Rabies in Foxes, Aegean Region, Turkey

At the end of the 1990s in the Aegean region of Turkey, rabies rapidly spread among foxes. This spread likely resulted from spillover infection from dogs and led to increased rabies cases among cattle. To control this outbreak, oral rabies vaccination of foxes has been used.     

Human rabies post exposure prophylaxis in Bhutan, 2005-2008: trends and risk factors

The aim of this study was to understand the use and distribution of human rabies post exposure prophylaxis (PEP) vaccine in Bhutan and to identify risk factors for receiving an incomplete course of the vaccine. We analyzed post exposure treatment records from 28 medical hospitals from 2005 to 2008. Males (59%) accounted for significantly more PEP events than females (41%) across all age groups (P < 0.001). Children - particularly 5-9 years of age - received more rabies PEP than other age groups. Animal bite and non-bite accounted for 27% (n = 2239) and 16% (n = 1303) of rabies PEP, respectively, whilst 57% (n = 4773) of the PEP events had no recorded information about the reasons for post exposure treatment. Post exposure treatment was provided throughout the year with a higher number during the winter and spring months. The number of PEP events significantly (P < 0.001) increased between 2005 and 2008, from <1000 to >2800 events, respectively. Significantly (P < 0.001) more PEP events were reported from the southern parts of Bhutan that are endemic for rabies or those areas in eastern Bhutan that have reported rabies outbreaks than other parts of Bhutan. Forty percent (n = 3360) of the patients received an incomplete course of vaccine (<5-doses of vaccine intramuscular). Results suggest that patients with animal bite injury were less likely to receive an incomplete vaccine course than non-bite recipients, and patients presented to hospitals in rabies endemic or outbreak areas were less likely to receive an incomplete course than in non-rabies areas or rabies free areas. Similarly, patients presenting to hospitals for PEP during spring and summers months were less likely to receive an incomplete vaccine course than those during other seasons. Public education campaigns need to be conducted in Bhutan to reduce dog bite incidents and also to prevent mass exposures to rabies. A thorough assessment of each individual case based on the WHO guidelines would reduce unnecessary PEP (and therefore costs) in Bhutan.     

江苏省盐城市1999-2008年狂犬病流行病学研究

目的 分析盐城市狂犬病的流行病学特征.方法 收集狂犬病疫情资料,开展犬密度、犬免疫率、犬伤人率及狂犬病处置门诊工作调查;检测犬脑中狂犬病毒并进行相关分子生物学研究.结果 1999-2008年盐城市共报告135例人狂犬病,形成自1958年以来的第二次流行高峰,其中2003年报告40例狂犬病.135例患者中114例为农民.监测点调查发现盐城市犬密度为每100人中约豢养犬3～6只,每年平均100只犬伤人6.37人次,2008年犬的免疫率只有20%,暴露人群狂犬病疫苗接种率为77%.狂犬病处置门诊中抗狂犬病血清(球蛋白)的使用率仅为5%～10%.在采集108份犬脑标本中,4份狂犬病毒阳性,扩增、测序并分析病毒的N和G基因显示,这些病毒为基因Ⅰ型狂犬病毒,与目前使用的狂犬疫苗株CTN同源性最高.结论 盐城市人间狂犬病的持续流行与当地犬的饲养量大、免疫率低以及农村地区群众受动物伤害后的处理不及时规范及处理率低密切相关.     

Rabies virus strains circulating in Bhutan: implications for control

We report a molecular epidemiological study of rabies virus (RABV) strains circulating in animal populations in Bhutan, and investigate potential origins of these viruses. Twenty-three RABV isolates originating from dogs and other domestic animals were characterized by sequencing the partial nucleoprotein (N) gene (395 bp). Phylogenetic analysis was conducted and the Bhutanese isolates were compared with rabies viruses originating from other parts of the world. Phylogenetic analysis showed that Bhutanese isolates were highly similar and were closely related to Indian strains and South Asian Arctic-like-1 viruses. Our study suggests that the rabies viruses spreading in southern parts of Bhutan have originated from a common ancestor, perhaps from the Indian virus strain.     

