTDs. Lockdowns and clinic closures causing disruption to essential healthcare services restricted NTD surveillance and treatment programs. Community fears around contracting COVID-19 exacerbated the constraints to service delivery. Disparities in global vaccine distribution have widened with LMICs facing limited access to vaccines and disruption to immunization programs. Finally, the pandemic has led to increased poverty with poor and marginalized communities, impacting nutrition, healthcare access and education all of which have long term implications for NTD management and control. CONCLUSIONS The COVID-19 pandemic profoundly impacted global health research and global health equity. Attention and funding were diverted from all sectors, significantly affecting research and development efforts set out in the World Health Organization's NTD elimination Roadmaps. Ongoing changes to funding, economic crises, logistics and supply chain disruptions as well as deepening poverty has put a strain on already weak healthcare systems and exacerbated LMIC healthcare challenges. In particular, the delays and constraints to NTD management and elimination programs will have long-reaching consequences highlighting the need for global cooperation and renewed investment to put the NTD roadmap back on track. Targets and milestones are unlikely to be met without significant investment for recovery, in place.
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Affiliation(s)
- Caitlin Brigid Butala
- Infection Medicine, Edinburgh Medical School: Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9TB, Scotland, UK
- Zhejiang University - University of Edinburgh Institute: Biomedicine, Zhejiang University School of Medicine, 718 East Haizhou Road, Haining, 314400, People's Republic of China
| | - Roo Nicola Rose Cave
- Infection Medicine, Edinburgh Medical School: Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9TB, Scotland, UK
| | - Jenna Fyfe
- Infection Medicine, Edinburgh Medical School: Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9TB, Scotland, UK
| | - Paul Gerard Coleman
- Infection Medicine, Edinburgh Medical School: Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9TB, Scotland, UK
| | - Guo-Jing Yang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, The School of Tropical Medicine, The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, Hainan, People's Republic of China
| | - Susan Christina Welburn
- Infection Medicine, Edinburgh Medical School: Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9TB, Scotland, UK.
- Zhejiang University - University of Edinburgh Institute: Biomedicine, Zhejiang University School of Medicine, 718 East Haizhou Road, Haining, 314400, People's Republic of China.
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, The School of Tropical Medicine, The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, Hainan, People's Republic of China.
- School of Global Health, Chinese Centre for Global Tropical Disease Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.
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Castillo-Neyra R, Xie S, Bellotti BR, Diaz EW, Saxena A, Toledo AM, Condori-Luna GF, Rieders M, Bhattacharya BB, Levy MZ. Optimizing the location of vaccination sites to stop a zoonotic epidemic. Sci Rep 2024; 14:15910. [PMID: 38987306 PMCID: PMC11237137 DOI: 10.1038/s41598-024-66674-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 07/03/2024] [Indexed: 07/12/2024] Open
Abstract
Mass vaccinations are crucial public health interventions for curbing infectious diseases. Canine rabies control relies on mass dog vaccination campaigns (MDVCs) that are held annually across the globe. Dog owners must bring their pets to fixed vaccination sites, but sometimes target coverage is not achieved due to low participation. Travel distance to vaccination sites is an important barrier to participation. We aimed to increase MDVC participation in silico by optimally placing fixed-point vaccination locations. We quantified participation probability based on walking distance to the nearest vaccination site using regression models fit to participation data collected over 4 years. We used computational recursive interchange techniques to optimally place fixed-point vaccination sites and compared predicted participation with these optimally placed vaccination sites to actual locations used in previous campaigns. Algorithms that minimized average walking distance or maximized expected participation provided the best solutions. Optimal vaccination placement is expected to increase participation by 7% and improve spatial evenness of coverage, resulting in fewer under-vaccinated pockets. However, unevenness in workload across sites remained. Our data-driven algorithm optimally places limited resources to increase overall vaccination participation and equity. Field evaluations are essential to assess effectiveness and evaluate potentially longer waiting queues resulting from increased participation.
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Affiliation(s)
- Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Sherrie Xie
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brinkley Raynor Bellotti
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elvis W Diaz
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Aris Saxena
- The Wharton School, University of Pennsylvania, Philadelphia, PA, USA
| | - Amparo M Toledo
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gian Franco Condori-Luna
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Rieders
- The Wharton School, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Michael Z Levy
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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5
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Xie S, Rieders M, Changolkar S, Bhattacharya BB, Diaz EW, Levy MZ, Castillo-Neyra R. Enhancing Mass Vaccination Programs with Queueing Theory and Spatial Optimization. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.14.24308958. [PMID: 38947058 PMCID: PMC11213063 DOI: 10.1101/2024.06.14.24308958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background Mass vaccination is a cornerstone of public health emergency preparedness and response. However, injudicious placement of vaccination sites can lead to the formation of long waiting lines or queues, which discourages individuals from waiting to be vaccinated and may thus jeopardize the achievement of public health targets. Queueing theory offers a framework for modeling queue formation at vaccination sites and its effect on vaccine uptake. Methods We developed an algorithm that integrates queueing theory within a spatial optimization framework to optimize the placement of mass vaccination sites. The algorithm was built and tested using data from a mass canine rabies vaccination campaign in Arequipa, Peru. We compared expected vaccination coverage and losses from queueing (i.e., attrition) for sites optimized with our queue-conscious algorithm to those obtained from a queue-naive version of the same algorithm. Results Sites placed by the queue-conscious algorithm resulted in 9-19% less attrition and 1-2% higher vaccination coverage compared to sites placed by the queue-naïve algorithm. Compared to the queue-naïve algorithm, the queue-conscious algorithm favored placing more sites in densely populated areas to offset high arrival volumes, thereby reducing losses due to excessive queueing. These results were not sensitive to misspecification of queueing parameters or relaxation of the constant arrival rate assumption. Conclusion One should consider losses from queueing to optimally place mass vaccination sites, even when empirically derived queueing parameters are not available. Due to the negative impacts of excessive wait times on participant satisfaction, reducing queueing attrition is also expected to yield downstream benefits and improve vaccination coverage in subsequent mass vaccination campaigns.
