The impact of the COVID-19 pandemic on rabies reemergence in Latin America: The case of Arequipa, Peru

Abstract

In Latin America, there has been tremendous progress towards eliminating canine rabies. Major components of rabies elimination programs leading to these successes have been constant and regular surveillance for rabid dogs and uninterrupted yearly mass dog vaccination campaigns. Unfortunately, vital measures to control COVID-19 have had the negative trade-off of jeopardizing these rabies elimination and prevention activities. We aimed to assess the effect of interrupting canine rabies surveillance and mass dog vaccination campaigns on rabies trends. We built a deterministic compartment model of dog rabies dynamics to create a conceptual framework for how different disruptions may affect rabies virus transmission. We parameterized the model for conditions found in Arequipa, Peru, a city with active rabies virus transmission. We examined our results over a range of plausible values for R0 (1.36–2.0). Also, we prospectively evaluated surveillance data during the pandemic to detect temporal changes. Our model suggests that a decrease in canine vaccination coverage as well as decreased surveillance could lead to a sharp rise in canine rabies within months. These results were consistent over all plausible values of R0. Surveillance data from late 2020 and early 2021 confirms that in Arequipa, Peru, rabies cases are on an increasing trajectory. The rising rabies trends in Arequipa, if indicative to the region as whole, suggest that the achievements made in Latin America towards the elimination of dog-mediated human rabies may be in jeopardy.

The impact of the COVID-19 pandemic on the incidence and mortality of zoonotic diseases in China

“…Raynor et al reported that the yearly mass dog vaccination programme in Peru was interrupted during COVID-19, resulting in a negative effect on rabies elimination and prevention activities. 26 Fifth, decreased incidence and mortality of zoonotic diseases might be due to their own long-term downward trends, which is a confounding factor in this study. However, to avoid the interference of the long-term trend of disease itself, some analyses were conducted, including the Cox-Stuart test and Farrington surveillance algorithm.…”

Rabies Elimination in Rural Kenya: Need for Improved Availability of Human Vaccines, Awareness and Knowledge on Rabies and Its Management Among Healthcare Workers

“…COVID-19 pandemic has disrupted many essential health services including strategies for rabies elimination ( 32 ) with funding for non-COVID-19 disease projects redirected to control of COVID-19. These has disrupted mass dog vaccination, provision of PEP and community awareness activities ( 33 ).…”

Continued Failure of Rabies Elimination—Consideration of Challenges in Applying the One Health Approach

“…COVID-19 has disrupted the lives and economies of most countries all over the world, whether directly or indirectly ( 29 ). As public health professionals are diverted to working on the pandemic, it has disrupted vaccination campaigns in countries ( 30 ), including rabies vaccination, and field training. Field staff were overloaded with COVID-19 related duties, and rabies was once again neglected ( 31 ).…”

“…Additionally, due to prioritization failure and supply chain disruption, many remote provinces, where rabies is often widespread ( 5 , 12 ), faced vaccine shortage ( 31 , 32 ). Due to lockdowns, fewer people were leaving home, and increased difficulty in travel to and from hospitals or clinics led to decrease in identification of suspected rabid dogs, slower dispatch of rabies response teams, and delayed removal of suspected rabid dogs ( 30 ). Lockdowns also deterred people from seeking medical attention due to fear of contracting COVID-19 or because hospitals were overflowing.…”

“…As the world continues to battle the pandemic, true data on the preventable human-rabies cases and deaths will take some time to emerge. As COVID-19 continues to challenge the public health sector, it is important to develop strategies for rabies prevention and surveillance activities which can accommodate social distancing ( 30 ), such as oral rabies vaccine for dogs ( 33 ), survive lockdowns, and account for and manage abandoned pets.…”