Critical Analysis of the Cat’s Role in the Epidemiology of Rabies (original) (raw)

Fifty Years of the National Rabies Control Program in Brazil under the One Health Perspective

Pathogens

In 1973, the National Rabies Program was created in Brazil through an agreement between the Ministry of Health and Agriculture. Since its beginning, it developed integrated action through access to free post-exposure prophylaxis (PEP) for people at risk, dog vaccination campaigns, a joint surveillance system, and awareness. This study aims to describe human rabies in Brazil under the One Health perspective in recent decades, including achievements in the control of dog-mediated cases and challenges in human cases transmitted by wild animals. This paper also explores possible drivers of human rabies in the Northeast Region with half of the cases. The first part of this study was descriptive, presenting data and examples by periods. Statistical analysis was performed in the last period (2010–2022) to explore possible drivers. Dog-mediated human cases decreased from 147 to 0, and dog cases decreased from 4500 to 7. A major challenge is now human cases transmitted by wild animals (bats,...

Epidemiology of human rabies in the state of Ceará, Brazil, 1970 to 2019

2021

OBJECTIVE To describe cases of human rabies in Ceará State, Brazil between 1970 and 2019. METHODS This was a descriptive study using secondary data from the Ceará State Department of Health and the state reference hospital. RESULTS Of 171 cases, 75.7% occurred in males, 60.0% in <19-year-olds, and 56.0% in urban areas. Rabies was transmitted by dogs in 74.0% of cases, marmosets in 16.7% and bats in 7.3%. Between 1970 and 1978, there was an increase of cases (using the Joinpoint Regression Program, annual percentage change [APC] = 13.7 - 95%CI 4.6;41.5), while between 1978 and 2019 there was a decrease (APC = -6.7 - 95%CI -8.8;-5.9). There was a reduction in transmission by dogs (71 cases, last case in 2010) and an increase by sylvatic animals (5 cases since 2005). CONCLUSION This study demonstrates changes in rabies transmission dynamics during the period studied, with a reduction in transmission by dogs and an increase of transmission by sylvatic animals.

EPIDEMIOLOGY OF HUMAN RABIES IN BRAZIL: A BRIEF REVIEW (Atena Editora)

EPIDEMIOLOGY OF HUMAN RABIES IN BRAZIL: A BRIEF REVIEW (Atena Editora), 2022

Rabies is a disease of great importance in public health, as it is considered a viral zoonosis that affects all mammals, and is 100% lethal in most cases, and cures have been considered very rare since its discovery. The objective of this study was to carry out a review of the disease and cases of human rabies in Brazil, differentiating the aggressor species and region, in order to provide technical and scientific information about rabies to veterinary students, veterinarians and other health-related professionals.

Rabies in Animals with Emphasis on Dog and Cat in Ethiopia

Rabies is a major viral anthropozoonosis of public health significance. The animals play a crucial role in maintenance and circulation of the rabies virus. Determining the occurrence of rabies in animals was implicated as a fundamental step to guide prevention and control efforts. The study involved cross sectional study by retrieval previously recorded cases between September 2009 and January 2012, Ethiopia. Suspected animal rabies cases were quarantined for 10 days observation period and brain samples were tested for confirmation using direct fluorescent antibody test. The statistical analysis was performed using SPSS program and Chi-square and analysis of variance (ANOVA) was used to assess the significance difference. Domestic and wild animals were associated with human exposure and death cases. However, dogs were the culprit for the highest human fatal (97%) and human exposure cases (89.5%). Only 2% of human deaths were associated with cats and wild animals. Higher rabies positivity was noted in owned dogs 138 (74.2%) than ownerless ones 49 (25.8%). The difference was statistically significant (p=0.0001). Further, all positive cases in cats were apparent in those believed to be owned. Majority of positive results associated with dogs were aged above 12 months 70 (81.4%), 10 (11.6%) were from the age between 6 and 12 months followed by 3 to 6 months 6 (7%). Positive cases in cats were more common among those aged above 12 months (60%) followed by 6 to 12 (20%) and 3 to 6 months (20%) of age. Of the animals with positive results, 4 (1.6%) were vaccinated against rabies. Overall, majority of the dogs had no vaccination history 247 (96.1%), only 10 (3.9%) were found to have been vaccinated. On contrary, none of the cats were vaccinated against rabies. The number of submitted samples had a direct correlation with the number of positive results (p<0.05), however, no season variation was encountered. Five sub-cities that border with another region showed a significantly higher occurrence (p<0.05) of exposure and confirmed cases and post exposure prophylaxis. Thus, integrated implementation of compulsory animal management, immunization and creation of awareness is highly imperative.

