A Panamerican Initiative for World Rabies Day

10 Sep 2014

Elimination of dog-transmitted human rabies is a 30-year old goal of the Americas. Regional efforts started in 1983 coordinated by the Pan American Health Organization (PAHO) and have led to the elimination of the disease in a number of countries and territories (see Vigilato et al., 2013). The current goal is regional elimination by 2015, as it was reiterated by the countries at the 19th Session of PAHO Directing Council through CD49.R19 Resolution referring to the elimination of neglected diseases and other poverty related infections. 

The concept of One Health is epitomized in the control of dog mediated rabies. Mass dog vaccination has been, and still is, the flagship intervention chosen by the countries in the Americas to reduce human fatalities, from over 300 human cases in 1980´s to fewer than 10 in 2013. The region has a unique approach to dog mediated rabies control. For starters, there is a regional drive behind the elimination goal. This drive, supported by PAHO through the coordination of regular regional meetings (the REDIPRA series that will hold its 14th meeting in 2015), feeds the traditional solidarity between countries manifested in different ways, e.g. supporting neighboring countries with diagnostic capacity, vaccine loans, exchange of experience and best practices etc. The region also benefits from PAHO´s revolving fund to support human vaccine stocks, and since 2014, canine vaccine too. The region is also unique in that all rabies control activities fall within the countries’ Ministries of Health, from dog vaccination to post-exposure prophylaxis measures. This is true except for Haiti where the Ministry of Agriculture, in particular its veterinary services, are responsible for dog vaccination. (To learn more about the situation in Haiti and how to help please click here.)

The Panamerican World Rabies Day Initiative for 2014 was organized in February to bring renewed and continuing attention to the issue of Rabies in Panamerica for World Rabies Day in September.  This coalition has representatives from eight organizations: the American Veterinary Medical Association (AVMA), the Canadian Veterinary Medical Association (CVMA), the Federación Iberoamericana de Asociaciones Veterinarias de Animales de Compañía (FIAVAC), the Global Alliance for Rabies Control (GARC), the Panamerican Association of Veterinary Sciences (PANVET), the Pan American Health Organization/World Health Organization (PAHO/WHO), World Animal Protection and the World Small Animal Veterinary Association (WSAVA)

Three significant groups in the countries and island nations of North America, Central America, South America, and the Caribbean were identified.  These were the Chief Veterinary Officers within the Ministries of Agriculture, the Rabies Program Managers within the Ministries of Health, and the offices and leadership of the national Veterinary Medical Associations. Letters of introduction were sent to these three groups about the initiative, to develop an expanded and stronger One Health network with them, and their responses used to determine a focused and unified message for World Rabies Day. 

The Panamerican World Rabies Day Initiative message focuses on three areas:

  1. For GOVERNMENT AGENCIES - Initiate, continue, and enforce effective canine vaccination programs. If a core population of 70% of dogs are vaccinated, that will essentially eliminate the risk of humans rabies transmitted from dogs! The initial success of the rabies control efforts can lead to complacency in continued support and enforcement for the vaccination programs.  It is important not to lose what has been gained in recent years!  See the canine rabies blueprint.
  2. For the PUBLIC - In some countries, wildlife (especially bats) is a major risk for rabies exposure to humans. Bats and other wild animals, such as skunks, foxes, and mongoose, are important animals for a healthy ecosystem but people need to be aware of the health risks of direct contact. Respect wildlife from a distance. See these resources.
  3. For ANYONE - If bitten by a dog or bat, or other wild animal, clean the wound thoroughly with soap and water, and seek immediate attention by a physician and for possible post-exposure rabies prophylaxis (PEP) if indicated. See guidance here.

We have started a Facebook Page called the Panamerican World Rabies Day Initiative at www.facebook.com/panamerican2014worldrabiesdayinitiative.  Please visit this page, Like it, Follow it, Share it, and Post on it. 

Rabies is 100% fatal without treatment, yet 100% preventable with vaccination and knowledge about the disease and its reservoirs.  Mass canine vaccination programs work to prevent needless suffering due to rabies in humans and dogs.  We hope to further encourage government agency support for canine vaccination programs, public education about rabies and its risks for exposure, and increased knowledge and availability for post-exposure prophylaxis treatment.

It is possible to eliminate dog mediated human rabies from the Americas. 

 

Contributed by Dr Victor J Del Rio Vilas of PAHO, and Dr René Carlson of the AVMA, on behalf of the coalition.