Epidemiology of rabies in northern Nigeria

Data on the rabies situation in Kaduna State, in northern Nigeria, were obtained by questionnaire and interview with all Divisional Veterinary Officers, physicians, hospital superintendents, village and hamlet heads or chiefs in various local government areas. All persons reporting animal bites to the Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, were also interviewed. Direct immunofluorescence staining, using both the regular conjugated anti-rabies globulin and a conjugated monoclonal antibody battery to lyssaviruses, was performed on brain samples from suspect animals sent to the Faculty of Veterinary Medicine. There were more dogs, and consequently more rabies outbreaks, in the southern part of the state than in the north; this did not appear to be associated with the religious beliefs of the local population. There seems to be a cyclic pattern of distribution of the outbreaks. Most dogs involved in bites had identifiable owners (74.5%), were older than one year (70.0%), and were not vaccinated (75.5%). Male children (under 10 years) were the high risk group for dog bites. Rabies cases seemed to cluster around April and September, corresponding to breeding seasons for dogs in Zaria. All the isolates checked by conjugated monoclonal antibodies for lyssaviruses were found to be rabies. Enforcing leash laws, vaccination of dogs against rabies especially before the breeding seasons, and control of stray and free-roaming dogs would reduce the incidence of rabies in Kaduna State.     

High prevalence of antibodies against canine adenovirus (CAV) type 2 in domestic dog populations in South Africa precludes the use of CAV-based recombinant rabies vaccines

Rabies in dogs can be controlled through mass vaccination. Oral vaccination of domestic dogs would be useful in the developing world, where greater vaccination coverage is needed especially in inaccessible areas or places with large numbers of free-roaming dogs. From this perspective, recent research has focused on development of new recombinant vaccines that can be administered orally in a bait to be used as adjunct for parenteral vaccination. One such candidate, a recombinant canine adenovirus type 2 vaccine expressing the rabies virus glycoprotein (CAV2-RG), is considered a promising option for dogs, given host specificity and safety. To assess the potential use of this vaccine in domestic dog populations, we investigated the prevalence of antibodies against canine adenovirus type 2 in South African dogs. Blood was collected from 241 dogs from the Gauteng and KwaZulu-Natal provinces. Sampled dogs had not previously been vaccinated against canine adenovirus type 1 (CAV1) or canine adenovirus type 2 (CAV2). Animals from both provinces had a high percentage of seropositivity (45% and 62%), suggesting that CAV2 circulates extensively among domestic dog populations in South Africa. Given this finding, we evaluated the effect of pre-existing CAV-specific antibodies on the efficacy of the CAV2-RG vaccine delivered via the oral route in dogs. Purpose-bred Beagle dogs, which received prior vaccination against canine parvovirus, canine distemper virus and CAV, were immunized by oral administration of CAV2-RG. After rabies virus (RABV) infection all animals, except one vaccinated dog, developed rabies. This study demonstrated that pre-existing antibodies against CAV, such as naturally occurs in South African dogs, inhibits the development of neutralizing antibodies against RABV when immunized with a CAV-based rabies recombinant vaccine.     

银川市居民狂犬病防治知识现况调查分析

目的 了解银川市城乡居民狂犬病防治知识知晓情况,为广泛开展狂犬病防治工作及相关健康教育提供依据。 方法 在全市6个县区(市)进行随机抽样调查,共有效调查1200名居民。 结果 银川市居民犬类饲养率达45.17%;27.06%的犬类饲养方式为散养和与人共居;定期给犬类接种动物狂犬病疫苗率为35.06%,城乡犬只免疫率差异具有统计学意义(χ2=27.55,P<0.01)。 结论 我市居民犬只饲养率高,但免疫率极低,居民狂犬病防治意识淡薄,政府有关部门应加强犬只管理及狂犬病健康教育工作。     

湖南省武岗市洞口县狂犬病流行病学研究

目的分析2003-2004年间在湖南省武岗市与洞口县发生的狂犬病并探讨局部地区流行的因素.方法对狂犬病进行个案调查,用直接免疫荧光法检测犬脑组织中的狂犬病毒抗原,用RT-PCR法扩增N基因片段,测定核苷酸序列并构建系统发生树进行遗传特征分析.结果自1991-2002年武岗市与洞口县仅各报告1例人狂犬病,但2003-2004年间,分别报告30例人狂犬病.62例狂犬病患者中61例被犬所伤,1例被猫所伤.在有完整记录的50例患者中,平均潜伏期为44.18天.其中7例（14%）狂犬病患者的潜伏期≤15天,16例（32%）潜伏期≤20天.在疫点周围采集的99只犬脑组织中,13只犬脑组织狂犬病毒抗原阳性,阳性率为13.13%.将Wg13与Dk13株病毒的部分N基因核苷酸序列与已报道中国病毒株比较,发现2株病毒与广西及安徽的毒株有最高的同源性,构建的系统发生树也分在同一分支.用全N基因核苷酸序列分析发现,Wg13与Dk13毒株全为Ⅰ型狂犬病毒,2株病毒之间的同源性为99.4%以上.比较分析2株病毒N基因编码的氨基酸序列,发现包括第Ⅳ抗原位点区在内的多个氨基酸位点发生了氨基酸的替代.结论引起武岗市与洞口县的狂犬病流行的病毒不是新型狂犬病毒,犬饲养量大与病毒携带率高是狂犬病暴发的直接原因.     

