Globe Hopping, Rabies Stopping: Outreach to DRC

We often talk about what we’ve done to help others stay free of infectious diseases. But something that often goes unstated is the training we provide that gives other health and medical professionals the tools to keep people healthy. Although a lot of this work happens here in the United States, the assistance we provide to other countries facing overwhelming disease outbreaks is also important.

I often communicate with people in other countries about their rabies prevention and control needs. But it’s not every day that I get to meet and work with them face-to-face. That’s one reason I was very excited to travel with my colleagues in CDC’s Rabies Team to the Democratic Republic of the Congo (DRC), where we administered training to help the country in its efforts to combat a recent rabies outbreak.

Every year, an estimated 55,000 people worldwide die from rabies. Most of these deaths occur in Asian and African countries, where dog rabies is still widespread, unlike in the United States. In DRC, where dogs are the leading cause of human rabies deaths, over 120 suspected cases of human rabies were identified over a 2-year period. However, we know that the majority of human rabies cases go unreported or misdiagnosed, so these reports could be just the tip of the iceberg. This becomes an even bigger problem when there are not enough resources to address the problem. That’s where we stepped in.

My colleagues, Dr. Richard Franka, Lillian Orciari, and Jesse Blanton, and I provided laboratory training to employees at the country’s National Institute of Biomedical Research (Institut National de Recherche Biomedical [INRB]). Our key focus was on the use of the direct rapid immunohistochemistry test (dRIT), which is used to test for rabies. The test is ideal for countries like DRC since it requires very little equipment – just a light microscope and a few basic lab supplies. In fact, it has already been successfully used in Chad, Tanzania, Ethiopia, and Nigeria, countries that face similar barriers to effective rabies prevention and control.

We also provided instruction on aspects of rabies surveillance using CDC’s Epi-Info software. Effective surveillance requires collecting and analyzing data. With respect to rabies, surveillance includes looking at animal bite data since rabies is primarily spread through animal bites. In addition, we demonstrated how to use Epi-Info to help map data and provided training on the use of Geographic Information System (GIS) software to add greater precision to surveillance efforts.

Before coming home, we toured several clinics that treat patients for potential rabies exposures and learned more about the challenges faced by communities in the country. In addition, we participated in interdisciplinary meetings to discuss how their rabies prevention and control initiatives can be improved. Plans are now under way for a DRC rabies control working group, an effort my teammates and I expect to assist with in the future. Agreements have also been put in place that will allow us to continue providing materials and support for DRC laboratory efforts.

I’m glad we had this opportunity to not only share our expertise with DRC but also enhance our own understanding of rabies in a county where the burden of this disease presents unique challenges. But just because we’re back in the United States doesn’t mean the work with DRC is over. In fact, we’ve just begun.

We know that, to be successful, efforts to prevent and control rabies must be continuous. Even though rabies is a big problem in many parts of the world, with the right tools and commitment to public health, positive change is possible. My colleagues and I are glad that we were able to help DRC make such changes and look forward to working with them in the future.