ISDS Annual Conference Proceedings 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution- Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ISDS 2016 Conference Abstracts Progress towards rabies elimination from Pemba Island, Southern Tanzania Kennedy S. Lushasi*1, 2, Sarah Cleaveland2, Joel J. Changalucha1, 2, Daniel Haydon2, Rudovick Kazwala3, Tiziana Lembo2, Msanif Masoud4, Mathew Maziku5, Geofrey Mchau6, Zacharia Mtema1, Kassim Omar7, Sambo Maganga1, 2, Kristyna Rysava2 and Katie Hampson1, 2 1Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania, United Republic of; 2Glasgow University, Glasgow, United Kingdom; 3Sokoine University of Agriculture, Morogoro, Tanzania, United Republic of; 4Ministry of Health, Zanzibar, Pemba, Tanzania, United Republic of; 5Ministry of Livestock and Fisheries Development, Dar es Salaam, Tanzania, United Republic of; 6Ministry of Health and Social Welfare, Dar es Salaam, Tanzania, United Republic of; 7Ministry of Livestock and Fisheries, Zanzibar, Pemba, Tanzania, United Republic of Objective Using active surveillance approaches to investigate the transmission dynamics of rabies on Pemba Island and across Southern Tanzania, whilst a large-scale dog vaccination program was underway1, to gain a greater understanding of the dynamics of infection as the disease is driven towards elimination. Introduction Rabies is endemic in Tanzania and has circulated on Pemba Island since the late 1990s. In 2010, an elimination programme was initiated in Southern Tanzania to demonstrate that human rabies deaths can be eliminated through mass dog vaccinations. We used active surveillance approaches2 to investigate the dynamics of rabies across the area where this programme was implemented. Methods Government census data and post-vaccination transects were used to estimate the dog population and coverages achieved by vaccination campaigns. Routine surveillance of animal bite injuries using a mobile phone-based surveillance system3 and active contact tracing were used to identify animal rabies cases and human exposures. Epidemic trees were constructed using spatiotemporal distances between cases and used to estimate the effective reproduction number (Re). We examined factors affecting rabies incidence and transmission using generalized linear mixed models. Results We estimated a small dog population of 4095 and low dog:human ratio on Pemba (1:105). Overall island-wide vaccination coverage increased from 16.8% in 2011 to 68.2% in 2014. We found a further 48 human exposures (343%), who either were not reported or did not obtain post exposure prophylaxes (PEP). Routine surveillance was found to detect less than 10% (~8.75%). There was a rapid decline in cases detected on Pemba, from 42 before mass dog vaccinations were implemented in 2011, to 2 cases in 2014 (Figures 1). Since May 2014, no rabies cases have been detected. Similarly, Re declined from 1.02 to 0 and a significant relationship was found with rabies cases decreasing with increasing vaccination coverage (p = 0.013, Figure 2). Across seven other districts on the Tanzanian mainland we also observed major declines in rabies cases with very few cases of rabies in dogs detected in 2016 (Figure 3). Conclusions We conclude that rabies has been eliminated from domestic dog populations on Pemba over the five years since vaccination campaigns have been implemented. Continued surveillance and investigations of any bite incidents are therefore needed to ensure any subsequent incursions are controlled and freedom from rabies is maintained. On the Tanzanian mainland, it has taken longer to control rabies, however trajectories look promising with several districts close to eliminating the disease. However, detection of some wildlife cases in the last 12 months in these districts indicates the need to further investigate remaining foci and the role of wildlife in maintenance. Suspect rabies cases in animals (black) and human exposures (red) on Pemba Island, from 2010 to 2015 Estimated vaccination coverage of the dog population (shading) in villages on Pemba, and suspected animal rabies cases (dots) since 2010 following each vaccination campaign from 2011 to date. Darker shading corresponds to higher vaccination coverage Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e118, 2017 ISDS Annual Conference Proceedings 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution- Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ISDS 2016 Conference Abstracts Trajectories of all bite injuries reported to clinics through routine mobile phone-based surveillance (grey) and of rabies cases in dogs (black) and wildlife (red) detected through contact tracing Keywords Canine rabies; elimination; vaccination; dogs; Pemba Island Acknowledgments We are grateful for the support provided by the staff of the Animal and Health Departments of Pemba and to the Tanzania Ministries of Health and Social Welfare, and of Livestock and Fisheries Development, WHO Country Office, and the Bill and Melinda Gates Foundation for support. This work was funded by the Wellcome Trust and UBS Optimus Foundation. References 1 WHO. The sixth meeting of the International Coordinating Group (ICG) of the Bill & Melinda Gates foundation–World Health Organization project on eliminating human and dog rabies. (Durban, South Africa, 2014). 2 Hampson, K. et al. Transmission Dynamics and Prospects for the Elimination of Canine Rabies. Plos Biology 7, e1000053, doi:10.1371/ journal.pbio.1000053 (2009). 3 Mtema, Z. et al. Mobile Phones As Surveillance Tools: Implementing and Evaluating a Large-Scale Intersectoral Surveillance System for Rabies in Tanzania. PLoS Med 13, doi:10.1371/journal.pmed.1002002 (2016). *Kennedy S. Lushasi E-mail: klushasi@ihi.or.tz Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e118, 2017 ISDS16_Abstracts-Final 113 ISDS16_Abstracts-Final 114