Knowledge, attitudes, and practices survey of rabies in a community in Sri Lanka

Objectives The primary objective of this study was to determine the level of knowledge, attitudes and practices (KAP) of rabies management and control of a sample population. The secondary objective was to compare the KAP with respect to rabies management and control between urban and rural areas and between pet and non-pet owners. Methods This cross-sectional study was carried out by conducting face-to-face interviews using structured questionnaires among 1570 respondents from selected households in the Kandy District, Sri Landa. Results Approximately 58% of the sample population was pet owners. Among all the respondents, there was a high level of awareness (90%) that dogs are the most common rabies reservoir, that the disease is fatal (79%), and that rabies can be prevented by vaccination (88%). Most of the subjects (96%) would seek treatment from a doctor or a hospital after being bitten by a dog. Although 76% of the respondents said that their pet dogs were vaccinated, only one-half were able to present a vaccination certificate upon request. The subjects from the urban areas would submit the head of an animal for rabies evaluation (69%) compared with those from the rural areas (57%). Pet owners (93%) are more aware that dog rabies vaccines are available from authorized offices than non-pet owners (87%). Conclusions The level of awareness of rabies and the level of receptiveness to rabies control measures are high. There is a difference in the attitudes and pet care practices relevant to rabies control between urban and rural areas. Pet owners tend to be more cooperative to rabies control activities. The attitudes and practices of the respondents may reflect the inaccessibility of facilities and the lack of services that would enable community participation in rabies control.     

An evaluation of dog rabies control in Limpopo province (South Africa)

Rabies is a prevalent and re-emerging disease in South Africa particularly in rural areas with high human densities. Outbreaks are frequently reported in the north and eastern parts of this country, probably an indication of inadequacy in the control of the disease. Following the 2005/2006 outbreak in Limpopo, we undertook an analysis of case surveillance data and genetically characterized 18 rabies viruses, all recovered from domestic dogs. Although rabies prevalence gradually declined annually from 2007, dog rabies still remains a public and veterinary health hazard in this region. Sylvatic rabies cycles are maintained by the black-backed jackal species in specific ecological conditions in the northwest of the province (Waterberg area), unlike in the north and east (Vhembe and Mopani districts, respectively), where spillover of infection between dogs and jackals is likely to predominate. Genetic analysis demonstrated that the rabies virus strain currently circulating within dog populations in Limpopo province is the same variant responsible for the 2005/2006 rabies outbreak. However, residual foci probably exist hence the observed sporadic outbreaks. These data further underline the value of continuous and sustainable dog immunization in controlling rabies.     

蒙山县1995-2007年狂犬病流行病学分析

目的了解蒙山县的狂犬病疫情。探讨其流行趋势,评价防治效果,为制订预防控制策略提供依据。方法应用描述性流行病学方法对资料进行分析。结果1995-2007年发病率为0—1．01／10万,病死率为100％,疫情波及全县9个乡镇的4个镇。潜伏期最短的不到1个月1例,最长的近58年1例,其余的是在二三个月左右发病。在9例病例中,有2例被流浪犬咬伤,1例在杀犬过程中被感染,其余6例,都是被家犬咬伤。病程最短2d,最长6d死亡。结论农村和边远山区是狂犬病防治工作的重点,需要加大狂犬病科普知识的宣传力度,加强犬的管理,做好易感人群人用狂犬病疫苗的暴露前后免疫工作。     

Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths

Domestic dogs are responsible for nearly all the »59,000 global human rabies deaths that occur annually. Numerous control measures have been successful at eliminating dog-mediated human rabies deaths in upper-income countries, including dog population management, parenteral dog vaccination programs, access to human rabies vaccines, and education programs for bite prevention and wound treatment. Implementing these techniques in resource-poor settings can be challenging; perhaps the greatest challenge is maintaining adequate herd immunity in free-roaming dog populations. Oral rabies vaccines have been a cornerstone in rabies virus elimination from wildlife populations; however, oral vaccines have never been effectively used to control dog-mediated rabies. Here, we convey the perspectives of the World Organisation for Animal Health Rabies Reference Laboratory Directors, the World Organisation for Animal Health expert committee on dog rabies control, and World Health Organization regarding the role of oral vaccines for dogs. We also issue recommendations for overcoming hesitations to expedited field use of appropriate oral vaccines.     

