부산대학교 도서관

Rabies was first reported in ancient Iraqi civilizations, yet it remains a poorly quantified and important public health threat in the region. Efforts to control rabies in Iraq including dog population control, and vaccination of livestock and dogs, have increased since 2010. Officially reported data on human rabies, dog bites, and animal rabies cases between 2012 and 2017 are analysed here to assess the effect of existing control efforts, to inform future strategies, and to highlight gaps in surveillance and reporting. The results of molecular characterization of 32 viruses from animal cases from throughout Iraq are presented, to improve the understanding of rabies dynamics in the animal reservoir. Although annual numbers of reported human cases were lower in the period between 2012 and 2017 than prior to 2010, human cases continue. There was a distinct gender and age bias among human cases with nine cases in males for every one female and twice as many cases in children than adults. Spatial clustering analysis and phylogenetic evidence suggests rabies is endemic throughout the country, with no regional variation in risk, but better surveillance and reporting is required to underpin control strategies. Author summary: Rabies was first reported from the region that is modern day Iraq, yet the disease remains a poorly quantified and important public health threat there. Efforts to control rabies in Iraq including culling and vaccinating dogs, have been increased since 2010, but their effect on the disease is unknown. Officially reported data on human rabies, reported dog bites, and animal rabies cases between 2012 and 2017 are analysed here to assess the effect of existing control efforts, to inform future strategies, and to highlight gaps in surveillance and reporting. The results of virus typing of 32 viruses from animal cases from throughout Iraq are presented, to improve understanding of which strains of the virus are circulating in the country. Results of the analysis show that although annual numbers of reported human cases were lower after 2012 than prior to 2010, human cases continue. There was a distinct gender and age bias among human cases with nine cases in males for every one in females and twice as many cases in children than adults. Investigating the distribution of cases among governates, and reconstructing the evolutionary history of the viruses using virus typing data suggests rabies is endemic throughout the country, with no differences in risk between areas. These data together provide useful information for prioritizing control efforts, but demonstrate that better surveillance and reporting is required. [ABSTRACT FROM AUTHOR]