Article

Reemerging Rabies and Lack of Systemic Surveillance in People’s Republic of China

Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Emerging Infectious Diseases (Impact Factor: 7.33). 08/2009; 15(8):1159-64. DOI: 10.3201/eid1508.081426
Source: PubMed

ABSTRACT Rabies is a reemerging disease in China. The high incidence of rabies leads to numerous concerns: a potential carrier-dog phenomenon, undocumented transmission of rabies virus from wildlife to dogs, counterfeit vaccines, vaccine mismatching, and seroconversion testing in patients after their completion of postexposure prophylaxis (PEP). These concerns are all scientifically arguable given a modern understanding of rabies. Rabies reemerges periodically in China because of high dog population density and low vaccination coverage in dogs. Mass vaccination campaigns rather than depopulation of dogs should be a long-term goal for rabies control. Seroconversion testing after vaccination is not necessary in either humans or animals. Human PEP should be initiated on the basis of diagnosis of biting animals. Reliable national systemic surveillance of rabies-related human deaths and of animal rabies prevalence is urgently needed. A laboratory diagnosis-based epidemiologic surveillance system can provide substantial information about disease transmission and effective prevention strategies.

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Available from: Xianfu Wu, Feb 09, 2015
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    • "Similar to the situation in many developing countries, rabies is a serious reemerging disease in China (Wu et al., 2009). Despite the high public health burden of more than 120,000 human deaths from rabies from 1950 to 2010, rabies is still neglected and not regarded as a priority in the disease control and prevention system in China (Hu et al., 2009). "
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    ABSTRACT: Rabies is a major public health problem in some developing countries including China. One of the reasons is that there is a very large number of dogs, both domestic and stray, especially in Guangdong Province which has the third most rabies cases (after Guangxi and Hunan) among the 31 provinces, autonomous regions and municipalities in Mainland China, and at least 18.2% of the human rabies cases are caused by stray dogs. In this paper, based on the reported data and characteristics of the rabies infection in Guangdong Province, we propose a mathematical model for the dog-human transmission of rabies. We first determine the basic reproduction number R₀ and discuss the stability of the disease-free equilibrium and persistence of the disease. By carrying out sensitivity analysis of the basic reproduction number in terms of some parameters, we find that the domestic dog vaccination rate, the recruitment rate of domestic dogs, and the quantity of stray dogs play important roles in the transmission of rabies. This study suggests that rabies control and prevention strategies should include public education and awareness about rabies, increase of the domestic dog vaccination rate and reduction of the stray dog population.
    Journal of Theoretical Biology 01/2012; 300:39-47. DOI:10.1016/j.jtbi.2012.01.006 · 2.30 Impact Factor
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    • "The high incidence of rabies reported in this reemergence leads to numerous concerns which include; a potential carrier-dog phenomenon, undocumented transmission of rabies virus from wildlife to dogs, counterfeit vaccines, vaccine mismatching, and seroconversion testing in patients after their completion of postexposure prophylaxis (PEP). These concerns are all scientifically arguable given a modern understanding of rabies (Wu et al., 2009 "
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    ABSTRACT: This review reports on the rabies vaccines: Its role, considerations and implications for the global control and possible eradication of rabies. Attempts to control human rabies have a long history; animal and human vaccines provide efficient weapons for prevention. Vaccines are one of the m ost effective public health interventions. Vaccines are the basis of the medical and veterinary medical future. Rabies vaccine is made from killed rabies virus. Rabies vaccine can prevent rabies. It is offered to people at high risk of exposure. The primary intention of vaccine is to produce stimulation to the cellular immune system, via the production of antibodies. Methods for Rabies Virus (RABV) manipulation have changed fundamentally from random attenuation to defined modifications. In 2001, WHO issued a resolution for the complete replacement of nerve tissue vaccines by 2006 with cell-culture rabies vaccines? In recent years, purified and concentrated Vero cell rabies vaccines using the 3aG and CTN-1 strains have been developed. The Purified Vero Rabies Vaccines (PVRV), is also being developed to meet the increasing demand for human rabies vaccine. However, for animals, all fixed RABV strains recommended by WHO, such as PVRV, Challenge Virus Standard (CVS), Flury-Low Egg Passage (LEP), High Egg Passage (HEP), Evelyn-Rokitnicki-Abelseth (ERA), and SAD variants, have been successfully used in industrialized countries, where rabies is well controlled. Any potent rabies vaccine will protect against rabies. A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions, though the risk of causing serious harm, or death, is extremely small and very rare. As international concerns increased, several corrective actions have been implemented in many countries since 2005, which aimed at improving vaccination protocols and a consistent vaccination strategy aiming to eliminate the residual focus. However, we should bear in mind that vaccination is still the key to prevent rabies in small animals and transmission to human beings. It is hoped that the various strategies, well coordinated and corrective actions and initiatives for global control of rabies, to make important contributions in stemming the magnitudes, roles and implications of vaccines for global control and possible eradication of rabies and other rabies-related viruses which poses threat to global public health.
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