Rabies: A holistic and updated review

This is the authors' abstract. We don't add key points for this paper.

Rabies is a zoonotic disease caused by the rabies virus, which occurs worldwide, primarily in Asia and Africa, and is present on all continents except Antarctica. Rabies is transmitted through bites of rabid animals, primarily dogs. This narrative review aims to synthesize current evidence on epidemiology, preventive strategies, and challenges in global rabies elimination, and to provide a way forward for future research and health system strengthening. We searched electronic databases, including PubMed and Google Scholar, as well as World Health Organization (WHO) reports and documents, and Centers for Disease Control and Prevention (CDC) guidance documents. The literature was reviewed from January 2018 to September 2025 AD. Despite being vaccine-preventable, rabies is still an endemic disease in many countries and a significant public health concern globally, causing almost 59,000-70,000 deaths per year worldwide. Elimination and control of rabies are achieved through awareness programs and community education on animal bites and their prevention, as well as vaccination programs implemented through the One Health approach, with engagement and collaboration among multiple sectors and organizations. The disease is preventable through timely wound care and vaccinations either before or immediately after exposure. Currently available therapeutic approaches, such as the Milwaukee and Recife (Brazilian) protocols, are experimental for rabies and have not demonstrated consistent clinical benefit. Improving case monitoring, surveillance, diagnostic methods, monitoring the incidence of bite cases, and the equitable distribution of vaccines are essential for effective rabies control, particularly in endemic and rural areas