Rabies in North Africa and the Middle East: current situation, strategies and outlook.

In the Middle East and North Africa (MENA) region, dogs are the main reservoir for rabies. In this region, rabies affects more domestic carnivores (50% of cases) than farm animals (40% of cases). Rabies in large livestock animals, which are infected mainly by dogs, results in economic losses, undermines food safety and poses a risk for humans. In the MENA region, rabies is largely an urban problem, the virus being transmitted to humans by free-roaming dogs, 30% of which are less than one year old. In cities, the density of the free-roaming dog population varies between 0.6 and 1.5 dogs per km2, and almost double this figure in suburban and rural areas, where 80% of canine rabies cases occur. In the Maghreb, the annual average number of confirmed human deaths from rabies is around 47, showing a strong correlation with the number of animal cases declared (approximately 1,442 cases a year). In the Middle East, only a few rabies cases in humans are officially reported, suggesting that rabies cases in humans are grossly underreported. National strategies to control rabies include vaccination, controlling the freeroaming dog population and raising awareness among the human population at risk. Owing to limited resources and poor coordination between the different stakeholders, these strategies are only partially implemented. The Food and Agriculture Organization of the United Nations, in close collaboration with the World Organisation for Animal Health and the World Health Organization, supports countries in formulating and implementing coordinated strategies between the ministries concerned, local authorities and non-governmental organisations.