Combining genomics and epidemiology to investigate a zoonotic outbreak of rabies in Romblon Province, Philippines

Rabies is a viral zoonosis that kills thousands of people annually in low- and middle-income countries across Africa and Asia where domestic dogs are the reservoir. 'Zero by 30', the global strategy to end dog-mediated human rabies, promotes a One Health approach underpinned by mass dog vaccination, post-exposure vaccination of bite victims, robust surveillance and community engagement. Using Integrated Bite Case Management (IBCM) and whole genome sequencing (WGS), we enhanced rabies surveillance to detect an outbreak in a formerly rabies-free island province in the Philippines. We inferred that the outbreak was seeded by at least three independent human-mediated introductions that were identified as coming from neighbouring rabies-endemic provinces. Considerable local transmission went undetected, and two human deaths occurred within 6 months of outbreak detection. Suspension of routine dog vaccination due to COVID-19 restrictions likely facilitated rabies spread from these introductions. Emergency response, consisting of awareness measures, and ring vaccination, were performed, but swifter and more widespread implementation is needed to contain and eliminate the outbreak and to secure rabies freedom. We conclude that strengthened surveillance making use of new tools such as IBCM, WGS, and rapid diagnostic tests can support One Health in action and progress towards the 'Zero by 30' goal.

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Publication Details

Journal
Nature Communications
Published
2024-12-30
DOI
https://doi.org/10.1038/s41467-024-54255-5
Citations
3
Primary Topic
Rabies epidemiology and control
Type
article
Field-Weighted Citation Impact
0.88

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article

Combining genomics and epidemiology to investigate a zoonotic outbreak of rabies in Romblon Province, Philippines

Eleanor M. Rees, Christina A. Cobbold, Kirstyn Brunker, Mikolaj Kundegorski et al.
3 citations
Nature Communications
Rabies epidemiology and control
0.88
article

Combining genomics and epidemiology to investigate a zoonotic outbreak of rabies in Romblon Province, Philippines

Eleanor M. Rees, Christina A. Cobbold, Kirstyn Brunker, Mikolaj Kundegorski, Daria L. Manalo, Rowan Durrant, Carlijn Bogaardt, V. Cruz, J.J. Badimón Maestro, Criselda T. Bautista, Duane Raphael Manzanilla, Nai Rui Chng, Shynie Vee. M. Telmo, Katie Hampson, Mirava Yuson, Jude Karlo G. Bolivar, Leilanie B. Nacion, Mary Elizabeth Miranda, Jeromir G. Bondoc, Hannaniah Aloyon, Efraim P. Panganiban, Anna Formstone
article en
3 citations

Abstract

Rabies is a viral zoonosis that kills thousands of people annually in low- and middle-income countries across Africa and Asia where domestic dogs are the reservoir. 'Zero by 30', the global strategy to end dog-mediated human rabies, promotes a One Health approach underpinned by mass dog vaccination, post-exposure vaccination of bite victims, robust surveillance and community engagement. Using Integrated Bite Case Management (IBCM) and whole genome sequencing (WGS), we enhanced rabies surveillance to detect an outbreak in a formerly rabies-free island province in the Philippines. We inferred that the outbreak was seeded by at least three independent human-mediated introductions that were identified as coming from neighbouring rabies-endemic provinces. Considerable local transmission went undetected, and two human deaths occurred within 6 months of outbreak detection. Suspension of routine dog vaccination due to COVID-19 restrictions likely facilitated rabies spread from these introductions. Emergency response, consisting of awareness measures, and ring vaccination, were performed, but swifter and more widespread implementation is needed to contain and eliminate the outbreak and to secure rabies freedom. We conclude that strengthened surveillance making use of new tools such as IBCM, WGS, and rapid diagnostic tests can support One Health in action and progress towards the 'Zero by 30' goal.

Nature CommunicationsVol. 15(1)
Research Institute for Tropical Medicine (PH), Fetal Medicine Foundation (GB), Glasgow Centre for Population Health (GB), University of Glasgow (GB), City of Glasgow College (GB)
Wellcome, Wellcome Trust, Department of Science and Technology, Republic of the Philippines, Medical Research Council, Engineering and Physical Sciences Research Council
Good health and well-being
Openalex Percentile: Top 25%
Rabies epidemiology and control
0.88
DOIOpen Access PDFOpenAlex
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