Rabies

Rabies is an acute viral infection that is nearly always fatal. Transmission is usually through saliva via the bite of an infected animal, with dogs being the main transmitter of rabies to humans.

The World Health Organization has estimated the annual number of human rabies deaths to be between 40,000 and as high as 70,000. Most of these deaths take place in developing countries, particularly in South and South East Asia.

In the UK the last human death from indigenous classical rabies occurred in 1902, and the last case of indigenous terrestrial animal rabies was in 1922. Most cases of rabies in the UK now occur in quarantined animals, or in people infected abroad. Since 1946 there have been 24 deaths in people infected with rabies abroad, 4 of which have occurred since 2000. There were two imported cases of rabies in 2001, one acquired in Nigeria and the other in the Philippines. A case occurred in 2005 which had been acquired by a dog bite in Goa. None of these imported cases received post-exposure prophylactic treatment for rabies either in the country of origin or in the UK. The most recent case (December 2008) of human rabies in the UK resulted from a dogbite in South Africa.

In 2003 it was recognised that UK bats may carry a rabies-like virus, European Bat Lyssavirus 2 (EBL2). A man who was a bat handler died from EBL2 infection probably acquired in Scotland.

The Health Protection Agency provides advice to health professionals on pre-exposure and post-exposure prophylaxis for rabies, and issues rabies vaccine or vaccine and rabies immunoglobulin according to Department of Health recommendations. It also provides advice about suspected human cases of human rabies.

Further information on rabies is published in a Department of Health Memorandum, through the World Health Organization and the Rabies Bulletin Europe.