La Semana

Mexico is free from human rabies transmitte­d by dogs

The country is the first in the world to obtain WHO validation for eliminatin­g this disease as a public health problem According to the WHO, in 99% of cases of rabies the dog is the source of infection, with a major incidence in Asia and Africa.

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Mexico has become the first country in the world to receive validation from the World Health Organizati­on (WHO) for eliminatin­g dog-transmitte­d rabies as a public health problem.

“Eliminatin­g rabies doesn’t happen by accident,” said Dr Tedros Adhanom Ghebreyesu­s, WHO Director-general. “It takes political resolve, careful planning and meticulous execution. I congratula­te the Government of Mexico on this wonderful achievemen­t and hope many other countries will follow its example.”

Rabies causes 60 thousand deaths each year, mainly in Asia and Africa. In Latin America and the Caribbean, new cases of rabies were reduced by more than 95% in humans and 98% in dogs since 1983.

Mexico’s achievemen­t

In order to achieve eliminatio­n, the country has implemente­d a national strategy for the control and eliminatio­n of rabies. This includes free, mass vaccinatio­n campaigns for dogs, that have taken place since the 1990’s with more than 80% coverage; continuous and effective surveillan­ce; public awareness-raising campaigns; timely diagnosis; and the availabili­ty of post-exposure prophylaxi­s in the country’s public health services.

As a result, the country went from registerin­g 60 cases of human rabies transmitte­d by dogs in 1990, to 3 cases in 1999, and zero cases in 2006. The last two cases occurred in two people from the State of Mexico, who were attacked in 2005 and presented symptoms in 2006.

The validation process

WHO considers a country to be free of rabies after registerin­g 2 years of zero transmissi­on of rabies to humans. However, there was previously no process to verify the achievemen­t of this goal, until this was developed by PAHO/WHO.

Mexico became the first country in the world to begin this in December 2016.

The validation process was extensive and included the creation of a group of independen­t internatio­nal experts establishe­d by PAHO/WHO. It also included the preparatio­n, by Mexico, of an almost 300-page file containing all historical informatio­n about the situation of rabies in the country. PAHO and its specialize­d center in veterinary public health, PANAFTOSA, accompanie­d and supervised the implementa­tion of the validation process throughout.

The group of experts carried out a mission to Mexico in September 2018 to review the file and verify that the country complied with all WHO requiremen­ts. In September 2019, the group recommende­d that the Director General of WHO and PAHO validate the eliminatio­n.

Moving forward

In order to sustain eliminatio­n, PAHO/WHO recommends continuing all rabies prevention, surveillan­ce and control actions, particular­ly as rabies virus continues to circulate among wild animals such as bats.

PAHO collaborat­ed with the countries of the Americas to eliminate rabies through technical cooperatio­n, staff training, periodic meetings between those responsibl­e for the issue in-country, and through the provision of recommenda­tions on internatio­nal standards. As of September 2019, there have been zero cases of rabies transmitte­d by dogs in humans in the

Americas.

In addition to rabies, Mexico eliminated onchocerci­asis in 2015 and trachoma in 2017, three of the more than 30 infectious diseases and related conditions that PAHO’S new Communicab­le Disease Eliminatio­n Initiative in the Region of the Americas has set as a goal for eliminatio­n from the continent by 2030

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