Downloaded from http://veterinaryrecord.bmj.com/ on June 25, 2015 - Published by group.bmj.com
British Veterinary Association
Sarah Cleaveland and colleagues comment: We are grateful to Andrew Rowan and colleagues for raising several important points about rabies transmission and the role of dog sterilisation programmes in rabies prevention and control programmes. We would like to
October 25, 2014 | Veterinary Record | 409
Downloaded from http://veterinaryrecord.bmj.com/ on June 25, 2015 - Published by group.bmj.com
British Veterinary Association Letters vaccination coverage that we know will be effective. Finally, we are keen to dispel a misperception that is commonly held by many authorities as to the ‘impossibility’ of dog rabies control without culling, removing dogs or mass sterilisation. We emphasise a central and unambiguous message, that mass dog vaccination campaigns that reach 70 per cent of the population are effective in bringing rabies under control and can result in canine rabies elimination, and that this is feasible in many different sites across the world.
Owners wait for their dogs to be vaccinated against rabies at a mass vaccination organised under an NGO-funded programme near the Serengeti National Park in Tanzania
emphasise our support for efforts towards humane management of dog populations and applaud the health and welfare achievements of the Jaipur and Chennai programmes. In response to some of the specific issues raised, we agree the geographical scales of empirical dog density estimates are crude. Nonetheless, across these scales (spanning two orders of magnitude) there is no evidence of density-dependent transmission. This is important because it underlines the fact that culling (the first line of response in many rabies endemic countries) will not be effective in controlling rabies, as we have also seen repeatedly in practice. We also agree that the number of dogs per human may affect transmission (particularly human exposures, but also dog-to-dog transmission, as human responses such as killing or restraining rabid/exposed dogs may curtail transmission). Research to uncover the mechanisms underlying rabies transmission and persistence is important and could generate important practical and theoretical insights. However, this does not affect our conclusion, derived from the consistently low estimates of R0 in a diverse range of dog populations, that a vaccination coverage target of 70 per cent should be sufficient to control and eliminate rabies in most, if not all, dog populations. Rowan and colleagues demonstrate the important role for dog sterilisation in certain communities, particularly in relation to changing human behaviour towards street dogs. A reduction in dog bites is particularly important in reducing demand for costly rabies postexposure prophylaxis, which could thus enhance cost-effectiveness and sustainability of rabies control programmes. As we indicated in our article, other potential benefits of sterilisation include a greater ‘buy-in’ from communities that seek assistance to tackle nuisance dog problems, and a potential decline in 410 | Veterinary Record | October 25, 2014
population turnover rate, which may help to sustain population vaccination coverage between vaccination campaigns. However, as Rowan and colleagues point out, there are few data available to formally quantify the contribution of dog sterilisation to enhancing effectiveness or cost-effectiveness of rabies control and prevention, and we consider that there is still an urgent need for studies that compare health and welfare outcomes in areas where dog vaccination alone has been carried out to those where dog vaccination and sterilisation are both practised. We fully support efforts to collect such data within humane dog population control programmes, and are very supportive of the initiative of the International Companion Animal Management Coalition to encourage monitoring and evaluation of dog population management interventions. Our intention has always been to encourage the implementation of mass dog rabies vaccination campaigns, not to discourage sterilisation programmes per se. Every community will have different requirements for dog population management, of which sterilisation programmes form a component, and there will be complexities and subtleties in human-dog relationships in different communities that mean that ‘no one size fits all’. However, in the context of rabies control, we are keen to emphasise management objectives that improve the health and longevity of dogs that would enhance both welfare and rabies control objectives, rather than an emphasis on reducing the numbers or density of dogs. We are concerned that in many parts of the world where canine rabies is endemic, particularly rural areas where rabies tends to persist and most dogs are owned, rabies control budgets and personnel would be entirely subsumed by a perceived requirement for mass surgical sterilisation programmes, which may not be warranted for rabies control, and would come at the detriment of achieving the target levels of
Sarah Cleaveland, Katie Hampson, Tiziana Lembo, Sunny Townsend, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ e-mail: [email protected] Felix Lankester, Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, 99164, USA doi: 10.1136/vr.g6352
Downloaded from http://veterinaryrecord.bmj.com/ on June 25, 2015 - Published by group.bmj.com
Role of dog sterilisation and vaccination in rabies control programmes Sarah Cleaveland, Katie Hampson, Tiziana Lembo, Sunny Townsend and Felix Lankester Veterinary Record 2014 175: 409-410
doi: 10.1136/vr.g6352 Updated information and services can be found at: http://veterinaryrecord.bmj.com/content/175/16/409.2
These include:
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Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
British Veterinary Association
Sarah Cleaveland and colleagues comment: We are grateful to Andrew Rowan and colleagues for raising several important points about rabies transmission and the role of dog sterilisation programmes in rabies prevention and control programmes. We would like to
October 25, 2014 | Veterinary Record | 409
Downloaded from http://veterinaryrecord.bmj.com/ on June 25, 2015 - Published by group.bmj.com
British Veterinary Association Letters vaccination coverage that we know will be effective. Finally, we are keen to dispel a misperception that is commonly held by many authorities as to the ‘impossibility’ of dog rabies control without culling, removing dogs or mass sterilisation. We emphasise a central and unambiguous message, that mass dog vaccination campaigns that reach 70 per cent of the population are effective in bringing rabies under control and can result in canine rabies elimination, and that this is feasible in many different sites across the world.
