Rabies resurgence in Peru highlights global threats of health inequity
A Penn Medicine analysis shows that surveillance of dog rabies in Arequipa, Peru, is lacking in areas with lower socioeconomic status and could spell problems for infectious disease worldwide.
2 min. read
Insight into what Peru’s second-largest city may be missing in its efforts to track rabies could provide insight to the rest of the world on a disease that still kills 70,000 people per year. A team led by researchers from the Perelman School of Medicine has found that efforts to track dog-related rabies in poorer areas were lacking even though more dogs were found to have the disease there than in wealthier neighborhoods.
“The people most at risk were also the least ‘seen’ by the surveillance system for this,” says Ricardo Castillo, an assistant professor of epidemiology, senior author of a new report in The Lancet Regional Health—Americas.
Rabies in dogs was eradicated from Peru for many years but has recently reemerged. Dogs cause 99% of recorded rabies cases worldwide; tracking cases in them is vital to prevent outbreaks of the disease among humans.
In Arequipa, Peru, where the researchers based their study, surveillance of rabies is largely tied to a “passive” strategy that relies on people to report dead dogs they see to local health facilities for sample collection and testing. However, that passive system can be a particular problem in disadvantaged neighborhoods.
“These areas often lack nearby facilities and residents may have informal jobs, limited time, and less awareness of rabies,” Castillo explains. “There are also fewer veterinary and public health personnel in these areas. So, there are structural barriers and geographic inequity. When dog rabies reemerged, I realized that it was these social and spatial differences that allowed rabies to persist.”
Castillo hopes that the work he and his colleagues have done will help promote better methods for control over rabies and animal-borne diseases, overall, and prompt public health officials to evaluate their methods for equity.
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