Special Issue "Lyssaviruses and Rabies: Prevention, Control and Elimination"

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366).

Deadline for manuscript submissions: 31 December 2019.

Special Issue Editor

Dr. Charles E. Rupprecht
E-Mail Website
Guest Editor
1. Adjunct Professor, The Wistar Institute, Philadelphia, United States
2.CEO, LYSSA LLC, Lawrenceville, GA 30044, United States
Interests: lyssaviruses; zoonoses; One Health; epidemiology; conservation biology
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

Rabies is one of the oldest documented zoonoses, but it remains a neglected infectious disease with a pressing need for resolution of many unanswered questions. Prior to the 1950s, rabies was believed to be caused only by rabies virus. Since that time, more than 17 different lyssaviruses have been described, due, in part, to improvements in laboratory-based surveillance and viral characterization. Yet, if our current approach to such pathogen discovery and biosecurity is to be considered adequate, how are new lyssaviruses being reported from Western Europe, and what does this finding say about the undiscovered lyssavirus diversity within Africa and Asia?

Annually, most of the tens of thousands of human rabies fatalities result from the bite of a rabid dog. During 2015, the FAO (Food and Agriculture Organization of the United Nations), the OIE (World Organisation for Animal Health), and the WHO (World Health Organization) described a plan for the global elimination of human rabies from dogs (GEHRD) by 2030 through the application of mass canine vaccination and human prophylaxis. Substantial progress on canine rabies elimination in the Americas provided a regional proof of concept for this plan. In 2016, WHO established a Strategic Advisory Group of Experts (SAGE) to consider new recommendations on human rabies vaccines and immune globulins, in support of the GEHRD. This is an ambitious but achievable goal. However, especially considering the poorly defined burden of human rabies in lesser developed countries, are we on track to declare zero human fatalities caused by dogs over the ensuing decade?

As an acute, progressive, incurable viral encephalitis, elimination of exposure to lyssaviruses is a fundamental feature of any agricultural, environmental, or public health plan. The GEHRD is no exception. Education of professionals and the public is a priority, especially children, who remain a highly vulnerable population at risk. While many education programs on bite prevention have been created, and multiple community knowledge, attitudes and practice surveys have been conducted, how do we evaluate their utility objectively to demonstrably affect positive change?

Somewhat unique for viral zoonoses, vaccination against rabies includes both postexposure prophylaxis (PEP) if a bite occurs and preexposure (Pre-P) for individuals determined to be at risk of exposure, such as veterinarians, animal handlers, laboratory workers, cavers, and certain travelers. During 2017, while on tour in India, a woman from Virginia was bitten by a puppy; she returned home and became the ninth person exposed to rabies virus abroad who has died from rabies in the USA since 2008. Given such incidents in highly developed countries with adequate health care resources, do we believe our discussions with travelers on bite avoidance, Pre-P considerations and PEP-seeking behavior as well as such obvious deliberations for residents within highly enzootic regions are still relevant?

At its root cause, rabies is a disease of nature. All warm-blooded vertebrates are believed to be susceptible. Uniquely, rabies is the only zoonosis in which routine laboratory examination of a suspect animal directly determines the need for immediate biomedical care to an exposed person with life-saving prophylaxis. Throughout the 20th century, sensitive and specific diagnostic methods were developed for viral detection, and safe and effective vaccines were constructed for humans, domestic animals, and free-ranging wildlife. Will such methods still be applicable today or do we need newer tools in diagnosis and immunization to better support the SAGE recommendations and the GEHRD specifically and to better appreciate aspects of rabies holistically in conservation biology, public health, and veterinary medicine?

Historically, lethal control of animal populations was employed widely in an attempt to curb rabies incidents at local, national, and regional levels. Over the years, substantial evidence has mounted that seriously questions the basis for the killing of healthy animals in response to rabies concerns on firm ethical, ecological, and economic grounds. Clearly, the rationale for the GEHRD lies in the resulting herd immunity from vaccinated dogs en masse and the prophylaxis of exposed persons. Unfortunately, reports of inhumane and ineffective culling continue to surface. What needs to occur to reverse such incidents and promote more modern economical and efficacious means of rabies prevention and control?

In this Special Issue, we will focus upon applied research, clinical studies, and case reports that contribute to relevant improvements in the laboratory-based surveillance, epidemiology, pathogen discovery, prophylaxis, and related aspects of the GEHRD towards the realization of broader disease prevention, control, and elimination actions.

Much remains to be accomplished; we value your involvement to date and look forward to your additional provocative scientific contributions towards this trans-disciplinary subject.

Dr. Charles E. Rupprecht
Guest Editor

Manuscript Submission Information

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Keywords

  • diagnosis
  • epidemiology
  • lyssavirus
  • neglected diseases
  • prophylaxis
  • rabies
  • surveillance
  • vaccine
  • viral infections
  • zoonosis

Published Papers (3 papers)