Owners wait for their dogs to be vaccinated against rabies at a mass vaccination organised under an NGO-funded programme near the Serengeti National Park in Tanzania
emphasise our support for efforts towards humane management of dog populations and applaud the health and welfare achievements of the Jaipur and Chennai programmes. In response to some of the specific issues raised, we agree the geographical scales of empirical dog density estimates are crude. Nonetheless, across these scales (spanning two orders of magnitude) there is no evidence of density-dependent transmission. This is important because it underlines the fact that culling (the first line of response in many rabies endemic countries) will not be effective in controlling rabies, as we have also seen repeatedly in practice. We also agree that the number of dogs per human may affect transmission (particularly human exposures, but also dog-to-dog transmission, as human responses such as killing or restraining rabid/exposed dogs may curtail transmission). Research to uncover the mechanisms underlying rabies transmission and persistence is important and could generate important practical and theoretical insights. However, this does not affect our conclusion, derived from the consistently low estimates of R0 in a diverse range of dog populations, that a vaccination coverage target of 70 per cent should be sufficient to control and eliminate rabies in most, if not all, dog populations. Rowan and colleagues demonstrate the important role for dog sterilisation in certain communities, particularly in relation to changing human behaviour towards street dogs. A reduction in dog bites is particularly important in reducing demand for costly rabies postexposure prophylaxis, which could thus enhance cost-effectiveness and sustainability of rabies control programmes. As we indicated in our article, other potential benefits of sterilisation include a greater ‘buy-in’ from communities that seek assistance to tackle nuisance dog problems, and a potential decline in 410 | Veterinary Record | October 25, 2014
population turnover rate, which may help to sustain population vaccination coverage between vaccination campaigns. However, as Rowan and colleagues point out, there are few data available to formally quantify the contribution of dog sterilisation to enhancing effectiveness or cost-effectiveness of rabies control and prevention, and we consider that there is still an urgent need for studies that compare health and welfare outcomes in areas where dog vaccination alone has been carried out to those where dog vaccination and sterilisation are both practised. We fully support efforts to collect such data within humane dog population control programmes, and are very supportive of the initiative of the International Companion Animal Management Coalition to encourage monitoring and evaluation of dog population management interventions. Our intention has always been to encourage the implementation of mass dog rabies vaccination campaigns, not to discourage sterilisation programmes per se. Every community will have different requirements for dog population management, of which sterilisation programmes form a component, and there will be complexities and subtleties in human-dog relationships in different communities that mean that ‘no one size fits all’. However, in the context of rabies control, we are keen to emphasise management objectives that improve the health and longevity of dogs that would enhance both welfare and rabies control objectives, rather than an emphasis on reducing the numbers or density of dogs. We are concerned that in many parts of the world where canine rabies is endemic, particularly rural areas where rabies tends to persist and most dogs are owned, rabies control budgets and personnel would be entirely subsumed by a perceived requirement for mass surgical sterilisation programmes, which may not be warranted for rabies control, and would come at the detriment of achieving the target levels of
Sarah Cleaveland, Katie Hampson, Tiziana Lembo, Sunny Townsend, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ e-mail: [email protected] Felix Lankester, Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, 99164, USA doi: 10.1136/vr.g6352
Downloaded from http://veterinaryrecord.bmj.com/ on June 25, 2015 - Published by group.bmj.com
Role of dog sterilisation and vaccination in rabies control programmes Sarah Cleaveland, Katie Hampson, Tiziana Lembo, Sunny Townsend and Felix Lankester Veterinary Record 2014 175: 409-410
doi: 10.1136/vr.g6352 Updated information and services can be found at: http://veterinaryrecord.bmj.com/content/175/16/409.2
These include:
Email alerting service
Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
