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In the Middle East and North Africa (MENA) region, dogs are the main reservoir for rabies. In this region, rabies affects more domestic carnivores (50% of cases) than farm animals (40% of cases). Rabies in large livestock animals, which are infected mainly by dogs, results in economic losses, undermines food safety and poses a risk for humans. In the MENA region, rabies is largely an urban problem, the virus being transmitted to humans by free-roaming dogs, 30% of which are less than one year old. In cities, the density of the free-roaming dog population varies between 0.6 and 1.5 dogs per km2, and almost double this figure in suburban and rural areas, where 80% of canine rabies cases occur. In the Maghreb, the annual average number of confirmed human deaths from rabies is around 47, showing a strong correlation with the number of animal cases declared (approximately 1,442 cases a year). In the Middle East, only a few rabies cases in humans are officially reported, suggesting that rabies cases in humans are grossly underreported. National strategies to control rabies include vaccination, controlling the freeroaming dog population and raising awareness among the human population at risk. Owing to limited resources and poor coordination between the different stakeholders, these strategies are only partially implemented. The Food and Agriculture Organization of the United Nations, in close collaboration with the World Organisation for Animal Health and the World Health Organization, supports countries in formulating and implementing coordinated strategies between the ministries concerned, local authorities and non-governmental organisations.

Rabies is a major zoonosis that affects the central nervous system of warm-blooded mammals. The disease is present worldwide, except for some islands. Africa and Asia record over 95% of the fatal cases of rabies worldwide, and therefore the greatest risk to human life from rabies occurs in these regions. Mass vaccination of dogs is the most appropriate way to control and eliminate the disease at the animal source, in order to interrupt the infectious cycle of the disease from animals to humans. Rabies is endemic in the North African region, and countries should be encouraged to develop programmes for eliminating human rabies through the implementation of sustained campaigns to immunise dogs and by providing post-exposure prophylaxis (PEP) to people who have been exposed to suspected rabid dogs. In Tunisia, the national strategy against rabies was started in 1981 and it has been upgraded since. Following the launch of the annual vaccination programme in 1993, there was a significant improvement in the health status for rabies in Tunisia, with a decrease in the number of cases in animals and humans. Since 2011, an increase in cases of rabies in dogs and humans has been observed, due to lower vaccination coverage, mismanagement of waste and an increase in the stray dog population. The political will at international, regional and national levels is the cornerstone of the strategy to eliminate the disease. In the framework of the regional approach in the Maghreb, additional efforts and political willingness are necessary at the national level to better control and eventually eliminate rabies.

Objectives: This study sought to determine whether abnormal ventricular repolarization is implicated in cardiac arrhythmias of German shepherd dogs with inherited sudden death., Background: Moïse et al. (9) have identified German shepherd dogs that display pause-dependent lethal ventricular arrhythmias., Methods: Ventricular repolarization was studied both in vivo using electrocardiogram recordings on conscious dogs and in vitro with a standard microelectrode technique performed on endomyocardial biopsies and Purkinje fibers. Pharmacological manipulation was used to evaluate the role of potassium channels., Results: In control conditions, electrocardiogram parameters were similar in both groups of dogs, except for the PR interval (18% longer in affected dogs, p < 0.05). Injection of d,l-sotalol (2 mg/kg) prolonged QT interval more in affected dogs (+14%, n = 9) than it did in unaffected dogs (+6%, n = 6, p < 0.05) and increased the severity of arrhythmias in affected dogs. In vitro, in control conditions, action potential duration (APD90) of endomyocardial biopsies and Purkinje fibers were significantly longer in affected dogs (respectively 209 +/- 3 ms, n = 30 and 352 +/- 15 ms, n = 17) than they were in unaffected dogs (197 +/- 4 ms, n = 25 and 300 +/- 9 ms, n = 30) at a pacing cycle length (PCL) of 1,000 ms. This difference increased with PCL. The kinetics of adaptation of APD90 to a change in PCL was faster in affected dogs. D,l-sotalol (10(-5) and 10(-4)M) increased APD90 in both groups of dogs, but this increase was greater in affected dogs, with the occurrence of triggered activity on Purkinje fibers. E-4031 (10(-7) and 10(-6) M), an I(Kr)-blocker, increased APD90 similarly in both groups of dogs. Chromanol 293B (10(-6) and 10(-5)M), an I(Ks)-blocker, increased significantly APD90 in unaffected dogs but had no effect in affected dogs., Conclusions: These results support the hypothesis of an abnormal cardiac repolarization in affected dogs. The effects of 293B suggest that I(Ks) may be involved in this anomaly.