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Page 149 Millien et al. One Health Implement Res 2023;3:148-60 https://dx.doi.org/10.20517/ohir.2023.37

the Ministry of Agriculture for further investigations. HARSP marked a pivotal moment in the Rabies Control and
Elimination Program. Between January 2013 and December 2017, there were 9,342 reported human exposures to
animals suspected of carrying rabies in Haiti. The number of Human exposures to rabies suspected animals in Haiti
from January 2013 to December 2017 was 9,342 heads. Among these cases, 2.4% were confirmed, 4.9% probable,
17.8% suspected, and 74.6% discarded. The One Health rabies program has demonstrated the potential for
achieving control of both animal and human rabies in Haiti if the ministries of Agriculture and Health commit
unequivocally to continue their collaborative development efforts and adhere to HARSP methodology, including
vaccinating over 70% of the dog population.

Keywords: History of rabies, Haiti, One Health approach, epidemiological surveillance, control

INTRODUCTION
Rabies is a central nervous system disease that affects all mammals including humans. It is primarily
transmitted through bites from animals infected with the rabies virus. The main sources of virulent material
are saliva, nerve tissue, and lacrimal secretions. Rabies is caused by a virus belonging to the genus Lyssavirus
[1]
and the family Rhabdoviridae . Rabies virus (RABV) is the only species of Lyssavirus found in the
[2]
Americas, where it mainly circulates in bats and mesocarnivores . It typically causes behavioral
disturbances, hyperexcitability, anxiety, paralysis, dysphagia, hydrophobia, and other neurological
abnormalities. The evolution of the disease is always fatal once its clinical signs begin to appear [1,3,4] . In dogs,
it often causes a change in the timbre of the voice, a tendency to run away, hallucinations, excessive
salivation, and paralysis of the lower jaw which becomes drooping .
[3]

Rabies is estimated to be responsible for more than 59,000 human deaths each year . Although all
[5,6]
mammals are susceptible to infection by the rabies virus, the domestic dog is responsible for approximately
99% of human rabies deaths, particularly in regions where rabies is endemic, such as Africa and Asia .
[6]

Canine rabies has been eliminated in most developed countries, primarily due to successful rabies
[4]
vaccination programs and responsible dog population management . Haiti is one of the higher-risk areas
for human rabies transmitted by dogs, necessitating increased collaboration and financial support . The
[7]
most recent large-scale reduction in the prevalence of canine rabies has been observed in the Western
Hemisphere, where human deaths from rabies transmitted by dogs reached historic lows starting in 2014 .
[8]
The Republic of Haiti, a Caribbean nation with a population of 11.65 million, has been identified as one of
the few countries in the Western Hemisphere where progress in controlling canine rabies is not evident.
Dogs are the only known reservoir for the rabies virus in Haiti, but neighboring countries Cuba and the
Dominican Republic have identified endemic transmission cycles in mongooses and bats . Both of these
[2]
species are endemic to Haiti and may represent cryptic reservoir species .
[2,9]
THEORETICAL FRAME
Rabies in the American continent, especially in Saint Domingue
Despite the existence of rabies in bats and skunks for millennia, and the fact that dog populations entered
the Americas with humans long before the arrival of Europeans, overlapping in the same geographic areas
and at the same time, with RABLV variants circulating in bats and skunks, America remained free of canine
rabies long after the first Europeans arrived [10,11] .This situation seems to have lasted for more than two
centuries, without being able to explain with the greatest certainty why the Americas (North, South, Central,
and Caribbean) remained free from enzootic rabies maintained by dogs for such a long period. Mexico was
the first country in 1709 to record the first dog-borne epizootic of rabies in the New World. It would have
occurred in the Greater Antilles during the period 1776-1778 .
[12]