Rabies Encephalitis in Malaria-Endemic Area, Malawi, Africa

Mallewa, Macpherson; Fooks, Anthony R.; Banda, Daniel L.; Chikungwa, Patrick; Mankhambo, Limangeni; Molyneux, Elizabeth; Molyneux, Malcolm E.; Solomon, Tom

doi:10.3201/eid1301.060810

Cited by 171 publications

(126 citation statements)

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“…No investigations into infections of humans were made during these investigations, but lyssavirus infections in humans in Africa are underdiagnosed (12). Despite reduced pathogenicity of LBV in the laboratory, it has been isolated from dogs, cats, and a mongoose (2).…”

Section: Discussionmentioning

confidence: 99%

Antibodies against Lagos Bat Virus in Megachiroptera from West Africa

Hayman

Fooks

Horton

et al. 2008

Emerg. Infect. Dis.

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To investigate the presence of Lagos bat virus (LBV)-specifi c antibodies in megachiroptera from West Africa, we conducted fl uorescent antibody virus neutralization tests. Neutralizing antibodies were detected in Eidolon helvum (37%), Epomophorus gambianus (3%), and Epomops buettikoferi (33%, 2/6) from Ghana. These fi ndings confi rm the presence of LBV in West Africa. Bats host a range of lyssaviruses, depending on their species and locality. The genus Lyssavirus is differentiated into 7 genetically divergent genotypes: classical rabies virus (genotype 1), Lagos bat virus (LBV; genotype 2), Mokola virus (MOKV; genotype 3), Duvenhage virus (genotype 4), European bat lyssavirus (genotypes 5 and 6), and Australian bat lyssavirus (genotype 7) (1). All but MOKV have been isolated from bats.LBV and MOKV are each distributed in Africa and are members of phylogroup 2 within the genus Lyssavirus (1). Because LBV isolates (2) from African bats are increasing, our goal was to determine the prevalence of virus neutralizing antibodies against LBV in bat populations in West Africa. The StudyBats were sampled in January and May 2007 at 6 sites in Ghana: the center of Accra (urban habitat); the wooded outskirts of Accra (savannah habitat); and forested habitats at Pra, Kibi, Adoagyiri, and Oyibi (a plantation with woodland/forest border). Bats were captured by using 6-18-m mist nets; roosting Eidolon helvum were captured by using nets on poles. A sample size of 59 would provide 95% confi dence of fi nding at least 1 LBV-seropositive bat in a large population (>5,000), given a seroprevalence of 5% and assuming random sampling (3). Species were identifi ed by using a dichotomous key (4). Captured bats were manually restrained and anesthetized by intravenous injection; ≈0.2-1.0 mL of blood was collected from the propatagial vein before the bat was released. Blood was centrifuged in the fi eld at ambient temperature at 3,000 rpm for 15 min. Serum was heat treated at 56°C for 30 min and frozen at -70°C.Two species, Epomophorus gambianus and E. helvum, were caught in suffi cient numbers (117 and 66, respectively) for reasonable inferences to be made about LBV seroprevalence rates (Table). A standard approach was used to calculate 95% confi dence intervals (CIs) for seroprevalence (3). Because of the relatively short distances between study sites and the likelihood of bats mixing between these sites, bats of each species were considered to belong to single populations. All but 3 E. helvum were derived from a colony in Accra, whereas E. gambianus were derived from all habitat types.Bat serum samples were tested for virus neutralizing antibody against classical rabies virus (challenge virus standard) by using a standard fl uorescent antibody virus neutralization (FAVN) test (5). Antibodies to LBV were measured by using a modifi ed FAVN test (6). Because positive bat antiserum from naturally infected bats was not available, for positive controls we used human rabies immunoglobulin, LBV-positive rabbit serum, and serum from mice vaccina...

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Section: Discussionmentioning

confidence: 99%

Antibodies against Lagos Bat Virus in Megachiroptera from West Africa

Hayman

Fooks

Horton

et al. 2008

Emerg. Infect. Dis.

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“…Nonetheless, 65 human rabies fatalities were reported in 2014 (12,13). This reported mortality likely corresponds to an actual burden of about 80 deaths, given that only 80% of human rabies cases present with the characteristic "furious" symptoms and that the other 20% presenting as febrile and paralytic are generally misdiagnosed (2,14), often as malaria (15). Despite the high prioritization of rabies control by zoonotic disease experts in India (16), policymakers have been reluctant to implement widespread canine rabies interventions without assessments of the balance between expenditure and effectiveness (17).…”

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confidence: 99%

“…Additionally, with 42% of the canine population recorded as stray (27), measures that reduce the stray population have public support as an approach to address the thousands of dog bite incidents, both rabid and nonrabid, that occur annually in Tamil Nadu alone. However, such a combined strategy is more This paper results from the Arthur M. Sackler Colloquium of the National Academy of Sciences, "Coupled Human and Environmental Systems," held March [14][15]2016, at the National Academy of Sciences in Washington, DC. The complete program and video recordings of most presentations are available on the NAS website at www.nasonline.…”

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confidence: 99%

One Health approach to cost-effective rabies control in India

Fitzpatrick

Shah

Pandey

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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Over 20,000 rabies deaths occur annually in India, representing one-third of global human rabies. The Indian state of Tamil Nadu has pioneered a "One Health" committee to address the challenge of rabies in dogs and humans. Currently, rabies control in Tamil Nadu involves postexposure vaccination of humans after dog bites, whereas potential supplemental approaches include canine vaccination and sterilization. We developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu. Integrating local estimates for canine demography and costs, we predicted the impact of canine vaccination and sterilization on human health outcomes and evaluated cost-effectiveness according to the WHO criteria for India, which correspond to thresholds of $1,582 and $4,746 per disability-adjusted life-years (DALYs) for very cost-effective and cost-effective strategies, respectively. We found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 y, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Through integration over parameter uncertainty, we find that, for a cost-effectiveness threshold above $1,400 per DALY, canine interventions are at least 95% likely to be optimal. If owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective. This case study of cost-effective canine interventions in Tamil Nadu may have applicability to other settings in India and beyond. mathematical modeling | cost-effectiveness | rabies | sterilization | vaccination

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“…The rabies virus (genus Lyssavirus) is still an important cause of fatal cases of encephalitis (Mallewa et al, 2007). The most likely route for human infection is through bite wound, where the virus contaminated saliva enters into the bloodstream of the new host.…”

Section: Rhabdoviridae Family: Rabies and Chandipura Virus And Austramentioning

confidence: 99%