Rabies: almost always fatal, almost entirely preventable

The size of the problem

Rabies is a disease caused by a virus that attacks the brain and nerves. It spreads mainly through the bite or scratch of an infected animal. WHO’s current estimate, from a 2021 model, is 44,203 deaths a year, and WHO says the true number is likely much higher, as many cases are missed or misdiagnosed.^[1] An earlier study, using data from around 2010, put deaths from dog rabies at about 59,000 a year, almost all in Asia and Africa.^[3] The two use different methods and cannot be compared directly.

Dogs are the source of up to 99 in every 100 human cases, and about 40 in every 100 deaths are children under 15.^[1] The same study found India had more deaths than any other country, about 35 in every 100.^[3]

Why symptoms are the dividing line

Symptoms usually start two to three months after a bite, though the gap can range from one week to one year. Once symptoms appear, rabies is virtually always fatal, and WHO recommends care that keeps the patient comfortable. There is no WHO-approved test that finds the infection before symptoms start.^[1]

What works after a bite

Stopping it at the source

In the Americas, human cases of rabies caught from dogs have fallen by about 98 percent since 1983, when there were 300.^[5] Mexico went from 60 such cases in 1990 to its last two in 2006, with free mass dog vaccination covering more than 80 percent of dogs at the heart of its plan.^[6]

The 2030 goal

In 2018, WHO and three partner bodies for food, animal health and rabies control published Zero by 30, a joint plan to end human deaths from dog-borne rabies by 2030.^[4] As of 17 September 2026, WHO had validated three countries, Mexico, Bhutan and Chile, as having eliminated dog-borne human rabies as a public health problem.^[1]

India launched its own plan on World Rabies Day in 2021, with the same 2030 target and a goal of vaccinating at least 70 percent of dogs in each area every year for three years.^[7][8]

The rare survivors

In 2004, a 15-year-old girl treated in Milwaukee, in the United States, survived rabies caught from a bat without ever receiving vaccine. Doctors put her into an induced coma while her own immune system responded, and gave her antiviral drugs. She went home after 76 days. Nearly five months after she entered hospital she was alert and could talk, but still had trouble with movement and speech.^[9] The approach became known as the Milwaukee protocol.^[10]

The protocol has since failed in at least 64 patients. A 2025 review counts about 34 well-documented survivors worldwide, meaning people alive six months after symptoms began, given intensive care without the protocol’s main steps. Apart from the Milwaukee girl, it finds no high-quality report of anyone surviving with the protocol, and most survivors were left with serious brain damage.^[10] The protocol’s lead author has published a reply disputing this verdict, and the review’s author has answered him, so the debate is still open.^[11][12]