WHO Expert Consultation

27 Sept 12

A recent World Health Organization (WHO) International Expert Consultation on rabies urged countries where canine rabies is endemic to initiate and strengthen their rabies prevention and control activities, and to increase the level of awareness about the disease, particularly among children. It noted that under reporting and misdiagnosis of human rabies cases, and problems of access to post-exposure prophylaxis (PEP) in rural areas where dog rabies is uncontrolled remain big problems.

Around 70 participants attended the Consultation held at WHO’s headquarters in Geneva, Switzerland, on 18–20 September 2012. Participants discussed a wide range of topics including a review of the rabies situation in domestic and wild animals in endemic countries, laboratory diagnosis techniques, the management of rabid patients, rabies biological products, the need for immediate wound treatment and full effective PEP, and the economic burden of the disease.

“A re-assessment of the burden of rabies made during the meeting showed that 50 000 people, mostly in Africa and Asia, still die in spite of 20 million others receiving PEP worldwide,” said Dr François Meslin, Team Leader for Neglected Zoonotic Diseases at WHO’s Department of Control of Neglected Tropical Diseases. “Data show that the majority of fatal cases involve people from poor, rural communities without access to dog bite management  centres and rabies biologicals. Also, too many PEP delivered in the world today are not administered to the right people.”

It was recommended that national rabies control programmes involve the animal and public health sectors as well as other sectors such as education, local government, police and civil society, particularly animal welfare and conservation associations. Research into the socioeconomic challenges of implementing rabies control and the potential for integration of rabies control into that of other canine transmitted diseases (such as echinococcosis and leishmaniasis) was called for.

Having reviewed recent successful canine rabies control programmes in Africa, Asia and Latin America, the consultation urged WHO to continue to advocate for human rabies prevention through the elimination of rabies in dogs and to promote a wider use of the intradermal route for PEP, which reduces volume and the cost of cell-cultured vaccine by 60% to 80%. WHO’s target, as outlined in its NTD roadmap (published in January 2012) is to eliminate human and dog rabies in all Latin American countries by 2015 and human rabies transmitted by dogs in South-East Asia by 2020.

Based on the news story available on the WHO website here.