A comparative review of prevention of rabies incursion between Japan and other rabies-free countries or regions.

Although rabies still kills many people, global eradication of human rabies is considered to be feasible. Because the progress toward eradication may be different among regions with different socio-economic status, states that successfully eradicate this disease must be vigilant for re-emergence of rabies. In this article, we describe arguments over current rabies prevention measures and risk assessment results for rabies introduction and spread in rabies-free Japan. We also summarize the measures taken by representative countries and regions free from rabies. Our risk assessment results revealed that the risk of rabies reintroduction under current circumstances is very low, and that subsequent spread of the disease would be minimal because of quite low value of basic reproduction number. Similar assessments conducted in other rabies-free areas also showed quite limited risks of introduction. The majority of rabies-free countries maintain their rabies-free status through strict import quarantine of carnivorous animals, efficient surveillance of animal rabies including wildlife, quick emergency responses, and raising public awareness of the disease. To keep current rabies-free status in Japan, it is strongly recommended to maintain current quarantine system as well as to reinforce compliance of stakeholders involved in international dog movement. Sustainable surveillance system targeting wildlife is also indispensable.