Transmission dynamics and prospects for the elimination of canine rabies.
Transmission dynamics and prospects for the elimination of canine rabies.
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DOI：
10.1371/journal.pbio.1000053
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发表时间：
2009-03-10
期刊：
影响因子：
9.8
通讯作者：
Dobson A
中科院分区：
文献类型：
--
作者：
Hampson K;Dushoff J;Cleaveland S;Haydon DT;Kaare M;Packer C;Dobson A
狂犬病已经从西欧和北美的家犬种群中消灭，但每年仍在非洲和亚洲杀死成千上万的人。对国内犬种群传播动力学的定量了解为评估全球消除犬狂犬病是否可能提供了关键信息。我们报告了对坦桑尼亚个别狂犬病动物的广泛观察，并对传播生物学进行了独特的详细分析，解释了重要的流行病学特征，包括流行病轨迹的变化程度。我们发现，狂犬病的基本生殖数R0在我们的研究区域非洲农村（1.2）和整个历史全球范围（<2）非常低。这一发现为通过疫苗接种控制地方性犬狂犬病的可行性提供了强有力的支持，即使在野生动物区附近也有大量的野生食肉动物种群。然而，我们发现，国内犬种群的快速周转一直是发展中国家成功控制的主要障碍，因此需要定期脉冲接种疫苗，以保持运动之间的人群水平的免疫力。尽管如此，我们的分析表明，通过持续的国际承诺，全球范围内消除家犬种群中的狂犬病，这是对人类最危险的媒介，是一个现实的目标。犬狂犬病已在西欧和北美成功消除，但在发展中国家，每十分钟就有一人死于这种可怕的疾病，这种疾病主要由家犬传播。定量了解狂犬病在家犬种群中的传播动力学对于确定是否能够实现全球消除至关重要。在坦桑尼亚北方的狂犬病爆发期间，狂犬病的独特病理学使我们能够直接追踪病例间的传播。从这些不寻常的数据中，我们对狂犬病传播生物学进行了详细分析，并发现了令人惊讶的低水平传播的证据。我们还分析了来自世界各地的疫情数据，发现犬狂犬病的传播在其全球历史范围内一直很低，这解释了发达国家控制工作的成功。然而，我们发现，当家犬种群的出生率和死亡率很高时，例如在坦桑尼亚的研究种群中，在疫苗接种活动之间维持群体水平的免疫力就更加困难。尽管如此，我们的结论是，尽管所需的疫苗接种覆盖率水平高于天真的传播模型预测，全球消除犬狂犬病可以通过适当设计，持续的国内犬疫苗接种运动。非洲农村和其他地方的低传播率表明，持续、适当设计的家犬疫苗接种运动可能导致全球消除犬狂犬病，每年将挽救5万多人的生命。
Rabies has been eliminated from domestic dog populations in Western Europe and North America, but continues to kill many thousands of people throughout Africa and Asia every year. A quantitative understanding of transmission dynamics in domestic dog populations provides critical information to assess whether global elimination of canine rabies is possible. We report extensive observations of individual rabid animals in Tanzania and generate a uniquely detailed analysis of transmission biology, which explains important epidemiological features, including the level of variation in epidemic trajectories. We found that the basic reproductive number for rabies, R0, is very low in our study area in rural Africa (∼1.2) and throughout its historic global range (<2). This finding provides strong support for the feasibility of controlling endemic canine rabies by vaccination, even near wildlife areas with large wild carnivore populations. However, we show that rapid turnover of domestic dog populations has been a major obstacle to successful control in developing countries, thus regular pulse vaccinations will be required to maintain population-level immunity between campaigns. Nonetheless our analyses suggest that with sustained, international commitment, global elimination of rabies from domestic dog populations, the most dangerous vector to humans, is a realistic goal. Canine rabies has been successfully eliminated from Western Europe and North America, but in the developing world, someone dies every ten minutes from this horrific disease, which is primarily spread by domestic dogs. A quantitative understanding of rabies transmission dynamics in domestic dog populations is crucial to determining whether global elimination can be achieved. The unique pathology of rabies allowed us to trace case-to-case transmission directly, during a rabies outbreak in northern Tanzania. From these unusual data, we generated a detailed analysis of rabies transmission biology and found evidence for surprisingly low levels of transmission. We also analysed outbreak data from around the world and found that the transmission of canine rabies has been inherently low throughout its global historic range, explaining the success of control efforts in developed countries. However, we show that when birth and death rates in domestic dog populations are high, such as in our study populations in Tanzania, it is more difficult to maintain population-level immunity in between vaccination campaigns. Nonetheless, we conclude that, although the level of vaccination coverage required is higher than would be predicted from naïve transmission models, global elimination of canine rabies can be achieved through appropriately designed, sustained domestic dog vaccination campaigns. Low transmission rates in rural Africa and elsewhere suggest that sustained, appropriately designed domestic dog vaccination campaigns could lead to global elimination of canine rabies, which would save over 50,000 human lives per year.
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影响因子：
4.2
作者：
Kitala, PM;McDermott, JJ;Dye, C
通讯作者：
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DOI：
10.1098/rspb.2002.2191
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2003-01-22
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