Rabies in the Caribbean

Seetahal Janine F.R., Pradel Jennifer, Carrington Christine V.F., Louison Bowen, Roopnarine Rohini, Van Sauers Astrid, James Colin, Millien Max, Rupprecht Charles E., Vokaty Alexandra. 2015. Rabies in the Caribbean. In : Changing viruses in a changing world. CIRAD, ESVV, EPIZONE European Research Group. Montpellier : CIRAD, Résumé, 149-151. International Congress for Veterinary Virology. 10, Montpellier, France, 31 Août 2015/3 Septembre 2015.

Note générale : A l'occasion de ce congrès, s'est également déroulé le 9th Annual Meeting of EPIZONE, August 31st - September 3rd 2015, Montpellier, France

Résumé : Objective: The Pan American Health Organization (PAHO) regional program introduced to Latin America and the Caribbean (LAC) in 1983 was ratified in 2009 with the goal of eliminating dog-transmitted human rabies by 2015. Despite a >90% decrease in cases, the latter has been extended to 2018 due to persistence in certain areas. In discussions about rabies, LAC are often grouped as one. However, data from Latin America generally obscures the Caribbean situation so that it is inadequately represented in the literature. The present study aims to independently analyse the rabies situation in the Caribbean through use of an internal Caribbean Network (Caribbean Animal Health Network), and to examine the changing epidemiology of the disease in comparison to Latin America. Methods: A questionnaire was developed and administered in February 2014, to the 33 countries or territories of the Caribbean Animal Health Network (CaribVET), through the Adobe Forms Central Web-based platform. Country submissions were collected from April 2014 to June 2015. Responses from30 countries were analysed from June to July 2015 and results were summarized into a regional situation analysis. Complementary information was obtained through a comprehensive literature review using internet searches and the institutional libraries of the PAHO Office in Trinidad and Tobago and the Caribbean Public Health Agency (CARPHA). Selected literature was then summarized and collated with questionnaire responses. Results: Rabies is a notifiable disease in almost all islands and territories of the Caribbean region, where the disease is present in ten countries and/territories (Trinidad and Tobago, Belize, Grenada, Guyana, Suriname, Cuba, Puerto Rico, Dominican Republic, French Guiana and Haiti). In most instances, the disease is endemic in wildlife with periodic spill over into domestic animals; however urban (canine) rabies still occurs in Hispaniola (Dominican Republic and Haiti) and Cuba. Caribbean sylvatic rabies is maintained by two main reservoir hosts, the vampire bat and the mongoose. The main reservoir host is the mongoose in Grenada, Puerto Rico and Cuba, and the vampire bat in Trinidad and Tobago, Guyana, Suriname, Belize and French Guiana. In four (40%) rabies endemic Caribbean countries and/territories (French Guiana, Dominican Republic, Haiti, Cuba) human cases have occurred within the last 10 years. The estimated number of human rabies cases per year was highest in Haiti (6-10 cases) and lowest in French Guiana (0-1 cases). Sporadic human cases also occur in Suriname every 8-10 years, with the last case reported in 1998. Rabies cases were reported in the animal population, within the last 10 years, in all endemic countries except Suriname (last case reported in 2002). The average number of cases reported per year ranged from 0-1 (French Guiana) to 90 (Cuba). Cattle were the most significantly affected species, particularly in countries with vampire bat rabies. Human bite incidents from potential rabies vectors are reportable in 8 (80%) rabies endemic countries, (excluding Trinidad and Tobago and Suriname) and in 8 (40%) non-endemic countries. In contrast, animal bite incidents are reportable in 7 (70%) endemic versus 6 (30%) non-endemic countries. All endemic countries/territories (except Suriname) have passive or enhanced passive surveillance programs for animal rabies. Active surveillance in the stray domestic carnivore population is carried out in Cuba, Haiti, Dominican Republic and Grenada, whereas active surveillance is conducted in wildlife (bats and mongoose) exclusively in Trinidad and Puerto Rico. None of the non-endemic countries conduct rabies diagnostic testing for humans or animals. Among endemic countries, only Cuba, Dominican Republic and Puerto Rico conduct human rabies diagnostics, and all but Belize, Suriname