A call to accelerate an end to human rabies deaths

Abstract

Every year, an estimated 59 000 vaccine-preventable deaths occur globally due to rabies. These deaths occur despite more than 100 years of existence of effective vaccines against rabies in humans and dogs, which serve as the main source of infection for humans. Most of these deaths are in Africa and Asia among neglected populations that are hard to reach or economically disadvantaged, living in areas where availability of and access to these life-saving human rabies vaccines is poor and dog vaccination is low. Several epidemiological characteristics support the feasibility of rabies elimination. For example, the virus is transmitted by a known and accessible vector (ie, the domestic dog); transmission is by symptomatic animals, making it possible to identify suspected rabid animals; efficacious rabies vaccines exist that confer long-term immunity; and, across many settings, the basic reproduction ratio for rabies cases is low (R0< 2), with vaccination covering 70% of dogs in a region being sufficient to eliminate the disease.