The first global survey of rabies reporting systems, recently published, has uncovered a shocking lack of preparedness against this deadly disease across Africa and Asia. Accurate reporting of rabies cases to authorities is a critical first step in controlling rabies and preventing further outbreaks.
Across the 91 countries surveyed by the Global Alliance for Rabies Control, effective reporting systems were found almost exclusively where rabies control measures are well implemented. Across Africa and Asia, where rabies kills the most people, most reporting systems were judged to be ineffective. Overall, 41% of the population covered by this survey – around 2.5 billion people – live in countries where there is no system, or an ineffective rabies reporting system.
“Because most rabies endemic countries don’t collect accurate data on the number of people dying from the virus, they fail to adequately invest in its control. An appreciation of the scale of the problem can help countries prioritize control of this disease.” says lead author of the paper, Dr Louise Taylor, a biologist with the Global Alliance for Rabies Control.
The lack of accurate reporting means we only have estimates of the global human and animal toll of rabies. The virus is estimated to kill around 70,000 people every year, almost all of whom die through a lack of access to lifesaving medical treatment. These estimates suggest at least 95% are infected as a result of a bite from a rabid dog.
Humans are not the only victims. Animals, dogs in particular, are also victims of the horrific clinical symptoms, but perhaps the most disturbing consequence is the estimated tens of millions of dogs culled, often inhumanely, in misguided attempts to control the disease.
All of these deaths can be prevented with effective rabies vaccination programs . Reporting systems are fundamental to these programs, to monitor and assess the success of prevention efforts.
The survey found that while the reporting of human rabies cases is a legal requirement in many countries, the systems to do this vary enormously and are often poorly enforced. Accurate data is just not being produced for most countries where rabies is common.
The survey also identifies a number of reasons for this, including rabies not being a health priority, poor training of medical staff, a lack of resources to implement reporting, and the problem that many poor victims die without ever accessing the health system.
International commitment to the elimination of human rabies transmitted from dogs is increasing. A first step to turning this commitment into sustainable programs is the urgent need for regional databases for rabies reporting, especially in Asia and Africa.
The Global Alliance for Rabies Control (GARC) is working with international agencies and governments to assist in improving rabies reporting, along with providing tools and support to help countries to eliminate deaths from rabies, particularly through the creation of regional platforms. The first meeting of the regional Pan African Rabies Control Network (PARaCoN) will be held in South Africa in June 2015, where the main topics for discussion will be data sharing and dissemination, improving governmental support, optimal rabies control strategies and their roll-out.
Article first published online: 14 FEB 2015 DOI: 10.1111/zph.12183