Response to a Rabies Epidemic, Bali, Indonesia, 2008–2011

Putra, Anak Agung Gde; Hampson, Katie; Girardi, Janice; Hiby, Elly; Knobel, Darryn L.; Mardiana, I Wayan; Townsend, Sunny E.; Scott-Orr, Helen

doi:10.3201/eid1904.120380

Cited by 113 publications

(123 citation statements)

References 4 publications

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“…In 2008, however, an incursion occurred, and the disease spread rapidly across the island. The resulting epidemic led to over 100 human rabies deaths (8) and thousands of human exposures requiring expensive postexposure prophylaxis (9). Local, national, and international pressure led to concerted efforts to control the disease, largely based on mass vaccination of dogs, but also including culling of dogs by local authorities, as described by Putra et al (9).…”

Section: Introductionmentioning

confidence: 99%

“…The resulting epidemic led to over 100 human rabies deaths (8) and thousands of human exposures requiring expensive postexposure prophylaxis (9). Local, national, and international pressure led to concerted efforts to control the disease, largely based on mass vaccination of dogs, but also including culling of dogs by local authorities, as described by Putra et al (9). The first dog vaccination campaign was conducted from October 2010 to March 2011, followed by the second campaign in April through June 2011, and third campaign in March to June 2012 (10, 11).…”

Section: Introductionmentioning

confidence: 99%

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Determinants of Vaccination Coverage and Consequences for Rabies Control in Bali, Indonesia

et al. 2017

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Maintaining high vaccination coverage is key to successful rabies control, but mass dog vaccination can be challenging and population turnover erodes coverage. Declines in rabies incidence following successive island-wide vaccination campaigns in Bali suggest that prospects for controlling and ultimately eliminating rabies are good. Rabies, however, has continued to circulate at low levels. In the push to eliminate rabies from Bali, high coverage needs to be maintained across all areas of the island. We carried out door-to-door (DTD) questionnaire surveys (n = 10,352 dog-owning households) and photographic mark–recapture surveys (536 line transects, 2,597 observations of free-roaming dogs) in 2011–2012 to estimate dog population sizes and assess rabies vaccination coverage and dog demographic characteristics in Bali, Indonesia. The median number of dogs per subvillage unit (banjar) was 43 (range 0–307) for owned dogs estimated from the DTD survey and 17 (range 0–83) for unconfined dogs (including both owned and unowned) from transects. Vaccination coverage of owned dogs was significantly higher in adults (91.4%) compared to juveniles (<1 year, 43.9%), likely due to insufficient targeting of pups and from puppies born subsequent to vaccination campaigns. Juveniles had a 10–70 times greater risk of not being vaccinated in urban, suburban, and rural areas [combined odds ratios (ORs): 9.9–71.1, 95% CI: 8.6–96.0]. Free-roaming owned dogs were also 2–3 times more likely to be not vaccinated compared to those confined (combined Ors: 1.9–3.6, 95% CI: 1.4–5.4), with more dogs being confined in urban (71.2%) than in suburban (16.1%) and rural areas (8.0%). Vaccination coverage estimates from transects were also much lower (30.9%) than household surveys (83.6%), possibly due to loss of collars used to identify the vaccination status of free-roaming dogs, but these unconfined dogs may also include dogs that were unowned or more difficult to vaccinate. Overall, coverage levels were high in the owned dog population, but for future campaigns in Bali to have the highest chance of eliminating rabies, concerted effort should be made to vaccinate free-roaming dogs particularly in suburban and rural areas, with advertising to ensure that owners vaccinate pups. Long-lasting, cheap, and quick methods are needed to mark vaccinated animals and reassure communities of the reach of vaccination campaigns.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determinants of Vaccination Coverage and Consequences for Rabies Control in Bali, Indonesia

et al. 2017

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“…Even in wildlife-rich areas in Africa, dogs act as maintenance hosts and reservoirs for canine rabies (Lembo and others 2008), and vaccination of 70 per cent of the dog population is sufficient to disrupt transmission cycles and eliminate the disease, not only in domestic dogs, but in all other mammalian hosts (Hampson and others 2009), with corresponding declines in rabies exposures in people (Cleaveland and others 2003). Operational research has demonstrated that, even where most dogs are free-roaming, as is the case in most communities in Africa and Asia, it is feasible to implement campaigns that achieve 70 per cent vaccination coverage (Kayali and others 2003, Kaare and others 2009, Davlin and Vonville 2012, Putra and others 2013). Dog vaccination campaigns are also likely to be more cost-effective for preventing human rabies deaths than relying on human PEP alone, and over five- to 10-year horizons have the potential to result in net economic benefits (Bögel and Meslin 1990, Zinsstag and others 2009, Tenzin and others 2012, Fitzpatrick and others 2014).…”

Section: The Global Rabies Problemmentioning

confidence: 99%

Rabies control and elimination: a test case for One Health

et al. 2014

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As One Health becomes more widely advocated, particularly within the veterinary profession, practitioners are coming under increasing scrutiny to demonstrate the added value of these approaches. Despite an intuitive appreciation that complex health problems need to be tackled through an integration of the interdisciplinary and transdisciplinary approaches that define One Health, there still remains a need to generate quantitative and qualitative evidence to clearly demonstrate these benefits (Okello and others 2011, Zinsstag and others 2011, Häsler and others 2012, Gibbs 2014). One Health encompasses a wide variety of disease and health problems; however, zoonoses have always been an area of interest and, of these, rabies provides an exemplar of the benefits of a One Health approach. In this paper, we outline how One Health has underpinned successful rabies control programmes, and why integrated approaches are likely to be essential to enhance the cost-effectiveness of control and elimination measures, particularly in lowincome countries. The global rabies problem Rabies is a devastating and often fatal disease caused by neurotropic RNA viruses of the Lyssavirus genus. It is a globally distributed

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“…Less than 11% of the dog population has been identified as ownerless in Zimbabwe, Chad, Tanzania, and South Africa (15). In densely populated Asian settings, where community dogs are common, techniques for vaccinating free-roaming dogs have been successfully applied (11).…”

Section: Elimination Is Achievablementioning

confidence: 99%