A Perspective on Rabies in the Middle East—Beyond Neglect

Abstract

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.

Rodent Ectoparasites in the Middle East: A Systematic Review and Meta-Analysis

“…Countries in the Middle East are hotspots for emerging and re-emerging infectious diseases, partly because of their ecological, cultural, socioeconomic, and political diversity, but also due to the unrest, conflict, and wars in this region [ 18 , 19 ]. The lack of relevant information on infectious diseases, their sources, and their diversity is a major drawback for public health studies in this area, possibly misguiding both civilians and governments in their attempts at mitigation [ 20 ].…”

Zoonotic Risk: One More Good Reason Why Cats Should Be Kept Away from Bats

“…While the risk run by humans of being bitten by a rabid wildlife species is small [ 64 ], this is intuitively substantially higher when it comes to domestic animals such as cats. Through this way, even historically rabies-free areas—particularly when involving migratory bat species [ 65 ]—and urban or rural environments [ 66 , 67 , 68 ] may be affected. For instance, in Brazil, in 2008–2016, only 1.4% cases of people bitten by animals concerned wildlife vs. 94% of bites by dogs and cats [ 64 ].…”

Helminth Parasites among Rodents in the Middle East Countries: A Systematic Review and Meta-Analysis

“…No report on rodent helminths was available from Bahrain, Jordan, Lebanon, Oman, United Arab Emirates, and Yemen. Cestodes were the most frequently reported (50 articles) helminths in the Middle Eastern rodents, followed by nematodes (49), and trematodes (14). All 65 studies reported at least 9628 rodents (47% females and 53% males).…”

“…Cultural diversity, weak economic policy, poor governance, rapid population growth, low educational structure, gender discrimination, underdeveloped infrastructure, and war and conflict have turned the region into a hot spot for many emerging and re-emerging diseases, including rodent-borne parasitic infections [ 9 , 12 , 13 ]. In the past, rodent-borne infections have led to multiple instances of a fatal epidemic, in part due to a lack of relevant information available on the subject, which makes it difficult to maintain public health sustainability [ 14 , 15 ].…”