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Cases of rabies in humans are very infrequent in the United States and Canada, averaging one or two a year (down from over 100 cases annually in 1900), but the worldwide incidence is estimated to be between 30,000 and 50,000 cases each year. These figures are based on data collected by the World Health Organization (WHO) in 1997 and updated in 2002. Rabies is most common in developing countries in Africa, Latin America, and Asia, particularly India. Dog bites are the major origin of infection for humans in developing countries, but other important host animals may include the wolf, mongoose, raccoon, jackal, and bat. A group of researchers in India found that monkeys as well as dogs were frequent vectors of rabies. The team also reported that the male:female ratio of rabies patients in India is 4:1.

Most deaths from rabies in the United States and Canada result from bat bites; the most recent fatality was a 66-year-old man in California who died in September 2003. The death of a nine-year-old girl in Quebec in the fall of 2000 was the first case of human rabies in Canada since 1985. Public health officials eventually determined that the girl had been bitten while she was sleeping by a silver-haired bat that had gotten into the family's home.

On October 18, 2004, a Wisconsin teenager was diagnosed with full-blown rabies after suffering from a minor bat bite on September 12, 2004. Miraculously, she was cured of rabies after doctors induced coma and administered four antiviral drugs to her. Since the therapy was only given and successful for one case, its curative properties needs to be corroborated by other cases before it will be considered a viable treatment option. The case and the physicians' findings will be published in a medical journal.

People whose work frequently brings them in contact with animals are considered to be at higher risk than the general population. This would include those in the fields of veterinary medicine, animal control, wildlife work, and laboratory work involving live rabies virus. People in these occupations and residents of or travelers to areas where rabies is a widespread problem should consider being immunized.

In late 2002, rabies re-emerged as an important public health issue. Dr. Charles E. Rupprecht, director of the World Health Organization (WHO) Collaborating Center for Rabies Reference and Research, has listed several factors responsible for the increase in the number of rabies cases worldwide:

  • Rapid evolution of the rabies virus. Bats in the United States have developed a particularly infectious form of the virus.
  • Increased diversity of animal hosts for the disease.
  • Changes in the environment that are bringing people and domestic pets into closer contact with infected wildlife.
  • Increased movement of people and animals across international borders. In one recent case, a man who had contracted rabies in the Philippines was not diagnosed until he began to feel ill in the United Kingdom.
  • Lack of advocacy about rabies.

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