title: Laboratory diagnostics in dog-mediated rabies: an overview of performance and a proposed strategy for various settings.
abstract: The diagnosis of dog-mediated rabies in humans and animals has greatly benefited from technical advances in the laboratory setting. Approaches to diagnosis now include the detection of rabies virus (RABV), RABV RNA, or RABV antigens. These assays are important tools in the current efforts aimed at the global elimination of dog-mediated rabies. The assays available for use in laboratories are reviewed herein, as well as their strengths and weaknesses, which vary with the types of sample analyzed. Depending on the setting, however, the public health objectives and use of RABV diagnosis in the field will also vary. In non-endemic settings, the detection of all introduced or emergent animal or human cases justifies exhaustive testing. In dog RABV-endemic settings, such as rural areas of developing countries where most cases occur, the availability of or access to testing may be severely constrained. Thus, these issues are also discussed along with a proposed strategy to prioritize testing while access to rabies testing in the resource-poor, highly endemic setting is improved. As the epidemiological situation of rabies in a country evolves, the strategy should shift from that of an endemic setting to one more suitable for a decreased rabies incidence following the implementation of efficient control measures and when nearing the target of dog-mediated rabies elimination.
authors.affiliation: Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
authors.forename: Veasna
authors.initials: V
authors.lastname: Duong
authors.affiliation: Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, 5, Bvd Monivong, BP 983, Phnom Penh, Cambodia. Electronic address: atarantola@pasteur-kh.org.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Tarantola
authors.affiliation: Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
authors.forename: Sivuth
authors.initials: S
authors.lastname: Ong
authors.affiliation: Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
authors.forename: Channa
authors.initials: C
authors.lastname: Mey
authors.affiliation: Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
authors.forename: Rithy
authors.initials: R
authors.lastname: Choeung
authors.affiliation: Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, 5, Bvd Monivong, BP 983, Phnom Penh, Cambodia.
authors.forename: Sowath
authors.initials: S
authors.lastname: Ly
authors.affiliation: Institut Pasteur, Lyssavirus Dynamics and Host Adaptation Unit, National Reference Centre for Rabies, WHO Collaborating Centre for Reference and Research on Rabies, Paris, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Bourhy
authors.affiliation: Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
authors.forename: Philippe
authors.initials: P
authors.lastname: Dussart
authors.affiliation: GlaxoSmithKline Vaccines, R&D Asia Pacific, 150 Beach Road, Unit 22-00, 189720 Singapore. Electronic address: philippe.x.buchy@gsk.com.
authors.forename: Philippe
authors.initials: P
authors.lastname: Buchy
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission; D004285:Dogs; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards*; D011818:Rabies / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission / Q000821:virology; D011820:Rabies virus / Q000235:genetics / Q000302:isolation & purification*
keywords: Animal; Diagnosis; Endemic; Human; Rabies; Virus