Eliminating dog-mediated rabies: challenges and strategies

Abstract

Rabies is an acute encephalitis caused by a lyssavirus. It is primarily transmitted through bites of infected dogs which results in the worldwide death of an estimated 59000 humans every year. The disease is preventable through the application of post-exposure prophylaxis (PEP) and its elimination has been demonstrated in many countries by applying multiple interventions simultaneously. Nonetheless, rabies is still widespread in many developing countries, primarily due to the poor implementation of intervention strategies that include inadequate dog-bite wound management practices, unavailability/unaffordability of PEP by the communities, failure to control the disease in free-roaming dogs and wildlife, improper dog population management, weak surveillance and diagnostic facilities and a lack of a One Health approach to the disease. In this review, strategies to control dog-mediated rabies through a One Health approach were discussed. We recommend applying multiple interventions against the disease by involving all the concerned stakeholders in selected urban and rural areas of the countries where rabies is endemic. An empirical demonstration of disease freedom in the selected areas through a One Health approach is needed to convince policymakers to invest in rabies prevention and control on the national level. This multifaceted One Health control model will enhance the likelihood of achieving the goal of global rabies eradication by 2030.

Enhancing research integration to improve One Health actions: learning lessons from neglected tropical diseases experiences

“…For example, dog-transmitted rabies control strategies are the very resources demanding to ensure annual mass revaccination of more than 70% of a country’s canine population to maintain sufficient immunity to stop virus transmission. Hence, the results obtained are fragile and can be annihilated by prematurely stopping the vaccination effort 17 18. Canine vaccination strategies would certainly benefit from developing potent rabies vaccine inducing lifelong immunity in dogs that would shorten and lighten the burden of the mass dog vaccination campaigns, and stepping up oral vaccination schemes19 as well as better understanding human-dog relationships 20.…”

Geographic distribution of laboratory-confirmed cases of rabies in domestic and wild animals based on passive surveillance records in Uganda: 2015-2022

“…RABV is responsible for rabies disease in mammals with a 100% fatality in the absence of treatment following the neurological clinical manifestation of the disease [1][2][3]. Rabies is still widespread in many developing countries, primarily due to the limited bio surveillance and response including implementation of early detection, surveillance and intervention strategies that include failure to control the disease in the community by free-roaming dogs and wildlife, lack of diagnostic facilities and a One Health approach to combat such zoonotic disease of public and veterinary importance [4,5].…”

Where Rabies Is Not a Disease. Bridging Healthworlds to Improve Mutual Understanding and Prevention of Rabies

“…In most endemic countries, each of these components faces challenges. The design of mass dog vaccination campaigns is often poorly informed by an understanding of people's attitudes toward dogs and perceptions around dog vaccination ( 4 ); PEP delivery struggles to reach those that need it most ( 5 ); and awareness about how to manage dog bites is often low not only amongst the public ( 6 ) but also healthcare providers ( 7 ). The common denominator of these issues is frequently a disconnect between research and policy ( 8 ), hence the design of strategies that are not context-specific ( 9 ).…”

“…By influencing individual and community dog keeping practices and concepts of animal welfare, religion also impacts mass dog vaccination, but this aspect of rabies control is rarely studied ( 16 ), even by anthropologists ( 17 ). For example, people in India feed free-roaming dogs more because of the belief in karma (i.e., good deeds in the current life lead to a happier rebirth) than a genuine concern for dog welfare ( 4 ).…”