Assuring the quality and sustainability of a rabies dog vaccination programme: vaccination, rabies surveillance and post-vaccination monitoring

摘要

The annual number of human rabies cases is estimated at more than 55,000, more than 99.9% of which occur in Africa and Asia, in areas where rabies is mediated by dogs. One technique that has shown to be effective in achieving long-term prevention of human rabies is the coordinated mass vaccination of dogs. A stepwise mass dog vaccination programme, based on various international guidelines, could be organised as follows. The first phase is to establish adequate interlinked rabies surveillance systemsand networks for both animals and humans. Surveillance is of utmost importance to determine rabies incidence, to identify areas for vaccination, and to assess the success of vaccination campaigns. The second phase is to study local dog populations to estimate the proportion of ownerless and owned dogs that are impossible to vaccinate. This will influence the choice of the vaccination strategy (parenteral or parenteral in combination with oral when the proportion of inaccessible dogs is over 30%). As soon as continuous adequate long-term financial funding of a rabies control project is guaranteed, based on available surveillance data, a National Committee for Rabies Control, comprising all stakeholders, should decide the area to be vaccinated, the vaccine to be used, additional measures to be taken (complementary oral vaccination of dogs) and the monitoring system to be implemented to assess the impact of vaccination campaigns.