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Buenos Aires, 20 June 2008 |
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III LATIN AMERICAN ZOONOSIS CONGRESS |
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Rabies, especially canine rabies, remains a public health and economic problem around the world, including the Americas, where it is one of the major zoonoses. In 1983, the region’s governments, with the backing of the Pan-American Health Organization, launched an Action Plan for the Elimination of Urban Rabies from the Principal Cities of Latin America, later expanded as a new plan for the Elimination of Human Rabies Transmitted by Dogs in Latin America.
This initiative has been extremely successful as shown by a 90-percent reduction in the annual number of cases in both humans and dogs. Some countries and territories have recorded no new cases of rabies transmitted by dogs in a long time; in them, circulation of the virus in this animal species has been stopped. This is due to the implementation of effective epidemiological surveillance programs, as corroborated by viral research based on techniques for antigenic and genetic identification of the isolated rabies viruses.
Proof of a link between the rabies virus and certain animal species has led to the recognition of highly independent cycles. On this continent, two virus variants (1 and 2) that perpetuate themselves from dog to dog have been identified.
In the Americas, several countries have declared themselves or are considered free of canine rabies. In Latin America, success in controlling canine rabies many years ago led to nonformalized initiatives and proposals aimed at the recognition and declaration of countries and territories free of dog-transmitted rabies. At the Seventh Meeting of Directors of National Rabies Control Programs-REDIPRA, held in Puerto Vallarta, Mexico, in October 1998, PAHO presented a working document on “Canine rabies-free municipalities: a recognition proposal.” This document provided the basis for an Experts Consultation Meeting on Rabies-free Municipalities, held in Havana, Cuba in June 1999, on which occasion a Plan of Action for the recognition and maintenance of canine rabies-free municipalities was considered. In August 2005, Mexico’s Ministry of Health issued a publication on criteria for the certification of geographical areas that have eliminated the transmission of canine rabies. More recently (September 2007), the United States declared itself free of canine rabies.
The World Animal Health Organization-OIE has specific procedures that should be followed for a country to be officially recognized as free of some zoonoses. In the case of rabies, the Terrestrial Animal Health Code indicates that a country can consider itself rabies-free if (1) the disease is subject to obligatory notification; (2) an effective surveillance system is in place; (3) regulatory measures for preventing and combating rabies are applied, including effective import procedures; (4) no case of human or autochthonous animal rabies infection has been confirmed in the past two years – however, the isolation of an European bat lyssavirus (EBL 1 or EBL 2) does not prevent the country from been recognized as rabies-free; and (5) no case of rabies in any imported carnivorous animal has been detected other than in a quarantine facility in the past six months.
Accordingly, countries are in compliance with the basic OIE requirements whenever they define rabies as a disease subject to obligatory notification; maintain a rabies prevention and control program consistent with their epidemiological reality, including, among other things, legal provisions and specific norms about the disease and the control of foci; laboratory diagnosis – including virus specification – of all positive samples taken from whatever species; immediate attention to any suspicious case; community education and participation; and the selective control of the unconfined canine population.
Strategies and areas of action
It is in the interest of these countries to proceed to a careful review of their accumulated experience to verify if they are in condition to declare their entire territories or part of them free of canine rabies, as well as to maintain this health status by implementing the requisite measures to reduce the risk of introduction or reintroduction of the specific canine rabies’ virus variants. |
