An average of 60 000 people die from rabies annually, and more than 15 million people receive post-exposure prophylaxis every year.
The rabies virus is contracted through wounds (e.g. scratches from an infected animal) or by direct contact with mucosal surfaces (e.g. bite from an infect animal). Once inside the body, the virus replicates in the bitten muscle and gains access to motor endplates and motor axons to reach the central nervous system. The virus then travels to the central nervous system, where a majority of the clinical symptoms manifest as an acute encephalitis or meningoencephalitis. The incubation period averages 2–3 months and death occurs within 2 weeks after the appearance of clinical symptoms if intensive care is not sought.
In more than 99% of all cases of human rabies, the virus is transmitted via dogs; half of the global population lives in canine rabies-endemic areas and is considered at risk for contracting rabies.
Although all age groups are susceptible, rabies is most common in people younger than 15 years. 4 out of every 10 deaths due to rabies are in children younger than 15 years. Post-exposure prophylaxis is given on average to 40% of children in Asia and Africa aged 5–14 years, and the majority receiving treatments are male.