Fifty Years of the National Rabies Control Program in Brazil under the One Health Perspective.

In 1973, the National Rabies Program was created in Brazil through an agreement between the Ministry of Health and Agriculture. Since its beginning, it developed integrated action through access to free post-exposure prophylaxis (PEP) for people at risk, dog vaccination campaigns, a joint surveillance system, and awareness. This study aims to describe human rabies in Brazil under the One Health perspective in recent decades, including achievements in the control of dog-mediated cases and challenges in human cases transmitted by wild animals. This paper also explores possible drivers of human rabies in the Northeast Region with half of the cases. The first part of this study was descriptive, presenting data and examples by periods. Statistical analysis was performed in the last period (2010-2022) to explore possible drivers. Dog-mediated human cases decreased from 147 to 0, and dog cases decreased from 4500 to 7. A major challenge is now human cases transmitted by wild animals (bats, non-human primates, and wild canids). Most current human cases occur in municipalities with a tropical and subtropical moist broadleaf forest biome and a Gini index higher than 0.5. In the multivariable analysis, an association with temperature was estimated (OR = 1.739; CI95% = 1.181-2.744), and primary healthcare coverage (OR = 0.947; CI95% = 0.915-0.987) was identified as a protector. It is possible to significantly reduce the number of dog-mediated human rabies cases through the efforts presented. However, Brazil has wildlife variants of the rabies virus circulating. The association of human cases with higher temperatures in the Northeast is a concern with climate change. To reduce human cases transmitted by wild animals, it is important to continue distributing free PEP, especially in remote at-risk areas in the Amazon Region, and to increase awareness.

Presence and Multi-Species Spatial Distribution of Oropouche Virus in Brazil within the One Health Framework.

Oropouche virus (OROV) is an emerging vector-borne arbovirus with high epidemic potential, causing illness in more than 500,000 people. Primarily contracted through its midge and mosquito vectors, OROV remains prevalent in its wild, non-human primate and sloth reservoir hosts as well. This virus is spreading across Latin America; however, the majority of cases occur in Brazil. The aim of this research is to document OROV's presence in Brazil using the One Health approach and geospatial techniques. A scoping review of the literature (2000 to 2021) was conducted to collect reports of this disease in humans and animal species. Data were then geocoded by first and second subnational levels and species to map OROV's spread. In total, 14 of 27 states reported OROV presence across 67 municipalities (second subnational level). However, most of the cases were in the northern region, within the tropical and subtropical moist broadleaf forests biome. OROV was identified in humans, four vector species, four genera of non-human primates, one sloth species, and others. Utilizing One Health was important to understand the distribution of OROV across several species and to suggest possible environmental, socioeconomic, and demographic drivers of the virus's presence. As deforestation, climate change, and migration rates increase, further study into the spillover potential of this disease is needed.