WHO Expert Consultation

27 Sept 12

A recent World Health Organization (WHO) International ExpertConsultation on rabies urged countries where canine rabies is endemic toinitiate and strengthen their rabies prevention and control activities, and toincrease the level of awareness about the disease, particularly among children.It noted that under reporting and misdiagnosis of human rabies cases, andproblems of access to post-exposure prophylaxis (PEP) in rural areas where dograbies is uncontrolled remain big problems.

Around 70 participants attended the Consultation held at WHO’sheadquarters in Geneva, Switzerland, on 18–20 September 2012. Participantsdiscussed a wide range of topics including a review of the rabies situation indomestic and wild animals in endemic countries, laboratory diagnosis techniques,the management of rabid patients, rabies biological products, the need for immediate wound treatment and full effective PEP, and theeconomic burden of the disease.

“A re-assessment ofthe burden of rabies made during the meeting showed that 50 000 people, mostlyin Africa and Asia, still die in spite of 20 million others receiving PEPworldwide,” said Dr François Meslin, Team Leader for Neglected ZoonoticDiseases at WHO’s Department of Control of Neglected Tropical Diseases. “Datashow that the majority of fatal cases involve people from poor, ruralcommunities without access to dog bite management  centres and rabies biologicals. Also, too manyPEP delivered in the world today are not administered to the right people.”

It was recommended that national rabies controlprogrammes involve the animal and public health sectors as well as othersectors such as education, local government, police and civil society,particularly animal welfare and conservation associations. Research into the socioeconomicchallenges of implementing rabies control and the potential for integration ofrabies control into that of other canine transmitted diseases (such asechinococcosis and leishmaniasis) was called for.

Having reviewed recent successful canine rabies control programmesin Africa, Asia and Latin America, the consultation urged WHO to continue toadvocate for human rabies prevention through the elimination of rabies in dogsand to promote a wider use of the intradermal route for PEP, which reducesvolume and the cost of cell-cultured vaccine by 60% to 80%. WHO’s target, asoutlined in its NTD roadmap (published in January 2012) is to eliminate humanand dog rabies in all Latin American countries by 2015 and human rabiestransmitted by dogs in South-East Asia by 2020.

Based on the newsstory available on the WHO website here.