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Affiliation(s)
- Sherrie Xie
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA
| | - Maria Rieders
- Operations, Information and Decisions Department, The Wharton School, University of Pennsylvania
| | - Srisa Changolkar
- Operations, Information and Decisions Department, The Wharton School, University of Pennsylvania
| | | | - Elvis W. Diaz
- Zoonotic Disease Research Lab, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Michael Z. Levy
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA
- Zoonotic Disease Research Lab, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ricardo Castillo-Neyra
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA
- Zoonotic Disease Research Lab, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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Briceño-Loaiza C, Fernández-Sanhueza B, Benavides-Silva C, Jimenez JY, Rubio AV, Ábalos P, Alegría-Morán RA. Spatial clusters, temporal behavior, and risk factors analysis of rabies in livestock in Ecuador. Prev Vet Med 2024; 226:106188. [PMID: 38513566 DOI: 10.1016/j.prevetmed.2024.106188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 02/12/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Abstract
Rabies, a globally distributed and highly lethal zoonotic neglected tropical disease, has a significant impact in South America. In Ecuador, animal rabies cases are primarily linked to livestock, and hematophagous bats play a crucial role in disease transmission. This study aims to identify temporal trends, spatial patterns, and risk factors for animal rabies in Ecuador between 2014 and 2019. Epidemiological survey reports from the official Animal Rabies Surveillance Program of the Phyto and Zoosanitary Regulation and Control Agency of Ecuador (AGROCALIDAD) were used. The Animal Rabies Surveillance Program from AGROCALIDAD consists of an official passive surveillance program that receives reports from farmers or individuals (both trained or untrained) who have observed animals with neurological clinical signs and lesions compatible with bat bites, or who have seen or captured bats on their farms or houses. Once this report is made, AGROCALIDAD personnel is sent for field inspection, having to confirm the suspicion of rabies based on farm conditions and compatibility of signs. AGROCALIDAD personnel collect samples from all suspicious animals, which are further processed and analyzed using the Direct Fluorescent Antibody (DFA) test for rabies confirmatory diagnosis. In this case, study data comprised 846 bovine farms (with intra-farm sample sizes ranging from 1 to 16 samples) located in different ecoregions of Ecuador; out of these, 397 (46.93%) farms tested positive for animal rabies, revealing six statistically significant spatial clusters. Among these clusters, three high-risk areas were identified in the southeast of Ecuador. Seasonality was confirmed by the Ljung-Box test for both the number of cases (p < 0.001) and the positivity rate (p < 0.001). The Pacific Coastal lowlands and Sierra regions showed a lower risk of positivity compared to Amazonia (OR = 0.529; 95% CI = 0.318 - 0.883; p = 0.015 and OR = 0.633; 95% CI = 0.410 - 0.977; p = 0.039, respectively). The breeding of non-bovine animal species demonstrated a lower risk of positivity to animal rabies when compared to bovine (OR = 0.145; 95% CI = 0.062 - 0.339; p < 0.001). Similarly, older animals exhibited a lower risk (OR = 0.974; 95% CI = 0.967 - 0.981; p < 0.001). Rainfall during the rainy season was also found to decrease the risk of positivity to animal rabies (OR = 0.996; 95% CI = 0.995 - 0.998; p < 0.001). This study underscores the significance of strengthening the national surveillance program for the prevention and control of animal rabies in Ecuador and other countries facing similar epidemiological, social, and geographical circumstances.
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Affiliation(s)
- César Briceño-Loaiza
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile; Agencia de Regulación y Control Fito y Zoosanitario (AGROCALIDAD), Ecuador; Carrera de Agroecología, Instituto Superior Tecnológico Juan Montalvo, Loja, Ecuador
| | - Bastián Fernández-Sanhueza
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile; Escuela de Medicina Veterinaria, Facultad de Recursos Naturales y Medicina Veterinaria, Universidad Santo Tomás, Santiago, Chile
| | - César Benavides-Silva
- Facultad de Historia, Geografía y Ciencia Política, Instituto de Geografía, Pontificia Universidad Católica, Chile; Centro de Investigaciones Territoriales, Universidad Nacional de Loja, Ecuador
| | - José Yaguana Jimenez
- Carrera de Medicina Veterinaria, Facultad Agropecuaria y de Recursos Naturales Renovables, Universidad Nacional de Loja, Ecuador
| | - André V Rubio
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Pedro Ábalos
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Raúl A Alegría-Morán
- Escuela de Medicina Veterinaria, Facultad de Recursos Naturales y Medicina Veterinaria, Universidad Santo Tomás, Santiago, Chile.
