Canine Rabies Outbreaks, Vaccination Coverage, and Transmission in Humans: Greater Accra Region, Ghana- A Retrospective Study-2006-2011

Rabies is a highly fatal, viral, zoonotic disease caused by a Lyssa virus. It is acquired through the bite of an infected animal, mostly dogs. Estimated annual global human mortalities from rabies is 61,000, over 99% of which are from developing countries where about US$583.5 million is spent on its control. Rabies is enzootic in Ghana. Vaccinating about 70% of the dog population leads to a reduction in rabies transmission to humans; however, percentage dog anti-rabies vaccination coverage in Ghana is unknown. This study therefore investigated the magnitude of rabies in dogs and humans in the Greater-Accra region, and assessed annual percentage dog anti-rabies vaccination coverage from 2007-2011. Secondary data on rabies vaccination, post mortem and dog quarantine records for all ten districts in the region, and human rabies records were analysed. Means and percentages were calculated, graphs drawn and trends analysed. The number of animal samples which tested positive out of 309, was 283. Predictive value positive was 91.6%. Of the positive cases, 97.5% (276/283) had no previous vaccination history, and 96.1% (272/283) were from dogs. Fifty-five out of 174 (31.6%) samples were from dogs which bit more than one person. Human exposures to dog and other animal bites are not differentiated. Average annual number of outbreaks was 31, whereas percentage dog vaccination ranged from 10.26-17.56. Current annual percentage dog anti-rabies vaccination coverage is very low, whereas the incidence of dog rabies in the region is high. The number of humans affected may be underestimated. Government should immediately facilitate annual mass vaccination of pets.