The Amazonian Tropical Bites Research Initiative, a hope for resolving zoonotic neglected tropical diseases in the One Health era.

BACKGROUND: Neglected tropical diseases (NTDs) disproportionately affect populations living in resource-limited settings. In the Amazon basin, substantial numbers of NTDs are zoonotic, transmitted by vertebrate (dogs, bats, snakes) and invertebrate species (sand flies and triatomine insects). However, no dedicated consortia exist to find commonalities in the risk factors for or mitigations against bite-associated NTDs such as rabies, snake envenoming, Chagas disease and leishmaniasis in the region. The rapid expansion of COVID-19 has further reduced resources for NTDs, exacerbated health inequality and reiterated the need to raise awareness of NTDs related to bites. METHODS: The nine countries that make up the Amazon basin have been considered (Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Peru, Surinam and Venezuela) in the formation of a new network. RESULTS: The Amazonian Tropical Bites Research Initiative (ATBRI) has been created, with the aim of creating transdisciplinary solutions to the problem of animal bites leading to disease in Amazonian communities. The ATBRI seeks to unify the currently disjointed approach to the control of bite-related neglected zoonoses across Latin America. CONCLUSIONS: The coordination of different sectors and inclusion of all stakeholders will advance this field and generate evidence for policy-making, promoting governance and linkage across a One Health arena.

Pre-exposure rabies prophylaxis: a systematic review.

OBJECTIVE: To review the safety and immunogenicity of pre-exposure rabies prophylaxis (including accelerated schedules, co-administration with other vaccines and booster doses), its cost-effectiveness and recommendations for use, particularly in high-risk settings. METHODS: We searched the PubMed, Centre for Agriculture and Biosciences International, Cochrane Library and Web of Science databases for papers on pre-exposure rabies prophylaxis published between 2007 and 29 January 2016. We reviewed field data from pre-exposure prophylaxis campaigns in Peru and the Philippines. FINDINGS: Pre-exposure rabies prophylaxis was safe and immunogenic in children and adults, also when co-administered with routine childhood vaccinations and the Japanese encephalitis vaccine. The evidence available indicates that shorter regimens and regimens involving fewer doses are safe and immunogenic and that booster intervals could be extended up to 10 years. The few studies on cost suggest that, at current vaccine and delivery costs, pre-exposure prophylaxis campaigns would not be cost-effective in most situations. Although pre-exposure prophylaxis has been advocated for high-risk populations, only Peru and the Philippines have implemented appropriate national programmes. In the future, accelerated regimens and novel vaccines could simplify delivery and increase affordability. CONCLUSION: Pre-exposure rabies prophylaxis is safe and immunogenic and should be considered: (i) where access to postexposure prophylaxis is limited or delayed; (ii) where the risk of exposure is high and may go unrecognized; and (iii) where controlling rabies in the animal reservoir is difficult. Pre-exposure prophylaxis should not distract from canine vaccination efforts, provision of postexposure prophylaxis or education to increase rabies awareness in local communities.

Situación actual y control de la rabia en el Perú / Current status and control of rabies in Peru

La rabia es una enfermedad endémica del Perú, que se presenta en dos ciclos, uno urbano relacionado a la transmisión por canes, y otro silvestre causado principalmente por la mordedura de murciélagos hematófagos. La mayoría de casos humanos de las últimas décadas han sido por rabia urbana, sin embargo, las medidas de control empleadas (campañas de vacunación canina, producción de vacunas, identificación del can mordedor, atención oportuna de la víctima y sistemas de vigilancia y notificación) han logrado reducir la incidencia de rabia canina y por ende de los casos en humanos. Actualmente, el mayor número de casos humanos que se notifican en el Perú son causados por Desmodus rotundus.

Rabies is an endemic disease of Peru, that appears in two cycles, one urban related with transmission by dog, and another wild caused mainly by vampires bats bite. Most of human cases of the last decades they have been by urban rabies, nevertheless the used measures of control (canine vaccine campaigns, vaccine production, identification of biting dog, opportune attention ofthe victim and surveillance and notification system) they have managed to reduce the incidence of canine rabies and therefore of the human cases. Currently the greater number of human cases notified are caused by Desmodus rotundus in Peru.

Situación epidemiológica y estrategias de prevención y control de la Brucelosis melitensis en el Perú

La brucelosis en el Perú es una zoonosis que tiene importancia por su repercusión en la salud humana, especialmente en el grupo económicamente activo y por el impacto en la economía del país, debido a los altos costos que representa el tratamiento de los enfermos. Constituyéndose como principal fuente de infección para la persona, el consumo de queso fresco elaborado con leche sin pasteurizar proveniente de cabras infectadas, procedentes de ganaderos de bajos recursos económicos y de trashumantes que necesitan trasladarse para buscar alimentación de su ganado. El problema de brucelosis humana en el Perú está circunscrito a los Departamentos de Lima, Ica y la Provincia Constitucional del Callao, donde se registran el 95% de los casos notificados en el País y en donde continua la costumbre ancestral de consumir queso fresco de cabra.