Rabies is a viral disease that is transmitted through the saliva or nervous system tissues of an infected mammal to another mammal. The rabies virus infects the central nervous system and causes severely distressing neurological symptoms, disease in the brain, and, ultimately, death.
Rabies is a zoonotic disease, which means that it can pass from other animals to humans. Rabies is the deadliest disease on earth with a 99.9% fatality rate.
Infection usually occurs following a bite or scratch from an infected animal, and the rabies virus is transmitted through the saliva of the host animal. Most often, the virus is passed to human populations through dogs (95% of worldwide cases), but the other species have been identified as important reservoirs of the rabies virus, including bats, raccoons, skunks, foxes, and coyotes.
While not as prevalent, transmission can also occur when saliva comes into direct contact with mucous membranes (i.e., eyes, nose, mouth), and very rarely through inhalation of aerosolized saliva, and through corneal and internal organ transplantation.
There have been cases where butchering raw meat from rabid animals has transmitted the infection, presumably through infectious neural tissue coming into contact with open wounds in the skin.
Rabies is found on every continent except Antarctica. In Africa, the Middle East, and Asia, canine rabies is a wide-spread problem and contributes to over 90% of rabies cases world-wide. In developed nations and island nations, rabies is either well-controlled amongst domesticated animals, or it is non-existent.
Today, over 90% of rabies deaths are in Africa, Asia and the Middle East where canine rabies is widespread.
Rabies kills people, domestic animals (such as dogs and cattle) and causes financial hardship when people have to pay for vaccination after bite wounds. It is estimated that more than 5.5 billion people live at daily risk of rabies.
Estimates suggest that over 5.5 billion people live with the daily risk of rabies, with 59,000 deaths every year. Over 95% of these deaths are in Africa and Asia, with the majority occurring from rabid dog bites. Around half of the people who die are children.
In western nations, deaths are rare (1-3 deaths per year in the United States), with cases of clinical rabies occurring typically in people who did not realize that they had been exposed.
Yes, there is no effective treatment once clinical symptoms appear. Rabies has the highest case-fatality rate of any infectious disease known to man, because there is no proven cure or treatment available once there are signs of an infection.
However, if proper medical treatment (post-exposure prophylaxis, PEP) is received immediately after exposure to the bite or scratch of a rabid animal, rabies infection can be halted before symptoms of the disease are present, and the disease can be prevented.
Some of the world’s poorest people are those most at risk of the disease.
Post-Exposure Prophylaxis (PEP) is a course of vaccines administered urgently after exposure to the virus from a rabid animal. PEP stops the onset of clinical symptoms and certain death. However, it comes at a high price, sometimes several times a household's monthly income.
Families living in rural areas of Africa and Asia often face the desperate choice of selling livestock (on which they depend for food) to pay for the cost of rabies treatment or dying (or allowing a family member to die) of the disease.
Currently, PEP costs the global economy 10 times the amount it would cost to eliminate canine rabies at source (by vaccinating dogs). Overwhelmingly, this cost is paid for by the world's poorest people, perpetuating their poverty.