Rabies is a fatal viral disease spread through animal bites that causes approximately 59,000 human deaths annually. It is estimated to threaten over 3 billion people globally, with over 95% of cases occurring in Africa and Asia. The rabies virus affects the central nervous system and is transmitted most often via dog bites. While rabies is virtually 100% fatal once symptoms present, it can be fully preventable through pre- and post-exposure vaccination and controlling the disease in animal populations. Mass dog vaccination programs have helped significantly reduce human rabies cases in countries like Bangladesh. A multidisciplinary One Health approach is needed to continue working towards global rabies elimination.

1. RABIES
DR. MOHAMMAD ASHRAFUL AMIN
MBBS

2. INTRODUCTION
• • Rabies is one of the oldest recognized diseases affecting humans and one of the most
important zoonotic diseases
• • The word rabies originates from the Latin word rabere. • Rabere means to rage or rave,
and may have roots in a Sanskrit word rabhas, which means to do violence. • The
Greeks called rabies lyssa or lytta, which means frenzy or madness.
• • Discovered and named by Girolamo Fracastoro in 15th century
• • Acute, highly infectious and fatal disease of the CNS
• • Caused by Lyssavirus type 1
• • Zoonotic disease of warm blooded animals
• • Transmitted by bites of rabid animal
• • Virtually 100% fatal but 100% preventable

3. WHO AND WHERE
• Rabies is estimated to cause 59,000 human deaths annually in over 150
countries, with 95% of cases occurring in Africa and Asia. • Potential threat to
more than 3 billion people
• 99% of rabies cases are dog-mediated and the burden of disease is
disproportionally borne by rural poor populations, with approximately half of cases
attributable to children under 15
• • Incidence -- 35,000-60,000 deaths/Year (WHO)
• 30,000 deaths/yr in India
• 24,000 deaths/yr in Africa
• • 15 million people receive rabies prophylaxis annually with majority males
• India accounts for 36% of the Global and 65% of the Asian human rabies deaths.

4. RABIES FREE AREAS
• Continents: Australia and Antarctica
• Asia: Japan, Malaysia, Oman and Qatar
• Europe: Great Britain, Scandinavian countries, Spain and Portugal
• America: Guyana, Uruguay and Jamaica
• Oceania: Fiji and Papua New Guinea
• India: Andaman & Nicobar and Lakshadweep Islands

5. • INFECTIVE MATERIAL
• Rabid animals- saliva, serum, urine and milk • Human cases- saliva, sweat, semen and tears
• MODES OF TRANSMISSION
• Bites from infected animals
• Licks on Broken Skin or Mucous Membrane
• Scratches
• Inhalation
• INCUBATION PERIOD:
• • Normally 3 weeks – 3 months • May be short that is 15 days or may be prolonged for years.
• Pathology :
• Despite 100% fatal nature of the disease there are only minimal pathological changes

6. RABIES FATALITY RATE WITH OTHER DISEASE

7. PATHOGENESIS

8. DISTRIBUTION OF RISK LEVELS FOR HUMENS
CONTACTING RABIES,WORLDWIDE,2013

9. AGE & SEX WISE DISTRIBUTION OF RABIES

11. CLINICO-EPIDEMIOLOGICAL FEATURES OF
HUMAN RABIES CASES IN BANGLADESH 2006–
2018

12. DISTRIBUTION OF HUMAN RABIES CASES
FROM DIFFERENT DISTRICTS OF
BANGLADESH

13. BANGLADESH PROSPECTIVE
DOGS VACCINATED

14. IMPACT OF MASS DOG
VACCINATION (MDV)
AND POST-EXPOSURE
PROPHYLAXIS (PEP)
ON HUMAN RABIES
INCIDENCE IN
BANGLADESH, 2006–
2018.

15. WHO EXPERT CONSULTATION ON RABIES :
DEATHS FROM RABIES

16. WHO DATA UPDATE
Country
Death
2017
Death
2016
Death
2015
Death
2014
Death
2013
Death
2012
Death
2011
Death
2010
Bangladesh No date No date No date No date No date No date No date No date
India No date No date No date No date No date No date No date No date
Philippines 219 209 217 236 205 213 229 299
Srilanka 23 20 24 19 28 38 41 49
Mozambiqu
e 89 29 29 0 0 0 0 0
China 516 644 801 854 1128 1361 1879 2014
0
500
1000
1500
2000
2500
No date No date No date No date No date No date No date No date
No date No date No date No date No date No date No date No date
Death 2017 Death 2016 Death 2015 Death 2014 Death 2013 Death 2012 Death 2011 Death 2010
Chart Title
Philippines Srilanka Mozambique China

17. RABIES PREVENTION WITH A ONE HEALTH
APPROACH

18. POST-EXPOSURE PROPHYLAXIS (PEP)

19. THANK YOU