Designing programs for eliminating canine rabies from islands: Bali, Indonesia as a case study

Townsend, S.E. et al. (2013) Designing programs for eliminating canine rabies from islands: Bali, Indonesia as a case study. PLoS Neglected Tropical Diseases, 7(8), e2372. (doi:10.1371/journal.pntd.0002372)

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Publisher's URL: http://dx.doi.org/10.1371/journal.pntd.0002372

Abstract

<p>Background: Canine rabies is one of the most important and feared zoonotic diseases in the world. In some regions rabies elimination is being successfully coordinated, whereas in others rabies is endemic and continues to spread to uninfected areas. As epidemics emerge, both accepted and contentious control methods are used, as questions remain over the most effective strategy to eliminate rabies. The Indonesian island of Bali was rabies-free until 2008 when an epidemic in domestic dogs began, resulting in the deaths of over 100 people. Here we analyze data from the epidemic and compare the effectiveness of control methods at eliminating rabies.</p> <p>Methodology/Principal Findings: Using data from Bali, we estimated the basic reproductive number, R0, of rabies in dogs, to be ~1·2, almost identical to that obtained in ten–fold less dense dog populations and suggesting rabies will not be effectively controlled by reducing dog density. We then developed a model to compare options for mass dog vaccination. Comprehensive high coverage was the single most important factor for achieving elimination, with omission of even small areas (<0.5% of the dog population) jeopardizing success. Parameterizing the model with data from the 2010 and 2011 vaccination campaigns, we show that a comprehensive high coverage campaign in 2012 would likely result in elimination, saving ~550 human lives and ~$15 million in prophylaxis costs over the next ten years.</p> <p>Conclusions/Significance: The elimination of rabies from Bali will not be achieved through achievable reductions in dog density. To ensure elimination, concerted high coverage, repeated, mass dog vaccination campaigns are necessary and the cooperation of all regions of the island is critical. Momentum is building towards development of a strategy for the global elimination of canine rabies, and this study offers valuable new insights about the dynamics and control of this disease, with immediate practical relevance.</p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Haydon, Professor Daniel and Cleaveland, Professor Sarah and Hampson, Dr Katie and Shand, Mr Michael and Townsend, Dr Sunny
Authors: Townsend, S.E., Sumantra, I.P., Pudjiatmoko, , Bagus, G.N., Brum, E., Cleaveland, S., Crafter, S., Dewi, A.P.M., Dharma, D.M.N., Dushoff, J., Girardi, J., Gunata, I.K., Hiby, E.F., Kalalo, C., Knobel, D.L., Mardiana, I.W., Putra, A.A.G., Schoonman, L., Scott–Orr, H., Shand, M., Sukanadi, I.W., Suseno, P.P., Haydon, D.T., and Hampson, K.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2727
ISSN (Online):1935-2735
Copyright Holders:Copyright © 2013 The Authors
First Published:First published in PLoS Neglected Tropical Diseases 7(8):e2372
Publisher Policy:Reproduced under a Creative Commons License
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
508041Understanding how a complex intervention works: designing large-scale vaccination programsDaniel HaydonMedical Research Council (MRC)G0901135/91914RI BIODIVERSITY ANIMAL HEALTH & COMPMED
569041Hierarchical epidemiology: the spread and persistence of infectious diseases in complex landscapesKatie HampsonWellcome Trust (WELLCOME)095787/Z/11/ZRI BIODIVERSITY ANIMAL HEALTH & COMPMED