Combining genomics and epidemiology to investigate a zoonotic outbreak of rabies in Romblon Province, Philippines

Mirava Yuson (), Criselda T. Bautista, Eleanor M. Rees, Carlijn Bogaardt, Cruz Van Denn D., Rowan Durrant, Anna Formstone, Daria L. Manalo, Duane R. Manzanilla, Mikolaj Kundergorski, Leilanie Nacion, Hannaniah Aloyon, Jude Karlo Bolivar, Jeromir Bondoc, Christina Cobbold, Efraim Panganiban, Shynie Vee. M. Telmo, Jobin Maestro, Mary Elizabeth G. Miranda, Nai Rui Chng, Kirstyn Brunker and Katie Hampson
Additional contact information
Mirava Yuson: University of Glasgow
Criselda T. Bautista: University of Glasgow
Eleanor M. Rees: University of Glasgow
Carlijn Bogaardt: University of Glasgow
Cruz Van Denn D.: Field Epidemiology Training Programme Alumni Foundation Inc (FETPAFI)
Rowan Durrant: University of Glasgow
Anna Formstone: University of Glasgow
Daria L. Manalo: Research Institute for Tropical Medicine (RITM)
Duane R. Manzanilla: Field Epidemiology Training Programme Alumni Foundation Inc (FETPAFI)
Mikolaj Kundergorski: University of Glasgow
Leilanie Nacion: Research Institute for Tropical Medicine (RITM)
Hannaniah Aloyon: Research Institute for Tropical Medicine (RITM)
Jude Karlo Bolivar: Research Institute for Tropical Medicine (RITM)
Jeromir Bondoc: Research Institute for Tropical Medicine (RITM)
Christina Cobbold: University of Glasgow
Efraim Panganiban: Research Institute for Tropical Medicine (RITM)
Shynie Vee. M. Telmo: Regional Animal Disease Diagnostic Laboratory
Jobin Maestro: Municipal Health Office
Mary Elizabeth G. Miranda: Field Epidemiology Training Programme Alumni Foundation Inc (FETPAFI)
Nai Rui Chng: University of Glasgow
Kirstyn Brunker: University of Glasgow
Katie Hampson: University of Glasgow

Nature Communications, 2024, vol. 15, issue 1, 1-14

Abstract: Abstract Rabies is a viral zoonosis that kills thousands of people annually in low- and middle-income countries across Africa and Asia where domestic dogs are the reservoir. ‘Zero by 30’, the global strategy to end dog-mediated human rabies, promotes a One Health approach underpinned by mass dog vaccination, post-exposure vaccination of bite victims, robust surveillance and community engagement. Using Integrated Bite Case Management (IBCM) and whole genome sequencing (WGS), we enhanced rabies surveillance to detect an outbreak in a formerly rabies-free island province in the Philippines. We inferred that the outbreak was seeded by at least three independent human-mediated introductions that were identified as coming from neighbouring rabies-endemic provinces. Considerable local transmission went undetected, and two human deaths occurred within 6 months of outbreak detection. Suspension of routine dog vaccination due to COVID-19 restrictions likely facilitated rabies spread from these introductions. Emergency response, consisting of awareness measures, and ring vaccination, were performed, but swifter and more widespread implementation is needed to contain and eliminate the outbreak and to secure rabies freedom. We conclude that strengthened surveillance making use of new tools such as IBCM, WGS, and rapid diagnostic tests can support One Health in action and progress towards the ‘Zero by 30’ goal.

Date: 2024
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DOI: 10.1038/s41467-024-54255-5

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