A modified DELPHI approach to outline strategies for raccoon rabies elimination

The National Rabies Management Program (NRMP) has prevented appreciable spread of raccoon rabies to new areas through the strategic annual application of 6-9 million doses of oral rabies vaccine in 15 eastern states. In 2011,... [ view full abstract ]

The National Rabies Management Program (NRMP) has prevented appreciable spread of raccoon rabies to new areas through the strategic annual application of 6-9 million doses of oral rabies vaccine in 15 eastern states. In 2011, a modified DELPHI meeting composed of wildlife management, rabies, and ecologic and economic modeling experts from agencies, universities, NGOs and the private sector, including experts from Canada established inputs critical to macro-economic modeling for characterizing costs and benefits of intervention to prevent raccoon rabies virus variant from spreading to new areas in the U.S. Total projected cost of raccoon rabies spreading west in the U.S. in absence of intervention was $1.1 billion over a 22 year spread horizon. A similar panel of experts was reconvened in March 2016 to provide guidance on short and long term raccoon rabies elimination strategies as well to identify research gaps and effective communication messages. A group decision-making process was again used to explore risk-based strategic approaches to achieve raccoon rabies elimination in the eastern U.S. Three oral rabies vaccination (ORV) based raccoon rabies elimination scenarios were evaluated: 1) short term landscape strategies shown in 3-5 year increments based on a $2.5 million in funds dedicated to elimination from current NRMP budget; 2) maximize progress toward elimination shown in 5 year increments based on a 50% increase in the current budget plus the $2.5 million ($12.5 million); and, 3) raccoon rabies elimination within 30 years with no budget limitations shown in 5 year increments. The outputs from the three specific scenario evaluations provide spatio-temporal details for benefits and cost of rabies and it elimination from the U.S. These models should in turn enhance our ability to make science-based decisions to achieve progress toward eliminating raccoon rabies its attendant high costs and significant impacts to human health, domestic animals and wildlife.