Fifty Years of the National Rabies Control Program in Brazil under the One Health Perspective

Area of Science:

• Veterinary Public Health
• Epidemiology
• One Health

Background:

• Brazil's National Rabies Program, established in 1973, integrated free post-exposure prophylaxis (PEP), dog vaccination, surveillance, and awareness campaigns.
• Significant progress has been made in controlling dog-mediated rabies.
• Human rabies cases transmitted by wild animals present a growing challenge.

Purpose of the Study:

• To analyze human rabies epidemiology in Brazil from a One Health perspective over recent decades.
• To detail achievements in controlling dog-transmitted rabies and identify challenges in managing wildlife-transmitted cases.
• To explore potential drivers of human rabies in the Northeast Region.

Main Methods:

• Descriptive analysis of rabies data across different periods.
• Statistical analysis (2010-2022) to identify factors associated with human rabies.
• Exploration of biome and socioeconomic factors in rabies-prevalent areas.

Main Results:

• Dog-mediated human rabies cases reduced from 147 to 0; dog cases decreased from 4500 to 7.
• Wild animal (bats, non-human primates, wild canids) transmission is the primary challenge.
• Higher temperatures (OR=1.739) and lower primary healthcare coverage were associated with increased risk, while higher coverage (OR=0.947) was protective.

Conclusions:

• Integrated rabies control strategies have drastically reduced dog-transmitted cases.
• Addressing wildlife rabies transmission requires sustained PEP distribution, especially in the Amazon, and enhanced public awareness.
• Climate change-associated temperature increases in the Northeast may exacerbate rabies risk.