From dogs to bats: Concerns regarding vampire bat-borne rabies in Brazil

Abstract

BackgroundAU : Pleaseconfirmthatallheadinglevelsarerepresentedcorrectly: Human rabies is a neglected reemerging disease that has a major impact on public health in poor communities and low- and middle-income countries [1]. With a lethality of almost 100% worldwide, rabies has an incidence of approximately 59,000 cases per year in 150 countries [2]. Rabies is transmitted by exposure to the saliva of infected animals, and it is 100% vaccine preventable [3]. Every year, more than 15 million people worldwide receive pre-exposure prophylaxis and 29 million receive a post-bite vaccination, which is estimated to prevent thousands of rabies deaths annually [2]. With a worldwide distribution of cases of the disease, the largest number occur in Asia and Africa, which together account for 95% of all human cases, with 99% acquired from the bite of an infected dog [4]. Globally, canine rabies causes approximately 59,000 human deaths annually [5]. Vaccination is the main effective strategy for preventing fatal viral diseases. Considering the dog-mediated urban cycle in areas of high endemicity, the only way to stop the transmission of rabies is to vaccinate at least 80% of the canine population [6]. Vaccinating the highest number of dogs in a region creates herd immunity, slowing the progression of rabies infections among dogs, and reducing the chances of transmission. In Americas, approximately 100 million dogs are vaccinated annually. Furthermore, the World Health Organization has implemented the global strategic plan to end human deaths from dog-mediated rabies by 2030, focusing on the regional goal of eliminating rabies by strengthening programs to improve their surveillance and vaccination coverage for dogs in the areas most at risk [6]. Considering the growing importance of the sylvatic cycle where the RABV lineages are maintained in different independent epidemiologic cycles in the Americas by wild animals, particularly chiropterans [7], in this article, we will discuss the change in the epidemiological profile of rabies in Brazil, from dogs to bats as the main reservoirs of the disease today and how this impacts the surveillance and disease control actions.