{
  "abstract": "The 2023 reemergence of dog-mediated human rabies in Arequipa, Peru, after nearly a decade of absence, represents a critical failure in public health systems. Despite regional progress toward the “Zero by 30” strategy, this human rabies case highlights persistent systemic vulnerabilities. Here we investigate how this preventable death emerged, by integrating epidemiologic, socioecological, and policy data through a One Health lens. Using the Swiss cheese model, we identified multiple defensive layers—policies, outbreak response, system capacity building, and socio-geographical features—that aligned to permit transmission. We identified critical breaches, such as an 80% decrease in surveillance sampling, insufficient management of feral dog populations in urban corridors, and clinical misdiagnosis of the victim. These findings suggest that rabies persists not for lack of tools, but due to fragmented application and institutional amnesia. We propose a redesigned multisectoral framework to transform human rabies from a neglected tragedy into a true “never event”.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1038/s41598-026-65032-3.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, 423 Guardian Drive, Room 715, Blockley Hall, Philadelphia, PA 19104-6021 USA",
    "Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA USA",
    "One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru",
    "Department of Tropical Medicine and Infectious Disease, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA",
    "Department of Preventive Medicine and Public Health, Facultad de Medicina San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Ricardo Castillo-Neyra"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Lizzie Ortiz-Cam"
    },
    {
      "affs": [
        2
      ],
      "name": "Elvis W. Díaz"
    },
    {
      "affs": [
        2
      ],
      "name": "Jorge L. Cañari-Casaño"
    },
    {
      "affs": [
        4
      ],
      "name": "Sergio E. Recuenco"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Valerie A. Paz-Soldán"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5caw9ggz48mzf.bib",
  "cited_by": 2,
  "doi": "10.1038/s41598-026-65032-3",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13727665/",
  "id": "5caw9ggz48mzf",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://doi.org/10.1038/s41598-026-65032-3",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2406|Rabies epidemiology and control"
    ]
  ],
  "openalex": "W7171935277",
  "pdf_url": "https://www.nature.com/articles/s41598-026-65032-3_reference.pdf",
  "pmcid": "PMC13727665",
  "pmid": null,
  "published": "2026-07-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5caw9ggz48mzf.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T12:23:30Z",
      "native_id": "PMC13727665",
      "source": "pmc",
      "url": "https://doi.org/10.1038/s41598-026-65032-3"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2406|Rabies epidemiology and control",
      "subfield": "microbiology"
    }
  ],
  "title": "A one health analysis of the reemergence of dog-mediated human rabies in Peru",
  "title_text": "A one health analysis of the reemergence of dog-mediated human rabies in Peru",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:48Z",
  "url": "https://research.draconitic.com/paper/5caw9ggz48mzf",
  "venue": "Scientific Reports",
  "versions": []
}