Progress towards dog-mediated rabies elimination in PR China:a scoping review

Background Rabies continues to be a serious threat to global public health endangering people’s health and public health safety.In the People’s Republic of China,multi-sectoral and comprehensive prevention and control strategies have aimed to extensively curb human rabies transmission.Here,we examine the current state of rabies infection in China,explore strategic interventions put in place in response to WHO’s ambition of“Zero rabies deaths by 2030”and critically assess the constraints and feasibility of dog-mediated rabies elimination in China.Methods This study analyzed and evaluated the process towards dog-mediated rabies elimination in China from five perspectives:namely,human,dog,policy,challenge,and prospects.Evidence-based data on progress of dog-mediated rabies elimination in China was derived from a number of sources;a literature search was undertaken using PubMed,Web of Science and CNKI databases,distribution data for human rabies cases as derived from the Data-center of the China Public Health Science and policy and document data were obtained from official websites of the relevant China ministries and commissions.Results The incidence of human rabies cases in China have shown a downward trend year-on-year since 2007.Implementation of a government-led,multi-sectoral“One Health”approach to combating rabies has driven down the total number of rabies deaths nationwide to around 200 in 2020.The number of provincial-level administrative divisions(PLADs)reporting human cases of rabies has also decreased to 21 in 2020,13 of which reported less than 10 cases.Furthermore,the number of outpatient visits seeking rabies post-exposure prophylaxis has risen dramatically over the past two decades,with demand being 15 times higher than it was initially.There remain however,significant gaps in rabies elimination outcomes across the different regions of China.To date the target of achieving a canine rabies vaccination rate of>75%has not been met.The challenges of rabies immunization of dogs and dog management in underdeveloped cities and rural areas need to be addressed together with more effective animal surveillance and rabies risk from and too wildlife and livestock.Conclusions The Chinese government-led,multi-sectoral“One Health”approach to combating rabies and has made significant progress over the past decade.Development and adoption of more cost-effective One Health strategies can achieve more nationally beneficial rabies elimination outcomes.The ambitious target of“Zero rabies deaths by 2030”can be met through establishment of long-lasting herd immunity in dogs by means of dog mass vaccination campaigns,dog population management,epidemiological surveillance and the application of large-scale oral rabies vaccine to eliminate rabies in wild animals coupled with deployment of cost-effective human post-exposure prophylaxis,and community education.

SARS-CoV-2 and Zoonotic Preparedness:Unknown Knowns?

Emerging infectious diseases(EIDs)with pandemic potential are a major threat to global health security and the global economy.Prevention,preparedness,and response to EIDs within hotspots for EIDs is considered a global public service.In December 2019,coronavirus disease 2019 came under the spotlight;caused by a novel single-stranded RNA coronavirus,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).The rapidity at which the virus spread worldwide has been remarkable and the global response to the pandemic unprecedented.The rate of emergence of infectious diseases of zoonotic origin is increasing.Multiple new pathogens have emerged or reemerged over the past few decades,many of viral origin,of which 75%are considered to have originated in animals.1 Before SARSCoV-2,globally,around 1 billion zoonotic infections occurred in humans each year of which around 0.1%resulted in death.1 Prominent examples of EIDs include acquired immunodeficiency syndrome,Ebola and Marburg hemorrhagic fevers,Escherichia coli O157 infection,Middle East respiratory syndrome(MERS),and severe acute respiratory syndrome(SARS).