Trends in Animal Rabies Surveillance in the Endemic State of Minas Gerais, Brazil

PLOS Neglected Tropical Diseases, 2015

Rabies is a viral zoonosis affecting mammal species and causes large economic losses. Included among the neglected diseases, it is still insufficiently addressed by governments and the international community, despite formal surveillance and control programs. This study used a dataset of 10,112 rabies diagnoses in animals provided by the Brazilian passive surveillance system from 2001 to 2012. The positivity rate of the tested samples was 26.4%, and a reduction in the total samples sent during the last six years was observed. The kernel density map indicated case concentration in the south region and a decrease in density of rabies cases in the second period studied (2007 to 2012). The directional trend of positive rabies diagnoses remained in the south region, as shown by the standard deviational ellipse. The spatial scan statistic identified three large clusters of positive diagnoses, one in the first period (2001)(2002)(2003)(2004)(2005)(2006) and two in the second period (2007)(2008)(2009)(2010)(2011)(2012), indicating an expansion of risk areas. The decrease in rabies cases from 2006 to 2012 does not necessarily reflect lower viral circulation or improvement in actions by epidemiological surveillance; this decrease could indicate a deficiency in epidemiological surveillance during the observation period due to the increase in the silent areas. Surveillance should maintain an increasing or constant number of tests during the years in addition to a reduction in the number of outbreaks of rabies, which would indicate a lower positivity rate. The findings in this study indicate deterioration in the effectiveness of the passive surveillance for rabies. The number of rabies cases, total number of tests performed and positivity rate are good indicators for evaluating passive surveillance. This paper can function as a guide for the assessment and improvement of the actions in passive surveillance of rabies.

Current status of human rabies transmitted by dogs in Latin America

Cadernos De Saude Publica, 2007

Latin American countries made the political decision to eliminate human rabies transmitted by dogs by the year 2005. The purpose of the current study is to evaluate to what extent this goal has been reached. The epidemiological situation and control measures were analyzed and broken down within the countries by georeferencing. The 27 human cases reported in 2003 occurred in some 0.2% of the second-level geopolitical units (municipalities or counties) in the region, suggesting that the disease is a local problem. Several areas within the countries reported no more transmission of rabies in dogs. Nearly 1 million people potentially exposed to rabies received treatment. On average, 34,383 inhabitants per health post receive anti-rabies treatment (range: 4,300-148,043). Nearly 42 million dogs are vaccinated annually. Surveillance is considered fair according to the epidemiological criteria adopted by the study. Samples sent for rabies testing represent 0.05% of the estimated canine population (range: 0.001 to 0.2%). The countries are quite close to achieving the goal.

An evaluation of Brazil’s surveillance and prophylaxis of canine rabies between 2008 and 2017

PLOS Neglected Tropical Diseases

An effective surveillance system is critical for the elimination of canine rabies in Latin America. Brazil has made substantial progress towards canine rabies elimination, but outbreaks still occurred in the last decade in two states. Brazil uses a health information system (SINAN) to record patients seeking post-exposure prophylaxis (PEP) following contact with an animal suspected of having rabies. This study evaluated: (i) whether SINAN can be reliably used for rabies surveillance; (ii) if patients in Brazil are receiving appropriate PEP and (iii) the benefits of implementing the latest World Health Organization (WHO) recommendations on PEP. Analysing SINAN records from 2008 to 2017 reveals an average of 506,148 bite-injury patients/year [range: 437k-545k] in the country, equivalent to an incidence of 255 bite-injuries/100,000 people/year [range: 231-280]. The number of reports of bites from suspect rabid dogs generally increased over time. In most states, records from SINAN indicating a suspect rabid dog do not correlate with confirmed dog rabies cases reported to the Regional Information System for Epidemiological Surveillance of Rabies (SIRVERA) maintained by the Pan American Health Organization (PAHO). Analyses showed that in 2017, only 45% of patients received appropriate PEP as indicated by the Brazilian Ministry of Health guidance. Implementation of the latest WHO guidance using an abridged intradermal post-exposure vaccination regimen including one precautionary dose for dog bites prior to observation would reduce the volume of vaccine required by up to 64%, with potential for annual savings of over USD 6 million from reduced vaccine use. Our results highlight the need to improve the implementation of SINAN, including training of health workers responsible for delivering PEP using an Integrated Bite Case Management approach so that SINAN can serve as a reliable surveillance tool for canine rabies elimination.