In North America, the gray fox (Urocyon cinereoargenteus) serves as an important wildlife reservoir for distinct rabies virus variants, particularly in the southwestern United States, northern Mexico, and parts of Texas. Gray fox rabies is maintained through intraspecific transmission and can spill over into other wildlife species, livestock, and domestic pets, posing ongoing challenges for disease management. Additional challenges include the spillover of non-gray fox rabies virus variants into gray fox.

Regional and global contexts influence rabies risk of local populations. In this session, we will discuss how One Health is operationalized in local public health for rabies prevention – the systems and resources required and lessons that may be adaptable and scalable for other settings.

Learning Objectives:

Background: SYN023 (zamerovimab plus mazorelvimab) is a dual-monoclonal-antibody cocktail developed for passive immunization in rabies post-exposure prophylaxis (PEP). We evaluated its performance in pediatric studies and in a high-risk real-world outbreak setting in China.

Accurate detection of intrathecal antibodies against rabies virus (RABV) is critical for ante-mortem diagnosis and disease monitoring, particularly when virus-neutralizing activity is low or delayed. In this study, indirect ELISAs were developed to detect IgM, IgG, and polyvalent (IgA/IgM/IgG) antibodies against RABV glycoprotein (RABV G) in cerebrospinal fluid. The RABV G antigen, purified by Lens culinaris lectin affinity chromatography, retained physicochemical and immunoreactive properties, as confirmed by SDS-PAGE, monoclonal antibody recognition and lectin-binding assays.

On September 28, 2023, the Nebraska Department of Health and Human Services (NDHHS) was notified of a rabid stray kitten in Omaha, Nebraska. On October 6, CDC variant typing confirmed eastern raccoon rabies virus variant (RRVV), ~850 miles west of an endemic area. To prevent RRVV spread, a multiagency response was initiated to conduct enhanced rabies surveillance (ERS) and vaccinate wildlife. Beginning October 14, NDHHS and CDC conducted ERS using a lateral flow assay on found-dead and euthanized at-risk wildlife and feral cats collected ≤10 km from the kitten.

The Laboratory Environment Management System (Sistema Gerenciador de Ambiente Laboratorial - GAL) is a laboratory information system whose data are essential for identifying epidemiological patterns, monitoring diseases, and supporting the development of control strategies. This study aimed to evaluate data related to animal samples submitted for rabies diagnosis at the Instituto Pasteur, São Paulo, Brazil, from January/2018 to December/2024.

Free-roaming dogs (FRDs) pose a persistent obstacle to canine rabies elimination in low- and middle-income countries, as current parenteral vaccination strategies struggle to reach this population, thereby sustaining rabies virus transmission. We conducted cross-sectional surveys in Nigeria and  Sierra Leone and fitted country-specific probabilistic models to identify factors associated with FRD ownership. The proportion of households allowing dogs to roam freely was higher in Sierra Leone (71%) than in Nigeria (58.5%).

Enhanced rabies surveillance (ERS) of wildlife populations is a critical component of North American rabies management programs. Merging ERS with public health surveillance data has provided strong inferences about virus distribution and movement patterns which has facilitated early identification of potential outbreaks, and informed containment and elimination strategies at regional and landscape scales. Effective ERS relies on accurate and efficient laboratory diagnostic methods with several validated methods available for detection of Lyssavirus rabies (RV).

Objective: Human Rabies Immune Globulin (HRIG) is commonly administered to children after rabies exposure; however, the safety of the 300 IU/ml concentration in children is not well documented. The objective of this observational, prospective study was to collect adverse events (AEs) within 30 days after HRIG 300 IU/mL (HyperRab®) administration in children (age ≤ 17 years).

Background: HyperRAB® is a concentrated human rabies immune globulin (HRIG; 300 IU/mL) that enables weight-based dosing and wound infiltration with less volume. Because higher concentrations may raise treatment risks, particularly in children, we evaluated healthcare utilization, treatment patterns, and clinical outcomes among pediatric and adult patients receiving HyperRAB.