Asian Scientist Magazine (Nov. 01, 2023) — One in every three rabies deaths in the world occur in India, with a majority of them attributed to dog bites. India’s rabies problem is exacerbated by unvaccinated stray dogs and lack of local government systems to control dogs known to attack people on the streets. Further, due to severe underreporting of rabies cases, scientists and policymakers lack insights into the true prevalence of rabies virus in stray dog populations.
This poses a huge challenge to India’s goal of eradicating rabies deaths by 2030. It also impedes the country’s progress towards One Health, an emerging paradigm to simultaneously improve the health of people, animals, and ecosystems. Monitoring zoonotic diseases to prevent outbreaks is an important aspect of One Health.
Stray dog populations deserve particular attention as they constitute a large reservoir of rabies and their poop harbours other disease-causing organisms. Abi Tamim Vanak, an animal ecologist at the Ashoka Trust for Research in Ecology and the Environment (ATREE), worked with RESQCT, a Pune-based NGO to map rabies in the city.
In a four-year study published in the journal CABI One Health, the team repurposed RESQCT’s rescue system into a rabies monitoring tool.
“We are massively underestimating the presence of rabies in Indian cities,” Vanak told Asian Scientist Magazine.
RESQCT has a phone line and web line through which Pune residents report sick, aggressive, or injured animals including domestic animals. Between 2017-2021, it received over 1,100 calls for suspected rabies cases in dogs. Of these, nearly two-thirds were confirmed, constituting an ongoing rabies outbreak in the city. Most of the cases were seen in stray dogs.
Some dogs that were brought in for head injuries or ear infections also tested positive for rabies. In the absence of a monitoring system, these dogs might have never been diagnosed with rabies.
Over 1 in every 10 dogs that tested positive for rabies were found to have been neutered. Since dogs are generally vaccinated before neutering, these dogs were likely vaccinated at least once. The high rates of rabies in neutered dogs suggested that most of them did not receive booster shots. This is explained by the fact that neither government authorities nor NGOs keep track of revaccinations.
One in every 20 dogs tested positive were pets: a significant proportion of dog owners are not vaccinating or revaccinating their pets. When a canine rabies case was confirmed, the team conducted vaccination drives in the area the dog was captured from and provided people living there with educational material on anti-rabies treatment. As a result, over 20,000 people were sensitized about rabies and its rabies treatment, and a greater number of dogs were vaccinated.
Vaccination, however, isn’t sufficient. Pune, for example, has a long history of Animal Birth Control (ABC) programs that include mass vaccination drives. An outbreak despite these measures shows that vaccination and neutering don’t lead to any significant declines in stray dog populations or rabies cases.
A One Health approach like the one described in the study equips researchers to assess the effectiveness, or lack thereof, of different prevention measures. Relying on citizen reports, the passive monitoring approach still underestimates the extent of rabies. But, if implemented on a larger scale, it could allow authorities to prioritize areas to focus resources on.
On the contrary, active surveillance by randomly sampling stray dogs and testing them for rabies provides a more detailed picture. It would require euthanizing these dogs as rabies can only be confirmed in dead animals. However, Indian regulations don’t permit euthanasia of even rabid dogs let alone for zoonotic surveillance.
Vanak stressed that India should do away with these regulations to enable evidence-based, active rabies surveillance. In the spirit of One Health, different stakeholders need to come together.
“Veterinarians, medical health practitioners, and public health professionals need to include ecologists when designing surveillance systems”, Vanak added.
Source: Ashoka Trust for Research in Ecology and the Environment (ATREE) ; Image: Shutterstock
The paper can be found at: A passive ‘One Health’ surveillance system to track canine rabies in urban India
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