Rabies and the pandemic: lessons for One Health

Nadal, Deborah; Beeching, Sarah; Cleaveland, Sarah; Cronin, Katy; Hampson, Katie; Steenson, Rachel; Abela-Ridder, Bernadette

doi:10.1093/trstmh/trab123

Cited by 44 publications

(43 citation statements)

References 3 publications

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“…Rabies control is a model for One Health implementation, as its proven methodologies demonstrate the effectiveness of collaboration at the human-animal interface, including at community and municipal level. However, the pandemic has also set back many countries' efforts toward rabies elimination ( 4 ).…”

Section: Rabies and One Healthmentioning

confidence: 99%

“…A recent survey found that rabies workforce capacity and financial resources were redirected toward COVID-19, movement restrictions limited access to healthcare facilities, and overwhelmed health systems had less capacity to treat cases of rabies exposure ( 4 ). Community outreach, including rabies prevention programs in schools, were suspended and the disruption of medical supply chains resulted in restricted PEP access for exposed individuals.…”

Section: Rabies and One Healthmentioning

confidence: 99%

“…The challenge is how to turn the One Health concept into practical action, especially in low-income settings. The current crisis has overwhelmed health systems and led to the redeployment of public health resources, resulting in setbacks to the control of endemic and neglected diseases such as rabies ( 4 ). However, rabies elimination can be a way to improve human and animal health system collaboration, boost engagement with communities and build workforce capacity, whilst delivering tangible results to the communities most vulnerable to rabies and other neglected diseases.…”

Section: Introductionmentioning

confidence: 99%

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United Against Rabies Forum: The One Health Concept at Work

Tidman

Thumbi

Wallace

et al. 2022

Front. Public Health

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Human deaths from rabies are preventable and can be eliminated by applying a systematic One Health approach. However, this ancient disease still threatens the lives of millions of people in up to 150 countries and kills an estimated 59, 000 people every year. Rabies today is largely a disease of poverty, almost always linked to dog bites, with most deaths occurring in neglected communities in Africa and Asia. The disease places an immense economic burden on its victims, a cost that far outweighs the investment needed to control it. A global framework for rabies elimination in humans is set out in Zero by 30: The Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. Despite the existence of proven control strategies and agreement on the path to eliminating human rabies deaths, mortality numbers from rabies remain high, and COVID-19 has set back efforts even further. But COVID-19 has also highlighted the value of a One Health approach to zoonotic disease and pandemic prevention. Rabies control programs offer a practical route to building One Health capacities that can also address other zoonotic threats, including those with pandemic potential. The United Against Rabies Forum aims to accelerate progress on rabies elimination while applying a One Health approach. The Forum promotes cross-sector collaboration among stakeholders and supports countries in their rabies elimination efforts. Increased political engagement and resource mobilization, both internationally and nationally, will be needed to achieve global rabies goals and can also make One Health implementation a reality.

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Section: Rabies and One Healthmentioning

confidence: 99%

Section: Rabies and One Healthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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United Against Rabies Forum: The One Health Concept at Work

Tidman

Thumbi

Wallace

et al. 2022

Front. Public Health

Self Cite

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“…COVID-19 pandemic has disrupted many essential health services including strategies for rabies elimination ( 32 ) with funding for non-COVID-19 disease projects redirected to control of COVID-19. These has disrupted mass dog vaccination, provision of PEP and community awareness activities ( 33 ). Funding rabies elimination programs will require local ownership and financing from governments in endemic countries such as Kenya.…”

Section: Discussionmentioning

confidence: 99%

Rabies Elimination in Rural Kenya: Need for Improved Availability of Human Vaccines, Awareness and Knowledge on Rabies and Its Management Among Healthcare Workers

Chuchu

Kitala

Bichanga

et al. 2022

Front. Public Health

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BackgroundIn Africa, rabies causes an estimated 24,000 human deaths annually. Mass dog vaccinations coupled with timely post-exposure prophylaxis (PEP) for dog-bite patients are the main interventions to eliminate human rabies deaths. A well-informed healthcare workforce and the availability and accessibility of rabies biologicals at health facilities are critical in reducing rabies deaths. We assessed awareness and knowledge regarding rabies and the management of rabies among healthcare workers, and PEP availability in rural eastern Kenya.MethodologyWe interviewed 73 healthcare workers from 42 healthcare units in 13 wards in Makueni and Kibwezi West sub-counties, Makueni County, Kenya in November 2018. Data on demographics, years of work experience, knowledge of rabies, management of bite and rabies patients, and availability of rabies biologicals were collected and analyzed.ResultsRabies PEP vaccines were available in only 5 (12%) of 42 health facilities. None of the health facilities had rabies immunoglobulins in stock at the time of the study. PEP was primarily administered intramuscularly, with only 11% (n = 8) of the healthcare workers and 17% (7/42) healthcare facilities aware of the dose-sparing intradermal route. Less than a quarter of the healthcare workers were aware of the World Health Organization categorization of bite wounds that guides the use of PEP. Eighteen percent (n = 13) of healthcare workers reported they would administer PEP for category I exposures even though PEP is not recommended for this category of exposure. Only one of six respondents with acute encephalitis consultation considered rabies as a differential diagnosis highlighting the low index of suspicion for rabies.ConclusionThe availability and use of PEP for rabies was sub-optimal. We identified two urgent needs to support rabies elimination programmes: improving availability and access to PEP; and targeted training of the healthcare workers to improve awareness on bite wound management, judicious use of PEP including appropriate risk assessment following bites and the use of the dose-sparing intradermal route in facilities seeing multiple bite patients. Global and domestic funding plan that address these gaps in the human health sector is needed for efficient rabies elimination in Africa.

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“…COVID-19 has disrupted the lives and economies of most countries all over the world, whether directly or indirectly ( 29 ). As public health professionals are diverted to working on the pandemic, it has disrupted vaccination campaigns in countries ( 30 ), including rabies vaccination, and field training.…”

Section: Covid-19 Pandemicmentioning

confidence: 99%