Patterns of rabies occurrence in Bhutan between 1996 and 2009

This study was conducted to evaluate incidence and seasonal trends of rabies in dogs and other domestic animals in Bhutan from 1996 to 2009. Time series analysis approach was used to determine the seasonal trend and temporal association between species-specific rabies cases in animals. A total of 814 rabies cases were reported during the 14-year period, of which cattle and domestic dogs accounted for 55% (447/814) and 39% (317/814) of the cases, respectively. The remaining 6% of the cases (50/814) were reported in horses (2%), cats (2%), pigs (1%) and goats (1%). Rabies cases were reported throughout the year with more reports during spring and summer months. The annual patterns of cases were stable from 1996 to 2005, but the incidence increased during 2006 and 2008. Fifty-nine of the 205 sub-districts reported rabies in animals from 1996 to 2009 with increased incidences in the four districts in southern Bhutan, an area located close to the border towns of India. A significant (P < 0.05) positive cross-correlation was observed between the number of cases in dogs and other domestic animals at time lags (months) 1-3 with the highest correlation (r = 0.94, P < 0.05) observed at time lag 0 (same month) indicating that the peak in rabies incidences occur in the same month when both dogs and other domestic animal cases are reported. Regression analysis predicted rabies in other domestic animal when there are reports of rabies in dogs during the previous months. This study provides useful information about the epidemiology of rabies that can be used to plan a rabies control programme in Bhutan.