AUG 10, 2021

Epidemiology and postexposure prophylaxis of rabies virus

WRITTEN BY: J. Bryce Ortiz

Rabies is a viral disease that can be transmitted from an infected animal to another animal or human. In the United States, rabies is commonly found in wild animals such as foxes, skunks, coyotes, and bats. An estimated 30,000 to 60,000 individuals are treated for rabies every year in the United States. Fortunately, rabies is a curable disease if treatment begins soon after infection. However, if left untreated, and symptoms develop, rabies is nearly always fatal.

Symptoms of untreated rabies include fever, headache, nausea, excessive salivation, insomnia, fear and anxiety, and hallucinations. After decades of postexposure prophylaxis, rabies deaths have essentially disappeared from North America and Europe. However, the incidence of rabies deaths are still prevalent in other countries that lack sufficient access to immunization against rabies and other preventative measures. As such, rabies remains a significant global health burden and claims close to 60,000 human lives per year. In two recent articles in the journal PLoS Neglected Tropical Diseases, researchers are looking at ways to assess and combat rabies virus deaths. 

The first study performed an epidemiological assessment of rabies deaths in China to understand how the disease is affecting humans across the large country. Results from the assessment found that rabies deaths have decreased steadily across the years, where there were over 3,000 deaths in the year 2007 to under 500 deaths in the year 2018. The researchers also found that a common cause of death in the most recent cases were in individuals who had been bitten by a dog that was infected by the virus. These individuals were usually male farmers over the age of 45. The authors state that these data will help to educate the public and health care officials to help eliminate the disease by the year 2030. 

second viewpoint article published in the same journal argues for a more accessible and more efficient delivery of posttreatment prophylaxis for rabies. The authors point out, that in the United States where rabies infection is low compared to other parts of the world, access to treatment is flawed. Indeed, there are many financial barriers and different methods of treatment for the disease. As such, the authors outline proposed guidelines that should be followed that can make treatment more accessible. These guidelines included: removing clinical and economic barriers for treatment access, developing a coordinated system for rabies treatment chain of care, and developing a guidance for wound treatment and vaccine administration for the entire country. Together, these studies highlight that rabies is a public health burden, but that the disease is easily treatable and coordinated efforts are needed to eliminate rabies across the globe. 

 

Sources: CDCPLoS Neglected Tropical DiseasesEpidemiology of Rabies in ChinaRabies postexposure prophylaxisYouTube