[Outbreak of urban rabies transmitted by dogs in Santa Marta, northern Colombia]

Andrés Páez, Gloria Rey, Carlos Agudelo, Alvaro Dulce, Edgar Parra, Hernando Díaz-Granados, Damaris Heredia, Luis Polo
Biomédica: Revista del Instituto Nacional de Salud 2009, 29 (3): 424-36

INTRODUCTION: An urban rabies outbreak occurred in the District of Santa Marta between April 2006 and January 2008, which resulted in the deaths of 4 humans and 28 dogs.

OBJECTIVES: Three objectives were entertained-first, the diagnostic laboratory techniques were described as well as the rabies control actions taken; second, the impact of anti-rabies dog vaccination was assessed in terms of neutralizing antibody seroconversion; and third, the epidemiological significance and public health implications of the outbreak were examined.

MATERIALS AND METHODS: Rabies diagnosis was achieved by direct immunofluorescence, inoculation of mice and immunohistochemistry. Typing of the virus was achieved by indirect immunofluorescence. Control activities included a dog population census, vaccination and treatments for persons exposed to rabies, mass vaccination of dogs and cats, and initiation of a community education program. Seroconversion was investigated by capture ELISA.

RESULTS: Antigenic variant 1 was detected in all cases. Of vaccinated dogs, 77% were seropositive, and 47% were seroprotected against rabies. No differences were found in the humoral response between dog gender; however significant differences in dog seroprotection were discovered between localized comunities in Santa Marta.

CONCLUSIONS: The 2006-2008 urban rabies outbreak was the largest reported in a city in Colombia. It was caused by rabid dogs, and demonstrated that these animals are still a threat for human health despite the existence of efficient rabies vaccines. The control of the outbreak was achieved 20 months after the first rabies case in dogs, and 14 months after the initiation of the first mass vaccination of animals. The necessity of implementation and maintenance of rabies control strategies is underlined for minimizing human risk.

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