Rabies: A neglected zoonotic disease
Rabies is a zoonotic disease (a disease that is transmitted from animals to humans), which is caused by a lyssavirus. Transmission of the virus is achieved by entering the body through wounds (e.g. scratches) or by direct contact with mucosal surfaces from an infected animal (e.g. bites), it cannot cross intact skin. There are two clinical manifestations of rabies – furious and paralytic. Furious rabies is most common form of human rabies.
Rabies is known to be present in more than 150 countries and territories and on all continents except Antarctica. It is estimated that more than 60 000 deaths occur annually from rabies with more human deaths occur in Asia than anywhere else in the world (30 000 deaths per annum), with Africa not far behind in numbers (23 700 deaths per annum). Some 84% of deaths from rabies occur in rural areas, with 4 out of every 10 deaths being a child. Underreporting in many developing countries is likely to lead to underestimation of the scale of the disease burden; therefore, field data to validate these estimates in a number of regions are needed to address the lack of accurate data.
Rabies is a vaccine-preventable disease. Countries embarking on rabies elimination programmes have experienced successful marked reductions and eventual elimination of rabies. Mass canine vaccination programs constitute a large part of a rabies elimination programmes that should cover at least 70% of the canine population.
Safe, effective vaccines can be used for pre-exposure immunization in people as well. Use of the intradermal vaccine has a cost savings of 60-80% in comparison to the intramuscular vaccine, and may be a more cost-effective option for rural areas where the disease is endemic.