Rage

Rabies is a viral zoonotic disease caused by Lyssavirus genus infection that produces progressive and fatal inflammation of the brain and spinal cord ^[2][3]. It is a vaccine-preventable neglected tropical disease affecting the central nervous system, transmitted from animals to humans ^[1][3].

Early infection may present with fever, pain, and unusual tingling or burning sensation at the wound site, before the virus reaches the central nervous system ^[2]. The disease manifests as furious rabies with hyperactivity, hydrophobia, and sometimes aerophobia, or paralytic rabies; death follows within days of symptom onset due to cardio-respiratory arrest ^[2][5]. Once clinical disease develops, it is almost certainly fatal, with only rare recoveries reported mostly among bat-variant infections ^[5][3].

Rabies occurs on all continents except Antarctica, causing an estimated 59,000 deaths yearly across more than 150 countries, though underreporting suggests true burden is higher ^[1][2][3]. Approximately 95% of cases are in Africa and Asia, with marginalized rural populations and children under 15 bearing disproportionate burden ^[1][2][3]. The global economic cost is around US$ 8.6 billion per year including lost lives and livelihoods ^[1].

The rabies virus spreads to people and animals through saliva, usually via bites, scratches, or contact with mucosa such as eyes, mouth, or open wounds ^[1][2]. Dogs are responsible for up to 99% of human cases, while in the Americas hematophagous bats are the primary source where dog rabies is controlled; rodent bites do not transmit rabies and human-to-human spread is unconfirmed ^[1][2][5][3]. Less common routes such as aerosol inhalation or consumption of infected animal products are extremely rare ^[5].

Primary prevention relies on dog vaccination campaigns to reduce the animal reservoir and interrupt transmission at its source ^[3]. Human prevention includes awareness of avoiding rabid animal bites, seeking timely post-exposure prophylaxis with wound care, immunoglobulins, and vaccination, and pre-exposure vaccination of at-risk groups ^[1][2][3]. A multifaceted approach with government support, disease awareness, and dog control is needed to achieve elimination of dog-mediated human rabies ^[3].

1. 1 World Health Organization. Rabies [Internet]. cited 3 Sept 2026. Available from: https://www.who.int/news-room/fact-sheets/detail/rabies
2. 2 World Health Organization. Rabies [Internet]. cited 3 Sept 2026. Available from: https://www.who.int/health-topics/rabies
3. 3 Fooks AR et al. Rabies. Nat Rev Dis Primers. 2017 Nov 30. PMID: 29188797. doi: 10.1038/nrdp.2017.91. PubMed: https://pubmed.ncbi.nlm.nih.gov/29188797/
4. 4 Lacy M et al. Human Rabies Treatment-From Palliation to Promise. Viruses. 2024 Jan 22. PMID: 38275970. doi: 10.3390/v16010160. PubMed: https://pubmed.ncbi.nlm.nih.gov/38275970/
5. 5 Hemachudha T et al. Human rabies: neuropathogenesis, diagnosis, and management. Lancet Neurol. 2013 May. PMID: 23602163. doi: 10.1016/S1474-4422(13)70038-3. PubMed: https://pubmed.ncbi.nlm.nih.gov/23602163/