A 6 part podcast series covering current issues surrounding a very old disease. Created and produced by United Against Rabies and hosted by Professor Katie Hampson of the University of Glasgow unitedagainstrabies.org

A lot of hard work goes into combatting rabies, but what is needed to achieve its elimination? Today on One Health Day, we dive into the reality of tackling this disease, seen through the eyes of Rabies Heroes in distant corners of the world…. India, Peru, Tanzania, Mozambique… What makes a true impact in the community? What hampers the effectiveness of campaigns in the field? What is strategic vaccination and what are its biggest challenges? How can the international community help make progress faster? To find answers to these and other questions Rachel Herschman, intern at International Veterinary Health (IVH), spoke with no one less than the recipients of the Rabies Hero Awards. As part of our #Rabies360Challenge last September, she conducted a series of interviews with the Rabies Heroes about their experiences and what they think is essential to control this disease. “I wanted to help create more awareness for rabies and the #Rabies360Challenge by spreading their messages to social media, something I was inspired to while listening to the emergence podcast episodes about rabies,” said Rachel. “Living in the US, I have the privilege of not having to worry about rabies in my daily life with the wide availability of rabies vaccines and rabies surveillance programs. The same cannot be said for many communities in the Global South, even in 2022. From a One Health standpoint, rabies is a clear example of how animal health impacts human health,” she explained. “I would like to thank my interviewees for giving their time to be interviewed and sending pictures of their work, I hope people find their messages to be as inspirational as I found them to be.” We learned a lot from these conversations: how teaching rabies at Indian schools makes a difference for the community, what matters when advocating for indigenous people in Peru, what is vaccine sustainability, and what can be achieved through international collaboration. They told us about smart ways of reaching dogs in remote places, reducing rabies transmission from Vampire Bats, and some novel methods of vaccine delivery... Read on as the Heroes reflect on their achievements, the challenges, and their hopes for the future. Charles Rupprecht: Global Collaboration Dr Charles Rupprecht received the Rabies Hero Award in 2021 for his tireless work to help eliminate deaths from rabies. In the interview, he explained the need for prioritizing rabies vaccination for dogs and the role of international conferences like Rabies in the Americas (RITA) for being a place where solutions can be freely discussed.  “Has RITA been a success? Yes! People are still attending. As the saying goes: if you build it, people will come.” Is RITA relevant for regions outside the Americas? Absolutely, according to Dr Rupprecht. Progress in Latin America can be used as a springboard for application in Africa and Asia. It is important to ask questions, speak the truth and encourage analysis of the projects that failed. Rabies in the Americas (RITA) International Conference in Querétaro Mexico, October 2022Dr. Charles E. Rupprecht - investigating a rabid dog bite to a child in a local neighborhood, India. Human deaths from rabies are still happening in many areas in South America, even more than 20 years into the 21st century. Dr Rupprecht said that RITA should be a place for new people, new ideas, open especially to those who have been historically underrepresented and underserved.  Imam Mzimbiri: Field Vaccination Efforts Dr Imam Mzimbiri received a Rabies Hero Award in 2021 for his hard work leading Tanzania's largest mass dog vaccination program around the Serengeti National Park. He leads a team of field officers to carry out dog vaccinations in remote villages, reaching approximately 40,000 dogs every year. His work in the field requires that he spends 9 months of the year away from his family, while also contributing to peer-reviewed publications focused on rabies. These efforts have led to increasing awareness of rabies in the community and have improved veterinary care.   Dr Mzimbiri, who is utterly dedicated to "saving human lives from this deadly disease which causes deaths to thousands of people each year", has shared these photos with us that picture the reality of his work in the field:  Sergio Recuenco: Science and Communication Dr Sergio Recuenco is a Professor at the Peru’s National University of San Marcos who studies Vampire Bat-mediated rabies. He was named a Rabies Hero in 2020 for his rabies research and advocacy. In the interview, Dr Recuenco talked about the challenge of getting rabies education and prevention tools to indigenous groups living deep in the Amazon Rainforest, where many rabies cases are occurring due to Vampire Bats. Rabies in these communities can be particularly devastating.  