In this update:
[1] Lebanon: human, dog
[2] Israel: north, dog
[1]レバノン: ヒト、イヌ

[1] Lebanon: human, dog

Date: Wed 7 Sep 2022
Source: Nidaa Al-Watan [in Arabic, machine trans., abridged, edited]

Rabies has returned to spread in Lebanon. The return of waste to the roads and with it stray dogs, brought one of the most dangerous diseases to the fore, as rabies has no cure, and its result is
inevitable death.


The child [M] is on a respirator and his family awaits his death from one moment to another. The child was infected with rabies as a result of a dog bite in his home in a southern village. This would bring the
number of child deaths from this disease in Lebanon to 2 within 2 months.


The number is announced, and the Ministry of Health did not pay attention to the matter, and is still dealing with the file of stray dogs and their dangers as a transient phase, despite the certainty of the extent of danger to the people as a result of this phenomenon. Due to the seriousness of the matter, the ministry has rushed to secure vaccines after missing for months.


Approximately a month ago [August 2022], the family's home dog scratched the child and others of the 10 family members. The family had not vaccinated the dog as a preventive measure, on the grounds
that the dog is an "in-house" one, despite knowing that it sometimes meets stray dogs. Symptoms of rabies began to appear in the child a few days ago. He was rushed to the Rafic Hariri University Hospital
and put on a respirator, awaiting his death within 2 days or more.

1ヶ月ほど前[22年8月]、家族に飼われているイヌが、その男児及び他の10名の家族を引っ掻いた。そのイヌがしばしば放浪犬と接触していることを知っていたにもかかわらず、“室内”犬という理由で、その家族は予防措置であるワクチンをイヌに接種していなかった。数日前から男児狂犬病の症状が現れ始めた。彼は、Rafic Hariri大学病院に急いで運ばれ、人工呼吸器につながれ、2日程度以内の死を待っている。

He is the 2nd child dying of rabies within 2 months, following a Syrian child in Tyre. This happens as a result of the spread of stray dogs in Southern Lebanon villages and towns. These dogs are feeding on
the vast quantity of garbage and waste with its dire effects on public health and the environment.


So far, no statement has been issued by the Ministry of Health regarding the family infected with rabies. The ministry is silent about the issue for fear of panic that may afflict people, so it is trying, according to informed sources, to turn a blind eye due to its inability to confront the emerging crisis. According to the same sources, "the ministry opened an investigation and took samples of the infected family, while signs of behavioral changes began to appear in one of its members. Other than that, no steps have been undertaken to push municipalities to remove waste from the roads, or influencing animal welfare associations to move to curb the danger."


More than 10 cases of "dog bites" are recorded daily in the Nabatiyeh region, and similarly in Tyre, Bint Jbeil and Marjayoun. The increasing number of people bitten by dogs is beginning to worry medical institutions, who look at this issue with concern, especially since there is a lack of public awareness. Medical sources confirm that "the patient bitten by a dog must hurry to get vaccinated, to
prevent developing [clinical] rabies, for which there is no cure. The symptoms of rabies appear only 20 days to a month after the bite, just as what happened with child [M]."

Nabtiyeh地区では、毎日10件以上の咬傷事故が報告されており、Tyre、Bint Jbeil及びMarjayounでも同様である。咬傷事故数の増加については、この問題とりわけ市民の認識の欠如を懸念する医療機関が心配し始めている。医療関係者は「イヌに咬まれた患者は、治療することができない狂犬病が発症しないように、早急に予防接種を開始しなければならない。狂犬病の症状は、この男児で起こったように、受傷後僅か20日から1ヶ月ほどで発症する。」事を確認した。

Stray dogs are roaming, attacking people. There are no signs of a solution to this current crisis in view of the bankrupcy of municipalities and of the objection, by animal welfare societies, to the idea of killing the stray dogs in spite of them having become life threatening.

There are no accurate numbers about rabies deaths in Lebanon, although informal information says that the numbers have started to rise.

Communicated by:
ProMED Rapporteur Mahmoud Orabi

[The deteriorating rabies situation in Lebanon has been subject to analysis in a 2018 paper; unfortunately, the situation seems unchanged if not worsening. The (slightly abridged) abstract follows:


"The risk of rabies has taken a new turn over the past few years in Lebanon with 2 emerging situations that have made the control of the disease rather challenging: the neighbouring Syrian war and the local
garbage crisis. Both of these milestone events might have contributed to an increase in the number of disease vectors as well as individuals at risk, thus nourishing the cycle of disease transmission. In this
observational study, the effects of these 2 events are investigated, with an update on the status of this preventable, yet often neglected, disease in the country. Both events were found to be concomitant with a notable increase in the number of dog bites and thus possible rabies exposure. Current regulations are explored through interviews with veterinarians, and custom recommendations, ranging from policies to control dog populations to awareness campaigns in high-risk individuals, are then proposed to help control the disease".


The authors concluded: "Specific to Lebanon are 2 related aggravating issues: the current garbage crisis that unless adequately managed will be a driving catalyst to the rabies spread in Lebanon and the porous borders that need to be controlled in order to restrict the influx of stray dogs that have the capacity to cross boundaries. In this respect, regional cooperation is emphasised".


(Citation: Kassir MF, El Zarif T, Kassir G, et al. Human rabies control in Lebanon: a call for action. Epidemiol Infect. 2018 Nov 15;147:e46. doi: 10.1017/S095026881800300X. Erratum in: Epidemiol
Infect. 2021 Feb 26;149:e47. PMID: 30428942; PMCID: PMC6518599.)

