Eliminating Rabies: A Case Study From Greece

Rabies is an animal-borne illness that is present virtually everywhere in the world, and is still a major cause of death in developing countries. There is perhaps nowhere that the emergence, spread, and control of rabies has been more thoroughly documented than Greece. There, rabies has been studied and documented since the ancient and Byzantine eras, which makes it a fascinating case study for what works and what doesn’t when it comes to rabies control. Perhaps most interestingly, Greece was rabies free from 1987 to 2012, when Northern Greece experienced a reemergence of wild and domestic animals. No human cases of rabies have been seen since 1970.

This paper represents an attempt to review the history of rabies in Greece in order to better understand strategies that might help fight the current re-emergence in Greece, and other places in the world as well. A group of 10 researchers—including three public health officials, three vets, three experts on rabies epidemiology, and one historian—reviewed a broad range of literature to arrive at their conclusions. The paper begins by offering an extensive historical context ranging from ancient times all the way up to the modern era, when, in the 19th century, the government began trying to control the epidemic by tagging dogs and providing clean water for dogs in public places. In the early 20th century, royal decrees presented a more comprehensive plan, which included killing animals with the disease, isolating suspected animals, banning the movement of animals in affected areas, and more. In 1983, Greece turned the tide on rabies with strict controls on stray dogs, as well as compulsory and free of charge vaccination of dogs with registered owners. This program, along with more public awareness, helped to slowly chip away at rabies cases until Greece was rabies free in 1987.

The paper goes on to describe the re-emergence of the disease in wild animals in 2012. While the re-emergence was not a complete surprise because of the high rates of rabies in neighbouring countries, it has still led to a reboot of rabies control measures there, including a range of public awareness campaigns, as well as the issuing of an informative “Rabies Control Manual” to the public. Currently, rabies vaccinations are compulsory for dogs, but are not free. For companion animal and wild animal advocates, the authors note that the modern fight against the disease could be greatly enhanced by an oral vaccination program for wild animals, as well as more inter-sectoral collaboration between agencies that can help bring about change.