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Farias LABG, Caminha I, Perdigão LV, Cavalcanti LPDG. Human Rabies during the COVID-19 Pandemic: Insights into Rabies Worldwide and Brazil. Rev Soc Bras Med Trop 2024; 57:e003002024. [PMID: 38359308 PMCID: PMC10911283 DOI: 10.1590/0037-8682-0520-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
Human Rabies (HR) is a fatal zoonotic disease caused by lyssaviruses, with the rabies virus (RABV) identified as the causative agent. While the incidence of HR transmitted by dogs has decreased in Latin America, there has been a corresponding rise in transmission via wild animals. Given the lack of effective treatments and specific therapies, the management of HR relies on the availability of post-exposure prophylaxis and animal control measures. This review examines the dynamics and spread of HR during the global pandemic.
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Affiliation(s)
- Luís Arthur Brasil Gadelha Farias
- Universidade de São Paulo, Hospital das Clínicas e Laboratório de Investigação Médica - LIM 49, Departamento de Doenças Infecciosas, São Paulo, SP, Brasil
- Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brasil
- Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil
- Centro Universitário Christus, Faculdade de Medicina, Fortaleza, CE, Brasil
| | - Iusta Caminha
- Universidade Federal do Ceará, Programa de Pós-graduação em Patologia, Fortaleza, CE, Brasil
- Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - Lauro Vieira Perdigão
- Universidade de São Paulo, Hospital das Clínicas e Laboratório de Investigação Médica - LIM 49, Departamento de Doenças Infecciosas, São Paulo, SP, Brasil
- Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil
| | - Luciano Pamplona de Góes Cavalcanti
- Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brasil
- Centro Universitário Christus, Faculdade de Medicina, Fortaleza, CE, Brasil
- Universidade Federal do Ceará, Programa de Pós-graduação em Patologia, Fortaleza, CE, Brasil
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8
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Concha-Velasco F, Aguirre E, Ortiz-Cam L, Quispe-Jihuallancca H, Bernable-Villasante L, Bascope R, Arizabal M, Vargas-Luna E, Espinoza-Culupú A, Mantari C, Lopez –Ingunza R. Rabies in chozna ' Potus flavus': a warning of a potential threat to public and animal health. Vet Q 2023; 43:1-6. [PMID: 37560894 PMCID: PMC10443979 DOI: 10.1080/01652176.2023.2247453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/11/2023] Open
Abstract
We reported an outbreak of wild rabies in Potus flavus (choznas), a carnivorous mammal associated with insectivorous bats in Kosñipata, Cusco, Peru, from February 2021 to October 2022. Eight human exposures were reported, with aggressive attacks resulting in injuries. The outbreak prompted a public health response and raised concerns about zoonotic diseases due to habitat fragmentation and urbanization. The study involved antigenic and genetic characterization of the virus in the affected animals, revealing similarities with variants in non-hematophagous bats. This outbreak marked the first time rabies had been reported in choznas in the region, highlighting the need for early intervention programs and wildlife protection. Pre-exposure rabies vaccinations were administered to residents, and community surveillance was established to control the outbreak. The study emphasizes the importance of continuous surveillance and education to prevent rabies transmission from choznas to humans and other animals, as their role as potential secondary transmitters of the virus warrants further investigation.
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Affiliation(s)
- Fatima Concha-Velasco
- Gerencia Regional de Salud, Cusco, Peru
- Universidad Continental, Cusco, Peru
- Universidad Nacional San Antonio Abad del Cusco, Cusco, Peru
| | | | - Lizzie Ortiz-Cam
- Servicio Nacional Forestal y de Fauna Silvestre (SERFOR), Lima, Peru
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Fahrion AS, Freuling CM, Léchenne M, Müller T, Recuenco S, Vigilato MAN, Busch F, Heitz-Tokpa K, Mauti S, Muturi M, Dürr S. Editorial: Rabies, a long-standing One Health example - progress, challenges, lessons and visions on the way to 0 by 30. Front Vet Sci 2023; 10:1220327. [PMID: 37533452 PMCID: PMC10392924 DOI: 10.3389/fvets.2023.1220327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/07/2023] [Indexed: 08/04/2023] Open
Affiliation(s)
- Anna S. Fahrion
- Institute for International Animal Health/One Health, Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Riems, Germany
| | - Conrad M. Freuling
- Institute for Molecular Virology and Cell Biology, Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Riems, Germany
| | - Monique Léchenne
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Department of Public Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Thomas Müller
- Institute for Molecular Virology and Cell Biology, Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Riems, Germany
| | - Sergio Recuenco
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Marco A. N. Vigilato
- Pan American Foot and Mouth Disease and Veterinary Public Health Center, Pan American Health Organization, Rio de Janeiro, Brazil
| | - Frank Busch
- Institute for International Animal Health/One Health, Friedrich-Loeffler-Institute, Federal Research Institute for Animal Health, Riems, Germany
| | - Kathrin Heitz-Tokpa
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Stephanie Mauti
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Department of Public Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Mathew Muturi
- Zoonotic Disease Unit, State Directorate of Veterinary Services, Nairobi, Kenya
- Department of Veterinary Medicine, Dahlem Research School of Biomedical Sciences (DRS), Freie Universität Berlin, Berlin, Germany
| | - Salome Dürr
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Rupprecht CE, Mshelbwala PP, Reeves RG, Kuzmin IV. Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism. ANIMAL DISEASES 2023; 3:15. [PMID: 37252063 PMCID: PMC10195671 DOI: 10.1186/s44149-023-00078-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/02/2023] [Indexed: 05/31/2023] Open
Abstract
Rabies is an ancient disease. Two centuries since Pasteur, fundamental progress occurred in virology, vaccinology, and diagnostics-and an understanding of pathobiology and epizootiology of rabies in testament to One Health-before common terminological coinage. Prevention, control, selective elimination, and even the unthinkable-occasional treatment-of this zoonosis dawned by the twenty-first century. However, in contrast to smallpox and rinderpest, eradication is a wishful misnomer applied to rabies, particularly post-COVID-19 pandemic. Reasons are minion. Polyhostality encompasses bats and mesocarnivores, but other mammals represent a diverse spectrum of potential hosts. While rabies virus is the classical member of the genus, other species of lyssaviruses also cause the disease. Some reservoirs remain cryptic. Although global, this viral encephalitis is untreatable and often ignored. As with other neglected diseases, laboratory-based surveillance falls short of the notifiable ideal, especially in lower- and middle-income countries. Calculation of actual burden defaults to a flux within broad health economic models. Competing priorities, lack of defined, long-term international donors, and shrinking local champions challenge human prophylaxis and mass dog vaccination toward targets of 2030 for even canine rabies impacts. For prevention, all licensed vaccines are delivered to the individual, whether parenteral or oral-essentially 'one and done'. Exploiting mammalian social behaviors, future 'spreadable vaccines' might increase the proportion of immunized hosts per unit effort. However, the release of replication-competent, genetically modified organisms selectively engineered to spread intentionally throughout a population raises significant biological, ethical, and regulatory issues in need of broader, transdisciplinary discourse. How this rather curious idea will evolve toward actual unconventional prevention, control, or elimination in the near term remains debatable. In the interim, more precise terminology and realistic expectations serve as the norm for diverse, collective constituents to maintain progress in the field.
