Rabies in the Tropics

Abstract

Purpose of Review Rabies is an ancient yet still neglected tropical disease (NTD). This review focuses upon highlights of recent research and peer-reviewed communications on the underestimated tropical burden of disease and its management due to the complicated dynamics of virulent viral species, diverse mammalian reservoirs, and tens of millions of exposed humans and animals – and how laboratory-based surveillance at each level informs upon pathogen spread and risks of transmission, for targeted prevention and control. Recent Findings While both human and rabies animal cases in enzootic areas over the past 5 years were reported to PAHO/WHO and OIE by member countries, still there is a huge gap between these “official” data and the need for enhanced surveillance efforts to meet global program goals. Summary A review of the complex aspects of rabies perpetuation in human, domestic animal, and wildlife communities, coupled with a high fatality rate despite the existence of efficacious biologics (but no therapeutics), warrants the need for a One Health approach toward detection via improved laboratory-based surveillance, with focal management at the viral source. More effective methods to prevent the spread of rabies from enzootic to free zones are needed.

Ecological and Socioeconomic Factors in the Occurrence of Rabies: A Forgotten Scenario

“…It is imperative that relevant authorities consistently and systematically educate the public on how to prevent and manage rabies in their communities [ 6 , 72 ]. Most importantly, in LMICs, residents should be educated on the need to limit dog ownership and transportation, the need to vaccinate young dogs, and the importance of controlling reproduction [ 10 , 73 ]. Though rabies is 100% preventable, it still places a heavy strain on the world’s population [ 3 , 25 ].…”

Modelling modifiable factors associated with the probability of human rabies deaths among self-reported victims of dog bites in Abuja, Nigeria

“…Canine-mediated rabies is a model zoonosis for transdisciplinary One Health research into infections caused by rabies virus (RABV) and other lyssaviruses [1]. More than 20,000 people are annually estimated to die from rabies in Africa, with over 95% mortalities attributed to dog bites [2,3].…”

Diagnosis and management of rabies encephalitis in two patients in northwest Africa: A case series

“…Rabies is a zoonosis that continues to be an important public health problem in many developing countries 4,5 . Today, it is still considered a neglected tropical disease despite the fact that it causes more than 59,000 human deaths each year in the world, particularly in Asia and Africa, where more than one‐third of annual human deaths due to rabies occurs in each of these continents (>20,000 deaths in India alone and >20,000 in West and Central Africa), as well as in the Middle East (reliable data not available) 6–10 . Once declared clinically, it is inevitably fatal 4,5 .…”

“…4,5 Today, it is still considered a neglected tropical disease despite the fact that it causes more than 59,000 human deaths each year in the world, particularly in Asia and Africa, where more than one-third of annual human deaths due to rabies occurs in each of these continents (>20,000 deaths in India alone and >20,000 in West and Central Africa), as well as in the Middle East (reliable data not available). [6][7][8][9][10] Once declared clinically, it is inevitably fatal. 4,5 In most of Africa, especially in West and Central African countries, rabies notification is not mandatory, and epidemiological data are scarce.…”

“…4,5 In most of Africa, especially in West and Central African countries, rabies notification is not mandatory, and epidemiological data are scarce. [9][10][11] In Mauritania, enzootic rabies, which is known to have existed for a very long time, periodically affects animals and humans. Cases of death have been reported on several occasions.…”