Rabies is a neglected but preventable viral zoonosis that poses a substantial threat to public health. In this regard, a global program has been initiated for the elimination of human rabies caused by rabid dogs through the mass vaccination of canine populations. Geographic areas vary greatly towards attainment of this objective. For example, while dog-mediated and wildlife rabies have been largely controlled in major parts of the Americas and Western Europe, the Middle East still grapples with human rabies transmitted by unvaccinated dogs and cats. Rabies prevention and control in the Middle East is quite difficult because the region is transcontinental, encompassing portions of Africa, Asia, and Europe, while consisting of politically, culturally, and economically diverse countries that are often subject to war and unrest. Consequently, one over-riding dilemma is the misinformation or complete lack of rabies surveillance data from this area. This communication is an attempt to provide an overview of rabies in the Middle East, as a cohesive approach for the honing of disease management in each area, based on data compiled from multiple sources. In addition, the related regional transboundary movement of rabies was investigated through phylogenetic studies of available viral gene sequences. Thereafter, the epidemiological status of rabies was assessed for the region. Finally, localities were classified first by the Stepwise Approach towards Rabies Elimination framework and then categorized into four different groups based on management theme: "rabies free"; owned dog and domestic animal vaccination; community dog vaccination; and wildlife vaccination. The classification system proposed herein may serve as a baseline for future efforts. This is especially important due to the severe lack of rabies information available for the Middle East as a whole and a need for a comprehensive program focusing on the entirety of the region in light of renewed international commitment towards canine rabies elimination.
Pathogen discovery contributes to our knowledge of bat-borne viruses and is linked to the heightened interest globally in bats as recognised reservoirs of zoonotic agents. The transmission of lyssaviruses from bats-to-humans, domestic animals, or other wildlife species is uncommon, but interest in these pathogens remains due to their ability to cause an acute, progressive, invariably fatal encephalitis in humans. Consequently, the detection and characterisation of bat lyssaviruses continues to expand our knowledge of their phylogroup definition, viral diversity, host species association, geographical distribution, evolution, mechanisms for perpetuation, and the potential routes of transmission. Although the opportunity for lyssavirus cross-species transmission seems rare, adaptation in a new host and the possibility of onward transmission to humans requires continued investigation. Considering the limited efficacy of available rabies biologicals it is important to further our understanding of protective immunity to minimize the threat from these pathogens to public health. Hence, in addition to increased surveillance, the development of a niche pan-lyssavirus vaccine or therapeutic biologics for post-exposure prophylaxis for use against genetically divergent lyssaviruses should be an international priority as these emerging lyssaviruses remain a concern for global public health. ; Defra, the Scottish Government and Welsh Government; European Union's Horizon 2020 research and innovation program; South African Research Chair Initiative (of the Department of Science and Innovation administered by the National Research Foundation of South Africa. ; http://www.mdpi.com/journal/viruses ; pm2021 ; Medical Virology
Canine rabies poses a significant risk to humans and animals in Nigeria. However, the lack of reliable tools to evaluate the performance of existing canine rabies control programs to inform public health policy decisions poses a severe obstacle. We obtained canine rabies surveillance data from the National Veterinary Research Institute (NVRI) and supplemented these data with rabies diagnoses reported in the published studies from Nigeria. To uncover contextual factors (i.e., environmental and sociodemographic) associated with canine rabies evidence at the Local Government Area (LGA) level, we classified LGAs in Nigeria into four categories based on evidence availability (i.e., LGAs with NVRI data or published studies, both, or no evidence). We described the geographical and temporal variation in coverage. We fitted a multinomial regression model to examine the association between LGA level canine rabies evidence and potential sociodemographic and ecological determinants of canine rabies evidence. The effective annual testing during the 19 years was less than one dog/100,000 Nigerian resident-year. Our results showed that 58% of Nigerian LGAs (450/774) had not been targeted by the existing national rabies surveillance or studies on rabies, including ten states capitals with high human populations. While 16% (122/774) of Nigerian LGAs concentrated in Taraba, Adamawa, and Abia had canine rabies evidence from published studies, none of these LGAs was represented in the NVRI rabies surveillance data. We also observed an increasing trend in rabies evidence over time towards the eastern part of Nigeria. Our multinomial regression model indicated that education level, poverty, population density, land use and temperature were significantly associated with canine rabies evidence at the LGA level. This study underscores the value of combining canine rabies evidence from different sources to better understand the current disease situation for targeted intervention.
