The disease occurs worldwide, with certain exceptions. Large regions in Europe becamefree of terrestrial rabies as a result of wildlife vaccination programmes.
The rabies situation and the regulations are continuously updated on the web sites of OIEand WHO (see reference section).
The number of human deaths caused each year by rabies is estimated to beapproximately 40, 000 to 100, 000, worldwide, and an estimated 10 million peoplereceive post-exposure treatments each year after being exposed to rabies suspectanimals [WHO, 2006]. Dog rabies is still very important in many parts of the world and isthe principal cause of human rabies cases. In many countries, wildlife rabies has becomeof increasing importance as a threat to domestic animals and humans, and transmissionfrom vampire bats is an important issue. The red fox, raccoon, skunk and mink are themain reservoir species of terrestrial rabies in Europe and North and South America.
The control of rabies in various regions of the world poses very different problems,depending upon the reservoir host and prevalence of infection.
Strictly enforced quarantine of dogs and cats for various periods before entry has beenused effectively to eliminate rabies virus from Japan, the United Kingdom (UK), Australia,New Zealand and several other islands. Rabies was never endemic in wildlife in the UKand was eradicated from dogs in the UK in 1902, and again in 1922 after it becameestablished in the dog population in 1918. Since then, there had been no rabies in the UKuntil recently when there were isolated reports of bats infected with European bat virus1. However, such isolated incidents did not alter the (terrestrial) rabies-free status of theUK. In contrast, rabies was not recognized in Australia until recently when Australian batlyssavirus was discovered, and found subsequently to be endemic in Southeast Australia.
In most countries of Asia, Latin America and Africa, endemic dog rabies is a seriousproblem, causing significant domestic animal and human mortality. In these countries,large numbers of doses of human vaccines are used and there is a continuing need for comprehensive, professionally organized and publicly supported rabies control agencies.That such agencies are not in place in many developing countries is a reflection of theirhigh cost; nevertheless, progress is being made. For example, a substantial decrease inrabies incidence has been reported in recent years in China, Thailand and Sri Lanka,following implementation of dog vaccination programmes and improved post-exposureprophylaxis of humans. Similarly, the number of rabies cases in Latin America is decliningsignificantly; the Pan American Health Organization has implemented a vaccinationprogram to eliminate urban dog rabies from the Southern hemisphere.
In most industrial countries, even those with modest disease burden, publicly supportedrabies control agencies operate in the following areas: (1) programmes of oralvaccination of wildlife, in Europe of the red fox; (2) stray dog and cat removal andcontrol of the movement of pets (quarantine is used in epidemic circumstances, butrarely); (3) immunization of dogs and cats, so as to break the chain of virustransmission; (4) laboratory diagnosis, to confirm clinical observations and obtainaccurate incidence data; (5) surveillance, to measure the effectiveness of all controlmeasures; and (6) public education programs to assure cooperation.
The cat is considered in some European countries to be high-risk species for transmissionto human beings. For example, of more than 20, 000 inhabitants in Switzerland that hadto be vaccinated after exposure to rabies in the years from the late 1960s until the early1990s, around 70% had been either bitten or in close contact with cats [Hohl et al,1978].
Even if feline rabies is considered to be a by-product of canine or wild rabies [Blancou &Pastoret 1990], behavioural characteristics of cats and clinical aspects of the disease inthis species render it important for public health reasons. In fact, despite a lower numberof post-exposure prophylaxis treatment for people following cat bites compared to dogbites, treatment is justified more often [Blancou & Pastoret 1990].