Key Findings
Between 1980 and 2010, rabies cases in dogs decreased from approximately 25,000 to fewer than 300. Several countries were on track to self-declare as free from both human rabies transmitted by dogs and canine rabies.
The key success factors included the 1983 regional agreement to take joint action, mass vaccination campaigns, the availability of post-exposure prophylaxis (PEP), and continuous surveillance.
Summary
Rabies, a viral disease causing acute encephalitis, has long been a major public health issue in Latin America and the Caribbean (LAC). However, the region has successfully controlled and eradicated diseases such as smallpox, polio, and measles through effective vaccines, improved healthcare infrastructure, and new primary healthcare strategies. Since 1983, LAC countries have committed to break the cycle of dog-transmitted rabies and have made significant strides. This paper aims to share the experiences of LAC countries in their efforts to eliminate human rabies transmitted by dogs and to detail the challenges encountered in the final stages of rabies eradication.
In 1983, countries in LAC committed to eliminating human rabies from major cities by the end of the 1980s due to the high number of street dogs and human rabies cases in urban areas. This commitment was formalized at the III Inter-American Meeting on Animal Health (RIMSA III) with ministerial-level agreements. The ‘Action Plan for the Elimination of Urban Rabies’ was approved the same year and further evaluated in 1988 and 1989.
Under this commitment, LAC countries promoted mass canine vaccination, epidemiological surveillance, and the provision of pre- and post-exposure prophylaxis for people at risk. The Pan American Health Organization’s Veterinary Public Health Programme provided technical cooperation by offering tools for a disease notification system and assisting countries in adhering to standards discussed at Inter-American and Rabies Experts meetings.
To implement the plan, health authorities coordinated mass vaccination campaigns annually or biannually, aiming to vaccinate 80% of the estimated canine population. These campaigns were successfully promoted through mass media, schools, and community centers. The availability of locally produced canine vaccines supported these efforts. Additionally, post-exposure prophylaxis (PEP) was made broadly accessible through a decentralized system of rabies treatment. Laboratories for diagnosis and surveillance were also decentralized, enhancing epidemiological surveillance across the region.
The program has been considered an overall success. Confirmed rabies cases in dogs decreased from approximately 25,000 in 1980 to less than 300 in 2010, and dog-transmitted human rabies deaths decreased from 350 to less than 10 during the same period. A survey of the status of dog-transmitted human rabies in LAC during 2001 and 2003 indicated that, on average, 81% of animals were vaccinated. Many countries have successfully eliminated dog-transmitted human rabies in urban areas and are now focusing on rural and border regions where challenges persist.
Despite the overall progress, there are still challenging areas where canine rabies transmission persists. Analysis showed that rabies cases in LAC were highly localized, affecting only 0.2% of municipalities. These areas are located in countries like Haiti, Bolivia, Cuba, Nicaragua, Colombia, Ecuador, Venezuela, and parts of northeast Brazil. In particular, surveillance data showed that Haiti and Bolivia were responsible for 53.5% of dog-transmitted human rabies cases between 2008 and 2011.
Factors contributing to these challenges include high poverty levels, large populations of unvaccinated stray dogs, and geographical and environmental limitations. In many of these regions, mass vaccination campaigns have not been consistently implemented due to a lack of resources. Addressing these challenges requires specific local strategies, extensive community participation, and continued international cooperation to provide the necessary resources and support.
To eliminate dog-transmitted human rabies in LAC, several steps are essential. These include maintaining high vaccination coverage in dogs, ensuring timely and adequate PEP for exposed individuals, and improving surveillance and diagnostic capacities. Countries need to address internal disparities by ensuring equitable access to healthcare and vaccination services. Strengthening regional cooperation and coordination, enhancing public awareness and education about rabies, and securing sustained funding for rabies control programs are also critical. Finally, adapting strategies to address the unique challenges of each region, particularly in border areas and rural communities, is necessary for achieving complete rabies elimination.
As of 2013, when this paper was published, efforts to eliminate canine rabies in Latin America and the Caribbean have seen significant success. This success is attributed to strong political commitment, international support, and effective public health strategies. Many countries were projected to self-declare as free from human rabies transmitted by dogs, as well as canine rabies. The experiences and lessons learned from LAC can serve as valuable models for other regions striving to control and eliminate rabies.
Miscellaneous
Read Next:
Ten years on, did Latin America and the Caribbean become rabies-free?
Data From Study:
Rabies Elimination History / Latin America
Year of Publication:
2013
External Link:
Vigilato Marco Antonio Natal, Clavijo Alfonso, Knobl Terezinha, Silva Hugo Marcelo Tamayo, Cosivi Ottorino, Schneider Maria Cristina, Leanes Luis Fernando, Belotto Albino José and Espinal Marcos Antonio. 2013. Progress towards eliminating canine rabies: policies and perspectives from Latin America and the Caribbean. Phil. Trans. R. Soc. B36820120143.
https://doi.org/10.1098%2Frstb.2012.0143