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Affiliation(s)
- Charles E. Rupprecht
- College of Forestry, Wildlife & Environment, College of Veterinary Medicine, Auburn University, Auburn, AL 36849 USA
| | - Philip P. Mshelbwala
- School of Veterinary Science, University of Queensland, Gatton, Australia
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - R. Guy Reeves
- Max Planck Institut Für Evolutionsbiologie, 24306 Plön, Germany
| | - Ivan V. Kuzmin
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555 USA
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11
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Bonaparte SC, Moodie J, Undurraga EA, Wallace RM. Evaluation of country infrastructure as an indirect measure of dog-mediated human rabies deaths. Front Vet Sci 2023; 10:1147543. [PMID: 37228840 PMCID: PMC10203152 DOI: 10.3389/fvets.2023.1147543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Background Rabies is a neglected disease, primarily due to poor detection stemming from limited surveillance and diagnostic capabilities in most countries. As a result, there is limited ability to monitor and evaluate country, regional, and global progress towards the WHO goal of eliminating human rabies deaths by 2030. There is a need for a low-cost, readily reproducible method of estimating rabies burden and elimination capacity in endemic countries. Methods Publicly available economic, environmental, political, social, public health, and One Health indicators were evaluated to identify variables with strong correlation to country-level rabies burden estimates. A novel index was developed to estimate infrastructural rabies elimination capacity and annual case-burden for dog-mediated rabies virus variant (DMRVV) endemic countries. Findings Five country-level indicators with superior explanatory value represent the novel "STOP-R index:" (1) literacy rate, (2) infant mortality rate, (3) electricity access, (4) political stability, and (5) presence/severity of natural hazards. Based on the STOP-R index, 40,111 (95% CI 25,854-74,344) global human rabies deaths are estimated to occur in 2022 among DMRVV-endemic countries and are projected to decrease to 32,349 (95% CI 21,110-57,019) in 2030. Interpretation The STOP-R index offers a unique means of addressing the data gap and monitoring progress towards eliminating dog-mediated human rabies deaths. Results presented here suggest that factors external to rabies programs influence the successes of rabies elimination, and it is now possible to identify countries exceeding or lagging in expected rabies control and elimination progress based on country infrastructure.
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Affiliation(s)
- Sarah C. Bonaparte
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Janae Moodie
- New York University College of Global Public Health, New York, NY, United States
- James A. Ferguson Emerging Infectious Diseases RISE Fellow, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Eduardo A. Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Initiative for Collaborative Research in Bacterial Resistance (MICROB-R), Santiago, Chile
- Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago, Chile
| | - Ryan M. Wallace
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Analysis of available animal testing data to propose peer-derived quantitative thresholds for determining adequate surveillance capacity for rabies. Sci Rep 2023; 13:3986. [PMID: 36894610 PMCID: PMC9998015 DOI: 10.1038/s41598-023-30984-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Historical targets for country-level animal rabies testing volumes were abandoned due to ethical and welfare concerns, and interpretation challenges of testing healthy animals. To-date, no quantitative threshold has been established for evaluating adequate surveillance capacity specific to suspected rabid animals. The purpose here is to establish quantitative testing thresholds for rabies suspected animals to assess a country's rabies surveillance capacity. Animal rabies testing data was obtained from official and unofficial rabies surveillance platforms from 2010 to 2019 and supplemented with official country reports and published literature. Testing rates were determined for all-animal and domestic animals, and standardized per 100,000 estimated human population; the domestic animal rate was also standardized per 100,000 estimated dog population. There were 113 countries that reported surveillance data eligible for analysis. Countries reporting the most data were under WHO categories as having endemic human rabies or no dog rabies. The annual median all-animal testing rate for all countries was 1.53 animals/100,000 human population (IQR 0.27-8.78). Three proposed testing rate thresholds are an all-animal rate of 1.9 animals/100,000 humans, a domestic animal per human rate of 0.8 animals/100,000 humans, and a domestic animal per dog rate of 6.6 animals/100,000 dogs. These three peer-derived rabies testing thresholds for passive surveillance can be used to facilitate assessment of a country's rabies surveillance capacity.
