Laboratory diagnostics in dog-mediated rabies: an overview of performance and a proposed strategy for various settings

Duong, Veasna; Tarantola, Arnaud; Ong, Sivuth; Mey, Channa; Choeung, Rithy; Ly, Sowath; Bourhy, Hervé; Dussart, Philippe; Buchy, Philippe

doi:10.1016/j.ijid.2016.03.016

Cited by 44 publications

(42 citation statements)

References 49 publications

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“…It has been estimated that an average of 8,528 dog bites are reported annually in Lao PDR [8] underlining the importance of rabies surveillance and control. More recently, studies have identified the increasing importance of dog rabies in Lao PDR [4], Cambodia [9], and southern China [10], examining diagnostic issues, case numbers, epidemiology and genetic relatedness of contemporary regional strains.…”

Section: Introductionmentioning

confidence: 99%

Rabies surveillance in dogs in Lao PDR from 2010-2016

et al. 2017

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BackgroundRabies is a fatal viral disease that continues to threaten both human and animal health in endemic countries. The Lao People’s Democratic Republic (Lao PDR) is a rabies-endemic country in which dogs are the main reservoir and continue to present health risks for both human and animals throughout the country.MethodsPassive, laboratory–based rabies surveillance was performed for suspected cases of dog rabies in Vientiane Capital during 2010–2016 and eight additional provinces between 2015–2016 using the Direct Fluorescent Antibody Test (DFAT).ResultsThere were 284 rabies positive cases from 415 dog samples submitted for diagnosis. 257 cases were from Vientiane Capital (2010–2016) and the remaining 27 cases were submitted during 2015–2016 from Champassak (16 cases), Vientiane Province (4 cases), Xieng Kuang (3 cases), Luang Prabang (2 cases), Saravan (1 case), Saisomboun (1 case) and Bokeo (1 case). There was a significant increase in rabies cases during the dry season (p = 0.004) (November to April; i.e., <100mm of rainfall per month). No significant differences were noted between age, sex, locality of rabies cases.ConclusionThe use of laboratory-based rabies surveillance is a useful method of monitoring rabies in Lao PDR and should be expanded to other provincial centers, particularly where there are active rabies control programs.

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Section: Introductionmentioning

confidence: 99%

Rabies surveillance in dogs in Lao PDR from 2010-2016

et al. 2017

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“…Current rabies surveillance guidelines focus on use of validated laboratory diagnostic tests, which are highly sensitive and specific 11,12 and emphasize the need for notifiability 13 . The World Animal Health Organization (OIE) provisions set out general principles for adequate surveillance systems 14 , but specific recommendations for rabies are limited.…”

Section: Introductionmentioning

confidence: 99%

Surveillance to Establish Elimination of Transmission and Freedom from Dog-mediated Rabies

Hampson¹,

Abela-Ridder²,

Brunker³

et al. 2016

Preprint

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Background: With a global target set for zero human deaths from dog-mediated rabies by 2030 and some regional programmes close to eliminating canine rabies, there is an urgent need for enhanced surveillance strategies suitable for declaring freedom from disease and elimination of transmission with known confidence. Methods: Using exhaustive contact tracing across settings in Tanzania we generated detailed data on rabies incidence, rabid dog biting behaviour and healthseeking behaviour of bite victims. Using these data we compared case detection of sampling-based and enhanced surveillance methodologies and investigated elimination verification procedures. Findings: We demonstrate that patients presenting to clinics with bite injuries are sensitive sentinels for identifying dog rabies cases. Triage of patients based on bite history criteria and investigation of suspicious incidents can confirm >10% of dog rabies cases and is an affordable approach that will enable validation of disease freedom following two years without case detection. Approaches based on sampling the dog population without using bite-injury follow-up were found to be neither sensitive nor cost-effective. Interpretation: The low prevalence of rabies, and short window in which disease can be detected, preclude sampling-based surveillance. Instead, active case finding guided by bite-patient triage is needed as elimination is approached. Our proposed methodology is affordable, practical and supports the goal of eliminating human rabies deaths by improving administration of lifesaving post-exposure prophylaxis for genuinely exposed but untreated contacts. Moreover, joint investigations by public health and veterinary workers will strengthen intersectoral partnerships and capacity for control of emerging zoonoses. Funding: Wellcome Trustpeer-reviewed) is the author/funder. All rights reserved. No reuse allowed without permission. The copyright holder for this preprint (which was not . http://dx.doi.org/10.1101/096883 doi: bioRxiv preprint first posted online Dec. 31, 2016; 2 Research in ContextEvidence before this study We searched PubMed for studies published in any language up until December 2016 on "rabies" and "surveillance" and "case detection" or "elimination". Almost all studies focused on methods of laboratory diagnosis, with none investigating means of increasing identification of potential case and recovery of samples for subsequent laboratory confirmation. Many studies alluded to underreporting and under detection of rabies, and a much higher burden of disease than confirmed cases suggest. A previous modelling study highlighted the need for improved case detection to validate elimination of transmission and more generally to improve responses to rabies outbreaks. Otherwise there was an absence of scientific recommendations for practical surveillance strategies, which are urgently needed to inform international guidelines for rabies control and elimination programmes. Added value of this study In this study we used detailed and compr...

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“…In this situation, the observation of clinical signs and symptoms is still used to diagnose rabies. In such settings, due to a variable clinical manifestations, laboratory assistance may be required [6,25,26]. The DFA test is the gold standard for rabies diagnosis; the method requires an expensive fluorescence microscope, which is often only available at the national level.…”

Section: Discussionmentioning

confidence: 99%

Using the LN34 Pan-Lyssavirus Real-Time RT-PCR Assay for Rabies Diagnosis and Rapid Genetic Typing from Formalin-Fixed Human Brain Tissue

Condori

Niezgoda

Lopez

et al. 2020

Viruses

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Human rabies post mortem diagnostic samples are often preserved in formalin. While immunohistochemistry (IHC) has been routinely used for rabies antigen detection in formalin-fixed tissue, the formalin fixation process causes nucleic acid fragmentation that may affect PCR amplification. This study reports the diagnosis of rabies in an individual from the Dominican Republic using both IHC and the LN34 pan-lyssavirus real-time RT-PCR assay on formalin-fixed brain tissue. The LN34 assay generates a 165 bp amplicon and demonstrated higher sensitivity than traditional PCR. Multiple efforts to amplify nucleic acid fragments larger than 300 bp using conventional PCR were unsuccessful, probably due to RNA fragmentation. Sequences generated from the LN34 amplicon linked the case to the rabies virus (RABV) strain circulating in the Ouest Department of Haiti to the border region between Haiti and the Dominican Republic. Direct sequencing of the LN34 amplicon allowed rapid and low-cost rabies genetic typing.

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Laboratory diagnostics in dog-mediated rabies: an overview of performance and a proposed strategy for various settings

Cited by 44 publications

References 49 publications

Rabies surveillance in dogs in Lao PDR from 2010-2016

Rabies surveillance in dogs in Lao PDR from 2010-2016

Surveillance to Establish Elimination of Transmission and Freedom from Dog-mediated Rabies

Using the LN34 Pan-Lyssavirus Real-Time RT-PCR Assay for Rabies Diagnosis and Rapid Genetic Typing from Formalin-Fixed Human Brain Tissue

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