Risk-based cost modelling of oral rabies vaccine interventions for raccoon rabies.

Distribution of oral rabies vaccine (ORV) is an effective but costly strategy to control raccoon rabies. Because of high costs, ORV for raccoon rabies in the U.S. has been limited primarily to epizootic areas, leaving extensive raccoon rabies regions without any ORV intervention. Several cost scenarios for ORV application in raccoon rabies enzootic and epizootic regions were modelled in New York State to obtain estimated costs of ORV baits per scenario and potential savings compared with a uniform ORV baiting strategy. These cost scenarios modelled at the census tract, level the application of ORV baits at different densities according to levels of risk defined by the observed number of raccoon rabies cases per km2 and the expected number of cases per km2 estimated with a Poisson regression model. Bait purchase costs were lower using the modelled cost scenarios than a uniform baiting strategy, for both the NYS enzootic region and the Long Island epizootic zone. The proportion of savings for the NYS enzootic region was 29.57%, and the proportion of savings for the Long Island epizootic zone was 38.9%. Use of these cost scenarios to determine bait distribution by rabies risk level should be considered to maximize efficacy and reduce costs of ORV interventions.