Rabies control in KwaZulu-Natal, South Africa.

PROBLEM: Urbanization, large dog populations and failed control efforts have contributed to continuing endemicity of dog-mediated rabies in KwaZulu-Natal province, South Africa. APPROACH: From 2007 to 2014 we used a OneHealth approach to rabies prevention, involving both the human and animal health sectors. We implemented mass vaccination campaigns for dogs to control canine rabies, and strategies to improve rabies awareness and access to postexposure prophylaxis for people exposed to rabies. LOCAL SETTING: A rabies-endemic region, KwaZulu-Natal is one of the smallest and most populous South African provinces (estimated population 10 900 000). Canine rabies has persisted since its introduction in 1976, causing an average of 9.2 human rabies cases per annum in KwaZulu-Natal from 1976 to 2007, when the project started. RELEVANT CHANGES: Between 2007 and 2014, the numbers of dog vaccinations rose from 358 611 to 395 000 and human vaccines purchased increased form 100 046 to 156 996. Strategic dog vaccination successfully reduced rabies transmission within dog populations, reducing canine rabies cases from 473 in 2007 to 37 in 2014. Actions taken to reduce the incidence of canine rabies, increase public awareness of rabies and improve delivery of postexposure prophylaxis contributed to reaching zero human rabies cases in KwaZulu-Natal in 2014. LESSONS LEARNT: Starting small and scaling up enabled us to build strategies that fitted various local settings and to successfully apply a OneHealth approach. Important to the success of the project were employing competent, motivated staff, and providing resources, training and support for field workers.

Global rabies control: the role of international organisations and the Global Strategic Plan to eliminate dog-mediated human rabies.

International partners are united to reach the shared goal of zero dog-mediated human rabies deaths by 2030, worldwide. Under the Tripartite collaboration, the World Health Organization, the World Organisation for Animal Health and the Food and Agriculture Organization of the United Nations are prioritising rabies as a model for 'One Health' in action. In 2015, the Global Rabies Conference led to the development of the Global Framework for the Elimination of Dog-Mediated Human Rabies. This long-term strategy centres around five pillars of rabies elimination (STOP-R): i) Sociocultural; ii) Technical; iii) Organisational; iv) Political; and v) Resources. Together with their partners, the Tripartite are working to operationalise the Framework through: i) engaging communities to build rabies awareness; ii) strengthening human and animal health systems, surveillance, and providing proof of concept that rabies elimination is feasible; iii) promoting intersectoral and regional collaboration; iv) advocating for political engagement and support; and v) building the case for investment through public-private partnerships and a Global Strategic Plan to end human deaths from dog-mediated rabies. By creating an enabling environment for countries to prioritise rabies and implement existing tools, the Tripartite are committed to catalysing change, empowering nations and providing the necessary support to consign rabies to the history books.

Les partenaires internationaux agissent de concert afin d'atteindre l'objectif de réduire à zéro le nombre de décès dus à la rage humaine transmise par les chiens dans le monde d'ici 2030. Dans le cadre de leur collaboration tripartite, l'Organisation mondiale de la santé, l'Organisation mondiale de la santé animale et l'Organisation des Nations Unies pour l'alimentation et l'agriculture ont fait de la rage la maladie phare de leur action gouvernée par le principe « Une seule santé ¼. En 2015, la Conférence mondiale sur la rage a abouti à la création du Cadre stratégique mondial d'élimination de la rage humaine transmise par les chiens. Cette stratégie à long terme repose sur cinq piliers visant l'élimination de la rage (STOP-R) : i) aspects socioculturels ; ii) aspects techniques ; iii) aspects organisationnels ; iv) aspects politiques ; v) ressources. Avec ses partenaires, la Tripartite met tout en oeuvre pour rendre ce cadre opérationnel, notamment à travers i) la participation des communautés à des activités de sensibilisation sur la rage ; ii) le renforcement des systèmes de santé humaine et animale, l'application de la surveillance et la démonstration de la faisabilité de l'élimination de la rage ; iii) la promotion de la collaboration intersectorielle et régionale ; iv) l'appel actif en faveur d'un engagement et d'un soutien politiques ; v) la justification de la rentabilité des investissements à travers des partenariats public-privé et un plan d'activités pour l'élimination mondiale de la rage. En créant un environnement propice permettant aux pays de prioriser la rage et de mettre en application les instruments existants, la Tripartite s'est engagée à dynamiser le changement, à donner aux pays les capacités d'agir et à fournir le soutien nécessaire pour que le rage soit un jour reléguée dans les livres d'histoire.