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Research

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Open AccessArticle
Development of a Non-Meat-Based, Mass Producible and Effective Bait for Oral Vaccination of Dogs against Rabies in Goa State, India
Trop. Med. Infect. Dis. 2019, 4(3), 118; https://doi.org/10.3390/tropicalmed4030118 - 04 Sep 2019
Abstract
Introduction: To achieve the global goal of canine-mediated human rabies elimination by 2030 there is an urgent need to scale-up mass dog vaccination activities in regions with large dog populations that are difficult to access; a common situation in much of India. Oral [...] Read more.
Introduction: To achieve the global goal of canine-mediated human rabies elimination by 2030 there is an urgent need to scale-up mass dog vaccination activities in regions with large dog populations that are difficult to access; a common situation in much of India. Oral rabies vaccination may enable the vaccination of free-roaming dogs that are inaccessible to parenteral vaccination, and is considered a promising complementary measure to parenteral mass dog vaccination campaigns. WHO and OIE have published detailed minimum requirements for rabies vaccines and baits to be used for this purpose, requiring that baits must not only be well-accepted by the target population but must also efficiently release the vaccine in the oral cavity. For oral rabies vaccination approaches to be successful, it is necessary to develop baits which have a high uptake by the target population, are culturally accepted and amenable to mass production. The aim of this study was to compare the interest and uptake rates of meat-based and an egg-based prototype bait constructs by free roaming dogs in Goa, India. Methods: Three teams randomly distributed two prototype baits; an egg-flavoured bait and a commercial meat dog food (gravy) flavoured bait. The outcomes of consumption were recorded and compared between baits and dog variables. Results: A total of 209 egg-bait and 195 gravy-bait distributions were recorded and analysed. No difference (p = 0.99) was found in the percentage of dogs interested in the baits when offered. However, significantly more dogs consumed the egg-bait than the gravy-bait; 77.5% versus 68.7% (p = 0.04). The release of the blue-dyed water inside the sachet in the oral cavity of the animals was significant higher in the dogs consuming an egg-bait compared to the gravy-bait (73.4% versus 56.7%, p = 0.001). Conclusions: The egg-based bait had a high uptake amongst free roaming dogs and also enabled efficient release of the vaccine in the oral cavity, whilst also avoiding culturally relevant materials of bovine or porcine meat products. Full article
(This article belongs to the Special Issue Lyssaviruses and Rabies: Prevention, Control and Elimination)
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Open AccessArticle
Cost Savings of Using Updated Thai Red Cross Intradermal Regimen in a High-Throughput Anti-Rabies Clinic in New Delhi, India
Trop. Med. Infect. Dis. 2019, 4(1), 50; https://doi.org/10.3390/tropicalmed4010050 - 22 Mar 2019
Cited by 1
Abstract
Replacement of the Essen intramuscular (EIM) by the updated Thai Red Cross intradermal (UTRCID) regimen for rabies post-exposure prophylaxis (PEP), in high-throughput hospitals of India, has been advocated since 2006 thanks to its cost-effectiveness. However, several anti-rabies clinics in India and other parts [...] Read more.
Replacement of the Essen intramuscular (EIM) by the updated Thai Red Cross intradermal (UTRCID) regimen for rabies post-exposure prophylaxis (PEP), in high-throughput hospitals of India, has been advocated since 2006 thanks to its cost-effectiveness. However, several anti-rabies clinics in India and other parts of the world have not initiated this switchover of regimens because of the paucity of financial literature, generated in realistic settings, regarding the same. We calculated the procurement costs of various items required for providing rabies vaccinations via the EIM regimen and UTRCID regimen, on an annual basis, a year before and after the switchover. From a healthcare provider’s perspective, the cost of vaccination per patient was calculated to be 5.60 USD for the EIM regimen and 2.40 USD for the UTRCID regimen. The switchover to the UTRCID regimen from the EIM regimen reduced the financial burden of the rabies vaccination by almost 60%. Procurement of vaccine vials contributed to the majority of the cost (>94%) in both of the regimens. Procurement of syringes with fixed needles contributed negligibly (<6%) to the financial burden in both the regimens. A policy to progressively switch over to the UTRCID regimen from the EIM in all high-throughput anti-rabies centers of India would dramatically reduce the economic burden of running a successful anti-rabies program. Full article
(This article belongs to the Special Issue Lyssaviruses and Rabies: Prevention, Control and Elimination)
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Review

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Open AccessReview
Zero Endemic Cases of Wildlife Rabies (Classical Rabies Virus, RABV) in the European Union by 2020: An Achievable Goal
Trop. Med. Infect. Dis. 2019, 4(4), 124; https://doi.org/10.3390/tropicalmed4040124 - 30 Sep 2019
Abstract
The elimination of rabies transmitted by Classical Rabies Virus (RABV) in the European Union (EU) is now in sight. Scientific advances have made it possible to develop oral vaccination for wildlife by incorporating rabies vaccines in baits for foxes. At the start of [...] Read more.
The elimination of rabies transmitted by Classical Rabies Virus (RABV) in the European Union (EU) is now in sight. Scientific advances have made it possible to develop oral vaccination for wildlife by incorporating rabies vaccines in baits for foxes. At the start of the 1980s, aerial distribution of vaccine baits was tested and found to be a promising tool. The EU identified rabies elimination as a priority, and provided considerable financial and technical resources to the infected EU Member States, allowing regular and large-scale rabies eradication programs based on aerial vaccination. The EU also provides support to non-EU countries in its eastern and south eastern borders. The key elements of the rabies eradication programs are oral rabies vaccination (ORV), quality control of vaccines and control of their distribution, rabies surveillance and monitoring of the vaccination effectiveness. EU Member States and non-EU countries with EU funded eradication programs counted on the technical support of the rabies subgroup of the Task Force for monitoring disease eradication and of the EU Reference Laboratory (EURL) for rabies. In 2018, eight rabies cases induced by classical rabies virus RABV (six in wild animals and two in domestic animals) were detected in three EU Member States, representing a sharp decrease compared to the situation in 2010, where there were more than 1500 cases in nine EU Member States. The goal is to reach zero cases in wildlife and domestic animals in the EU by 2020, a target that now seems achievable. Full article
(This article belongs to the Special Issue Lyssaviruses and Rabies: Prevention, Control and Elimination)
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