Epidemiology

Human rabies is present in 150 countries and territories and on all continents, except for Antarctica (1).

• in the US, classical rabies virus in animals has become more prevalent since the 1950s; skunks, raccoons and bats account for 85% of animal cases
• in Asia, Africa, Central and South America, classical rabies virus (genotype 1) is endemic in feral dogs and is also present in domestic dogs
• in Mexico and Central and South America, vampire bats carry the classical rabies virus
• most countries that are declared rabies-free probably have rabies-related viruses in their bat populations (1)

The disease exists in two major epidemiological settings:

• urban Rabies - is most frequently transmitted to humans through rabid dogs. Transmission may also occur via rabid cats.
• sylvian (wild) rabies - is maintained in the wild by a host of animal reservoirs including foxes, skunks and bats

The true burden of the disease is likely to be underestimated due to chronic underreporting and political neglect in many developing countries.

Globally, about 59,000 people die from rabies every year, many of whom are children (2). 95% of rabies cases in humans occur in Africa and Asia - 84% of these are in rural areas (3).

Human rabies is extremely rare in the UK. No human cases of rabies acquired from animals other than bats have been reported in the UK since 1902. (4) Six cases of rabies associated with animal exposures abroad have been reported between 2000-2018, the most recent case being a UK resident who became infected and died following a cat bite during a visit to Morocco. (5).

Reference:

1. World Health Organization (WHO). Rabies
2. Centers for Disease Control and Prevention. Human rabies. Sep 2021 [internet publication].
3. Crowcroft NS, Thampi N.The prevention and management of rabies. BMJ. 2015;350:g7827.
4. Rabies: the green book, chapter 27; UK Health Security Agency. (online, 2025)
5. Public Health England. Public Health England warns travellers of rabies risk. 12 November 2018 [internet publication].