Editing Rabies (section)

==Epidemiology==
{{Main|Prevalence of rabies}}
[[File:Rabies world map-Deaths per million persons-WHO2012.svg|thumb|upright=1.3|Deaths from rabies per million persons in 2012 {{refbegin|3}}{{legend|#ffff20|0}}{{legend|#ff9a20|1}}{{legend|#f08015|2–4}}{{legend|#e06815|5–9}}{{legend|#d85010|10–17}}{{legend|#d02010|18–69}}{{refend}}]]
[[File:Rabies Free Countries and Territories.svg|thumb|upright=1.3|Map of rabies-free countries and territories]]

In 2010, an estimated 26,000 people died from rabies, down from 54,000 in 1990.<ref name=Loz2012>{{cite journal | vauthors = Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, etal | title = Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2095–128 | date = December 2012 | pmid = 23245604 | doi = 10.1016/S0140-6736(12)61728-0 | hdl = 10536/DRO/DU:30050819 | s2cid = 1541253 | url = https://zenodo.org/record/2557786 | hdl-access = free }}</ref> The majority of the deaths occurred in Asia and Africa.<ref name="WHO factsheet" /> {{As of|2015}}, India, followed by China (approximately 6,000), and the Democratic Republic of the Congo (5,600) had the most cases.<ref>{{cite journal | vauthors = Hampson K, Coudeville L, Lembo T, Sambo M, Kieffer A, Attlan M, Barrat J, Blanton JD, Briggs DJ, Cleaveland S, Costa P, Freuling CM, Hiby E, Knopf L, Leanes F, Meslin FX, Metlin A, Miranda ME, Müller T, Nel LH, Recuenco S, Rupprecht CE, Schumacher C, Taylor L, Vigilato MA, Zinsstag J, Dushoff J | display-authors = 6 | title = Estimating the global burden of endemic canine rabies | journal = PLOS Neglected Tropical Diseases | volume = 9 | issue = 4 | pages = e0003709 | date = April 2015 | pmid = 25881058 | pmc = 4400070 | doi = 10.1371/journal.pntd.0003709 }}</ref> A 2015 collaboration between the World Health Organization, World Organization of Animal Health (OIE), Food and Agriculture Organization of the United Nation (FAO), and Global Alliance for Rabies Control has a goal of eliminating deaths from rabies by 2030.<ref>{{Cite web|url=https://www.who.int/mediacentre/factsheets/fs099/en/ |title=Rabies |website=World Health Organization |language=en-GB |access-date=2017-02-23 |url-status=live |archive-url=https://web.archive.org/web/20170215062245/http://www.who.int/mediacentre/factsheets/fs099/en/ |archive-date=15 February 2017 }}</ref>

===India===
[[India]] has the highest rate of human rabies in the world, primarily because of stray dogs,<ref>{{cite news|url=https://www.independent.co.uk/news/science/dead-as-a-dodo-why-scientists-fear-for-the-future-of-of-the-asian-vulture-818059.html |title=Dead as a dodo? Why scientists fear for the future of the Asian vulture |access-date=2008-10-11 |last=Dugan |first=Emily | name-list-style = vanc |date=30 April 2008 |newspaper=The Independent |quote=India now has the highest rate of human rabies in the world. |location=London |url-status=live |archive-url=https://web.archive.org/web/20080517100919/http://www.independent.co.uk/news/science/dead-as-a-dodo-why-scientists-fear-for-the-future-of-of-the-asian-vulture-818059.html |archive-date=17 May 2008 }}</ref> whose number has greatly increased since a 2001 law forbade the killing of dogs.<ref name="harris">{{cite news|url=https://www.nytimes.com/2012/08/07/world/asia/india-stray-dogs-are-a-menace.html |title=Where Streets Are Thronged With Strays Baring Fangs |newspaper=New York Times | last = Harris | first = Gardiner | name-list-style = vanc |date=6 August 2012 |access-date=6 August 2012 |url-status=live |archive-url=https://web.archive.org/web/20120808125223/http://www.nytimes.com//2012/08/07/world/asia/india-stray-dogs-are-a-menace.html |archive-date=8 August 2012 }}</ref> Effective control and treatment of rabies in India is hindered by a form of [[mass hysteria]] known as [[puppy pregnancy syndrome]] (PPS). Dog bite victims with PPS, male as well as female, become convinced that puppies are growing inside them, and often seek help from [[faith healer]]s rather than medical services.<ref>[http://www.dw.de/medicine-challenges-indian-superstition/a-16489334 Medicine challenges Indian superstition | Asia | DW.DE | 31.12.2012] {{webarchive|url=https://web.archive.org/web/20130131194746/http://www.dw.de/medicine-challenges-indian-superstition/a-16489334 |date=31 January 2013 }}</ref> An estimated 20,000 people die every year from rabies in India, more than a third of the global total.<ref name="harris"/>

