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      Epidemiological and viral studies of rabies in Bali, Indonesia

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          Abstract

          Background and Aim:

          Rabies has been endemic in Bali since 2009, and cases has recently increased. Unfortunately, there is a lack of available vaccines, which hinders the eradication program. This study aimed to investigate the epidemiological and virological aspects of rabies infection in Bali.

          Materials and Methods:

          A total of 24 brain samples were collected from rabid dogs in all districts of Bali. The samples were tested using the direct fluorescent antibody (DFA) test and polymerase chain reaction (PCR) to confirm the presence of rabies virus in the samples. Samples with the highest virus content were propagated in vivo and then inoculated into BALB/c mice. The brains of dead mice were used to prepare an inoculate cultured in murine neuroblastoma cells. Supernatant-positive viruses representing each district were then reinoculated into eight groups of five BALB/c mice. A brain sample from each dead mouse was tested using DFA and PCR and detected under a fluorescence microscope.

          Results:

          All rabies virus-positive samples collected from rabid dogs in all districts of Bali were positive. Rabies virus was detected by DFA test and PCR and was consistently confirmed in the in vivo and in vitro studies. BALB/c mice inoculated with the highest viral dilution (105 cells/mL) of culture supernatant showed typical signs of rabies, indicating that the virus could be properly investigated.

          Conclusion:

          This study demonstrated a wide epidemiological distribution of rabies in Bali. The obtained virus can be adapted for in vitro and in vivo studies and can be used to develop a homologous vaccine.

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          Most cited references15

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          Elimination of Dog-Mediated Human Rabies Deaths by 2030: Needs Assessment and Alternatives for Progress Based on Dog Vaccination

          Background Rabies imposes a substantial burden to about half of the world population. The World Health Organization (WHO), World Organization for Animal Health, and the Food and Agriculture Organization have set the goal of eliminating dog-mediated human rabies deaths by 2030. This could be achieved largely by massive administration of post-exposure prophylaxis—in perpetuity—, through elimination of dog rabies, or combining both. Here, we focused on the resources needed for the elimination of dog rabies virus by 2030. Materials and methods Drawing from multiple datasets, including national dog vaccination campaigns, rabies literature, and expert opinion, we developed a model considering country-specific current dog vaccination capacity to estimate the years and resources required to achieve dog rabies elimination by 2030. Resources were determined based on four factors: (a) country development status, (b) dog vaccination costs, (c) dog rabies vaccine availability, and (d) existing animal health workers. Our calculations were based on the WHO’s estimate that vaccinating 70% of the dog population for seven consecutive years would eliminate rabies. Findings If dog rabies vaccine production remains at 2015 levels, we estimate that there will be a cumulative shortage of about 7.5 billion doses to meet expected demand to achieve dog rabies elimination. We estimated a present cost of $6,300 million to eliminate dog rabies in all endemic countries, equivalent to a $3,900 million gap compared to current spending. To eliminate dog rabies, the vaccination workforce may suffice if all public health veterinarians in endemic countries were to dedicate 3 months each year to dog rabies vaccination. We discuss implications of potential technology improvements, including population management, vaccine price reduction, and increases in dog-vaccinating capacities. Conclusion Our results highlight the resources needed to achieve elimination of dog-mediated human rabies deaths by 2030. As exemplified by multiple successful disease elimination efforts, one size does not fit all. We suggest pragmatic and feasible options toward global dog rabies elimination by 2030, while identifying several benefits and drawbacks of specific approaches. We hope that these results help stimulate and inform a necessary discussion on global and regional strategic planning, resource mobilization, and continuous execution of rabies virus elimination.
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            Early Insights from Statistical and Mathematical Modeling of Key Epidemiologic Parameters of COVID-19

            We report key epidemiologic parameter estimates for coronavirus disease identified in peer-reviewed publications, preprint articles, and online reports. Range estimates for incubation period were 1.8–6.9 days, serial interval 4.0–7.5 days, and doubling time 2.3–7.4 days. The effective reproductive number varied widely, with reductions attributable to interventions. Case burden and infection fatality ratios increased with patient age. Implementation of combined interventions could reduce cases and delay epidemic peak up to 1 month. These parameters for transmission, disease severity, and intervention effectiveness are critical for guiding policy decisions. Estimates will likely change as new information becomes available.
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              Lessons for rabies control and elimination programmes: a decade of One Health experience from Bali, Indonesia.