and Guyana conduct animal rabies diagnostics. Most rabies-free countries did not implement rabies control programs to attain their disease free status and the risk of rabies introduction was considered by the local veterinary authorities to be low in 60% of these countries, with illegal importation of dogs being the most relevant route. Conversely, national legislation for animal rabies control and prevention exists in all endemic countries apart from Haiti, Belize and Suriname. Animal vaccination strategies for the prevention and control of rabies in the Caribbean, mainly target bovine and domestic carnivore animal populations, and governments provide vaccines free of charge in most (60%) rabies endemic countries. Annual mass vaccination programmes are carried out for both cattle and domestic carnivores (dogs and cats) in French Guiana, Grenada, Puerto Rico and Belize. The domestic carnivore populations are targeted in Cuba, the Dominican Republic and Haiti with estimated vaccine coverages of >90%, 80% and 40-50% respectively. The bovine population in Trinidad is largely covered by herd immunity with 70% vaccine coverage, compared to the 10% in Guyana that vaccinates only in outbreak situations. Vaccination is legislatively mandatory for the bovine population of Trinidad, and for both the bovine and domestic carnivore populations in French Guiana. Almost all countries in the Caribbean have rabies import health restrictions. In these countries the most regulated species are dogs and cats, with rabies vaccination being a requirement for entry. Countries without rabies related import restrictions are Grenada, Dominican Republic, Puerto Rico and Sint Eustatius. Conclusion: Canine-transmitted rabies occurs only on two Caribbean islands (Hispaniola and Cuba) compared to five countries in Latin America (Brazil, Bolivia, Peru, Honduras and Guatemala) with disease control in Haiti presenting the major challenge to elimination in the Caribbean. As of 2004, the prevalence of rabies transmitted by wildlife in the Americas exceeded that of domestic dogs which is mainly reflective of bat-transmitted cases in North and Latin America. However, although the mongoose is the main rabies reservoir host in 30% of endemic Caribbean countries, it is often overlooked as a vector in the LAC literature due to the ubiquitous presence of the vampire bat in Latin America. Furthermore, although vampire rabies predominates among existing reports in humans and domestic animals, other bat species should not be excluded from routine surveillance activities when warranted, as they have previously been implicated in rabies viral transmission in the region. Therefore, the long term objectives of rabies elimination programs in LAC therefore need to take into account the diverse rabies epidemiology within the Caribbean. Results of this study underscore the importance of regional animal health networks such as CaribVET in coordinating expertise and resources, facilitating regional training and sharing of information and knowledge. The Caribbean has limited rabies diagnostic capacity compared to Latin America. However, regional collaboration through CaribVET can increase the laboratory capability in countries without independent diagnostic facilities. Also a recent regional training workshop organized by CaribVET resulted in standardization of the rabies diagnostic testing regime throughout the Caribbean which will increase confidence in results. Regional collaboration can also facilitate the development of common protocols and regulations for the control and prevention of rabies in countries with similar epidemiological circumstances.

Classification Agris : L73 - Maladies des animaux
S50 - Santé humaine

Auteurs et affiliations

• Seetahal Janine F.R., UWI (TTO)
• Pradel Jennifer, CIRAD-BIOS-UMR CMAEE (GLP)
• Carrington Christine V.F., UWI (TTO)
• Louison Bowen, Ministry of Agriculture, Lands, Forestry and Fisheries (Grenade) (GRD)
• Roopnarine Rohini, St George's University (GRD)
• Van Sauers Astrid, Ministry of Agriculture, Animal Husbandry and Fisheries (Suriname) (SUR)
• James Colin, Ministère de l'agriculture, des ressources naturelles et du développement rural (Haïti) (HTI)
• Millien Max, Ministry of Agriculture (Haïti) (HTI)
• Rupprecht Charles E., Wistar Institute (USA)
• Vokaty Alexandra, Pan American Health Organization (TTO)

Source : Cirad-Agritrop (https://agritrop.cirad.fr/583681/)

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