He recalled an outbreak in Ecuador that resulted in the deaths of 11 children, 30% of the generation of that ethnic group. One method of prevention used mosquito nets but getting the nets to very rural areas can take a very long time and is expensive as many locations can only be reached by boat or walking. And the nets that do come frequently arrive damaged, rendering them ineffective. Another method was administering pre-exposure rabies vaccines to everyone living in the areas with the highest risk, which was done in 2011 and resulted in zero rabies cases. Dr Recuenco sorting bat serum samplesVampire Bat being measured by Dr Recuenco's team for a rabies research study Guatemala. Dr Recuenco is optimistic about the future of rabies control, including the solutions that come with digital technologies. Infrastructure and new molecular technology, such as monoclonal antibodies, created to combat COVID-19 can be adapted to combat rabies.  “I have a lot of hope. And that is why I am putting a lot of time into activism, awareness, and, of course, research,” said Dr Recuenco. He advocates for better scientific communication among his peers and his students so that rabies government policy can be effective: “It’s not about what you discover, it’s about how you use your discovery to change peoples’ lives.” Praveen Ohal: Rabies Education Mr. Praveen Ohal is a 2020 Rabies Hero who works with Mission Rabies to carry out rabies education in communities in India. This education is given largely in schools that have training modules specifically focused on rabies. “We teach children about animals and kindness. About how rabies spreads and dog vaccination” Mr. Ohal said about the lessons at schools. One of the things he focuses on is making sure that children do not become afraid of dogs, because fear of all dogs can make it harder to educate them on concepts like animal welfare. A benefit of teaching children directly through schools is that they can teach their family members and others in their communities about rabies. Mr. Ohal is very excited about being in charge of a new Mission Rabies truck because it will enable him to educate more communities. Ilona Otter: Vaccine Strategy “Rabies is controlled by annual vaccination programs… but we need a combination of different approaches,” said Dr Ilona Otter, a 2021 Rabies Hero who works in India through the Worldwide Veterinary Service (WVS) and Mission Rabies to coordinate innovative rabies vaccination strategies. During the interview, Dr Otter explained how traditional Animal Birth Control (ABC) programs that sterilize and vaccinate dogs for rabies are not the complete answer for rabies control. These programs were implemented starting in the 1960s as a humane alternative to culling dogs, but they mostly exist in cities while rural areas remain at the most risk due to the lack of assessable rabies vaccines. One of her key considerations is sustainability, in this context, meaning the consistent accessibility of rabies vaccines. Dr Otter’s strategies follow the World Health Organization’s (WHO) 2018 guidance calling for the integration of rabies vaccinations into existing vaccination programs. Working with village nurses and coordinating with local health departments has led to widespread success in reducing rabies cases. Rabies vaccination in India is not nationally required. But vaccination for Foot-and-Mouth Disease (FMD) is, which is why combined FMD and rabies vaccination programs do a great job providing the village-to-village vaccination that is needed.  One common challenge is vaccinating stray dogs and dogs that are owned but are allowed to roam free because some can be missed when vaccination services come to a village. Luckily, with herd immunity, rabies transmission stalls once 70% of a dog population is vaccinated, and Dr Otter commented that vaccinating 70% is easily achievable in most villages. Annual dog vaccination programs can catch the dogs missed the previous year and can reduce the amount of expensive dog bite post-exposure human vaccinations needed. Dr Otter is very excited about the usage of apps that can track dog vaccination with GPS to map vaccination coverage, which will soon be implemented in Mumbai. Vittoria Sogno: Animal Welfare Ms. Vittoria Sogno works on the island of Mozambique at Animal Welfare ILHA (AWI), an organization she co-founded. Ms. Songo, a 2020 Rabies Hero, has reduced the number of dog bites in her community and improved the community’s attitudes toward the local dog population. She has done this by educating the people there and creating awareness of animal welfare, so much so that locals now widely vaccinate their dogs for rabies at her clinic. “In our small way at AWI, we have tried to curb the number of unvaccinated bog bites, through constant and repeated vaccination campaigns. And it is working,” Ms Sogno said. “What started off as a dream has become a reality - the dogs and cats of Ilha de Moçambique are now safe as all are vaccinated. They now are an integral part of island life, play companions for