A spatial model to forecast raccoon rabies emergence.

Although raccoons are widely distributed throughout North America, the raccoon rabies virus variant is enzootic only in the eastern United States, based on current surveillance data. This variant of rabies virus is now responsible for >60% of all cases of animal rabies reported in the United States each year. Ongoing national efforts via an oral rabies vaccination (ORV) program are aimed at preventing the spread of raccoon rabies. However, from an epidemiologic perspective, the relative susceptibility of naïve geographic localities, adjacent to defined enzootic areas, to support an outbreak, is unknown. In the current study, we tested the ability of a spatial risk model to forecast raccoon rabies spread in presumably rabies-free and enzootic areas. Demographic, environmental, and geographical features of three adjacent states (Ohio, West Virginia, and Pennsylvania), which include distinct raccoon rabies free, as well as enzootic areas, were modeled by using a Poisson Regression Model, which had been developed from previous studies of enzootic raccoon rabies in New York State. We estimated susceptibility to raccoon rabies emergence at the census tract level and compared the results with historical surveillance data. Approximately 70% of the disease-free region had moderate to very high susceptibility, compared with 23% in the enzootic region. Areas of high susceptibility for raccoon rabies lie west of current ORV intervention areas, especially in southern Ohio and western West Virginia. Predicted high susceptibility areas matched historical surveillance data. We discuss model implications to the spatial dynamics and spread of raccoon rabies, and its application for designing more efficient disease control interventions.