The prevention of human rabies is dependent upon the effective and verifiable control of the disease within the domestic dog population, being the most common reservoir of the virus and cause of 99% of human cases. Dog-mediated human rabies is completely preventable using biologicals and tools that could be accessible even in low-resource settings. Public awareness, health education, dog vaccination and the availability and accessibility of PEP are key for rabies prevention and control.
Rabies vaccine banks have begun to support countries in their control efforts, providing incentive for them to engage in and leverage investments. A vaccine bank for dog vaccination in Asia has been set up by OIE, and by WHO in South Africa. National mass dog vaccination campaigns are the most cost-effective strategy for preventing rabies. At least 70% of the dog population must be vaccinated in order to break the cycle of transmission in dogs and to humans. Preventing human rabies through control of domestic dog rabies is a realistic goal for large parts of Africa and Asia where rabies is a significant public health issue, and is justified financially by the future savings of discontinuing post-exposure prophylaxis for people.
The elimination of rabies however, requires several components in addition to mass vaccination, including the effective engagement of communities and policymakers, dog population assessment and management, and surveillance capacity and legislation.
WHO strategies for dog rabies control and eventual elimination:
- WHO promotes organization of sustainable mass dog vaccination campaigns and dog population management through reduction of stray populations (by implementing animal-birth-control programs); control of trade and movement of dogs
- Oral vaccination of domestic carnivores as dog accessibility to vaccination by the parenteral route is one of the major obstacles for dog rabies control in many different parts of the world. WHO has stimulated studies on oral vaccination of dogs (OVD) and the development of safer and effective vaccines and baits for OVD.
- More information on animal vaccines
WHO strategies for human rabies prevention:
- WHO promotes wider access to appropriate post-exposure treatment using the cost-effective multi-site intradermal regimen with modern tissue culture or avian embryo-derived rabies vaccines
- Possible domestic production of rabies biologicals, particularly rabies immunoglobulin, which are in critical short supply globally
- Continual education of health and veterinary professionals in rabies prevention and control
- Public health educational strategies at the community level within endemic regions
- WHO's strategy for pre and post exposure vaccination