Sunday, 13 February 2011

Review of One Health Intellectual Exchange 2011 Session 5 (Dr. Charles Rupprecht, Dr. Carl Williams, Dr. G. Robert Weedon, and Peter Costa)

On Tuesday, February 8th 2011, we welcomed rabies virus experts Dr. Charles Rupprecht, Dr. Carl Williams, Dr. G. Robert Weedon, and Peter Costa to our One Health Collaborative Intellectual Exchange Group meeting to discuss the disease. Dr. Rupprecht was the first speaker of a four part presentation that promoted rabies awareness, management, and control from a series of domestic and global perspectives. He began with an informative background history of the virus as well as the United State’s role in laboratory-based surveillance of the disease. We also explored the necessary steps to eradicate rabies cost-effectively, and established that the solution lies in eliminating the virus at the vector source by vaccinating animals as opposed to humans. Dr. Williams provided a thorough explanation of how the North Carolina public health system takes the necessary precautions to regulate and control potential outbreaks. The NC Division of Public Health holds rabies in high priority for disease management and surveillance, alongside Tuberculosis, HIV/AIDS, and other infectious diseases. We discussed the state’s body of statutes to ensure all pets are vaccinated, as well as the standard procedure for animal observation and PEP administration in the event of an animal bite. Dr. Weedon then introduced the topic of rabies control in less developed countries. He illustrated two prime examples of rabies surveillance and regulation in the dog reservoir: Bohol, Phillipines and Jaipur, India. In both cases, rabies transmission to humans was lowered as a result of dog population control (sterilizations) and mass vaccination. In the Bohol intervention, a 70% vaccination of the dog population was found to be efficacious in controlling the spread of the virus. Our final presenter was Costa, who explained to us the greatest challenges in increasing rabies awareness worldwide. A lack of knowledge about the virus is the greatest global contributor to rabies mortality. Our mission should be preparing health systems with the capacity to distribute the resources to vaccinate animal populations, as well as educate the community on preventing disease transmission and recognizing outbreaks. In closing we discussed the significance of World Rabies Day in achieving One Health Initiative goals. World Rabies Day is an annual campaign founded by the global Alliance for Rabies Control that takes place on September 28th. Its diverse community of partners has united under the common goal to “mobilize awareness and resources in support of human rabies prevention and animal rabies control”. Its homepage can be found at . Special thanks to our guest speakers for sharing with us their past achievements and future goals in the fight against the rabies virus. It is imperative that even as we make progress in controlling the disease that we do not lose sight of its implications towards achieving One Health goals. Conquering rabies will require efforts from those aimed at improving the health of humans, animals, and the environment, making it an ideal target for the One Health Initiative and its affiliates.

Discussion questions from students and attendees:

Are there any transgenic or breeding (for rabies resistance) options to addressing the issue of rabies control? If so, what are the barriers and if not, is there research currently being done?

The elimination of dogs as a primary reservoir for rabies has largely been possible in North America and Western Europe because most dogs are domestic pets. How effective will rabies vaccination programs be in countries with large urban and rural populations of feral dogs (such as Southern Asia)?

According to the WHO position paper on rabies, intradermal administration of vaccines is a safe alternative to intramuscular injection, requiring only 1-2 vials of vaccine and low cost. If these programs are effective, why does the U.S. require intramuscular injections, higher doses, and much more expensive vaccine programs?