Strategies for controlling dog-mediated human rabies in Asia: using ‘One Health’ principles to assess control programmes for rabies

Abstract

Over 99% of human rabies cases in endemic areas are transmitted by dogs. Without the elimination of dog rabies, it is not easy to reduce human rabies infection. Controlling dog rabies, especially in ownerless or free-roaming dogs, is critical if we are to decrease the rate of human rabies infection. There are several components in a strategy to eliminate dog-mediated rabies in Asia. Each government must make sure that rabies is either a reportable disease or a notifiable disease and enforce the reporting requirements accordingly. They must also focus on organising and operating special rabies control committees that work with relevant agencies under the 'One Health' banner. They should also implement a national rabies control programme that includes mass dog vaccination, laboratory-based surveillance, stable budget allocation, a rapidreporting system, management of dog populations, international cooperation, prevention of animal introductions from other countries, and risk assessment to analyse the programme's weaknesses. As several developed countries have shown, an effective rabies control strategy leads to rabies-free status. In the Republic of Korea, human rabies has not occurred since 2004, and there have not been any confirmed cases of dog rabies or cases of rabies in wild animals, including raccoon dogs, since 2014. The successful implementation of the key strategies used to eliminate rabies in the Republic of Korea will enable other Asian countries to eliminate dog-mediated human rabies.

Global Dog and Human Rabies Control Efforts from Ancient Times to 2030 and Beyond

“…Despite the availability of effective canine rabies vaccines, rabies control has continued to rely on population reduction methods such as culling dogs or wildlife and vaccination of owned dogs (Kuwert et al, 1985;Rupprecht et al, 2020). While some countries have never managed to control rabies, some nations eliminated it at local or national levels, while others have seen outbreaks of dog or rabies occur in areas previously free of the disease (Yang et al, 2018;Rupprecht et al, 2020).…”

“…Similarly, Malaysia lost its rabies-free status after the declaration of a rabies epidemic in 2015. Canine rabies continues to be enzootic in China (Liu, 2013) and several other Asian countries (Yang et al, 2018). Like in Africa, field trials in Sri Lanka, the Philippines and Thailand have demonstrated the potential benefits of ORV for canine rabies control (Cliquet et al, 2018).…”

Rabies in the Tropics

“…There is no current literature for Guinea, Gambia, and Bissau Guinea, but the US CDC classifies these countries as “hotspots” ( https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/high-risk.html ). The Regional Disease Surveillance Systems Enhancement (REDISSE) program and other partners support programs throughout West Africa in an attempt to improve upon data collection [ 28 ].…”

“…Recent reports highlight the considerable progress towards this goal in some countries, achieved through targeted and diverse initiatives, as well as multiple challenges. Significantly, the Republic of Korea declared the elimination of enzootic transmission of canine rabies in 2017 and have controlled wildlife rabies by oral vaccination [ 28 , 35 ]. Sri Lanka, Bhutan, Thailand, and Bangladesh have registered a considerable reduction in human rabies deaths [ 1 , 26 ].…”

New Rabies Vaccines for Use in Humans

“…Mandatory dog rabies vaccination has virtually eliminated human rabies in Europe and most of the Americas [2]. Stray dogs are common in Asia and Africa and their vaccination requires either baiting by oral vaccines or parental vaccination upon capture of free-roaming dogs, which is time- and labor-intensive [3,4]. Alternatively, new human vaccines could be developed that achieve protective immunity after a single immunization, reduce the need for RIG if given after severe exposure and/or are cost effective if used for pre-exposure prophylaxis (PrEP) in highly endemic areas.…”