Challenges of Rabies Surveillance in the Eastern Amazon: The Need of a One Health Approach to Predict Rabies Spillover

Abstract

Brazil has been promoting essential improvements in health indicators by implementing free-access health programs, which successfully reduced the prevalence of neglected zoonosis in urban areas, such as rabies. Despite constant efforts from the authorities to monitor and control the disease, sylvatic rabies is a current issue in Amazon's communities. The inequalities among Amazon areas challenge the expansion of high-tech services and limit the implementation of active laboratory surveillance to effectively avoid outbreaks in human and non-human hosts, which also reproduces a panorama of vulnerability in risk communities. Because rabies is a preventable disease, the prevalence in the particular context of the Amazon area highlights the failure of surveillance strategies to predict spillovers and indicates the need to adapt the public policies to a “One Health” approach. Therefore, this work assesses the distribution of free care resources and facilities among Pará's regions in the oriental Amazon; and discusses the challenges of implanting One Health in the particular context of the territory. We indicate a much-needed strengthening of the sylvatic and urban surveillance networks to achieve the “Zero by 30” goal, which is inextricable from multilateral efforts to combat the progressive biome's degradation.

Identification of risk areas for arboviruses transmitted by Aedes aegypti in northern Brazil: A One Health analysis

“…In Brazil, the robust implementation of this strategy is still very discrete. In the scenario of public policies, isolated actions such as the inclusion of veterinarians as a part of primary health care (PHC) teams is already underway; however, with the immense challenges posed by socioenvironmental characteristics and the high burden of communicable zoonotic diseases, the inclusion of other areas of knowledge working in an integrated and targeted social, environmental, faunal, and epidemiological specificity regarding the region of operation, it would be possible to glimpse an effectiveness closer to the ideal of what is proposed in One Health [ 43 ].…”

Use of a Direct, Rapid Immunohistochemical Test for Diagnosis of Rabies Virus in Bats

“…Within the Americas, programs for the elimination of human rabies caused by dogs have resulted in significant regional progress [19]. Today, human and domestic animal cases in this region are caused primarily from RABV transmission via rabid wildlife, particularly from bats [20,21]. In North America, where canine RABV perpetuation has been eliminated, the majority of dRIT applications have been in support of enhanced rabies surveillance (ERS) activities focused upon the oral vaccination of free-ranging mesocarnivores, such as raccoons [22][23][24].…”

The Amazonian Tropical Bites Research Initiative, a hope for resolving zoonotic neglected tropical diseases in the One Health era

“…In 2018, a total of 33 549 cases of wild and domestic animal bite notifications were reported to the Brazilian Information System on Notifiable Diseases; Sistema de Informação de Agravos de Notificação (SINAN) database. 21 Established in 1969 by PAHO, the Sistema de Information Regional para la VigilanciaEpidemiologica de la Rabia (SIRVERA) is a database for both human and animal rabies cases. In 2021, seven cases of dog-mediated human rabies were reported to SIRVERA.…”