The rabies situation in southern Lebanon is reflected in data from Israel's Galilee region, bordering Lebanon (see item 2). - Mod.AS]

[2] Israel: north, dog

Date: Wed 31 Aug 2022
Source: Maariv Daily [in Hebrew, machine trans., edited]

The regional office of the Health Ministry has been informed about lab confirmation of rabies in a stray dog which had been roaming in Kibbutz Yiron, Upper Galilee. The Ministry of Health asks anyone who
was in contact with the sick dog or a any stray animal, or whose animals came into contact with the dog or any stray animal in the area, between the dates of 15 Aug 2022 and 29 Aug 2022 inclusive, to urgently contact the health office in Safed, or the nearest health office to his/her place of residence, in order for the professionals to examine the need for preventive treatment. In the evening and during the weekend one should refer to a hospital emergency room.

地域の保健局は、Kibbutz Yironで彷徨っていた放浪犬が、狂犬病である事が確定したと発表した。健康局は、2022年8月15日から29日の間に当該地区で病気のイヌまたは放浪している動物に接触した人および飼育動物については、専門家が予防的治療の実施必要性の有無について評価するため、Safedにある健康局、または居住区近隣の健康局に連絡するように求めている。夜間または休日は、病院の救急外来を受診するべきである。

[Byline: Alon Hachmon]
Communicated by:
ProMED Rapporteur Mahmoud Orabi

[The Kibbutz Yiron is situated 1 km from the border with south Lebanon
(map at https://tinyurl.com/2swdanft).

The above rabies case had been preceded, 3 days earlier, by a rabid dog in the village of Hurfeish, Upper Galilee, 3 km from the border with south Lebanon (map at https://tinyurl.com/3uadj6mn).

The notification included a description of the rabid dog and a call to potential contacts to urgently approach the regional health office in Acre or the health office closest to their place of residence.




Since the start of 2022, a total of 18 lab-confirmed animal rabies have been reported by Israel's Veterinary Services, comprising 9 jackals, 5 dogs, 3 cattle and one cat. Most of the cases were situated
adjacent to the Lebanese border. Please refer to the interactive rabies map, presenting the 2022 cases as of 6 Sep 2022, available at
In the legend, dogs are denoted using a pink color pin, jackals aqua, cat yellow, and cattle red.




Data from northern Israel are in tandem with the epidemiological observations from southern Lebanon. The following abstract of a 2009 paper is of relevance.



"Between 1979 and 2000, foxes constituted the main reservoir of rabies in the Northern regions of Israel. Following the implementation of the fox-targeted oral vaccination programme (ORV) in 1998, rabies was eradicated from this area. Subsequently during 2004-2007, the biological and molecular characterization of the rabies isolates showed that stray dogs emerged as the main animal reservoir in
Northern Israel while lower numbers of cases were reported in domestic animals. The virus isolates from foxes and dogs differed, in their molecular characterization, suggesting 2 distinct separate lineages. The transition from fox-mediated rabies to dog-mediated rabies is of great concern to public health because of the close contact between dogs and the human population".


(Citation: David D, Dveres N, Yakobson BA, Davidson I. Emergence of dog rabies in the northern region of Israel. Epidemiol Infect. 2009 Apr;137(4):544-8. doi: 10.1017/S0950268808001180. Epub 2008 Sep 16.
PMID: 18796169.)


During the past 15 years, jackals have gradually replaced foxes as the sylvatic reservoir of the virus. Dog rabies increased, in some years (e.g. 2021) exceeding jackal rabies.



Data of (lab-confirmed) events during recent years:

Year / all animals / dog / jackal

2017 / 74 / 10 / 47

2018 / 60 / 6 / 45

2019 / 17 / 10 / 7

2020 / 47 / 15 / 24

2021/ 40 / 21 / 10

2022*/ 18 / 5 / 9
[* as of 6 Sep 2022]


Rabies is essentially restricted, during the last decade, to regions bordering Lebanon and Syria. - Mod.AS



ProMED maps:
Lebanon: https://promedmail.org/promed-post?place=8705507,85
Israel: https://promedmail.org/promed-post?place=8705507,90]

[See Also:
Rabies (06): Eurasia (Israel, Malaysia, Turkey) dog, owned, stray,
human exp http://promedmail.org/post/20220222.8701585
Rabies (07): Asia, Pakistan (SD) human, Israel (HZ, HD) dog, spread
Rabies (05): Asia (Israel, Bangladesh) animal, human
Rabies (07): Asia (Cambodia, Indonesia, Israel) human, animal, control
Rabies (57): Asia (Lebanon) human, animal
Rabies (15): Asia (Lebanon) canine, OIE
Rabies (03): Asia (Israel) wild, domestic, OIE
Rabies (02): Asia (Israel) wild, domestic, spread, control measures
Rabies - Israel (05): (HZ) canine, human exposure
Rabies - Israel (04): (HZ,HA,HM) canine, human exposure
Rabies, animal - Israel (02): northeast, dog-mediated, human exp susp
Rabies - Israel: travel alert
Rabies, animal - Israel: (HZ)
Rabies, animal - Israel (07): (North-East), dog-mediated
Rabies, animal - Israel (06): bovine, canine origin
Rabies, animal - Israel (05): epidemiology, stray dogs