WSAVA Nov 2021 Proceedings - Flipbook - Page 21
Chandler M., Morgenegg G., Jouppi R. (2020). ”World Small Animal Veterinary Association Global Dental Guidelines”. JSAP, Vol 61. DOI: https://doi.
org/10.1111/jsap.13132
0005
THE STATUS QUO OF RABIES: FROM GLOBAL TO
LOCAL
T. Scott1, A. Coetzer2, L. Nel2
Luxembourg/Luxembourg, 2Pretoria/South Africa
1
Qualifications:
Dr. Terence Peter Scott
PhD Microbiology (Virology; Rabies)
terence.scott@rabiesalliance.org
Rabies remains endemic in more than 150 countries globally, with a person dying from the disease every 9 minutes. Africa and Asia remain the
most affected regions with the highest burden of disease. Approximately
35 000 people die from rabies every year in Asia alone, accounting for
more than half of the global burden which is estimated to be 59 000 human deaths each year1. While Africa accounts for fewer deaths annually,
it has the highest per capita death rate globally. In other regions such as
Europe and North America, dog rabies has been eliminated, significantly
reducing the public health threat from the disease. However, wildlife variants of the disease exist in raccoons, skunks, and bats in North America,
while Europe has eliminated the fox rabies variant in wildlife populations through mass oral bait vaccination. Yet, the public health risk for
rabies remains – even in these dog-rabies free areas – as rabies-related
lyssaviruses (all of which cause the disease rabies) are present in Europe.
Furthermore, the risk remains for the re-introduction of rabies via dog
importation, with a particular risk arising from illegal puppy trafficking2.
While rabies has been documented for more than 3 000 years, the disease
remains neglected. In fact, rabies was only recently officially recognised
and listed as a Neglected Tropical Disease by the World Health Organization, when the list of 12 diseases from the London Declaration in 2012
was expanded to 20 recognised NTDs that now includes rabies3. Human
rabies is the only vaccine preventable neglected tropical disease (NTD),
making it the strongest – and most feasible candidate – for elimination
under the United Nation’s Sustainable Development Goals (UN SDGs). Yet,
due to the lack of political will and limited action towards its elimination
at both the international and national level, the disease continues to
threaten the lives of tens of thousands of people and animals globally –
resulting in an estimated financial burden of USD8,6 billion in losses.
While rabies is typically considered a rural disease, this is in fact untrue,
as urban rabies outbreaks are well documented and typically pose a
higher risk to communities. Rather, rabies is a disease of the poorest and
most underserved communities, which are often those living in rural areas
where access to healthcare and veterinary services are lacking. While
there is no treatment for rabies after the onset of symptoms, the disease
is 100% preventable through mass dog vaccination (MDV) of at-risk populations, coupled with education, awareness, and prophylactic treatment
of exposed people. MDV is the most cost-effective and efficient means
to eliminate dog rabies, which would result in the elimination of 99% of
human rabies deaths globally4. In addition to preventing human rabies
deaths, the elimination of dog rabies would also result in a significantly
reduced risk of rabies to wildlife populations – in particular to endangered
species such as Ethiopian wolves (Canis simensis) and African Wild Dogs
(Lycaon pictus). While MDV remains key, the ability to implement successful and impactful MDV campaigns that target the at-risk population
in sufficient capacity to eliminate the disease is a multi-faceted challenge
reliant upon coordinated efforts from multiple partners and stakeholders.
Until relatively recently, a globally accepted and coordinated approach for
rabies elimination was lacking, with national governments and interest-
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