Rabies in the 21st Century

Why are 50,000–55,000 people dying from rabies worldwide each year, with 25,000–30,000 human deaths in India alone and over 3 billion people continuing to be at risk of rabies virus infection in over 100 countries in the 21st century? These are astonishing numbers, particularly as they represent individuals, a large proportion of whom are children, who have been attacked or are likely to be attacked by rabid dogs, the main source of rabies virus infection that, as yet, has not been brought under control in many parts of the world. The number of human deaths and the circumstances by which these deaths continue to occur are extraordinary, with over 95% of rabies victims reported residing in Asia and Africa and nearly all victims of a rabid dog bite. Rabies has been part of the history of civilization for several millennia, rooted in its enzootic environment (animal host) and causing severe threats to public health across continents. Rabies and the symptoms it presents can hardly be ignored, yet it appears to be unduly neglected in some parts of the world, notably in Asia and Africa, where the spread of canine rabies is not under control and is far from being eliminated. In other parts of the world, largely in developed countries, where elimination of canine rabies has been achieved, there are models to be followed and lessons learned that will challenge epidemiologists and molecular virologists alike in the future as they apply new techniques to achieve the elimination of canine and human rabies worldwide.