Rabies in the Kyrgyz Republic
Rabies in the Kyrgyz Republic: Improvement of Surveilance, Control and Prevention
Tech Area / Field
- MED-DIS/Disease Surveillance/Medicine
- AGR-DIS/Disease Surveillance/Agriculture
3 Approved without Funding
Kyrgyz Research Institute of Livestock, Veterinary and Pastures, Kyrgyzstan, Bishkek
- Osh Regional Veterinary Laboratory, Kyrgyzstan, Osh
- Centers for Disease Control and Prevention (CDC), USA, GA, Atlanta
Project summaryRabies is lethal incurable encephalitis caused by highly specialized neurotropic rhabdoviruses of the Genus Lyssavirus. This is the most important viral zoonosis causing 50,000 – 60,000 human deaths every year and enormous economic losses because of prophylaxis expenses and livestock mortality. The principal hosts of lyssaviruses are carnivores and bats. Among carnivores, canids are of the most importance. The main types of the terrestrial infection are (1) dog rabies and (2) sylvatic rabies, which involves different species of wild carnivores (foxes, jackals, coyotes, skunks, raccoons, mongooses). Dog rabies is significantly reduced or eliminated in Europe and the New World. However, canine rabies still predominates in Asia and Africa, particularly in the tropics, where it causes more than 95% of human mortality mentioned above. In India alone, 30,000 to 40,000 human rabies cases occur annually. However, the actual mortality is underestimated because of poor surveillance.
The moderate latitudes of Eurasia and the lower Arctic are enzootic for rabies as well. A significant rise of a dog epizootic has been registered in China. Previously, at the end of the 20th century, China reported no more than 200 human cases per year because of successful vaccination campaigns. Nevertheless, mortality increased ten-fold during 2004-2005. The epizootic appeared firstly among dogs across southern China but shortly expanded to the north, covering thousands of square miles. This situation makes possible the spread of this epizootic to neighboring countries, which are enzootic for rabies as well, and has major implications for epizootic rise.
The Kyrgyz Republic (KR), a former member of the Soviet Union, is one such country that may be affected. The dog population in the KR is not as great as in the tropics, which is one reason why the rabies incidence is not as great. Nevertheless, dogs still maintain rabies virus circulation and cause 1-14 human cases every year, predominantly in the southern provinces of KR. Additionally, over the broad territory sylvatic rabies is enzootic. More than 1000 animal rabies cases are registered in the KR annually. During 2004-2005, 94 districts of the KR were considered enzootic for rabies, and 109 cases of human rabies were registered. Ten to twelve thousand KR citizens seek postexposure rabies prophylaxis every year.
Clearly, the surveillance system in the KR is poor, mainly due to economical limitations. For this reason, both human and animal rabies mortality are underestimated. In addition, little is known about lyssavirus reservoirs (particularly in wildlife), and the rabies control system is less than ideal.
Our project is dedicated to study the distribution and circulation properties of rabies virus in the KR, determination of the principal virus reservoirs, genetic persity and molecular epidemiology of rabies and potentially non-rabies lyssaviruses, and assessment of possibilities to improve effectiveness of infection control and prophylaxis.
Bat lyssaviruses are of the particular significance. Bats maintain circulation of all lyssavirus genotypes except one (Mokola virus). In the Americas, after successful implementation of rabies control in the terrestrial mammals by regular vaccination of dogs and oral vaccination of wild canids and raccoons, bats are the main source of human rabies. In the New World bats maintain circulation of classic rabies virus only (lyssavirus genotype 1), but in the Old World bats harbor at least 9 genotypes, including 4 novel, recently discovered at the territory of the former Soviet Union (one isolated in the KR, and another was isolated in the neighboring province of Tajikistan). These lyssaviruses obviously circulate among bats, as was shown for other non-rabies bat lyssaviruses. Nevertheless, all studied bat lyssaviruses (such as European bat lyssaviruses type 1 and 2, Duvenhage virus and Australian bat lyssavirus) cause human rabies. In general, the number of human rabies cases after exposure to bats is underestimated more significantly than human rabies of carnivore origin.
Non-rabies bat lyssaviruses are antigenically distinct from rabies virus, which is the basis for all commercially available anti-rabies biologicals (vaccines and immune globulins). Consequently, these biologicals protect against non-rabies lyssaviruses incompletely. This fact increases the significance of the goal to study host range, distribution and circulation properties of such viruses. Additionally, there is the need to evaluate the protective effect of anti-rabies biologicals available in the KR against these non-rabies lyssaviruses.
The main goals of the project are:
- The study of rabies prevalence among animals and humans, by retrospective analysis and dynamic trends;
- The study of immune status of domestic and wild mammals within the enzootic territory;
- The study of principal and secondary rabies virus reservoirs among terrestrial mammals in different provinces of the country.
- Epizootological mapping of rabies.
- Introduction of molecular methods for rabies diagnosis (polymerase chain reaction, hybridization of the nucleic acids), and creation of the first specialized diagnostic laboratory for lyssavirus detection and identification within the Asian republics of the former Soviet Union.
- Creation of the collection of lyssavirus isolates circulating in the KR.
- The molecular epidemiology of rabies in the KR with particular attention to host range, geographic distribution and phylogenetic comparisons.
- Surveillance for bat lyssaviruses.
- Study of the protective effect of domestically available anti-rabies biologicals against non-rabies bat lyssaviruses discovered in Central Asia.
- Implications from the goals above for improvement of rabies surveillance, control and prophylaxis.
This proposal has been prepared by the Kyrgyz Research Institute of Livestock, Veterinary and Pastures named after A.Duysheev (KRILVP) of the Ministry of Agriculture, Water Resources and Reprocessing Industry of Kyrgyz Republic, together with Osh Regional Veterinary Laboratory, and in collaboration with the Rabies Unit, Centers for Disease Control and Prevention. Staff of the State Center for Quarantine and Highly Dangerous Infections of the Ministry of health and representatives of biological company “Altyn-Tamyr” will participate in the project as well.
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