Una serie de asociados internacionales trabajan codo a codo para alcanzar el objetivo común de que para 2030 no haya en el mundo ninguna persona que muera de rabia transmitida por perros. Como parte de una alianza tripartita, la Organización Mundial de la Salud (OMS), la Organización Mundial de Sanidad Animal (OIE) y la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO) están otorgando prioridad a la lucha antirrábica como modelo para poner en práctica los postulados de «Una sola salud¼. En 2015, la conferencia mundial dedicada a la lucha contra la rabia culminó con la elaboración de un marco estratégico mundial para eliminar la rabia humana transmitida por perros. Se trata de una estrategia a largo plazo (STOP-R) edificada en torno a cinco grandes pilares: i) aspectos socioculturales; ii) aspectos técnicos; iii) aspectos organizativos; iv) políticas; y v) recursos. Junto con sus colaboradores, la alianza tripartita trabaja para llevar ese marco a la práctica: i) haciendo participar a las comunidades en la sensibilización respecto de la rabia; ii) fortaleciendo los sistemas sanitarios y zoosanitarios, efectuando labores de vigilancia y demostrando empíricamente que la eliminación de la rabia es un objetivo factible; iii) promoviendo la colaboración intersectorial y regional; iv) presionando para lograr el compromiso y apoyo políticos; y v) aportando argumentos en defensa de la inversión por la vía de alianzas publicoprivadas y elaborando un plan de trabajo para la eliminación de la rabia a escala mundial. La alianza tripartita, al crear condiciones propicias para que los países otorguen prioridad a la rabia y apliquen las herramientas existentes, está impulsando el cambio, dotando a las naciones de capacidad de acción y prestando el apoyo necesario para conseguir que un día la rabia quede relegada a los libros de historia.

Economic comparison of common treatment protocols and J5 vaccination for clinical mastitis in dairy herds using optimized culling decisions.

This study used an existing dynamic optimization model to compare costs of common treatment protocols and J5 vaccination for clinical mastitis in US dairy herds. Clinical mastitis is an infection of the mammary gland causing major economic losses in dairy herds due to reduced milk production, reduced conception, and increased risk of mortality and culling for infected cows. Treatment protocols were developed to reflect common practices in dairy herds. These included targeted therapy following pathogen identification, and therapy without pathogen identification using a broad-spectrum antimicrobial or treating with the cheapest treatment option. The cost-benefit of J5 vaccination was also estimated. Effects of treatment were accounted for as changes in treatment costs, milk loss due to mastitis, milk discarded due to treatment, and mortality. Following ineffective treatments, secondary decisions included extending the current treatment, alternative treatment, discontinuing treatment, and pathogen identification followed by recommended treatment. Average net returns for treatment protocols and vaccination were generated using an existing dynamic programming model. This model incorporates cow and pathogen characteristics to optimize management decisions to treat, inseminate, or cull cows. Of the treatment protocols where 100% of cows received recommended treatment, pathogen-specific identification followed by recommended therapy yielded the highest average net returns per cow per year. Out of all treatment scenarios, the highest net returns were achieved with selecting the cheapest treatment option and discontinuing treatment, or alternate treatment with a similar spectrum therapy; however, this may not account for the full consequences of giving nonrecommended therapies to cows with clinical mastitis. Vaccination increased average net returns in all scenarios.