children and source of great pride for their owners.” The photos here tell the full story:  Rachel Wright: Standard vaccination Rachel Wright earned the Rabies Hero Award in 2020 for her tireless work to reduce rabies in India. She founded the Tree of Life for Animals (TOLFA) charity in 2005, which sterilizes and vaccinates dogs for rabies. Ms. Wright also works with local humanitarian nongovernmental organizations and schools to educate about rabies and provide seamless vaccination support for reported rabid dog bites. Dr Wright highlighted the importance of dog vaccination, the cornerstone of rabies elimination: "All it takes is a simple rabies vaccination to help keep a puppy safe”, she explained. “Our standard protocol is that before any dog or cat is released, it receives a rabies vaccination, and this puppy was no exception". “This puppy was just one of 4008 dogs to have received a rabies vaccination from TOLFA in the last year. It had been admitted to us with a small wound. After treating the wound and vaccinating the puppy against rabies, we released it to his family knowing that it was protected against this fatal disease. Sadly, rabies is ever prevalent in our area of India, but TOLFA is trying to do all it can to prevent it.” Dr Felix Lankester: Vaccine Delivery A final conversation, rounding up this interview series was with Dr Felix Lankester, a professor at Washington State University and Director of Rabies Free Tanzania, a 2020 Rabies Hero, about a novel method of rabies vaccine delivery called Zeepot Clay. “Zeepot cooling devices protect rabies vaccines from high temperatures enabling us to reach remote villages. They are effective, inexpensive, and locally made which allows us to scale up mass dog vaccination campaigns!”, Dr Lankester told us.  Zeepots are small clay pots that act as a passive cooling device (PCD) to help protect rabies vaccines from high temperatures while carrying out vaccinations in remote villages. Zeepots can be produced locally and help scale up mass dog vaccination programs in low-and-middle income counties. In 2020, this research was published in Tropical Medicine and Infectious Disease in an article titled “Controlling Human Rabies: The Development of an Effective, Inexpensive and Locally Made Passive Cooling Device for Storing Thermotolerant Animal Rabies Vaccines”, the first author being Dr Ahmed Lugelo, who Dr Lankester worked alongside as well as many others.  Before you go: To learn more about Rabies Heroes and their work visit the Rabies Hero Awards homepageCheck the Rabies Disease Page for more information about this disease. See what other work is being done to eliminate rabies in the Community Response to Rabies section. The views expressed in this article are those of the author(s) and interviewees, and do not necessarily represent those of MSD Animal Health. Photo credits: Rabies Heroes.

A field guide for veterinarians providing information on emergency animal diseases (EADs), a publication of Australia's Department of Agriculture, Fisheries and Forestry (DAFF) and CSIRO (Commonwealth Scientific and Industrial Research Organisation).

Guest for World Rabies Day is Dr Deborah Nadal, and we discuss her learnings from her time in India which led to the publication of her book "Rabies in the Streets - Interspecies Camaraderie in Urban India." See a video about her book at https://www.youtube.com/watch?v=JAIloLk_cRQ&feature=emb_imp_woyt or find further details at https://www.psupress.org/books/titles/978-0-271-08595-1.html

If you have listened to our podcast or seen me speak at conferences, you have probably heard me refer to partnerships. But what do I mean when I talk about being partners? The Knowledge Hub on the emergence site reflects some of what I consider partnership.  Here you will find infographics, information bulletins, and radio scripts to be used to alert the public about upcoming vaccination campaigns.  There are webinars, reports from conferences, and podcasts with experts from around the world. Partnership is about sharing knowledge and experience, about listening to others, and valuing their skills and opinions.  If we are to eliminate, or even control, these diseases, then we need to combine both local and global know-how.  Successful vaccination programs require an understanding of local socio-cultural aspects, monitoring and surveillance, herd dynamics, communication, epidemiology, and of vaccines. Photo by Carl salter World Rabies Day is the 28th September.  The focus of this day, and the month running up to it, is to bring rabies into the forefront of people’s minds.  To remind them that the poorest people in the world still have to cope with this devastating disease.  It is one of the WHO’s “neglected diseases”.  And yet eliminating this disease will not only save human and animal lives, it will improve the welfare of people and animals alike.  No one can do this alone, but together we can make the difference that is needed.  We do it by bringing our combined skills forward and being partners.