===Australia===
The rabies virus survives in widespread, varied, rural animal reservoirs. Despite Australia's official rabies free status,<ref>[https://www.who.int/rabies/rabies_maps/en/index.html "Essential rabies maps"] {{webarchive|url=https://web.archive.org/web/20100217210150/http://www.who.int/rabies/rabies_maps/en/index.html |date=17 February 2010 }}. World Health Organization (WHO).</ref> [[Australian bat lyssavirus]] (ABLV), discovered in 1996, is a strain of rabies prevalent in native bat populations. There have been three human cases of ABLV in Australia, all of them fatal.{{cn|date=May 2021}}

===Singapore===
Singapore has been completely rabies free for decades, with its last reported case in 1953. This has been attributed to strict quarantine laws including stringent checks on dogs, cats and wild animals imported into the country, as well as intensive control of [[feral]] animal populations.<ref>{{Cite web|title=Rabies - National Centre for Infectious Diseases|url=https://www.ncid.sg/Health-Professionals/Diseases-and-Conditions/Pages/Rabies.aspx|access-date=2021-05-11|website=www.ncid.sg}}</ref> Such measures are regulated by the [[Agri-Food and Veterinary Authority of Singapore]], a [[Government of Singapore|government]] [[Statutory boards of the Singapore Government|statutory board]].<ref>{{Cite web|title=Rabies|url=https://www.nparks.gov.sg/avs/animals/animal-health-and-veterinarians/animal-diseases-and-antimicrobial-resistance/rabies|access-date=2021-05-11|website=www.nparks.gov.sg}}</ref>

===United States===
[[File:Mm6823e1-F1.gif|thumb|upright=1.5|Rabies cases in humans and domestic animals — United States, 1938–2018]]

Canine-specific rabies has been eradicated in the United States. But rabies is common among wild animals in the United States, and an average of 100 dogs become infected from other wildlife each year.<ref>{{cite web|title=CDC – Rabies Surveillance in the U.S.: Human Rabies – Rabies |url=https://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html |website=www.cdc.gov |access-date=10 April 2017 |language=en-us |url-status=live |archive-url=https://web.archive.org/web/20170118072742/https://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html |archive-date=18 January 2017 }}</ref><ref>{{cite news|url=https://www.reuters.com/article/us-rabies-usa-idUSN0741162020070907 |title=U.S. free of canine rabies virus |last=Fox |first=Maggie | name-list-style = vanc |date=7 September 2007 |newspaper=[[Reuters]] |access-date=11 April 2017 |quote="We don't want to misconstrue that rabies has been eliminated – dog rabies virus has been," CDC rabies expert Dr. Charles Rupprecht told Reuters in a telephone interview. |url-status=live |archive-url=https://web.archive.org/web/20170517072630/https://www.reuters.com/article/us-rabies-usa-idUSN0741162020070907 |archive-date=17 May 2017 }}</ref> [[Bat]]s, [[raccoon]]s, [[skunk]]s and [[fox]]es account for almost all reported cases (98% in 2009). Rabid bats are found in all 48 contiguous states. Other reservoirs are more limited geographically; for example, the raccoon rabies virus variant is only found in a relatively narrow band along the East Coast.{{cn|date=May 2021}}

Due to a high public awareness of the virus, efforts at vaccination of domestic animals and curtailment of feral populations, and availability of [[postexposure prophylaxis]], incidence of rabies in humans is very rare in the United States. From 1960 to 2018, a total of 125 human rabies cases were reported in the United States; 36 (28%) were attributed to dog bites during international travel.<ref name=MMWR2019/> Among the 89 infections acquired in the United States, 62 (70%) were attributed to bats.<ref name=MMWR2019>{{cite journal | vauthors = Pieracci EG, Pearson CM, Wallace RM, Blanton JD, Whitehouse ER, Ma X, Stauffer K, Chipman RB, Olson V | display-authors = 6 | title = Vital Signs: Trends in Human Rabies Deaths and Exposures - United States, 1938-2018 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 68 | issue = 23 | pages = 524–528 | date = June 2019 | pmid = 31194721 | pmc = 6613553 | doi = 10.15585/mmwr.mm6823e1 }}</ref> No Americans have died from rabies since 2018, when a 55-year-old Utah man who had "extensive contact with bats" died from the disease.<ref>{{cite web |last1=Lorenz |first1=Jonna |title=Human Rabies Case in Utah Underscores Importance of Public Health Efforts |url=https://www.contagionlive.com/news/human-rabies-case-in-utah-underscores-importance-of-public-health-efforts |website=ContagionLive |access-date=11 August 2020}}</ref>

