Where Rabies Is Entrenched – The New York Times

Rabies has been known since antiquity, and has been completely preventable since Pasteur developed a vaccine more than a century ago. But the World Health Organization still considers it “a neglected disease of poor and vulnerable populations.”

Why? Rabies, one expert has written, “became a neglected disease when it was eliminated from Europe and North America.”

The vast majority of the estimated 59,000 human deaths each year from rabies are in Africa and Asia, in countries with large populations of free-roaming dogs that provide a so-called reservoir for the virus.

The virus kills any dog it infects. But if a rabid dog transmits the disease to one other dog before it dies, the virus remains alive and able to spread among dogs and to humans.

Some countries, like Australia, never had canine rabies, but have other viruses in the same family, lyssaviruses.

Canine rabies has been eliminated in the United States, Western Europe, Canada, Japan and Chile, Uruguay and Paraguay. And its toll has been drastically reduced in much of Central America and South America through vast vaccination programs involving yearly nationwide campaigns.

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“In 2016, 10 deaths due to dog-mediated rabies were reported in the Americas — eight in Haiti and two in Guatemala,” according to a 2018 report on global rabies from the W.H.O. There were 23 deaths from rabies spread by other species in the same year.

Africa and Asia have the greatest number of rabies deaths, although estimates are rough. About 20,000 people die each year in Africa and in India.

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