Dr Ankita Pathak, our latest recipient of Rabies Hero Award, has been relentlessly vaccinating stray dogs against rabies in and around Mumbai, India, for the last 10 years. She became a veterinarian following her passion and love for animals and is currently one of the most valued vets in the Mumbai area. Living in a society where rabies is a constant threat, she is known to ensure that every animal that comes within her reach is duly vaccinated against rabies, which she considers her duty in combatting this terrible disease. This video shows her hard work and boundless commitment to the betterment of stray animals. The video was provided by the Rabies Hero Award recipient. MSD Animal Health has no affiliation with amtmindia.org and is not endorsing donation. Ankita said she considers herself very lucky to be able to help the ‘speechless souls’. She feels deeply for animals and has never left any of them without care or treatment. She has received several awards for her good work and her contributions to rabies control in the area have been invaluable. She is always sought after for the care she provides. A tribute from Ankita's nominator: “Throughout history, in every culture around the world, extraordinary women have pushed society to think bigger and move forward. This woman is a glowing example of a boundless soul who has courageously made her passion, a job of love and joy: Dr Ankita V Pathak, popularly known as the "Injectionwali Dr", has been silently vaccinating dogs against rabies for the past 10 years. During this time she administered the vaccine to over 35000 stray dogs and abandoned pets all over Mumbai and beyond. A woman can play many roles but a woman who wears her heart over her sleeve for stray animals is a very rare sight. “ Dr Ankita Pathak vaccinates a dog at the Animal SanctuaryDr Ankita Pathak vaccinates a dog at the Animal SanctuaryDr Ankita Pathak at the Animal Sanctuary Dr Ankita Pathak during the vaccination drive in Mahad in 2021.Dr Ankita Pathak during the vaccination drive in Mahad in 2021.Dr Ankita Pathak during the vaccination drive in Mahad in 2021.Dr Ankita Pathak during the vaccination drive in Mahad in 2021.. Rabies vaccination in Mahad, India. The area had been affected by a flood short before the campaign.Rabies vaccination in Mahad, India. The area had been affected by a flood short before the campaign.Rabies vaccination in Mahad, India. The area had been affected by a flood short before the campaign. To go back to Rabies Heroes click here.

My name is Rachel Herschman and I have been an intern on the International Veterinary Health (IVH) team for three months. I attended the International Symposium of Veterinary Epidemiology and Economics (ISVEE) last month in Halifax, Canada from 7th August to 12th August 2022. The clear themes interwoven throughout the conference were the importance of having a diversity of evidence at hand, international collaboration, and having a One Health philosophy. ‘One Health’ is an approach that calls for interdisciplinary collaboration in recognizing how human health, environmental health, and animal health are interconnected. Understanding this interconnectedness across multiple points of view is thought to be the most optimal way to solve problems in these sectors. Halifax, Nova Scotia, Canada The Global Burden of Animal Diseases The Global Burden of Animal Diseases (GBADs) was one of the many shining organizations at ISVEE. Their talks focused on neglected zoonotic diseases (NZD), many of which disproportionally affect vulnerable groups in low/middle-income countries. Much of epidemiology depends on the availability and accessibility of large datasets, which often results in bias that can over and underprioritize diseases. One such example is Anthrax, a disease found to be the most prioritized in countries worldwide despite being estimated to have a very low disease burden. Therefore, GBABs is exploring graph databases and better data management frameworks to enable more data sharing and reportability. Animal Health Loss Envelope (AHLE). Animal Health Loss Envelope (AHLE). Mortality does not do a great job of capturing the total amount of damage a disease causes. Biomass and economic values were shown to be valuable denominators for disease burden estimates. Using these variables requires large amounts of data and discussion but can yield insightful measures such as the Animal Health Loss Envelope (AHLE). The AHLE can be broken up and attributed to specific causes using complex methodologies. Using this tool can formalize the relationship between health risks in livestock production. AHLE was used to look at the costs associated with poultry production in the UK and showed that the cost of disease burden is roughly the same as the cost of chicks (chicks being the second highest cost in production inputs next to feed costs). AHLE was used to look at the costs associated with poultry production in the UK and showed that the cost of disease burden is roughly the same as the cost of chicks (chicks being the second highest cost in production inputs next to feed costs). When speaking to Carlotta Di Bari about their poster detailing brucellosis burden, the usage of disability-adjusted life years (DALYs) was discussed as it is used by many public institutes to create a thorough comparisons of the health impacts felt in a population. This poster was also cited in a GBABs talk by David Pigott focusing on livestock impacts on human health Foot and Mouth Disease Dr. Polly Compston’s presentation was done with data from questionnaires that covered the impact of Foot and Mouth Disease (FMD) outbreaks on cattle, market activities, animal husbandry and production systems, and household demographics. The partial budget analysis included the current cost of the disease and inconsistent vaccination, the impact of effective disease control through vaccination, and the revenue forgone (i.e., lost milk yields caused by FMD infection). FMD infection can