The study, published in PLOS Neglected Tropical Disease, is
the first to assess the impact of canine rabies on a global scale, estimating its public health and economic burden and
measuring the extent of worldwide control efforts.
"This ground-breaking study is an essential step towards
improved control and eventual elimination of rabies," reports
Prof. Louis Nel, Executive Director of the Global Alliance for Rabies Control (GARC). "An understanding of the actual
burden helps us determine and advocate for the resources
needed to tackle this fatal disease."
The study was conducted by GARC's Partners for Rabies
Prevention Group and led by Dr. Katie Hampson of the University of Glasgow, Scotland.
In addition to the large amount of deaths caused by rabies, the
authors estimate that annual economic losses caused by the
disease total around $8.6 billion. This cost is attributed
primarily to premature deaths but also includes vaccination
spending and lost income for victims.
Rabies is a difficult disease to track and underreporting is
believed to be commonplace. As rabies is close to 100% fatal, a
large number of rabies victims never report to health facilities and are never diagnosed. In regions where malaria is prevalent, misdiagnosis is also frequent.
In light of these problems, the researchers decided that an
updated assessment of the global rabies burden was necessary. For their study, they combined all available data sources into a modeling framework that allowed them to estimate as accurately as possible any missing information.
"The breadth of data used in this study, from surveillance
reports to epidemiological study data to global vaccine sales
figures, is far greater than ever analyzed before, allowing this more detailed output," Dr. Hampson explains.
Dog vaccination programs could reduce medical sector costs
Rabies is a fatal viral disease that is usually acquired when
humans are bitten by infected animals, most typically domestic
dogs. Through the prompt administration of a fast-acting shot to bite victims, the disease is entirely preventable, yet in populations with limited access to health care, the disease is prevalent.
The researchers found the greatest risk of canine rabies was in the world's poorest countries. Sub-Saharan Africa is home to the highest death rates while India reports the highest number of human fatalities - approximately 20,800 deaths per year, over 35% of the global rabies burden.
Canine rabies can be controlled through the mass vaccination of
domestic dogs, yet the researchers also found that in nearly all African and Asian countries, the proportion of dogs vaccinated for the disease is far below the level necessary to control it.
Mass vaccination of dogs comprised a very small
proportion of the economic burden of rabies - less than
1.5%. The researchers report that outside of North America and Europe, a large investment in dog vaccination has only been sustained in the Americas,
leading to a small rabies burden in this region.
"Generally, medical sector costs were much higher than veterinary costs," write the study authors, "but investment in dog vaccination could bring down costs to the medical sector,
demonstrating the need for intersectoral coordination."
The study authors state that collaboration between the animal
and human health sectors - vaccinating dogs and improving
access to human vaccines - is necessary in order to save lives
and reduce the burden of this disease on some of the world's
most vulnerable economies.
In addition, effective systems for reporting rabies cases are
essential to rabies elimination efforts, as they allow for public health officials to monitor and evaluate prevention measures.
"No one should die of rabies and GARC and its partners will
continue to work together using a One Health approach towards global rabies elimination," Prof. Nel states.
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