A Century Spent Combating Rabies in Morocco (1911–2015): How Much Longer?

Abstract

Rabies has no known beginning in Morocco and to date, government control efforts and plans fail to eradicate the disease. A review and analysis of available epidemiological data are crucial to learn lessons from the past and to propose effective actions. Legally, animal rabies is a notifiable disease since 1913 and legislation has been updated periodically since. Dogs have always been considered as both the disease’s vector and reservoir, while cattle, other herbivores, and humans are victims. Animal rabies cases evolution from 1942 to 2015 is characterized by ascending phase then decreasing one following structured rabies control plan implementation in 1980s. Indeed, from 1986 to 2010, three rabies control plans have been conducted based on free of charge rabies vaccination of owned dogs through mass campaigns. The geographical distribution of rabies is stable over the years with highest cases number in rich rural areas and around cities. Human rabies cases are decreasing over the time (1976–2015) thanks to the opening of new antirabic treatment centers in the last decade which permit the administration of more PEPs. After a century of rabies control, Morocco registered an average of 301 animal cases and 21 human cases annually for the last decade (2005–2015). Few reasons led to those limited results. The lack in law enforcement and, moreover, the fact that the law do not take into account responsible dog ownership aspect are of importance. Lack of dog population knowledge and management and intersectoral coordination deficiency are additional failure reasons. The gathered data will help to build a new strategy with a focus on a “One Health” approach. Dog population ecology parameters’ study is of primary importance. We estimated dog population to be 2.8 million dogs based on human:dog ratio. Enhancing vaccination coverage of dog population is feasible by combining parenteral vaccination and complementary oral vaccination. Updating legislation by inclusion of responsible dog ownership and law enforcement are crucial. Over the last century, Morocco registered a slow decreasing tendency in the number of animal and human rabies cases. Urgent strategy need to be implemented because rabies elimination is an achievable goal in Morocco.

Knowledge, Attitudes, and Practices Regarding Rabies in El Jadida Region, Morocco

“…It was distributed as follows: 2421 thousand head of sheep, 5497 thousand head of cattle, and 46 thousand head of goats [14]. complicate rabies control efforts [12]. El Jadida is second in Morocco in terms ofthe incidence of human rabies cases [13].…”

“…The close relationship between the human and canine population is a major risk factor for disease occurrence [11]. There is a large dog population (about 2,798,126) and low vaccination rate (<20%) in Morocco; coupled with unrestricted movement and reproduction, these factors may complicate rabies control efforts [12]. El Jadida is second in Morocco in terms ofthe incidence of human rabies cases [13].…”

Determinants of Canine Rabies in Morocco: How to Make Pertinent Deductions for Control?

“…A multiple linear regression is realized and we notice that among the variables introduced: the variable distance with respect to the tar, uncontrolled discharges and IDC were particularly affected by this problem and do not contribute significantly to the regression as they present bad collinearity statistics (tolerance and VIF are far from 1 and outside the recommended limits (toler-ance>0. 3 modeling were independently associated with rabies: Weekly Rural Markets, Rural Habitat, Human Density, and Killing (Table 3).…”

“…After a century of rabies control, Morocco registered an average of 301 animal cases and 21 human cases annually for the last decade (2005-2015). 3 The reporting of the National Epidemiology Service 4 indicates that animal rabies is spread over almost the entire Morrocan territory and has been enzootic for several decades, all provinces are affected, but to varying degrees from 50 to a few cases per year with highest cases number in rich rural areas and around cities. It is unevenly distributed but in any case the dog is the vehicle and the main reservoir of the virus.…”

“…The gathered data will help to build a new strategy with a focus on a "One Health" approach. 3 This study is the first to clarify the risk factors for rabies in Morocco with the aim of improving prevention and adapting disease control recommendations based so far on vaccination measures and culling stray dogs.…”