Oral rabies vaccine baiting and targeted removal strategies for dog-mediated rabies outbreak control: A modelling framework for outbreak management

Background: Support for ongoing regional rabies elimination efforts in dogs and reducing cross border transmission is vital to prevent outbreaks. We explore the effectiveness of two control interventions, oral rabies vaccination (ORV) and targeted ring removal (TRR). Methods: A spatio-temporal compartmental microsimulation model of 2200 free-roaming dogs (FRDs) was fitted to surveillance data with multiple rabies importation events modelled. Based on estimated dog biting rates, seven intervention strategies were explored to assess transmission risk reduction. Results: In the absence of intervention, median human infections over 50 months were 0 (interquartile range: 0–8), 1 (0–11) and 16 (5–29) for one-time, once-per-year, and once-per-month importation events, with 23.5 %, 63.1 %, and 99.97 % of simulations estimating at least one human case. For one-time and annual importation, 90 % dog population TRR reduced this to 5.0 % and 23.5 %. Under monthly importation, both TRR and ORV did not substantially reduce the number of simulations without infection but did reduce the number of infections down to 4 (0–12) and 3 (0–8). Conclusions: ORV can be successfully utilised for dog-mediated rabies outbreak control in elimination settings for intermediate importation rates, while high TRR rates are required for an equivalent impact.