              Since the emergence of rabies on Bali, Indonesia, in 2008, the Indonesian Government and other stakeholders have implemented disease control and prevention activities with the aim of re-securing Bali's freedom from dog-mediated rabies. The authors report on the lessons learned during these efforts, and their applicability to other regions where canine rabies is endemic, as well as to rabies-free populations that are at risk from incursions. To eliminate rabies from Bali will require time and commitment, as well as a combination of approaches employing the principle of One Health. Efforts should be directed towards well-coordinated, highcoverage, annual dog vaccination campaigns using high-quality vaccines, and enhanced surveillance focused on investigations of biting animals. Bali, an island, is an ideal target for achieving freedom from rabies, but the logistics of vaccinating its very large, free-roaming dog population are challenging. Lessons can be drawn from Bali for other large and dense dog populations, where dog management and rabies control appear difficult. Well-trained teams with nets can rapidly catch and vaccinate large numbers of dogs where central-point vaccination is insufficient, and post vaccination surveys of collared dogs can be used to evaluate coverage and target supplementary vaccination. However, careful planning is required to ensure that all communities are reached during such campaigns and that sufficient vaccine is available over the following years. Effective communication strategies are needed to coordinate intersectoral activities, and to keep communities engaged, particularly during the 'end game', when the risk of rabies appears only minimal. An effective One Health approach to eliminate rabies requires long-term planning, multisectoral communication and coordination, and sustained effort, using tried and tested methods.
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                Author and article information

                Journal
                Vet World
                Vet World
                Veterinary World
                Veterinary World (India )
                0972-8988
                2231-0916
                December 2023
                20 December 2023
                : 16
                : 12
                : 2446-2450
                Affiliations
                [1 ]Department of Disease Prevention, Veterinary Public Health, Faculty of Veterinary Medicine, Udayana University, Denpasar Bali of Indonesia, Jl. PB Sudirman, Denpasar, Bali, 80234, Indonesia
                [2 ]Department of Veterinary Clinic, Faculty of Veterinary Medicine, Udayana University, Denpasar Bali of Indonesia, Jl. PB Sudirman, Denpasar, Bali, 80234, Indonesia
                [3 ]Laboratory of Biochemistry, Faculty of Veterinary Medicine, Udayana University, Denpasar Bali of Indonesia, Jl. PB Sudirman, Denpasar, Bali, 80234, Indonesia
                [4 ]Laboratory of Clinical Pathology, Faculty of Veterinary Medicine, Udayana University, Denpasar Bali of Indonesia, Jl. PB Sudirman, Denpasar, Bali, 80234, Indonesia
                [5 ]Laboratory of Parasitology, Faculty of Veterinary Medicine, Udayana University, Denpasar Bali of Indonesia, Jl. PB Sudirman, Denpasar, Bali, 80234, Indonesia
                [6 ]Laboratory of Virology, Faculty of Veterinary Medicine, Udayana University, Denpasar Bali of Indonesia, Jl. PB Sudirman, Denpasar, Bali, 80234, Indonesia
                [7 ]Laboratory of Virology, Veterinary Disease Investigation Center, Denpasar Bali, Jl. Raya Sesetan No. 266, Denpasar, Bali, 80223, Indonesia
                [8 ]Laboratory of Virology, Veterinary Disease Investigation Center, Bukittinggi Jl. Bukittinggi-Payakumbuh, Tabek Panjang, Sumatra Barat, Sumatra, 26192, Indonesia
                [9 ]Department of Disease Prevention, Veterinary Public Health, Faculty of Veterinary Medicine, Udayana University, Denpasar Bali of Indonesia, Jl. PB Sudirman, Denpasar, Bali, 80234, Indonesia.
                Author notes
                Article
                Vetworld-16-2446
                10.14202/vetworld.2023.2446-2450
                10844785
                38328353
                80d2aba8-34e4-4a64-a4c8-865deaf6f659
                Copyright: © Tenaya, et al.

                Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 08 August 2023
                : 07 November 2023
                Categories
                Research Article

                bali,dogs,polymerase chain reaction,rabies virus
                bali, dogs, polymerase chain reaction, rabies virus

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