Objective: The Pan American Health Organization (PAHO) regional program introduced to Latin America and the Caribbean (LAC) in 1983 was ratified in 2009 with the goal of eliminating dog-transmitted human rabies by 2015. Despite a >90% decrease in cases, the latter has been extended to 2018 due to persistence in certain areas. In discussions about rabies, LAC are often grouped as one. However, data from Latin America generally obscures the Caribbean situation so that it is inadequately represented in the literature. The present study aims to independently analyse the rabies situation in the Caribbean through use of an internal Caribbean Network (Caribbean Animal Health Network), and to examine the changing epidemiology of the disease in comparison to Latin America. Methods: A questionnaire was developed and administered in February 2014, to the 33 countries or territories of the Caribbean Animal Health Network (CaribVET), through the Adobe Forms Central Web-based platform. Country submissions were collected from April 2014 to June 2015. Responses from30 countries were analysed from June to July 2015 and results were summarized into a regional situation analysis. Complementary information was obtained through a comprehensive literature review using internet searches and the institutional libraries of the PAHO Office in Trinidad and Tobago and the Caribbean Public Health Agency (CARPHA). Selected literature was then summarized and collated with questionnaire responses. Results: Rabies is a notifiable disease in almost all islands and territories of the Caribbean region, where the disease is present in ten countries and/territories (Trinidad and Tobago, Belize, Grenada, Guyana, Suriname, Cuba, Puerto Rico, Dominican Republic, French Guiana and Haiti). In most instances, the disease is endemic in wildlife with periodic spill over into domestic animals; however urban (canine) rabies still occurs in Hispaniola (Dominican Republic and Haiti) and Cuba. Caribbean sylvatic rabies is maintained by two main reservoir hosts, the vampire bat and the mongoose. The main reservoir host is the mongoose in Grenada, Puerto Rico and Cuba, and the vampire bat in Trinidad and Tobago, Guyana, Suriname, Belize and French Guiana. In four (40%) rabies endemic Caribbean countries and/territories (French Guiana, Dominican Republic, Haiti, Cuba) human cases have occurred within the last 10 years. The estimated number of human rabies cases per year was highest in Haiti (6-10 cases) and lowest in French Guiana (0-1 cases). Sporadic human cases also occur in Suriname every 8-10 years, with the last case reported in 1998. Rabies cases were reported in the animal population, within the last 10 years, in all endemic countries except Suriname (last case reported in 2002). The average number of cases reported per year ranged from 0-1 (French Guiana) to 90 (Cuba). Cattle were the most significantly affected species, particularly in countries with vampire bat rabies. Human bite incidents from potential rabies vectors are reportable in 8 (80%) rabies endemic countries, (excluding Trinidad and Tobago and Suriname) and in 8 (40%) non-endemic countries. In contrast, animal bite incidents are reportable in 7 (70%) endemic versus 6 (30%) non-endemic countries. All endemic countries/territories (except Suriname) have passive or enhanced passive surveillance programs for animal rabies. Active surveillance in the stray domestic carnivore population is carried out in Cuba, Haiti, Dominican Republic and Grenada, whereas active surveillance is conducted in wildlife (bats and mongoose) exclusively in Trinidad and Puerto Rico. None of the non-endemic countries conduct rabies diagnostic testing for humans or animals. Among endemic countries, only Cuba, Dominican Republic and Puerto Rico conduct human rabies diagnostics, and all but Belize, Suriname and Guyana conduct animal rabies diagnostics. Most rabies-free countries did not implement rabies control programs to attain their disease free status and the risk of rabies introduction was considered by the local veterinary authorities to be low in 60% of these countries, with illegal importation of dogs being the most relevant route. Conversely, national legislation for animal rabies control and prevention exists in all endemic countries apart from Haiti, Belize and Suriname. Animal vaccination strategies for the prevention and control of rabies in the Caribbean, mainly target