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Human rabies transmitted by dogs is considered a neglected disease that can be eliminated in Latin America and the Caribbean (LAC) by 2015. The aim of this paper is to discuss canine rabies policies and projections for LAC regarding current strategies for achieving this target and to critically review the political, economic and geographical factors related to the successful elimination of this deadly disease in the context of the difficulties and challenges of the region. The strong political and technical commitment to control rabies in LAC in the 1980s, started with the regional programme coordinated by the Pan American Health Organization. National and subnational programmes involve a range of strategies including mass canine vaccination with more than 51 million doses of canine vaccine produced annually, pre- and post-exposure prophylaxis, improvements in disease diagnosis and intensive surveillance. Rabies incidence in LAC has dramatically declined over the last few decades, with laboratory confirmed dog rabies cases decreasing from approximately 25 000 in 1980 to less than 300 in 2010. Dog-transmitted human rabies cases also decreased from 350 to less than 10 during the same period. Several countries have been declared free of human cases of dog-transmitted rabies, and from the 35 countries in the Americas, there is now only notification of human rabies transmitted by dogs in seven countries (Bolivia, Peru, Honduras, Haiti, Dominican Republic, Guatemala and some states in north and northeast Brazil). Here, we emphasize the importance of the political commitment in the final progression towards disease elimination. The availability of strategies for rabies control, the experience of most countries in the region and the historical ties of solidarity between countries with the support of the scientific community are evidence to affirm that the elimination of dog-transmitted rabies can be achieved in the short term. The final efforts to confront the remaining obstacles, like achieving and sustaining high vaccination coverage in communities that are most impoverished or in remote locations, are faced by countries that struggle to allocate sufficient financial and human resources for rabies control. Continent-wide cooperation is therefore required in the final efforts to secure the free status of remaining countries in the Americas, which is key to the regional elimination of human rabies transmitted by dogs.

In Latin America and the Caribbean, around 195 million people live in poverty, a situation that increases the burden of some infectious diseases. Neglected diseases, in particular, are often restricted to poor, marginalized sections of the population. Tools exist to combat these diseases, making it imperative to work towards their elimination. In 2009, the Pan American Health Organization (PAHO) received a mandate to support the countries in the Region in eliminating neglected diseases and other poverty-related infections. The objective of this study is to analyze the presence of selected diseases using geo-processing techniques. Five diseases with information available at the first sub-national level (states) were mapped, showing the presence of the disease ("hotspots") and overlap of diseases ("major hotspots"). In the 45 countries/territories (approximately 570 states) of the Region, there is: lymphatic filariasis in four countries (29 states), onchocerciasis in six countries (25 states), schistosomiasis in four countries (39 states), trachoma in three countries (29 states), and human rabies transmitted by dogs in ten countries (20 states). Of the 108 states with one or more of the selected diseases, 36 states present the diseases in overlapping areas ("major hotspots"). Additional information about soil-transmitted helminths was included. The analysis suggests a majority of the selected diseases are not widespread and can be considered part of an unfinished agenda with elimination as a goal. Integrated plans and a comprehensive approach, ensuring access to existing diagnostic and treatment methods, and establishing a multi-sectoral agenda that addresses social determinants, including access to adequate water and sanitation, are required. Future studies can include additional diseases, socio-economic and environmental variables.

The recurrence and persistence of foot and mouth disease (FMD) could be the consequence of cyclic and massive transportation of calves. For this reason, in South America, vaccination strategies related to livestock dynamic are being promoted. In order to aid the evaluation of such strategies, a method for predicting the risk of transportation of nonvaccinated weaned calves was developed; this method combines expert opinion and empirical evidence using Bayesian estimators. It was applied through Monte Carlo simulation to data of Argentina under four hypothetical vaccination schemes: E1, extended vaccination season of 1/6 of the population of calves each month from July to December without second round vaccination (SRV); E2, extended irregular vaccination from July to December with SRV applied to 70% of the calves resembling the scheme applied in Argentina in 2001; E3, vaccination in November and December without SRV; and E4, vaccination concentrated in November. E1 resulted in probability of transporting non vaccinated calves (tnvc) reaching its maximum in the following year in May with mean=0.0250 and percentile 95% (P95)=0.0404; for the same month tnvc estimates for the other schemes were E2: mean=0.0071; P95=0.0162; E3: mean=0.0017; P95=0.0042 and E4: mean=0.0001; P95=0.0004. Bonferroni multiple comparison for simultaneous assertions for May showed that E4 resulted the best scheme, E1 the worst, and E2 and E3 are intermediate with nonsignificant difference observed between overall (p<0.05). Results were consistent with historical records and quantification for future needs for re-vaccination was made possible. While the ratio "total vaccinated"/"total estimated existences" will give a biased vision of vaccination coverage under the situation of extended vaccination campaigns, a model as the one developed here could allow a more accurate assessment and the design of mitigation plans., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Latin American countries made the political decision to eliminate human rabies transmitted by dogs by the year 2005. The purpose of the current study is to evaluate to what extent this goal has been reached. The epidemiological situation and control measures were analyzed and broken down within the countries by georeferencing. The 27 human cases reported in 2003 occurred in some 0.2% of the second-level geopolitical units (municipalities or counties) in the region, suggesting that the disease is a local problem. Several areas within the countries reported no more transmission of rabies in dogs. Nearly 1 million people potentially exposed to rabies received treatment. On average, 34,383 inhabitants per health post receive anti-rabies treatment (range: 4,300-148,043). Nearly 42 million dogs are vaccinated annually. Surveillance is considered fair according to the epidemiological criteria adopted by the study. Samples sent for rabies testing represent 0.05% of the estimated canine population (range: 0.001 to 0.2%). The countries are quite close to achieving the goal.