===Europe===

Either no or very few cases of rabies are reported each year in Europe; cases are contracted both during travel and in Europe.<ref>{{cite web|url=http://ecdc.europa.eu/sites/portal/files/documents/AER_for_2015-rabies.pdf|title=SURVEILLANCE REPORT - Annual Epidemiological Report for 2015 - Rabies, ECDC (European Centre for Disease Prevention and Control)| access-date=30 August 2018}}</ref>

In Switzerland the disease was virtually eliminated after scientists placed chicken heads laced with live [[attenuated vaccine]] in the [[Swiss Alps]].<ref name="Grambo"/> The foxes of Switzerland, proven to be the [[Portal:Main|main]] source of rabies in the country, ate the chicken heads and immunized themselves.<ref name="Grambo"/><ref name="thefactsource.com">{{cite web |url=https://thefactsource.com/switzerland-rabies-epidemic-air-dropping-chicken-heads/ |title=Switzerland ended rabies epidemic by air dropping vaccinated chicken heads from helicopters / thefactsource.com |access-date=2019-12-10|date=20 November 2019 }}</ref>

Italy, after being declared rabies-free from 1997 to 2008, has witnessed a reemergence of the disease in wild animals in the [[Triveneto]] regions ([[Trentino-Alto Adige/Südtirol]], [[Veneto]] and [[Friuli-Venezia Giulia]]), due to the spreading of an epidemic in the [[Balkans]] that also affected Austria. An extensive wild animal vaccination campaign eliminated the virus from Italy again, and it regained the rabies-free country status in 2013, the last reported case of rabies being reported in a red fox in early 2011.<ref>{{cite web|url=http://www.izsvenezie.com/rabies-in-africa-the-resolab-network/ |title=Rabies in Africa: The RESOLAB network |date=29 June 2015 |access-date=2016-04-18 |url-status=live |archive-url=https://web.archive.org/web/20160803081821/http://www.izsvenezie.com/rabies-in-africa-the-resolab-network/ |archive-date=3 August 2016 }}</ref><ref>{{cite web|url=http://www.quotidianosanita.it/governo-e-parlamento/articolo.php?articolo_id=13650 |title=Ministero della Salute: "Italia è indenne dalla rabbia". l'Ultimo caso nel 2011 - Quotidiano Sanità |access-date=2016-04-18 |url-status=live |archive-url=https://web.archive.org/web/20160603183359/http://www.quotidianosanita.it/governo-e-parlamento/articolo.php?articolo_id=13650 |archive-date=3 June 2016 }}</ref>

The United Kingdom has been free of rabies since the early 20th century except for a rabies-like virus in a few [[Daubenton's bat]]s. There has been one fatal case of transmission to a human. There have been four deaths from rabies, transmitted abroad by dog bites, since 2000.  The last infection in the UK occurred in 1922, and the last death from indigenous rabies was in 1902.<ref>{{cite web |url=https://www.nhs.uk/conditions/rabies/ |title=Rabies|website=NHS |date=23 February 2017 |access-date= 30 August 2018}}</ref><ref>{{cite news |url=https://www.bbc.co.uk/news/health-18188682 |title=Q&A: Rabies|website=BBC News |date=17 April 2015 |access-date= 30 August 2018}}</ref> Unlike many of the other countries of Europe it is protected by being an island, and by strict quarantine procedures.{{cn|date=May 2021}}

=== Mexico ===
Mexico was certified by the [[World Health Organization]] as free of dog-transmitted rabies in 2019 since no case of dog-human transmission has been recorded in two years.<ref>{{cite web|url=https://www.bbc.com/mundo/noticias-50390407|title=Cómo México se convirtió en el primer país del mundo libre de rabia transmitida por perros|website =BBC News|date=12 November 2019|access-date=12 November 2019}}</ref>