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Prevention Vaccinating dogs Vaccinating dogs, including puppies, through mass dog vaccination programs is the most cost-effective strategy for preventing rabies in people because it stops the transmission at its source. Culling free roaming dogs is not effective in controlling rabies. Awareness Public education for both children and adults on dog behaviour and bite prevention, what to do if bitten or scratched by a potentially rabid animal, and responsible pet ownership are essential extensions of rabies vaccination programmes.   Vaccinating people Effective vaccines are available to immunize people both before and after potential exposures. As listed under the WHO – Prequalification of Medical Products, as of 2024, there are only 3 WHO pre-qualified human rabies vaccines available globally: RABIVAX-S by Serum Institute of India Pvt. Ltd., VaxiRab N by Zydus Lifesciences Limited, and VERORAB by Sanofi Pasteur. Pre-exposure prophylaxis (PrEP) is recommended for people in high-risk occupations (laboratory workers handling live rabies and related viruses) and people whose professional or personal activities might lead to direct contact with infected animals (animal disease control staff and wildlife rangers). PrEP might be indicated before recreation or travel in some areas, and for people living in remote, highly rabies-endemic areas with limited local access to rabies biologicals. Note that PrEP does not

Key facts Overview Dog-mediated rabies Rabies is a vaccine-preventable, zoonotic, viral disease affecting the central nervous system. In up to 99% of the human rabies cases, dogs are responsible for virus transmission. Children between the age of 5 and 14 years are frequent victims. Rabies infects mammals, including dogs, cats, livestock and wildlife. Rabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Once clinical symptoms appear, rabies is virtually 100% fatal. The global cost of rabies is estimated to be around US$ 8.6 billion per year including lost lives and livelihoods, medical care and associated costs, as well as uncalculated psychological trauma. Rabies is present on all continents except Antarctica. Globally there are an estimated 59 000 deaths from rabies annually; however, due to underreporting, documented case numbers often differ from the estimate.  Rabies, a neglected tropical diseases (NTD), predominantly affecting marginalized populations. Although effective human vaccines and immunoglobulins exist for rabies, these are often inaccessible or unaffordable to those in need. As of 2018, the average estimated cost of rabies post-exposure prophylaxis (PEP) was US$ 108 (along with travel costs and loss of income), which can be a