Designing programs for eliminating canine rabies from islands: Bali, Indonesia as a case study

• Published in: PLoS neglected tropical diseases 2013-08, Vol.7 (8), p.e2372-e2372
• Main Authors: Townsend, Sunny E, Sumantra, I Putu, Pudjiatmoko, Bagus, Gusti Ngurah, Brum, Eric, Cleaveland, Sarah, Crafter, Sally, Dewi, Ayu P M, Dharma, Dewa Made Ngurah, Dushoff, Jonathan, Girardi, Janice, Gunata, I Ketut, Hiby, Elly F, Kalalo, Corlevin, Knobel, Darryn L, Mardiana, I Wayan, Putra, Anak Agung Gde, Schoonman, Luuk, Scott-Orr, Helen, Shand, Mike, Sukanadi, I Wayan, Suseno, Pebi Purwo, Haydon, Daniel T, Hampson, Katie
• Format: Article
• Language: English
• Subjects: Animals; Basic Reproduction Number; Biology; Control; Disease; Disease Eradication - methods; Disease Eradication - organization & administration; Disease transmission; Distribution; Dog Diseases - epidemiology; Dog Diseases - prevention & control; Dogs; Health services; Immunization; Indonesia - epidemiology; Livestock; Mass Vaccination - methods; Medical geography; Medicine; Models, Statistical; Population Density; Rabies; Rabies - epidemiology; Rabies - prevention & control; Rabies - veterinary; Rabies Vaccines - administration & dosage; Rabies Vaccines - immunology; Studies; Veterinary Science
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0002372

Canine rabies is one of the most important and feared zoonotic diseases in the world. In some regions rabies elimination is being successfully coordinated, whereas in others rabies is endemic and continues to spread to uninfected areas. As epidemics emerge, both accepted and contentious control methods are used, as questions remain over the most effective strategy to eliminate rabies. The Indonesian island of Bali was rabies-free until 2008 when an epidemic in domestic dogs began, resulting in the deaths of over 100 people. Here we analyze data from the epidemic and compare the effectiveness of control methods at eliminating rabies. Using data from Bali, we estimated the basic reproductive number, R(0), of rabies in dogs, to be ~1 · 2, almost identical to that obtained in ten-fold less dense dog populations and suggesting rabies will not be effectively controlled by reducing dog density. We then developed a model to compare options for mass dog vaccination. Comprehensive high coverage was the single most important factor for achieving elimination, with omission of even small areas (