Yuson Mirava, Bautista Criselda T, Rees Eleanor M, Bogaardt Carlijn, Cruz Van Denn D, Durrant Rowan, Formstone Anna, Manalo Daria L, Manzanilla Duane R, Kundergorski Mikolaj, Nacion Leilanie, Aloyon Hannaniah, Bolivar Jude Karlo, Bondoc Jeromir, Cobbold Christina, Panganiban Efraim, Telmo Shynie Vee M, Maestro Jobin, Miranda Mary Elizabeth G, Chng Nai Rui, Brunker Kirstyn, Hampson Katie
Boyd Orr Centre for Population and Ecosystem Health, School of Biodiversity, One Health & Veterinary Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK.
Field Epidemiology Training Programme Alumni Foundation Inc (FETPAFI), Quezon City, Philippines.
Nat Commun. 2024 Dec 30;15(1):10753. doi: 10.1038/s41467-024-54255-5.
Rabies is a viral zoonosis that kills thousands of people annually in low- and middle-income countries across Africa and Asia where domestic dogs are the reservoir. 'Zero by 30', the global strategy to end dog-mediated human rabies, promotes a One Health approach underpinned by mass dog vaccination, post-exposure vaccination of bite victims, robust surveillance and community engagement. Using Integrated Bite Case Management (IBCM) and whole genome sequencing (WGS), we enhanced rabies surveillance to detect an outbreak in a formerly rabies-free island province in the Philippines. We inferred that the outbreak was seeded by at least three independent human-mediated introductions that were identified as coming from neighbouring rabies-endemic provinces. Considerable local transmission went undetected, and two human deaths occurred within 6 months of outbreak detection. Suspension of routine dog vaccination due to COVID-19 restrictions likely facilitated rabies spread from these introductions. Emergency response, consisting of awareness measures, and ring vaccination, were performed, but swifter and more widespread implementation is needed to contain and eliminate the outbreak and to secure rabies freedom. We conclude that strengthened surveillance making use of new tools such as IBCM, WGS, and rapid diagnostic tests can support One Health in action and progress towards the 'Zero by 30' goal.
狂犬病是一种病毒性人畜共患病，在非洲和亚洲的低收入和中等收入国家，每年有数千人死于狂犬病，这些国家的家犬是病毒宿主。“30·清零”是一项终结犬传人狂犬病的全球战略，它倡导一种“同一健康”方法，其基础是大规模犬类疫苗接种、咬伤受害者的暴露后疫苗接种、强有力的监测以及社区参与。我们利用综合咬伤病例管理（IBCM）和全基因组测序（WGS），加强了狂犬病监测，以发现菲律宾一个以前无狂犬病的岛屿省份发生的疫情。我们推断，此次疫情是由至少三次独立的人为引入引发的，这些引入被确定来自狂犬病流行的邻国省份。大量的本地传播未被发现，在疫情被发现后的6个月内有两人死亡。由于新冠疫情限制导致常规犬类疫苗接种暂停，这可能助长了狂犬病从这些引入源传播开来。我们采取了包括宣传措施和环状疫苗接种在内的应急响应，但需要更快、更广泛地实施这些措施，以控制和消除疫情，并确保该地区无狂犬病。我们得出结论，利用IBCM、WGS和快速诊断测试等新工具加强监测，可以支持“同一健康”行动，并推动实现“30·清零”目标。