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Bonilla-Aldana DK, Ruiz-Saenz J, Martinez-Gutierrez M, Villamil-Gomez W, Mantilla-Meluk H, Arrieta G, León-Figueroa DA, Benites-Zapata V, Barboza JJ, Muñoz-Del-Carpio-Toia A, Franco OH, Cabrera M, Sah R, Al-Tawfiq JA, Memish ZA, Amer FA, Suárez JA, Henao-Martinez AF, Franco-Paredes C, Zumla A, Rodriguez-Morales AJ. Zero by 2030 and OneHealth: The multidisciplinary challenges of rabies control and elimination. Travel Med Infect Dis 2023; 51:102509. [PMID: 36435448 DOI: 10.1016/j.tmaid.2022.102509] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022]
Affiliation(s)
- D Katterine Bonilla-Aldana
- Research Unit, Universidad Continental, Huancayo, Peru; Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología (ACIN), Bogotá, DC, Colombia
| | - Julian Ruiz-Saenz
- Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología (ACIN), Bogotá, DC, Colombia; Grupo de Investigación en Ciencias Animales-GRICA, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
| | - Marlen Martinez-Gutierrez
- Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología (ACIN), Bogotá, DC, Colombia; Grupo de Investigación en Microbiología Veterinaria, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
| | - Wilmer Villamil-Gomez
- Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología (ACIN), Bogotá, DC, Colombia; Secretaría de Salud de Barranquilla, Barranquilla, Atlántico, Colombia
| | - Hugo Mantilla-Meluk
- Colección de Mastozoología y Centro de Estudios de Alta Montaña, Universidad del Quindío, Carrera 15 Calle 12N, Armenia, Quindío, Colombia
| | - German Arrieta
- Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología ACIN, Bogotá, DC, Colombia; Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Clínica Salud Social Sincelejo, Corporación Universitaria del Caribe: CECAR, Sucre, Colombia
| | - Darwin A León-Figueroa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru; Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo, Peru
| | - Vicente Benites-Zapata
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Joshuan J Barboza
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima, Peru
| | | | - Oscar H Franco
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maritza Cabrera
- Centro de Investigación de Estudios Avanzados del Maule CIEAM, Universidad Católica del Maule, Talca, 3480094, Chile; Facultad Ciencias de la Salud, Universidad Católica del Maule, Talca, 3480094, Chile
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal; Research Scholar, Harvard Medical School, Boston, MA, USA; Dr. D.Y Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Diseases Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Infectious Diseases Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ziad A Memish
- Al-Faisal University, Riyadh, Saudi Arabia; King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Fatma A Amer
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig, Egypt; Chair of Viral Infection Working Group, and Executive Committee Member, International Society for Antimicrobial Chemotherapy VIWG/ISAC, Egypt
| | - José Antonio Suárez
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Investigator 1 of the SNI, Senacyt, Panama City, Panama
| | - Andres F Henao-Martinez
- Division of Infectious Diseases, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO, 80045, USA
| | - Carlos Franco-Paredes
- Hospital Infantil de México, Federico Gómez, México City, Mexico; Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Centre, University College London Hospitals, London, UK
| | - Alfonso J Rodriguez-Morales
- Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología ACIN, Bogotá, DC, Colombia; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon; Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, 4861, Peru; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas - Institución Universitaria Visión de las Américas, 660003, Pereira, Risaralda, Colombia; Editor-in-Chief, Travel Medicine and Infectious Diseases.
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Nadal D, Abela-Ridder B, Beeching S, Cleaveland S, Cronin K, Steenson R, Hampson K. The Impact of the First Year of the COVID-19 Pandemic on Canine Rabies Control Efforts: A Mixed-Methods Study of Observations About the Present and Lessons for the Future. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.866811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Achieving zero human deaths from dog-mediated rabies has been set as a global target for 2030. However, the COVID-19 pandemic has disrupted essential health services across the world, with disproportionate impacts on Neglected Tropical Diseases. Through a mixed-method study using stakeholder questionnaires and in-depth interviews, we examined the scale and nature of disruption from the first year of the pandemic to rabies control programs, and reflected on lessons for the future. Study participants included practitioners and policymakers working in government, academia, international organizations, and the pharmaceutical industry across 48 countries, mainly in Africa and Asia. Mass dog vaccination, essential to rabies control, was most heavily impacted and in 2020, was carried out as planned in just 5% of surveyed countries. Access to post-exposure prophylaxis (PEP) also decreased due to fear of COVID-19 infection and difficulties in reaching health care centers. Dog vaccination and PEP delivery suffered from disruptions to the importation and distribution of vaccines. School closures affected rabies awareness activities and, when public events moved online, they could not reach the most disadvantaged groups. Surveillance, already weak, was severely disrupted by movement restrictions which, together with reduced demand for PEP, exacerbated under-reporting. Participants reported growing complaints around free-roaming dogs, with numbers likely to have increased in some settings. In some countries, dog rabies outbreaks and human rabies cases were already ascribed to the pandemic, but further impacts are likely still to be realized. Meanwhile, decreased demand for PEP from COVID-19 constraints could lead to reduced procurement in future. In the wake of post-COVID-19 demands on health services, there is an opportunity for veterinary services to show leadership in progressing the Zero by 30 agenda, particularly in scaling up mass dog vaccination within and across countries, as well as potential to make better use of community-based vaccinators. Countries must further secure stable procurement of dog and human vaccines, classifying them as essential goods prioritized for import and where needed, through sharing of stocks. Dedicated telemedicine services also show promise, for example through fostering participatory disease surveillance, including Integrated Bite Case Management, and delivering up-to-date instructions on the closest sources of PEP.