Between 1993 and 2002, the number of human and canine rabies cases in the Americas Region fell by approximately 80%. There were 39 human cases in 2002, 63% of them transmitted by dogs. Furthermore, human rabies transmitted by wildlife, mostly by bats is a risk to inhabitants in many countries in the Region. The objective of this study is to describe this epidemiological situation based in the information received from the countries of the Americas Region in Regional Rabies Surveillance System in the Americas (SIRVERA) administrated by the Pan American Health Organization. This sharp reduction is attributable mainly to the control measures implemented by the countries of the Region, such as the mass vaccination of dogs and prophylactic treatment for people who have been exposed.

As a result of the Argentine experience with foot-and-mouth disease (FMD) in 2001, a need was postulated for the establishment of efficient supranational schemes for continuous surveillance of the interrelations between tropical extractives livestock systems and the prairies that are optimal for the feeding of livestock in the southern region of South America. FMD in Argentina and in other countries, new or re-emerging risks from avian influenza with potential risks for public health, the spongiform encephalopathies, porcine reproductive and respiratory syndrome, and classical swine fever, among other animal diseases, have generated a strong reaction and evolution within the veterinary services of the country. These present lessons will influence decision-making within countries and should be accepted by the technical and scientific community. From the perspective of the official animal health sector and with the FMD eradication plan as a basis within the national territory, we have worked not only to achieve international recognition and credibility within animal health systems, but also to realize the formation of a regional block of countries that can be recognized internationally as an area with equivalent animal health status. We emphasize not only that this lesson is useful in FMD, but also that it is possible to apply the valuable conclusions reached for other emerging or re-emerging diseases.

The authors review the policies designed to prevent and deal with animal health emergencies which have been implemented in countries of South America. They describe the evolution of the epidemiological situation of the continent, the new arrangements for international trade in animals and products of animal origin arising from the creation of the World Trade Organization (WTO), and the consequences of such developments for livestock production in South America. Veterinary systems used to prevent and deal with emergencies in the eleven OIE Member Countries on the continent are described, together with emerging problems which confront the Veterinary Services of the continent, namely: exotic diseases, abnormal occurrence of endemic diseases subject to control programmes, faults in food-safety mechanisms, diseases which have an environmental impact, and problems connected with animal welfare. The emergencies which present the greatest risk to South America are foot and mouth diseases, transmissible spongiform encephalopathies, the porcine reproductive and respiratory syndrome, food poisoning, Newcastle disease and fowl plague. Other problems are the appearance of new strains of existing agents, and the presence of resistant individuals among species of bacteria or harmful arthropods. The authors emphasise the need to co-ordinate the prevention of emergencies with development work at the international level, particularly regional and international agreements, harmonization of procedures, progress in animal health and public health, risk analysis, etc. These systems and methods of prevention have a contribution to make in enhancing the potential of animal production in South America, and the adoption of stricter health and quality standards, according to criteria established by the WTO Agreement on the Application of Sanitary and Phytosanitary Measures.

The authors describe the method used in Argentina for quantification of risk in controls of the potency and innocuity of foot and mouth disease vaccine. Quantitative risk analysis is a relatively new tool in the animal health field, and is in line with the principles of transparency and equivalency of the Sanitary and Phytosanitary Agreement of the Uruguay Round of the General Agreement on Tariffs and Trade (GATT: now World Trade Organisation [WTO]). The risk assessment is presented through a description of the steps involved in manufacturing the vaccine, and the controls performed by the manufacturer and by the National Health Animal Service (Servicio Nacional de Sanidad Animal: SENASA). The adverse situation is considered as the lack of potency or innocuity of the vaccine, and the risk is estimated using a combination of the Monte Carlo simulation and the application of a Bayesian model.