Review of rabies in Nepal

Abstract

Rabies is a global problem, but the burden is higher in less developed or developing countries of Asia and Africa. In Nepal, rabies is reported to kill around 500 animals and up to 32 human beings in recent years, with possible under-reporting of cases and deaths. As a prophylactic measure, around 30,000 livestock and 300,000 humans get vaccinated each year in Nepal. This review summarizes the past, present and future perspectives of rabies control and prevention in Nepal. The global strategic plan of World Health Organization (WHO) aims to bring human deaths from dog-transmitted rabies to zero by 2030. To achieve this goal of ‘Zero by 30’, the concerned governmental and non-governmental agencies in Nepal should work together using the One Health concept.

Rabies control in South Asia requires a One Health approach

“…It is estimated that South Asia carries 45% of the global burden of dog mediated human rabies [ 7 ]. All the countries of South Asia are rabies endemic except the Maldives which is free from rabies due to its isolated location in the Indian Ocean [ 8 ]. A joint call for action to eliminate rabies by 2030 was made in 2015 by the World Health Organization (WHO), the World Organization for Animal Health (OIE), the Food and Agriculture Organization (FAO), and the Global Alliance for Rabies Control (GARC) [ 9 ].…”

“…About 35% of all human deaths from rabies occur in India which also accounts 60% of rabies deaths in Asia [ 8 , 23 ]. Some 95% of rabies cases are dog mediated.…”

The Role of Waste Management in Control of Rabies: A Neglected Issue

“…Kathmandu Valley (Nepal) is inhabited by 29 million humans with an annual population growth rate of 1.85% [ 39 , 40 ]. It is estimated that more than 22,000 street dogs are present in the Kathmandu Valley [ 5 ]. Around 100–150 cases of dog bites are reported in Shukraraj Tropical and Infectious Disease Hospital at Teku, Kathmandu, alone [ 5 ].…”

“…It is estimated that more than 22,000 street dogs are present in the Kathmandu Valley [ 5 ]. Around 100–150 cases of dog bites are reported in Shukraraj Tropical and Infectious Disease Hospital at Teku, Kathmandu, alone [ 5 ]. In 2010, the average MSW generated in Kathmandu was 523.8 metric ton (t) per day, where street litter was about 69.3t per day and organic material comprised the majority of household waste products [ 41 ].…”

“…The RNA viruses of the Lyssavirus genus, family Rhabdoviridae, are all known or suspected to induce rabies, although the main etiological agent for rabies worldwide remains rabies virus (RABV) [ 3 , 4 ]. In spite of being one of the oldest known zoonotic infections, it is still a neglected disease with the greatest burden in rural marginalized communities of developing countries [ 4 , 5 , 6 , 7 , 8 ]. Despite successful control and elimination of dog-mediated rabies in some parts of the world, this disease is still endemic in at least 122 countries [ 9 ].…”