34 research outputs found

    Defining new pathways to manage the ongoing emergence of bat rabies in Latin America

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    Rabies transmitted by common vampire bats (Desmodus rotundus) has been known since the early 1900s but continues to expand geographically and in the range of species and environments affected. In this review, we present current knowledge of the epidemiology and management of rabies in D. rotundus and argue that it can be reasonably considered an emerging public health threat. We identify knowledge gaps related to the landscape determinants of the bat reservoir, reduction in bites on humans and livestock, and social barriers to prevention. We discuss how new technologies including autonomously-spreading vaccines and reproductive suppressants targeting bats might manage both rabies and undesirable growth of D. rotundus populations. Finally, we highlight widespread under-reporting of human and animal mortality and the scarcity of studies that quantify the efficacy of control measures such as bat culling. Collaborations between researchers and managers will be crucial to implement the next generation of rabies management in Latin America

    First inter-laboratory comparison of Echinococcus granulosus sensu lato diagnosis in Latin America

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    To compare the performance of polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) tests for diagnosing Echinococcus granulosus in dog feces among national reference laboratories in Argentina, Chile, Peru, and Uruguay

    An evaluation of Brazil’s surveillance and prophylaxis of canine rabies between 2008 and 2017

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    An effective surveillance system is critical for the elimination of canine rabies in Latin America. Brazil has made substantial progress towards canine rabies elimination, but outbreaks still occurred in the last decade in two states. Brazil uses a health information system (SINAN) to record patients seeking post-exposure prophylaxis (PEP) following contact with an animal suspected of having rabies. This study evaluated: (i) whether SINAN can be reliably used for rabies surveillance; (ii) if patients in Brazil are receiving appropriate PEP and (iii) the benefits of implementing the latest World Health Organization (WHO) recommendations on PEP. Analysing SINAN records from 2008 to 2017 reveals an average of 506,148 bite-injury patients/year [range: 437k-545k] in the country, equivalent to an incidence of 255 bite-injuries/100,000 people/year [range: 231–280]. The number of reports of bites from suspect rabid dogs generally increased over time. In most states, records from SINAN indicating a suspect rabid dog do not correlate with confirmed dog rabies cases reported to the Regional Information System for Epidemiological Surveillance of Rabies (SIRVERA) maintained by the Pan American Health Organization (PAHO). Analyses showed that in 2017, only 45% of patients received appropriate PEP as indicated by the Brazilian Ministry of Health guidance. Implementation of the latest WHO guidance using an abridged intradermal post-exposure vaccination regimen including one precautionary dose for dog bites prior to observation would reduce the volume of vaccine required by up to 64%, with potential for annual savings of over USD 6 million from reduced vaccine use. Our results highlight the need to improve the implementation of SINAN, including training of health workers responsible for delivering PEP using an Integrated Bite Case Management approach so that SINAN can serve as a reliable surveillance tool for canine rabies elimination

    Pre-exposure rabies prophylaxis: A systematic review

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    To review the safety and immunogenicity of pre-exposure rabies prophylaxis (including accelerated schedules, co-administration with other vaccines and booster doses), its cost-effectiveness and recommendations for use, particularly in high-risk settings.We searched the PubMed, Centre for Agriculture and Biosciences International, Cochrane Library and Web of Science databases for papers on pre-exposure rabies prophylaxis published between 2007 and 29 January 2016. We reviewed field data from pre-exposure prophylaxis campaigns in Peru and the Philippines.Pre-exposure rabies prophylaxis was safe and immunogenic in children and adults, also when co-administered with routine childhood vaccinations and the Japanese encephalitis vaccine. The evidence available indicates that shorter regimens and regimens involving fewer doses are safe and immunogenic and that booster intervals could be extended up to 10\ua0years. The few studies on cost suggest that, at current vaccine and delivery costs, pre-exposure prophylaxis campaigns would not be cost-effective in most situations. Although pre-exposure prophylaxis has been advocated for high-risk populations, only Peru and the Philippines have implemented appropriate national programmes. In the future, accelerated regimens and novel vaccines could simplify delivery and increase affordability.Pre-exposure rabies prophylaxis is safe and immunogenic and should be considered: (i)\ua0where access to postexposure prophylaxis is limited or delayed; (ii)\ua0where the risk of exposure is high and may go unrecognized; and (iii)\ua0where controlling rabies in the animal reservoir is difficult. Pre-exposure prophylaxis should not distract from canine vaccination efforts, provision of postexposure prophylaxis or education to increase rabies awareness in local communities

    Neglected infectious diseases in the Americas: current situation and perspectives for the control and elimination by 2030

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    Neglected infectious diseases (NID) are a diverse group of conditions including more than 20 parasitic, bacterial, and fungal diseases, and envenoming by poisonous animals. Their risk factors include poverty, income inequality, lack of access to safe drinking water and proper sanitation, and barriers to education and health services, among other social determinants of health. They impose a large burden on marginalized populations globally and in the region of the Americas, including women and ethnic minorities. The region of the Americas has a track record of elimination of communicable diseases and countries have made significant progress in the elimination of NID in recent years. Between 2011 and 2020, one country eliminated trachoma, four eliminated onchocerciasis, one eliminated human rabies transmitted by dogs, and three were declared free of lymphatic filariasis. The COVID-19 pandemic impacted the continuity of actions to eliminate NID and there are challenges in controlling and eliminating NID, particularly in vulnerable and hard-to-reach populations with issues in accessing health services. There are still difficulties in the coordination between health and other sectors to work together on the socioeconomic and environmental determinants of NID. Forwarding the elimination of NID in the Americas involves continuous advocacy and resource mobilization at various levels (international, regional, national, and subnational), ensuring sufficient allocation of human and financial resources, access to essential health supplies, and implementing people-centered services. It also entails engaging and empowering civil society, communities, local governments, and public-private partnerships, while collaborating with stakeholders and donors for effective action

    Rabies laboratory capacities.

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    <p>Percent of countries that replied positively to the use of various laboratory techniques for rabies diagnosis. Seventeen of 19 countries responded; the two non-responders included one low income and one upper middle income country.</p
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