Communicable Diseases and Health Analysis
The number of human cases of rabies transmitted by dogs has declined some 95 percent in the Americas since 1980, thanks to prevention efforts carried out by countries with support from the Pan American Health Organization/World Health Organization (PAHO/WHO). These efforts include mass vaccination of dogs, promotion of responsible pet ownership, timely pre- and post-exposure prophylaxis, epidemiological surveillance and laboratory diagnosis, and community health education.
Prompt treatment of people who are bitten or scratched by an animal infected with rabies will prevent the development of symptoms and death. Post-exposure prophylaxis consists of local treatment of the wound—washing it with soap and water for at least 15 minutes—followed with administration of rabies vaccine in accordance with WHO recommendations, and administration of human rabies immune globulin.
Rabies is caused by a virus that infects both domestic and wild animals and that can be transmitted to humans through the animals’ saliva as a result of bites or scratches. Once symptoms appear, the disease is nearly always fatal. Dogs are the main hosts and vectors of rabies.
Worldwide, some 55,000 people die of rabies each year, mainly in Asia and Africa. As recently as the late 1970s and early 1980s, around 250 people in the Americas died each year due to rabies transmitted by dogs, mostly children from vulnerable communities with limited access to health services and timely post-exposure treatment.
“Animals are increasingly members of the family, and their care and rabies vaccination are ways of protecting not just pets but also people,” said Marco Antonio Natal Vigilato, of PAHO/WHO’s Pan American Foot-and-Mouth Disease Center (PANAFTOSA) in Rio de Janeiro, Brazil.
Since 1983, PAHO/WHO has coordinated the Program for the Elimination of Human Rabies Transmitted by Dogs in Latin America and the Caribbean. The program emphasizes timely pre- and post-exposure treatment, surveillance and laboratory diagnosis, mass vaccination of dogs, and health education on responsible pet ownership.
Despite the program’s success in reducing cases, on average some 15 human deaths are reported each year, concentrated in a few countries: Bolivia, Brazil, the Dominican Republic, Guatemala, Haiti and Peru.
“Deaths due to rabies can be prevented by vaccinating dogs so they do not become infected, keeping them at home rather than letting them roam free, and in case of a bite or scratch from an infected animal, washing the would immediately for 15 minutes and consulting a doctor to get an anti-rabies vaccine,” said Vigilato.
World Rabies Day is observed each year on September 28, promoted by the Global Alliance for Rabies Control to raise awareness of the consequences of human and animal rabies and how to prevent it. The date honors Louis Pasteur, who produced the first anti-rabies vaccine. Countries in the Americas participate in World Rabies Day with prevention and control activities, with the coordination and support of PAHO/WHO.
PAHO, which celebrates its 110th anniversary this year, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.
Rabies in the Americas
Each year the Region’s countries report between 5 and 15 cases of human rabies transmitted by dogs and an average of 17 cases of rabies transmitted by bats.
Some 45-50 million dogs are vaccinated against rabies in Latin America and the Caribbean each year.
Each year, some 1 million people at risk of rabies receive post-exposure prophylaxis in the Region.
PAHO/WHO member governments report voluntarily and periodically on the status of rabies in their countries through a specialized epidemiological surveillance system: http://www.siepi.panaftosa.org.br.
Further reductions in cases require stepped-up efforts in diagnosis and surveillance in priority areas and countries: in Bolivia, Brazil, the Dominican Republic, Guatemala, Haiti and Peru for rabies transmitted by dogs, and in Brazil, Ecuador, Mexico and Peru for rabies transmitted by bats.
So far this year (2012) only six cases of human rabies transmitted by dogs have been reported in Latin America and the Caribbean: Bolivia (1), Brazil (2), Haiti (2) and the Dominican Republic (1), compared with 30 cases in nine countries during 2006.