bovine and domestic carnivore animal populations, and governments provide vaccines free of charge in most (60%) rabies endemic countries. Annual mass vaccination programmes are carried out for both cattle and domestic carnivores (dogs and cats) in French Guiana, Grenada, Puerto Rico and Belize. The domestic carnivore populations are targeted in Cuba, the Dominican Republic and Haiti with estimated vaccine coverages of >90%, 80% and 40-50% respectively. The bovine population in Trinidad is largely covered by herd immunity with 70% vaccine coverage, compared to the 10% in Guyana that vaccinates only in outbreak situations. Vaccination is legislatively mandatory for the bovine population of Trinidad, and for both the bovine and domestic carnivore populations in French Guiana. Almost all countries in the Caribbean have rabies import health restrictions. In these countries the most regulated species are dogs and cats, with rabies vaccination being a requirement for entry. Countries without rabies related import restrictions are Grenada, Dominican Republic, Puerto Rico and Sint Eustatius. Conclusion: Canine-transmitted rabies occurs only on two Caribbean islands (Hispaniola and Cuba) compared to five countries in Latin America (Brazil, Bolivia, Peru, Honduras and Guatemala) with disease control in Haiti presenting the major challenge to elimination in the Caribbean. As of 2004, the prevalence of rabies transmitted by wildlife in the Americas exceeded that of domestic dogs which is mainly reflective of bat-transmitted cases in North and Latin America. However, although the mongoose is the main rabies reservoir host in 30% of endemic Caribbean countries, it is often overlooked as a vector in the LAC literature due to the ubiquitous presence of the vampire bat in Latin America. Furthermore, although vampire rabies predominates among existing reports in humans and domestic animals, other bat species should not be excluded from routine surveillance activities when warranted, as they have previously been implicated in rabies viral transmission in the region. Therefore, the long term objectives of rabies elimination programs in LAC therefore need to take into account the diverse rabies epidemiology within the Caribbean. Results of this study underscore the importance of regional animal health networks such as CaribVET in coordinating expertise and resources, facilitating regional training and sharing of information and knowledge. The Caribbean has limited rabies diagnostic capacity compared to Latin America. However, regional collaboration through CaribVET can increase the laboratory capability in countries without independent diagnostic facilities. Also a recent regional training workshop organized by CaribVET resulted in standardization of the rabies diagnostic testing regime throughout the Caribbean which will increase confidence in results. Regional collaboration can also facilitate the development of common protocols and regulations for the control and prevention of rabies in countries with similar epidemiological circumstances.
Rabies is a major neglected zoonotic disease and causes a substantial burden in the Asian region. Currently, Pacific Oceania is free of rabies but enzootic areas throughout southeast Asia represent a major risk of disease introduction to this region. On September 25–26, 2019, researchers, government officials and related stakeholders met at an IABS conference in Bangkok, Thailand to engage on the topic of human rabies mediated by dogs. The objective of the meeting was focused upon snowballing efforts towards achieving substantial progress in rabies prevention, control and elimination within Asia by 2030, and thereby to safeguard the Pacific region. Individual sessions focused upon domestic animal, wildlife and human vaccination; the production and evaluation of quality, safety and efficacy of existing rabies biologics; and the future development of new products. Participants reviewed the progress to date in eliminating canine rabies by mass vaccination, described supportive methods to parenteral administration by oral vaccine application, considered updated global and local approaches at human prophylaxis and discussed the considerable challenges ahead. Such opportunities provide continuous engagement on disease management among professionals at a trans-disciplinary level and promote new applied research collaborations in a modern One Health context.
