Domestic dogs are the most common reservoir of the virus, with 99% of human deaths caused by dog-mediated rabies. 3 billion people live in dog-mediated rabies endemic areas, putting them at risk for contracting rabies.
The virus is transmitted in the saliva of rabid animals and is generally contracted via exposure of virus-laden saliva to wounds (e.g. scratches), or by direct contact with mucosal surfaces (e.g. bite from an infected animal). Once inside the body, the virus replicates in muscle cells at the wound site, gaining access to motor endplates and motor axons, peripheral nerves and subsequently, the central nervous system.
Once the virus reaches the brain, it further replicates, resulting in clinical manifestion as an acute encephalitis or meningoencephalitis. The incubation period averages 2–3 months, however it can range from 7 days to 1 year. However, without treatment following the presentation of clinical symptoms, the viral infection may be fatal within 2 weeks.
While deaths from human rabies can be averted through post-exposure prophylaxis, this intervention will never eliminate the disease and costs will only escalate over time. A reduction in human mortality due to rabies can be achieved by eliminating rabies in dogs, supported by public awareness-raising and improved access to timely post-exposure prophylaxis.