Table 2.

Major milestone events for the gradual elimination of dog-specific RABLV lineages from the Western Hemisphere.

Period	Milestone events, in chronological order	Impact on confirmed rabies
		Cases in dogs	Cases in humans
1888-early 1900’s	Beginning of rabies vaccination in humans with Semple’s type vaccines.	ND	ND
1960–1979	Production of suckling-mouse-brain vaccine.	1960s: ND	1960s: ND
	Availability of PEP for humans in large cities.	1979: 23000	1979: 310
	Vaccination campaigns of owned dogs in large cities.
	Dog population management by removal of stray dogs in capital cities.
	Introduction of rabies diagnostic units in major cities, based on histopathology (Seller’s staining).
	Implementation of direct immunofluorescent antibody test (DFA) in national reference laboratories only.
1980–1990	Dog rabies is recognized as a public health problem	1980: 24000	1980: 300
	PAHO/WHO advocates and coordinates rabies control and prevention initiatives throughout	1990: 8500	1990: 270
	REDIPRA
	Creation of multifunctional anti-rabies centers in major cities.
1991–2015	Establishment of comprehensive national rabies control and prevention programs for dogs and humans, administered by Ministries of Health with federal budget.	1991: 16250	1991: 240
		2015: 316	2015: 3
	Acquisition of cell culture-derived rabies vaccines for humans and animals
	Implementation of a revolving fund administered by PAHO to acquire rabies biologics a cover expenses of cold chain storage
	Execution of massive dog vaccination campaigns with intersectoral and community cooperation twice a year.
	Establishment of minimum potency policies for human and animal rabies vaccine manufactures to counteract adverse cold chain and field conditions
	Implementation of regional financial strategies (PAHO revolving fund) for consolidated acquisition of rabies biologicals for humans and animals at more affordable prices
	Creation of decentralized nationwide rabies diagnostic networks, using DFA as gold standard. Improvement of cold chain for human and animal vaccines at Federal, State, Municipal and local levels
	Creation of decentralized nation-wide animal control Units
	Legislation and enforcement of responsible pet ownership
	Embrace policies for elimination and management of stray dog populations in collaboration with NGOs, humane societies and the community.
	Communication outreach sponsored by Ministries of Health and the federal government, with intersectoral collaboration.
	Technology transfer agreements with WHO collaborating centers on rabies to strengthen laboratory-based rabies surveillance.
	Implementation of oral rabies vaccination for free-roaming dogs and wildlife species maintaining dog-specific and dog-related RABV.

ND: not determined. Source for the numbers of humans and dogs infected with dog-specific RABLV variants: SIRVERA/SIEPI-PANAFTOSA/OPS-OMS (updated to 2015) http://siepi.panaftosa.org.br/. REDIPRA (Reunión de Directores de Programas de Rabia de las Américas), from its acronym in Spanish.