Preventing Childhood Rabies Mortality in Asia

Rabies is a neglected tropical disease associated with almost universal mortality. It is most often caused by the rabies virus (RABV) and transmitted to humans through the bite of dogs, so-called ‘canine’ rabies. Approximately half of the considerable global burden of disease occurs in Asia where its burden falls most heavily on poor, rural populations with a disproportionate impact on children. The disease can be eliminated through control of the viral reservoir in dogs and there are examples of successful eradication in the region achieved through mass dog vaccination and dog population control. Rabies, however, is poorly controlled in other countries where advocacy is required to achieve political commitment and the establishment of dedicated rabies control programmes with strong inter-sectoral coordination and community collaboration. I briefly review the 2012 World Health Organisation South East-Asia region (WHO-SEARO) strategic control guidelines and consider specific actions and activities that will lead to a reduction in rabies deaths in Asian countries. In addition, by prioritising a goal to reduce child mortality in particular, I argue for the implementation of pre-exposure prophylaxis in children by administering rabies vaccines as part of the expanded programme for immunisation in the highest burden countries.