<i>Notes from the Field</i>: A Multipartner Response to Prevent a Binational Rabies Outbreak — Anse-à-Pitre, Haiti, 2019

Adrien, J.; Georges, Yvenel; Augustin, Pierre Dilius; Monroe, Benjamin; Gibson, Andrew D.; Fénelon, Natael; Ludder, Fleurinord; Crowdis, Kelly; Mandra, Anna; Joseph, Haïm C; Etheart, Melissa D.; Wallace, Ryan M.; Blanton, Jesse D.; Cleaton, Julie M.; Condori, Rene Edgar; Petersen, Brett W.; Ross, Yasmeen; Morán, David; Tataryn, Joanne; Gamble, Luke; Lohr, Frederic; King, Alasdair

doi:10.15585/mmwr.mm6832a6

Cited by 15 publications

(12 citation statements)

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“…However, challenges in human case detection remain including the difficulty of laboratory diagnostics, lack of knowledge of both patients and providers, the long and variable incubation period between exposure and disease, and time and cost barriers to accessing care. Since 2018, the Haiti Animal Rabies Surveillance Program has used an app-based case investigation system that allows data to be recorded and shared in real time 21 . The timing of the increase in confirmed cases detected through surveillance matched that predicted by the model.…”

Section: Discussionmentioning

confidence: 99%

“…Dogs and other animals that have been found dead or are suspected of rabies due to illness or behavior are reported to HARSP by veterinarians, healthcare workers, or members of the public 10 . A standardized electronic case investigation form is used to document investigations, and provides near real-time information on epidemiologic changes 21 .…”

Section: Methodsmentioning

confidence: 99%

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The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis

Kunkel

Jeon

Joseph

et al. 2021

Sci Rep

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Dog vaccination is a cost-effective approach to preventing human rabies deaths. In Haiti, the last nation-wide dog vaccination campaign occurred in 2018. We estimated the number of human lives that could be saved by resuming dog vaccination in 2021 compared to 2022 and compared the cost-effectiveness of these two scenarios. We modified a previously published rabies transmission and economic model to estimate trends in dog and human rabies cases in Haiti from 2005 to 2025, with varying assumptions about when dog vaccinations resume. We compared model outputs to surveillance data on human rabies deaths from 2005 to 2020 and animal rabies cases from 2018 to 2020. Model predictions and surveillance data both suggest a 5- to 8-fold increase in animal rabies cases occurred in Haiti’s capital city between Fall 2019 and Fall 2020. Restarting dog vaccination in Haiti in 2021 compared to 2022 could save 285 human lives and prevent 6541 human rabies exposures over a five-year period. It may also decrease program costs due to reduced need for human post-exposure prophylaxis. These results show that interruptions in dog vaccination campaigns before elimination is achieved can lead to significant human rabies epidemics if not promptly resumed.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis

Kunkel

Jeon

Joseph

et al. 2021

Sci Rep

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Section: Data and Input Valuesmentioning

confidence: 99%

The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis

Kunkel

Jeon

Joseph

et al. 2021

Preprint

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OBJECTIVE: Dog vaccination is a cost-effective approach to preventing human rabies deaths. In Haiti, the 2019 dog vaccination campaign did not include the capital city, and the 2020 campaign was cancelled because of COVID-19 lockdown restrictions and redirection of funds. We estimated the number of human lives that could be saved by resuming dog vaccination in 2021 compared to 2022 and compared the cost-effectiveness of these two scenarios. METHODS: We modified a previously published rabies transmission and economic model to estimate trends in dog and human rabies cases in Haiti from 2005-2025. We compared model outputs to surveillance data on human rabies deaths from 2005-2020 and animal rabies cases from 2018-2020. We then estimated the human health and cost implications of restarting dog vaccination programs in either 2021 or 2022. FINDINGS: Model predictions and animal surveillance data from Haiti both suggest a 5- to 8-fold increase in animal rabies cases has occurred in the capital city between Fall 2019 and Fall 2020. We estimate that restarting dog vaccination in Haiti in 2021 compared to 2022 could save 285 human lives and prevent 6,541 human rabies exposures over a five-year period and may decrease program costs due to reduced need for human post-exposure prophylaxis. CONCLUSIONS: A one-year delay in resuming dog vaccination in Haiti, from 2021 to 2022, could cost hundreds of lives over the next 5 years. Interruptions in dog vaccination campaigns before elimination is achieved can lead to significant human rabies epidemics if not promptly resumed.

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“…In many rabies-endemic countries, the logistical infrastructure is inadequate to support vaccination campaigns capable of reaching adequate herd immunity (estimated at 70%) (8). Alternative vaccination methods that overcome these infrastructure deficits, such as capture-vaccinate-release (CVR) and door-to-door vaccination, have been piloted in subnational settings and have shown to be highly effective (40)(41)(42)(43). However, the feasibility of scaling up campaigns that rely upon parenterally focused alternative vaccination methods is now in doubt (44,42).…”

Section: Rationale For the Consideration Of Oral Vaccines For Dog Vacmentioning

confidence: 99%

Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths

Wallace¹,

Cliquet²,

Fehlner-Gardiner³

et al. 2020

Emerg. Infect. Dis.

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S ince the advent of Pasteur's germ theory and the general acceptance that infectious diseases do not develop spontaneously, humankind has strived to reduce and eliminate pathogens that pose a serious public health threat. Incorporating routine vaccinations to control human diseases such as pneumonia, diarrhea, pertussis, measles, and polio contributed to the prevention of >10 million human deaths during 2010-2015 (1). Intensive global efforts toward disease eradication have focused on only a few diseases, including Guinea worm disease (dracunculiasis) (>99% reduction in human cases), smallpox (eradicated in 1980), rinderpest (eradicated in 2011), polio (99% reduction in human cases), and lymphatic filariasis (73% reduction in human cases) (2-6). Those disease eradication efforts have focused on pathogens that are host-restricted or affect only a single host. In 2015, the world called for action by setting a goal of zero human dog-mediated rabies deaths by 2030 worldwide. In 2018, the World Health Organization (WHO), the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations, and the Global Alliance for Rabies Control launched the Global Strategic Plan for global elimination of dog-mediated human rabies deaths by 2030, which represents the first major effort to eliminate a classical zoonosis and poses

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Notes from the Field: A Multipartner Response to Prevent a Binational Rabies Outbreak — Anse-à-Pitre, Haiti, 2019

Cited by 15 publications

References 4 publications

The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis

The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis

The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis

Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths

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