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Tierradentro-García LO, Cortés-Albornoz MC, Talero-Gutiérrez C. Of love and other demons: depicting human rabies in Colombia. Heliyon 2022; 8:e09703. [PMID: 35734566 PMCID: PMC9207665 DOI: 10.1016/j.heliyon.2022.e09703] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/08/2021] [Accepted: 06/06/2022] [Indexed: 11/18/2022] Open
Abstract
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.
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Affiliation(s)
- Luis Octavio Tierradentro-García
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Neuroscience Research Group (NeURos), Escuela de Medicina y Ciencias de La Salud, Universidad Del Rosario, Bogotá D.C., Colombia
- Centro de Neurociencia Neurovitae-UR, Escuela de Medicina y Ciencias de La Salud, Universidad Del Rosario, Bogotá D.C., Colombia
- Corresponding author.
| | - María Camila Cortés-Albornoz
- Neuroscience Research Group (NeURos), Escuela de Medicina y Ciencias de La Salud, Universidad Del Rosario, Bogotá D.C., Colombia
- Centro de Neurociencia Neurovitae-UR, Escuela de Medicina y Ciencias de La Salud, Universidad Del Rosario, Bogotá D.C., Colombia
| | - Claudia Talero-Gutiérrez
- Neuroscience Research Group (NeURos), Escuela de Medicina y Ciencias de La Salud, Universidad Del Rosario, Bogotá D.C., Colombia
- Centro de Neurociencia Neurovitae-UR, Escuela de Medicina y Ciencias de La Salud, Universidad Del Rosario, Bogotá D.C., Colombia
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Subrata IM, Harjana NPA, Agustina KK, Purnama SG, Kardiwinata MP. Designing a rabies control mobile application for a community-based rabies surveillance system during the COVID-19 pandemic in Bali, Indonesia. Vet World 2022; 15:1237-1245. [PMID: 35765482 PMCID: PMC9210830 DOI: 10.14202/vetworld.2022.1237-1245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Rabies remains a public health concern in Indonesia, and the coronavirus disease (COVID-19) pandemic has stymied rabies prevention and control efforts. There is a need to transform the rabies program to be adaptable to pandemic situations to improve program coverage on dog vaccination and rabies surveillance. This study aimed to create a rabies control (RaCon) mobile application for a community-based rabies surveillance system during COVID-19 in Bali, Indonesia.
Materials and Methods: We employ the Design Science Research methodology. Surveillance officers, veterinarians, community leaders, outreach workers, and dog owners participated in a series of offline in-depth interviews and focus group discussions. The RaCon prototype was evaluated using the Post-Study System Usability Questionnaire (PSSUQ) framework, which included the system's usefulness, information quality, and interface quality. In this study, we used both a qualitative (n=50) and quantitative (n=342) approach.
Results: According to the findings of this study, integrating public health and animal health into the rabies surveillance system are critical to supporting the One Health approach and encouraging community engagement in rabies programs. The RaCon prototype is expected to include features such as pet ownership, case report, news and announcements, nearest vet, health information, outbreak radar, emergency call, and app feedback. The RaCon prototype passed both qualitative and quantitative evaluations, indicating that it could be used to support the rabies surveillance system, particularly in the COVID-19 situation.
Conclusion: The RaCon prototype was accepted by the users and got positive feedback in terms of the system's usefulness, information quality, and interface quality dimension. As a result, this prototype has the potential to be integrated into the rabies surveillance system in Bali, particularly to strengthen the community-based rabies surveillance system. Even though this prototype received positive feedback, this study focuses solely on the design development and evaluation of its user interface. As a result, further development is required before incorporating RaCon into the rabies prevention and control program.
