A Systematic Review of Historical and Contemporary Rabies Epidemiology and Management in Alabama, USA

The history of wildlife pathogens in time and space impacts current understanding, detection, and management of infectious diseases, which may best be appreciated dynamically at a local level. As in the rest of the USA, over the past two centuries the epizootiology, prevention, and control of rabies in Alabama has changed significantly. Canine rabies was reported in Alabama during the USA civil war and predominated until after World War II. Appreciation of wildlife rabies grew only after the control of rabies in dogs. During the 1950s, rabies in gray foxes (Urocyon cinereoargenteus) spread throughout the southeastern USA but declined unexpectedly in the ensuing decades. By the 21st century, besides multiple variants of rabies virus in bats, the only extant mesocarnivore reservoir was the raccoon (Procyon lotor). Currently, Alabama represents the westernmost extent of the raccoon rabies virus variant in the USA. Historically, rabies case detection evolved from passive reporting dependent on clinical signs towards enhanced, laboratory-based surveillance. Control progressed from host population reduction toward prevention by oral rabies vaccination of wildlife in combination with comprehensive vaccination of companion animals and postexposure prophylaxis in humans. Today, modern disease management is exemplified in Alabama via a One Health context, as reflected in this systematic review.