Can rabies be eradicated? The epidemiological basis for urban control in Venezuela

An epidemiological study of the pattern of urban rabies wascarried out in the City of Maracaibo in 1985, which had reported207 cases, or 58% of all canine cases in the country. The neighbourhoodsconsidered at high risk were those that had recently reportedrabies, had a high dog population density, a high proportionof stray dogs and low canine vaccination coverage. The controlprogramme involved the mass vaccination of nearly 100% of thedogs within the high and adjoining medium-risk areas, the eliminationof stray dogs, the quarantine of the area under vaccinationand health education and rabies outbreak control. In order toachieve maximum reduction in rabies incidence, mass vaccinationsshould be carried out over a short period of time, preferablyin less than two months. They should start in the first yearof a rabies cycle, before the onset of the seasonal rise andshould be carried out over three consecutive years. During thethird year, the number of high risk areas should be reduced.If one month-old dogs are known to have rabies, dogs of allages should be included in the vaccination programme. Such arabies control programme has been shown to eliminate rabiesin an urban district over a three-year period.     

Costs and effectiveness of alternative dog vaccination strategies to improve dog population coverage in rural and urban settings during a rabies outbreak

Dog-rabies elimination programs have typically relied upon parenteral vaccination at central-point locations; however, dog-ownership practices, accessibility to hard-to-reach sub-populations, resource limitations, and logistics may impact a country’s ability to reach the 70% coverage goal recommended by the World Organization for Animal Health (OIE) and World Health Organization (WHO). Here we report the cost-effectiveness of different dog-vaccination strategies during a dog-rabies outbreak in urban and peri-urban sections of Croix-des-Bouquets commune of the West Department, Haiti, in 2016. Three strategies, mobile static point (MSP), mobile static point with capture-vaccinate-release (MSP + CVR), and door-to-door vaccination with oral vaccination (DDV + ORV), were applied at five randomly assigned sites and assessed for free-roaming dog vaccination coverage and total population coverage. A total of 7065 dogs were vaccinated against rabies during the vaccination campaign. Overall, free-roaming dog vaccination coverage was estimated at 52% (47%-56%) for MSP, 53% (47%-60%) for DDV + ORV, and 65% (61%-69%) for MSP + CVR (differences with MSP and DDV + ORV significant at p < 0.01). Total dog vaccination coverage was 33% (95% CI: 26%-43%) for MSP, 49% (95% CI: 40%-61%) for MSP + CVR and 78% (77%-80%) for DDV + ORV (differences significant at p < 0.001). Overall, the least expensive campaign was MSP, with an estimated cost of about $2039 per day ($4078 total), and the most expensive was DDV + ORV with a cost of $3246 per day ($6492 total). Despite the relative high cost of an ORV bait, combining DDV and ORV was the most cost-effective strategy in our study ($1.97 per vaccinated dog), largely due to increased efficiency of the vaccinators to target less accessible dogs. Costs per vaccinated dog were $2.20 for MSP and $2.28 for MSP + CVR. We hope the results from this study will support the design and implementation of effective dog vaccination campaigns to achieve the goal of eliminating dog-mediated human rabies deaths by 2030.     

Molecular and mathematical modeling analyses of inter-island transmission of rabies into a previously rabies-free island in the Philippines

Rabies is endemic in the Philippines and dog bites are a major cause of rabies cases in humans. The rabies control program has not been successful in eliminating rabies because of low vaccination coverage among dogs. Therefore, more effective and feasible strategies for rabies control are urgently required in the country. To control rabies, it is very important to know if inter-island transmission can occur because rabies can become endemic once the virus is introduced in areas that previously had no reported cases. Our molecular epidemiological study suggests that inter-island transmission events can occur; therefore, we further investigated these inter-island transmission using phylogenetic and modeling approaches.We investigate inter-island transmission between Luzon and Tablas Islands in the Philippines. Phylogenetic analysis and mathematical modeling demonstrate that there was a time lag of several months to a year from rabies introduction to initial case detection, indicating the difficulties in recognizing the initial rabies introductory event. There had been no rabies cases reported in Tablas Island; however, transmission chain was sustained on this island after the introduction of rabies virus because of low vaccination coverage among dogs.Across the islands, a rabies control program should include control of inter-island dog transportation and rabies vaccination to avoid viral introduction from the outside and to break transmission chains after viral introduction. However, this program has not yet been completely implemented and transmission chains following inter-island virus transmission are still observed. Local government units try to control dog transport; however, it should be more strictly controlled, and a continuous rabies control program should be implemented to prevent rabies spread even in rabies-free areas.     