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Affiliation(s)
- I Made Subrata
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar 80225, Bali, Indonesia
| | - Ngakan Putu Anom Harjana
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar 80225, Bali, Indonesia; Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar 80225, Bali, Indonesia
| | - Kadek Karang Agustina
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Udayana University, Denpasar 80225, Bali, Indonesia
| | - Sang Gede Purnama
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar 80225, Bali, Indonesia
| | - Made Pasek Kardiwinata
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar 80225, Bali, Indonesia
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Ghai S, Hemachudha T. Continued Failure of Rabies Elimination—Consideration of Challenges in Applying the One Health Approach. Front Vet Sci 2022; 9:847659. [PMID: 35425835 PMCID: PMC9001886 DOI: 10.3389/fvets.2022.847659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
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18
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Chuchu VM, Kitala PM, Bichanga P, Ksee D, Muturi M, Mwatondo A, Nasimiyu C, Maritim M, Mutono N, Beyene TJ, Druelles S, Hampson K, Thumbi SM. Rabies Elimination in Rural Kenya: Need for Improved Availability of Human Vaccines, Awareness and Knowledge on Rabies and Its Management Among Healthcare Workers. Front Public Health 2022; 10:769898. [PMID: 35356016 PMCID: PMC8960031 DOI: 10.3389/fpubh.2022.769898] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/31/2022] [Indexed: 12/25/2022] Open
Abstract
Background In Africa, rabies causes an estimated 24,000 human deaths annually. Mass dog vaccinations coupled with timely post-exposure prophylaxis (PEP) for dog-bite patients are the main interventions to eliminate human rabies deaths. A well-informed healthcare workforce and the availability and accessibility of rabies biologicals at health facilities are critical in reducing rabies deaths. We assessed awareness and knowledge regarding rabies and the management of rabies among healthcare workers, and PEP availability in rural eastern Kenya. Methodology We interviewed 73 healthcare workers from 42 healthcare units in 13 wards in Makueni and Kibwezi West sub-counties, Makueni County, Kenya in November 2018. Data on demographics, years of work experience, knowledge of rabies, management of bite and rabies patients, and availability of rabies biologicals were collected and analyzed. Results Rabies PEP vaccines were available in only 5 (12%) of 42 health facilities. None of the health facilities had rabies immunoglobulins in stock at the time of the study. PEP was primarily administered intramuscularly, with only 11% (n = 8) of the healthcare workers and 17% (7/42) healthcare facilities aware of the dose-sparing intradermal route. Less than a quarter of the healthcare workers were aware of the World Health Organization categorization of bite wounds that guides the use of PEP. Eighteen percent (n = 13) of healthcare workers reported they would administer PEP for category I exposures even though PEP is not recommended for this category of exposure. Only one of six respondents with acute encephalitis consultation considered rabies as a differential diagnosis highlighting the low index of suspicion for rabies. Conclusion The availability and use of PEP for rabies was sub-optimal. We identified two urgent needs to support rabies elimination programmes: improving availability and access to PEP; and targeted training of the healthcare workers to improve awareness on bite wound management, judicious use of PEP including appropriate risk assessment following bites and the use of the dose-sparing intradermal route in facilities seeing multiple bite patients. Global and domestic funding plan that address these gaps in the human health sector is needed for efficient rabies elimination in Africa.
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Affiliation(s)
- Veronicah Mbaire Chuchu
- Department of Public Health, Pharmacology and Toxicology, University of Nairobi, Nairobi, Kenya
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
- Washington State University Global Health Program, Nairobi, Kenya
| | - Philip Mwanzia Kitala
- Department of Public Health, Pharmacology and Toxicology, University of Nairobi, Nairobi, Kenya
| | - Philet Bichanga
- Government of Makueni County, Department of Health Services, Wote, Kenya
| | - Daniel Ksee
- Government of Makueni County, Department of Agriculture, Irrigation, Livestock, and Fisheries Development, Wote, Kenya
| | - Mathew Muturi
- Zoonotic Disease Unit, Ministry of Health and Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Athman Mwatondo
- Zoonotic Disease Unit, Ministry of Health and Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Carolyne Nasimiyu
- Washington State University Global Health Program, Nairobi, Kenya
- Zoonotic Disease Unit, Ministry of Health and Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Marybeth Maritim
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya
| | - Nyamai Mutono
- Washington State University Global Health Program, Nairobi, Kenya
- Center for Epidemiological and Modelling Analysis, Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Tariku J. Beyene
- Center for Health Equity and Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Sophie Druelles
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, Lyon, France
| | - Katie Hampson
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - S. M. Thumbi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
- Center for Epidemiological and Modelling Analysis, Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), The University of Edinburgh, Edinburgh, United Kingdom
- Paul G Allen School for Global Health, Washington State University, Pullman, WA, United States
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19
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Ma C, Guo X, Wang L, Li W, Liu S, Lin F, Xu W. The impact of the COVID-19 pandemic on the incidence and mortality of zoonotic diseases in China. BMJ Glob Health 2022; 7:bmjgh-2021-007109. [PMID: 34996765 PMCID: PMC8743839 DOI: 10.1136/bmjgh-2021-007109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/16/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND It has been reported that strict non-pharmaceutical measures can significantly reduce the incidence and mortality of respiratory and intestinal infectious diseases during the COVID-19 pandemic, but there are limited reports on the impact in terms of the rates of zoonotic diseases. METHODS We extracted the incidence and mortality data of eight notifiable infectious zoonotic diseases from the website of the National Health Commission of the People's Republic of China for the period of January 2015 to April 2021. RESULTS First, the overall incidence of zoonotic diseases decreased from 0.3714 per 100 000 in 2015-2019 to 0.2756 in 2020 (25.79% reduction, p<0.001); however, a dramatic increase in activity was seen in 2021 compared with 2020 (0.4478 per 100 000 in 2021, 62.47% increase, p<0.001). Anthrax, brucellosis, leptospirosis and hydatid disease exhibited significant upward trends in 2021. Second, analysed further by stages, the monthly incidence in the routine stage (from May to December 2020) was much higher than that in the emergency stage of the COVID-19 (from January to April 2020) (55.33% increase, p<0.001). We also found that the monthly observed incidence was significantly lower than the predicted incidence of a 10.29% reduction in the emergency stage. Third, no differences were seen in mortality between 2021 and 2020, while a significant decline was found in 2020 compared with the previous 5 years (72.70%, p<0.001). CONCLUSIONS Strict containment and feasible suppression strategies during the 2020 period of the COVID-19 pandemic had positive impacts on the overall incidence of zoonotic diseases in China. However, anthrax, brucellosis, leptospirosis and hydatid diseases might increase with the relaxation of non-pharmacological interventions in 2021.