disrupt a female cattles’ reproductive cycle. Milk fertility is a measure of the milk lost due to these reproductive delays, and the analysis showed a consequence of six months of milk lost due to FMD that did not include the milk losses during the clinical infection The panel discussion and Q&A segment of “Modeling Approaches to Support Progressive Control and Eradication of Transboundary Animal Diseases, with a Focus on PPR and FMD” touched upon the importance of data availability and strategies to discuss modelling to non-scientific officials. Main points: The absence of a rich database for Peste des Petits Ruminants (PPR), can lead to overlooking uptake issues in vaccination program.Discussions with non-scientific officials must be a participative process where there is ownership and belief in modelling tools.It might even be beneficial to have a dedicated member to present the outcomes of a model, instead of the person who built the model, so that the information can be distilled into simple messaging. Panel discussion on “Modeling Approaches to Support Progressive Control and Eradication of Transboundary Animal Diseases, with focus on PPR and FMD. Avian Influenza China’s yellow boiler industry has been understudied with no prior research on the chickens before going to market, and current Avian Influenza (AI) control policy does not consider the unique ways yellow broilers are reared. A value chain analysis of this sector in Guangxi, China (Tang, et al., 2021) identified the use of trading platforms as a key point for targeted intervention to prevent the spread of H7H9 (Asian Lineage Avian Influenza A) to other birds and people. Contracted broiler farmers, used extensively in this region, send their market-weight chickens to trading platforms before they are transported to live bird markets to be sold to the public. Professor Arjan Stegeman from Utrecht University detailed how wild bird densities and landscape variables can predict spatial patterns in high pathogenicity AI (HPAI) outbreak risk across the Netherlands. The analysis was about HPAI introduction, not about its spread. Mallard ducks were shown to be the migratory bird with the most associated risk, but inland outbreaks were attributed to geese having a greater role. With the most important wild bird species’ populations varying year to year, models therefore need to be updated regularly to remain accurate. Professor Stegeman’s HPAI risk map of the Netherlands that uses three algorithms. Lumpy Skin Disease One of the most anticipated talks of the conference was on the qualitative assessment of the probability of introduction and onward transmission of Lumpy Skin Disease (LSD) in Ukraine (Farra, et al., 2022). LSD was detected in Russia in 2015, suspected to have been introduced via the Balkans. Instability in Ukraine this year could make LSD's introduction into the country a real possibility. Qualitative risk assessment analysis showed that the highest risk for LSD introduction was the illegal importation of cattle and that a strong legal framework was associated with the least risk. Local experts included veterinary authorities, field veterinarians, and academics from universities. The report was received well in Ukraine and is being used to revise strategies in place and to better understand the introduction pathways. African Swine Fever To be ready for a case of African Swine Fever (ASF) transmission, many countries are running simulations so that emergency plans and procedures can be more effectiveTo be ready for a case of African Swine Fever (ASF) transmission, many countries are running simulations so that emergency plans and procedures can be more effectiveTo be ready for a case of African Swine Fever (ASF) transmission, many countries are running simulations so that emergency plans and procedures can be more effective I spoke with Dr. Amy Hagerman, an Assistant Professor at Oklahoma State University, about her student’s research on ASF’s impact on the pork prices in the Hispaniola Island. The supply of Creole swine is forecasted not to recover until 2030, leaving the prices for the traditional pig product high and could mean its further displacement by commercial swine that are faster to recover. Rabies In this talk, free roaming domestic dogs (FRDDs, dogs belonging to a community) were identified as the main source of rabies transmission to humans in a study including Indonesia and Guatemala. The study tracked FRDDs to see what habitats they chose to live in. Knowing this could make oral rabies vaccination campaigns more successful. Veterinary Education The quality of a veterinarian’s communication skills impact client satisfaction. By training with this digital role-play, veterinary practitioners were better able to understand how to clarify clients’ needs and build strong working relationships. The Norwegian University of Life Sciences evaluated how having students making podcasts about epidemiological topics could be a way to actively aid their learning. The students worked in groups and took on different roles in the podcast. It was stated that this project creates a motivational learning environment by incorporating curiosity, challenges, choice, control, and collaboration.The Norwegian University of Life Sciences evaluated how having students making podcasts about epidemiological topics could be a way to actively aid their learning. The students worked in groups and took on different roles in the podcast. It was stated that this project creates a motivational learning environment by incorporating curiosity, challenges, choice, control, and collaboration. The views expressed in this article are those of the author(s) and do not necessarily represent those of MSD Animal Health.

Eritrea is one of the countries in Africa struggling with rabies. To help eliminate this devastating disease, Johann Kotzé, MSD Animal Health, assists WOAH in developing control strategy to support the country's journey towards a rabies-free future.