Gains and future road map for the elimination of dog-transmitted rabies in the americas

摘要

Today, most parts of the Americas have already eliminated the circulation of rabies virus in canine populations.7'8 Cases of human rabies transmitted by dogs in the region are circumscribed to a small number of well-defined areas9 (Figure 1). Of the 570 first administrative level sub-units (province, state, or department) in Latin America, only 11 units (2%) reported cases of human rabies transmitted by dogs in the last 4 years. These cases are concentrated in areas of the periphery of big cities, neglected communities, or international border areas where the population has little information about the risks of the disease, limited access to quality health services and poor living standards or working conditions. These areas are also characterized by having a high proportion of unvaccinated dogs10 and of limited availability or accessibility to immunobiological products for pre- or post-exposure prophylaxis.The elimination of these pockets of disease depends on the local implementation of proven control plans, widespread participation of the population, and the technical cooperation between countries.As commonly seen in control efforts for other diseases, the reduction of the number of cases of human rabies transmitted by dogs has led to a parallel decline in the attention given to the disease by institutions and health departments. Even for endemic areas within countries, the competitive allocation of scarce funds to other priorities at the national level can result in the allocation of fewer resources for the fight against rabies at lower administrative levels. As a result, institutional memory and awareness among the population might be lost.