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2015 ; 8
(3
): 113-21
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Rabies Epidemiology and Control in Ecuador
#MMPMID26493436
Ortiz-Prado E
; Ponce-Zea J
; Ramirez D
; Stewart-Ibarra AM
; Armijos L
; Yockteng J
; Cardenas WB
Glob J Health Sci
2015[Jul]; 8
(3
): 113-21
PMID26493436
show ga
OBJECTIVE: Describe the epidemiology and the control effort for rabies in
Ecuador. METHODS: This observational study included data from the Ecuadorian
National Institute of Census and Statistics (INEC), and mortality and morbidity
data reported by the Ministry of Public Health and the National Institute for
Social Security. We conducted a phylogeny analyses to compare the N gene from the
Challenge Virus Standard (CVS) vaccine strain used in Ecuador with published
Cosmopolitan, Asian and Sylvatic strains. Descriptive and inferential statistics
were used to determine the significance of the data. RESULTS: In 1996 Ecuador
suffered the highest rate of rabies per capita in the Americas, with an incidence
rate of 0.56 cases per 100 000 people per year. Human and canine rabies showed a
sharp decline until 2012. Between 1994 and 2014, we found a correlation of 0.925
(p<0.01) between annual cases of dog and human rabies. In 2011, there was an
epidemic of sylvatic rabies transmitted to people by vampire bats (Desmodus
rotundus) in the Amazon region, specifically in Morona Santiago, leading to 11
fatalities. Phylogenetic analyses of the CVS vaccine N gene showed an association
with urban canine rabies strains (the Cosmopolitan lineage and Asian strains),
whereas sylvatic rabies, like those reported in the Amazon region, were found to
be grouped in a different clade represented mainly by bat-derived strains.
CONCLUSIONS: This study presents the first compilation of epidemiological data on
rabies in Ecuador. The incidence of human and canine rabies, also known as urban
rabies, has clearly decreased due to massive canine vaccination campaigns.
Phylogenetic analysis of the prevailing vaccine used in the country showed a
clear separation from bat-derived rabies, the source of recent rabies outbreaks.
Efforts are ongoing to develop rabies vaccines that are highly specific to the
rabies virus genotype circulating in the region, including sylvatic rabies. These
efforts include the implementation of reverse genetics to generate recombinant
virus coding for the prevailing glycoprotein gene.
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