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Affiliation(s)
- Chenjin Ma
- College of Statistics and Data Science, Faculty of Science, Beijing University of Technology, Beijing, China
| | - Xiangyu Guo
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, China
| | - Lan Wang
- Department of Geriatrics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wang Li
- Nanjing Jiliang Information Technology, Nanjing, China
| | - Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Feng Lin
- Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wangli Xu
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, China
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20
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Kunkel A, Jeon S, Joseph HC, Dilius P, Crowdis K, Meltzer MI, Wallace R. The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis. Sci Rep 2021; 11:12476. [PMID: 34127783 PMCID: PMC8203735 DOI: 10.1038/s41598-021-92067-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/25/2021] [Indexed: 11/04/2022] Open
Abstract
Dog vaccination is a cost-effective approach to preventing human rabies deaths. In Haiti, the last nation-wide dog vaccination campaign occurred in 2018. We estimated the number of human lives that could be saved by resuming dog vaccination in 2021 compared to 2022 and compared the cost-effectiveness of these two scenarios. We modified a previously published rabies transmission and economic model to estimate trends in dog and human rabies cases in Haiti from 2005 to 2025, with varying assumptions about when dog vaccinations resume. We compared model outputs to surveillance data on human rabies deaths from 2005 to 2020 and animal rabies cases from 2018 to 2020. Model predictions and surveillance data both suggest a 5- to 8-fold increase in animal rabies cases occurred in Haiti's capital city between Fall 2019 and Fall 2020. Restarting dog vaccination in Haiti in 2021 compared to 2022 could save 285 human lives and prevent 6541 human rabies exposures over a five-year period. It may also decrease program costs due to reduced need for human post-exposure prophylaxis. These results show that interruptions in dog vaccination campaigns before elimination is achieved can lead to significant human rabies epidemics if not promptly resumed.
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Affiliation(s)
- Amber Kunkel
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Seonghye Jeon
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases , Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Haim C Joseph
- Ministry of Agriculture, Rural Development, and Natural Resources, Port-au-Prince, Haiti
| | - Pierre Dilius
- Ministry of Agriculture, Rural Development, and Natural Resources, Port-au-Prince, Haiti
| | | | - Martin I Meltzer
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases , Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ryan Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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21
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León B, González SF, Solís LM, Ramírez-Cardoce M, Moreira-Soto A, Cordero-Solórzano JM, Hutter SE, González-Barrientos R, Rupprecht CE. Rabies in Costa Rica - Next Steps Towards Controlling Bat-Borne Rabies After its Elimination in Dogs. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2021; 94:311-329. [PMID: 34211351 PMCID: PMC8223541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Rabies is an acute, progressive encephalitis caused by a lyssavirus, with the highest case fatality of any conventional infectious disease. More than 17 different lyssaviruses have been described, but rabies virus is the most widely distributed and important member of the genus. Globally, tens of thousands of human fatalities still occur each year. Although all mammals are susceptible, most human fatalities are caused by the bites of rabid dogs, within lesser developed countries. A global plan envisions the elimination of human rabies cases caused via dogs by the year 2030. The combination of prophylaxis of exposed humans and mass vaccination of dogs is an essential strategy for such success. Regionally, the Americas are well on the way to meet this goal. As one example of achievement, Costa Rica, a small country within Central America, reported the last autochthonous case of human rabies transmitted by a dog at the end of the 1970s. Today, rabies virus transmitted by the common vampire bat, Desmodus rotundus, as well as other wildlife, remains a major concern for humans, livestock, and other animals throughout the region. This review summarizes the historical occurrence of dog rabies and its elimination in Costa Rica, describes the current occurrence of the disease with a particular focus upon affected livestock, discusses the ecology of the vampire bat as the primary reservoir relevant to management, details the clinical characteristics of recent human rabies cases, and provides suggestions for resolution of global challenges posed by this zoonosis within a One Health context.
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Affiliation(s)
- Bernal León
- Biosecurity Laboratory, Servicio Nacional de Salud
Animal (SENASA), LANASEVE, Heredia, Costa Rica
- Universidad Técnica Nacional (UTN), Quesada, Costa
Rica
| | | | - Lisa Miranda Solís
- Specialist in Pediatric Pathology, Pathology Service,
Children National Hospital, Caja Costarricense de Seguro Social, San José, Costa
Rica
| | - Manuel Ramírez-Cardoce
- Specialist in Infectious Diseases, San Juan de Dios
Hospital, Caja Costarricense de Seguro Social, San José, Costa Rica
| | - Andres Moreira-Soto
- Research Center for Tropical Diseases (CIET), Virology,
Faculty of Microbiology, University of Costa Rica, San José, Costa Rica
- Charité-Universitätsmedizin Berlin, corporate member of
Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute
of Health, Institute of Virology, Berlin, Germany
| | | | - Sabine Elisabeth Hutter
- Coordinator of the National Risk Analysis Program,
Epidemiology Department, SENASA, Ministry of Agriculture, San José, Costa
Rica
- Institute of Food Safety, Food Technology and
Veterinary Public Health, Department for Farm Animals and Veterinary Public
Health University of Veterinary Medicine, Vienna, Austria
| | - Rocío González-Barrientos
- Pathology Area Biosecurity Laboratory, Servicio
Nacional de Salud Animal (SENASA), LANASEVE, Heredia, Costa Rica
- Department of Biomedical Sciences of Anatomic
Pathology, Cornell University, Ithaca, NY, USA
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