Epidemiology and control of rabies in Malawi

The official statistics for rabies in animals and man are reviewed and inaccuracies discussed. Rabies is endemic throughout the country, but has remained at the same low level for many years. An average of 186 cases are confirmed in animals each year. Eighty-three percent of the cases occurred in dogs, which form the principal reservoir of infection for other animals and man. Jackals and hyenas accounted for 5% of the cases. Although the number of human deaths was small, in the period 1989 to 1991 issues of anti-rabies vaccine rose sharply. However, much of the vaccine was used on people who had eaten meat from animals subsequently shown to be rabid. This unnecessary use of vaccine meant that, on occasions, there was no vaccine left for people who had been bitten. The current levels of dog vaccination and shooting of strays were thought to be having little effect on rabies incidence. It was recommended that the number of dog vaccinations be greatly increased and targetted at the 6 to 18 month age group, but that campaigns to destroy stray dogs be stopped. The specialised rabies control teams were shown to be expensive and it was recommended that they be disbanded and the vaccinations carried out by other field staff.