How many people die from rabies each year?

The California Department of Public Health has issued a warning to residents who believe they may have been exposed to rabies, urging them to seek immediate medical attention before it’s too late.

The warning comes after a teacher from Fresno County died following a bite from a presumably rabid bat last week.

“Bites from bats can be incredibly small and difficult to see or to detect,” Dr. Tomás J. Aragón, the CDPH Director and State Public Health Officer, said in a news release issued after the woman’s death. “It is important to wash your hands and look for any open wounds after touching a wild animal, and to seek immediate medical care if bitten.”

In the United States, the most common causes of rabies are bites or scratches from animals, most frequently from bats, raccoons, skunks and foxes (in that order), according to recent data cited by the Centers for Disease Control and Prevention. But because of widespread vaccination requirements, dogs do not generally pose a risk of spreading rabies to humans in America.

Those vaccinations, together with readily available care for those who may have been exposed and programs designed to manage outbreaks of rabies among wildlife, have drastically cut deaths in the U.S. over the last 65 years. Prior to 1960, the CDC says “several hundred” people would die of rabies pear year, while “fewer than 10” people now die of rabies annually.

On a global scale, however, the annual death toll from rabies numbers in the tens of thousands. The World Health Organization estimates that 59,000 people die each year from the disease (with 40% being children under 15), but acknowledges that this number may be a “gross underestimate” due to unreported or unidentified cases. The CDC, meanwhile, puts the number closer to 70,000.

The highest concentrations of deaths occur in Africa and Asia, where dog-mediated rabies has not been eradicated. The WHO estimates that 35% of all rabies deaths occur in India, partly due to the prohibitive cost of post-exposure healthcare.

In addition, many people who are exposed to rabies may not realize they have been infected until it’s too late, because the incubation period can last months. (The teacher in California only started to show symptoms about 1 month after the bite, her friend said.) Once a patient starts experiencing symptoms — which can include fever, aches, tingling at the bite site, and later more serious neurological issues and brain disfunction — “death is inevitable,” WHO writes.

For this reason, health officials urge anyone exposed to rabies to immediately seek medical attention to discuss post-exposure prophylaxis care, or PEP. This type of care generally includes wound washing, vaccination and antibody treatments, and can prevent the rabies virus from reaching the central nervous system.

The CDC estimates that around 60,000 Americans receive PEP treatments after bites or exposures every year. (Some people who work or live in higher risk jobs/areas may also be eligible for preventative vaccination, known as pre-exposure prophylaxis, or PrEP.)

The ultimate goal is to apply the same methods to bring down the number of deaths attributed to rabies throughout the world. CDC and WHO, together with international task forces and health organizations, are making ongoing strides to assist with vaccine availability, vaccination programs, education and training.

“Rabies control programmes are being implemented in many countries, with great success being seen with improved dog vaccination coverage, improved accessibility to PEP and reduced human deaths,” WHO writes. “The global community aims to eliminate human deaths from dog mediated rabies by 2030.”