Going viral in PNG - Exploring routes and circumstances of entry of a rabies-infected dog into Papua New Guinea.

In this qualitative study implemented in November 2016, we elicited narratives about fictional rabies incursions from key employees (n = 16) of the National Agriculture and Quarantine Inspection Authority in Papua New Guinea (PNG) to explore the potential circumstances and routes of entry of a rabies-infected dog, and direct rabies preparedness. Although PNG is rabies free, proximity to rabies-endemic Indonesia poses a risk of introduction and it is expected that an outbreak in PNG would have devastating human health impacts consistent with other countries with similarly low human development indices and abundant free-roaming dogs. Participants used their local and professional knowledge to create plausible narratives in response to contextual, but fictitious, newspaper stories. An ethnographic content analysis was used to extract themes and interpret the narratives. Themes were assessed in the context of their potential influence on rabies preparedness in PNG against the social and political background of PNG and relevant, published literature. Consistent themes included the ubiquity of trade and the complexity of routes between Indonesia and PNG. Dog ownership seemed pragmatic - actors in the narratives readily and rationally involved dogs in transactions in response to trade, exchange or gifting opportunities. Consequently, dogs changed ownership frequently. The findings of this study have important implications for rabies preparedness in PNG; there is potential for wide geographic dissemination of rabies in dogs before outbreak detection. However, common patterns of travel - trade of dogs via Papuan towns and use of traditional trade routes - do provide opportunity for targeted surveillance and response in the event of an incursion.