狂犬病24例病例流行病学调查分析

目的调查2009年陕西省汉中市突发的狂犬病疫情情况,分析其发病的原因和影响因素,为有效的预防控制提供依据。方法对汉中市医疗机构诊断报告的24例狂犬病病例,收集病例临床诊疗资料,开展个案流行病学调查,用Excel2003软件进行统计分析。结果 2009年3—9月,汉中市辖区毗邻的6个平川县区先后发生24例狂犬病病例,发病率为0.63/10万。24例狂犬病例中农民23例(95.83%),其中有2例(8.33%)及时接受了伤口处理并接种了狂犬疫苗,2例(8.33%)接受了狂犬病疫苗接种但不及时,20例(83.33%)未进行规范的伤口消毒处理或未进行伤口处理。24例狂犬病例均为犬只暴露,以流浪犬为主,当地犬密度为1只/10人。结论犬只饲养量大,管理工作不到位,群众对狂犬病的危害性认识不足或缺乏认知,暴露后未接受处置或处置不及时不规范是造成本次狂犬病发病的主要原因。     

Update: raccoon rabies epizootic--United States and Canada, 1999

In 1977, an outbreak of raccoon rabies was detected in an area on the West Virginia-Virginia border. Since then, the area affected by this distinct variant of rabies virus associated with raccoons has spread to Ohio in the west and New York, Pennsylvania, Vermont, New Hampshire, and Maine in the north. In addition, the once separate epizootics of rabies among raccoons in the southeastern and mid-Atlantic states converged in North Carolina. In July 1999, the raccoon rabies virus variant was reported from Ontario, Canada, on the New York border. This report describes the spread of this epizootic of raccoon rabies through mid-Atlantic and northeastern states and into Canada.     

2003年上海地区疑似狂犬的病毒检测及其意义的探讨

[目的]对上海地区2003年疑似狂犬进行病毒检测,并探讨其意义。[方法]采集90份犬脑标本,用ELISA法检测病毒抗原、小鼠感染法(MIT)行病毒分离、免疫荧光法(IFA)鉴定型别,并对咬人犬进行地区与时间分布调查。[结果]咬人犬的阳性率为21．2％(11／52),经IF法鉴定为Ⅰ型狂犬病毒;3种方法结果一致;非咬人犬均阴性;6～9月检出阳性犬最多,占全年的90．9％。阳性犬集中在嘉定和宝山。[结论]检测狂犬病毒3种方法各有作用,必不可少。有病毒阳性犬的地区,应及时采取防治措施。     

1953-2017年陕西省狂犬病的流行特征

  目的  分析陕西省1955-2017年狂犬病流行情况及第三流行期流行特征,为科学防控狂犬病提供依据。  方法  收集1953-2003年历史疫情资料、2004-2017年中国疾病预防控制信息系统狂犬病监测资料及2009-2017年狂犬病患者个案调查资料进行统计分析。  结果  1953-2017年,陕西省出现3次人间狂犬病流行。2009-2017年报告人狂犬病病例270例,每月均有狂犬病病例发生。病例主要集中在关中和陕南地区,陕北地区偶有病例报告。男女性别比为2.5:1,职业构成以农民为主（84.4%）。伤人犬中家养犬和流浪犬的构成比为13.1:1,家养犬伤人多发生在农村地区（86.9%）。暴露级别以Ⅲ级为主（84.2%）。超六成病例在伤后未对伤口进行任何处理,狂犬疫苗接种率和免疫球蛋白使用率均较低。  结论  民众对狂犬病的危害认识不足,致伤害后处理不规范甚至不处理,从而引起发病。应加大狂犬病防控知识宣传,并将重点放在农村偏远地区,倡导民众伤后主动就医病合理利用报销政策。     

Rabies virus in raccoons, Ohio, 2004

In 2004, the raccoon rabies virus variant emerged in Ohio beyond an area where oral rabies vaccine had been distributed to prevent westward spread of this variant. Our genetic investigation indicates that this outbreak may have begun several years before 2004 and may have originated within the vaccination zone.